Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Intention”

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 1,513 records · Page 84Linked to original sources
PubMed2003

Intention-to-treat analysis of Spetzler-Martin grades IV and V arteriovenous malformations: natural history and treatment paradigm.

OBJECT: In this study the authors quantified a subgroup of patients with Spetzler-Martin Grades IV and V arteriovenous malformations (AVMs) recommended for complete, partial, or no treatment, and calculated the retrospective hemorrhage rate for these lesions. METHODS: Between July 1997 and May 2000, 73 consecutive patients with Grades IV and V AVMs were evaluated prospectively by the cerebrovascular team at Barrow Neurological Institute. Treatment recommendations given to the patients or referring physicians were classified as complete treatment, partial treatment, and no treatment. Retrospectively, the hemorrhage rates associated with these treatment groups were also calculated. In the prospective portion of the study (the intention-to-treat analysis), no treatment of the AVM, was recommended for 55 patients (75%) and partial treatment was recommended for seven patients (10%). Aneurysms associated with an AVM were obliterated by surgical or endovascular treatment in seven patients (10%), and complete surgical removal was recommended for four patients (5%). The overall hemorrhage rate for Grades IV and V AVMs was 1.5% per year. The annual risk of hemorrhage was 10.4% among patients who previously had received incomplete treatment, compared with patients without previous treatment. CONCLUSIONS: The hemorrhage risk of 1.5% per year, which was associated with Grades IV and V AVMs appears to be lower than that reported for Grades I through III AVMs. The authors recommend that no treatment be given for most Grades IV and V AVMs. No evidence indicates that partial treatment of an AVM reduces a patient's risk of hemorrhage. In fact, partial treatment may worsen the natural history of an AVM. The authors do not support palliative treatment of AVMs, except in the specific circumstances of arterial or intranidal aneurysms or progressive neurological deficits related to vascular steal. Complete treatment is warranted for patients with progressive neurological deficits caused by hemorrhage of the AVM. This selection process plays a significant role in the relatively low combined morbidity and mortality rates for Grade IV and Grade V AVMs (17 and 22%, respectively) reported by the cerebrovascular group in both retrospective and prospective studies.

Adolescent↗
PubMed2006

Out of mind, but not out of sight: intentional control of visual memory.

Does visual information enjoy automatic, obligatory entry into memory, or, after such information has been seen, can it still be actively excluded? To characterize the process by which visual information could be excluded from memory, we used Sternberg's (1966, 1975) recognition paradigm, measuring visual episodic memory for compound grating stimuli. Because recognition declines as additional study items enter memory, episodic recognition performance provides a sensitive index of memory's contents. Three experiments showed that an item occupying a fixed serial position in a series of study items could be intentionally excluded from memory. In addition, exclusion does not depend on low-level information, such as the stimulus's spatial location, orientation, or spatial frequency, and does not depend on the precise timing of irrelevant information, which suggests that the exclusionprocess is triggered by some event during a trial. The results, interpreted within the framework of a summed similarity model for visual recognition, suggest that exclusion operates after considerable visual processing of the to-be-excluded item.

Adolescent↗
PubMed2005

Perspective taking during reading: an on-line investigation of the illusory transparency of intention.

Although proficient readers must be reasonably successful at keeping track of what information they share with characters and what information is privileged to them, there is evidence that they are unable to do so with complete accuracy. Keysar (1994) used off-line tasks to demonstrate that readers sometimes mistakenly use privileged information when evaluating a character's interpretation of an ambiguous message. After we replicated Keysar's (1994) findings (Experiment 1), the results of an on-line task indicated that this "illusory transparency of intention" extends to natural reading (Experiment 2). In Experiment 3, we provided preliminary support for the hypothesis that readers' accuracy in assessing a given character's perspective is influenced by whether or not that character is in the focus of the story. The results are discussed with regard to two competing theoretical views: the construal view and the standard view.

Affect↗
PubMed2004

False recognition without intentional learning.

Asked to memorize a list of semantically related words, participants often falsely recall or recognize a highly related semantic associate that has not been presented (the critical lure). Does this false memory phenomenon depend on intentional word reading and learning? In Experiment 1, participants performed a color identification task on distractor words from typical false memory lists. In Experiment 2, participants read the same words. In both experiments, the primary task was followed by a surprise recognition test for actually presented and unpresented words, including the critical lures. False alarms to critical lures were robust and quite equivalent across the two experiments. These results are consistent with an activation/monitoring account of false memory, in which processing of semantic associates can evoke false memories even when that processing is incidental.

Color Perception↗
PubMed2003

Conundrums with penumbras: the right to privacy encompasses non-gamete providers who create preembryos with the intent to become parents.

To date, five state high courts have resolved disputes over frozen preembryos. These disputes arose during divorce proceedings between couples who had previously used assisted reproduction and cryopreserved excess preembryos. In each case, one spouse wished to have the preembryos destroyed, while the other wanted to be able to use or donate them in the future. The parties in these cases invoked the constitutional right to privacy to argue for dispositional control over the preembryos; two of the five cases were resolved by relying on this right. The constitutional right to privacy protects intimate decisions involving procreation, marriage, and family life. However, when couples use donated sperm or ova to create preembryos, a unique circumstance arises: one spouse--the gamete provider--is genetically related to the preembryos and the other is not. If courts resolve frozen preembryo disputes that involve non-gamete providers based on the constitutional right to privacy, they should find that the constitutional right to privacy encompasses the interests of both gamete and non-gamete providers. Individuals who create preembryos with the intent to become a parent have made an intimate decision involving procreation, marriage, and family life that falls squarely within the the right to privacy. In such cases, the couple together made the decision to create a family through the use of assisted reproduction, and the preembryos would not exist but for that joint decision. Therefore, gamete and non-gamete providers should be afforded equal constitutional protection in disputes over frozen preembryos.

Contracts↗
PubMedDate not supplied

Perceptions of empowerment and intent to stay.

Investigating why nurses remain in organizations may serve as a stepping stone for future retention strategies. The relationship between intent to stay and workplace empowerment in nurses are described in this continuing education article.

Adult↗
PubMed1978

Intentional surgical overcorrection of acquired esotropia.

Fifty-eight patients with surgically treated acquired nonaccommodative esotropia were studied retrospectively, to ascertain what immediate surgical result gives the best chance for a postoperative bifoveal fusional result. Of the cases that were initially overcorrected (exodeviations), approximately two thirds were fusing six months or more after surgery. Of the cases that were initially aligned (orthophoric) or undercorrected (esodeviations), only one third were fusing after the same period. These results suggest that intentional surgical overcorrection of cases of acquired nonaccommodative esotropia that have a good fusional potential (ie, equal vision) does appear to be a desirable goal for the immediate postoperative period.

Adolescent↗
PubMed1994

Routine long-term follow-up in patients treated with curative intent for squamous cell carcinoma of the larynx, pharynx, and oral cavity. Does it make sense?

OBJECTIVE: To evaluate whether additional curative treatment was possible in patients for whom routine long-term follow-up had led to the early detection of locoregional recurrence, distant metastases, and second primary tumors (events). DESIGN: Cohort study with a maximum follow-up of 126 months and a consensus questionnaire. SETTING: Department of Head and Neck Oncology at the University Hospital Nijmegen (the Netherlands). PATIENTS: There were 428 patients treated with curative intent for carcinoma of the larynx, pharynx, and oral cavity from 1979 to 1983. MAIN OUTCOME MEASURES: Site, stage, differentiation grade, and type of treatment of index tumor (routine follow-up vs self-referral). RESULTS: There were 205 patients (47.9%) who developed events, 76.1% within 3 years of initial treatment. Eighty-nine patients (43.4%) received curative treatment. The detection rate for events during routine follow-up (6350 appointments) was one in 34, and for self-referrals (54) it was one in 2.7; the cure rates were one in 78 and one in 6.8, respectively. The mean survival after detection of events with routine follow-up was significantly (P < .05) better than with self-referral (58 vs 32 months, respectively). CONCLUSIONS: Routine follow-up is indispensible. Site and stage of the index tumor played a part in the length of routine follow-up, in contrast to the differentiation grade or type of initial treatment. Yearly chest roentgenograms were valuable only for laryngeal index tumors. Patients considered routine follow-up important; however, negative findings at physical examination of complaints did not reassure all patients.

Adolescent↗
PubMed1997

Healing by second intention following Mohs micrographic surgery.

Healing by second intention is a reconstructive option that is underused by many surgeons who treat skin cancers of the head and neck. Deutsch and Becker's article in the May issue of the ARCHIVES is a welcome addition to the sparse literature on the subject.

Cicatrix↗
PubMed1988

Intentional ipecac poisoning in children.

Ipecac (emetine) is a safe emetic for emergency home use. Its ready availability also provides the potential for child abuse and chronic self-induced emesis. The chronic administration of Ipecac can result in unusual symptom complexes such as chronic diarrhea and vomiting, muscle weakness, colitis, cardiomyopathy, fever, edema, or electrolyte disturbances. We describe patients who were intentionally poisoned and who demonstrated these symptoms. Because of the widespread use of ipecac for therapy in acute accidental poisonings, toxicology laboratories may not look for or report the presence of this drug in their routine screens. This may delay the recognition of chronic ipecac poisoning in patients.

Child Abuse↗
PubMed1977

The value of healing by secondary intention for sizeable defects of the face.

Sizeable facial wounds from trauma or tumor excision were allowed to heal by secondary intention in 20 patients. Because of its many advantages, including simplicity and satisfactory outcome as well as absence of donor site scarring, this most ancient mode of wound repair may be the procedure of choice under certain circumstances. The surgeon should not always feel compelled to use a flap or graft on the face when simple closure is not possible and when "nature" is available.

Adolescent↗
PubMed2007

Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer: a randomized controlled trial.

CONTEXT: The role of adjuvant therapy in resectable pancreatic cancer is still uncertain, and no recommended standard exists. OBJECTIVE: To test the hypothesis that adjuvant chemotherapy with gemcitabine administered after complete resection of pancreatic cancer improves disease-free survival by 6 months or more. DESIGN, SETTING, AND PATIENTS: Open, multicenter, randomized controlled phase 3 trial with stratification for resection, tumor, and node status. Conducted from July 1998 to December 2004 in the outpatient setting at 88 academic and community-based oncology centers in Germany and Austria. A total of 368 patients with gross complete (R0 or R1) resection of pancreatic cancer and no prior radiation or chemotherapy were enrolled into 2 groups. INTERVENTION: Patients received adjuvant chemotherapy with 6 cycles of gemcitabine on days 1, 8, and 15 every 4 weeks (n = 179), or observation ([control] n = 175). MAIN OUTCOME MEASURES: Primary end point was disease-free survival, and secondary end points were overall survival, toxicity, and quality of life. Survival analysis was based on all eligible patients (intention-to-treat). RESULTS: More than 80% of patients had R0 resection. The median number of chemotherapy cycles in the gemcitabine group was 6 (range, 0-6). Grade 3 or 4 toxicities rarely occurred with no difference in quality of life (by Spitzer index) between groups. During median follow-up of 53 months, 133 patients (74%) in the gemcitabine group and 161 patients (92%) in the control group developed recurrent disease. Median disease-free survival was 13.4 months in the gemcitabine group (95% confidence interval, 11.4-15.3) and 6.9 months in the control group (95% confidence interval, 6.1-7.8; P<.001, log-rank). Estimated disease-free survival at 3 and 5 years was 23.5% and 16.5% in the gemcitabine group, and 7.5% and 5.5% in the control group, respectively. Subgroup analyses showed that the effect of gemcitabine on disease-free survival was significant in patients with either R0 or R1 resection. There was no difference in overall survival between the gemcitabine group (median, 22.1 months; 95% confidence interval, 18.4-25.8; estimated survival, 34% at 3 years and 22.5% at 5 years) and the control group (median, 20.2 months; 95% confidence interval, 17-23.4; estimated survival, 20.5% at 3 years and 11.5% at 5 years; P = .06, log-rank). CONCLUSIONS: Postoperative gemcitabine significantly delayed the development of recurrent disease after complete resection of pancreatic cancer compared with observation alone. These results support the use of gemcitabine as adjuvant chemotherapy in resectable carcinoma of the pancreas. TRIAL REGISTRATION: isrctn.org Identifier: ISRCTN34802808.

Adult↗
PubMed1998

DNA ploidy and survival of patients with clinically localized prostate cancer treated without intent to cure.

BACKGROUND: The optimal approach to diagnosis and treatment of localized prostate cancer remains controversial. Deoxyribonucleic acid (DNA) ploidy has been suggested as an important predictor for outcome in prostate cancer. The purpose of this study was to correlate DNA ploidy with disease-specific survival in patients with clinically localized prostate cancer treated with no intent to cure. METHODS: DNA ploidy was determined by flow cytometry in archival formalin fixed, paraffin embedded tumor tissue obtained at diagnosis in 120 patients with clinically localized prostate cancer with a nearly complete follow-up. RESULTS: Ninety (75%) of the tumors were diploid, while only 11 (9%) tumors were categorized as tetraploid. Tumor DNA ploidy (diploid versus nondiploid) significantly associated with histopathological grade (P=0.002) and disease-specific survival (P=0.011), while there was no association with tumor stage (P=0.054). In a multivariate Cox analysis, histopathological grade (P=0.005) was the only significant predictor of disease-specific death, while analyzing the 96 low-grade tumors separately, DNA ploidy became significant (P= 0.024). CONCLUSIONS: Flow cytometric determined nondiploidy was associated with disease-specific death in patients with clinically localized prostate cancer, but DNA ploidy provided additional prognostic information in patients with low-grade tumors only.

Aged↗
PubMed1994

Epidermoid carcinoma of the anal canal. Results of curative-intent radiation therapy in a series of 270 patients.

BACKGROUND: Epidermoid carcinoma of the anal canal is an uncommon disease, and most institutions have only a small series of patients. The current study of a large series of patients treated with radiation therapy in a single institution evaluates the outcome, prognostic factors, and the late complications for these patients. METHODS: From 1972 to 1991, 270 patients with anal canal epidermoid carcinoma without evident distant metastasis were irradiated with curative intent in the Radiotherapy Department of Tenon Hospital. The sex ratio was 1 man/5.7 women, with a mean age of 67.5 years. The histology included 59.6% well-differentiated epidermoid carcinoma, 32.2% moderately or poorly differentiated epidermoid carcinoma, and 8.2% cloacogenic. The T-classification was: T1: 8.5%; T2: 51.1%; T3: 30.4%; T4: 10%. Abnormal inguinal lymph nodes were present in 12.5% of the patients. Patients were irradiated by external beam. They received a first course of photon irradiation consisting of (mostly 18 mV or 25 mVl; some Co60 or 6 mV) 40-45 Gy (box technique) in the pelvis for 4-5 weeks. After a rest of 4-6 weeks, a second course of 15-20 gy in 2 weeks was given through a perineal field by an electron beam of suitable energy. When rectal involvement was important, a four-field, small box technique was used. Fourteen patients were given a booster irradiation of 30 Gy by interstitial brachytherapy (Iridium 192 sources), and four patients were treated with interstitial brachytherapy alone, to a mean dose of 62.5 Gy. RESULTS: At 5 and 10 years, determinate survival rates were: T1: 86% and 86%; T2: 86.2% and 82.5%; T3: 60.1% and 56.8%; T4: 45% and 45%, respectively. The overall local control rate was 80%. The overall anal conservation rate was 67%. In 154 patients (57%), the anus had maintained its normal function. At 5 and 10 years, determinate survival was 76% and 73.7%, respectively, for N0 and 53.5 and 53.5% for clinically involved inguinal lymph nodes. According to the log-rank test, survival comparisons between T2 and T3 classifications and of tumor sizes less than or equal to 4 cm in length and greater than or equal to 5 cm in length were significant (P = 0.0001 and P < 0.0001, respectively). The presence of clinical abnormal inguinal lymph nodes had a significant negative influence on survival rates (P = 0.047). Multivariate analysis indicated that T-classification and tumor size in centimeters were the only predictive variables. Nonpredictive variables included nodal status, histology, age, total dose, overall treatment time, and irradiation technique. The grade 3 complication rate requiring surgical treatment was 27/270 (10%), considering all patients (27/190 represents a 14% rate for patients who had local tumor control after radiation therapy alone without secondary salvage amputation). There was no significant relationship between complication rate and the aforementioned variables. Because of the homogeneity of the irradiation doses, no significant relationship was found between dose, local control rate, or complication rate. CONCLUSIONS: After radiation therapy, recognizing the distinction between tumor sizes of less than or equal to 4 cm in length and more than 4 cm in length (which is not considered in TNM Classification criteria [International Union Against Cancer, 1987]) could help to improve treatment strategies. For tumors more than 4 cm in length and/or with clinically involved lymph nodes, the treatment should be more extensive with combined chemotherapy and radiation therapy, but the increased local control with the addition of cytotoxic chemotherapy to irradiation has not been proven.

Adult↗
PubMed1976

Semantic differential ratings of concepts and suicide intent.

Ninety-four Ss (28 attempters, 32 threateners and 34 psychiatric controls) rated 10 concepts twice 1 month apart. Extreme rating scores and factor (attitude) scores were derived from the ratings. Suicidal Ss made no more use of extreme ratings than did control Ss. Highly suicidal Ss did not differ from less suicidal Ss in extremeness of ratings. Suicidal Ss did report less favorable attitudes to the concepts life and myself and more favorable attitudes toward suicide. Highly suicidal Ss could be differentiated from less suicidal Ss on these concepts. Contrary to the theory of Neuringer and Lettieri, it was suggested that suicidal Ss do not show a general difference in cognitive style from other psychiatric patients. Concept rated and direction of rating are crucial. Significant changes in ratings occurred over time in conjunction with hopelessness, depression and self-rated suicide intent. It was suggested that these changes indicate that the ratings are a function of a state, rather than a stable trait.

Adult↗
PubMed1989

Intentional cranial vault deformation and induced changes of the cranial base and face.

Three morphologically distinct populations of Peruvian crania (n = 130) were metrically analysed to quantify changes resulting from intentional artificial vault deformation. Two of these samples are artificially deformed (anteroposterior [AP] and circumferential [C] types). Measurements taken from lateral radiographs demonstrated that alternative forms of the cranial base angle (N-S-Ba, planum angle, planum sphenoidale to plane of the clivus and PANG angle, planum sphenoidale to basion-sella plane) and the orbital and OANG angles (orbital roof to plane of the clivus and basion-sella plane, respectively) of both deformed groups increased while the angle S-Ba-O decreased significantly with respect to the undeformed (N) sample. Changes in the AP group are largely due to anteroinferior displacement of the basion-sella plane. Similar changes in group C are amplified by this group's posterosuperior frontal migration. This migration results in a relatively shallow orbit at the orbital plate/frontal squama interface. Unlike the deformation experienced by the external vault plates, the basion-sella plane orientation remains stable with respect to the Frankfort Horizontal. Additionally, nasal region measurements such as maximum nasal aperture breadth and nasal height were largely stable between each deformed group and the undeformed group. However, facial (bimaxillary and bizygomatic), basicranial, cranial, and frontal breadths decreased significantly from group AP to group N to group C. Thus, gross morphological facial changes between each undeformed group and the control group are largely accounted for by dimensional changes in peripheral structures. These results stress the importance of the dynamic interrelationship between the cranial vault and base in the development of the craniofacial complex.

Cephalometry↗
PubMed2005

Violation of the intent-to-treat principle and rate of missing data in superiority trials assessing structural outcomes in rheumatic diseases.

OBJECTIVE: To evaluate the methodologic quality of and identify methodologic issues in superiority trials assessing structural outcomes in rheumatic diseases. METHODS: We searched Medline and the Cochrane Central Register of Controlled Trials for reports of randomized controlled trials assessing structural outcomes in osteoarthritis (OA), rheumatoid arthritis (RA), and osteoporosis (OP) published between January 1994 and December 2003 in high-impact factor general medical and specialty journals. One reader extracted data (quality assessment, intent-to-treat analysis [ITT analysis], rate of missing data, and methods of handling missing data), using a standardized form. RESULTS: A total of 81 reports were included in the analysis (37 on OP, 34 on RA, and 10 on OA). The mean +/- SD methodologic quality scores on the Jadad scale (possible range 0-5) and the Delphi list (possible range 0-9) were 2.9 +/- 1.2 and 6.4 +/- 1.3, respectively. Although it was reported in 54 articles (66.7%) that the analysis was done on an ITT basis, full ITT analysis was performed in only 6 of the studies (7.4%), modified ITT analysis in 11 (13.6%), and case-complete analysis in 48 (59.3%); the analysis was unclear in 16 articles (19.8%). The rate of missing data on structural outcomes could be determined in only 63 articles (77.8%) and was >20% in approximately one-third of these reports. Methods for handling missing data on structural outcomes were described in 19 articles (23.5%) and were, in general, inappropriate. CONCLUSION: Lack of ITT analysis and a high rate of missing data in superiority trials assessing structural outcomes may bias results from such trials. Our recommendations for improving these shortcomings may help researchers plan, analyze, and report the results of such trials.

Arthritis, Rheumatoid↗