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Anabolic-androgenic steroids: effects on social behavior and baseline heart rate.

Examined the effects of anabolic-androgenic steroids (AS) on behavior, baseline heart rate (HR), and stress-induced HR responses. Twenty-four cynomolgus monkeys were assigned to four mixed social groups of both AS and sham control animals. For 2 months, AS-treated monkeys received biweekly injections of testosterone, and, on an identical schedule, the control animals were injected with a sham solution. Behavioral data revealed that AS disrupted the social milieu such that all dominant animals exhibited increases in dominant behavior and subordinates manifested increased submission. These changes returned to pretest levels 8 weeks following termination of the drug intervention. Affiliative behaviors decreased on the part of all animals as a function of AS and, with the exception of play behavior, failed to return to pretest levels after the 8-week period of recovery. AS created an increase in baseline HR, particularly among the dominant animals. Interestingly, the subordinate AS animals experienced a decrease in baseline HR response. AS had no apparent influence on stress-induced HR reactivity.

Agonistic Behavior↗

Contingent suppression of tolerance to the "anorexigenic" effect of haloperidol.

Whether tolerance develops to the "anorexia" induced by haloperidol (HAL) was determined. Rats were given HAL (2.5 or 5 mg/kg) either before or after access to milk for 53 days. Controls were given injections of saline. On Day 54, when all groups received pretest injections of the drug, only rats previously given posttest injections of HAL were tolerant. The absence of tolerance in rats previously given pretest injections suggests that tolerance is suppressed when rats are given access to food in the drugged state. It is concluded that tolerance develops to HAL as a result of pharmacological exposure but is suppressed by the "anhedonic" effect of the drug. The relevance of these findings to the role of reinforcement in behavioral tolerance is briefly discussed.

Animals↗

Enhancement and impairment of memory retrieval by a vasopressin metabolite: an interaction with the accessibility of the memory.

A series of 3 experiments was conducted to determine the generalizability of the improved recall seen with pretest administration of vasopressin in aversively motivated tasks. The learning paradigm selected for this purpose assessed the transmission of a food preference between rats; retention intervals of 8, 10, and 14 days were used in the 3 experiments, respectively. Pretest subcutaneous injection of a vasopressin metabolite, AVP4-9, significantly improved recall under conditions in which memory was poor in vehicle-treated rats but significantly impaired memory at a time when good recall was evident in controls. These findings support the postulate that administration of vasopressin or its metabolites modulate memory retrieval processes and suggest that the nature of this effect depends on the degree of forgetting that has occurred.

Animals↗

Stress and adenosine: II. Adenosine analogs mimic the effect of inescapable shock on shuttle-escape performance in rats.

In 3 experiments, the authors examined the role of adenosine regulation in escape deficits produced by earlier exposure to inescapable shock in rats (learned helplessness). Adenosine analogs injected before escape testing mimicked the effect of earlier inescapable shock, with the magnitude of the deficit varying with dose and drug specificity for A2 adenosine receptors. Agonist-induced and stress-induced escape deficits were eliminated by pretest treatment with the centrally acting adenosine receptor antagonist theophylline but not the peripheral antagonist 8-[p-sulfophenyl]-theophylline. Finally, preexposure to an ineffective number of inescapable shocks interacted in synergy with an ineffective pretest injection of adenosine agonist to maximize deficits in escape performance. These data implicate energy regulation and a central compensatory action by adenosine in the aspects of helplessness related to conservation-withdrawal.

Adenosine↗

Development and examination of an expectancy-based measure of test-taking motivation.

A 10-item multidimensional measure of test-taking motivation based on expectancy theory, the Valence, Instrumentality, Expectancy Motivation Scale (VIEMS), was developed using a student sample (N = 90) and tested using 2 samples of job applicants in a field setting (N = 296; N = 246). In Field Study 1, the VIEMS was related to test performance. Hierarchical regression analysis showed that the VIEMS explained variance in test score beyond a general measure of test motivation. In a second longitudinal field study, pretest and posttest perceptions of motivation were compared. Results indicated that expectancy was related to actual test performance, and perceived test performance accounted for variance in posttest reports of motivation after controlling for pretest levels of motivation. Test-taking motivation did not account for variance in test performance differences between African Americans and Whites in either field study.

Adult↗

Consequences of organizational justice expectations in a selection system.

This study examined several consequences of applicants' expectations of organizational justice at multiple stages in a selection process. The authors assessed the justice expectations of 1,832 job applicants prior to their participation in a testing process and examined how these expectations influenced their pretest attitudes and intentions as well as their perceptions of the testing process. Results revealed that applicants with higher expectations of justice reported higher levels of pretest motivation and more positive job acceptance and recommendation intentions. Justice expectations were also positively related to applicants' perceptions of justice in the testing process. Results provided some evidence that justice expectations have a moderating influence, such that justice perceptions have a greater influence on applicants' affective and cognitive states when expectations of justice are high. The theoretical and practical implications of these findings are discussed in the context of research on organizational justice and applicant perceptions.

Adolescent↗

Passage meditation reduces perceived stress in health professionals: a randomized, controlled trial.

The authors evaluated an 8-week, 2-hr per week training for physicians, nurses, chaplains, and other health professionals using nonsectarian, spiritually based self-management tools based on passage meditation (E. Easwaran, 1978/1991). Participants were randomized to intervention (n = 27) or waiting list (n = 31). Pretest, posttest, and 8- and 19-week follow-up data were gathered on 8 measures, including perceived stress, burnout, mental health, and psychological well-being. Aggregated across examinations, beneficial treatment effects were observed on stress (p = .0013) and mental health (p = .03). Treatment effects on stress were mediated by adherence to practices (p = .05). Stress reductions remained large at 19 weeks (84% of the pretest standard deviation, p = .006). Evidence suggests this program reduces stress and may enhance mental health.

Adult↗

Is the context shift effect a case of retrieval failure? The effects of retrieval enhancing treatments on forgetting under altered stimulus conditions in rats.

This series of experiments sought to clarify the role of retrieval failure in forgetting that results from a change in context between training and testing (the context shift effect [CSE]). Because spontaneous forgetting (SF) is generally considered to reflect a retrieval failure, the effects of three manipulations known to alleviate SF were examined on forgetting due to an explicit shift in context at a short delay (24 hr). Pretest exposure to a reminder treatment involving the reinforcer from training (Experiment 1), pretest amphetamine administration (Experiment 2), and overtraining (Experiment 3) alleviated both SF and the CSE, supporting the view that the CSE reflects a retrieval deficit. Implications for the context change account of SF are discussed.

Animals↗

Long-term effectiveness of a group program for caregivers of frail elderly veterans.

Long-term results of an evaluation of a multicomponent support-group program for spouses caring for frail elderly veterans indicated that participants experienced significant reductions in subjective burden. As compared to those of the control group, caregivers' perceptions of their husbands' health improved significantly from pretest to one year, while perceptions of their husbands' functioning on measures of instrumental daily activities showed significantly less deterioration in the period from pretest to posttest.

Activities of Daily Living↗

Predictive DNA-testing for Huntington's disease and reproductive decision making: a European collaborative study.

This European collaborative study addresses the question whether a predictive test result for Huntington's disease (HD) has an effect on subsequent reproduction by comparing carriers and non-carriers of the Huntington mutation. A unique characteristic of this study is that this evaluation is done in persons at reproductive age who had a predictive test after the identification of the Huntington gene and who were counselled in one of the participating centres. Data were collected for 180 carriers and 271 non-carriers who received a predictive test result in the period 1993-1998 in Aberdeen, Athens, Cardiff, Leiden, Leuven, Paris or Rome. The mean age of the total study group was 31.5 years and for about half of the group the follow-up interval was 3 years or more, with a maximum of 7 years. The collaborative study clearly revealed an overall impact of the predictive test result on subsequent reproduction: 14% of the carriers had one or more subsequent pregnancies vs 28% of the non-carriers. In the total carrier group a prenatal test was carried out in about two thirds of the pregnancies and one child was born after preimplantation genetic diagnosis; artificial insemination by donor, egg cell donation or adoption were not reported. A more refined analysis was performed in the subgroup with a follow-up interval of at least 3 years and who reported 'family planning' as a motive to apply for predictive testing in the pretest period. The complexity of this motive is discussed. In this subgroup with a desire for children in the pretest period the effect of the predictive test result was more pronounced: 69% of the non-carriers had subsequent pregnancies while only 39% of the carriers who mentioned 'family planning' as one of the major reasons to apply for predictive testing had a subsequent pregnancy. Of the carriers with one or more subsequent pregnancies the percentage using prenatal diagnosis was slightly higher than the percentage not using it, although there were clear differences from one centre to another. The latter group's decisions may seem more intriguing but may be partially understood based on stage theories of health behaviour. Last, but not least, whatever option is chosen by a couple at increased risk of transmitting the Huntington mutation, it is of the utmost importance that professionals fully respect this decision and support the couple.

Adult↗

Modulating the rate and rhythmicity of perceptual rivalry alternations with the mixed 5-HT2A and 5-HT1A agonist psilocybin.

Binocular rivalry occurs when different images are presented simultaneously to corresponding points within the left and right eyes. Under these conditions, the observer's perception will alternate between the two perceptual alternatives. Motivated by the reported link between the rate of perceptual alternations, symptoms of psychosis and an incidental observation that the rhythmicity of perceptual alternations during binocular rivalry was greatly increased 10 h after the consumption of LSD, this study aimed to investigate the pharmacology underlying binocular rivalry and to explore the connection between the timing of perceptual switching and psychosis. Psilocybin (4-phosphoryloxy-N,N-dimethyltryptamine, PY) was chosen for the study because, like LSD, it is known to act as an agonist at serotonin (5-HT)1A and 5-HT2A receptors and to produce an altered state sometimes marked by psychosis-like symptoms. A total of 12 healthy human volunteers were tested under placebo, low-dose (115 microg/kg) and high-dose (250 microg/kg) PY conditions. In line with predictions, under both low- and high-dose conditions, the results show that at 90 min postadministration (the peak of drug action), rate and rhythmicity of perceptual alternations were significantly reduced from placebo levels. Following the 90 min testing period, the perceptual switch rate successively increased, with some individuals showing increases well beyond pretest levels at the final testing, 360 min postadministration. However, as some subjects had still not returned to pretest levels by this time, the mean phase duration at 360 min was not found to differ significantly from placebo. Reflecting the drug-induced changes in rivalry phase durations, subjects showed clear changes in psychological state as indexed by the 5D-ASC (altered states of consciousness) rating scales. This study suggests the involvement of serotonergic pathways in binocular rivalry and supports the previously proposed role of a brainstem oscillator in perceptual rivalry alternations and symptoms of psychosis.

Adult↗

Pharmacogenetics and pharmacogenomics: origin, status, and the hope for personalized medicine.

Pharmacogenetics arose with studies of single genes, which had major effects on the action of particular drugs. It turned into pharmacogenomics through realization that the controls of most drug responses are multifactorial. Then, variable gene expression posed new problems, for example what do drugs do to genes, or how useful is any genetic pretesting of a person? A common disease may be caused by different groups of genes in different people, who therefore require different drugs for treatment. Personalized medicine is currently represented by a physician's attention to a patients age, sex, or ethnic background, that is groups showing smaller genetic variation than is typical for general humanity. Occasionally, there is also the use of single-gene pretesting of a patient before drug administration. Over time, improvements in multigenic testing promise to increase the role of personalized medicine. However, the many pharmacogenomic complexities, and particularly time-dependent changes of gene expression, will never allow personalized medicine to become an error-free entity.

Biomarkers↗

A program to prevent iron poisoning using public health nurses in a county health department.

Despite 50 years of educational and legislative efforts aimed at increasing public awareness of the toxicity of iron, it remains a leading cause of poisoning death in children. The purpose of this study was to educate public health nurses (PHNs) on the prevention of iron poisoning utilizing, a "Train the Trainer" design. Educational programs were based on cognitive and behavioral approaches and consisted of a pretest, lecture, posttest, and evaluation. In addition, a follow-up survey was conducted at 8-months posttraining in order to determine the application of iron poison-prevention principles. Prior to the program, 71% of the PHNs were unable to identify iron as a leading household poison. Sixty percent reported storage habits of medication that predispose children to poisoning. The overall score on the pretest was 56% compared with the mean posttest score of 96%. Of the 45 respondents to the follow-up survey, 87% had used the program information to educate patients on the dangers of iron poisoning. This iron poison prevention program provided a successful educational program for PHNs that was then applied to patient education.

Education, Nursing, Continuing↗

Investigating the proximal limit of lymphadenectomy in patients with adenocarcinoma of the oesophagus in the mid-thoracic region

AIMS: The benefit of extended lymphadenectomy in patients with squamous cell carcinoma of the oesophagus is established, but there is little evidence to support this in patients with adenocarcinoma. The aim of this study was to investigate the extent of lymphatic spread of oesophageal adenocarcinomas, and particularly the proximal spread in tumours located in the mid thorax. METHODS: Twenty-six consecutive patients with tumours arising between 29 and 35 cm from the incisor teeth underwent three-stage oesophagectomy with two-field lymphadenectomy, including nodes in the recurrent laryngeal chains. The proximal extent was measured by endoscopic ultrasonography and confirmed at operation, with division of the lymph node harvest into anatomical sites according to the Japanese classification of oesophageal cancer. RESULTS: There were 21 men and five women, with a mean age of 64 (range 42-78) years; seven patients were lymph node negative in both the mediastinal and abdominal fields. Six patients had nodal metastases more than 2 cm above the tumour and all had extensive involvement of other nodes at the level of the tumour or below, with 7, 7, 9, 12, 15 and 18 nodes positive. There were no patients in whom nodes above the tumour contained metastases while those at the level or below were clear. CONCLUSIONS: Dissection of proximal lymph nodes along the recurrent laryngeal nerve chains in patients with adenocarcinoma of the oesophagus is not warranted. Lymphatic spread above the level of the tumour occurs in association with extensive lymph node involvement elsewhere and removal of proximal nodes from difficult locations is not warranted as a means of improving staging or survival.

Journal Article↗

Attentional demands reflect learning-induced alterations of bimanual coordination dynamics.

This study aimed to investigate the effects of practice on bimanual coordination dynamics and attentional demands. Participants were asked to perform a dual-task associating a cyclic antiphase bimanual pattern and a discrete reaction time task. A pretest determined each individual critical transition frequency. In the training session, participants practised 120 trials. They were instructed to maintain the antiphase coordination pattern at the critical transition frequency. The training session was interrupted and followed by an intermediate test (after 60 trials) and a post-test (30 min after 120 trials), respectively. A retention test was performed 7 days after the end of the training session. Results showed that: (i) the number of transitions decreased as a consequence of practice; and (ii), subjects were able to maintain the antiphase pattern at a higher frequency than in the pretest. Analysis of the trade-off between relative phase variability and reaction time showed that participants were able to maintain a higher level of stability at the same (intermediate and post-test) or a lower attentional cost (retention test). These findings show that phase transition dynamics and pattern stability can be significantly modified as a result of practice. Changes in the trade-off between pattern stability and cost with learning confirm that the attentional cost incurred by the central nervous system to maintain pattern stability decreased with practice. In line with recent neurobiological studies, the present study provides new insights regarding relationships between brain processes, attentional demands and coordinated behaviour in learning bimanual patterns.

Attention↗

Cross-cultural adaptation of the Nordic musculoskeletal questionnaire.

BACKGROUND: Reports in the literature have identified a need for internationally standardized and reliable measurements to analyse musculoskeletal symptoms. Screening of musculoskeletal disorders may serve as a diagnostic tool to evaluate the work environment. The Nordic general questionnaire is a standardized instrument used to analyse musculoskeletal symptoms in an ergonomic or occupational health context. PURPOSE: To translate and adapt a version of the Nordic general questionnaire into Brazilian Portuguese and evaluate its reliability. METHOD: The cross-cultural adaptation was performed according to internationally recommended methodology, using the following guidelines: translation; back-translation; committee review; and pretesting. First, the questionnaire was independently translated into Portuguese by two teachers and one doctor, and a consensus version was generated. Second, two other translators performed a back-translation independently from one another. This version was then submitted to a committee, consisting of six specialists in the area of knowledge of the instrument, to evaluate its equivalence to the original instrument. The final version was pretested on 20 subjects randomly selected in an outpatient clinic. Reliability was assessed by a test-retest procedure at 1-day intervals using the Kappa coefficient in a group of 40 subjects. The Kappa agreement values were calculated for each one of the four questions of the questionnaire. The agreement among the same observers was substantial, varying from 0.88 to 1, according to the Kappa values. RESULTS: these demonstrated strong agreement of the instrument, suggesting that the Brazilian version of the "Standardized Nordic Questionnaire" offers substantial reliability.

Adult↗

Integrated Obstetric Curriculum for Obstetrics and Gynecology Residency, Radiology Residency and Maternal-Fetal Medicine Fellowship program at an accredited American Institute of Ultrasound in Medicine Diagnostic Ultrasound Center.

OBJECTIVE: The purpose of this work was to demonstrate the approach to developing an integrated curriculum for obstetric ultrasound training by utilizing an accredited American Institute of Ultrasound in Medicine teaching platform. METHODS: During the 1996-98 academic years, the American College of Obstetricians and Gynecologists and American Institute of Ultrasound in Medicine guidelines for ultrasound performance and training were integrated into a multifaceted training program for obstetric and radiological residents and maternal-fetal medicine fellows consisting of a structured reading program, self study of a 35-mm slide program of normal/abnormal anatomy, a basic ultrasound and fetal echocardiography interactive CD program, hands-on supervised scanning program and practical and certificate-bearing fetal echocardiography courses for fellows. All obstetric residents were given pretests and post-tests to measure learning performance in the program. The results from these tests were analyzed for statistical significance. RESULTS: Thirteen obstetric residents completed the training program. The locally developed pretest showed a mean of 16/40 correct questions with an SD of 1.85. After completing the training, the mean obstetric resident scores on the post-test were 32/40 with an SD of 5.9. This difference was statistically significantly different, P < 0.009. Radiology residents showed an improvement from no residents passing the obstetric ultrasound portion on the 1996 Radiology Boards to 100% pass rate in 1997 (four residents per year) after completing the course. Maternal-fetal medicine fellows progressed from inability to perform acceptable fetal echocardiography to full ability to perform fetal echocardiographic examinations. CONCLUSION: An integrated approach to obstetric ultrasound training for obstetric and radiologic residents and maternal-fetal medicine fellows with multifaceted learning methods is easily achieved with available guidance from the American College of Obstetricians and Gynecologists and American Institute of Ultrasound in Medicine.

CD-I↗

A method for identifying the financial burden of hospitalized infants on families.

OBJECTIVES: To describe a method for measuring the direct and indirect costs to families of infants hospitalized with respiratory syncytial virus (RSV). METHODS: After pretesting and revising a questionnaire, a prospective survey was conducted in multiple tertiary-care hospitals with pediatric intensive care units. Eligible patients were infants less than 12 months old who had not received RSV prophylaxis and were hospitalized with a confirmed RSV infection. All English- and Spanish-speaking caregivers of eligible subjects were asked to participate in a face-to-face, structured interview on the day of hospital discharge regarding hospitalization-related direct and indirect costs. Thirty days later, caregivers were re-interviewed by telephone about their RSV-related costs during the elapsed month. The survey was initiated in February 2000 and continued through April 2001. RESULTS: In addition to the infants' parents, numerous adults visited 55% of hospitalized infants. In 17% of cases, nonparents missed work to visit the child. Volunteers watched siblings of 26% of the infants. Relying only on closed-ended questions about parents' costs during the hospitalization would have missed important information about child-care volunteers and types of expenses. Follow-up interviews revealed that RSV-related out-of-pocket expenses and missed work continued during the month following discharge. CONCLUSIONS: Survey instruments should be pretested with potentially eligible subjects. Open-ended questions are needed, because all costs cannot be anticipated. Respondents should be probed for details. This method revealed certain time and financial burdens during and after hospitalization that had not been previously reported in the literature.

Adult↗