Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Reasoning”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,117 records · Page 62Linked to original sources
PubMed1979

Different Chinese hamster cell lines express a G1 period for different reasons.

Previous studies from our laboratory have shown that the absence of G1(G1-condition) in two lines of Chinese hamster cells is dominant over the presence of G1(G1+condition) in a variety of intraspecific cell hybrids. G1+ mutants or variants cna be isolated from G1- cells following mutagenesis and selection. These G1+ mutants fall into multiple complementation groups based on their abilities to form G1- cell hybrids with one another. This is evidence that different mutants have G1 intervals for different reasons, possibly as the result of deficiencies in functions necessary for G1- cell cycles. In this report we have used cell hybrid analysis to ask whether cells of different, naturally occurring G1+ lines of Chinese hamster are able to complement to produce G1- hybrids. We have found three complementation groups among the four G1+ cell lines examined. Therefore, these lines define three different reasons or bases for the existence of a G1 interval. These results lead us to suggest that multiple requirements must be met for these cells to start the S period, but that failure to fulfill only a single and different requirement is responsible for the presence of a G1 interval in any given cell line.

Animals↗
PubMed1981

Reasons for the occurrence of the twenty coded protein amino acids.

Factors involved in the selection of the 20 protein L-alpha-amino acids during chemical evolution and the early stages of Darwinian evolution are discussed. The selection is considered on the basis of the availability in the primitive ocean, function in proteins, the stability of the amino acid and its peptides, stability to racemization, and stability on the transfer RNA. We conclude that aspartic acid, glutamic acid, arginine, lysine, serine and possibly threonine are the best choices for acidic, basic and hydroxy amino acids. The hydrophobic amino acids are reasonable choices, except for the puzzling absences of alpha-amino-n-butyric acid, norvaline and norleucine. The choices of the sulfur and aromatic amino acids seem reasonable, but are not compelling. Asparagine and glutamine are apparently not primitive. If life were to arise on another planet, we would expect that the catalysts would be poly-alpha-amino acids and that about 75% of the amino acids would be the same as on the earth.

Amino Acids↗
PubMed1995

Intraoperative reasons for abandoning ileal pouch-anal anastomosis procedures.

PURPOSE: Ileal pouch-anal anastomosis (IPAA) has become the operation of choice for most patients with chronic ulcerative colitis and familial adenomatous polyposis. However, because of technical or disease factors at the time of pouch construction, IPAA must sometimes be abandoned. A retrospective review was conducted to find reasons for IPAA failure or abandonment. METHODS: Since 1981, 103 patients have had to have an IPAA procedure at the George Washington University Medical Center in Washington, DC. All charts were reviewed and data retrospectively collected. RESULTS: Six of 103 patients (six percent) were unable to have IPAA constructed. Five patients ultimately received a standard end ileostomy, and one had an ileorectal anastomosis. The reasons for abandoning the IPAA procedure were an ischemic pouch, failure to reach the anus, poorly controlled presacral hemorrhage, desmoid of the mesentery, and finding incurable colon carcinoma. CONCLUSIONS: Information regarding the risk of failure or abandonment during the IPAA procedure should be discussed with the patient during preoperative counseling and must be included as an element of informed consent.

Adenomatous Polyposis Coli↗
PubMed1999

Decisions about access to health care and accountability for reasonableness.

Insurers make decisions that directly limit access to care (e.g., when deciding about coverage for new technologies or formulary design) and that indirectly limit access (e.g., by adopting incentives to induce physicians to provide fewer or different services). These decisions raise questions about legitimacy and fairness. By holding health plans accountable for the reasonableness of their decisions, it is possible to address these questions. Accountability for reasonableness involves providing publicly accessible rationales for decisions and limiting rationales to those that all "fair-minded" persons can agree are relevant to meeting patient needs fairly under resource constraints. This form of accountability is illustrated by examining its implications for the three examples of direct and indirect limit setting noted here.

Decision Making, Organizational↗
PubMedDate not supplied

HIV-positive women: reasons they are tested for HIV and their clinical characteristics on entry into the health care system.

STUDY OBJECTIVE: To describe the reasons for the HIV testing of HIV-positive women and their clinical presentation and to make specific laboratory comparisons between women intravenous drug users (IVDUs) and non-IVDUs who were heterosexually infected (HTs). DESIGN: Consecutive case series. SETTING: Four primary care sites associated with the Brown University AIDS Program. PARTICIPANTS: 140 consecutive HIV-seropositive women. RESULTS: The most common reason for HIV testing in both groups was self-perception of risk. Presenting T-helper lymphocyte counts, leukocyte counts, and hematocrits did not differ significantly between the groups. Intravenous drug users were significantly more likely than HTs to have evidence of hepatitis B virus exposure (p less than 0.0001) and to report the history of a sexually transmitted disease (p = 0.005). Twenty percent of HTs versus 10% of IVDUs were tested only after they had HIV-related symptoms. The most frequent clinical presentation for both groups was Centers for Disease Control Group IV/A constitutional symptoms. CONCLUSIONS: Many HIV-seropositive women do not enter the health care system until they are symptomatic, but those infected heterosexually and those using parenteral drugs have similar laboratory indices at presentation. AIDS education strategies toward all women at risk must include information about manifestations of HIV disease in women, as well as preventive measures, to ensure early access to the health care system.

AIDS Serodiagnosis↗
PubMed2003

[Early pensioning: reasons and sequelae. A retrospective study of prognosis in early pensioning and course of illness subsequent to premature retirement].

The aim of the present study was to identify factors at the beginning of inpatient rehabilitation for musculoskeletal diseases, predicting the employment state as early retiree or employed person 5 years after discharge. Of the cases, 88.7% could be correctly classified by logistic regression through "results of radiological imaging procedures," "duration of sick leave," and "wish for social compensation." Another objective was investigation of the influence of retirement on development of complaints. Early retirees were compared retrospectively to working persons 5 years after discharge with regard to development of main symptoms and well-being, considering the initial reason for social compensation. Early retirees with clinical reason for early retirement showed no marked changes, whereas patients who continued to work improved significantly in the long run. Results are discussed in relation to their socioeconomic implications.

Chronic Disease↗
PubMed2003

Reasons why women with long-term urinary incontinence do not seek professional help: a cross-sectional population-based cohort study.

The aims of this study were to investigate the reasons why some women with long-term urinary incontinence (UI) seek professional help whereas others do not, their experiences and satisfactions with the healthcare services, and how women deal with their incontinence. In total, 95 women aged 23-51 years with persistent UI (median 10 years, range 6-20 years) were included in this telephone interview survey. Seventy-four percent of the women with long-term UI had not sought help. The most common reason given was that the disorder was considered a minor problem, which they felt they could cope with on their own. When women did consult professional help they did so because they were afraid of the odor of urine and that they perceived the leakage as shameful and embarrassing. These women felt that the healthcare service offered appropriate care for their condition. Pelvic floor exercises were the most commonly used management methods for all participants.

Adult↗
PubMed2000

Fact finding beyond all reasonable doubt--legal aspects.

A description is provided of the European (esp. German and Austrian) legal concept of "fact finding beyond all reasonable doubt". The uncontested principle of the free evaluation of evidence is closely connected with the dispute about the "probative standard" (= this means the degree of the judge's conviction which is necessary for the fact finding). There can neither be a purely subjective nor a purely objective theory of the probative standard. Because of the human limits of possible perception and of the subjective cognitive faculties the total conviction of truth as demanded by the "conviction-of-truth-theory" could never mean absolute certainty. It is sufficient if "no other reasonable man with a clear view of the conditions of life would be convinced". On the other hand, the objective theory, which sees the judge's task only in consideration of probabilities, becomes more and more important. As a third principle, there is the preponderance principle influenced by the Anglo-American system.

Journal Article↗
PubMedDate not supplied

Digital photography in plastic surgery: how to achieve reasonable standardization outside a photographic studio.

Accurate photographic documentation has become essential in reconstructive and cosmetic plastic surgery both for clinical and scientific purposes. Digital imaging systems currently are popular, being reasonably affordable and much improved in quality. They offer multiple advantages in terms of quality, easy image storage and retrieval. Nevertheless, obtaining standardized, consistent, and relevant digital images is not easy outside a photographic studio. The purpose of this report is to define guidelines for accurate image capture in different anatomic areas, following elementary general criteria based on practical issues beyond the purely theoretical, to obtain reasonable standardization, consistency, and reproducibility.

Equipment Design↗
PubMed2004

Reasons for conversion from laparoscopic to open or hand-assisted adrenalectomy: review of 261 laparoscopic adrenalectomies from 1993 to 2003.

Over the past decade, laparoscopic adrenalectomy has become the operation of choice for resecting adrenal tumors. However, few reported data exist regarding the reasons for conversion from laparoscopic to open or hand-assisted adrenalectomy. We retrospectively reviewed the records of 261 consecutive laparoscopic adrenalectomies performed by one surgeon between 1993 and 2003. Laparoscopic adrenalectomy could not be completed in 8 of the 261 patients (3%); four of the operations were converted to hand-assisted laparoscopic adrenalectomy and four to open adrenalectomy. The reasons for the conversion were as follows: In three patients the tumor was too adherent to surrounding structures to be resected laparoscopically; in three patients the tumor was found to have malignant features during laparoscopy, and the operation was converted to achieve proper resection margins; in two patients the tumors were too large (15 and 16 cm, respectively) to be safely removed laparoscopically. The eight resected tumors included three pheochromocytomas, one myelolipoma, one angiomyolipoma, one solitary fibrous tumor, one liposarcoma, and one metastatic hepatocellular carcinoma. There were no cases in which conversion was required emergently for bleeding or other intraoperative catastrophes. All eight of the tumors removed were at least 5 cm in size (range 5-16 cm). The mean length of hospitalization was 4.4 days (range 3-8 days).

Adrenal Gland Neoplasms↗
PubMed2006

Reasons to withhold intra-arterial thrombolysis in clinical practice.

BACKGROUND: In selected stroke centers intra-arterial thrombolysis (IAT) is used for the treatment of acute stroke patients presenting within 6 hours of symptom onset. However, data about eligibility of acute stroke patients for IAT in clinical practice are very scarce. METHODS: We collected prospectively data on indications advising for or against IAT of 230 consecutive stroke patients in a tertiary stroke center. RESULTS: 76 patients (33.0%) presented within 3 hours, 69 (30%) between 3 and 6 hours of symptom onset and 85 (37%) later than 6 hours. Arteriography was performed in 71 patients (31%) and IAT in 46 (20%). In 11 patients no or only peripheral branch occlusions were seen on arteriography and therefore IAT was not performed. In 9 patients the ICA was occluded and barred IAT and in five anatomical or technical difficulties made IAT impossible. 72 patients presenting within 6 hours did not undergo arteriography and thrombolysis, mostly because of mild (n=44) or rapidly improving neurological deficits (n=13). Other reasons to withhold IAT were CT and/or clinical findings suggesting lacunar stroke due to small vessel occlusion (n=7), limiting comorbidty (n=7) and baseline international normalized ratio>1.7 (n=1). CONCLUSIONS: A third of the patients underwent diagnostic arteriography and one fifth received IAT. The most important reasons to withhold thrombolysis were presentation beyond the 6 hours time window and mild or rapidly improving symptoms.

Adolescent↗
PubMed2002

Analysis of the reasons for DMARD therapy discontinuation in patients with rheumatoid arthritis in the Czech and Slovak republics.

The aim of the study was to evaluate the efficacy and safety of disease-modifying drugs (DMARDs) in everyday clinical practice in Central European States (the Czech and Slovak republics). This was a retrospective, multicentre study. With the help of a special questionnaire, the medical files of 760 patients in 15 centres were analysed looking for reasons for DMARD discontinuation (e.g. insufficient efficacy, toxicity). The secondary endpoints were duration of therapy with individual DMARDs and the influence of other factors (demographic, disease specific, concomitant therapy) on duration of therapy. In 47.1 % of patients therapy was interrupted because of lack of efficacy, in 43.2 % because of adverse events, and in 9 % for undefined reasons. Toxic reactions leading to withdrawal were most common with gold (62.6 %) and methotrexate (62.5 %). Because of insufficient effect, treatment was most frequently interrupted with antimalarials (62.3 %) and penicillamine (53.2 %), but in only 22% treated with methotrexate. The mean duration of one treatment episode with DMARDs was 28.1 +/- 48.9 months. Surprisingly, it was longest for cyclophosphamide (53.5 + 55.1 months) and shortest for cyclosporin (7.0 +/- 6.7 months). The mean duration of treatment with methotrexate was only 14.9; +/- 16.2 months. The mean duration of treatment with one DMARD was statistically longer in patients with positive rheumatoid factor, extra-articular disease and age lower than 50 years. There was no impact of sex, concomitant steroid treatment and high or low sedimentation rate on treatment duration. Considerable differences in everyday clinical practice with DMARDs between Central European states and published data from the US and western Europe have been found. More education about modern strategies in the treatment of RA is probably necessary for practising rheumatologists.

Adult↗
PubMed2005

[The medical reason for the prescription of COX-2 selective cyclo oxygenase inhibitor rofecoxib for the treatment of rheumatoid arthritis. A post-marketing surveillance study from Austria].

This study was designed to analyze reasons why rheumatologists prescribed coxibs instead of non-selective NSAIDs in the treatment of rheumatoid arthritis in Austria. A simple questionnaire was distributed among interested doctors of internal or orthopedic medicine in medical practices treating patients with rheumatic diseases. 730 patients with rheumatoid arthritis could be included in this study. The argument most often mentioned was the low incidence of gastrointestinal side-effects followed by analgesic effectiveness compared with non-selective NSAIDs. Easy to use, age of patients and general tolerability were further reasons for the decision to prescribe rofecoxib.

Adolescent↗
PubMed2005

Systems failure in hospitals--using Reason's model to predict problems in a prescribing information system.

Both hospitals and hospital patients are bearing a massive cost as a result of the occurrence of medication prescribing errors in the public health system (Bates, D., et al. J. Am. Med. Inform. Assoc. 8(4):299-308, 2001; Lombardi, T. Medscape Pharm. Online J. 02(1), 2001; Roberts, M., and Stokes, J. eMed. J. Aust. 168:317-318, 1998). Consequently, it is important to examine and address the possible causes of this problem. In this paper we suggest that poor information systems may be a contributing factor in the occurrence of these errors. We research this issue in an HIV ward of a large public hospital through interviews and a survey instrument. We find that in a significant number of instances prescribing errors are linked to situations where information is unavailable or inaccessible. This link, between problems in information delivery and prescribing errors, is a link whose extent has not been measured previously. It is, however, a link which exposes all stakeholders in the hospital system, the patient, the clinicians, the hospital, and governments funding prescription medications, to possible loss and damage and indicates a need for the implementation of more effective systems in this area. We use Reason's model for predicting systems error (Vincent, C. BMJ 316:1154-1157, 1998) as a tool to suggest that prescribing errors have an increased likelihood of occurring if one or more of the types of failure identified in the model are present in the existing prescribing information delivery process in the hospital. While Reason's model has been applied in a medical context, it has not been previously applied to errors which result from information systems failure. We feel that applying it in this way may shed some light on the causes of prescribing error.

HIV Infections↗
PubMed2006

The effects of attribution of responsibility and work history on perceptions of reasonable accommodations.

Under the Americans with Disabilities Act (ADA), employers must provide employees with disabilities reasonable accommodations that will enable them to perform job duties, as long as the accommodations do not financially burden the organization. Two studies were conducted to investigate whether disability origin and/or prior work history impermissibly influence the granting of reasonable accommodations under the ADA. In both studies, participants granted more accommodations for employees whose disability was caused by some external factor than for those whose disability was caused by the employee's own behavior. In Study Two, participants also granted more and costlier accommodations for an employee with an excellent work history than for an employee with an average work history. Implications of the use of extralegal factors in accommodation decisions are discussed.

Administrative Personnel↗
PubMed2006

Motivating donors to genetic research? Anthropological reasons to rethink the role of informed consent.

In this article we explore the contribution from social anthropology to the medical ethical debates about the use of informed consent in research, based on blood samples and other forms of tissue. The article springs from a project exploring donors' motivation for providing blood and healthcare data for genetic research to be executed by a Swedish start-up genomics company. This article is not confined to empirical findings, however, as we suggest that anthropology provides reason to reassess the theoretical understanding of autonomy as generally defined by Beauchamp and Childress. Careful consideration of the trust expressed by donors through the act of donation, furthermore, suggests that there is reason to redirect the ethical scrutiny from informed consent to issues concerning institutional arrangements and social responsibility. In particular, we suggest that an anthropological approach could facilitate a reconsideration of the political implications of using informed consent as a regulatory practice in tissue-based research.

Anthropology, Cultural↗
PubMed1996

Must reasoning.

The mental model theory of reasoning postulates that individuals reason by constructing models of the situations described by the premises, but the number of explicit models and the information in them is kept to a minimum. The initial models of modal conditionals don't only represent the situations, but they also comment these situations, in terms of permissible and impermissible. The present paper reports three experiments which test the prediction of the mental model theory that a modus tollens inference is easier with a rule that contains the auxiliary verb 'must'. Unlike a normal rule, there is no need to flesh out the models explicitly with a rule containing 'must'. Overall, the results corroborate the prediction of the mental model theory.

Cognition↗
PubMed1994

Health of infant is the main reason for breast-feeding in a WIC population in Hawaii.

OBJECTIVE: To determine factors influencing infant feeding method choices among women who received services from the Special Supplemental Food Program for Women, Infants, and Children (WIC) during pregnancy in Hawaii. DESIGN: A retrospective survey mailed to all resident mothers who had live births in Hawaii between January 1, 1989, and March 31, 1989, and who received WIC services during pregnancy. SETTING: The state of Hawaii. SUBJECTS: The subjects were 322 mothers who received WIC services during pregnancy for whom data were complete, taken from a sample of 2,013 women who had live births in the state of Hawaii (51% response rate) between January 1, 1989, and March 31, 1989, of whom 324 participated in WIC during pregnancy. MAIN OUTCOME MEASURES: Infant feeding method (exclusive breast, exclusive formula or mixed) at hospital discharge. STATISTICAL ANALYSES PERFORMED: The chi 2 analysis for differences among feeding method groups and multiple logistic regression to calculate odds ratios for independent effects of maternal characteristics and other influences on feeding method choice. RESULTS: Reasons for infant feeding choice, timing of the choice, maternal age, parity, and place of residence were the main factor influencing infant method choice. Health of the infant was the primary reason for choice of feeding method and was the strongest determinant of exclusive breast-feeding (odds ratio = 23.99; confidence interval = 9.75-59.02; P < .0001) and was negatively related to the choice to formula-feed (odds ratio = 0.03; confidence interval = 0.01-0.08; P < .0001). APPLICATIONS: Relationship between WIC and hospital lactation consultants could enhance follow up in the hospital and after returning home with WIC mothers who prenatally state an intention to breast-feed. Convenience and bonding are aspects of breast-feeding enjoyed by WIC mothers in Hawaii that could be used in breast-feeding promotion efforts.

Adult↗