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PubMed2000

Pre-employment intentions of home care aides.

The demand for home care aides (HCA) is projected to increase substantially over the next several years. One of the reasons for this projection is the high turnover rates associated with the occupation. Although there are many reasons for the high turnover after HCAs have been hired, their pre-employment intentions are unclear. A better understanding of HCAs' pre-employment intentions may help to decrease recruitment and training costs for home care agencies and improve continuity of care for clients.

Employment↗
PubMed2000

Colorectal cancer risk perceptions and screening intentions in a minority population.

This is a 2-year follow-up to a previously reported baseline paper. We focused on a predominantly low-income African-American population from a community health center and investigated the relationships among perceptions of perceived risks for colorectal cancer (CRC), concerns about getting CRC, screening intentions, and whether participants had a fecal occult blood test (FOBT) on schedule at follow-up. Baseline absolute risk did not predict screening intentions or being on schedule (15% of sample), nor did it predict follow-up perceived absolute risk, comparative risk, or CRC concerns. Participants who expressed greater perceived absolute risk, comparative risk, and concerns at follow-up were more likely to report thinking about or definitely planning to get an FOBT within the next 2 years (49% of the sample). In addition, baseline absolute risk and whether or not a person had an FOBT on schedule at baseline did not predict being on schedule at follow-up. A significant percentage of the population (20%) were not able to state whether their CRC risk was below average, average, or above average. In addition, 44% of the population viewed their risks as lower than their peers, and 58% reported being not at all or slightly concerned about getting CRC. These results suggest that educational efforts are needed especially for low-income minority populations to enhance knowledge and accuracy of risk perceptions for CRC and interventions that explicitly manipulate risk are needed to assess to what extent risk perceptions can be modified and subsequently affect screening.

Black or African American↗
PubMed2000

Masked intentions: the masquerade of killing thoughts used to justify dehydrating and starving people in a "persistent vegetative state" and people with other profound neurological impairments.

Denying food and water to profoundly impaired people who may not be conscious, or may only be "minimally" conscious, raises challenging ethical issues. While there is growing support for withdrawing/withholding food and water (assisted nutrition and hydration, or "AHN") from people described as being in a "persistent vegetative state" ("PVS") and people with other profound neurological impairments, such as advanced dementia, the issue remains controversial, and for many, unresolved. In this article, the author argues that if a profoundly impaired person is not imminently dying from a disease process, denying food and water causes him or her to die of dehydration and starvation. When provision of food and water does not create excessive burdens (such as extreme pain and discomfort), and if the food and water can be digested and absorbed, denying such nourishment is immoral and unethical. Under these circumstances, this denial (by commission or omission) is motivated by a real intention to cause death, whether or not that intention is explicitly recognized.

Attitude to Health↗
PubMed2001

An annotated history of craniofacial surgery and intentional cranial deformation.

The history of craniofacial surgery and the use of intentional cranial deformation is a long and varied one. Researching some of the earliest medical writings and reviews of early terracotta and stone figures from throughout the world clearly revealed that these two forms of treatment were widely extant. Intentional cranial deformation was used for a number of reasons including beautification, tribal identification, and social stature. The development of craniofacial surgery is a more modern practice and its historical evolution is reviewed in the context of techniques and the personalities involved.

Adult↗
PubMed2000

[Intent to treat].

Intent to treat methodology consists of keeping all patients included, in their initial group in the case of randomization, to perform final analysis of a study. This attitude is justified methodologically, as it preserves the validity of the statistical rationale, and clinically, as it more closely reproduces real prescribing conditions. In the light of a classical example, this review illustrates several clinical situations raising the problem of intent to treat.

Clinical Trials as Topic↗
PubMedDate not supplied

Assistive technology to improve PC interaction for people with intention tremor.

Many patients with upper limb intention tremor encounter difficulties in mouse-driven interaction with the personal computer (PC). An assistive technology system ("the Tremor Control System"), consisting of a motion-filtering software program that supports multiple interfaces, was developed and validated with 36 persons with Multiple Sclerosis in a multi-center trial. PC-tests, requiring basic functions such as cursor placement and click and drag function, were able to differentiate between patients and control subjects (ANOVA: p<0.05). A significant time improvement on the PC-tests was found when using an optimal alternative interface instead of the standard PC-mouse (paired t-tests: p<0.01 for Point & Click test, p<0.05 for Drag & Drop test and p<0.1 for Double Click test). A significant time improvement was found for the Double Click test (paired t-tests: p<0.05) when the motion-filtering program was implemented. The number of patients able to perform fully the PC-tests increased with the Tremor Control System. Patients with marked intention tremor seemed to profit especially from this assistive technology. These users reported that working with the Tremor Control System was less fatiguing and more comfortable compared to the use of the standard PC-mouse.

Computers↗
PubMed2000

The anti-kickback statute standard(s) of intent: the case for a rule of reason analysis.

Mr. Aspinwall presents a comprehensive overview of the anti-kickback statute to show how Congress enacted the legislation to prevent inappropriate utilization and to reduce the ambiguity of the anti-kickback prohibitions by adding a knowing and willful requirement to the standard of intent. He discusses the different lines of caselaw on the anti-kickback standard of intent, and closely examines the standard endorsed by the OIG. He proposes adopting a standard of reasonableness modeled after the rule of reason from antitrust law, using cost-effectiveness as the primary criterion. He argues that a cost-benefit outcomes-based approach to the anti-kickback statute would better serve the public interest.

Antitrust Laws↗
PubMed2001

Update: Investigation of anthrax associated with intentional exposure and interim public health guidelines, October 2001.

On October 4, 2001, CDC and state and local public health authorities reported a case of inhalational anthrax in Florida. Additional cases of anthrax subsequently have been reported from Florida and New York City. This report updates the findings of these case investigations, which indicate that infections were caused by the intentional release of Bacillus anthracis. This report also includes interim guidelines for postexposure prophylaxis for prevention of inhalational anthrax and other information to assist epidemiologists, clinicians, and laboratorians responding to intentional anthrax exposures.

Adult↗
PubMed2001

Recognition of illness associated with the intentional release of a biologic agent.

On September 11, 2001, following the terrorist incidents in New York City and Washington, D.C., CDC recommended heightened surveillance for any unusual disease occurrence or increased numbers of illnesses that might be associated with the terrorist attacks. Subsequently, cases of anthrax in Florida and New York City have demonstrated the risks associated with intentional release of biologic agents. This report provides guidance for health-care providers and public health personnel about recognizing illnesses or patterns of illnessthat might be associated with intentional release of biologic agents.

Anthrax↗
PubMed2001

Intentional puncture of the dural space as an aid to epidural placement in a morbidly obese parturient.

OBJECTIVE: In this case report the authors discuss a technique occasionally employed at their institution to aid in identification of the epidural space in morbidly obese parturients. CASE REPORT: A 29-year-old primagravida, with a body mass index of 90 (155 cm tall, 215 kg) presented for induction of labor. A 27-ga. Sprotte spinal needle was intentionally passed through a Weiss epidural needle and into the subarachnoid space to confirm placement of the Weiss needle in the epidural space. An epidural catheter was then placed which functioned well for labor and subsequent caesarian delivery. CONCLUSIONS: In selected patients, intentional puncture of the dura can aid in confirmation of the epidural space.

Adult↗
PubMed1999

Intentional pulp capping: a clinical perspective of the adhesive experience.

UNLABELLED: A new standard of biocompatibility has evolved for dental tissues. This paper attempts to trace the extraordinary transformation of composite resin from dissident to healer. Intentional pulp capping is a logical progression of the adhesive era given the fact that current enamel-dentin bonding systems are biologically acceptable and potentially provide a gap-free therapeutic seal at the restorative interface. The probationary status of the adhesive pulp capping procedure is acknowledged; nevertheless, it is abundantly clear that there is a place for this treatment modality in clinical practice. PURPOSE: The objective of the accompanying pictorial essay is to give a clinical perspective of the author's experience with intentional pulp capping over the past seven years. The focus of this paper is the detailed examination of the clinical variables which influence the quality of the "seal" surrounding the exposed pulpal tissues.

Dental Caries↗
PubMed2002

Intentional resection of the diaphragm during cytoreductive laparoscopic radical nephrectomy.

PURPOSE: Laparoscopic radical nephrectomy is being performed more commonly. To our knowledge intentional resection of the diaphragm during laparoscopic radical nephrectomy for large renal tumors has not yet been described. We detail the laparoscopic management of diaphragmatic resection. MATERIALS AND METHODS: From March 1996 to February 2001, 36 patients underwent cytoreductive laparoscopic radical nephrectomy at our institution in preparation for systemic immunotherapy. Charts and operative tapes were reviewed and cases were identified in which diaphragmatic resection was performed for locally invasive tumors. RESULTS: In 3 patients a portion of the diaphragm was dissected via laparoscopy during debulking nephrectomy. All patients had renal cell carcinoma with documented metastatic disease. The diaphragm was repaired laparoscopically using intracorporeal suturing techniques in 2 of the 3 patients and a chest tube was placed in all 3. Transient systolic hypotension and hypercarbia in 1 case resolved with manual ventilation. The chest tube was removed on postoperative days 2 to 4. There were no complications and no ipsilateral pleural metastasis was identified at an average of 6 weeks (range 2 to 23) of followup. CONCLUSIONS: A portion of the diaphragm may be intentionally resected during laparoscopic radical nephrectomy. This maneuver may be successfully managed without conversion to an open procedure. In cases of a large diaphragmatic defect or the potential for coagulopathy postoperatively a chest tube should be inserted. Potential invasion of the diaphragm by large tumors should not be considered a contraindication to cytoreductive laparoscopic radical nephrectomy.

Adult↗
PubMed2002

Toddlers' attention to intentions-in-action in learning novel action words.

Toddlers' ability to use cues such as eye gaze and gestures to infer the meaning of novel action words was examined. In Experiment 1, 21- and 27-month-olds were taught labels for pairs of videotaped actions that were either similar or dissimilar in appearance. Similar actions differed mainly in the presence of behavioral cues related to the agents' intentions (e.g., extended arms). Only the older children were able to learn the labels for the similar actions. In Experiment 2, 3 new pairs of labels (2 similar, 1 dissimilar) were taught to children in the same age range. Eye gaze and gestures were the main features distinguishing the similar events. The same developmental effect was observed, with only the older children showing learning of both types of verbs and the younger children being impeded by the appearance of the actions. The results show that by the middle of the 2nd year, children begin to consider intentions-in-action when acquiring the meaning of novel action verbs.

Attention↗
PubMed2001

Medical quality assessment by scoring adherence to guideline intentions.

Quality assessment of clinician actions and patient outcomes is a central problem in guideline- or standards-based medical care. In this paper we describe an approach for evaluating and consistently scoring clinician adherence to medical guidelines using the intentions of guideline authors. We present the Quality Indicator Language (QUIL) that may be used to formally specify quality constraints on physician behavior and patient outcomes derived from medical guidelines. We present a modeling and scoring methodology for consistently evaluating multi-step and multi-choice guideline plans based on guideline intentions and their revisions.

Algorithms↗
PubMed1975

Intentionality, degree of damage, and moral judgments.

153 first graders were given Piagetian moral judgment problems with a new simplified methodology as well as the usual story-pair paradigm. The new methodology involved making quantitative judgments about single stories and examined the influence of level of intentionality and degree of damage upon absolute punishment ratings. Contrary to results obtained with a story-pair methodology, it was found that with single stories even 6-year-old children responded to the level of intention in the stories as well as the quantity and quality of damage involved. This suggested that Piaget's methodology may be forcing children to employ a simplifying strategy while under other conditions they are able to perform the mental operations necessary to make complex moral judgments.

Child↗
PubMedDate not supplied

[Determinant beliefs nurses' intentions concerning the presence of parents in neonatal intensive care units].

This study aims at learning about the beliefs, attitudes and social rules which determine the nurse's intention to allow the presence of parents in Neonatal Intensive Care Units. The content of semi-structured interviews conducted with 11 nurses was analyzed by using the Rationalized Action Theory as a theoretical framework. The thematic units enabled the comprehension of the relationship between the nurse's intention and behavior when allowing the presence of parents in Neonatal Intensive Care Units as well as the influence of the nurse's personal beliefs and subjective norms on her behavior.

Adult↗
PubMed1986

[Marriage intentions...and how they turned out].

The results of a follow-up survey conducted in 1985 concerning marriage intentions in the Netherlands are presented. The survey included 83 percent of those who participated in the Netherlands Fertility Survey of 1982. The results indicate that more women actually married during the three years following 1982 than expected to marry. This increase was largely due to marriage among women who had indicated an intention to marry without specifying when. The author concludes that "there will be a decline in the percentage of women who ever get married, but the decline will be less pronounced than was estimated from the 1982 data alone. The question is not only how many people will ever get married, but also at what age they will eventually do so." (SUMMARY IN ENG)

Age Factors↗
PubMed1983

International and internal migration decision making: a value-expectancy based analytical framework of intentions to move from a rural Philippine province.

"The study compares determinants of internal and international migration intentions, drawing upon interview data from a sample of adults in Ilocos Norte, a largely rural province in the Philippines. A regression model is applied to test the relative determinants of intentions to migrate to Manila and to Hawaii. The study is based on a value-expectancy model of migration decision making. The results document the importance of subjective expectations related to the attainment of different values and goals in Manila and Hawaii."

Americas↗