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PubMed1993

Clinical components of suicidal intent in adolescent overdose.

Previous research has found that adolescents' statements about an overdose do not correlate well with their actions. This study examined the Beck Suicide Intent scale, which questions adolescents on their actions surrounding an overdose and on their beliefs as to its seriousness, in 50 adolescents after an overdose. The correlation between actions and belief was only 0.24. A factor analysis of the Beck Suicide Intent scale identified four factors labeled expressed intent, planning, concealment, and communication. It is suggested these factors could help clinicians making qualitative assessments of adolescent overdose.

Adolescent↗

PubMed2002

Nurses' job satisfaction, organizational commitment, and career intent.

OBJECTIVE: The objective of this survey was to define the characteristics of the nursing work force of a mixed urban/rural region of New York state and to determine the nurses' level of job satisfaction and commitment to the work setting. BACKGROUND: Recent investigations suggest nurses are highly dissatisfied with the demands of the healthcare environment and are expressing increased likelihood of leaving the work setting. These factors, in combination with the increasing age of the current nursing work force, are contributing to serious concerns about the future of patient care. METHODS: A random sample survey was mailed to registered nurses in the Finger Lakes Region of New York State in June 2000. Items in the questionnaire addressed nurse characteristics, reasons for leaving or staying with an employing agency, one- and five-year career intent, and level of job satisfaction and organizational commitment. RESULTS: Forty-six percent of the nurses returned completed questionnaires. Within this sample, most of the nurses were older, European American, and female. Personal and organizational characteristics contributed to differences in levels of job satisfaction, organizational commitment, and 1- and 5-year intent. In addition, many of the most satisfied and committed nurses reported their intent to leave nursing within the next 5 years. CONCLUSIONS: Findings of this investigation suggest the organizational environment, educational preparation, and personal characteristics of currently employed registered nurses affect their current job satisfaction, organizational commitment, and plans for continuing as a nurse.

Adult↗

PubMedDate not supplied

Predictors of sexual intercourse and condom use intentions among Spanish-dominant Latino youth: a test of the planned behavior theory.

BACKGROUND: Spanish-dominant Latino youth represent a growing yet underserved segment of the U.S. population, especially in terms of protection from sexually transmitted HIV infection. There is evidence to suggest that this subgroup engages in both risk and protective behaviors that may be different from the behaviors of English-dominant Latino youth. OBJECTIVE: To examine theoretical predictors (attitude, subjective norm, behavioral beliefs, normative beliefs, control beliefs) of sexual intercourse and condom use with a sample of Spanish-dominant Latino youth. METHODS: Participants in this study were part of a larger randomized controlled intervention designed to reduce the risk of sexually transmitted HIV among Latino youth. This article is based on preintervention data from 141 Spanish-speaking Latino adolescents (77 girls and 64 boys) who completed a Spanish version of the questionnaire. RESULTS: Multiple regression analyses showed significant effects of attitudes, perceived partner approval, self-pride, and parental pride on intentions to engage in sexual intercourse. Attitudes, intentions to engage in sex in the next 3 months, self-pride, parental pride, goals, and partner approval predicted sexual intercourse in the preceding 3 months. Attitudes, subjective norms, self-efficacy, partner and parental approval, and impulse control beliefs were significant predictors of intentions to use condoms. CONCLUSIONS: This study represents initial efforts to address the needs of Spanish-dominant Latino youth. The identification of salient beliefs that may predict sexual risk and protective behavior are relevant to the design of culturally and linguistically effective interventions.

Adolescent↗

PubMedDate not supplied

University students' intention to seek medical care promptly if symptoms of sexually transmitted diseases were suspected.

The aim of this study was to identify the factors explaining intention to seek medical care promptly if STD symptoms were suspected. A random sample of 1617 undergraduate students completed a questionnaire assessing intention, attitude, perceived norm among friends, perceived behavioral control, and risk of disease, along with different socio-demographic variables. The regression of intention on all variables yielded an adjusted R2 of 0.32 (P < 0.0001). The factors explaining this variance were the perceived advantages, easiness, and social norm among friends regarding seeking medical care promptly, age, and gender. Perception of risk to delay seeking medical care and perceived personal risk of getting STDs were not significant variables. Overall, the results indicate the need to develop programs for male first-year students. These programs will have to influence the attitude, that is, the perceived advantages of seeking medical care promptly if STD symptoms are suspected. Seeking advice from students' friends, and perception of these friends as a significant reference source if STD symptoms are suspected, should also be promoted.

Adolescent↗

PubMed1990

The prediction of intention to smoke only in designated work site areas.

The aim of the study was to identify the psychosocial factors influencing intention to smoke only in work site areas designated for smoking. The subjects were 71 cigarette smokers who completed a questionnaire investigating intentions, attitudes, subjective social norm, perceived control, past behavior, role beliefs, personal normative belief, and self-efficacy regarding smoking only in restricted work site areas. The regression of intention on all variables yielded an adjusted R2 of .76 (P less than .0001), with personal normative belief (beta = .55, P less than .0001), perceived self-efficacy (beta = .26, P less than .005), and perceived barriers (beta = .19, P less than .05) being the significant predictors. The results suggest that access to designated areas should be facilitated if the aim of the policy is to ensure that smokers smoke only in these areas. If the purpose of the smoking policy, however, is to put additional pressure on smokers in designating only a limited number of smoking areas, then enforcement of the policy is a necessary condition for smoker compliance.

Adult↗

PubMedDate not supplied

Hospital nurses' intentions to remain: exploring a northern context.

Retaining nurses is of significant concern to all hospitals but even more of a concern to northern and rural hospital managers. This study provides insights into factors related to nurses' intentions to remain. A sample of 122 nurses from 13 northern hospitals in Western Canada participated in the study. The nurses completed questionnaires and participated in structured interviews. A model was proposed which suggested that work experiences (job and decision latitude, feedback, perceptions of how viewed and treated by others, fairness of policies, and safety of the job environment) would be related to job satisfaction and then affective commitment. Age and tenure, and ties to the community were proposed as predictors of continuance commitment. Both affective and continuance commitments were expected to be related to intention to remain in the hospital. The model was partially supported by regression analyses. Work experiences predicted job satisfaction and affective commitment. Affective commitment, continuance commitment, and ties to the community are related to nurses' intentions to remain. Supplemental analyses indicated that the strongest relationships were found for management's views and treatment of nurses, knowledge and ability utilization, safe environment, and fairness of organizational policies.

Attitude↗

PubMed2006

Organizational climate and intensive care unit nurses' intention to leave.

OBJECTIVE: The purposes of this study were to a) estimate the incidence of intensive care units nurses' intention to leave due to working conditions; and b) identify factors predicting this phenomenon. DESIGN: Cross-sectional design. SETTING: Hospitals and critical care units. SUBJECTS: Registered nurses (RNs) employed in adult intensive care units. INTERVENTIONS: Organizational climate, nurse demographics, intention to leave, and reason for intending to leave were collected using a self-report survey. MEASUREMENTS AND MAIN RESULTS: Nurses were categorized into two groups: a) those intending to leave due to working conditions; and b) others (e.g., those not leaving or retirees). The measure of organizational climate had seven subscales: professional practice, staffing/resource adequacy, nurse management, nursing process, nurse/physician collaboration, nurse competence, and positive scheduling climate. Setting characteristics came from American Hospital Association data and a survey of chief nursing officers. RESULTS: A total of 2,323 RNs from 66 hospitals and 110 critical care units were surveyed across the nation. On average, the RN was 39.5 yrs old (SD = 9.40), had 15.6 yrs (SD = 9.20) experience in health care, and had worked in his or her current position for 8.0 yrs (SD = 7.50). Seventeen percent (n = 391) of the respondents indicated intending to leave their position in the coming year. Of those, 52% (n = 202) reported that the reason was due to working conditions. Organizational climate factors that had an independent effect on intensive care unit nurse intention to leave due to working conditions were professional practice, nurse competence, and tenure (p < .05). CONCLUSIONS: Improving professional practice in the work environment and clinical competence of the nurses as well as supporting new hires may reduce turnover and help ensure a stable and qualified workforce.

Adult↗

PubMed2003

Effect of intentional cryo-injury to the renal collecting system.

PURPOSE: We determined the short-term and long-term sequelae of intentional cryoablation of the renal pelvicaliceal system and evaluated whether continuous irrigation of the renal pelvicaliceal system with warm saline protects it against cryo-injury. MATERIALS AND METHODS: In 12 swine open bilateral renal cryoablation using an argon gas based system was performed to create a cryolesion in the lower pole that was intentionally extended into the collecting system. A single cryoprobe was used to create a 3 cm ice ball in group 1 (6 animals) and 2, 3 mm cryoprobes were used to create a 4.5 cm ice ball in group 2 (6). In all 12 right kidneys pelvicaliceal warming (range 38C to 42C) was performed using continuous retrograde saline irrigation through an indwelling 5Fr ureteral catheter. In all 12 left kidneys cryoablation was performed without pelvicaliceal warming. Real-time confirmation of caliceal involvement by the cryolesion was obtained by retrograde ureteropyelogram. Immediately after cryo-injury 6 left and 6 right kidneys were harvested for histology and the animals with a solitary kidney were followed for 1 to 3 months. RESULTS: Nadir cryoprobe tip temperature was -136C with a mean cryolesion time of 10.5 minutes. Cryolesion size was comparable in the right vs left kidneys in groups 1 and 2 (2.9 vs 3.0 and 4.7 vs 4.6 cm, respectively). Similarly cryoablation time was comparable between the right and left kidneys in groups 1 and 2 (11.3 vs 10.8 and 11.9 vs 12.2 minutes, respectively). Two animals died of aspiration pneumonia (1) and wound dehiscence (1). In all 10 surviving animals no instance of urinary extravasation was noted. At 1-month followup regrowth of normal urothelium occurred with some scarring of the lamina propria or underlying smooth muscle. Adjacent renal parenchyma was replaced by fibrous scar. At 3 months the cryo-injured collecting system was completely healed with a fibrous scar. There were no appreciable histological differences between the kidneys with or without warm pelvicaliceal irrigation. CONCLUSIONS: Our data suggest that absent physical puncture injury of the collecting system with the cryoprobe tip the cryodamaged renal collecting system heals by secondary intention in a watertight manner. These data have clinical relevance for facilitating cryoablation of a small, localized, central renal tumor in proximity to the pelvicaliceal system.

Animals↗

PubMed2004

Injury patterns among female trauma patients: recognizing intentional injury.

BACKGROUND: Intimate partner violence and interpersonal violence are a major source of morbidity and mortality among women. Our objective was to identify patterns of injury consistent with intentional injury in female trauma patients admitted to the hospital. METHODS: Subjects were women aged 16 to 65 years discharged from acute care hospitals in a single year with a primary diagnosis of injury. Data were collected from 14 states across the United States. Analysis was performed using multivariate logistic regression. RESULTS: Women who suffered blunt intentional trauma exhibited very different injury patterns than those hospitalized for motor vehicle collisions or falls. The risk of facial injury with blunt intentional trauma was much higher than for other mechanisms (odds ratio, 4.9; 95% confidence interval, 4.20-5.74). Head injury was also more common in these women (odds ratio, 1.4, 95% confidence interval, 1.15-1.70). CONCLUSION: Physicians can potentially improve identification of cases of intimate partner violence and interpersonal violence by understanding common injuries associated with interpersonal violence.

Accidental Falls↗

PubMed2003

Effects of intention load and background context on prospective remembering: an event-related brain potential study.

Prospective remembering reflects the ability to realize intentions that must be delayed over some period of time. Recent evidence indicates that distinct modulations of the event-related brain potentials may be associated with the detection of a prospective memory cue (N300) and the recovery of an intention from memory (LPC, slow wave). The present experiments examined the degree to which these modulations were influenced by task manipulations that were expected to differentially influence cue detection and memory-related processes. Varying the number of intentions modulated the amplitude of a slow wave that may reflect memory-related processes. In contrast, varying the distinctiveness of the cues modulated the N300 and the early portion of the LPC indicating that this manipulation primarily influenced detection and categorization processes. These findings indicate that the N300, LPC and slow wave reflect functionally distinct processes associated with prospective memory.

Adolescent↗

PubMed2004

Intentional replantation of an immature permanent lower incisor because of a refractory peri-apical lesion: case report and 5-year follow-up.

We performed an intentional replantation of an immature lower incisor that had a refractory peri-apical lesion. The incisor was extracted and the peri-apical lesion was removed by curettage. The root canal of the tooth was then rapidly irrigated, and filled with a calcium hydroxide and iodoform paste (Vitapex(R)), after which the tooth was fixed with an arch wire splint. Five years later, no clinical or radiographic abnormalities were found, and the root apex was obturated by an apical bridge formation. A team of two dentists is essential to prevent a prolonged operation time, thus eliminating any of the causes of ankylosis. Furthermore, calcium hydroxide and iodoform paste, along with an arch wire splint retained with composite resin, led to good healing of the periodontal tissue after the intentional replantation. Our results indicate that intentional replantation is a useful method for an immature tooth with refractory peri-apical problems.

Calcium Hydroxide↗

PubMed2006

Underestimation and overestimation of personal weight status: associations with socio-demographic characteristics and weight maintenance intentions.

OBJECTIVE: Unwarranted underestimation and overestimation of personal weight status may prevent weight maintenance behaviour. The present study reports on correlates of under- and overestimation of personal weight status and the association with weight maintenance intentions and self-reported action. DESIGN: Comparison of three cross-sectional surveys, representing different population groups. SUBJECTS: Survey 1: 1694 adolescents 13-19 years of age; survey 2: 979 nonobese adults 25-35 years of age; survey 3: 617 adults 21-62 years of age. MEASUREMENTS: Self-administered written questionnaires (surveys 1 and 3) and telephone-administered questionnaires (survey 2); self-reported BMI, self-rated weight status, intentions and self-reported actions to avoid weight gain or to lose weight, sex, age, education and ethnic background. Respondents were classified as people who are realistic about personal body weight status or people who under- and overestimate their body weight status, based on BMI and self-rated weight status. RESULTS: Most respondents in the three survey populations were realistic about their weight status. Overestimation of weight status was consistently more likely among women, whereas underestimation was more likely among men, older respondents and respondents from ethnic minorities. Self-rated weight status was a stronger correlate of intentions and self-report actions to avoid weight gain than weight status based on Body Mass Index. CONCLUSIONS: Relevant proportions of the study populations underestimated or overestimated their bodyweight status. Overestimation of personal weight status may lead to unwarranted weight maintenance actions, whereas underestimation may result in lack of motivation to avoid further weight gain.

Adolescent↗

PubMed2004

Non-resective ablation therapy for hepatocellular carcinoma: effectiveness measured by intention-to-treat and dropout from liver transplant waiting list.

BACKGROUND: Orthotopic liver transplantation (OLT) for patients with small hepatocellular carcinoma (HCC) is widely accepted, and the usefulness of local ablation techniques as a bridge for liver transplantation is still under investigation. METHODS: From December 1997 to February 2003, patients with cirrhosis and T0-T1-T2-T3 stage HCC received multi-modality ablative therapy (MMT) for the treatment of their HCC and were evaluated for OLT; listed, and transplanted when an allograft became available. MMT included radiofrequency ablation (RFA), and/or Trans-Arterial Chemo-Embolization (TACE), and alcohol (EtOH) ablation, followed by Trans-Arterial Chemo-Infusion (TACI), with repeated treatments based on follow up hepatic magnetic resonance imaging (MRI) during the waiting period for OLT. RESULTS: A total of 135 HCC patients were seen at our center within this time frame. The intention-to-treat group included 33 (24.4%) patients with T0, T1, T2, T3 HCC and cirrhosis. There were 31 men and two women. The mean age was 53.6 +/- 7.2 yr. All patients received MMT with a mean of 2.90 +/- 1.5 procedures per patient. Tumor-node-metastasis (TNM) stages at time of listing were: T0 in one patient, T1 in nine patients, T2 in 17 patients, and T3 in six patients. Twenty-eight (85%) patients have received OLT. Five (12.19%) patients were listed and removed (dropout) from the transplant waiting list after waiting 5, 5, 5, 8, and 14 months respectively. The waiting time of the HCC listed group was 9.1 +/- 14.8 months with a mean follow up of 32 months. OLT patient survival and cancer-free survival are 92.9% and 95.24%, respectively; the overall survival of intention-to-treat group was 79% at 32 months follow up. Predictors of dropout included an alpha-fetoprotein (AFP, >400 ng/mL) and T3 HCC stage. CONCLUSION: Aggressive ablation therapy with a short transplant waiting time optimizes the use of OLT for curative intent in selective cirrhotic HCC patients.

Antineoplastic Agents↗

PubMed2006

Comparing three theories in predicting reproductive health behavioral intention in adolescent women with diabetes.

BACKGROUND: Understanding factors that affect decision-making in using preconception planning is important to reduce the rate of unplanned pregnancies and pregnancy-related complications in all women with diabetes. Previously, there were no studies of reproductive health-related beliefs, attitudes, or behaviors of adolescent women with diabetes. Constructs from social cognitive models, such as, the health belief model (HBM), theory of reasoned action, and social cognitive theory, are factors that can influence these behavioral outcomes. OBJECTIVE: To compare the predictive powers of these three theories in regard to decision-making with reproductive health behaviors in teens with diabetes and to identify a composite model of the strongest predictors across all three theories. METHOD: Data were collected from a telephone interview by same-gender research assistants on a sample of 87 female adolescents with type 1 diabetes (T1D) from four medical centers using the reproductive health attitudes and behavior (RHAB) questionnaire. Measures represent demographic variables, constructs of the three theories, and behavioral outcomes. Standard multiple regression analyses were used to examine the prediction of the three theories in the outcome variable [intention for using birth control (BC)]. RESULTS: Among the three theories considered, the HBM explained the highest percent of variance (24.4%) in intention to using BC. The best composite model consisted of perceived barriers, cues to action, and self-efficacy (explaining 26.1% of the variance). These three variables were also the strongest predictors among all constructs considered. CONCLUSION: In this sample of adolescent females with T1D, the strongest predictors from the three theories for intention to using BC appeared to be perceived barriers, cues to action, and self-efficacy. Intervention studies to decrease future unplanned pregnancies in this high-risk population could focus on strategies to target these factors that are amenable to change.

Adolescent↗

PubMed2004

'Unwilling' versus 'unable': chimpanzees' understanding of human intentional action.

Understanding the intentional actions of others is a fundamental part of human social cognition and behavior. An important question is therefore whether other animal species, especially our nearest relatives the chimpanzees, also understand the intentional actions of others. Here we show that chimpanzees spontaneously (without training) behave differently depending on whether a human is unwilling or unable to give them food Chimpanzees produced more behaviors and left the testing station earlier with an unwilling compared to an unable (but willing) experimenter These data together with other recent studies on chimpanzees' knowledge about others' visual perception show that chimpanzees know more about the intentional actions and perceptions of others than previously demonstrated

Animals↗

PubMed2005

Repair of the alar groove with combination partial primary closure and second-intention healing.

BACKGROUND: The reconstruction of small defects of the alar groove can be a unique challenge owing to the importance of maintaining its concave structure. OBJECTIVE: To present a report of a patient with a small alar groove defect that was repaired using a combination of partial primary closure and second-intention healing. METHODS: A 73-year-old female was referred for the treatment of a basal cell carcinoma of the right nasal ala and underwent Mohs micrographic surgery with clearance of the lesion. The final defect, less than 1 cm, extended to the subcutaneous fat. Two absorbable subcutaneous sutures were placed in the defect, and the wound was then allowed to heal by second intention. RESULTS. This closure yielded a good cosmetic result, with preservation of the alar groove. CONCLUSION: A combination of primary closure and second-intention healing is a time-efficient, low-risk option for nonperforating, small alar groove defects.

Aged↗

PubMed1982

Intentional prescription nonadherence (noncompliance) by the elderly.

Prescription drugs are not always taken as directed. When there is a discrepancy between the use of a drug and the prescription directions, the drug-taking behavior is considered "nonadherent." To determine the extent of prescription non adherence by old persons and the reasons for nonadherence, an in-home survey was made of 111 elderly subjects who were taking prescription drugs. Drug-taking behavior was compared with the behavior implied by the prescription instructions, the reasons for the differences were sought. Of the study sample, 43 per cent showed such differences in use of one or more prescription drugs. The chief type of discrepancy was underuse (90 per cent of nonadherence). No difference was observed in most of the psychosocial variables studied between those who took drugs as directed and those who did not. Hypertensive subjects did not differ from those without hypertension. A large proportion of nonadherence (73 per cent) was intentional. Intentional nonadherence was more likely to occur in subjects who used two or more pharmacies and two or more physicians. Traditional efforts aimed at reducing the incidence of forgetting to take medicines would not seem to be helpful in cases of intentional nonadherence.

Aged↗

PubMed2004

Comparison of patient questionnaires and plasma assays in intentional drug overdoses.

Our aim was to explore the agreement between clinically collected information on purported drug intake and plasma data in intentional drug overdose. We included all subjects with intentional drug overdose above 15 years of age consecutively admitted to the Emergency Department of the University Hospital during 4 months. Information about drugs used and sources of this information was collected and compared to presence of drug in plasma, concerning four drugs with high toxic potential (tricyclic antidepressants, meprobamate, paracetamol and ethanol). Sensitivity, specificity, predictive positive and negative values of all sources of information pooled were assessed for each drug. 413 intentional drug overdoses were included, 66% with more than one drug. According to clinical information, 8% took tricyclic antidepressants, 11% meprobamate, 9% paracetamol and 41% ethanol. Systematic plasma assays confirmed this in 59% of cases for tricyclic antidepressants, 76% for meprobamate and ethanol, and 77% for paracetamol. Plasma concentrations were considered toxic in 28% of cases for tricyclic antidepressants, 65% for meprobamate, 43% for ethanol and never for paracetamol. Tricyclic antidepressants and meprobamate were found unexpectedly in 3%, paracetamol in 7% and ethanol in 6%. Toxic concentrations were found only with meprobamate. The risk of erroneous, clinically collected information was greater by excess (25 to 40% false positives) than by lack (3 to 7% false negatives). Thus, the consequences of erroneous, clinically collected information were probably more excess cost for the institution than medical risk for the patients. However these results found at the population level may not be true at an individual level.

Acetaminophen↗