Urinary continence/incontinence. Modifying behavior at home: a team effort.
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Rett syndrome (RTT) is an autistic spectrum disorder with a known genetic basis. RTT is caused by loss of function mutations in the X-linked gene MECP2 and is characterized by loss of acquired motor, social and language skills in females beginning at 6-18 months of age. MECP2 mutations also cause non-syndromic mental retardation in males and females, and abnormalities of MeCP2 expression in the brain have been found in autistic spectrum disorders. We studied home-cage behavior and social interactions in a mouse model of RTT (Mecp2(308/Y)) carrying a mutation similar to common RTT causing alleles. Young adult mutant mice showed abnormal home-cage diurnal activity in the absence of motor skill deficits. Nesting, a phenotype related to social behavior, and social interactions were both impaired in these animals. Mecp2(308/Y) mice showed deficits in nest building and decreased nest use. Although there were no differences in aggression or exploration of novel inanimate stimuli, mutant mice took less initiative and were less decisive approaching unfamiliar males and spent less time in close vicinity to them in several social interaction paradigms. The abnormalities of diurnal activity and social behavior in Mecp2(308/Y) mice are reminiscent of the sleep/wake dysfunction and autistic features of RTT. These data suggest that MECP2 regulates the expression and/or function of genes involved in social behavior. The study of Mecp2(308/Y) mice will allow the identification of the molecular basis of social impairment in RTT and related autistic spectrum disorders.
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When a rat treated with amphetamine (0.5-5 mg/kg) locomotes in an unfamiliar environment, there are one or two places which it visits most often. In these one or two places the mean duration of a visit (stop) is the longest, and, compared to other places, the incidence of grooming and rearing are the highest. Since in intact rats these features of place characterize it as a 'home base', it is concluded that under amphetamine rats also establish one or two home bases. One home base was generally established by rats treated with low doses of amphetamine, while two bases were most evident in those treated with high doses. Since the paths of locomotion in amphetamine-treated rats were previously described to be stereotyped, it is suggested that home base location under this drug may be used as a reference point in the assessment of the organization of stereotyped locomotor behavior.
When rats are placed in a novel environment, they alternate between progression and stopping: in the course of a session they stop briefly in many places, but in one or two places they also stop for very long periods. The place in which they stay for the longest cumulative time is defined as the rat's home base. In this place the incidences of grooming and of rearing are high and often the highest. In addition, the number of visits to the home base is typically the highest. Some rats establish a secondary base with similar properties to those of the main home base. The location of the base influences the mode of progression throughout the environment: progression away from base is slower and includes more stops than progression back. It is suggested that this paradigm may be used for the analysis of the spatial organization of locomotor behavior in neuroscience research.
A 9-year-old clinic-referred boy, his mother, and his teacher were observed in 38 home and 38 school sessions on the same days. Categories of the boy's oppositional behavior and the inappropriate social attention of his mother and teacher were graphed to visually inspect changes during baseline, a parent-training phase, a follow-up phase, and a final parent-training booster phase. Parent-training phases produced reductions in the mother's inappropriate attention and in the boy's oppositional behavior, whereas the follow-up and baseline phases were associated with higher rates of these categories. Generalization occurred in the school across these home phases, as seen in the increase in rates of the boy's problem behavior, despite the lack of change in his teacher's attention. Correlational analyses of proportion scores reflecting the boy's home-school oppositional behavior and mother-teacher social attention suggested his responsiveness to relative changes in adult social contingencies across settings.
This study evaluated a treatment procedure in which 126 incontinent nursing home patients were checked on an hourly basis, asked if they needed toileting assistance (prompted), and socially reinforced for appropriate toileting. Urodynamic analysis (including cystometrogram), provocative stress test, and behavioral assessment revealed that the nursing home patients were severely debilitated, with 65% demonstrating bladder abnormalities, 87% incapable of independent toileting, and 25% failing to score on the Mini-Mental Status Exam (average score, 8.0). The treatment procedures were evaluated with a multiple baseline design in which subjects were randomly divided into immediate or delayed treatment groups after a baseline observation period. During treatment, the frequency of incontinence per 12 hours changed from a baseline average of 3.85 to a treatment average of 1.91. Three behavioral measures that can be easily collected by nursing staff significantly predicted continence levels during treatment (multiple R, 0.79) and change in incontinence during treatment (multiple R, 0.64). These prognostic criteria offer nursing staff a cost-effective method for selecting the most responsive patients for prompted-voiding treatment.
The rich ethological tradition that characterizes the homing behavior of pigeons offers an excellent opportunity to examine the importance of the hippocampal formation for the regulation of spatial cognitive mechanisms. The present review summarizes both anatomical and behavioral data obtained in researches on the pigeon hippocampal formation that have been performed over the last 12 years. Pathway connection studies and investigations on the neurochemical organization of the avian hippocampal formation show that this structure shares many similarities with the mammalian hippocampus and provide the basis for structural as well as functional homology. The initial research on the role of the hippocampal formation in the homing behavior showed that this brain structure is likely to be involved in phenomena of spatial cognition. Therefore, the homing behavior of pigeons has been extensively used as an experimental model to investigate the role of the hippocampal formation in spatial cognition related to a naturally occurring behavior. These studies have revealed that the hippocampal formation plays a fundamental role in the learning of a navigational map based on atmospheric odors, but it doesn't seem to be involved in the operation of such a map. In contrast, both the learning and the operation of a navigational map based on the recognition of familiar landmarks require a functional hippocampal formation. Further investigations indicated that these functions of the hippocampal formation are mediated by its involvement in the use of the sun compass, and suggested that the hippocampal formation plays a fundamental role in a cognitive process in which the sun compass is specifically used to learn about the location of stimuli in space. The studies reviewed in the present paper have provided a considerable amount of experimental data both on the anatomical/neurochemical organization of the avian hippocampal formation and on the role played by this brain structure in spatial cognition. The future development of these researches will need to consider the contribution to hippocampal function of specific transmitter systems that are involved in hippocampal circuitry. In particular, the afferent cholinergic system and some of the peptidergic systems intrinsic to the hippocampal formation deserve particular attention in view of their possible involvement in the acquisition and/or operation of spatial cognitive abilities by homing pigeons.
This study presents findings from 35 interviews with mothers of infants who were monitored for apnea following discharge from the same neonatal intensive care unit. The interviews took place at a mean of 28 weeks following discontinuation of the infant home apnea monitor and focused upon the mothers' behavior with the monitor. One family had independently ceased to use the monitor within 1 week of their infant's hospital discharge. All other mothers reported always having used the monitor at night, and 92% always used it during their infants' daytime naps. Approximately one half of the mothers would not have been able to consistently hear an alarm, however, when their infant was asleep. Consistency of availability to a monitored infant was not related to the mothers' background, attitudes, or experiences with their infant. These data indicate the need to emphasize for all caregivers the importance of being available to their monitored infant at all times.
Homing behavior was tested in pigeons (Columba livia) after removing a portion of the ventrolateral telencephalon, which receives extensive projections from the olfactory bulb and is comparable with the mammalian pyriform cortex. Ablated pigeons show unaffected cardiac responses to odorous stimuli but altered homing behavior. After the operation, the birds were trained by repeated flock releases along with control birds from a site 40 km from the loft. After being released singly from this familiar site, the ablated birds turned out to be unaffected by the operation. In releases from two unfamiliar sites, ablated birds, unlike control birds, were not homeward oriented and were mostly lost. The ablation of the pyriform cortex has the same effect on homing behavior as olfactory deprivation. It can be concluded that the pyriform cortex plays an important role in the specific mechanisms linking olfactory inputs with the navigational response.
The effectiveness of "home-based" exposure and response prevention was assessed in a series of 11 subjects with obsessive-compulsive disorder (OCD). Patients received 24 treatment sessions in a range of natural settings and situations. Sixty-four percent of the patients responded to behavior therapy in these settings, and 36% achieved lasting improvements in their OCD symptoms. Implications for the impact on consumers of this seldom-used application of behavior therapy are discussed and some recommendations for future research are made.
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The present study examined the use of gingival bleeding as a reinforcement mechanism for interproximal home care with the toothpick. After initial assessments of plaque and gingival bleeding, 36 subjects were given a professional toothcleaning and instructed to maintain oral hygiene by toothbrushing alone for 3 months. After 3 months of brushing only, subjects were re-examined and given another professional toothcleaning. Having been matched for age and percentage of sites bleeding on probing, as determined at the initial examination, they were than randomly attached to one of three groups. One group, the control, continued to clean their teeth with only a toothbrush, while the other two groups used the toothbrush supplemented with the toothpick for interproximal subgingival cleaning. Both toothpick groups received identical instruction in toothpick technique, but one group was taught to use bleeding as an interpretive device for health. Three months later, clinical assessments indicated significantly less gingival bleeding for both toothpick groups as compared with the control (whose gingival health worsened). Although there was no significant difference between the final scores of the toothpick groups, only the group that used gingival bleeding as a sign of disease showed a significant improvement in gingival health (P less than 0.003), and also had a fivefold higher rate of return of self-report compliance cards. These results suggest that the use of gingival bleeding as a reinforcement mechanism should be considered as a strategy in oral home care instruction to promote compliance with recommended behavior.
A home-based telephone and mail intervention was evaluated for its effectiveness in promoting walking in a sample of sedentary, ethnic minority women. One hundred twenty-five women (ages 23-54) were randomly assigned to behavioral or brief educational interventions. Women in the 8-week behavioral condition received behavior change materials through the mail and 6 structured telephone counseling sessions. Educational condition participants received a single 5-min telephone call and educational information. Both groups reported significantly increased walking at a 2-month posttest (M change = 86 and 81 min per week for behavioral and educational groups, respectively) and 5-month follow-up (M change = 40 and 52 min per week). A 30-month follow-up of 50 participants indicated both groups continued to report more walking than at baseline. The behavioral intervention was not superior to the educational condition at any assessment point. The findings may be explained as (a) both interventions were equally effective, so extensive telephone counseling is unnecessary; (b) changes over time reflected secular trends; or (c) increases in self-reported walking may be due to socially desirable reporting. Other strategies need to be evaluated for promoting walking that are tailored to the needs of ethnic minority women.
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The purpose of this report is to summarize data from a sample of 230 residents in eight nursing homes (NHs) that are relevant to the development of environmental and behavioral interventions for sleep. Four conclusions can be drawn: (1) there is strong evidence that the nighttime sleep of these residents was adversely affected by environmental noise and light; (2) residents appear to spend substantial time in bed and sleeping during the day; (3) there are significant differences between some homes in the amount of time that residents spend in bed and sleeping during the day, as well as the frequency of nighttime awakenings associated with environmental events; and (4) residents' preference and nighttime noise source data suggest that a multifaceted intervention to improve sleep hygiene could successfully implemented in the NH setting. An intervention addressing these issues may result in improved sleep and overall well-being for a substantial portion of the NH population.
Chronic morphine treatment of newborn Long-Evans rat pups between 3-26 days of age (thrice daily starting with 0.5 mg/kg, increased daily by 0.5 mg/kg to 10 mg/kg) led to lags of 1 to 3 days in physical development (body weights and eye opening times) and motor coordination (catalepsy test, grasping, swimming). Chronic naloxone treatment (5 mg/kg administered thrice daily from day 3-26), in contrast, led to modest gains in development on a number of measures (body weights, vaginal opening). Morphine animals also lagged behind controls and naloxone-tested animals in social behaviors, such as homing and play. Chronic naloxone did not block or retard social development; in fact naloxone-treated animals exhibited more rapid acquisition of homing behavior than controls.
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