Auditory learning in an operant task with social reinforcement is dependent on neuroestrogen synthesis in the male songbird auditory cortex.

Animals continually assess their environment for cues associated with threats, competitors, allies, mates or prey, and experience is crucial for those associations. The auditory cortex is important for these computations to enable valence assignment and associative learning. The caudomedial nidopallium (NCM) is part of the songbird auditory association cortex and it is implicated in juvenile song learning, song memorization, and song perception. Like human auditory cortex, NCM is a site of action of estradiol (E2) and is enriched with the enzyme aromatase (E2-synthase). However, it is unclear how E2 modulates auditory learning and perception in the vertebrate auditory cortex. In this study we employ a novel, auditory-dependent operant task governed by social reinforcement to test the hypothesis that neuro-E2 synthesis supports auditory learning in adult male zebra finches. We show that local suppression of aromatase activity in NCM disrupts auditory association learning. By contrast, post-learning performance is unaffected by either NCM aromatase blockade or NCM pharmacological inactivation, suggesting that NCM E2 production and even NCM itself are not required for post-learning auditory discrimination or memory retrieval. Therefore, neuroestrogen synthesis in auditory cortex supports the association between sounds and behaviorally relevant consequences.

Social incentives for adherence to tuberculosis treatment / Incentivos sociales en la adhesión al tratamiento de la tuberculosis / Incentivos sociais na adesão ao tratamento da tuberculose

ABSTRACT Objective: To analyze the influence of social incentives for adherence to tuberculosis (TB) treatment. Method: Qualitative study, in which 26 primary health care professionals of São Paulo were interviewed in 2015.Their testimonies were submitted to the speech analysis technique. The theoretical reference was the social determination of the health-disease process. Ethical procedures were observed. Results: TB is related to precarious living conditions. Incentives such as the basic food basket and transportation stipends are relevant for patients' adherence to treatment, as well as to the create bonds between the patient and the health team. Final considerations: The incentives strengthened adherence to TB treatment. However, interventions in the context of public measures must transcend the remedial dimension and be guided towards the transformation of the TB situation, which means supporting processes that modify living conditions.

RESUMEN Objetivo: Analizar la influencia de los incentivos sociales en la adhesión al tratamiento de la tuberculosis (TB). Método: Estudio cualitativo, en el que 26 profesionales de la Atención Primaria a la Salud del municipio de São Paulo fueron entrevistados en 2015, y sus testimonios fueron sometidos a la técnica de análisis de discurso. El referencial teórico fue la determinación social del proceso salud-enfermedad. Se han resguardado los procedimientos éticos. Resultados: La TB se relaciona con las condiciones precarias de la vida, siendo que los incentivos como la canasta básica y la ayuda para el transporte son relevantes para la adhesión del paciente al tratamiento, así como para el vínculo entre el paciente y el equipo de salud. Consideraciones finales: Los incentivos fortalecen la adhesión al tratamiento de la TB. Sin embargo, las intervenciones en el marco de medidas públicas deben trascender la dimensión paliativa y orientarse para transformar la situación de la TB, lo que significa apoyar procesos que modifiquen las condiciones de vida.

RESUMO Objetivo: Analisar a influência de incentivos sociais na adesão ao tratamento da tuberculose (TB). Método: Estudo qualitativo, em que 26 profissionais da Atenção Primária à Saúde do município de São Paulo foram entrevistados em 2015, e seus depoimentos foram submetidos à técnica de análise de discurso. O referencial teórico foi a determinação social do processo saúde-doença. Os procedimentos éticos foram resguardados. Resultados: A TB está relacionada às condições precárias de vida, sendo que incentivos como a cesta básica e o vale-transporte são relevantes para a adesão do paciente ao tratamento, assim como para o vínculo entre o paciente e a equipe de saúde. Considerações finais: Os incentivos fortalecem a adesão ao tratamento da TB. Contudo, intervenções no âmbito de medidas públicas devem transcender a dimensão paliativa e orientarem-se para transformar a situação da TB, o que significa apoiar processos que modifiquem as condições de vida.

Social representations of HIV/AIDS by older people and the interface with prevention / Representaciones sociales del VIH/SIDA de ancianos y la interrelación con la prevención / Representações sociais do HIV/Aids por idosos e a interface com a prevenção

ABSTRACT Objective: To apprehend the social representations elaborated by older people about HIV/AIDS and to understand how they relate to the prevention of HIV infection. Method: Descriptive and qualitative research based on the Theory of Social Representations with 42 older people assisted at primary care. Data were produced through in-depth interviews with a semi-structured instrument, processed in the IRaMuTeQ software, and analyzed by means of the descending hierarchical classification. Results: Five classes emerged: "HIV/AIDS: a problem of young people"; "Quality of life improvement for people living with HIV/AIDS"; "Vulnerability to HIV/AIDS among heterosexual women in a stable union"; "HIV/AIDS Information Network: process of creation and transformation of social representations" and "Prevention versus stigma". Final considerations: The social representations that older people have about HIV/AIDS influence the adoption of preventive measures negatively because stigma is present and HIV/AIDS is attributed to young men, and to men who have sex with other men.

RESUMEN Objetivo: Comprender las Representaciones Sociales elaboradas por ancianos sobre el VIH/SIDA y entender cómo se relacionan con la infección por VIH. Método: Investigación descriptiva, cualitativa, fundamentada en la Teoría de las Representaciones Sociales, con 42 ancianos atendidos en atención primaria. Datos recolectados mediante entrevistas en profundidad aplicando instrumento semiestructurado, procesados en software IRaMuTeQ y analizados por Clasificación Jerárquica Descendente. Resultados: Surgieron cinco clases: "VIH/SIDA: un problema de jóvenes"; "Mejora de calidad de vida de personas que viven con VIH/SIDA"; "Vulnerabilidad al VIH/SIDA de mujeres heterosexuales en pareja estable"; "Red de informaciones sobre VIH/SIDA: Proceso de creación y transformación de las Representaciones Sociales"; y "Prevención versus Estigma". Consideraciones finales: Las representaciones sociales que los ancianos tienen respecto del VIH/SIDA influyeron negativamente a la adopción de medidas preventivas, pues el estigma está presente y el VIH/SIDA es atribuido a jóvenes y hombres que tienen sexo con otros hombres.

RESUMO Objetivo: Apreender as Representações Sociais elaboradas por idosos sobre o HIV/Aids e compreender como elas se relacionam com a prevenção da infecção pelo HIV. Método: Pesquisa descritiva e qualitativa fundamentada na Teoria das Representações Sociais, com 42 idosos atendidos na atenção primária. Os dados foram produzidos por meio de entrevistas, em profundidade, com um instrumento semiestruturado, processados no software IRaMuTeQ e analisados pela Classificação Hierárquica Descendente. Resultados: Emergiram cinco classes: "HIV/Aids: um problema de jovens"; "Melhoria da qualidade de vida de pessoas vivendo com HIV/Aids"; "Vulnerabilidade ao HIV/Aids de mulheres heterossexuais em união estável"; "Rede de informações sobre HIV/Aids: Processo de criação e transformação das Representações Sociais"; e "Prevenção versus Estigma". Considerações Finais: As representações sociais que os idosos têm sobre o HIV/Aids influenciam de forma negativa na adoção de medidas preventivas, pois o estigma está presente e o HIV/Aids é atribuído a jovens e homens que fazem sexo com homens.

A Patient-Centered Activity Regimen Improves Participation in Physical Activity Interventions in Advanced-Stage Lung Cancer.

INTRODUCTION: Physical activity (PA) is a potential therapy to improve quality of life in patients with advanced-stage lung cancer (LC), but no PA regimen has been shown to be beneficial, clinically practical, and sustainable. We sought to test the hypothesis that a patient-centered activity regimen (PCAR) will improve patient participation and PA more effectively than weekly phone calls. METHODS: In patients with advanced-stage LC, we implemented a walking-based activity regimen and motivated patients via either weekly phone calls (n = 29; FitBit Zip accelerometer) or PCAR (n = 15; FitBit Flex, an educational session, and twice-daily gain-framed text messages). Data collection over a 4-week period was compared, and a repeated-measures, mixed-effects model for activity level was constructed. RESULTS: Subjects receiving PCAR more frequently used the device (100% vs 79%) and less frequently had missing data (11% vs 38%). "More active" and "less active" groups were created based on mean step count in the first week. "Less active" patients in the PCAR group increased their PA level, whereas PA level fell in the "more active" group. Most subjects found PCAR helpful (92%) and would participate in another activity study (85%). DISCUSSION: Compared with weekly phone calls, PCAR has higher patient participation, is more likely to improve PA in "less active" subjects, and has high patient satisfaction. A multifaceted PA regimen may be a more efficacious mechanism to study PA in advanced LC. PCAR should be used in a randomized controlled trial to evaluate for improvements in symptom burden, quality of life, and mood.

Social reinforcement as alternative to sucrose reinforcement is increased by nicotine and methylphenidate in male Fischer-344 rats.

BACKGROUND: Stimulant drugs such as nicotine (NIC) and methylphenidate (MPH) are hypothesized to increase the reinforcing value of sensory stimuli, thus increasing the effectiveness of such reinforcers as alternatives to sucrose reinforcers. METHODS: Inbred Fischer-344 rats (n = 30) were assigned to three groups: saline (SAL; n = 10), nicotine (NIC; n = 10), or methylphenidate (MPH; n = 10). Testing was done in three phases: sucrose only, (SUC), sucrose and drug (SUC/DRUG), and sucrose, drug, and social reinforcement (SUC/DRUG/SOC). During the SUC phase, rats were trained on a progressive ratio 5 (PR5) reinforcement schedule for sucrose (20% solution). In the SUC/DRUG phase, animals were treated with SAL, NIC (0.4 mg/kg, n = 10 SC), or MPH (2.0 mg/kg, n = 10 IP) 30 min prior to testing. In the SUC/DRUG/SOC phase, animals continued receiving drug treatment, and social reinforcement was introduced concurrently with the sucrose reinforcer. The progressive ratio for each reinforcer ran independently of the others. Reinforcing value was measured as break point (BP), the highest number of responses resulting in a reinforcer. RESULTS: SAL-treated animals showed no significant change in sucrose BP. MPH-treated animals showed decreased sucrose BP in the SUC/DRUG phase, with a further reduction in the SUC/DRUG/SOC phase. NIC-treated animals decreased sucrose BP only when a social alternative was offered. CONCLUSION: Both NIC and MPH reduce the sucrose BP in the presence of a social alternative. The decrease in sucrose responding, coupled with increased social responding, suggests that the social alternative acted as an effective alternative reinforcer to sucrose. From a translational perspective, these results suggest that stimulant drugs such as NIC and MPH may increase the effectiveness of treatments that use alternative social reinforcers to decrease eating.

Smoking Cessation 1 Year or More: Experiences of Successful Quitters.

There is a paucity of research focused on the experience of maintaining cessation for a year or longer, and recidivism rates for smoking cessation are estimated at 50% to 97%. As cigarette smoking is one of the leading causes of death worldwide, there is a critical need for more knowledge about maintaining smoking cessation. Therefore, this study was undertaken to explore the lived experience of maintaining cigarette smoking cessation for a year or more. Using Streubert's nurse-developed descriptive phenomenological method, seven adults who sustained cessation for 1.5 to 18 years, after repeated relapses, were interviewed about their experience of sustaining cessation. Data collection included interviews, field notes, and a reflexive journal. Phenomenological analysis involved dwelling intensely with the data, extracting parts of the transcript, and identifying codes and themes, defined by Streubert as essences, common to all participants' descriptions of the experience of sustained cessation. Through this inductive process, the investigator ascertained relationships among the essences, forming the basis for a formalized, exhaustive description of the experience. Six essences captured participants' experiences of maintaining cigarette smoking cessation: (a) breaking free, (b) developing an olfactory aversion, (c) reframing, (d) learning through relapse, (e) reclaiming acceptance, and (f) self-transformation. The findings suggest that maintaining cessation for a year or more is shaped by biological, psychological, and social conditions, as reflected in the essences. The essences coalesced to a tipping point of motivation and conditions leading to sustained behavior change, allowing participants to maintain cessation.

A Randomized Controlled Trial of the Food Dudes Program: Tangible Rewards are More Effective Than Social Rewards for Increasing Short- and Long-Term Fruit and Vegetable Consumption.

BACKGROUND: Despite many health benefits, children do not consume enough fruits and vegetables (F/V). The Food Dudes program increases in-school F/V consumption, but the cost of prizes might be an adoption barrier. OBJECTIVE: Our aim was to compare the effects of the Food Dudes program when prizes vs praise are used to reward F/V consumption. DESIGN: We conducted a randomized controlled trial with three groups (ie, prize, praise, and control). Schools were randomly assigned to groups while approximately equating the percentage of students qualifying for free or reduced-price lunch. F/V consumption (lunch-tray photos) was assessed twice at pre-intervention and once after phase I, phase II, and at 6 months post-intervention, spanning approximately 11 months overall. PARTICIPANTS/SETTING: In total, 2,292 students attending six elementary schools participated, with 882, 640, and 770 in the prize, praise, and control groups, respectively. INTERVENTION: The Food Dudes program was implemented over 4.5 months in all but the control schools. Two Food Dudes schools implemented the program with tangible prizes contingent on individual students' F/V consumption (prize group); two schools implemented Food Dudes using teacher praise instead of prizes (praise group). Follow-up data were collected 6 months post-intervention. MAIN OUTCOME MEASURE: F/V consumption was assessed by digital imaging of lunch trays. STATISTICAL ANALYSIS PERFORMED: Linear mixed-effects modeling, including sex, grade, and baseline consumption as covariates, was performed. RESULTS: Students attending the Food Dudes schools consumed more F/V than control schools after phase I, with larger differences in prize schools (92% difference) than praise schools (50% difference). After phase II, Food Dudes schools consumed 46% more F/V than control schools, with no difference between prize and praise schools. At 6-month follow-up, only prize schools consumed more F/V than control schools (0.12 cups more per child, 42.9% difference). CONCLUSIONS: Social praise proved an inadequate substitute for tangible prizes within the Food Dudes program. Program-related increases in F/V consumption decreased after the intervention, underscoring the need to develop low-cost, long-term interventions to maintain and make habitual consumption of recommended levels of F/V.

Extending animal models to explore social rewards associated with designated smoking areas on college campuses.

OBJECTIVE: Animal studies have shown that when nicotine is administered in the presence of other animals (as compared with alone), it is more rewarding. As a human analogue to these studies, rewards associated with designated smoking areas on university campuses were examined, since these areas promote using nicotine in the presence of others. PARTICIPANTS: Participants were 118 (Sample 1, collected November 2011) and 94 (Sample 2, collected April 2012) student smokers at a midwestern university. METHOD: Data were collected via an Internet survey. RESULTS: Social interaction while smoking on campus (as compared with smoking alone) significantly increased the perceived reward of smoking, looking forward to spending time in the campus smoking areas, and how many times the campus smoking areas were visited. CONCLUSIONS: Although designated smoking areas may protect nonsmoking students from the dangers of secondhand smoke, these areas may increase the rewards associated with nicotine for the smokers who use them.

Additive and subtractive resilience strategies as enablers of biographical reinvention: a qualitative study of ex-smokers and never-smokers.

The notion of developing resilience is becoming increasingly important as a way of responding to the social determinants of poor health, particularly in disadvantaged groups. It is hypothesized that resilient individuals and communities are able to 'bounce back' from the adversities they face. This paper explores the processes involved in building resilience as an outcome in relation to both quitting smoking and never smoking. The study involved 93 qualitative, oral-history interviews with participants from population groups with high and enduring smoking rates in Adelaide, Australia, and was essentially interested in how some people in these groups managed to quit or never start smoking in the face of adversities, in comparison to a group of smokers. Our key findings relate to what we call additive and subtractive resilience strategies, which focus on the practices, roles and activities that individuals either 'took on' or 'left behind' in order to quit smoking or remain abstinent. The theoretical lenses we use to understand these resilience strategies relate to biographical reinforcement and biographical reinvention, which situate the resilience strategies in a broader 'project of the self', often in relation to attempting to develop 'healthy bodies' and 'healthy biographies'.

Análise funcional de comportamentos verbais inapropriados de um esquizofrênico / Functional analysis of inappropriate verbal behaviors of a schizophrenic

O presente estudo registrou as verbalizações inapropriadas de um esquizofrênico adulto e do sexo masculino. Os comportamentos verbais inapropriados foram observados durante breves períodos de exposição a quatro condições: atenção, atenção não contingente, demanda e sozinho. Os resultados indicaram que as condições afetaram os comportamentos verbais inapropriados diferentemente. Esses resultados são discutidos em termos das suas implicações para as avaliações funcionais antes de intervenções psicológicas.

The present study registered the inappropriate verbalizations of a schizophrenic male adult. The inappropriate verbal behaviors were observed during periods of brief exposure to four conditions: attention, non-contingent attention, demand and alone. Results indicated that these conditions affected the inadequate verbalizations in different ways. These results are discussed in terms of their implications for functional evaluations before the psychological interventions.

Observation, reflection, and reinforcement: surgery faculty members' and residents' perceptions of how they learned professionalism.

PURPOSE: To explore perceptions of how professionalism is learned in the current academic environment. Professionalism is a core competency in surgery (as in all of medical practice), and its presence or absence affects all aspects of clinical education and practice, but the ways in which professional values and attitudes are best transmitted to developing generations of surgeons have not been well defined. METHOD: The authors conducted 34 semistructured interviews of individual surgery residents and faculty members at two academic institutions from 2004 to 2006. Interviews consisted of open-ended questions on how the participants learned professionalism and what they perceived as challenges to learning professionalism. Two researchers analyzed the interview transcripts for emergent themes by using a grounded-theory approach. RESULTS: Faculty members' and residents' perceptions of how they learned professionalism reflected four major themes: (1) personal values and upbringing, including premedical education experiences, (2) learning by example from professional role models, (3) the structure of the surgery residency, and (4) formal instruction on professionalism. Of these, role modeling was the dominant theme: Participants identified observation, reflection, and reinforcement as playing key roles in their learning from role models and in distinguishing the sometimes blurred boundary between positive and negative role models. CONCLUSIONS: The theoretical framework generated out of this study proposes a focus on specific activities to improve professional education, including an active approach to role modeling through the intentional and explicit demonstration of professional behavior during the course of everyday work; structured, reflective self-examination; and timely and meaningful evaluation and feedback for reinforcement.

Soft drink consumption in adolescence: associations with food-related lifestyles and family rules in Belgium Flanders and the Veneto Region of Italy.

BACKGROUND: The number of studies among adolescents that focus on several lifestyle behaviours and family rules as determinant of soft drink consumption are limited. The aim of this study is to investigate the associations between daily soft drink consumption, food-related lifestyles and family rules in adolescence. METHODS: The data are part of the Health Behavior in School-aged Children (HBSC) cross-sectional survey. Adolescents between 11 and 16 years of age were included, resulting in a final sample of 14 407 adolescents representative of Belgium Flanders (N = 7904) and the Veneto Region of Italy (N = 6503). Binary logistic regression was used to test the association between soft drink consumption and food-related lifestyle (breakfast habits, family meals, snacking, meals in fast food restaurants and television viewing) and family rules (restriction and obligation rules) by region and gender. RESULTS: Each independent variable is significantly associated with daily soft drink consumption, despite some sub-groups exceptions. When we entered all the variables into the same statistical model, the positive association with daily soft drink consumption remained significant for frequent meals in fast food restaurants, television variables and low restriction rules. Breakfast during weekdays, evening meal with parents and obligation rules remained significant only in specific sub-groups and not the entire sample. Finally, the association with breakfast with parents and during the weekend disappeared. CONCLUSION: These findings suggest that considering gender and cultural differences, involving parents and limiting adolescents' exposure to television would increase the effectiveness of interventions aimed to reduce soft drink consumption in adolescence.

Efeitos de histórias de reforço social sobre o seguir regras / Effects of social reinforcement histories on rule-following

Com o objetivo de investigar os efeitos de histórias de reforço social sobre o seguimento de regras, 12 estudantes universitários foram expostos a um procedimento de escolha de acordo com o modelo. A tarefa era apontar cada um dos três estímulos de comparação em uma dada sequência. Nas duas condições experimentais, nenhuma sequência era reforçada ou instruída na Fase 1. A Fase 2 era iniciada com a regre correspondente às contingências e a Fase 3 com a regra discrepante das contingências. Nas Fases 2 e 3 a única sequência reforçada era a especificada pela regra correspondente na Fase 2. As duas condições diferiam quanto às consequências programadas para a sequência correta. A sequência correta produzia reforço social na Condição 1 e produzia reforço social mais ponto trocável por dinheiro na Condição 2. A sequência correta era reforçada em esquema de reforço contínuo. Todos os 12 participantes seguiram a regra correspondente na Fase 2. Na Fase 3, quatro dos seis participantes da Condição 1 e três dos seis participantes da Condição 2 seguiram a regra discrepante. Sugere-se que uma história de reforço social para o seguimento de regra correspondente pode contribuir para manter o seguimento subsequente de regra discrepante das contingências.

The objective was to study the effects of social reinforcement histories on rule-following using 12 undergraduate students exposed to a matching to-sample procedure. The task was to point out each one of the three comparison stimuli in a given sequence. In both experimental conditions, no sequence was reinforced or instructed in Phase 1. Phase 2 initiated the rule corresponding to the contingenciesand Phase 3 with the rule that was discrepant to the contingencies. In Phases 2 and 3, the only reinforced sequence was the one specified by the correspondent rule of Phase 2. The two conditions differed in the consequences programmed for the correct sequence. The correct sequence would produce social reinforcement in Condition 1 and would produce social reinforcement, plus points exchangeable for money in Condition 2. The correct sequence was reinforced in continuous reinforcement. All 12 participants followed the correspondent rule in Phase 2. In Phase 3, four out of six participants in Condition 1 and three out of six participants in Condition 2 followed the discrepant rule. It is suggested that a history of social reinforcement for following a correspondent rule cancontribute to maintain a subsequent following of a rule discrepant from the contingencies.

Smoke-free homes and smoking cessation and relapse in a longitudinal population of adults.

INTRODUCTION: The present study reports on the prevalence of smoke-free homes, the characteristics of participants who adopted a smoke-free home policy, and the association between smoke-free homes and subsequent predictors of smoking cessation. METHODS: Data are reported on 4,963 individuals who originally participated in the Community Intervention Trial for Smoking Cessation between 1988 and 1993 and completed follow-up surveys in 2001 and 2005. The relationship between home smoking policy and smoking behavior was examined with a multivariate regression model. RESULTS: Among those who were smokers at the 2001 follow-up, the percentage reporting that no smoking was allowed in their home increased from 29% in 2001 to 38% in 2005. Smokers most likely to adopt smoke-free home policies between 2001 and 2005 were males, former smokers, and those who had lower levels of daily cigarette consumption (among those who continued to smoke), those with higher annual household incomes, and those with no other smokers in the household. Some 28% of smokers with smoke-free homes in 2001 reported that they had quit smoking by 2005 compared with 16% of those who allowed smoking in their homes (odds ratio [OR] = 1.7, 95% CI = 1.4-2.2), and baseline quitters with smoke-free homes also were less likely to relapse (OR = 0.6, 95% CI = 0.4-0.8). DISCUSSION: Smoke-free homes are becoming more prevalent, and they are a powerful tool not only to help smokers stop smoking but also to help keep those who quit from relapsing back to smoking.

Correlates of home smoking restrictions among rural smokers.

The prevalence of smoking is greater and smoking restrictions are less common in rural areas in comparison to urban areas. Consequently, rural smokers and their families are at increased risk for adverse health consequences from smoking. The presence of home smoking restrictions (i.e., limiting or banning cigarette smoking in the home) can be a mediator for smoking cessation and can reduce health risks for those who live with smokers. The purpose of the present study was to identify correlates of home smoking restrictions among rural smokers. We surveyed 472 smokers from 40 rural Kansas primary care practices who were enrolled in a smoking cessation intervention study. We assessed the prevalence of home smoking restrictions and examined the relationship between such restrictions, demographic variables, comorbid diagnoses, and psychosocial measures of smoking abstinence self-efficacy and motivation to quit. Complete home smoking restrictions were found among 25.4% of rural smokers with an additional 28.3% reporting some restrictions. Restrictions were associated with younger age, higher controlled motivation to quit (i.e., motivation from external pressure), the presence of children under age 6 years living in the home, fewer friends who smoke, and a partner who does not smoke. Smokers with a comorbid diagnosis of high cholesterol, chronic lung disease, or heart disease were less likely to have restrictions. Most smokers in rural primary care practices do not have home smoking restrictions, particularly those without children or a nonsmoking partner and those with significant risk factors for smoking-related illnesses. These patients may be critical targets for broaching issues of home smoking restrictions.

Reforçamento diferencial de comportamentos verbais alternativos de um esquizofrênico / Differential reinforcement of alternative verbal behavior of a schizophrenic patient

O presente estudo teve como objetivo investigar o comportamento verbal de um homem de 49 anos que havia sido diagnosticado como esquizofrênico crônico desde os 20 anos de idade. A intervenção foi conduzida em duas classes de respostas: falas psicóticas e falas apropriadas. Os procedimentos de reforçamento diferencial de comportamentos alternativos e extinção foram conduzidos por auxiliares de pesquisa em sessões de 45 minutos, duas vezes por semana. Controle experimental foi obtido por meio de um delineamento de reversão do tipo ABAB seguido por Follow-up. Todas as sessões foram filmadas para posterior cálculo de fidedignidade. Os resultados do estudo mostram uma redução das falas psicóticas e um aumento das falas apropriadas durante as sessões de intervenção. Os dados demonstram que o comportamento verbal da pessoa diagnosticada como esquizofrênica pode ser controlado pelo reforço social combinado com extinção. Delírios e alucinações foram discutidos como comportamentos verbais

How connectedness contributes to experimental smoking among rural youth: developmental and ecological analyses.

The influences of peer, sibling, and parents' smoking on adolescents' initiation of tobacco use have been explained as a function of peer pressure, genetics, and social learning processes, but rarely in combination or with assessments of the quality of these relationships. This study examined the additional contributions of connectedness to friends, siblings, parents, and teachers beyond the effects of friend, sibling, and parental smoking using logistic regression analyses with a cross-sectional middle and high school sample of 303 rural adolescents. Friends' and siblings' smoking, and connectedness to friends, were the strongest predictors of experimental smoking. Parental smoking and connectedness to parents and to teachers were significant predictors of experimental smoking when considered independently, but not after accounting for friend and sibling factors. Connectedness to parents and teachers decreased the odds of experimental smoking, while connectedness to friends increased the odds. EDITORS' STRATEGIC IMPLICATIONS: This strategy of assessing connectedness to-and smoking behaviors of-friends, siblings, teachers, and parents shows promise in predicting teens' cigarette smoking choices. The finding that the negative effects of unconventional connectedness and smoking by friends and siblings outweigh positive effects of connectedness to adults awaits replication with different samples and measures.

Relationship of social support and social burden to repeated breast cancer screening in the women's health initiative.

Direct and interactive effects of social support, social burden (caregiving, negative life events, and social strain), education, and income on repeated use of breast cancer screening among a large (N=55,278), national sample of postmenopausal women participating in the Women's Health Initiative observational study were examined. Repeated screening decreased as emotional/informational support and positive social interactions decreased (ps<.01). Repeated mammography decreased with frequent caregiving (p<.01). Less social strain reduced the frequency of repeated breast self-examinations (BSEs; ps<.01), but frequent caregiving and more negative life events increased repeated use of BSE (ps<.01). Interactive effects suggested that emotional/informational but not tangible support is associated with repeated mammography and clinical breast examinations (ps<.01) and may be particularly important among low-income older women, especially those burdened by caregiving.

Behavioural activation as predictor of substance use: mediating and moderating role of attitudes and social relationships.

Alcohol, tobacco, and drug use were investigated in 4,501 Russian youths aged 14-25 years. The participants also filled out the short forms of the Gray-Wilson Personality Questionnaire and the Eysenck Personality Questionnaire along with questions about attitudes and social relationships. Behavioural Activation (BAS) was the best personality predictor of substance use. Its influence was mediated by disobedience to adults, affiliation with peers (Outings) and tolerant attitude toward illegal activity. BAS was negatively associated with subjective well-being and educational aspiration (Learn). Extraversion was the second strongest predictor of substance use with its influence being mostly mediated by Outings. Besides, Extraversion was positively associated with some protective factors such as subjective well-being, Learn and good relationship with parents. Effects of Neuroticism and Behavioural Inhibition (BIS) on substance use were weak and gender-specific. In females BIS provided a degree of protection while in males it increased the risk of substance use. The personality factors interacted so that BAS and Extraversion tended to mutually increase the impact of each other, while BIS diminished the effect of BAS. Among attitude variables, Outings acted as the most potent predictor of substance use. Relationship with parents was a protective factor, which acted most strongly in adolescents with higher Psychoticism and Extraversion.