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Adolescents and condoms. Associations of beliefs with intentions to use.

Sexually active adolescents should use condoms to prevent the transmission of sexually transmitted diseases, including human immunodeficiency virus. This study examined, among male and female adolescents, which beliefs about condoms are associated with intentions to use them if they have coitus in the next year. Teenagers attending adolescent health clinics completed self-administered surveys. Although most adolescents knew that condoms prevent sexually transmitted diseases, an increasing belief in the preventive effects of condoms was not associated with an increased motivation to use them. Instead, other immediate, short-term consequences, such as the ease with which they can be used and discomfort associated with their use, were most strongly associated with adolescents' intentions to use condoms. To encourage condom use, messages from physicians and other health care professionals must focus on adolescents' beliefs that are most likely to encourage or inhibit use of condoms. Health considerations should not be the sole emphasis of such communications if the goal is to increase the use of condoms among sexually active adolescents.

Adolescent↗

Do intentions predict fertility? The experience in Taiwan, 1967-74.

Are responses to survey questions about desire for additional children useful in predicting future fertility? Data from Taiwan covering the years 1967--74, a period of rapid fertility decline and increasing contraceptive practice, indicate that reproductive intentions and contraceptive use were very good predictors of subsequent fertility. Whether more children were wanted was itself the most important determinant of contraceptive use. Aggregate consistency between attitudes and behavior was higher than found in US surveys during the same period. Similar studies are needed to determine whether statements of intentions have predictive value in other settings as well.

Adolescent↗

Cigarette smoking intentions and physical fitness: a multivariate study of high school males.

This study was conducted to determine the extent to which several measures of physical fitness, treated compositely and individually, vary among adolescent males differentiated according to cigarette smoking status (i.e., strong intenders, mild intenders, and nonintenders). A total of 381 high school males were administered The Physical Performance Test for California to measure six traits of physical fitness, and a written questionnaire to assess smoking intentions and demographic data. As hypothesized, the teenage males who reported no intentions of smoking cigarettes were significantly more physically fit than were mild intenders and strong intenders, especially the latter. Etiological factors mediating the association are discussed within an underlying theme of prevention and cessation of the habit.

Adolescent↗

Health locus of control and self-esteem as related to adolescent health behavior and intentions.

A health behavior and attitudes questionnaire was administered to 246 fifth-grade and 265 sixth-grade students during class time. The questions included 20 children's health locus of control (CHLC) items reported by Parcel and Meyer (1978), 17 children's self-esteem (CSE) items modified from those reported by Coopersmith (1967), and questions concerning past and current behavior and future intentions with respect to cigarette smoking, alcohol use, and marijuana use. The results indicate that the relationships between dimensions of children's health locus of control and self-esteem and their behaviors and intentions are not large enough to suggest that intervention programs directed at the prevention of detrimental health behaviors focus on the enhancement of self-esteem or the internal locus of control. An appropriate test of the efficacy of such an approach requires a longitudinal rather than a cross-sectional study, monitoring changes in the levels of self-esteem and health locus of control and associated changes in health behavior.

Adolescent↗

Sex of previous children and intentions for further births in the United States, 1965-1976.

The research reported herein, using samples of women interviewed in the 1965 and 1970 National Fertility Studies and the 1976 National Survey of Family Growth, shows that the sex of women's previous children has an effect on their subsequent fertility intentions which differs at each parity. The persistence of that effect among women with two children in particular argues strongly for including sex of previous children as an independent variable in models of fertility intentions, since the decline in family size norms makes factors which affect the decision to have (or not have) a third child increasingly important.

Adolescent↗

[Intention and action myoclonus disclosing occupational mercury poisoning].

A 58-year-old laboratory-glassware manufacturer was referred to hospital because of coarse "tremor" of the upper extremities of 16-months-duration. Examination showed severe intention and action myoclonus, confirmed by electromyographic recording, slight memory impairment but was otherwise normal. Mercury levels were high in blood and urine (not in CSF) and, as other causes of myoclonus were excluded, inorganic mercury poisoning, was diagnosed. Only slight unilateral intention tremor persisted after dimercaprol treatment. Inhalation of mercury vapor was the mode of contamination. Myoclonus is the hallmark of severe inorganic mercury intoxication, the main clinical and pathological aspects of which are briefly discussed.

Humans↗

Effects of motor activity on children's intentional and incidental memory for spatial locations.

Kindergartners (means = 57) and third graders (means = 8-7) encountered a large model town in 1 of 3 conditions of motor involvement with the environment: standing, riding, or walking. Half the children in each motor condition were instructed to remember the location of the buildings (international memory), while the remaining children were not given specific memory instructions (incidental memory). Only the kindergartners' accuracy increased as a function of the amount of motor activity. There was no difference between intentional and incidental memory conditions. It was concluded that: (1) Kindergartners depend on motor activity more than third graders to learn about the location of objects in an unfamiliar environment; and (2) the complexity of the spatial task was primarily responsible for equivalent performance in the intentional and incidental memory conditions.

Age Factors↗

Hopelessness, depression, and suicide intent.

Seventy-three inpatients completed Beck's Suicide Ideator Scale, Beck's Hopelessness Scale and the MMPI Depression Scale. As hypothesized, suicide intent was significantly more correlated with hopelessness than with depression. When the effect of hopelessness was removed statistically, there was no relationship between suicide intent and depression.

Adult↗

Specialty intentions of 1995 U.S. medical school graduates and patterns of generalist career choice and decision making.

The authors report on the specialty intentions that graduating students declared on the 1995 AAMC Medical School Graduation Questionnaire (GQ) and compare the pattern of career choices in 1995 with that in 1992. Family practice was the leading choice of graduates in 1995, followed by internal medicine subspecialties and general internal medicine. These choices represented significant gains over those made in these specialties in 1992 and were at the expense of declines in the interest of 1995 graduates for internal medicine specialties, radiology, anesthesiology, obstetrics-gynecology subspecialties, and some other fields. In 1992, 14.6% of graduating students declared plans to pursue careers in one of the generalist specialties; in 1995, 27.6% declared such plans. In 1992, no school graduated 50% or more students with generalist intentions, and only one school reached 40%; in 1995, five schools graduated more than 50%, and another 15 graduated more than 40% who favored generalist careers. Medical schools with significant GQ response rates (110 out of 125) were aggregated by level of generalist production (top 25%, middle 50%, and bottom 25%) according to the percentages of their 1995 graduates selecting careers in the individual generalist specialties of family practice, general internal medicine, and general pediatrics, and in these generalist specialties in toto. Within these groups, the linking of GQ responses to declarations given by the same students on the Matriculating Student Questionnaire (MSQ) made it possible to determine the extent to which graduates' specialty choices represented early interests that were retained or interests acquired later during medical school.(ABSTRACT TRUNCATED AT 250 WORDS)

Career Choice↗

Skin cancer prevention and early detection intentions and behavior.

This longitudinal study examined predictors of (1) skin cancer prevention and early detection intentions and (2) compliance with recommendation for medical follow-up for suspicious skin lesions. Subjects were 324 hospital employees who were at increased risk for skin cancer and who participated in a worksite skin cancer screening program. Based on behavioral self-regulation theory and the Health Belief Model, multivariate analyses showed that optimism, perceived risk, reasons for doing skin self-examination (SSE), and SSE frequency prior to screening were the best predictors of intentions to engage in future health promotion behaviors (i.e., monthly SSE, regular sunscreen use, and participation in a skin cancer screening program the following year). Although our results also showed that optimism, reasons for doing SSE, and SSE frequency were the best predictors of compliance with medical follow-up, these three variables accounted for only a small amount of the variance in compliance with recommended follow-up care.

Adult↗

Do fertility intentions predict subsequent behavior? Evidence from Peninsular Malaysia.

Data from the 1984 Malaysian Population and Family Survey were matched with birth registration records for 1985-87 to determine the accuracy of statements regarding desired family size that were reported in a household survey in predicting subsequent reproductive behavior. The findings of this study were that stated fertility intention provides fairly accurate forecasts of fertility behavior in the subsequent period. In other words, whether a woman has another child is predicted closely by whether she wanted an additional child. Informational, educational, and motivational activities of family planning programs would, therefore, have greater success in reducing family size if fertility intentions were taken into account.

Adolescent↗

The transition to reaching: mapping intention and intrinsic dynamics.

The onset of directed reaching demarks the emergence of a qualitatively new skill. In this study we asked how intentional reaching arises from infants' ongoing, intrinsic movement dynamics, and how first reaches become successively adapted to the task. We observed 4 infants weekly in a standard reaching task and identified the week of first arm-extended reach, and the 2 weeks before and after onset. The infants first reached at ages ranging from 12 to 22 weeks, and they used different strategies to get the toy. 2 infants, whose spontaneous movements were large and vigorous, damped down their fast, forceful movements. The 2 quieter infants generated faster and more energetic movements to lift their arms. The infants modulated reaches in task-appropriate ways in the weeks following onset. Reaching emerges when infants can intentionally adjust the force and compliance of the arm, often using muscle coactivation. These results suggest that the infant central nervous system does not contain programs that detail hand trajectory, joint coordination, and muscle activation patterns. Rather, these patterns are the consequences of the natural dynamics of the system and the active exploration of the match between those dynamics and the task.

Arm↗

Effects of intentional hemodilution on pulmonary stasis and edema in patients and experimental animals.

The therapeutic effects of intentional hemodilution (IHD) on 64 patients of rheumatic mitral valvular disease with chronic pulmonary stasis were estimated. The mean hematocrit was decreased from 0.50 +/- 0.06 to 0.41 +/- 0.04 by withdrawing blood and replacing it with diluent. The whole blood ratio viscosity was decreased from 11.7 +/- 2.4 to 6.4 +/- 0.8 (P < 0.01), the pulmonary arterial pressure was reduced from 6.4 +/- 0.6 to 4.1 +/- 0.5 kPa (0.133 kPa = 1 mmHg) (P < 0.01), the pulmonary vascular resistance brought down from 536.0 +/- 108.0 to 315.0 +/- 62.0 dynes.s.cm-5 (P < 0.01), the cardiac output increased from 3.4 +/- 0.4 to 5.6 +/- 0.5 L/min (P < 0.01), the cardiac index increased from 2.2 +/- 0.5 to 3.5 +/- 0.4 L/min/m2 (P < 0.01), and venous oxygen saturation and oxygen content increased from 28.5 +/- 3.4%, 5.1 +/- 0.5% to 56.0 +/- 5.0%, 11.3 +/- 1.2%, respectively (P < 0.01). The patients' symptoms and signs improved significantly. The protective role of IHD in the early stage of lethal pulmonary edema induced by epinephrine in 39 rabbits and 27 rats was also observed. The experimental data show that intentional hemodilution increased the animals' survival rate (P < 0.01), reduced the pulmonary coefficient, permeability index of Evans blue and protein content in broncho-alveolar lavage fluid (BALF) (all P < 0.01), and alleviated the pathomorphological changes of the lungs of animals in Group IHD were alleviated. The results suggest that IHD acts well in both chronic pulmonary stasis and acute pulmonary edema.

Adolescent↗

Predictors of intention to be sexually active among Tanzanian school children.

This paper presents the results from a study of human immunodeficiency virus/AIDS risk behaviour conducted among primary school children in the Kilimanjaro and Arusha regions of northern Tanzania. The study was guided by the theory of reasoned action, and the decision to have or abstain from sexual intercourse was studied. All sixth and seventh grade pupils at eighteen schools were invited to participate. A total of 2,026 pupils (mean age 14.0 years) participated (participation rate of 85%), representing a wide variety of ethnic, socio-economic and urban-rural groups. Sixty-three percent of the boys and 24% of the girls reported having had their sexual debut. Attitudes, subjective norms and self-efficacy were all predictors of intention to have sexual intercourse within the next three months, but prior behaviour emerged as the strongest predictor of intention. Primary schools appear to be an important arena for HIV/AIDS education in Tanzania and it is recommended that such education be directed toward young adolescents.

Adolescent↗

The impact of patient education about the effect of zidovudine on HIV perinatal transmission: knowledge gain, attitudes, and behavioral intent among women with and at risk of HIV.

The termination of the perinatal HIV transmission trial, ACTG 076, by the Data Safety and Monitoring Board in February 1994 because of the efficacy of zidovudine (ZDV) in substantially reducing maternal-infant HIV transmission has created a considerable need for efficacious patient education approaches and materials for women with and at risk of HIV infection. Complexities surrounding patients' decisions to use ZDV in accordance with the treatment arm protocol of this study must be communicated to women, especially the consequences for both themselves and their potential children. In March 1994, a public-private partnership was formed to develop and test the impact of patient education information on 076 and to explore cultural differences in decision-making surrounding ZDV use during pregnancy. Objectives were (1) to develop an efficacious patient informational booklet on the results of ACTG 076 and (2) to determine the differential attitudes and behavioral intentions of women toward taking AZT during pregnancy. A multi-disciplinary group of providers and researchers developed the patient education booklet and field-tested it in five New York City area sites. Subjects were a multiethnic group of women of childbearing age who were predominantly HIV-positive or at risk of HIV infection (n = 120). This 076 education resulted in a substantial increase in intention to use ZDV to reduce perinatal transmission despite full disclosure of the unknowns (P < .001). There were differences in knowledge acquired between racial/ethnic groups, which must be viewed cautiously since the study did not assess socioeconomic status adequately. Attitudes toward ZDV (P < .05), trust in health care providers (P < .03), and opinions on whether testing should be voluntary (P < .02) also varied by race/ethnicity. Medical Subject Headings (MeSH): perinatal transmission, AIDS education, pregnancy, HIV, ACTG 076.

Adolescent↗

Hemodynamic response to intentionally altered flow continuity of dobutamine and dopamine by an infusion pump in infants.

STUDY OBJECTIVE: To evaluate the effect of an intentional alteration in infusion pump flow continuity on the hemodynamic stability of infants receiving either dobutamine or dopamine. DESIGN: Prospective, open-label study. SETTING: A university-affiliated children's hospital. PATIENTS: Ten hemodynamically stable infants (age 2 wks-10 mo) in intensive care receiving dobutamine (5) or dopamine (5). Three patients received both agents and were studied at independent times. INTERVENTIONS: Dobutamine and dopamine were administered using the Flo-Gard VP pump that delivers an intentional alteration of flow continuity (rate pulse). Heart rate and mean arterial pressure (MAP) were recorded every second. Analysis was based on the measurements obtained from the first 5 minutes on the study pump and the 2 minutes before and after the rate pulse. MEASUREMENTS AND MAIN RESULTS: Although hemodynamic changes in pre- and post-rate pulses were statistically significant (p < 0.05) in some individuals, only one infant had a greater that 10% change in MAP 2 minutes after the rate pulse. Alterations in hemodynamics were not consistent among or within patients. CONCLUSION: In infants requiring dobutamine or dopamine, no clinically significant pharmacodynamic effects were associated with alteration in continuity of drug delivery caused by the single positive rate pulse. Therefore, we conclude there is no contraindication to the use of this infusion pump in hemodynamically stable infants receiving these drugs.

Cardiotonic Agents↗

[Use of hearing aids by the elderly: correlation between intention and behavior].

Hearing in old age has negative consequences for elderly hearing impaired individuals. Most important in aural rehabilitation is the fitting of hearing aids. Problematic is the low use of hearing aids by elderly hearing impaired individuals. Therefore, in the present study predictors of hearing aid use will be analyzed. The theory of planned behavior was used in a sample of 54 men and women with presbyacusis (54-87 years old) for the prediction of hearing aid use. The analyses revealed that actual hearing aid use is influenced mainly by the intention to use hearing aids and by normative beliefs of the person. The intention to use hearing aids is influenced mainly by the attitude towards using hearing aids. Practical implications of the results are discussed: Aural rehabilitation possibly can be improved by changing attitudes toward hearing aid use and asking important members of the social network to participate actively in the aural rehabilitation process.

Aged↗