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Disposition to recognize goals in infant chimpanzees.

Do nonhuman primates attribute goals to others? Traditional studies with chimpanzees provide equivocal evidence for "mind reading" in nonhuman primates. Here we adopt looking time, a methodology commonly used with human infants to test infant chimpanzees. In this experiment, four infant chimpanzees saw computer-generated stimuli that mimicked a goal-directed behavior. The baby chimps performed as well as human infants, namely, they were sensitive to the trajectories of the objects, thus suggesting that chimpanzees may be endowed with a disposition to understand goal-directed behaviors. The theoretical implications of these results are discussed.

Analysis of Variance↗

Goal directed locomotion and balance control in autistic children.

This article focuses on postural anticipation and multi-joint coordination during locomotion in healthy and autistic children. Three questions were addressed. (1) Are gait parameters modified in autistic children? (2) Is equilibrium control affected in autistic children? (3) Is locomotion adjusted to the experimenter-imposed goal? Six healthy children and nine autistic children were instructed to walk to a location (a child-sized playhouse) inside the psychomotor room of the pedopsychiatric centre located approximately 5 m in front of them. A kinematic analysis of gait (ELITE system) indicates that, rather than gait parameters or balance control, the main components affected in autistic children during locomotion are the goal of the action, the orientation towards this goal and the definition of the trajectory due probably to an impairment of movement planning.

Attention↗

Physical activity, psychosocial health, and life goals among youth.

The main goal of the present study is to investigate the relationship between youth's physical activity, their psychosocial health and well-being, and their life goals. Data were collected among students (n = 1109, age range between 14 and 21 years of age, mean: 16.5 years, SD = 1.3 years) enrolled in the secondary schools of the Southern Plain Region (three counties), Hungary. Our findings support previous results that more active students have a better self-perceived health and fitness, lower levels of depressive symptoms and higher levels of life satisfaction. In addition, students who are regularly active prefer less extrinsic values as life goals for their future. However, there are no significant differences by physical activity status in terms of intrinsic values (except for physical health). These findings suggest that physical activity is not per se a beneficial health behavior only through its functions. In community health programs, a health-related physical education approach should be addressed to improve the psychosocial benefits of physical activity.

Adolescent↗

Can we justify goal blood pressure of <140/90 mm Hg in most hypertensives?

Hypertension is a common disorder with well-recognized consequences on the heart, brain, and kidney as target organs. Guidelines espouse a treatment goal of blood pressure reduction to <140 mm Hg for the systolic pressure and <90 mm Hg for the diastolic pressure in most hypertensive patients. In this review, the basis for these recommendations, the practical achievement of these goals in various practice settings, and the risk versus the benefit of achieving such goals in most hypertensive patients are examined.

Antihypertensive Agents↗

Intrametropolitan planning for community-based residential care: a goals programming approach.

Small community-based residential facilities have increasingly supplanted large-scale institutions as treatment settings for mentally and physically disabled, indigent, elderly and ex-offender populations in the United States. Because the intrametropolitan assignment of these service-dependent populations and their community care facilities has not been purposively planned, most facilities and clients have clustered in inner cities, resulting in the formation of service-dependent population ghettos. This paper outlines a goals programming approach to the client/facility assignment problem. The model provides a basis for an intrametropolitan distribution of residential service facilities that balances equity and efficiency goals and that protects both client and community rights. A regional fair-share plan that incorporates negotiation and arbitration techniques is offered as an institutional mechanism for implementing the goals programming framework.

Community-Institutional Relations↗

The influence of proximal vs. distal goals on adherence to prescribed calories.

Females and males undergoing behavioral treatment for obesity were advised to consume 1200 or 1500 calories daily. Subjects were instructed to reference calories either immediately following consumption, or daily, after having consumed the last food item. Subjects who referenced calories daily were not provided with further calorie goals. Subjects who referenced calories immediately following consumption were advised to set calorie subgoals for daily meals and snacks according to personal preference. Treatment was followed by a 6-month maintenance phase and continuation of the experimental manipulation. Subjects reported a progressive reduction in calories during treatment with no significant changes in intake evident during maintenance. Differential goal instructions produced reports of greater deprivation and greater attrition yet substantial weight losses among subjects given daily goals compared to subjects who also set meal and snack subgoals.

Adult↗

Interpersonal and intrapsychic goal-related conflict reported by cigarette smokers, unaided quitters, and relapsers.

Current cigarette smokers not actively trying to cut down (n = 38), recent relapsers (n = 40), and successful self-initiated quitters (n = 36), matched on age, gender, and smoking background, completed questionnaires retrospectively assessing (a) the degree of conflict among important personal goals and the goal of smoking cessation, and (b) the level of perceived social hindrance from significance others vis-à-vis their efforts to quit smoking. Results indicated that unaided quitters, in contrast to current smokers and relapsers, recalled significantly less goal-related interpersonal interference and significantly lower levels of intergoal conflict. The findings are considered to provide support for a social/cognitive perspective on the process of self-managed smoking cessation.

Adolescent↗

Use of goal attainment scaling in measuring clinically important change in the frail elderly.

The selection of appropriate outcome measures is important in evaluating specialized geriatric programs, but how the various measures compare, and which are most appropriate, are matters still largely unexplored. We compared several outcome measures, including goal attainment scaling, to assess their sensitivity to changes in the health status of frail elderly patients admitted to two geriatric medicine wards. GAS is a measurement approach which accommodates multiple individual patient goals, and has a scoring system which allows for comparisons between patients. Forty-five patients (mean age 81 years, 30 females) received comprehensive assessments. GAS yielded a mean 5 goals per patient. The mean gain in the GAS score was 22 points (SD = 7) which was compared with the change in the Barthel Index (r = 0.59), the Functional Independence Measure (r = 0.45), the Physical Self-Maintenance Scale (r = 0.54), the Katz Activities of Daily Living Index (r = 0.49) and the Spitzer Quality of Life Index (r = 0.38). The inter-rater reliability of scoring the GAS follow-up guides was 0.91. Using a relative efficiency statistic, GAS proved more efficient than any other measure. The effect size statistic also demonstrated an increased responsiveness to change of GAS compared with standard measures. GAS is an individualized measurement approach which shows promise as a responsive measure in frail elderly patients.

Activities of Daily Living↗

Starting at the end: the importance of goals in spatial language.

We explored the linguistic encoding of Paths in children between the ages of three and seven, in children with Williams syndrome, and in normal adults, focusing specifically on Source and Goal Paths. The results showed an asymmetry, with Goal Paths regularly and systematically encoded, but Source Paths often omitted. This pattern occurred among all groups and across a broad range of domains including Manner of Motion, Change of Possession, Change of State, and Attachment/Detachment events. It also occurred whether participants spontaneously described events or were asked to use a specific verb that biased them towards a Goal or Source Path (e.g. 'give' vs. 'get'). The results are discussed in terms of non-linguistic foundations of spatial language and the linguistic mapping biases that arise when we describe what we see.

Adolescent↗

Will any doll do? 12-month-olds' reasoning about goal objects.

Infants as young as 5 months of age view familiar actions such as reaching as goal-directed (Woodward, 1998), but how do they construe the goal of an actor's reach? Six experiments investigated whether 12-month-old infants represent reaching actions as directed to a particular individual object, to a narrowly defined object category (e.g., an orange dump truck), or to a more broadly defined object category (e.g., any truck, vehicle, artifact, or inanimate object). The experiments provide evidence that infants are predisposed to represent reaching actions as directed to categories of objects at least as broad as the basic level, both when the objects represent artifacts (trucks) and when they represent people (dolls). Infants do not use either narrower category information or spatiotemporal information to specify goal objects. Because spatiotemporal information is central to infants' representations of inanimate object motions and interactions, the findings are discussed in relation to the development of object knowledge and action representations.

Decision Making↗

The role of the medial prefrontal cortex in achieving goals.

Achieving goals in changing environments requires the course of action to be selected on the basis of goal expectation and memory of action-outcome contingency. It is often also essential to evaluate action on the basis of immediate outcomes and the discrimination of early action steps from the final step towards the goal. Recently, in single-cell recordings in monkeys, the neuronal activity that appears to underlie these processes has been noted in the medial part of the prefrontal cortex. Medial prefrontal cells were also active when the subjects extracted the rules of a task in a novel environment. The processes described above might play important roles in rule learning.

Animals↗

Impact of the life goals group therapy program for bipolar patients: an open study.

BACKGROUND: To evaluate the level of satisfaction of bipolar patients participating in the structured group Life Goals Program (LGP), as well as the impact of this psychoeducative program on mood stability, treatment compliance and relapse prevention. METHODS: Forty-five patients (30 females and 15 males) with bipolar disorder were included. Their level of satisfaction was evaluated at the end of the 6-week phase 1 of LGP and after one-year participation in phase 2 (median duration 366 days, range 68-483). The impact of the LGP was also evaluated with respect to mood stability, compliance with pharmacological treatment and ability to prevent and cope with relapse. Participants' mood was rated at study entry, end of phase 1 and end of phase 2 with the Montgomery and Asberg Depression Rating Scale (MADRS) and Bech-Rafaelsen Mania Scale. RESULTS: Thirty-six participants (80.0%) completed phase 1 and 17 entered phase 2. A majority of participants (82.4%) were very satisfied with the information delivered during phase 1. After attending phase 2, participants reported a subjective improvement in mood stability, relapse prevention strategies as well as coping with relapse. MADRS score decreased significantly between the beginning of phase 1 and end of phase 2 (p=0.016). LIMITATIONS: This is an open study and results need to be replicated in a randomized controlled trial. CONCLUSIONS: Results of this open study suggest that the life goals psychoeducative program is well perceived by bipolar patients and has a positive impact on mood stability, relapse prevention and ability to go beyond symptoms in order to reach specific goals.

Adult↗

JCAHO'S National Patient Safety Goals 2006.

The Joint Commission of Accreditation of Healthcare Organizations released their first set of National Patient Safety Goals in 2002, which became effective in January 2003. This original set of goals is reviewed and a new set published every year. This article provides a review of the 2006 National Patient Safety Goals with an emphasis on perioperative/perianesthesia implications.

Accidental Falls↗

Nucleus accumbens cell firing and rapid dopamine signaling during goal-directed behaviors in rats.

The nucleus accumbens (Acb) is a key neural substrate underlying goal-directed behaviors for both drugs of abuse as well as 'natural' rewards. Here, I review electrophysiological and electrochemical studies completed in our laboratory that examined Acb cell firing and rapid dopamine signaling during behaviors directed toward reward procurement. Electrophysiological studies are reviewed showing that Acb neurons exhibit patterned discharges relative to operant responding for intravenous self-administration of cocaine versus 'natural' reinforcement in rodents. Importantly, subsequent studies showed that discrete subsets of Acb neurons are selectively activated during multiple schedules for a natural reward (water or food) versus cocaine self-administration. These later findings indicate that separate neural circuits selectively process information about goal-directed behaviors for cocaine versus natural reward. In addition, recent findings are reviewed showing that reinforcer selective firing of Acb neurons is not a direct consequence of chronic drug exposure. Next, electrochemical studies are summarized that used fast scan cyclic voltammetry to measure rapid (subsecond) changes in dopamine in the Acb during cocaine self-administration as well as 'natural' reinforcement in rodents. These findings are considered with respect to the role of dopamine in modulating the activity of Acb neurons that encode goal-directed behaviors, the functional organization of the Acb on a microcircuit level, and proposed directions for future studies.

Animals↗

Linking analytic performance goals to medical outcome.

As laboratorians relate analytic performance to medical goals, they face complex choices among competing subjective and objective criteria for the assessment of acceptable analytic error. Defining desirable performance as some fraction of physiologic variability provides potentially excessive benchmarks for quality. More important than the recognition of health are the clinical decisions which deal with diseases, particularly the latters' degrees of severity and the different medical actions these prompt. It is equally essential to take into account the reasoning by which physicians arrive at these decisions, since their mental processes condition desirable performance goals. Considering these modalities, a universal model of analytic performance requirements uniformly applicable to all measured parameters clearly cannot be devised. Rather, tolerance limits for analytic error must be tailored to specific medical problems. To facilitate this seemingly Herculean task, this paper develops concepts and principles derived from operation research, and illustrates their application by three examples. The generic conclusion evidenced by the latter is that the linkage between analytic performance goals and medical strategies is reciprocal, namely that outcome can just as well be optimized by tailoring medical strategy to existing analytic performance as by adapting analytic performance to medical strategy.

Clinical Medicine↗

Goal attribution in chimpanzees.

Does the chimpanzee attribute goals to others? Recent infant studies using the looking time measure have been interpreted as evidence that human infants attribute goals. An experiment modeled on these studies was carried out on chimpanzees, and the chimpanzees responded the way infants do. This indicates that chimpanzees also attribute goals and hence that this capacity is not distinctively human.

Animals↗

What are the treatment goals for Helicobacter pylori infection?

The goals of therapy of Helicobacter pylori are commonly viewed as either clinical (e.g., avoid further morbidity, mortality, or prevent disease from occurring) or economic (e.g., save healthcare dollars by avoiding further expenditure of resources). However, when viewed globally, these goals are not incongruent but are inexorably linked. Prevention of disease or avoidance of further morbidity and mortality by curing H. pylori infection is obviously an improved clinical outcome, but it also concurrently avoids further utilization of healthcare resources and is "cost-effective," resulting in improved economic outcome as well. The more clinically effective an H. pylori treatment is, the more economically effective it is as well. When comparing regimens, the cost-effectiveness is determined by efficacy of the regimen, not its cost. Put more simply, "The most expensive therapy is the one that doesn't work!" Therefore, the goals of the therapy are simple: avoid further morbidity, mortality, and prevent disease while minimizing further utilization of healthcare resources, thus saving money. The most clinically effective therapy is also the most cost-effective therapy. Regimens used should have demonstrated greater than 90% efficacy or effectiveness in the population being treated for H. pylori infection. The regimens should be simple and well tolerated. It is clinically and economically inappropriate to use a regimen not meeting these criteria.

Gastroenterology↗

Rehabilitation of executive function: facilitation of effective goal management on complex tasks using periodic auditory alerts.

The 'dysexecutive syndrome' represents a major challenge to functional recovery and adaptation following brain injury--and an important target for rehabilitation. Previous reports of everyday difficulties, and performance on complex, life-like tasks, indicate that an adequately represented goal may become neglected as patients become overly engaged in current activity. Here we examine whether the provision of brief auditory stimuli, acting to interrupt current activity and to cue patients to consider their overall goal, would improve performance in a complex task. Ten brain injured patients completed a modification of Shallice and Burgess' Six Elements task under two conditions. In the 'Hotel' test, the patients were asked to try and do some of each of five sub-tasks within 15 min. As the total time to complete all of the tasks would exceed an hour, the measure emphasises patients' ability to monitor the time, switch between the tasks and keep track of their intentions. Without the external auditory cues, the patients performed significantly more poorly than age- and IQ-matched control volunteers, a common error being to continue performing one task to the detriment of beginning or allocating sufficient time to others. When exposed to the interrupting tones, however, their performance was both significantly improved and no longer significantly different from the control group on important variables. The results have value in assessment in helping to attribute poor performance to 'goal neglect' rather than, for example, poor memory or comprehension. They also suggest that providing environmental support to one aspect of executive function may facilitate monitoring and behavioural flexibility--and therefore the useful expression of other skills that may be relatively intact.

Acoustic Stimulation↗