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PubMed2002

Development of the reasons for living inventory for young adults.

Assessment of the reliability, validity, and predictive power of a new measure, the Reasons for Living Inventory for Young Adults (RFL-YA) is described. A series of three studies was conducted at two Midwestern universities to develop initial items for this new measure, refine item selection, and demonstrate the psychometric properties of the RFL-YA. The theoretical differences between the RFL-YA and the College Student Reasons for Living Inventory (CS-RFL) are discussed. Although the two measures were not directly compared, it appears that the RFL-YA has greater specificity for exploring aspects of the protective construct and may be more parsimonious than the CS-RFL. Principal-axis factor analysis yielded a five-factor solution for the RFL-YA accounting for 61.5% of the variance. This five-factor oblique model was confirmed in the final phase of investigation. Alpha estimates for the five subscales ranged from.89 to.94. Concurrent, convergent-discriminant, and criterion validity also were demonstrated. The importance of assessing protective factors in addition to negative risk factors for suicidality is discussed. Directions for future research with the RFL-YA also are discussed.

Adolescent↗
PubMed2003

Situated clinical reasoning: distinguishing acute confusion from dementia in hospitalized older adults.

In this study a dimensional analysis approach was used to explore the clinical reasoning of nurses who care for hospitalized older adults to identify factors that might explain their failure to detect acute confusion and to distinguish it from dementia in this patient population. Data analysis yielded a grounded theory of situated clinical reasoning, which proposes that the ability of nurses to identify acute confusion varies widely. This variation can be attributed to the differences in nurses' philosophical perspectives on aging. According to this theory, three distinct perspectives are unwittingly embraced by nurses who care for older patients. These perspectives influence how nurses characterize aging and the aged and condition the ways in which they judge and ultimately deal with older adults in clinical situations.

Adult↗
PubMed2006

Attitudes towards sex selection for non-medical reasons: a review.

Early non-invasive fetal sexing is widely available over the Internet, leading to concerns about its possible use for sex selection. The aim of this review is to summarise the results of surveys describing lay attitudes towards sex selection for non-medical reasons to help address or inform such concerns. A search of electronic databases and key journals was supplemented by an Internet search and citation-tracking. Twenty-one quantitative studies were identified. Most were conducted in the US, with five recent studies in the UK and Germany. Most studies found that, overall, people were not in favour of sex selection. However, this varied from 94 to 18%. People may hold more negative attitudes when the method of sex selection is specified, particularly if this involves termination of pregnancy (TOP). Attitudes towards the general availability of sex selection are less negative than those towards personal use. Attitudes were consistently negative in German surveys. Little is known of such attitudes outside the US, the UK and Germany, and how such attitudes may change as new sex selection technologies become available. Studies of use of early non-invasive fetal sexing for sex selection for non-medical reasons are needed to assess the extent to which concerns about usage are justified and to assist in debates on how these might be most appropriately addressed.

Attitude↗
PubMed2006

Therapists' experiences and perceptions of teamwork in neurological rehabilitation: reasoning behind the team approach, structure and composition of the team and teamworking processes.

BACKGROUND AND PURPOSE: Teamwork and the interdisciplinary team approach have been strongly advocated for use in the provision of neurological rehabilitation services. However, whether teamwork has been adopted, and in what form, has yet to be established. The present study investigated therapists' experiences and perceptions of the reasoning behind the team approach in neurological rehabilitation, the structure and composition of the team within which they worked and the team working process. METHOD: This article reports part of an exploratory qualitative study. Five occupational therapists and five physiotherapists from three teams: a rehabilitation centre; a community team; and a stroke unit based within the UK. Semi-structured interviews were undertaken with each participant and then transcribed. Content and thematic analysis of the qualitative interview data was carried out, with respondents validating both the transcription and analysis stages. RESULTS: Perceived composition and structure of the neurological rehabilitation team was variable across teams and between individual team members. There was disparity as to whether patients were included within the neurological team; the interdisciplinary team approach had not been consistently adopted and there were sub-teams and other team memberships in existence. Reasoning behind the team approach supported the perceived benefits of teamwork from a number of perspectives, and the activities reported as part of the team process were diverse. CONCLUSIONS: Different teams may choose to use different strategies depending on the aims and context of the team effort. In some instances interdisciplinary teamwork and patient-centred approaches were not adopted consistently and the process of teamwork itself is both complex and diverse.

Communication↗
PubMed1997

Ethical reasoning in physical therapy and occupational therapy.

The purpose of the study was to describe and then compare ethical dilemmas reported by eight physical therapists and eight occupational therapists. A co-operative research method was adopted with the therapists participating in the analysis of the transcripts of the interviews. The analysis was carried out using a 'multiple' readings methods taken from hermeneutic phenomenology. Results showed that the context or setting of the dilemma had a major effect on the therapists' reasoning. Features which emerged from the context were the site of the dilemma, the work group, the patient group and the hierarchical or power relations in operation. Physical therapists and occupational therapists showed differences in reasoning style with the former more likely to adopt a diagnostic or procedural style, and the latter a narrative style. Dealing with ethical dilemmas was found to be a skilled and stressful aspect of practice. Capacity to deal with the dilemmas was negatively influenced by uncertainty of outcome, emotional sequelae of the event, and social pressure to behave in certain ways. Positive influences included previous experience with similar dilemmas, time for reflection, and support from peers.

Decision Making↗
PubMed1991

Physical reasons for secondary structure stability: alpha-helices in short peptides.

It was recently found that some short peptides (including C- and S-peptide fragments of RNase A) can have considerable helicity in solution, which was considered to be surprising. Does the observed helicity require a new explanation, or is it consistent with previous understanding? In this work we show that this helicity is consistent with the physical theory of secondary structure based on an extension of the conventional Zimm-Bragg model. Without any special modifications, this theory explains reasonably well almost all the experimentally observed dependencies of helicity on pH, temperature, and amino acid replacements. We conclude that the observed "general level" of helicity of C- and S-peptides (5-30% at room temperature and 10-50% near 0 degrees C) is "normal" for short peptides consisting mainly of helix-forming and helix-indifferent residues. The helicity is modified by a multitude of weak specific side chain interactions, many of which are taken into account by the present theory; some discrepancies between the theory and experiment can be explained by weak side-chain-side chain interactions that were neglected. A reasonable coincidence of the theory with experiment suggests that it had been used to investigate the role of local interactions in the formation of alpha-helical "embryos" in unfolded protein chains.

Amino Acid Sequence↗
PubMed2000

Loss of pleasure, ideological food choice reasons and eating pathology.

The study compared four types of dieters who stressed ideological food-choice reasons and pleasure in their food choice in different ways. A total of 66 female dieters were included in the study. As hypothesized, the dieters in the high ideology-low pleasure cluster showed more signs of eating disorders, lower psychological well-being and more body-dissatisfaction than other dieters. The differences in internalization of societal thinness ideals and magical beliefs about food and health were not significant. The discussion considers the reasons for the dysfunctionality of the high ideology-low pleasure motive combination in food choice.

Adolescent↗
PubMed2001

Inductive reasoning in Alzheimer's disease.

We evaluated knowledge of basic level and superordinate semantic relations and the role of cognitive resources during inductive reasoning in probable Alzheimer's disease (AD). Nineteen mildly demented AD patients and 17 healthy control subjects judged the truthfulness of arguments with a premise and a conclusion that contain familiar concepts coupled with "blank" predicates, such as "Spiders contain phosphatidylcholine; therefore all insects contain phosphatidylcholine." Like healthy control subjects, AD patients were relatively insensitive to the typicality of the premise category when judging the strength of arguments with a conclusion containing a basic-level concept, but were relatively sensitive to typicality during judgments of arguments containing a superordinate in the conclusion. Moreover, AD patients resembled control subjects in judging arguments with an immediate superordinate in the conclusion compared to arguments with a distant superordinate. AD patients differed from control subjects because they could not take advantage of two premises in an argument containing basic-level concepts. We conclude that semantic knowledge is sufficiently preserved in AD to support inductive reasoning, but that limited cognitive resources may interfere with AD patients' ability to consider the entire spectrum of information available during semantic challenges.

Aged↗
PubMed1997

Interventions in Children's Deductive Reasoning with Indeterminate Problems

This study examined the effectiveness of three intervention measures designed to facilitate 10- and 12-year-old children's recognition of indeterminacy in reasoning with illogical syllogisms. The indeterminate nature of these syllogisms arises from the lack of logical connection between the premises, which means a single, logically correct solution cannot be drawn. The interventions addressed: (a) children's purported difficulties with closure, specifically, a lack of awareness and acceptability of indeterminate situations; (b) children's construction of complete mental models of the premise information; and (c) a combined approach, incorporating (a) and (b). The children brought a strong foundation of deductive processes to the study, which was necessary, but insufficient, for dealing with the indeterminate problems. Neither intervention (a) nor (b) alone, was adequate in developing children's ability to explicitly recognize indeterminacy; only the combined intervention made a significant difference. Possible reasons for this are explored, along with an analysis of children's difficulties in resolving these problems. A number of educational implications are also addressed.

Journal Article↗
PubMed1997

Categorization and reasoning among tree experts: do all roads lead to Rome?

To what degree do conceptual systems reflect universal patterns of featural covariation in the world (similarity) or universal organizing principles of mind, and to what degree do they reflect specific goals, theories, and beliefs of the categorizer? This question was addressed in experiments concerned with categorization and reasoning among different types of tree experts (e.g., taxonomists, landscape workers, parks maintenance personnel). The results show an intriguing pattern of similarities and differences. Differences in sorting between taxonomists and maintenance workers reflect differences in weighting of morphological features. Landscape workers, in contrast, sort trees into goal-derived categories based on utilitarian concerns. These sorting patterns carry over into category-based reasoning for the taxonomists and maintenance personnel but not the landscape workers. These generalizations interact with taxonomic rank and suggest that the genus (or folk generic) level is relatively and in some cases absolutely privileged. Implications of these findings for theories of categorization are discussed.

Adult↗
PubMed2000

Bridging the gap between moral reasoning and adolescent engagement in risky behavior.

Relations among moral reasoning, domain judgment and engagement in risky behaviors were assessed with 68 students attending a Just Community school and 122 comparison students from the larger high school with which the alternative school is affiliated. Risky behaviors were perceived as personal decisions, rather than as ones of morality or convention. Engagement and domain judgment of risky behavior interacted; with increasing substance involvement, students were more likely to view the decision to use drugs and alcohol as a personal decision than as either a moral or conventional decision. Domain judgments of risks appeared to moderate the relation between moral reasoning and engagement in risky behavior, suggesting that moral education interventions must encourage youth to explore their views that much of their behavior is only their own business.

Adolescent↗
PubMed2001

Rostrolateral prefrontal cortex involvement in relational integration during reasoning.

Patient and neuroimaging studies indicate that complex reasoning tasks are associated with the prefrontal cortex (PFC). In this study, we tested the hypothesis that the process of relational integration, or considering multiple relations simultaneously, is a component process of complex reasoning that selectively recruits PFC. We used fMRI to examine brain activation during 0-relational, 1-relational, and 2-relational problems adapted from the Raven's Progressive Matrices and hypothesized that PFC would be preferentially recruited by the 2-relational problem type. Event-related responses were modeled by convolving a canonical hemodynamic response function with the response time (RT) associated with each trial. The results across different analyses revealed the same pattern: PFC activation was specific to the comparison between 2- and 1-relational problems and was not observed in the comparison between 1- and 0-relational problems. Furthermore, the process of relational integration was specifically associated with bilateral rostrolateral PFC (RLPFC; lateral area 10) and right dorsolateral PFC (areas 9 and 46). Left RLPFC showed the greatest specificity by remaining preferentially recruited during 2-relational problems even after comparisons were restricted to trials matched for RT and accuracy. The link between RLPFC and the process of relational integration may be due to the associated process of manipulating self-generated information, a process that may characterize RLPFC function.

Adolescent↗
PubMedDate not supplied

Reasons for delay in breast cancer diagnosis.

BACKGROUND: A study of system delay, the time between the initial medical consultation and the establishment of a diagnosis, in breast cancer patients revealed that almost 40% of women reported delays of at least 4 weeks. The objective of this study was to explore the reasons for these prolonged intervals between initial medical consultation and establishment of a diagnosis. METHODS: A total of 367 female breast cancer patients from the National Cancer Institute's Black/White Cancer Survival Study were studied. Medical systems involved in the diagnosis and treatment of these women included hospital outpatient and emergency room, private clinic, public clinic, private doctor, and health maintenance organization. RESULTS: In about 25% of the cases, the delay was attributed by the woman to the patient herself, and the most common reason she gave was that she felt that the problem was not important. In about 45% of the cases, the provider and the health care system were said to be responsible for the delay through difficulties in scheduling or physician inaction, while in another 17% both the patient and the system were responsible. CONCLUSIONS: This study looked at the issue of how the behaviors of women and their providers contribute to the timing of breast cancer diagnosis. It is one of the only studies to examine the woman's role in delay. It is clear from this study that additional work is needed to look at this question. However, the results of this study suggest that efforts must be made to reduce the time needed to get an appointment with a physician or a diagnostic test, as well as to educate physicians and the women themselves regarding the importance of breast symptoms and the value of prompt evaluation, diagnosis, and treatment.

Adult↗
PubMed1999

Predicting children's sunscreen use: application of the theories of reasoned action and planned behavior.

BACKGROUND: Skin cancer remains the most common form of cancer in the United States despite the fact that most cases can be prevented by limiting sun exposure. Childhood and adolescence are periods of life during which prolonged sun exposure is particularly common. Accordingly, promoting sun-protective behaviors during these formative years can be of critical importance in preventing skin cancer. The present study applied the theories of reasoned action and planned behavior to the understanding of children's sunscreen use. Based on these theories, it was hypothesized that attitudes, subjective norms, and perceived behavioral control would be related to intentions to use sunscreen, which, in turn, would be related to actual sunscreen use. METHODS: Questionnaires measuring sun-related attitudes, beliefs, perceived control, and intentions were administered to 199 fourth graders (ages 9 to 13, mean = 10.3) attending public schools in Florida. Self-report measures of sun-related behavior were administered to the same subjects 1 month later. RESULTS: Results of correlational analyses were consistent with study hypotheses. Higher rates of sunscreen use at follow-up were predicted by stronger intentions to use sunscreen assessed 1 month previously. In addition, stronger intentions to use sunscreen were found to be related to more favorable attitudes toward sunscreen use, stronger beliefs that peers and parents favored sunscreen use, and greater perceptions of personal control in using sunscreen. Path and multiple regression analyses identified direct and indirect relationships among study variables that partially confirmed those predicted by the theories and provided support for the use of an expanded model that included perceived behavioral control. CONCLUSIONS: The present study confirmed hypotheses derived from the theories of reasoned action and planned behavior regarding the relation of attitudes, subjective norms, and perceived behavioral control to sunscreen use among fourth graders. In addition to their theoretical significance, these findings suggest ways to intervene at the individual, classroom, and family levels to promote greater sunscreen use in this age group.

Adolescent↗
PubMed1987

Childhood bacterial meningitis: initial symptoms and signs related to age, and reasons for consulting a physician.

The relationship of symptoms and signs to age and the reasons for consulting a physician were analyzed in 110 cases of culture-proven childhood bacterial meningitis. H. influenzae caused 74, meningococci 28, pneumococci 6 and streptococci 2 of the cases. Apart from fever (present in 94%), the most common symptoms according to age were as follows: 1-5 months: irritability (85%), 6-11 months: impaired consciousness (79%), 12 months or more: vomiting (82%) and neck rigidity (78%). Absence of neck rigidity at diagnosis was associated with young age (less than 12 months, P less than 0.001) and, in older children, to a short duration of symptoms (P less than 0.01) but not to the degree of CSF pleocytosis. Symptoms of meningitis caused by H. influenzae differed from those of meningococcal meningitis. Meningitis should be suspected in irritable or lethargic febrile children despite absence of neck rigidity. Fever and vomiting were the most frequent reasons for consulting a physician (60% and 31%, respectively). Despite the frequency and alarming character of irritability, impaired consciousness and neck rigidity, their presence led infrequently to a consultation (6%, 22% and 3%, respectively). Parental ignorance of such symptoms or of their importance may cause treatment delay, despite readily available medical services.

Adolescent↗
PubMed1989

Moral reasoning among medical geneticists in eighteen nations.

We surveyed the approaches of 661 geneticists in 18 nations to 14 clinical cases and asked them to give their ethical reasons for choosing these approaches. Patient autonomy was the dominant value in clinical decision-making, with 59% of responses, followed by non-maleficence (20%), beneficence (11%) and justice (5%). In all, 39% described the consequences of their actions, 26% mentioned conflicts of interest between different parties and 72% placed patient welfare above the welfare of others. The U.S., Canada, Sweden, and U.K. led in responses favoring autonomy. There were substantial international differences in moral reasoning. Gender differences in responses reflected women's greater attention to relationships and supported feminist ethical theories.

Asia↗
PubMed1987

AI/LEARN: an interactive videodisk system for teaching medical concepts and reasoning.

This paper describes AI/LEARN, an educational videodisk system designed to teach clinical observational skills and reasoning in medicine. The AI/LEARN system uses a learning conditions approach to teaching. To teach visual concepts, we use the principle of exemplar/nonexemplar pairs and immediate feedback. To teach If-Then problem solving we use the format of minicases with delayed feedback. The software to operate the system has been custom developed and is domain independent. The result is a prototype of a new authoring package for videodisk teaching which operates on IBM compatible microcomputers. The medical domain selected for this prototype system was rheumatic diseases; the knowledge used to teach reasoning skills is derived from the knowledge base of an expert system: AI/RHEUM.

Computer Systems↗
PubMed1995

The Diagnostic Interview Schedule for Children (PC-DISC v.3.0): parents and adolescents suggest reasons for expecting discrepant answers.

To identify reasons for discrepancies between parent and child reports of child/adolescents's psychiatric symptoms, parents and adolescents (51 pairs) were asked to guess what the other would answer to questions from the PC-DISC about the adolescent's psychiatric symptoms, and to explain why they expected disagreement when the answer they provided for the other was different from their own. Adolescents' explanations for expecting (1) parental denial of symptoms the adolescent reported were: the parent was unaware of, forgot about, assumed the adolescent could not have, or trivialized the symptom; and (2) parental report of symptoms the adolescent denied were: the parent misread or exaggerated the adolescent's symptom, had too high expectations for the adolescent's behavior, put a negative label on or did not trust the adolescent. Parents' reasons for expecting their children to (1) deny symptoms the parents reported were: the adolescent did not remember how s/he felt, lied, did not recognize or minimized the importance or frequency of the symptom; and (2) report symptoms the parents denied were: the adolescent lied, exaggerated the importance of or interpreted the symptom differently.

Adolescent↗