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Intent-based process control configuration models.

Process control application engineering would be substantially less expensive if supported with readable self-documentation. An important advance would be models and languages designed to more clearly represent application Intent (as formalized herein), without the usual implementation obscurity. This paper analyzes how Intent, in the sense later defined, can be usefully defined and expressed. Process control has traditionally been defined in terms of a number of automation levels. This supports the intended Intent concept in one way, defining the implementation of higher application goals in terms of lower level ones. But a different, even more useful model is the leveling of physical sciences where each level of problem is best addressed by an appropriate kind of theory, itself dependent on lower level theories. Each theory must be proved by more fundamental theories even though those theories are much too complex to address the higher level problem directly. But more than leveling is needed. At each application level, the associated language should support concepts that make its normal usages clear. It should ensure that appropriate application practices can be expressed transparently in terms of their Intent. It should allow the engineer to clearly relate the result to the expected implementation, allowing him full control over the application. The paper will expand on prior papers to show more generally how these concepts can be developed.

Journal Article↗

Testing a model of absence and intent to stay in employment: a study of registered nurses in Malta.

This study used a cross-sectional, correlational design to test a model of absence and turnover of registered nurses developed from a review of the research literature (Gauci Borda and Norman, 1997). Testing the model involved comparing the relationship between job satisfaction, kinship responsibility, pay, employment opportunity, intent to stay in employment and absence for male and female registered nurses. All registered nurses (n = 254) working in clinical areas on a full-time shift basis, in one large general hospital in Malta were surveyed by questionnaire and their absence data were obtained from the hospital personnel records. A response rate of 67% (n = 171) was achieved. The results showed that nurses were satisfied with their job and intended to stay in their present employment for the next 12 months. Relationships between variables differed between male and female nurses, with job satisfaction being associated with intent to stay for male nurses but not for females and kinship responsibility and intent to stay being associated with absence in female but not male nurses. In contrast to many previous studies of nurses, an association was found between job satisfaction and absence. Several variables, including fear of change, which may influence intent to stay of Maltese nurses, were identified. The proposed model of absence and turnover stood up reasonably well to testing, but the results for the whole sample, and the sub-samples of male and female nurses supported different parts of the model. The main implication for future research is that male and female nurses should be studied separately due to differences found between the two groups.

Absenteeism↗

Intentional limited resection for selected patients with T1 N0 M0 non-small-cell lung cancer: a single-institution study.

OBJECTIVES: To comparatively evaluate lobectomy and limited resection for T1 N0 M0 non-small-cell lung cancer, we reviewed case series with concurrent nonrandomized controls. METHODS: Limited resection with curative intent was performed for 63 patients with T1 N0 M0 non-small-cell lung cancer over a 10-year period. These 63 patients included 46 patients who underwent a segmentectomy as an intentional limited resection. These patients had good pulmonary function and could tolerate a lobectomy in the management of their disease. The other 17 patients underwent wedge resection or segmentectomy as a compromised limited resection because they had poor pulmonary reserve or other limiting factors and could withstand a thoracotomy but could not tolerate a lobectomy in the management of their disease. RESULTS: The 5-year survival was 93% in the intentional resection group. The survival curve for this group was not different from that for 77 patients who underwent the standard operation (lobectomy plus complete mediastinal lymph node dissection) for T1 N0 M0 non-small-cell lung cancer during the same period. The frequency of local/regional recurrence in the intentional resection group was 8.7% (4/46); the recurrence in three patients was situated in the mediastinum. According to multivariate analysis, limited resection was not associated with poor survival. CONCLUSION: Segmentectomy with regional lymph node dissection, including the mediastinum, should be considered as an acceptable alternative treatment for selected patients with T1 N0 M0 disease.

Aged↗

Intention-related activity in the posterior parietal cortex: a review.

Over the last few years it is becoming increasingly apparent that an important role of the posterior parietal cortex is to process sensory information for the purpose of planning actions. We review studies showing that a large component of neural activity in area LIP is related to planning saccades and activity in a nearby parietal reach region (PRR) to reaches. This intention related activity dominates the delay period in delayed movement tasks, and also comprises a substantial component of the transient response. These findings, along with additional anatomical and physiological evidence, lends support to the idea that different cortical areas within the PPC represent plans for different actions. We also found strong modulation of activity when movement plans were changed without changes in the locus of attention. This result suggests that PPC, which has been postulated to play a role in shifting attention, may also play a role in changing movement intentions. Sensory related activity was also present in these tasks and may be related to the stimulus or to attention. These experiments show that there are intention and sensory related activities in the PPC consistent with its proposed role in sensory-motor transformations. These studies also show that care must be taken to measure intention-related signals and not assume that all task dependent modulation in the PPC reflects attention.

Movement↗

A comparison between the effect of intentional modulations and the action of L-dopa on gait in Parkinson's disease.

The aims of the present study were to analyze how L-Dopa allows parkinsonian patients to increase their gait velocity and to compare these L-Dopa-induced modifications with those achieved by consciously attempting to walk as fast as possible (intentional modulations). The 'intentional modulations' of velocity were also compared with those of healthy elderly subjects. The results showed that parkinsonian patients walked more slowly, with shorter strides and shorter durations of swing phase, and longer durations of stance and double support phases, although no differences were observed for cycle duration. The mechanisms involved in increasing gait velocity were found to differ according to whether this was achieved through the action of L-Dopa, or by intentional increases in velocity. Intentional increases in velocity were greater than those caused by the effect of L-Dopa. The patients, however, used efficient strategies to increase their velocity when under the influence of L-Dopa. As L-Dopa leads to a ceiling effect on stride length, the patients can increase their velocity by modifying the cycle to such an extent that it compensates for the limitation in stride length. This strategy effectively increases velocity, despite the L-Dopa ceiling effect. The effects of L-Dopa on locomotion and, more generally, on motor control aspects are discussed.

Aged↗

Intention as a component of the alpha-rhythm response to mental activity.

Many studies of alpha-rhythm reactivity conclude that alpha is selectively attenuated by attention accompanying mental activity. The topography of this attenuation is assumed to match the relevant functional topography of the cortex. But there are reports of apparent increased attention resulting in no change, or even enhanced alpha - the paradoxical response. It is proposed that in this case, alpha amplitude may be dependent on an intention component of behaviour. Some conflicting reports of alpha reactivity to mental processes may then be resolved. It is argued that the classical attention model of alpha is untenable, except for simple sensori-motor responses. Reasons are given to support this and the concept of intention as a neuropsychological variable is introduced. Evidence is presented for a generalisation of an oculomotor model of alpha activity proposed by Wertheim who demonstrated that alpha reduces during attentive, but not during intentive visual behaviour. The generalisation follows from reports of enhanced alpha in the few seconds prior to a skilled action in sport, and by neurophysiological evidence for a separate cortical organisation for perception and action. Varying proportions of attention and intention then add a dimension to the factors influencing alpha blocking which may explain its inconsistent response.

Adult↗

Second-intention healing of exposed facial-scalp bone after Mohs surgery for skin cancer: review of ninety-one cases.

BACKGROUND: Second-intention healing over exposed bone is considered by some to be subject to the complications of pain, infection, and nonhealing. OBJECTIVE: Our purpose was to determine would healing by second intention over exposed scalp or facial bone after Mohs micrographic surgery for skin cancer. METHODS: The chart records of all patients treated between 1981 and 1992 for skin cancer that resulted in exposed bone were identified. RESULTS: There were 115 wounds in 91 patients that were managed by second-intention healing, or partial closure, or both. Three cases of soft tissue infection occurred adjacent to nasal and sinus areas. The overall complication rate was 5.4% (6 of 112 cases) and consisted of localized soft tissue infections (2.7%) and poor wound healing (2.7%). There were no cases of osteomyelitis. Second-intention wound healing was successful in 95% of the wounds. CONCLUSION: The outpatient management of exposed bone after Mohs surgery is relatively safe. Relative risk factors for development of complications include (1) a history of previous x-radiation treatment for skin cancer, (2) manipulation of the operative site, and (3) an open defect located near the nose or exposed sinus cavity.

Adult↗

Treatment of hidradenitis suppurativa with carbon dioxide laser excision and second-intention healing.

BACKGROUND: Hidradenitis suppurativa is a disabling disease. Although medical management can at times control the disease, the treatment of choice is surgical excision. Surgical defects have been managed by second-intention healing, simple surgical closure, or complex surgical repairs. OBJECTIVE: Our purpose was to determine the benefit of carbon dioxide laser excision with healing by second intention to treat lesions of hidradenitis suppurativa. METHODS: We treated seven patients who had axillary and inguinoperineal hidradenitis suppurativa with carbon dioxide laser excision followed by second-intention healing. A total of 12 procedures were performed (five bilateral and two unilateral). Follow-up periods were 10 to 27 months. RESULTS: After a healing time of 4 to 8 weeks, scars were flat and linear. Only one recurrence of hidradenitis suppurativa has been observed; this occurred along the margin of the surgical scar in a previously treated area. Some patients, however, had continued disease activity in untreated areas. All subjects were satisfied with the results of the procedure, and complications were minimal. CONCLUSION: Carbon dioxide laser excision with second-intention healing is safe and effective for hidradenitis suppurativa.

Adult↗

Attitudes, norms, intentions and hedonic responses in the selection of low salt bread in a longitudinal choice experiment.

A total of 61 subjects selected a type of bread twice a week, 15 times in all, to be used in their families at home. Four bread types were available: white, wheat, rye and sour rye, each with two sodium chloride levels (normal salt = NS, low salt = LS, half of the normal level). The subjects' attitudes, norms and buying intentions concerning the LS bread were measured at the beginning and at the end of the experimental period. The data were used to test the feasibility of the Fishbein model for the prediction of buying intention and actual selection. In addition, hedonic responses to the breads were measured. The LS bread was selected in 32-39% of cases in all, depending on the bread type. However, there were large individual differences. The proportion of LS breads chosen decreased during the experimental period for all the four bread types. In accordance with this, buying intentions, attitudes and hedonic responses were less favorable to the LS breads by the end of the experiment. Low salt content was best accepted in sour rye breads. The Fishbein model predicted 38% of the buying intentions and 21% of the actual selections (end measurements). When the hedonic response was inserted into the model, the values were improved to 52 and 32%, respectively. It is concluded that the Fishbein model is a useful frame of reference for human food selection studies, and that its predictive power in this particular field of behavior appears to improve substantially when the hedonic response is included in the model.

Adult↗

Determinants of condom use intentions of university students in Ghana: an application of the theory of reasoned action.

The study examined the applicability of the Theory of Reasoned Action to the study of condom use intentions of students at a university in southern Ghana. The data supported the model, explaining 33% of the variance in students' condom use intentions. Subjective norms and the perceived disadvantages of condom use were significant determinants of intention, with the former being more important. Respondents who intended to use condoms consistently ("intenders") and those with no such intentions ("non-intenders") were equally motivated to comply with the wishes of their significant referents (sexual partners, close friends, parents and medical doctors). The critical difference was that "intenders" consistently held a stronger belief than "non-intenders" that their significant referents approved of condom use. Significantly, whereas "intenders" believed that their sexual partners would approve of condom use, the "non-intenders" held the contrary belief that their partners would disapprove of such behavior. This suggests that AIDS education interventions targeting a similar audience like the university students in this study should shift their foci away from individuals alone and instead, focus simultaneously on individuals, their sexual partners and their broader social networks in order to enhance perceptions of peer acceptance of condom use.

Acquired Immunodeficiency Syndrome↗

The effect of intention to learn novel, environmental sounds on the novelty P3 and old/new recognition memory.

Brain electrical activity was recorded while 32 young adults listened to frequent tones, infrequent target tones, and infrequent novel environmental sounds (some of which repeated). Subjects in the incidental group were not informed about the novel sounds, while subjects in the intentional group were informed and, in addition, were asked to memorize them for a subsequent memory test. Following the novelty oddball task, all subjects were given an old/new sound recognition memory task. The novelty P3 showed a more anterior scalp distribution and an effect of repetition in the incidental compared to the intentional group, suggesting that pre-categorizing the novel sounds influenced how they were processed. For the intentional group only, a subsequent memory effect was elicited by novel sounds that were subsequently recognized compared to those that were not, although both groups showed robust old/new ERP effects during the recognition task. The robust subsequent memory effects in the intentional group were associated with greater recognition accuracy of familiar environmental sounds relative to the incidental group. These data suggest that the encoding activity reflected in the ERP subsequent memory effect may have engendered an advantage in subsequent recognition memory performance.

Acoustic Stimulation↗

Suicidal intent in patients with chronic pain.

Suicidal ideation among individuals suffering from chronically painful conditions has not been widely studied, although rates of completed suicide are believed to be elevated in this population relative to the general population. The psychiatric literature on suicide documents the importance of controlling for the severity of depression when studying factors associated with suicidal ideation, attempts, or completion. The present study examined the relationships between suicidal ideation and the experience of pain, pain-related disability, and pain coping efforts among a sample of individuals experiencing chronically painful conditions. Of 200 patients evaluated on an inpatient rehabilitation unit in a psychiatric service, 13 individuals (6.5%) reported suicidal intent on a commonly used self-report measure of symptoms of depression, the Beck Depression Inventory. This group was compared to a matched (age, sex, pain duration) group of similarly depressed individuals (N=13) and a matched group of non-depressed individuals (N=13) on measures of pain, disability, pain beliefs, and pain coping strategies. A history of a suicide attempt was associated with suicidal intent. Family history of substance abuse was significantly more prevalent among the depressed groups, regardless of suicidal thinking. The depressed/suicidal group and depressed/non-suicidal groups reported higher levels of pain, higher levels of pain-related disability, lower use of active coping, and higher use of passive coping compared to the non-depressed group. The depressed groups did not differ from one another on any of the measures of pain experience. Depression, not suicidal status, consistently predicted level of functioning. The prevalence of suicidal intent was comparable to rates observed in other studies and relatively low. When individuals with chronic pain report suicidal intent, it is imperative that measures preventing self-harm be implemented immediately and the patient's depression be treated aggressively.

Activities of Daily Living↗

Intention-to-treat meets missing data: implications of alternate strategies for analyzing clinical trials data.

True intention-to-treat analyses are rare in reports of randomized clinical trials. To highlight the complex issues that arise in conducting and interpreting data from intention-to-treat analyses in studies with substantial levels of protocol violation (e.g. attrition, noncompliance, or withdrawal of participants), data from a clinical trial of treatment for cocaine dependence were analyzed using three strategies to manage missing data: Strategy 1 addressed the effectiveness of treatments based on data collected from participants up to the point of dropout. Strategy 2 addressed the effectiveness of treatments based on data from the full intended duration of the protocol including data collected after participant dropout. The third strategy used a more novel approach, which used an intention-to-treat strategy for the full duration of the trial and the full sample, but also evaluated the effect of treatment retention outcomes by including an independent variable to reflect active treatment retention as a time-varying covariate. Conclusions about the relative efficacy of the study treatments varied to some extent depending on the analytic strategy used. These findings suggest that investigators should make every effort to conduct intent-to-treat analyses, but also to make use of multiple analytic strategies to fully understand the effects of the treatments studied. Moreover, regardless of the strategy used, investigators should clearly describe their handling of data from participants who violate the protocol.

Data Interpretation, Statistical↗

Canadian menopause study-I: Understanding women's intentions to utilise hormone replacement therapy.

OBJECTIVES: This research examines women's intentions to use or to continue to use HRT, as a function of perceived advantages and disadvantages of HRT and perceived social support for utilising HRT. METHODS: A cross-national sample of 205 pre-, peri-, and postmenopausal women convened in 33 'Women's Health Discussion Groups' in small, mid-sized, and large cities across the regions of Canada. Participants completed close-ended questionnaires assessing perceptions of advantages, disadvantages, and social support for HRT, and intentions to utilise or to continue to utilise HRT in the future. RESULTS: Women who intended to utilise or to continue to utilise HRT, compared with women who did not, perceived significantly more advantages of HRT and significantly more social support for utilising HRT, and did not, in general, differ in their perceptions of the negative side effects of HRT. Regression analysis indicated that perceived advantages of HRT and perceived social support for using HRT, but not perceived negative side effects of HRT, were significantly associated with intentions to utilise or to continue to utilise therapy and explained 46% of the variance in these intentions. CONCLUSIONS: Findings suggest that the importance of perceived health benefits of HRT and perceived social support for HRT may be substantially underestimated, and that the importance of perceived negative side effects of HRT may be substantially overestimated, in understanding women's HRT decision making and in counselling women about initiation or maintenance of therapy.

Adult↗

Predictors of cervical Pap smear screening awareness, intention, and receipt among Vietnamese-American women.

BACKGROUND: Compared with white women, Vietnamese women in the United States have a higher rate of cervical cancer and lower Papanicolau (Pap) test utilization. We evaluated factors associated with awareness of the Pap test, intention to obtain it, and its receipt in Vietnamese-American women. METHODS: In 2000, we conducted a telephone survey of Vietnamese-American women aged >or=18 years living in Santa Clara County, California, and Harris County, Texas. We collected data on sociodemographics, healthcare system access and attitudes, as well as Pap test awareness, attitudes, intentions, and practices. RESULTS: Of 1566 subjects, 74% had heard of the Pap test, and 76% had had at least one. Only 42% of those who never had a Pap test had considered obtaining one. There were no significant differences between the two sites. Women aged >or=65 had the lowest rates for all three outcomes. For all women, younger age, being married, having requested a Pap test, physician recommendation, and preferring a female standby if the doctor was male were associated with Pap test intention. Being married, higher level of education, having a female doctor, having a respectful doctor, having requested the test, and physician recommendation were associated with Pap test receipt. CONCLUSION: Vietnamese-American women have low rates of Pap test awareness, intention, and receipt. The patient-doctor interaction is an important determinant. Efforts to increase Pap test utilization in this population need to be directed at encouraging physicians to offer the Pap test and empowering women to ask for the test.

Adult↗

Intentional and unintentional injury in the State of Nevada: 1989-1992.

INTRODUCTION: Data from a large population-based trauma registry were used to assess risk factors and outcomes associated with injuries that were either caused unintentionally, were self-inflicted, or resulted from an assault. DESIGN: A retrospective analysis was conducted of all cases of serious trauma (N = 19,505) occurring in the State of Nevada during the 4-year period from January 1, 1989, through December 31, 1992. The outcome measures of interest were Injury Severity Score, hospitalization, and mortality. RESULTS: Of all patients with unintentional injuries, 9.9% died compared with 44.8% of those whose injuries were intentionally caused. Nearly half (49.0%) of all deaths occurred in persons who were intentionally injured. Of the intentional injuries, 70% were from assaults. Self-inflicted injuries accounted for 5.2% of all injuries but 28.2% of the deaths in the registry. Firearms were most often used in both assaults (38.8%) and self-inflicted injuries (87.4%). Logistic regressions showed that, compared with unintentional injuries, assaults were more likely to occur in urban counties, among males, African Americans, and young adults. Also, compared with unintentional injuries, self-inflicted injuries were more likely to occur in urban counties, among Caucasian, and the 65+ age group. CONCLUSION: Although the overwhelming number of injuries in the registry were unintentionally caused, deaths from intentionally caused injuries accounted for almost half of all deaths. The data from Nevada's registry provided the ability to identify who is at risk for trauma-related injury and death. Prevention programs should be designed to target these populations. As prevention programs are implemented, trauma registries such as Nevada's will provide a sound source of data for assessing long-term trends in injury patterns.

Adolescent↗

How contraceptive use patterns differ by pregnancy intention: implications for counseling.

To increase awareness of issues to include in contraceptive counseling-the objectives of this study were to evaluate: 1) how contraceptive use patterns (eg, non-use), level of effectiveness of contraceptive method, and sociodemographic characteristics may be associated with the occurrence of unintended pregnancy; 2) patterns of health care use for women with intended and unintended pregnancy; and 3) the association between contraceptive use patterns and sociodemographic characteristics. In-person interviews were conducted with 279 women enrolled in a Medicaid managed care health plan who had been pregnant in the last 5 years. Self-reported measures of pregnancy intention, contraceptive use, and health care use were collected. The relationships of pregnancy intention with contraceptive use patterns, level of effectiveness of contraceptive method used, and patterns of recent health care use were assessed. Differences in contraceptive use patterns by sociodemographic groups were assessed. Seventy-eight percent of women reported an unintended pregnancy. Non-use of birth control the month before conception was reported by 57% of women with unintended pregnancies and 84% of women with intended pregnancies. Use of birth control of low effectiveness was reported by 20% of women with unintended pregnancies and 8% of women with intended pregnancies. Non-use or use of contraceptive methods of low effectiveness did not differ for women in different sociodemographic groups regardless of pregnancy intention status. A majority of women reported recent health care use. Health care providers should be aware that women who have no intention for pregnancy may not be using an effective contraceptive method NOR have an effective pattern of contraceptive use.

Adolescent↗

Influences of visibility, intentions, and probability in a peripheral cuing task.

According to the concept of direct parameter specification, nonconsciously registered information can be processed to the extent that it matches currently active intentions of a person. This prediction was tested and confirmed in the current study. Masked visual information provided by peripheral cues led to reaction time (RT) effects only if the information specified one of the required responses (Experiments 1 and 3). Information delivered by the same masked cues that did not match the intentions was not used. However, the same information influenced RT if it was provided by visible cues (Experiments 2 and 3). The results suggest that the processing of nonconsciously registered information is flexible because it is susceptible to the changing intentions of a person. Yet, these processes are apparently restricted, as nonconsciously registered information cannot be used as easily for purposes not corresponding to the currently active intentions as better visible information.

Adult↗