Análise comportamental da prática de exercício físico em adultos em contexto de ginásio ao longo de dois anos / Análisis del comportamiento del ejercicio físico en adultos en el gimnasio durante dos años / Analysis of the exercise behavior in gym exercisers across two years

O objetivo deste estudo consistiu em analisar o comportamento dos praticantes de exercício físico ao longo de dois anos, considerando a sua frequência como preditor da frequência futura. Participaram neste estudo 4788 novos praticantes de exercício físico (feminino = 2556) com idades compreendidas entre os 18 e 75 anos. Os acessos aos ginásios e health clubs foi recolhida com recurso aos sistemas eletrónicos dos ginásios. Os dados foram analisados com o recurso a um modelo de equações estruturais e um modelo de mediação em série. Relativamente à taxa de abandono e posteriormente exclusão da análise: 39% abandonaram a prática de exercício físico entre os primeiros seis meses (T1) e os seis meses seguintes (T2); 25% desistiu da prática entre T2 e os seis meses após um ano de prática regular (T3); e 10% abandonaram entre T3 e os seis meses após um ano e meio de prática regular (T4). De acordo com os resultados do modelo de equações estruturais, foram encontrados diversos efeitos diretos e indiretos significativos, sugerindo assim que T2 e T3 poderão ser mediadores entre o T1 e T4. De acordo com os resultados do modelo de mediação é possível observar que o efeito direto não é significativo. Os resultados mostram a existência de mediação total entre o período T1 → T4, dado o efeito indireto total ser significativo e superior ao efeito direto. Os indivíduos que praticam exercício físico pelo menos duas vezes por semana sem interrupção foram aqueles que demonstraram maior probabilidades em se manterem na prática após os dois anos de acompanhamento do comportamento

El objetivo de este estudio fue analizar el comportamiento de los practicantes de ejercicio físico durante dos años, considerando su frecuencia como un predictor de la frecuencia futura. Participaron en este estudio 4788 nuevos practicantes de ejercicio físico (mujeres = 2556) con edades comprendidas entre 18 y 75 años. El acceso a gimnasios y health clubs se recopiló utilizando los sistemas electrónicos. Los datos se analizaron utilizando un modelo de ecuación estructural y un modelo de mediación. En cuanto a la tasa de abandono y posterior exclusión del análisis: 39% abandonó la práctica de ejercicio físico entre los primeros seis meses (T1) y los siguientes seis meses (T2); 25% abandonó la práctica entre T2 y seis meses después de un año de práctica regular (T3); y 10% abandonó entre T3 y seis meses después de un año y medio de práctica regular (T4). Según los resultados del modelo de ecuaciones estructurales, se encontraron varios efectos directos e indirectos significativos, lo que sugiere que T2 y T3 pueden ser mediadores entre T1 y T4. Según los resultados del modelo de mediación, es posible observar que el efecto directo no es significativo. Los resultados muestran la existencia de una mediación total entre el período T1 → T4, ya que el efecto indirecto total es significativo y superior al efecto directo. Las personas que practican ejercicio físico al menos dos veces por semana sin interrupción fueron las que tenían más probabilidades de permanecer en la práctica después de dos años de monitorear su comportamiento

This study aimed to examine the behavior of exercisers across two years, considering their exercise frequency as a predictor of future frequency. In total, 4788 new gym exercisers (female = 2556) aged between 18 and 75 years were enrolled for analysis. Adherence. Computerized records at the gyms and health clubs were used to measure exercise adherence. The collected data was analyzed using structural equation modelling and mediation model specifications. Regarding the dropout rate and later exclusion from the analysis: 39% dropped out within the first six months (T1) and the following six months (T2); 25% withdraw the practice between T2 and six months after one year of regular practice (T3); and 10% dropped out between T3 and six months after a year and a half of regular practice (T4). According to the results of the structural equation model, several significant direct and indirect effects were found, thus suggesting that T2 and T3 may play a mediation role between T1 and T4. Looking at the results from the mediation model, it is possible to observe that the direct effect was not significant. The results show the existence of total mediation between the period T1 → T4, since the total indirect effect is significant and greater than the direct effect. Individuals who practice physical exercise at least twice a week without interruption were those who were more likely to remain in practice after two years of monitoring their behavior

The effects of transition to technician-delivered telehealth ABA treatment during the COVID-19 crisis: A preliminary analysis.

Telehealth delivery of applied behavior analysis treatment has focused on supervision or staff and parent training, rather than the direct delivery of treatment to clients. The novel coronavirus (COVID-19) crisis had the potential to significantly disrupt access to direct treatment for individuals with autism. We report a sample of 17 cases that transitioned from in-person to telehealth delivery of treatment when shelter-in-place orders were issued. Of these cases, 76% of participants transitioned to technician-delivered telehealth services whereas the rest transitioned to a caregiver-implemented telehealth model. Participants continued to access a similar dosage of treatment hours per week in spite of the treatment model transition (in-person M = 12; telehealth M = 11) and maintained or improved correct independent responding across all targets from in-person treatment (M = 75%) to telehealth treatment (M = 80%). These findings provide initial evidence that some clients with autism benefit from technician-delivered telehealth services.

Animal Behavior and Learning: Support from Applied Behavior Analysis.

Applied behavior analysis (ABA) is a relevant field for veterinarians helping clients whose animals engage in problem behaviors. In ABA, learning is defined as behavior change due to changes in the environment. Changing behavior then requires changes in conditions. Understanding the importance of control and the difference between emotional behavior and emotional feelings also is informed by ABA. Every behavior intervention should start with a systematic, analytical process called a functional assessment. Behavior change strategies are described, including an ethical procedural hierarchy based on the least intrusive, effective behavior change solution.

[Effectiveness of Behavioral Activation for the Treatment of Severe Depression in Clinical Settings]. / Évaluation des effets de l'activation comportementale de groupe pour le traitement de la dépression sévère en milieu clinique.

Objectives Among interventions that have been shown to be efficacious in the treatment of depression, behavioural activation (AC) is receiving increasing attention as the evidence supporting its effectiveness continues to accumulate. Although the efficacy of AC for the treatment of depression has been established through numerous randomized controlled trials, studies evaluating the effectiveness of AC when implemented in mental health settings are rare and there is insufficient supportive data. This step is, however, essential to the validity and the generalization of the treatment to the reality of clinical settings. This study focuses on AC applied to take into account the reality of clinical settings and patients seeking treatment. It evaluates the effectiveness of group-based AC for the treatment of severe depression in a clinical setting in a heterogeneous population in terms of diagnosis (unipolar and bipolar depression) and comorbidity (Axis I and II). Methods A sample of 45 participants with severe depression was recruited in a psychiatric hospital. Participants received a 10 sessions group intervention of AC. Questionnaires were administered to obtain pretreatment, post-treatment and four-week post-treatment data. The impact of the intervention was observed on measures of depression, behavioural activation, reinforcement, anxiety, social adjustment and quality of life. Various moderation effects associated with the heterogeneity of the sample were tested on the evolution of depressive symptoms. The integrity of the treatment administered by the therapists and the acceptability of the intervention by participants were also documented. Results Mixed model analyses of variance were performed to assess whether (a) AC caused a significant change at the end of treatment on depressive symptoms, behavioural activation, reinforcement, anxiety, social adjustment and quality of life and whether (b) gains were maintained after four weeks. A significant change was obtained between the pre-post measures on the average score of all these variables, with the exception of a subscale of the quality of life measure. Analyses were also performed to verify various moderating effects on the evolution of depressive symptoms, level of activation and reinforcement. No interaction effects are observed on depression, activation and reinforcement measures. There is no significant difference according to pretreatment severity category, diagnosis (unipolar vs bipolar), presence of comorbidity (other Axis I and/or Axis II disorder) or co-morbidity of Axis II disorder. As for the activation measure in people with bipolar depression versus unipolar depression, it should be noted that the result is at the threshold of statistical significance. Conclusion The results support the effectiveness of group-based AC for the treatment of severe depression in clinical settings in a heterogeneous population, as well as for the maintenance of gains after four weeks. The effectiveness of AC was also observed across all associated psychosocial measures.

A standardized social preference protocol for measuring social deficits in mouse models of autism.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication deficits and other behavioral abnormalities. The three-chamber social preference test is often used to assess social deficits in mouse models of ASD. However, varying and often contradicting phenotypic descriptions of ASD mouse models can be found in the scientific literature, and the substantial variability in the methods used by researchers to assess social deficits in mice could be a contributing factor. Here we describe a standardized three-chamber social preference protocol, which is sensitive and reliable at detecting social preference deficits in several mouse models of ASD. This protocol comprises three phases that can all be completed within 1 d. The test mouse is first habituated to the apparatus containing two empty cups in the side chambers, followed by the pre-test phase in which the mouse can interact with two identical inanimate objects placed in the cups. During the test phase, the mouse is allowed to interact with a social stimulus (an unfamiliar wild-type (WT) mouse) contained in one cup and a novel non-social stimulus contained in the other cup. The protocol is thus designed to assess preference between social and non-social stimuli under conditions of equal salience. The broad implementation of the three-chamber social preference protocol presented here should improve the accuracy and consistency of assessments for social preference deficits associated with ASD and other psychiatric disorders.

Functional assessment and function-based treatment delivered via telehealth: A brief summary.

As the world navigates the COVID-19 health crisis, behavior analysts are considering how best to support families while maintaining services and ensuring the health and safety of everyone involved. Telehealth is one service delivery option that provides families with access to care in their own communities and homes. In this article, we provide a brief summary of the telehealth literature in applied behavior analysis that provided coaching and training to families for individuals who displayed challenging behavior. These studies targeted functional assessment and function-based treatment for challenging behavior. We briefly summarize what is known relative to the assessment and treatment of challenging behavior via telehealth, place these results within a descriptive context of the decisions made by the research team at the University of Iowa, and discuss what we, as behavior analysts, should consider next to advance our understanding and practice of telehealth.

Perceiving facial affective ambiguity: A behavioral and neural comparison of adolescents and adults.

The current study examined perceptual differences between adults and youth in perceiving ambiguous facial expressions. We estimated individuals' internal representation for facial expressions and compared it between age groups (adolescents: N = 108, Mage = 13.04 years, 43.52% female; adults: N = 81, Mage = 31.54, 65.43% female). We found that adolescents' perceptual representation for facial emotion is broader than that of adults', such that adolescents experience more difficulty in identifying subtle configurational differences of facial expressions. At the neural level, perceptual uncertainty in face-selective regions (e.g., fusiform face area, occipital face area) were significantly higher for adolescents than for adults, suggesting that adolescents' brains more similarly represent lower intensity emotional faces than do adults'. Our results provide evidence for age-related differences concerning psychophysical differences in perceptual representation of emotional faces at the neural and behavioral level. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Evaluating the Influence of Intraverbal Topography in Conditional Discrimination Procedures.

Stimulus equivalence training has been relatively under represented in the research literature for training individuals with autism spectrum disorder (ASD) in early letter-sound correspondence. The primary purpose of the current study was to compare the effectiveness of two different topographies of intraverbals on the emergence of untrained relations between letters and their phonemic sounds for two elementary aged children with ASD. Given frequent difficulties answering WH-questions for children with ASD, assessment and training using questions or statements was compared using a test-train-test sequence. Relations that required auditory-visual match to sample tasks emerged for both participants; however, emergence of untrained intraverbal relations differed based on the topography of assessment and training used. Limitations and future directions are discussed.

Randomization tests as alternative analysis methods for behavior-analytic data.

Randomization statistics offer alternatives to many of the statistical methods commonly used in behavior analysis and the psychological sciences, more generally. These methods are more flexible than conventional parametric and nonparametric statistical techniques in that they make no assumptions about the underlying distribution of outcome variables, are relatively robust when applied to small-n data sets, and are generally applicable to between-groups, within-subjects, mixed, and single-case research designs. In the present article, we first will provide a historical overview of randomization methods. Next, we will discuss the properties of randomization statistics that may make them particularly well suited for analysis of behavior-analytic data. We will introduce readers to the major assumptions that undergird randomization methods, as well as some practical and computational considerations for their application. Finally, we will demonstrate how randomization statistics may be calculated for mixed and single-case research designs. Throughout, we will direct readers toward resources that they may find useful in developing randomization tests for their own data.

Telehealth as a Model for Providing Behaviour Analytic Interventions to Individuals with Autism Spectrum Disorder: A Systematic Review.

Interventions based on applied behaviour analysis are considered evidence based practice for autism spectrum disorders. Due to the shortage of highly qualified professionals required for their delivery, innovative models should be explored, such as telehealth. Telehealth utilises technology for remote training and supervision. The purpose of our study was to systematically review the literature researching telehealth and ABA. We analysed intervention characteristics, outcomes and research quality in 28 studies and identified gaps. Intervention characteristics were: (1) research design (2) participants (3) technology (4) dependent variables (5) aims. Outcomes were favourable with all studies reporting improvements in at least one variable. Quality ratings were significantly low. Implications for future research and practice are discussed in light of identified methodological downfalls.

Delineamento experimental em Análise do Comportamento: discussão sobre o seu uso em intervenções educacionais inclusivas / Plan expérimental en Analyse Comportementale: discussion sur son utilisation dans les interventions éducatives inclusives / Diseño experimental en el Análisis de la Conducta: discusión sobre su uso en intervenciones educativas inclusivas / Experimental design in Behavior Analysis: discussion on its use in inclusive educational interventions

Resumo A aplicação de intervenções educacionais inclusivas por agentes educacionais em estudantes da educação especial deveria ser sistematicamente avaliada, para garantir replicação futura dos procedimentos e resultados, a partir do uso de um delineamento experimental adequado à proposta. O objetivo foi analisar como pesquisas aplicadas podem contribuir no arranjo de intervenções educacionais inclusivas mais sistemáticas, a partir do uso de delineamentos experimentais em Análise do Comportamento; discutir a tomada de decisão para a escolha de um delineamento e o impacto dessa escolha nos dados coletados e no conhecimento que se deseja produzir, especialmente a partir do envolvimento dos diferentes agentes educacionais na aplicação de intervenções pedagógicas com estudantes com DI ou TEA. Discute-se a garantia de um delineamento que avalie os resultados das intervenções aplicadas por agentes e a dificuldade de identificar um delineamento que assegure com precisão científica o impacto de cada intervenção aplicada por cada um deles.

Résumé L'application d'interventions éducatives inclusives par des agents de l'éducation à des étudiants de l'éducation specialisée devrait être systématiquement évaluée afin de garantir la reproduction à l'avenir des procédures et des résultats de l'utilisation d'un plan expérimental approprié. L'objectif était d'analyser en quoi la recherche appliquée pouvait contribuer à le arrangement d'interventions éducatives inclusives plus systématiques, fondées sur l'utilisation de modèles expérimentaux dans l'analyse comportementale; discuter de la prise de décision pour le choix d'un design et de l'impact de ce choix sur les données collectées et les connaissances à produire, en particulier grâce à la participation des différents agents de l'éducation à la mise en œuvre d'interventions pédagogiques auprès d'élèves présentant un IDD ou un TSA. Il traite de la garantie d'un plan qui évalue les résultats des interventions appliquées par les agents et de la difficulté d'identifier un plan qui assure avec une précision scientifique l'impact de chaque intervention appliquée.

Resumen La aplicación de intervenciones educativas inclusivas por agentes educativos a los estudiantes de la educación especial debería ser sistemáticamente evaluada para garantizar la futura replicación de los procedimientos y resultados a partir del uso de un diseño experimental adecuado a la propuesta. El objetivo del texto fue analizar cómo las investigaciones aplicadas pueden contribuir a la disposición de intervenciones educativas inclusivas más sistemáticas, a partir del uso de diseños experimentales en el Análisis de la Conducta; así como discutir la toma de decisiones para seleccionar un diseño y el impacto de esa elección en los datos recolectados y en el conocimiento que se desea producir, especialmente desde la participación de los diferentes agentes educativos en la aplicación de intervenciones pedagógicas con estudiantes con DI o TEA. Se discute la garantía de un diseño que evalúe los resultados de las intervenciones aplicadas por agentes y la dificultad de identificar un diseño que garantice con precisión científica el impacto de cada intervención aplicada por cada uno de ellos.

Abstract The application of inclusive educational interventions by educational agents to special education students should be systematically evaluated to ensure future replication of procedures and results from the use of an adequate experimental design. The aim was to analyze how applied researches can contribute to the arrangement of more systematic inclusive educational interventions, based on the use of experimental designs in Behavior Analysis; to discuss decision making for choosing a design and the impact of this choice on the data collected and on the knowledge to be produced, especially from the involvement of different educational agents in the application of pedagogical interventions with students with ID or ASD. It discusses the guarantee of a design that evaluates the results of interventions applied by agents and the difficulty to identify a design that assures with scientific precision the impact of each intervention applied.

Setting global research priorities for child protection in humanitarian action: Results from an adapted CHNRI exercise.

BACKGROUND: Armed conflict, natural disaster, and forced displacement affect millions of children each year. Such humanitarian crises increase the risk of family separation, erode existing support networks, and often result in economic loss, increasing children's vulnerability to violence, exploitation, neglect, and abuse. Research is needed to understand these risks and vulnerabilities and guide donor investment towards the most effective interventions for improving the well-being of children in humanitarian contexts. METHODS: The Assessment, Measurement & Evidence (AME) Working Group of the Alliance for Child Protection in Humanitarian Action (ACPHA) identified experts to participate in a research priority setting exercise adapted from the Child Health and Nutrition Research Initiative (CHNRI). Experts individually identified key areas for research investment which were subsequently ranked by participants using a Likert scale. Research Priority Scores (RPS) and Average Expert Agreement (AEA) were calculated for each identified research topic, the top fifteen of which are presented within this paper. RESULTS: Intervention research, which aims to rigorously evaluate the effectiveness of standard child protection activities in humanitarian settings, ranked highly. Child labor was a key area of sector research with two of the top ten priorities examining the practice. Respondents also prioritized research efforts to understand how best to bridge humanitarian and development efforts for child protection as well as identifying most effective way to build the capacity of local systems in order to sustain child protection gains after a crisis. CONCLUSIONS: Rigorous, scientific research that assesses the scope of child protection risks, examines the effectiveness of interventions to improve child well-being, and translates evidence to practice is critical. Findings from this research priority setting exercise offer guidance for a global research agenda on child protection in humanitarian settings, encouraging cooperation among donors, implementers, and academics to pursue a coordinated approach to evidence generation.

Development and Validation of the Transgender Inclusive Behavior Scale (TIBS).

Transgender-inclusive behaviors are actions and communication supporting transgender individuals. Examples include using language not reinforcing the gender binary, asking for and using correct pronouns, creation of spaces that welcome members of the transgender community, and acknowledging cisgender (non-transgender) privilege. A survey was developed measuring this behavior in individuals to examine the impact of transgender-inclusive behavior and the potential effect of interventions on promoting inclusive behavior. Data were collected utilizing an online survey (N = 1,051). The sample was split in half to run two sets of cases in a principal components analysis. Analysis of the full sample showed Cronbach's alpha to be .93 (n = 918). Findings suggest that the Transgender Inclusive Behavior Scale (TIBS) may be a useful instrument for identifying behaviors related to being inclusive of transgender individuals, groups, and communities. It may also be used to measure behavior change before and after transgender-specific educational and behavioral interventions.

Produção do conhecimento sobre o cuidado fenomenológico na enfermagem / Producción de conocimiento sobre el cuidado de enfermería fenomenológica / Production of knowledge about the phenomenological care in nursing

RESUMO Introdução: na fenomenologia o cuidado é consolidado no modo de ser, atuante em todo e qualquer comportamento humano. Logo, sendo o cuidado a essência da enfermagem, ao pensarmos este em seu sentido fenomenológico, nos atemos à essência e ao sentido do cuidar. Objetivo: realizar o levantamento das produções do conhecimento que objetivaram o cuidado por intermédio da enfermagem em fenomenologia e apresentar suas contribuições para o cuidado. Métodos: estudo de revisão integrativa, de característica crítica e retrospectiva. Estratégia de busca: utilização da palavra-chave "phenomenology" e descritores "nursing care" e "health". A busca ocorreu nas bases: MEDLINE; LILACS; BDENF e SCOPUS. Critérios de inclusão: artigos publicados entre os anos de 2010 a 2015, nos idiomas Português, Inglês e Espanhol, que apresentavam aderência à temática, e que constassem o referencial filosófico adotado. Critérios de exclusão: artigos de revisão, teóricos ou de reflexão, e também os que não apresentaram aderência às questões do cuidado na enfermagem com enfoque fenomenológico. Foram analisados 26 artigos. Conclusões: o cuidado fenomenológico encontra seu desenvolvimento mais significativo sob a dimensão social, se apropriando e compreendendo o sujeito permeado por suas vivências, experiências e significados, sem esquecer-se dos familiares envolvidos no processo de cuidar e dos profissionais de saúde, o que demonstra a importância destes terem suas esferas biopsicossociais cuidadas para que o cuidado se faça substancial e efetivo(AU)

RESUMEN Introducción: el cuidado de la fenomenología se consolida con el fin de estar activo en cada comportamiento humano. Por lo tanto, teniendo cuidado de la esencia de la enfermería, a pensar de esta en su sentido fenomenológico, nos ceñimos a la esencia y el sentido de cuidado. Objetivo: realizar el levantamiento de las producciones del conocimiento dirigidas a la atención a través de la enfermería en la fenomenología y presentar sus contribuciones a la atención. Métodos: estudio de revisión integradora de la función crítica y retrospectiva. Estrategia de búsqueda: el uso de palabras clave "fenomenología" y descriptores "cuidados de enfermería" y "salud". La búsqueda se produjo en: MEDLINE; LILACS; BDENF y SCOPUS. Criterios de inclusión: los artículos publicados entre los años 2010 a 2015 en los idiomas portugués, inglés y español, que presentan la adherencia al tema, y que se trataran en el marco filosófico adoptado. Criterios de exclusión: los artículos de revisión, teóricos o de reflexión, y aquellos que no muestran la adhesión a la atención de enfermería en temas con enfoque fenomenológico. Fueron analizados 26 artículos. Conclusiones: el cuidado fenomenológico encuentra su desarrollo más significativo en la dimensión social, la apropiación y la comprensión de la materia permeada por sus experiencias, experiencias y significados, sin olvidar las familias que participan en los profesionales de procesos de atención y de salud, lo que demuestra la importancia que tienen sus esferas biopsicosociales cuidadas para que la atención se realiza sustancial y efectiva(AU)

ABSTRACT Introduction: in phenomenology care is consolidated in order to be active in every human behavior. Therefore, being careful the essence of nursing, to think of this in its phenomenological sense, we stick to the essence and sense of caring. Objective: to carry out the survey the knowledge productions aimed care through nursing in phenomenology and present their contributions to care. Methods: study of integrative review of critical feature and retrospective. Search strategy: keyword use "phenomenology" and descriptors "nursing care" and "health". The search occurred in: MEDLINE; LILACS; BDENF and SCOPUS. Inclusion criteria: articles published between the years 2010 - 2015 in the languages Portuguese, English and Spanish, presenting adherence to the theme, and to see covered in the philosophical referential adopted. Exclusion criteria: review articles, theoretical or reflection, and those who did not show adherence to care issues in nursing with phenomenological approach. 26 articles were analyzed. Conclusions: the phenomenological care finds its most significant development on the social dimension, appropriating and understanding the subject permeated by their experiences, experiences and meanings, without forgetting families involved in the care process and health professionals, which demonstrates the importance these have their biopsychosocial cared spheres so that care is done substantial and effective(AU)

Predictors of longitudinal ABA treatment outcomes for children with autism: A growth curve analysis.

BACKGROUND: Autism spectrum disorder (ASD) is a developmental disorder that causes lifelong disability. Applied Behavior Analysis (ABA) is one of the most empirically studied and validated approaches for treating children diagnosed with ASD. Due to the heterogeneity of ASD, it is important to ascertain who will most benefit from treatment. METHODS: In this study, 35 participants, with a mean entry age of 3 years, received ABA therapy. Children were assessed at intake and every 6 months thereafter using the Developmental Profile-3 (DP-3) to measure their communication, social-emotional, adaptive behavior, and physical development (2-6 measures per participant). Using a growth curve analysis, we investigated if age, diagnosis severity, cognitive functioning, treatment hours, gender, parent education level, or primary language spoken at home significantly predicted the growth trajectories of ABA treatment outcomes. RESULTS: Our findings indicated that higher cognitive functioning significantly predicted faster growth across all four developmental domains, age at entry predicted initial status, and other variables only predicted growth rates in one or two domains. IMPLICATIONS: Knowing the predictors of treatment outcome is important information for customizing treatment and this study demonstrated how longitudinal analyses can illuminate how participant characteristics affect the course of ABA therapy.

Análisis de Conducta en Medicina Evaluadora: una propuesta interdisciplinary / Behavioral analysis in disability assessment medicine: an interdisciplinary proposal

Se propone un nuevo marco teórico, el Análisis de Conducta en Medicina, para abordar los desafíos que la evaluación de la incapacidad y la medicina pericial afrontan en su práctica clínica diaria. Mediante un enfoque con base científica interdisciplinar y flexible pero sistemático en su aplicación, el Sistema de Análisis de Validez en la Evaluación (SAVE) está diseñado para incorporar una amplia gama de métodos, técnicas y habilidades útiles, tomadas de diferentes fuentes (psicología forense, criminología, derecho sanitario, detección del engaño y el fraude, etc.). Se estructura en tres fases sucesivas, Verosimilitud (V1), que corresponde al análisis del contenido verbal de la declaración; Veracidad (V2) como congruencia entre lo verbal y lo no verbal, y Verificación (V3), el proceso de comprobación de la información previamente obtenida. Estos conocimientos y habilidades se pueden aprender y entrenar, todos ellos han sido probados científicamente y cuentan con un amplio número de referencias publicadas para profundizar en cada tema. Además, este proceso permite una fácil adaptación a cada caso y contexto, evitando molestar a los informados genuinamente impedidos al pasar desapercibido excepto cuando la probabilidad de fraude es elevada. Por lo tanto, creemos que cualquier profesional de la salud y especialmente los peritos médicos, sean funcionarios o independientes, se beneficiarán de este modo de realizar la consulta médica, mejorando la relación médico-paciente y la necesaria gestión del engaño cuando sea preciso (AU)

A new theoretical framework, the Behavioral Analysis in Medicine is proposed to address the challenges that disability assessment and clinical forensic medicine face in everyday practice. Through an interdisciplinary approach, scientifically based and flexible yet systematically applied, the System of Validity Analysis in Assessment (referred to by its Spanish acronym SAVE) is designed to incorporate a wide array of useful methods, techniques and skills from different sources (forensic psychology, criminology, health law science, deception and fraud detection, etc.). It is structured in three successive phases, Verisimilitude (V1), as verbal content analysis of the statement; Veracity (V2) as congruence between verbal and non-verbal communication, and Verification (V3), the checking process of previously obtained information. These knowledge and abilities are affordable to learn and train. All of them have been scientifically tested and have an extensive number of published references to delve deeper in each subject. Additionally, this process allows an easy adaptation to each case and context, avoiding disturbing those genuinely disabled examinees by going unnoticed unless there is a high probability of fraud. Hence, we believe that every health practitioner, especially the medical examiners, public servants or independent ones will benefit from this way to accomplish every medical consultation, improving the patient-physician relationship and the necessary fraud management whenever necessary (AU)

Problemas de comportamiento, problemas emocionales y de atención en niños y adolescentes que viven en acogimiento residencial / Behavioral problems, emotional problems and attention in children and adolescents living in residential care

Resumen El objetivo general del estudio es comparar la información aportada por padres, profesores y cuidadores sobre el comportamiento problemático y los problemas emocionales de preadolescentes y adolescentes venezolanos institucionalizados y que viven con sus familias, cuyas edades están comprendidas entre 11 y 16 años. La muestra estuvo constituida por 111 participantes institucionalizados en asociaciones civiles y entidades de protección del Estado, y 111 preadolescentes y adolescentes que conformaron la muestra control y pertenecían a colegios públicos, privados o subsidiados. Se valoraron los síntomas emocionales, el déficit de atención e hiperactividad, problemas con los compañeros, problemas de conducta y comportamiento prosocial. Los comportamientos problemáticos y los problemas emocionales fueron medidos a través del Cuestionario de Capacidades y Dificultades (SDQ), con la información proveniente de padres/cuidadores y profesores, y los problemas de atención fueron evaluados a través de la Escala para la evaluación del Trastorno por Déficit de Atención con Hiperactividad (EDAH) con la información de los profesores. Las conclusiones del estudio permiten afirmar que los participantes que viven en las instituciones presentan mayor nivel de problemas de comportamiento, problemas emocionales y de atención que los preadolescentes y adolescentes que conviven con sus familias de acuerdo a los informes de los padres, profesores y cuidadores.

Abstract The general objective of the study is to compare the information provided by parents, teachers and caregivers about pre-adolescents and Venezuelan adolescents institutionalized and living with their families, whose ages are between 11 and 16 years old. The sample was constituted by 111 participants institutionalized in civil associations and state protection entities, and 111 preadolescents and adolescents who conformed the control sample and belonged to public, private or subsidized schools. Emotional symptoms, attention deficit and hyperactivity, problems with peers, behavior problems and prosocial behavior were assessed. Problematic behaviors and emotional problems were measured through the Capacities and Difficulties Questionnaire (SDQ), with information from parents / caregivers and teachers, and care problems were assessed through the Scale for the Evaluation of Disorder Attention Deficit Hyperactivity Disorder (EDAH) with information from teachers. The conclusions of the study allow us to affirm that the participants living in the institutions present a higher level of behavior problems, emotional problems and attention than the preadolescents and adolescents who live with their families according to the reports of parents, teachers and caregivers.

Procedures and compliance of a video modeling applied behavior analysis intervention for Brazilian parents of children with autism spectrum disorders.

Video modeling using applied behavior analysis techniques is one of the most promising and cost-effective ways to improve social skills for parents with autism spectrum disorder children. The main objectives were: (1) To elaborate/describe videos to improve eye contact and joint attention, and to decrease disruptive behaviors of autism spectrum disorder children, (2) to describe a low-cost parental training intervention, and (3) to assess participant's compliance. This is a descriptive study of a clinical trial for autism spectrum disorder children. The parental training intervention was delivered over 22 weeks based on video modeling. Parents with at least 8 years of schooling with an autism spectrum disorder child between 3 and 6 years old with an IQ lower than 70 were invited to participate. A total of 67 parents fulfilled the study criteria and were randomized into two groups: 34 as the intervention and 33 as controls. In all, 14 videos were recorded covering management of disruptive behaviors, prompting hierarchy, preference assessment, and acquisition of better eye contact and joint attention. Compliance varied as follows: good 32.4%, reasonable 38.2%, low 5.9%, and 23.5% with no compliance. Video modeling parental training seems a promising, feasible, and low-cost way to deliver care for children with autism spectrum disorder, particularly for populations with scarce treatment resources.

A Positive Behavioral Approach for Aggression in Forensic Psychiatric Settings.

Aggression toward self and others by complex patients admitted to forensic psychiatric settings is a relatively common yet extremely difficult behavior to treat. Traditional interventions in forensic inpatient settings have historically emphasized control and management over treatment. Research over the past several years has demonstrated the value of behavioral and psychosocial treatment interventions to reduce aggression and to increase prosocial skill development in inpatient forensic population. Positive behavioral support (PBS) offers a comprehensive approach that incorporates the science of applied behavioral analysis (ABA) in support of patients with challenging behaviors, including aggression and violence. In this article, we describe a PBS model to treat aggression in forensic settings. PBS includes a comprehensive functional assessment, along with four basic elements: ecological strategies, positive programming, focused support strategies, and reactive strategies. Other key components are described, including data collection, staff training, fidelity checks to ensure correct implementation of the plan, and ongoing monitoring and revision of PBS strategies, according to treatment outcomes. Finally, a behavioral consultation team approach within the inpatient forensic setting is recommended, led by an assigned doctoral-level psychologist with specialized knowledge and training in behavioral methods. The behavioral consultation team works directly with the unit treatment team and the identified patient to develop, implement, and track a plan that may extend over several weeks to several months including transition into the community. PBS can offer a positive systemic impact in forensic inpatient settings, such as providing a nonpharmacologic means to address aggression, reducing the incidences of restraint and seclusion, enhancing staff proficiency in managing challenging patient presentations, and reducing recidivism when used as part of the bridge to community re-entry.