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Evaluation of a Diabetes Education Call Center intervention.

Patients require education and information as they engage in self-help, self-care, and disease management activities. The purpose of this study was to determine how effective voice technologies are in diabetes patient education. A pretest-posttest study was conducted to evaluate the effectiveness of prerecorded educational messages delivered via the telephone to participants with diabetes. The intervention consisted of 24 four-minute messages on the topics of knowledge and prevention, glucose level, diet and activity, and management and coping. Eighteen persons with diabetes participated in the pretest-posttest trial. A total of 324 educational messages were listened to over a 12-week intervention period. The pretest-posttest trial demonstrated that a brief telephone-based diabetes education intervention can have a significant impact on increasing frequency of checking blood for glucose (p = 0.017), improving general diabetes knowledge (p = 0.048), and improving insulin-specific knowledge (p = 0.020). Automated educational interventions should be based on scientifically sound evidence and can be effectively delivered by telephone. Automated telephone-based diabetes education may be used alone or as a supplement to existing diabetes education. Automated education is a viable solution when healthcare organizations and regions that as a result of a lack of human and financial resources cannot afford a diabetes educator.

Adult↗

Effect of the BACE intervention on agitation of people with dementia.

PURPOSE: This study tests the effectiveness of the theoretically driven BACE (i.e., Balancing Arousal Controls Excesses) intervention in decreasing agitation in residents of long-term care with moderate or severe dementia. DESIGN AND METHODS: A pretest-posttest double-blinded experimental design with random assignment was used with a sample of 78 participants. The BACE intervention controls the daily activity schedule so that there is a balance between a person's high-arousal and low-arousal states. The outcome measure was observed agitation. RESULTS: When time spent in arousal imbalance at pretest was controlled for, a repeated measures analysis of covariance revealed a statistically significant Group x Time interaction, F(1, 69) = 4.26, p =.043, with a partial eta(2) =.06. The average change in agitation for the treatment group was a decrease of 8.43 points (SD = 12.01) from pretest to posttest, an effect size of.7. IMPLICATIONS: The results of this study support the theory that balancing arousal states by using an individualized approach is effective in decreasing agitation levels of people with dementia.

Aged↗

The effect of reminiscence music therapy sessions on changes in depressive symptoms in elderly persons with dementia.

This study examined the effectiveness of reminiscence focused music therapy treatment on depressive symptoms in elderly people with dementia. Twenty elderly (3 male & 17 female) who were diagnosed as having dementia and residing at 2 different residential care facilities in Florida were assigned to 1 of 4 small groups. Each of the participants served as his or her own control in an O1 O2 X O3 design. The depressive symptoms were measured using Cornell Scale for Depression in Dementia. The differences between the scores of pretest, posttest 1 after a week of 5-day no treatment, and posttest 2 after a week of 5-day reminiscence focused music therapy treatment were compared. A one-way analysis of variance (ANOVA) and Newman-Keuls Multiple Comparison Procedure indicated statistically significant differences between pretest and posttest 2 as well as posttest 1 and posttest 2, while no significant differences were found between pretest and posttest 1. Results indicated that participation in small group reminiscence focused music therapy groups might help to reduce depressive symptoms in elderly people with dementia. Results of behavioral observations and future implications are also discussed.

Aged↗

Highly specific prediction of antineoplastic drug resistance with an in vitro assay using suprapharmacologic drug exposures.

Bayes' theorem has been used to describe the relationship between the accuracy of a predictive test (posttest probability) and the overall incidence of what is being tested (pretest probability). Bayes' theorem indicates that laboratory assays will be accurate in the prediction of clinical drug resistance in tumors with high overall response rates (e.g., previously untreated breast cancer) only when the assays are extremely (greater than 98%) specific for drug resistance. We developed a highly specific drug-resistance assay in which human tumor colonies were cultured in soft agar and drugs were tested at high concentrations for long exposure times. Coefficients for concentration x time exceeded those reported in contemporaneous studies by about 100-fold. We reviewed 450 correlations between assay results and clinical response over an 8-year period. Results were analyzed by subsets, including different tumor histologies, single agents, and drug combinations. Extreme drug resistance (an assay result greater than or equal to SD below the median) was identified with greater than 99% specificity. Only one of 127 patients with tumors showing extreme drug resistance responded to chemotherapy. This negligible posttest probability of response was independent of pretest (expected) probability of response. Once this population of patients with tumors showing extreme drug resistance had been identified, posttest response probabilities for the remaining cohorts of patients varied according to both assay results and pretest response probabilities, precisely according to predictions based on Bayes' theorem. This finding allowed the construction of a nomogram for determining assay-predicted probability of response.

Antineoplastic Agents↗

Effects of respiratory exercises on the vital capacity and forced expiratory volume in children with cerebral palsy.

The purpose of this study was to determine if breathing exercises can increase the vital capacity in children with cerebral palsy. Ten children with spastic cerebral palsy, five in the experimental group and five in the control group, were the subjects for the study. A spirometer was used to measure vital capacity and the forced expiratory volume before and after the children performed a breathing exercise program. The pretest values for all 10 youngsters indicated a vital capacity lower than the normal predicted values. The breathing exercises selected emphasized strengthening of the muscles of inspiration and the muscles of expiration. In the breathing exercise program, the physical therapists also attempted to follow the Bobath treatment approach by inhibiting the abnormal breathing patterns and by teaching the child proper ways of breathing control. The results seem to indicate that a breathing exercise program can increase the vital capacity in youngsters with cerebral palsy. The vital capacity of the experimental group was increased by 0.46 liters after exercising for five to seven minutes each day for a period of eight weeks. The mean increase of the vital capacity was 31 percent over the pretest values. The control group showed no change in vital capacity. The pretest and posttest forced expiratory volumes of both groups were within normal limits.

Breathing Exercises↗

Clinical experience and cognition of a physical therapy procedure.

This investigation was designed to determine if clinical experience influences cognition of a physical therapy procedure. We hypothesized that experience in the application of a physical therapy procedure on patients would increase the student's cognition of that procedure. Twenty-two junior students in a physical therapy baccalaureate program were study subjects. A multiple-choice test pertaining to gait training was administered to all subjects as a pretest and posttest. The pretest was given after classroom instruction and laboratory practice in gait training; posttest was administered eight weeks later. During the interim eight weeks, 11 subjects completed 32 hours of clinical experience and 11 subjects had no clinical experience. Analysis of the results of posttest compared with pretest indicated that for these subjects, clinical experience did not increase cognition of gait training.

Educational Measurement↗

Sensitivity and reliability of force tracking and joint-movement tracking scores in healthy subjects.

The purpose of this study was to examine the sensitivity and reliability of two tracking tests designed to measure control of handgrip force and finger movement. In one test, the subject exerts careful control of handgrip force on a dynamometer, which is interfaced with a computer, and attempts to guide a cursor as accurately as possible along a stationary target track displayed on the computer screen. In the second test, the subject attempts to trace a different target track by precise flexion-extension movement of the metacarpophalangeal joint of the index finger to which an electrogoniometer is attached. For both tests, the computer quantifies the subject's performance with an accuracy index. Fourteen healthy subjects participated in the force tracking test (FTT), which involved three pretest tracking trials, a 20-minute inactivity period, and three posttest trials. Thirteen different healthy subjects participated in the joint-movement tracking test (JMTT) using the same testing format. One-tailed, paired t tests of the pretest-posttest tracking scores showed significant (p less than .01) improvement in tracking accuracy for both the FTT and the JMTT. Additionally, intraclass correlation coefficients for both the pretest and the posttest trials showed acceptable reliability in the FTT and the JMTT. We concluded, for healthy subjects, that 1) these tracking tests are sensitive to small changes in force control and joint-movement control, and 2) the tracking scores are reliable. We believe that these tests could be very useful in documenting objectively the effects of treatment applied to the hand.

Adult↗

The effects of an AIDS education program on the knowledge and attitudes of a physical therapy class.

BACKGROUND AND PURPOSE: The purpose of this investigation was to determine the effect of an education unit on physical therapy students' knowledge about acquired immunodeficiency syndrome (AIDS), their attitudes toward patients with AIDS, and their willingness to treat patients who have AIDS. SUBJECTS: A sample of convenience of 103 entry-level undergraduate junior physical therapy students, aged 20 to 35 years (mean = 22.1, SD = 2.8), from one class at one institution participated in this study. METHODS: A two-group pretest-posttest with control group delayed-intervention design was used. Subjects were randomly assigned to either a group that received an AIDS education unit (experimental group) or a group that did not receive a special education unit (control group). All subjects were pretested and posttested together with a modified version of the State University of New York at Buffalo School of Nursing AIDS Study Questionnaire. Willingness to treat patients who have AIDS was assessed based on self-report responses. After the pretest of both groups, the experimental group received an AIDS education unit followed by the posttest, whereas the control group received no AIDS education unit before the posttest. RESULTS: The experimental group showed significant improvement of knowledge, attitudes, and willingness to treat patients who have AIDS as a result of the AIDS education unit. The control group showed no significant change or a lowered score and thus a change in a nondesired direction. The results of this study confirm the effectiveness of an AIDS education program for physical therapy students at this institution. CONCLUSION AND DISCUSSION: Further study of entry-level graduate physical therapy students, licensed physical therapists, and other allied health professionals is needed to determine whether the education of these groups can affect their knowledge and attitudes toward patients with AIDS. Improved knowledge and attitudes of the health care provider with an increased willingness to treat patients who have AIDS ensures these patients will receive optimal and appropriate health care.

Acquired Immunodeficiency Syndrome↗

Effects of exercise on hip range of motion, trunk muscle performance, and gait economy.

BACKGROUND AND PURPOSE: The purposes of this study were (1) to examine the effects of a passive hip extension stretching exercise program on hip extension range of motion (ROM), (2) to examine the effects of a trunk flexor exercise program on trunk flexor muscle performance, and (3) to examine the effects of passive hip extension stretching or trunk flexor exercises on walking and running economy. ("Gait economy" is defined as the steady-state oxygen consumption per unit of body weight required to walk or run at a specified velocity.) SUBJECTS: Twenty-five healthy, athletic, male college students (mean age = 21 years, mean weight = 75 kg, mean height = 172 cm) were randomly assigned to one of three groups: a control group (n = 7), a hip extension stretching group (n = 9), or a trunk flexor exercise group (n = 9). METHODS: Before and after 3 weeks of intervention, the following measurements were obtained: right and left hip extension ROM, trunk flexor muscle performance, and walking and running economy. A three x two-way (groups x test sessions) analysis of variance (ANOVA) for repeated measures for unequal subject numbers was performed on each of the five dependent measures, with analysis of simple main effects applied when significant interactions were found. RESULTS: The ANOVA on right and left hip extension ROM revealed a significant interaction. Analyses of simple main effects showed that 3 weeks (six sessions) of passive hip extension stretching significantly improved right hip extension ROM (pretest = -20.4 degrees, posttest = -8.3 degrees) and left hip extension ROM (pretest = -16.8 degrees, posttest = -7.0 degrees). There also was a significant interaction for trunk flexor muscle performance. The analysis of simple main effects revealed that 3 weeks of daily trunk flexor exercises significantly improved trunk flexor muscle performance (pretest = 41.5 degrees, posttest = 60.4 degrees). The 3-week intervention program of hip extension stretching or trunk flexion exercises, however, did not produce significant changes in walking or running economy. CONCLUSION AND DISCUSSION: The results suggest that (1) six treatment sessions of passive stretching were sufficient to improve hip extension ROM; (2) 3 weeks of exercises performed daily improved trunk flexor muscle performance; and (3) training of isolated tasks, such as hip flexibility or trunk strengthening activities, did not produce the desired outcome in the economy of walking or running. Possible reasons for the results are discussed.

Adult↗

A pilot randomized, controlled trial of a longitudinal residents-as-teachers curriculum.

PURPOSE: To determine whether a longitudinal residents-as-teachers curriculum improves generalist residents' teaching skills. METHOD: From May 2001 to February 2002, 23 second-year generalist residents in four residencies affiliated with the University of California, Irvine, College of Medicine, completed a randomized, controlled trial of a longitudinal residents-as-teachers program. Thirteen intervention residents underwent a 13-hour curriculum during one-hour noon conferences twice monthly for six months, practicing teaching skills and receiving checklist-guided feedback. In a 3.5-hour, eight-station objective structured teaching examination (OSTE) enacted and rated by 15 senior medical students before and after the curriculum, two trained, blinded raters independently assessed each station with detailed, case-specific rating scales (rating scale reliability = 0.96, inter-rater reliability = 0.78). RESULTS: The intervention and control groups were similar in academic performance, specialty distribution, and gender (chi(2) = 0.434, p =.81). On a five-point Likert scale (5 = best teaching skills), intervention and control residents showed similar mean pretest OSTE scores (2.83 vs. 2.88, p =.736). The intervention group improved their mean overall OSTE scores 22.3% (more than two standard deviations) from 2.83 (pretest) to 3.46 (post-test; p <.0005; 95% CI 0.53 to 0.72). Intervention residents also improved significantly on six of eight OSTE stations. Within the control group, no pretest-to-post-test change achieved statistical significance. Mann-Whitney and Wilcoxon signed-rank tests confirmed these results. CONCLUSIONS: Generalist residents randomly assigned to receive a 13-hour longitudinal residents-as-teachers curriculum consistently showed improved OSTE scores. Future research should clarify which aspects of residents-as-teachers curricula most effectively improve educational outcomes.

California↗

Do children retain what they are taught?

Burn prevention lectures instituted in early childhood education is believed to have decreased burn-related injuries in children. Validation of retention of information to verify effectiveness of school lectures is needed. A pretest and posttest were developed to measure the retention of burn prevention methods taught to students. The pretests were administered by the teachers to fourth and fifth graders (n = 500) one day before the prevention lecture. Programs were taught assembly style. The teachers were asked to reissue the posttest within 2 days after the program. The tests were then returned to the community educator. The test included 15 multiple choice questions. Questions addressed escaping a burning building and burn prevention items such as cooking, first aid tips, and other general prevention ideas. Test results showed overall improvement of scores. Additional analysis showed that though test scores improved, there was less improvement in scores of inner-city students. Pretesting and posttesting has provided valuable information regarding student learning. It has also identified target groups and areas where increased efforts of prevention programs must be directed.

Adolescent↗

Training residents using simulation technology: experience with ultrasound for trauma.

BACKGROUND: The need for surgeons to become proficient in performing and interpreting ultrasound examinations has been well recognized in recent years, but providing standardized training remains a significant challenge. The UltraSim (MedSim, Ft. Lauderdale, Fla) ultrasound simulator is a modified ultrasound machine that stores patient data in three-dimensional images. By scanning on the UltraSim mannequin, the student can reconstruct these images in real-time, eliminating the need for finding normal and abnormal models, while providing an objective method of both teaching and testing. The objective of this study was to compare the posttest results between residents trained on a real-time ultrasound simulator versus those trained in a traditional hands-on patient format. We hypothesized that both methods of teaching would yield similar results as judged by performance on the interpretive portion of a standardized posttest. It is designed as a prospective, cohort study from two university trauma centers involving residents at the beginning of their first or second postgraduate year of training. The main outcome measure was performance on a standardized posttest, which included interpretation of ultrasound cases recorded on videotape. METHODS: Students first took a written pretest to evaluate their baseline knowledge of ultrasound physics as well as their ability to interpret basic ultrasound images. The didactic portion of the course used the same teaching materials for all residents and included lectures on ultrasound physics, ultrasound use in trauma/critical care, and a series of instructional videos. This didactic session was followed by 1 hour for each student of hands-on training on medical models/medical patients (group I) or by training on the ultrasound simulator (group II). The pretest was repeated at the completion of the course (posttest). Data were stratified by postgraduate year, i.e., PG1 or PG2. RESULTS: A total of 74 residents were trained and tested in this study (PG1 = 48, PG2 = 26). All residents showed significant improvement in their pretest and posttest scores (p = 0.00) in both their knowledge of ultrasound physics and in their interpretation of ultrasound images. Importantly, we could not demonstrate any significant difference between groups trained on models/patients (group I) versus those trained on the simulator (group II) when comparing their posttest interpretation of ultrasound images presented on videotapes (PG1, group I mean score 6.9 +/- 1.4 vs. PG1, group II mean score 6.5 +/- 1.6, p = 0.32; PG2, group I mean score 7.7 +/- 1.4 vs. PG2, group II mean score 7.9 +/- 1.2, p = 0.70). CONCLUSION: The use of a simulator is a convenient and objective method of introducing ultrasound to surgery residents and compares favorably with the experience gained with traditional hands-on patient models.

Cohort Studies↗

Testability of preschoolers on stereotests used to screen vision disorders.

OBJECTIVE: The purpose was to determine whether preschool children aged 3 years 0 months through 3 years 6 months could be tested with the Random Dot E, Stereo Smile, and Randot Preschool stereoacuity tests, which are random dot stereotests marketed for use with preschoolers. METHODS: A total of 118 children from five Vision In Preschoolers Study Clinical Centers participated. Strabismic children, as determined by the cover test at distance and near, were excluded from this study. Stereopsis was tested on each child using each of the three tests in a variable, balanced order. A child's testability for each test was determined by the ability to complete the nonstereo task (pretest) and the gross stereo task for each stereotest. Proportions of children able to perform each test were compared using statistical methods accommodating multiple measurements per child. RESULTS: Testability of children on the pretest was greater for the Stereo Smile test (91%) than for the Random Dot E test (81%; p = 0.007) or the Randot Preschool test (71%; p < 0.0001) and greater for the Random Dot E test than for the Randot Preschool test (p = 0.02). For all children, testability on the gross stereo task was greater for the Stereo Smile (77%; p < 0.0001) and Random Dot E (74%; p = 0.005) tests than for the Randot Preschool test (56%) but did not differ significantly between the Stereo Smile and Random Dot E tests (p = 0.19). There were no significant differences among the proportion of children able to complete the gross stereo task among those who were testable on the pretest (p > 0.12, all comparisons). CONCLUSIONS: Among preschoolers aged 3 years 0 months through 3 years 6 months, testability differs significantly across the three commercially available random dot stereotests evaluated. The results suggest that two-choice procedures increase testability of young preschoolers.

Amblyopia↗

Education attainment level of caregivers versus readability level of written instructions in a pediatric emergency department.

Our objectives were 1) to determine the education attainment level (EAL) of parents attending the pediatric emergency department (PED); 2) to assess the readability level (RL) of the written instructions available to these parents; and 3) to revise these instruction forms at a level of comprehension based on the EAL of parents. We used a questionnaire of EAL and RL assessment using the SMOG and FOG readability formulas. We then revised the written instructions and used parents in the PED to pretest them. The setting was a PED in a tertiary care hospital (Children's Hospital of Western Ontario). The participants were 1034 parents of children in the PED between 8 AM and 11 PM over a six-month period. Parents were chosen at 30-minute intervals on randomly selected weekdays and weekends. A total of 1022 completed the study. Seven forms commonly used in the PED were assessed for RL. Seven forms were rewritten at grade 6 to 7 RL, and each was pretested in 21 of 24 parents or guardians in the PED using a standardized questionnaire with open-ended questions. Ninety percent of respondents spoke English, and 85% had English as their first language. Forty-nine percent of parents had a grade 13 or lower EAL. This included the following EALs; < grade 12 EAL, 23%; < grade 10 EAL, 15%; and < grade 8 EAL, 4%. Of the seven forms tested, five were written at a college RL. Pretesting of revised forms elicited the following responses from parents: easy to understand (100%), understood everything (96-100%), worth remembering (77-96%), liked the form (67-100%), found it informative (52-85%), and thought it was applicable to all people (82-100%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

The promise of integrated representative surveys about sexually transmitted diseases and behavior.

BACKGROUND: It has been difficult to conduct representative surveys measuring both sexually transmitted disease prevalence and behavioral data. This article reviews the literature, describes a recent pretest of the feasibility of integrated surveys, and discusses the potential implications. METHODS: Several national surveys are reviewed, including the National Health and Nutrition Examination Surveys, National Health and Social Life Survey, and National Survey of Adolescent Males. The 1994 pretest of the National Survey of Adolescent Males collected urine specimens of male respondents, which were tested for Chlamydia trachomatis using ligase and polymerase chain reaction tests. RESULTS: There have not been any prior national surveys that collect clinical measures of STD infection and detailed behavioral data. In the pretest, 85% of the eligible interview respondents provided a urine specimen. Of those tested, 6% were positive for C. trachomatis. CONCLUSIONS: Combining behavioral surveys with collection of urine specimens for STD testing in representative samples is feasible. However, STD testing adds new operational and ethical challenges to the conduct of household surveys.

Adolescent↗

Effect of coordination training with and without stochastic resonance stimulation on dynamic postural stability of subjects with functional ankle instability and subjects with stable ankles.

OBJECTIVE: To examine the effects of coordination training with and without stochastic resonance (SR) stimulation on dynamic postural stability. DESIGN: Experimental with repeated measures. SETTING: Research Laboratory. PARTICIPANTS: Thirty subjects with functional ankle instability (FAI) and 30 healthy subjects. INTERVENTIONS: Subjects were assigned to a conventional coordination training group, SR stimulation coordination training group, or control group. Training groups performed coordination exercises for 6 weeks. Single leg jump-landing tests were performed before training began (pretest), and then once every 2 weeks. Jump-landing tests required subjects to land on a single leg on a force plate and stabilize quickly. MAIN OUTCOME MEASURES: Anterior/posterior (A/P) and medial/lateral (M/L) time-to-stabilization (TTS). RESULTS: The FAI group improved their A/P TTS over their pretest by 16% (test 2), 22% (test 3), and 22% (posttest). They also improved their M/L TTS over their pretest by 16% (test 3) and 22% (posttest). Control groups did not improve their TTS (P>0.05). SR stimulation did not statistically influence TTS (P>0.05). Effect sizes (ES), however, for our 3-way interaction analyses for A/P TTS (ES=0.40) and M/L TTS (ES=0.30) suggested that SR stimulation improved the FAI group's M/L TTS after 2 weeks of training, and improved their A/P TTS and M/L TTS to a greater degree after 4 weeks than coordination training alone. CONCLUSION: Coordination training can improve dynamic postural instabilities associated with FAI. SR stimulation might be an alternative therapy for FAI, as this stimulation might improve dynamic postural stability more quickly and to a greater extent than coordination training without SR stimulation.

Ankle Injuries↗

Responsive evaluation of competency-based public health preparedness training programs.

OBJECTIVES: To describe how the Michigan Center for Public Health Preparedness (MI-CPHP) responded to the challenge and urgency in delivering competency-based preparedness training and documenting its impact utilizing a responsive evaluation approach. METHODS: Pretest-posttest evaluation designs were implemented when feasible to document the impact of training activities on knowledge and competency gains. The development of evaluation instruments is described with a focus on being responsive to the specific goals of each training activity. A randomized experimental design was used to examine the effects of taking a pretest for one of the training events. RESULTS: The analyses noted statistically significant improvements for every comprehensive training event in key content knowledge and self-rated competencies. The impact of taking a pretest revealed a modest, but statistically significant, effect on the self-rated competencies and a nonsignificant effect on the content knowledge scores. CONCLUSIONS: A summary of the results and their implications is followed by a discussion about taking a responsive approach to evaluating the training activities of the MI-CPHP. The challenge of evaluating the impact of knowledge-focused training activities on the development of performance competencies was also reviewed.

Bioterrorism↗

Heart rate and motor-activating effects of orally self-administered ethanol in alcohol-preferring (P) rats.

BACKGROUND: Autonomic and behavioral arousals often accompany reinforcement. Additionally, contextual cues associated with alcohol consumption elicit increases in heart rate in alcoholics. This study examined changes in heart rate (HR) and motor activity before and during limited-access to ethanol, saccharin, or water in adult male alcohol-preferring (P) rats. METHODS: Adult male P rats were implanted with radiotelemetric transmitters to measure HR and motor activity. The experiment involved placing the animals in a test chamber for a 90-min pretest period, with water available. Thereafter, the animals were given a 90-min test session with access to one of three test solutions: water, 0.0125% saccharin, or 15% (v/v) ethanol (EtOH). After a week of habituation (water served as the test solution for all three groups), the animals were given their respective test solution for 3 weeks. RESULTS: Analyses of HR revealed that the saccharin and EtOH groups had significantly higher HR than the water group during the pretest period of the third test week. Both the saccharin and EtOH groups had significantly higher HR than the water group during the test period of all three test weeks. Analyses of motor activity revealed that the EtOH group displayed higher motor activity than the water and saccharin groups during the pretest period of the third test week. CONCLUSIONS: The data indicate that oral self-administration of EtOH enhances behavioral and autonomic activation, compared with saccharin or water, in adult male P rats and support previous observations that changes in HR can be used as an index of reinforcement. Additionally, it seems that the behavioral and autonomic activation elicited by EtOH self-administration can be conditioned to the environment in which EtOH was self-administered. These findings parallel reports on cued reactivity (behavioral and autonomic activation) in alcoholics exposed to alcohol-associated stimuli.

Administration, Oral↗