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PubMed2004

Inductive reasoning and implicit memory: evidence from intact and impaired memory systems.

In this study, we modified a classic problem solving task, number series completion, in order to explore the contribution of implicit memory to inductive reasoning. Participants were required to complete number series sharing the same underlying algorithm (e.g., +2), differing in both constituent elements (e.g., 2468 versus 57911) and correct answers (e.g., 10 versus 13). In Experiment 1, reliable priming effects emerged, whether primes and targets were separated by four or ten fillers. Experiment 2 provided direct evidence that the observed facilitation arises at central stages of problem solving, namely the identification of the algorithm and its subsequent extrapolation. The observation of analogous priming effects in a severely amnesic patient strongly supports the hypothesis that the facilitation in number series completion was largely determined by implicit memory processes. These findings demonstrate that the influence of implicit processes extends to higher level cognitive domain such as induction reasoning.

Adult↗

PubMed2005

Influenza vaccination coverage and reasons to refrain among high-risk persons in four European countries.

This paper examines influenza vaccine coverage using a population base of an average of 2300 persons in each of four European countries (Germany, Spain, Poland and Sweden). The reasons for non-vaccination of those in the high-risk groups were explored by questionnaire. The vaccine coverage rate (VCR) for elderly ranged from 18% in Poland to 67% in Spain. The VCR for high-risk population under 65 was 10% in Poland, 13% in Sweden, 27% in Germany and 30% in Spain. The most important reasons mentioned for not being vaccinated were: perceived sufficient resistance to flu (33-42%) in all countries; financial barriers in Poland (25%), and not to qualify for the vaccination (30%) and forgetfulness (20%) in Germany. Receiving a personal invitation for the vaccination, results in higher coverage rates in all four countries. We think that future interventions could be directed towards: an information campaign with special attention to the high-risk groups due to disease; promotion of personal invitations; and, for Poland, solving financial barriers to vaccination.

Aged↗

PubMed2005

An exploration of self-reported negative affect by adolescents as a reason for smoking: implications for tobacco prevention and intervention programs.

BACKGROUND: Negative affect is related to initiation and maintenance of smoking among youth and understanding its role is important when developing effective prevention and cessation programs. This study investigates the relationship between adolescent negative affect and smoking dependence, behaviors, attitudes, and self-efficacy in order to shed light on differences in adolescent smoking maintenance and cessation. METHODS: 721 smoking youth participated in a cognitive-behavioral smoking cessation program. Reasons for smoking were categorized (alpha = 0.87) and youth were placed into one of two groups based on presence or absence of negative affect. One-way repeated measures ANOVA determined if differences existed between the groups on smoking behaviors, attitudes, and self-efficacy. One-way ANOVA determined if differences existed on Fagerström Nicotine Tolerance Dependence (FTND) scores. RESULTS: Adolescents indicating negative affect for smoking were significantly more likely to have future smoking intentions and had significantly less self-efficacy to quit smoking than adolescent reporting other reasons. CONCLUSIONS: This study supports the need to address negative affect among adolescents participating in prevention and cessation programs. An examination of negative affect will provide program developers and facilitators with information to improve their interventions, assist with cessation, and provide an avenue to access other needed health services.

Adolescent↗

PubMed2000

Assessment of university students' coping strategies and reasons for driving in high-risk drinking-driving situations.

A total of 116 students (87 women; 29 men) enrolled at a large, public Midwestern university in the United States were recruited to complete a set of demographic questionnaires and drinking-driving episode surveys. The latter surveys assessed participants' reported motivations for driving or not driving during four recent drinking episodes. Content analyses were used to develop lists of commonly reported reasons for not driving (e.g. found alternate transportation), reasons for driving after drinking (e.g. perceived need to go to destination), potential alternatives to driving after drinking (e.g. walking to destination), and strategies used to avoid detection or arrest by police (e.g. driving more slowly, using back roads or side streets). Participants made both situational and self-coping attributions to explain why they did not, on occasion, drive after drinking. These results may be used as a foundation for prevention and education programs that are designed to: (a) encourage use of coping strategies and alternatives to driving while disputing peer-generated justifications for driving after drinking, and (b) challenge the value of potentially unsafe strategies for avoiding detection and arrest when driving under the influence.

Accidents, Traffic↗

PubMed2001

Emotion- and intrusion-based reasoning in Vietnam veterans with and without chronic posttraumatic stress disorder.

Patients suffering from anxiety disorders other than posttraumatic stress disorder (PTSD) interpret anxiety responses themselves as evidence that threat is impending: "if anxiety, then threat" (Arntz, Rauner, & van den Hout, 1995, Behaviour Research and Therapy, 33, 917-925). This "emotion-based reasoning" (ER) may render a disorder self-perpetuating. Analogous to ER, danger might also be inferred from the presence of intrusions: "intrusion-based reasoning" (IR). The aims of this study were to test whether ER and IR are involved in chronic PTSD. Vietnam combat veterans with or without PTSD or other anxiety disorders rated perceived danger of brief scenarios in which information about objective danger (danger vs safety) and response (anxiety/intrusions vs non-distressing emotion) was systematically varied. Two series were administered: ER-scenarios were non-specific for PTSD and IR-scenarios were specific for PTSD. Relative to control participants, PTSD patients engaged in both ER and IR: whereas veterans without PTSD inferred the danger of scenarios from objective stimulus information, veterans with PTSD also inferred danger from the presence of anxiety or intrusions. Further analyses showed that these effects were largely mediated by perceived uncontrollability.

Anxiety↗

PubMedDate not supplied

Hoarding, compulsive buying and reasons for saving.

Two studies examined hypotheses about compulsive hoarding, compulsive buying and beliefs about saving and discarding derived from the cognitive-behavioral model of compulsive hoarding [Frost, R. O. and Hartl, T. (1996). A cognitive behavioral model of compulsive hoarding. Behaviour Research and Therapy, 34, 341-350.]. Study 1 examined the hypotheses in a college student population, while study 2 compared members of a support group for hoarding and clutter-related problems with a nonclinical control. Across studies the hypotheses were supported. Compulsive hoarding was associated with compulsive buying and the frequency of acquisition of possessions discarded by others, suggesting that compulsive acquisition may be a broader construct than compulsive buying among people with hoarding problems. Regarding its association with OCD symptoms, hoarding was most closely associated with the impaired mental control features of OCD. Finally, offa hoarding-related task, hoarding was associated with a greater frequency of reasons to save, but was not associated with fewer reasons to discard a target possession.

Adult↗

PubMed2003

Thumb reconstruction for aesthetic reasons using an exteriorised microvascular pedicle.

Thumb reconstruction following amputation is usually performed in order to restore function. Nevertheless, the reconstruction should be cosmetically acceptable in order to be fully functional, and, in some cases, reconstructive surgery may be justified for purely aesthetic reasons. The most satisfying aesthetic results in adults are obtained with microsurgical partial great-toe transfer. The technique that we use for thumb reconstruction is illustrated by two case reports: that of a 26-year-old female patient and that of a 35-year-old male patient. Both patients had a distal thumb amputation with destroyed nail apparatus, and both sought thumb reconstruction for cosmetic reasons. Aesthetic reconstruction was performed in both cases with a partial ipsilateral great-toe transfer, composed of nail apparatus, underlying bone and custom-made pulp tissue. The vascular anastomosis was done at the snuff-box, through a small incision, with an exteriorised pedicle. The result was satisfactory in both cases, with minimal donor-site sequelae. Partial toe transfer has proven to be a reliable technique for thumb reconstruction. It is an evolving technique. Many modifications have been introduced to optimise the aesthetic result and to reduce donor-site morbidity. Our technique allows us to restore thumb length, replace the missing nail and reconstruct the pulp, with acceptable sequelae at the donor toe. The exteriorised-pedicle technique prevents pedicle compression and twisting and reduces scarring and stiffness. It does, however, require delicate postoperative care and a second procedure for pedicle division.

Adult↗

PubMed2000

Two reasons to abandon the false belief task as a test of theory of mind.

The false belief task has often been used as a test of theory of mind. We present two reasons to abandon this practice. First, passing the false belief task requires abilities other than theory of mind. Second, theory of mind need not entail the ability to reason about false beliefs. We conclude with an alternative conception of the role of the false belief task.

Animals↗

PubMed2002

Returning the tables: language affects spatial reasoning.

Li and Gleitman (Turning the tables: language and spatial reasoning. Cognition, in press) seek to undermine a large-scale cross-cultural comparison of spatial language and cognition which claims to have demonstrated that language and conceptual coding in the spatial domain covary (see, for example, Space in language and cognition: explorations in linguistic diversity. Cambridge: Cambridge University Press, in press; Language 74 (1998) 557): the most plausible interpretation is that different languages induce distinct conceptual codings. Arguing against this, Li and Gleitman attempt to show that in an American student population they can obtain any of the relevant conceptual codings just by varying spatial cues, holding language constant. They then argue that our findings are better interpreted in terms of ecologically-induced distinct cognitive styles reflected in language. Linguistic coding, they argue, has no causal effects on non-linguistic thinking--it simply reflects antecedently existing conceptual distinctions. We here show that Li and Gleitman did not make a crucial distinction between frames of spatial reference relevant to our line of research. We report a series of experiments designed to show that they have, as a consequence, misinterpreted the results of their own experiments, which are in fact in line with our hypothesis. Their attempts to reinterpret the large cross-cultural study, and to enlist support from animal and infant studies, fail for the same reasons. We further try to discern exactly what theory drives their presumption that language can have no cognitive efficacy, and conclude that their position is undermined by a wide range of considerations.

Cognition↗

PubMed1998

The development of calibration-based reasoning about collision events in young infants.

Previous research indicates that, when shown a collision between a moving and a stationary object, 11-month-old infants believe that the size of the moving object affects how far the stationary object is displaced. The present experiments examined whether 6.5- and 5.5-month-old infants hold the same belief. The infants sat in front of a horizontal track; to the left of the track was an inclined ramp. A wheeled toy bug rested on the track at the bottom of the ramp. The infants were habituated to an event in which a medium-size cylinder rolled down the ramp and hit the bug, propelling it to the middle of the track. Next, the infants saw two test events in which novel cylinders propelled the bug to the end of the track. The two novel cylinders were identical to the habituation cylinder in material but not in size: one was larger (large-cylinder event) and one was smaller (small-cylinder event) than the habituation cylinder. The 6.5-month-old infants, and the 5.5-month-old female infants, looked reliably longer at the small- than at the large-cylinder event. These and control results indicated that the infants (a) believed that the size of the cylinder affected the length of the bug's trajectory and (b) used the habituation event to calibrate their predictions about the test events. Unlike the other infants, the 5.5-month-old male infants tended to look equally at the small- and large-cylinder events. Further results indicated that this negative finding was not due to the infants' (a) failure to remember how far the bug rolled in the habituation event or (b) inability to use the habituation event to calibrate predictions about novel test events. Together, the present results suggest the following conclusions. First, when shown a collision between a moving and a stationary object, infants aged 5.5-6.5 months (a) believe that there is a proportional relation between the size of the moving object and the distance traveled by the stationary object and (b) can engage in calibration-based reasoning about this size/distance relation. Second, female infants precede males by a few weeks in this development, for reasons that may be related to sex differences in the maturation of depth perception.

Age Factors↗

PubMed1998

A pragmatic implementation of medical temporal reasoning for clinical medicine.

In most development tools for knowledge-based systems object-property-value-triples are the basic ontological representation. We have extended this approach for temporal reasoning by replacing the values with time-objects. A time-object is a combination of a value with a time-point or a time-interval. By preserving the object-property-value-triples basic artificial intelligence techniques can be applied without modifications in the temporal case. The greater complexity of temporal inferences is compensated by a blackboard control architecture enabling small knowledge-sources. The control of the strategic reasoning is in accordance with the select and test model. A prototype of a knowledge-based advisor for the acute radiation syndrome has been implemented and partially evaluated. Due to the affected proliferative tissues it is a strongly time-oriented medical domain.

Acute Disease↗

PubMed1997

Depot medroxyprogesterone acetate. Patterns of use and reasons for discontinuation.

Little information is available from outside clinic settings about the acceptability of depot medroxyprogesterone acetate (DMPA, Depo-Provera) as an injectable contraceptive. In this national, population-based study, New Zealand women aged 25 to 54 years were selected at random from voter rolls. The 1864 subjects were interviewed by telephone after an initial approach by letter. More than 1 in 8 women (13.7%) had used DMPA at some time. The proportion was higher among Maori women and among those of lower income and education, but DMPA had been used by a substantial proportion of all socioeconomic groups. A quarter of all users reported receiving only a single injection of DMPA, and only 53% had used this method for a total of 12 months or more. Only 5 (1.6%) of discontinuations were attributed to contraceptive failure; this corresponds to a contraceptive failure rate of 0.9 per 100 woman-years. Side effects were given as the most common reasons for stopping, with menstrual disturbances and weight gain being cited most often. Other reasons for stopping included no further need for contraception or doubts about the appropriateness of DMPA. In this developed country population, DMPA is widely used for short periods but its acceptability is limited by the occurrence of side effects.

Adult↗

PubMed1999

Arithmetic reasoning and implicit memory: a neuropsychological study on amnesia.

The present study investigates implicit memory and arithmetic reasoning in a group of severely amnesic patients. Priming effects have been observed in the retrieval of arithmetic facts in amnesic patients (Delazer, Ewen and Benke, 1997), but no studies have so far investigated the effect of previous experience in a pure reasoning task. Findings indicate that answering to a first numerical series (e.g, 1 3 5 7, answer "9") facilitates answering to a second numerical series (2 4 6 8, answer "10") including different numbers but sharing the same underlying algorithm (+ 2). Within the model of Langdon and Warrington (1997) priming effects are attributed to the stage of abstract formula generation.

Adult↗

PubMed2001

The palliative management of fungating malignant wounds--generalising from multiple-case study data using a system of reasoning.

The project focused on individual experiences, from 45 participants, of living with a fungating wound and the performance of wound dressings in reducing the impact of the wounds on daily living. A case study design was adopted. This posed a key methodological challenge in the form of the contentious epistemological issue, characterised in the literature as the "nomothetic-idiographic dilemma". This issue concerns the nature of knowledge generated from an individual case and its generalisability. A system of reasoning was adopted as the analytic strategy, within a theory-driven evaluation, to abstract general issues from the case study data to construct explanations of symptom control and dressing performance. The latter were generalised beyond the individual cases with the use of theory. This paper focuses on the methodological issues that are inherent in the use of a case study design and the nature of the evidence generated. The system of reasoning is described and illustrated using data from a single participant with advanced uterine cancer and a fungating nodule in the groin.

Activities of Daily Living↗

PubMed2002

Reasons for physically restraining patients and residents: a systematic review and content analysis.

OBJECTIVE: The purpose of this systematic review was to determine why people are physically restrained in the acute and residential care settings. METHOD: A comprehensive search was undertaken of electronic databases to identify studies addressing the reasons for using physical restraint. Findings were synthesised using content analysis. RESULTS: Twenty-three studies were identified. The most common reason for using restraints related to patient-oriented issues such as ensuring the safety of people. However, they are also commonly used to facilitate treatment, maintain the social environment and because of issues such as understaffing.

Behavior Control↗

PubMed2002

Sources and reasons for delays in the care of acute stroke patients.

OBJECTIVE: This study aimed to identify sources and reasons for delays in the care of our acute stroke patients. METHODS: Data on time interval from symptom onset or awareness to initial presentation, to neurology assessment, to performance of cranial CT scan, and demographic and medical factors associated with delays among stroke patients admitted at St. Luke's Medical Center from May to October 2000 were obtained by interview and record review. RESULTS: Of 259 patients (mean age 61.5+/-13.6 years, 43% females), 63% had infarction (INF), 32% intracerebral hemorrhage (ICH) and 5% subarachnoid hemorrhage (SAH). Fifty-nine percent presented within 3 h of symptom onset or awareness, 73% within 6 h (median=2 h). Patients with ICH presented earlier than those with infarction. Reasons for delayed consultation included failure to recognize symptoms as serious and stroke-related. A non-neurologist was initially consulted in 97% of cases. Median delay from presentation to neurology evaluation was 7.5 h. Median time from presentation to brain imaging was significantly shorter for patients brought to CT-equipped facilities (2 h) than for those needing transfer to other hospitals (11.5 h). CONCLUSIONS AND RECOMMENDATIONS: Patient delay in presentation is only one cause of delay in acute stroke care. Longer delays arise from healthcare-related factors such as delays in neurologist referral and neuroradiologic diagnosis. Professional and public education on the necessity of early neurologic evaluation and patient transport to CT-equipped "Stroke Centers" is recommended.

Adult↗

PubMed1990

Reasons for replacement of long-term urethral catheters: implications for randomized trials.

On any given day more than 100,000 nursing home patients have indwelling urethral catheters in place. We prospectively followed 47 such patients for almost 18 patient-years and observed 249 catheter replacements. The mean number of replacements per 100 days of catheterization was 3.1 (71% of the catheters were replaced within 30 days of insertion). Nonprescribed removal by the patient or nursing staff was the most frequent cause of replacement (43%), followed by leakage (33%) and obstruction (24%). Catheter replacements followed patient-specific patterns, with each reason for replacement being associated significantly with the reason for the prior replacement (p less than 0.001). To minimize the effect of patient-specific replacement patterns, studies of complications of catheterization that may be affected by catheter obstruction or replacement should use cross-over designs.

Aged↗

PubMed1988

Accuracy of and reasons for frozen sections: a correlative, retrospective study.

Previous studies on the accuracy of frozen sections (FS) were not based on the reasons for which the FS was performed. By omitting this important information, those studies reported FS accuracy of 94% to 97.4%. The current study analyzes the accuracy of FS diagnoses based on the reasons for which they were conducted. Of 482 specimens examined by FS in 1986, 41 were performed for evaluation of section margins of tumors, 29 for identification of unknown tissue, and 43 for detection of lymph node metastases. All 113 of these examinations proved to be 100% accurate. The remaining 369 FS were performed for diagnosis of an unknown pathologic process. Of these, 83.47% were precisely diagnosed; in 10.30%, the pathologic process was correctly, but not precisely, diagnosed; in 3.79%, the diagnosis was deferred; and the remaining 2.44% were incorrectly diagnosed (with no harmful consequences to the patients). By eliminating the cases of deferred diagnoses, the accuracy rate increased to 86.76%. Therefore, we suggest that the pathologist and the surgeon should not draw any conclusion from an inconclusive interpretation of FS and should proceed as though an FS had not been performed. When combining results of "precise diagnoses" with those of "correct pathologic process," the overall accuracy rate increased to 97%. The investigators conclude that FS should be used for a general diagnosis of a pathologic process rather than for an exact or precise diagnosis. Finally, we suggest that a similar survey of FS be periodically performed in every pathology department as part of its quality assurance program.

Diagnostic Errors↗