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PubMed2006

Mexican women's reasons for accepting or declining HIV antibody testing in pregnancy.

OBJECTIVE: To determine pregnant women's reasons for accepting or declining the HIV test in Leon, Mexico. DESIGN: A cross-sectional study using a face-to-face questionnaire. SETTING: The antenatal clinic at a tertiary-care referral hospital in Leon, Mexico. PARTICIPANTS: 1184 pregnant women. DATA COLLECTION: Reasons for accepting or declining the HIV antibodies test, socio-economic characteristics and risk factors for HIV were recorded. Blood samples were obtained from women who accepted to be tested, and positive serologies to HIV on duplicate enzyme-linked immunosorbent assay testing were confirmed by Western Blot assay. FINDINGS: 1009 (85.2%) women accepted the HIV antibodies test. The main reason for accepting it was that women felt the test could be beneficial to their babies (45.1%). The two main reasons for rejecting the HIV antibodies test were that women felt the test was unnecessary because their husbands did not have sexual intercourse with other women (32.6%), and because they did not have permission from their husbands for accepting the test (23.5%). None of the women tested positive for HIV antibodies (0 per 1009). KEY CONCLUSIONS: The reasons for accepting the HIV test were similar to those reported in developed countries. One important reason for declining the test was that women did not have their husband's permission. IMPLICATIONS FOR PRACTICE: The acceptance rate for HIV testing in pregnant women could be improved by counselling men on the value of their wives being tested in pregnancy.

AIDS Serodiagnosis↗

PubMed2003

Set theory in diagnostic reasoning.

BACKGROUND: Regarding diagnostic reasoning, the currently taught Bayesian theory is a form of hypothetical-deduction reasoning. Using set theory, we offer syllogism reasoning instead of hypothetical-deductive reasoning and establish an online diagnostic expert system model based on this diagnostic methodology. METHODS: Concepts of set theory were employed to demonstrate diagnostic reasoning. ASP, Vbscript and Microsoft Access were used to establish the expert system and data of 50 cases from Shanghai pulmonary hospital were put into the program to test its efficiency. CONCLUSION: Diagnostic procedure is type of syllogism rather than hypothetical-deductive reasoning.

Cluster Analysis↗

PubMed1999

Reasons for contraceptive discontinuation in women 20-39 years old in New Zealand.

To estimate the frequency and the medical and nonmedical reasons for discontinuation of oral contraceptive (OC), intrauterine device (IUD), and injectable depot medroxyprogesterone acetate (DMPA) use, data from a cohort of experienced contraceptive users in New Zealand are reported. The current analysis consists of 2469 OC, 2072 IUD, and 1721 DMPA users followed over a period of 5 years. The percentage of women who discontinued the use of the method within 24 months after entry into the cohort were 42%, 44%, and 48%, respectively, for OC, IUD, and DMPA; these differences were not statistically significant. The most common reasons given for discontinuing a contraceptive method, regardless of which method was in use, were the desire to conceive, patient preference, no longer needing contraception, and vasectomy. Among the medical reasons, menorrhagia and intermenstrual bleeding were the reasons for discontinuing use of the method in 1.5 and 1.1 times per 100 women-years among DMPA users and in 1.8 and 4.7 times per 100 women-years among OC users. Pelvic pain and infection were reasons for discontinuing contraceptive method, respectively, 4.4 and 4.3 times per 100 women-years among IUD users. In conclusion, the present study confirms, in this New Zealand population, the high discontinuation rate of contraceptive methods reported elsewhere. In contrast with previous suggestions, in this study, irregular bleeding was not an important medical reason for discontinuation of DMPA use.

Adult↗

PubMedDate not supplied

The neural basis of conditional reasoning with arbitrary content.

Behavioral predictions about reasoning have usually contrasted two accounts, Mental Logic and Mental Models. Neuroimaging techniques have been providing new measures that transcend this debate. We tested a hypothesis from Goel and Dolan (2003) that predicts neural activity predominantly in a left parietal-frontal system when participants reason with arbitrary (non-meaningful) materials. In an event-related fMRI investigation, we employed propositional syllogisms, the majority of which involved conditional reasoning. While investigating conditional reasoning generally, we ultimately focused on the neural activity linked to the two valid conditional forms--Modus Ponens (If p then q; p//q) and Modus Tollens (If p then q; not-q//not-p). Consistent with Goel and Dolan (2003), we found a left lateralized parietal frontal network for both inference forms with increasing activation when reasoning becomes more challenging by way of Modus Tollens. These findings show that the previous findings with more complex Aristotlean syllogisms are robust and cast doubt upon accounts of reasoning that accord primary inferential processes uniquely to either the right hemisphere or to language areas.

Adult↗

PubMed2000

The role of the left hemisphere in verbal and spatial reasoning tasks.

Laterality of reasoning processes have long been a source of investigation. Differing formats of verbal and spatial reasoning tasks have meant it has not been possible to extricate true performance level from artefacts of input and output modalities. The Verbal and Spatial Reasoning Test (VESPAR) offers this opportunity, by virtue of matched sets of verbal and spatial inductive reasoning problems. Two series of 40 patients with unilateral left and right hemisphere lesions were tested on two verbal and two spatial subtests of the VESPAR, together with a battery of baseline tests. The performance of the left and right hemisphere lesion cases was compared with a normal standardisation sample. Whereas only the left hemisphere group failed the verbal sections, both left and right hemisphere groups failed the spatial sections. The influence of aphasia on spatial reasoning was considered to be an incomplete explanation for the failure of the left hemisphere group on the spatial sections. It is concluded that this investigation provides firmer evidence of a crucial role for the left hemisphere in both verbal and spatial abstract reasoning processes.

Adult↗

PubMed2001

Functional neuroanatomy of three-term relational reasoning.

In a recent study we demonstrated that reasoning with categorical syllogisms engages two dissociable mechanisms. Reasoning involving concrete sentences engaged a left hemisphere linguistic system while formally identical arguments, involving abstract sentences, recruited a parietal spatial network. The involvement of a parietal visuo-spatial system in abstract syllogism reasoning raised the question whether argument forms involving explicit spatial relations (or relations that can be easily mapped onto spatial relations) are sufficient to engage the parietal system? We addressed this question in an event-related fMRI study of three-term relational reasoning, using sentences with concrete and abstract content. Our findings indicate that both concrete and abstract three-term relational arguments activate a similar bilateral occipital-parietal-frontal network. However, the abstract reasoning condition engendered greater parietal activation than the concrete reasoning condition. We conclude that arguments involving relations that can be easily mapped onto explicit spatial relations engage a visuo-spatial system, irrespective of concrete or abstract content.

Adult↗

PubMed1998

Distinct brain loci in deductive versus probabilistic reasoning.

Deductive versus probabilistic inferences are distinguished by normative theories, but it is unknown whether these two forms of reasoning engage similar cerebral loci. To clarify the matter, positron emission tomography was applied during deductive versus probabilistic reasoning tasks, using identical stimuli. Compared to a language comprehension task involving the same stimuli, both probabilistic and deductive reasoning increased regional cerebral blood flow (rCBF) bilaterally in the mesial frontal region and in the cerebellum. In the direct comparison, probabilistic reasoning increased rCBF in left dorsolateral frontal regions, whereas deductive reasoning enhanced rCBF in associative occipital and parietal regions, with a right hemispheric prevalence. The results suggest that reasoning about syllogisms engages distinct brain mechanisms, depending on the intention to evaluate them deductively versus probabilistically.

Adult↗

PubMed1995

Reasons patients with chest pain delay or do not call 911.

STUDY OBJECTIVE: To determine the reasons patients with suspected acute myocardial infarction (AMI) delay seeking medical care or do not call 911. DESIGN: Telephone interview of patients hospitalized with suspected AMI. SETTING: Nine hospitals in King County, Washington. PARTICIPANTS: Patients admitted to a CCU or ICU between October 1, 1986, and December 31, 1987, with suspected AMI occurring out-of-hospital. Spouses of patients who met criteria but died during the hospitalization also participated. INTERVENTIONS: Hospital records were reviewed, and a 20-minute telephone interview was conducted of patients who reside in King County but do not live in an extended care facility. MEASUREMENTS: Patient demographics, cardiac history, symptoms, time of acute symptom onset, time of emergency department arrival, method of transportation, discharge diagnosis, and hospital outcome were abstracted from hospital records. Circumstances leading to the hospitalization, reasons for delay in seeking care, and reasons for not calling 911 were determined in the telephone interview. RESULTS: In a 15-month period, 5,207 patients were hospitalized for suspected AMI in King County, Washington. Twenty-seven percent had AMI. Median patient delay between symptom onset and hospital arrival was 2 hours. Paramedics transported 45% of all patients. A representative subset of patients (2,316) were interviewed. The main reasons for delay were because the patient thought that the symptoms would go away, because the symptoms were not severe enough, and because the patient thought that the symptoms were caused by another illness. The main reasons for not calling 911 were because the symptoms were not severe enough, because the patient did not think of calling 911, and because the patient thought that self-transport would be faster because of his or her close location to the hospital. CONCLUSION: Maximal benefit from thrombolytic therapy is not realized in a substantial proportion of patients with AMI because of delays in seeking medical care. Knowledge of the reasons patients delay or do not call 911 can help focus efforts on achieving more rapid treatment of patients with AMI.

Adult↗

PubMed2001

Reasons for extraction by dental practitioners in England and Wales: a comparison with 1986 and variations between regions.

OBJECTIVES: To compare reasons for extraction in 1997 and 1986, and to consider regional variations for the 1997 data. METHODS: Random samples of general dental practitioners (GDPs) completed questionnaires for all extractions for 4 weeks in 1986 and in 1997. Reasons for extraction by region were compared for the 1997 data. RESULTS: 220 and 562 GDPs participated in 1986 and 1997, respectively, averaging 24 extractions in 1986 and 20 in 1997. 'Caries' remained the commonest reason for < or =50-year-olds (excluding 'ortho'), but peaked a decade later than in 1986. One-third of 'perio' extractions in both studies were for 51-60-year-olds, but in 1997 there were fewer such extractions for < or =40-year-olds and more for >70-year-olds than in 1986. In 1997 'caries' and 'perio' extractions remained equally common for patients >50 years, but there were far more extractions for both reasons for >80-year-olds. Patients < or =30 years in S. England and in the Midlands/E. Anglia had more 'ortho' than 'caries' extractions, whereas 'caries' predominated in N. England and in Wales. 'Caries' exceeded 'perio' for patients >40 years in Wales, whereas in the three English regions the two reasons were equally frequent. CONCLUSIONS: Comparisons of results of two studies conducted a decade apart indicate that there have been some changes in reasons for extraction. Overall, mean number of extractions per dentist has declined, and it appears that the trend is for extractions due to the common dental diseases to be carried out later in life. The 1997 data also suggest that young patients in Wales and N. England are relatively disadvantaged, having more caries and less orthodontic treatment than those in other parts of England.

Adolescent↗

PubMed2001

The reasons for the extraction of various tooth types in Scotland: a 15-year follow up.

OBJECTIVES: The aim of this survey was to investigate the reasons for extraction of the various tooth types in Scotland. This study replicated one which was undertaken 15 years earlier. A further aim, therefore, was to identify any changes in the frequency of extraction of each tooth type in the 15 years between the two studies. METHODS: The names of every fourth dentist on the list of the Scottish Dental Practice Board were obtained. Four hundred and twenty-five general dental practitioners were asked to record permanent tooth extractions for 1 week. Data requested for each extraction were: the patient's age, gender and dental attendance pattern, the type of tooth removed and the reason for the extraction. RESULTS: Three hundred and fifty-two dentists participated (a response rate of 82.8%). There were 25% fewer teeth extracted per patient and 30% fewer per dentist than in the 1984 study. In 1999, more teeth of most types were extracted from regular attenders whereas, in 1984, more teeth of all types were extracted from irregular attenders. Premolars and first and second molars were the tooth types most frequently extracted in both surveys. In 1999 premolars were the teeth most commonly removed below 21 years of age, accounting for 57.5% of extractions in this age range. Molars accounted for 33.8% of extractions in this age range compared with 52% in 1984. Overall, caries was found to be the principal reason for loss of all tooth types apart from lower incisors which were extracted mainly for periodontal reasons. However, below 21 years, 84.5% of premolar extractions were performed for orthodontic purposes. CONCLUSIONS: Over the last 15 years, the overall number of extractions has reduced and the proportion of extractions from regular attenders has increased. Proportionately more premolars and fewer molars were extracted from under-21-year-olds. This observation can be explained by an increase in orthodontic extractions or a decline in extractions for caries in this age group. However, when extractions from the population as a whole are considered, caries and its sequelae remains the principal reason for loss of all tooth types other than lower incisors which are extracted mainly for periodontal reasons.

Adolescent↗

PubMed2000

Reasons for tooth extraction in Scotland.

OBJECTIVES: A 1984 study investigated the reasons underlying the extraction of teeth in Scotland. The survey described in this paper, used a similar methodology and aimed to determine the reasons for the extraction of permanent teeth by general dental practitioners and investigate changes in the influences on tooth extraction over a 10 year period. METHODS: During a 1 week period in November 1994, 139 general dental practitioners working throughout Scotland, recorded the reasons for all permanent tooth extractions. RESULTS: A total of 917 permanent teeth were extracted from 613 patients, the reason for extraction being stated as dental caries (51%), periodontal disease (21%), orthodontics (11%) and failed endodontics (4%). Trauma, pericoronitis and other reasons accounted for 5.5% of extractions whilst, in 7.5% of cases, patients requested extraction in preference to other treatments. The proportion of extractions attributed to periodontal disease increased from age 31-60 years, but declined thereafter. CONCLUSIONS: Comparing the results with those obtained in the 1984 study, whilst the mean number of teeth extracted by each practitioner had reduced, the overall relative contribution of different reasons for extraction was similar.

Adolescent↗

PubMed2001

Reasons why women have induced abortions in a developing country.

OBJECTIVE: The immediate explanation that women often give for seeking induced abortion is that the pregnancy was unplanned or unwanted. However, the myriad social, economic and health circumstances that underlie such explanations have not yet been fully explored. We wanted to evaluate these factors that lead one to have an abortion. STUDY DESIGN: This prospective study was performed on 588 women applied to our family planning unit to obtain an abortion. Analysis is based on the records of the women's age, educational level, their contraceptive usage and the reasons that they give for having an abortion. We also examined how these reasons were related to women's age, educational attainment and contraceptive choices. RESULTS: The desire to postpone a birth or to stop childbearing is a very common reason given by the women seeking abortion. It is seen that despite the women's desire to postpone or stop childbearing, the majority of them were not using an effective contraceptive method. Women's age is closely related to their reasons for seeking an abortion. On the other hand, we have found no clear association between women's educational level and their main reasons for seeking an abortion. CONCLUSION: Reasons women give for why they seek abortion are often far more complex than simply not intending to become pregnant. While improved contraceptive use can help reduce the unintended pregnancy and abortion, some abortions will remain difficult to prevent, because of limits to women's ability to determine and control all circumstances of their lives.

Abortion, Induced↗

PubMed2005

Racial differences among reasons for participating in research of pregnancy outcomes: the right from the start experience.

BACKGROUND: Historically, racial minorities and women are less likely to participate in medical research than are whites and men. Although much is known about barriers to enrollment for those who decline to participate, much less is known about factors that motivate those who choose to enroll. OBJECTIVE: This study examines the reasons for participation in pregnancy outcomes research and determines whether these reasons varied by race. METHODS: Right From The Start is an ongoing prospective cohort study. Pregnant women aged >or=18 years, who enrolled in and completed the study between December 2000 and June 2003, were interviewed by telephone at the conclusion of their participation and asked about motivators for enrolling. Univariate and bivariate statistics were used to determine the relationship between self-identified race and main reason for participating in the study. Logistic regression was used to adjust for the influence of age, gravidity, education, marital status, and income. RESULTS: A total of 1106 women were interviewed: 735 (66.5%) whites; 285 (25.8%) blacks; 30 (2.7%) Hispanics; and 56 (5.1%) others (Asians, Pacific Islanders). Black women listed a free ultrasound (73/247, 29.6%), contribution to medical knowledge (60/247, 24.3%), wanting to learn about pregnancy health (46/247, 18.6%), and concern about pregnancy health (30.247, 12.1%) as their main reason for participation. Black women were significantly less likely than white women to cite contribution to medical knowledge as the main reason for participation (odds ratio [OR] = 0.44; 95% CI, 0.36-0.63). Blacks were more likely than whites to list wanting to learn about pregnancy health (OR = 3.12; 95% CI, 1.88-5.55) or concern about pregnancy health (OR = 3.0; 95% CI, 1.56-5.94), even after adjusting for age, gravidity, pregnancy loss, education, marital status, and income. CONCLUSIONS: Access to free pregnancy ultrasounds and contribution to medical knowledge were important motivators for both white and black women. However, whereas black women were more likely to report concerns about pregnancy health or pregnancy health education as the main reason for participation, white women were more likely to report a desire to contribute to medical knowledge.

Adult↗

PubMedDate not supplied

Reasons prehospital personnel do not administer aspirin to all patients complaining of chest pain.

INTRODUCTION: Aspirin is administered to patients with acute coronary syndromes (ACSs), but prehospital providers do not administer aspirin to all patients with chest pain that could be secondary to an ACS. OBJECTIVE: To identify reasons prehospital providers fail to administer aspirin to all patients complaining of chest pain. METHODS: A convenience sample of prehospital providers was surveyed as they transported patients with a chief complaint of chest pain to the emergency department. The providers were asked if they had given aspirin, nitroglycerin, or oxygen, or if they utilized a monitor. If the medications had not been administered, the paramedic was asked about the reason. The patient's age and previous cardiac history also was recorded. RESULTS: A total of 52 patients with chest pain who were transported were identified over eight weeks, and all of the providers agreed to participate in the study. Only 13 of the patients (25%) received aspirin. Reasons given for not administering aspirin to the other 39 patients included: (1) chest pain was not felt to be cardiac in 13 patients (33%); (2) 10 patients already had taken aspirin that day (26%); (3) the medical provider was a basic-level emergency medical technician (EMT)-Basic and could not administer aspirin to six patients (15%); (4) pain subsided prior to arrival of emergency medical services (EMS) in these three patients; and (5) other reasons were provided for the remaining seven patients. CONCLUSIONS: The most common reason that paramedics did not administer aspirin was the paramedic's belief that the chest pain was not of a cardiac nature. Another common reason for not giving aspirin was the inability of EMT-Basic providers to administer aspirin.

Aspirin↗

PubMed2002

Mental models in deductive reasoning.

We report research investigating the role of mental models in deduction. The first study deals with conjunctive inferences (from one conjunction and two conditional premises) and disjunctive inferences (from one disjunction and the same two conditionals). The second study examines reasoning from multiple conditionals such as: If e then b; If a then b; If b then c; What follows between a and c? The third study addresses reasoning from different sorts of conditional assertions, including conditionals based on if then, only if, and unless. The paper also presents research on figural effects in syllogistic reasoning, on the effects of structure and believability in reasoning from double conditionals, and on reasoning from factual, counterfactual, and semifactual conditionals. The findings of these studies support the model theory, pose some difficulties for rule theories, and show the influence on reasoning of the linguistic structure and the semantic content of problems.

Cognition↗

PubMed1997

Bias in adolescents' everyday reasoning and its relationship with intellectual ability, personal theories, and self-serving motivation.

The author presented 60 9th- and 12th-graders with hypothetical arguments that contained logical fallacies. Arguments were either consistent or inconsistent with participants' theories. Participants rated the quality and truth of each argument, identified perceived strengths and weaknesses in the arguments, and verbally described hypothetical experiments that could lead to evidence falsifying the claims made in the arguments. Results indicated that intellectual ability, particularly verbal ability, was the best predictor of each index of everyday reasoning. However, neither the ability measures nor age were related to biases in everyday reasoning. Hierarchical multiple regression analyses showed that, for each reasoning variable, adolescents' personal theories accounted for the most variance in reasoning biases. These findings are discussed in terms of the roles that intellectual ability and theory-driven motivation play in everyday reasoning and self-serving adolescent reasoning.

Adolescent↗

PubMed1989

Perceived locus of causality and internalization: examining reasons for acting in two domains.

Theories of internalization typically suggest that self-perceptions of the "causes" of (i.e. reasons for) behavior are differentiated along a continuum of autonomy that contains identifiable gradations. A model of perceived locus of causality (PLOC) is developed, using children's self-reported reasons for acting. In Project 1, external, introjected, identified, and intrinsic types of reasons for achievement-related behaviors are shown to conform to a simplex-like (ordered correlation) structure in four samples. These reason categories are then related to existing measures of PLOC and to motivation. A second project examines 3 reason categories (external, introject, and identification) within the domain of prosocial behavior. Relations with measures of empathy, moral judgement and positive interpersonal relatedness are presented. Finally, the proposed model and conceptualization of PLOC are discussed with regard to intrapersonal versus interpersonal perception, internalization, cause-reason distinctions, and the significance of perceived autonomy in human behavior.

Achievement↗

PubMed1990

Reasoning about the self and relationships in maturity: an integrative complexity analysis of individual differences.

This study examined age (35-55 versus 65-85), gender, and self-concept-orientation differences in reasoning about the self, relationships, and morality, on the basis of the theorizing of Gilligan (1982). Participants were interviewed about general relationship issues, a specific relationship, and about the self. Reasoning was scored for integrative complexity (Suedfeld & Tetlock, 1977). Life experience measures and the standard Kohlberg justice reasoning index were obtained. Results showed gender differences in the connectedness of the self-concept for middle-aged, but not older, adults. No age or gender differences in the complexity of relationship reasoning or in justice reasoning were found. Those with more connected self-concepts reasoned in more complex ways about relationships and about the self.

Adaptation, Psychological↗