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The effect of reproductive intentions on subsequent fertility among low-parity Korean women, 1971-76.

The effect of reproductive intentions on subsequent fertility is evaluated for a group of low-parity, primarily rural, Korean women. These women were more successful in achieving wanted additional births than in avoiding unwanted births, both at the aggregate and individual level. Several models of fertility behavior are tested. Reproductive intentions and number of living sons are the best predictors of subsequent fertility, and their effects are mediated largely by their impact on induced abortion. Overall the effect of reproductive intentions on subsequent fertility among Korean women is very similar to findings reported for the United States and Taiwan.

Abortion, Induced↗

Staff nurses' career development relationships and self-reports of professionalism, job satisfaction, and intent to stay.

The purpose of this study was to investigate the range of career development relationships (CDRs) experienced by staff nurses in relation to the outcomes of professionalism, job satisfaction, and intent to stay. A sample of 390 Army staff nurses completed questionnaires measuring five CDRs--precepting, peer-strategizing, coaching, sponsoring, and mentoring--and the outcome variables. Findings indicated that 61% of the sample experienced a CDR, with the predominant CDR being coaching. No CDR affected professionalism; however, job satisfaction and intent to stay may warrant further investigation in relation to CDRs. The findings suggest that if nurses perceived that an interest was taken in their career development, and felt valued by the developer, then usually staff nurses viewed the relationship as professionally important. The perception of importance often influenced intent to stay in a positive direction.

Adult↗

Intent and coincidence in pharmaceutical discovery. The impact of biotechnology.

Drug research developed around a purpose: the cure of diseases. This intent to cure, however, offered no clue to the understanding of diseases and to their treatment. Instead such guidance had to come from scientific disciplines which laid the foundations for drug research and offered specific opportunities for the solution of therapeutic problems. In the sequence of their appearance, these scientific disciplines were: chemistry, pharmacology/physiology, microbiology, biochemistry and molecular biology. It can be shown that new therapeutic classes of drugs like muscle relaxants, diuretics, L-dopa, antibiotics, recombinant proteins, monoclonal antibodies and others were generated on the basis of scientific opportunities rather than therapeutic need. All of these drugs were created within the confines of a chemical paradigm of medicine and drug therapy. We are now witnessing the entry of a new informational paradigm into medicine which is most prominently represented by genomic sciences. This paradigm will bring two important changes to the therapy of diseases. First, molecular biology has matured to such a degree that it can now study complex genomes and their functionality in complex organisms such as humans. Therefore, results from these studies no longer have to be translated into the context of medicine: they are already within this context. Secondly, drug therapy which used to be largely symptomatic, will now aim at targets which are closer to the causes of diseases than previously. Therapeutic progress, which used to be indirect, conjectural and coincidental, is about to become more directed, definitive and intentional. At least from the limited and utilitarian perspective of medicine, drug discovery will be more often based on intent rather than coincidence. But industry and, for that matter, society as a whole should not forget that this situation has come about through the evolution of science which was not, and can never be, predictable.

Biotechnology↗

Social and personal factors in marijuana use and intentions to use drugs among inner city minority youth.

Limited information is available about the etiology of illicit drug use among minority youth. This study examined predictors of marijuana use and intentions to use marijuana, cocaine/crack, and other drugs for African-American and Hispanic seventh graders (N = 757). Self-reports of marijuana use and intentions to use drugs were collected along with data concerning background, social environmental, and individual characteristics hypothesized to be related to drug use. Results indicated that social influences, including adults, friends, and the most admired person's marijuana use, predicted marijuana use. Individual characteristics, such as a lack of knowledge about the prevalence and negative social consequences of marijuana use, positive attitudes toward marijuana use, and inadequate social, communication, and refusal skills increased suspectability to marijuana use. Lack of self-efficacy was related to intentions to use cocaine and other drugs. Implications of these findings are discussed with respect to the development of effective prevention programs.

Achievement↗

Active living in communities: understanding the intention to take up physical activity as an everyday way of life.

The purpose of this study was to identify psychosocial factors influencing the intention to incorporate physical activity into daily routine. The subjects were 353 residents from New Brunswick aged 15 to 80 years. The intention to be active was explained by current physical activity habit (beta = 0.563, p < 0.0001), age (beta = -0.197, p < 0.0001), attitude toward the behaviour (beta = 0.164, p < 0.0001), and the obligation felt to perform the behaviour (beta = 0.155, p < 0.0001). These variables explained 52% of the variability in intention. MANOVAs revealed significant differences between high and low intenders concerning the perceived consequences of carrying out the behaviour (p < 0.0001) and the evaluation of these consequences (p < 0.01). It is suggested that a social marketing program should promote the concept that "walking every day for 15 consecutive minutes is fun and healthy; it will make me feel better, more energetic, and more relaxed, not to mention that it should contribute to the improvement of my physical condition while I enjoy the outdoors".

Adolescent↗

Prevalence and correlates of AIDS-related behavioral intentions among urban minority high school students.

Using data from a cross-sectional survey of 926 predominantly black and Hispanic ninth through twelfth graders in three New York City public high schools, the explanatory power of theoretically and empirically derived predictors (i.e., demographic, contextual, and cognitive) of intentions to engage in sexual intercourse, to be sexually monogamous, to use condoms during intercourse, and to ascertain intercourse partners' sexual and drug-use histories was compared. One-third of sampled students "definitely" intended to have sexual intercourse in the next year, one-half "definitely" intended to be sexually monogamous, two-thirds "definitely" intended to use condoms during intercourse, and three-quarters "definitely" intended to ascertain intercourse partners' sexual and drug-use histories. In a predictive model including all investigated variables, those variables derived from the cognitive set (i.e., beliefs about susceptibility to getting AIDS, and beliefs about barriers, self-efficacy, norms, and values pertaining to AIDS-preventive actions) were most strongly associated with the four investigated behavioral intentions. However, certain variables derived from the demographic set (i.e., age, gender, race/ethnicity) and contextual set (i.e., previous behavioral involvement, cues, academic failure, substance use) also contributed explained variance to all four intentions.

Acquired Immunodeficiency Syndrome↗

Childbearing motivations, desires, and intentions: a theoretical framework.

After briefly reviewing different approaches in the social and behavioral sciences to conceptualize the reasons that humans become motivated to bear children, I present a theoretical framework that incorporates many elements of these approaches. The framework is based on a four-step psychological sequence: the formation of traits, the activation of traits into desires, the translation of desires into intentions, and the implementation of intentions in the form of behavior. I use data from 401 married couples to develop regression models of the two middle steps of this sequence that indicate how childbearing motivational traits lead to childbearing desires and how the latter lead to childbearing intentions. I also develop a regression model that indicates how childbearing motivation affects an individual's perception of his or her spouse's childbearing desires.

Adult↗

Integrating behavior and intention regarding mammography by respondents in the 1990 National Health Interview Survey of Health Promotion and Disease Prevention.

Achieving and maintaining high rates of screening mammography are major public health priorities. This report examines data from the 1990 National Health Interview Survey of Health Promotion and Disease Prevention on the utilization of mammography among women ages 40-75. Results show that progress is being made in some areas--57.7 percent of women "ever had" a mammogram; 50.3 percent, in previous 2 years. However, those not having repeated regular screening appear to be a sizable proportion. Only 28.6 percent of women ages 40-75 had been both screened on the recommended age-specific schedule and expressed an intention to continue screening; another 29.2 percent indicated no intention to have a mammogram in the near future. Income, clinical breast examination, and Pap (Papanicolaou's) test, having no regular source of care, region of the country and residential variables, smoking status, not exercising, not knowing how to do breast self-examination, and race were among the variables having the strongest associations with mammography status. Several groups in the population therefore remain at risk of not receiving regular screening. The combination of mammography status to date and future intention to have the examination provides an important perspective on efforts to reach public health screening objectives and appears to provide a strategy for targeting interventions.

Adult↗

Intentional iron overdose: an institutional review.

OBJECTIVE: To document the frequency of admissions and the outcome of patients with a diagnosis of intentional iron overdose to a large urban hospital. DESIGN: Retrospective review of hospital records. SETTING: Health Sciences Centre, Winnipeg, an 1100-bed primary and tertiary care centre serving a regional population of about 1.2 million. PATIENTS: All patients with a discharge diagnosis of iron overdose who were admitted from Jan. 1, 1979, to July 1, 1991. Of these 113 cases 66 (58%) represented an intentional iron overdose on the basis of information derived from the patient, family or friends. MAIN OUTCOME MEASURES: Frequency of admissions, length of hospital stay and survival rate. RESULTS: Most (53 [80%]) of the 66 patients were females. The mean age was 19.8 (standard deviation [SD] 6.1) years (range 9 to 48 years). One third of the cases were associated with excess alcohol intake. The frequency of hospital admissions increased during the study period (1.4 cases per year in the first 5 years and 9.8 cases per year in the last 5; 5.3 cases per year overall). The mean length of hospital stay was 6.8 (SD 12.1) days, and the mortality rate was 10%. CONCLUSIONS: Hospital admissions because of intentional iron overdose are becoming more frequent in this centre and are associated with appreciable morbidity and mortality rates. Prospective studies are required to delineate clearly the signs, symptoms and abnormal laboratory findings associated with this problem.

Adolescent↗

Intention to use contraceptives and subsequent contraceptive behavior in Morocco.

In this article, the relationship between stated intention to use contraceptives and subsequent use during a three-year period in Morocco is examined. Longitudinal data are drawn from two Demographic and Health Surveys: the 1992 Morocco DHS and the 1995 Morocco Panel Survey. Reported contraceptive intentions in 1992 have a strong predictive effect on subsequent contraceptive use even after controlling for other characteristics of respondents, and the strength of the effect is second only to that of previous contraceptive use. Women who in 1992 said they intended to use contraceptives in the future but did not do so are the most likely to have had an unmet need for contraception in 1995. Weakly held fertility preferences reported by some of the women surveyed in 1992 appear to have been a contributing factor in the subsequent failure of these women to act upon their intention to practice contraception.

Adolescent↗

An intention-based language for representing clinical guidelines.

Automated support for guideline-based care would be enhanced considerably by a standard representation of clinical guidelines. To faciliate use and reuse, we suggest a representation that includes the explicit intentions of the guideline's author. These intentions include the desirable actions of the care provider and the patient states to be achieved before, during, and after the administration of the guideline. Intentions are temporal patterns of provider actions or patient states to be maintained, achieved, or avoided. We view automated support as a collaborative effort of the health-care provider and an automated assistant and involves several different tasks. We defined the syntax and, the semantics of a text-based language (ASBRU) for representation and annotation of clinical guidelines. The language supports maintenance of the automated assistant's knowledge base and could improve the quality and flexibility of the automated assistant's recommendations. In the ASGAARD project, we are developing reasoning mechanisms that use the ASBRU language for execution and critiquing tasks in conjunction with online electronic patient medical records.

Expert Systems↗

Intentional replantation of a mandibular molar with calcified canal: a case report.

Intentional replantation is an accepted endodontic technique for treating teeth in which both conventional and/or surgical endodontic treatments are not recommended. A rare case using intentional replantation technique on one mandibular molar has been successfully treated. This procedure was used owing to inaccessible calcified canal and pain intolerance of the patient. A thirty month post-operative evaluation revealed an asymptomatic, functional tooth with no radiographic signs of pathosis. The favorable results obtained in this case might be attributed to certain factors, such as occlusal adjustment prior to replantation, maintaining asepsis during replantation, no-damaging pressure during extraction, use of noneugenol periodontal packing, preservation of the vitality of the periodontal ligament, a minimal extraoral period, non-rigid splinting, apicoectomy and retrograde amalgam filling were done for hermetic apical seal. Intentional replantation may be limited to those cases when conventional endodontic therapy is not possible, but may be a treatment alternative to maintain the dentition and save an otherwise hopeless tooth.

Adult↗

Comparing the emotional reactions and behavioral intentions of violent and nonviolent husbands to aggressive, distressed, and other wife behaviors.

The present study was designed to compare the self-reported emotional reactions and behavioral intentions of violent and nonviolent husbands to a variety of wife behaviors depicted with standardized stimuli. We recruited four subject groups, including 25 men beginning domestic violence treatment programs and three groups from the community-21 maritally violent and maritally distressed men, 23 nonviolent/distressed men, and 28 nonviolent/nondistressed men. Using stimuli and measures derived from Biglan, Rothlind, Hops, and Sherman (1989), along with stimuli designed for this study, subjects read written descriptions and examples of various wife statements (e.g., aggressive, distressed, and facilitative) and viewed videotaped depictions of wife behaviors varying in verbal content and nonverbal affect (i.e., aggressive/irritated, aggressive/dysphoric, distressed/irritated, and distressed/dysphoric). In response to each wife behavior, subjects rated what their emotional reactions (e.g., sympathetic, caring, supportive, sad, anxious, irritated, angry) and their behavioral responses (e.g., try to comfort, say something supportive, discuss the subject, not say anything, say something hostile, argue) would be. As predicted, in response to a wide range of wife behaviors, and relative to nonviolent men, violent men were less likely to report sympathetic/positive emotions and more likely to experience anger and irritation, but not other negative (i.e., sad or anxious) emotions. They were also more likely to report negative behavioral intentions and less likely to report positive behavioral intentions. The theoretical and clinical implications of these findings are discussed.

Adult↗

Age differences in intention to left and right hemispace using a dichotic listening paradigm.

This study assessed the influence of age (younger women and elderly women living in communities) on cerebral laterality using dichotic listening. Previous research has purported to show a relative right cerebral decline with age. To date, however, research on the right hemiaging hypothesis has provided mixed findings. It is possible that these mixed findings are caused by use of simple versus complex dichotic listening tasks. As a test of this hypothesis, older women were expected to have a heightened right ear advantage (REA) for phonemic speech sounds and greater difficulty switching intention to the left ear when instructed to focus to either the left or the right ear. No age difference was found using the traditional presentation of concurrent phonemes. However, the right hemiaging hypothesis was supported on the intentional task, in which older women were less able to switch intention to the left but not to the right ear. Implications for right hemiaging are discussed.

Adult↗

Predictors of intention to study nursing among school students speaking a language other than English at home.

There is currently a shortage of bilingual nurses in New South Wales. It is important to include bilingual nurses in the workforce to meet not only the cultural and social needs of people speaking a language other than English at home, but also to facilitate the achievement of appropriate health outcomes for a multicultural population. The purpose of this study was to identify demographic and social factors which explain students' intention to study nursing. Respondents were 789 year 11 or 12 students speaking Arabic, Serbo-Croatian, Spanish, Turkish or Vietnamese from twenty-five schools in South Eastern, South Western and Western Sydney. Data were collected through a self-completed questionnaire. Chi square, t-test and logistic regression analysis were used for data analysis. Logistic regression analysis concluded that perceived parental income, years of settlement in Australia and father's occupation were significant factors. Bivariate analysis also revealed that significant differences were found in the intention to study nursing between male and female students and between students with a higher and lower Tertiary Entrance Rank (TER). Parental influence also affects students' intention. However, gender and TER were found to be insignificant after adjustment for other variables in the logistic regression model.

Adolescent↗

Economic outcomes with antidepressant pharmacotherapy: a retrospective intent-to-treat analysis.

Herein we describe a retrospective intent-to-treat evaluation designed to compare the natural course of antidepressant utilization and direct health service expenditures for the treatment of a single episode of major depression among patients enrolled in a multistate network-model health maintenance organization and initially prescribed either a tricyclic antidepressant (amitriptyline or nortriptyline) or the serotonin selective reuptake inhibitor (SSRI) fluoxetine. Patient-level paid-claims data for the period July 1, 1988, through December 31, 1991, were abstracted. During the above time frame, fluoxetine was the only SSRI available in the United States. Patients prescribed amitriptyline were more than three times as likely to require a change in antidepressant pharmacotherapy (OR = 3.27, 95% CI = 2.31 to 5.49), while patients prescribed nortriptyline were nearly four times more likely to change medication (OR = 3.82, 95% CI = 2.74 to 6.83) relative to patients initially prescribed fluoxetine. Consistent with our intent-to-treat design, all accrued health service expenditures were assigned to the pharmacotherapeutic option initially prescribed. Multivariate analyses revealed that initiation of antidepressant pharmacotherapy with amitriptyline resulted in a 25.7% increase in per capita depression-related health service expenditures per year, while initiation of antidepressant pharmacotherapy with nortriptyline resulted in a 28.1% increase in per capita depression-related health service expenditures per year relative to patients initially prescribed fluoxetine. A financial break-even point was achieved at the conclusion of Month 5, at which time all three intent-to-treat cohorts had comparable health service expenditures in total. From a financial perspective, results stemming from this inquiry suggest that the initiation of antidepressant pharmacotherapy with an SSRI is warranted.

Adult↗

Predictors of AIDS-preventive behavioral intentions among adult heterosexuals at risk for HIV-infection: extending current models and measures.

This study examined the predictors of the intention to use condoms with new sexual partners. A sample of heterosexual adult females and males (n = 711) was recruited through various channels. A substantial part of the sample had engaged in risky sexual behavior. Predictors were based on various theoretical models. Compared with men, women were in general more aware of the risks of AIDS and perceived fewer barriers to using condoms, but they also perceived less support for condom use among potential new partners. Among those with a risk factor for HIV infection (n = 514), various types of barriers, absolute and comparative self-efficacy, and three types of social norms were independently related to the intention to use condoms. When including all relevant predictors, self-efficacy, anticipated regret, and descriptive norms in the reference group, were independent predictors of condom use intention among men as well as among women. The implications for prevention are discussed.

Acquired Immunodeficiency Syndrome↗

Cervical cancer and STD health beliefs: predicting pelvic exam intentions in undergraduates.

We surveyed 119 female undergraduates to investigate if the health belief model for both cervical cancer and sexually transmitted diseases (STDs) would predict pelvic examination intentions. Results for cervical cancer and STDs were similar, with barriers to obtaining an exam and perceived susceptibility contributing most consistently to intentions. Respondents rated themselves as more susceptible to cervical cancer than to STDs and rated STDs more serious than cancer. Discriminant analysis found sexual activity, barriers, susceptibility to STDs, benefits of a pelvic exam for cervical cancer, and age to reliably distinguish women who had gotten a pelvic exam from those who had not. Contrary to previous research, physique anxiety was a positive predictor of intentions when health beliefs were controlled, suggesting it may represent generalized body anxiety for some women.

Adolescent↗