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PubMed1977

The goal-attainment scale: an instructional guide for the delivery of social reinforcement.

Goal-attainment scaling, a method for evaluating treatment programs, has been reported to benefit therapeutic encounters. In order to evaluate its effect on staff therapeutic behavior, raters were trained to rate the appropriateness of inpatient behavior and the staffs' responses to it. General distribution of the goal-attainment scale on a psychiatric inpatient unit influenced the delivery of positive social reinforcement for appropriate behavior.

Achievement↗
PubMed1981

Mental health workers' ratings of the importance of the goals of a cooperative CMHC-state hospital screening-aftercare program.

Ratings of the importance of the goals of a pilot community mental health center (CMHC)-state psychiatric hospital cooperative program aimed at providing screening and aftercare were obtained from 214 mental health professionals. Respondents were employed at state hospitals, at CMHCs that were participating in the program, and at CMHCs that were not participating in the pilot cooperative program. Ratings of importance were found to differ across goals, between mental health workers of state hospitals and CMHCs, between participating and nonparticipating CMHCs, between professions, and as a function of distance between CMHCs and state hospitals. Implications of the findings for the evaluation of the success of a cooperative screening-aftercare pilot program are discussed.

Aftercare↗
PubMed2006

Defining and redefining the scope and goals of genetic counseling.

Many definitions of genetic counseling have been proposed since Sheldon Reed first defined the term in 1947. This study reviews selected definitions of genetic counseling including the most recent definition proposed by a committee of the National Society of Genetic Counselors. The analysis focuses on the professional background of who was formulating the definition; the reasons why the definition was created; medical, historical, and social factors; and the definer's implicit or explicit goals of genetic counseling. No definition of genetic counseling is ideal, and any definition can only reflect the values, ethics, goals, and medical practices of the person or group defining the practice of genetic counseling.

Eugenics↗
PubMed2006

A midpoint assessment of the American Cancer Society challenge goal to halve the U.S. cancer mortality rates between the years 1990 and 2015.

BACKGROUND: The American Cancer Society has challenged the U.S. to reduce cancer mortality rates 50% over the 25 years from 1990 to 2015. The current report is an analysis and commentary on progress toward that goal through 2002, the midpoint of the challenge period. METHODS: Cancer mortality rates were examined from 1990 through 2002, and projections to the Year 2015 were made. Cancer deaths that were prevented or deferred by the declining death rates were expressed as the difference between the observed and projected numbers of deaths and the numbers that would have been observed over that period had the 1990 death rates persisted. RESULTS: Since 1990, cancer mortality rates have been declining in the U.S. by approximately 1% per year. Trends especially have been favorable for cancers of the breast, prostate, and colorectum and for lung cancer among men. Should this rate of decline continue over the coming decade, death rates from cancer will be approximately 23% lower in the Year 2015 than they were in 1990, and approximately 1.8 million deaths from cancer will have been prevented or deferred. CONCLUSIONS: At this midpoint of the 25-year challenge period, it appears that fully reaching the goal will require substantial breakthroughs in cancer early detection and/or in cancer therapy. Between now and 2015, however, many more cancer deaths can be averted by concerted action to control tobacco and obesity, by redoubling efforts in mammography and colorectal screening, and by enacting policies to close gaps in access to cancer detection and treatment services.

Adult↗
PubMed2005

A supramodal limbic-paralimbic-neocortical network supports goal-directed stimulus processing.

Limited processing resources are allocated preferentially to events that are relevant for behavior. Research using the novelty "oddball" paradigm suggests that a widespread network of limbic, paralimbic, and association areas supports the goal-directed processing of task-relevant target events. In that paradigm, greater activity in diverse brain areas is elicited by rare task-relevant events that require a subsequent motor response than by rare task-irrelevant novel events that require no response. Both stimulus infrequency (unexpectedness) and novelty, however, may contribute to the pattern of activity observed using that paradigm. The goal of the present study was to examine the supramodal neural activity elicited by regularly occurring, equiprobable, and non-novel stimuli that differed in the subsequent behavior they prescribed. We employed event-related functional magnetic resonance imaging (fMRI) during auditory and visual versions of a Go/NoGo task. Participants made a motor response to the designated "Go" (target) stimulus, and no motor response to the equiprobable "NoGo" (nontarget) stimulus. We hypothesized that task-relevant Go events would elicit relatively greater hemodynamic activity than would NoGo events throughout a network of limbic, paralimbic, and association areas. Indeed, Go events elicited greater activity than did NoGo events in the amygdala-hippocampus, paralimbic cortex at the anterior superior temporal sulcus, insula, posterior orbitofrontal cortex, and anterior and posterior cingulate cortex, as well as in heteromodal association areas located at the temporoparietal junction, anterior intraparietal sulcus and precuneus, and premotor cortex. Paralimbic cortex offers an important site for the convergence of motivational/goal-directed influences from limbic cortex with stimulus processing and response selection mediated within the frontoparietal areas.

Acoustic Stimulation↗
PubMed2002

Psychoanalytic goals, therapeutic action, and the analyst's tension.

The author draws a distinction between the goals of psychoanalysis and its therapeutic action. Goals are consciously (or at least preconsciously) held by the analyst, and can be clearly articulated. Ideas about the mechanism of therapeutic action, in contrast, are hypothetical constructs, and cannot be completely spelled out. This is bound to leave analysts in a state of tension; we are certain about what we are trying to do, but what we are actually accomplishing is elusive. This tension may be optimal for the analyst, because attention must be paid simultaneously to the idiosyncratic relationship in the dyad and to the broader purposes of the analytic engagement.

Freudian Theory↗
PubMed2006

Goal attainment for spasticity management using botulinum toxin.

BACKGROUND AND PURPOSE: To determine whether goal attainment scaling (GAS) can demonstrate functional gains following injection of botulinum toxin (BTX) for spasticity in severely disabled patients. METHOD: Subjects were categorized as 'responder' (positive clinical outcome) and 'non-responder' (non-significant clinical outcome) on the basis of their overall clinical response. GAS scores for functional goals were calculated retrospectively and compared with standard outcome assessments undertaken at the time of intervention. Integrated care pathway (ICP) proformas were interrogated for 18 patients with acquired brain injuries. Mean age was 44.4 (SD 13.4) years. RESULTS: Baseline GAS and Barthel scores were similar for the responder and non-responder groups. The outcome GAS score was significantly greater in the responder than in the non-responder group (Mann-Whitney U = 11.0; p = 0.011) as was the change in GAS score (Mann-Whitney U = 8.0; p = 0.004). GAS scores reflected change recorded in focal outcome measures. However, the Barthel Index measured change in only one case. CONCLUSIONS: This exploratory retrospective study provides preliminary support for the hypothesis that GAS provides a useful measure of functional gains in response to treatment with BTX, and is more sensitive than global measures such as the Barthel Index.

Adult↗
PubMed1998

Kinematics of goal-directed arm movements in neglect: control of hand velocity.

Do patients with unilateral neglect exhibit direction-specific deficits in the control of movement velocity when performing goal-directed arm movements? Five patients with left-sided neglect performed unrestrained three-dimensional pointing movements to visual targets presented at body midline, the left and right hemispace. A group of healthy adults and a group of patients with right-hemispheric brain damage but no neglect served as controls. Pointing was performed under normal room light or in darkness. Time-position data of the hand were recorded with an opto-electronic camera system. We found that compared to healthy controls, movement times were longer in both patient groups due to prolonged acceleration and deceleration phases. Tangential peak hand velocity was lower in both patient groups, but not significantly different from controls. Single peak, bell-shaped velocity profiles of the hand were preserved in all right hemispheric patients and in three out of five neglect patients. Most important, the velocity profiles of neglect patients to leftward targets did not differ significantly from those to targets in the right hemispace. In summary, we found evidence for general bradykinesia in neglect patients, but not for a direction-specific deficit in the control of hand velocity. We conclude that visual neglect induces characteristic changes in exploratory behavior, but not in the kinematics of goal-directed movements to objects in peripersonal space.

Adolescent↗
PubMed1998

Manual asymmetries in goal-directed movement: examination of the motor output hypothesis.

Two experiments are reported which examined the viability of motor output hypothesis as an explanation for manual asymmetries in goal-directed movement. Experiment 1 isolated the variability due to force generation by directly assessing precision of force production during an isometric wrist flexion task. Experiment 2 examined the additional role of externally based and internally created timing patterns on the performance of a repetitive force production task. Virtually no effects involving hand were apparent in either experiment. These findings provide no support for a hypothesis based solely on motor output to adequately account for hand differences in the performance of rapid, goal-directed movement.

Adult↗
PubMed1999

Adolescents' ideas of normative life span development and personal future goals.

We investigated how 57 adolescents (23 girls and 34 boys), aged 12 to 15 years, compared their idea of normative life span development to their personal future goals. A two-stage study (questionnaire and follow-up interview) included two open-ended "life paths", measures for self-evaluation and self-other comparisons. Overlap of content categories in the life paths supported the relationship between individual goals and normative expectations about life span development, especially when it comes to the life domains of education, occupation, family, property and retirement. The respondents showed an awareness of the accumulation of social problems, reporting that crises (e.g. alcoholism) and negative events (e.g. unemployment) are more likely to occur to the average adult than in their personal future. If adolescents rated their future as better than the future of others, they also regarded that future as different from the normative life span. Self-evaluation was indirectly related with self-other comparisons. Similarity between the normative life span and personal future correlated with higher probability of problem occurrence and possibility to avoid the problems.

Adolescent↗
PubMed1984

Invariants in loaded goal directed movements.

Goal directed movements, executed by means of a manipulator with various dynamics, were investigated in order to establish to what extent the loading affects the executed movement. The desired movement concept, together with a describing function model for goal directed movements, was applied to parameterize the movements. Analysis of the results showed that the position trajectories, when scaled by means of a fundamental scale property, with respect to the maximum velocity of the desired movements, were invariant under variation of the manipulator dynamics. From this invariance in the phasing of the movements, it was concluded that the subjects fully adapted to the applied loads.

Goals↗
PubMed1988

Health behavior as goal-directed action.

The perceived relationship of different health-related activities to a number of goals, including that of staying healthy, was examined by means of a postal questionnaire completed by 403 members of the general public. Other questions concerned subjects' own health behavior, intentions for behavior change, and vulnerability to specific conditions. The results showed that the extent to which subjects would value and engage in different behaviors (smoking, drinking, exercising, eating, and relaxing) was related to how far such behaviors were seen to facilitate the attainment of different goals. However, the value subjects placed on "staying healthy" was at best a partial predictor of their health habits and intentions.

Adult↗
PubMedDate not supplied

The motivational dominant in goal-directed behavior.

Results of experimental studies on discontinuation of the motivational dominants thirst and hunger and the "polarization" motor dominant, taken together with a theoretical analysis of the development of types I and II conditioned reflexes, lead to the conclusion that discontinuation of the motivational dominant plays a key role in organization goal-directed behavior. The activation of reciprocal connections between the appropriate centers provides a basis for the performance of goal-directed behavior.

Animals↗
PubMed2005

Dynamic visual-vestibular integration during goal directed human locomotion.

Normal visual input plays a very dominant role during locomotion. Functionally, it can assist the central nervous system to overcome a destabilizing effect of abnormal or perturbed vestibular information. However, a recent study has shown a directional effect of transmastoidal galvanic vestibular stimulation (GVS) on gait trajectory when visual information is unreliable. The purpose of this study was to investigate how inputs from the visual and vestibular systems are weighted to optimize locomotor performance under impoverished visual conditions during goal directed locomotion. For unimodal stimulation, the visual input was manipulated using displacing prisms that caused 14 degrees horizontal displacement of perceived target location to the right or left. In addition, GVS (0.8 mAmp) was applied to manipulate vestibular system information during bimodal stimulation conditions. Two bimodal stimulation conditions were defined by the polarity of the galvanic current (anode on congruent and incongruent sides of prismatic deviation). The center of mass (CoM) displacement, head and trunk yaw angles and trunk roll angles were computed to analyze the global output as well as segmental coordination, as the participants walked towards the target. Although the performance was primarily guided by visual information, both congruent and incongruent GVS significantly altered CoM displacement. Similarly, the basic pattern of segmental responses during steering was maintained; however, the magnitude of the responses was altered. Spatio-temporal analysis demonstrated that during bimodal stimulation, the effect of GVS on global output tapered off as the participants approached the target. Results suggest a dynamic visual-vestibular interaction in which the gain of the vestibular input is initially upregulated in the presence of insufficient or impoverished visual information. However, there is a gradual habituation and the visual information, although insufficient, primarily dominates during goal directed locomotion. The experimental trajectories resembled mathematically simulated trajectories with a decaying GVS gain as opposed to a constant gain, further supporting the dynamic nature of sensory integration.

Adult↗
PubMed2005

The inadequacy of Individual Educational Program (IEP) goals for high school students with word-level reading difficulties.

This investigation analyzed goals from the Individual Educational Programs (IEPs) of 54 high school students with diagnosed reading disabilities in basic skills (decoding and/or word identification). Results showed that for 73% of the students, the IEPs written when they were in high school failed to specify any objectives regarding their acute difficulties with basic skills. IEPs from earlier points in the students' educations were also reviewed, as available. For 23 of the students, IEPs were present in the students' files for three time points: elementary school (ES), middle school (MS), and high school (HS). Another 20 students from the sample of 54 had IEPs available for two time points (HS and either MS or ES). Comparisons with the IEPs from younger years showed a pattern of decline from ES to MS to HS in the percentage of IEPs that commented on or set goals pertaining to weaknesses in decoding. These findings suggest that basic skills deficits that persist into the upper grade levels are not being sufficiently targeted for remediation, and help explain why older students frequently fail to resolve their reading problems.

Achievement↗
PubMed1994

The relationship between treatment goals and recidivism among child molesters.

Preliminary findings from a longitudinal outcome study of sex offender treatment are presented. Ss included 76 child molesters who were treated in a comprehensive relapse prevention program, and 79 molesters who were randomly assigned to a control (no treatment) condition. Three sets of findings are reported: survival analyses of time to reoffense; in-treatment change data relevant to the program's treatment goals; and the relationships between treatment measures and risk of reoffense. Over an average followup period of 38 months, there was a trend for treatment Ss to be at lower risk for both sex and violent crimes than were controls. Treatment Ss showed significant progress towards treatment goals of increased acceptance of personal responsibility for their crimes and decreased levels of deviant sexual arousal. Measures of personal responsibility, however, were not related to risk of rearrest for new sex crimes. Treatment Ss with high levels of both deviant and nondeviant sexual arousal were more likely to commit new sex offenses, but not other violent offenses. The strongest predictor in the study was a measure of the Ss' skills in applying the relapse prevention model, with highly skilled Ss being less likely to commit new sex crimes.

Adaptation, Psychological↗
PubMed1985

Goal-directed critiquing by computer: ventilator management.

VQ-ATTENDING is an expert system which critiques aspects of the ventilator management of a patient receiving mechanical respiratory support. To use VQ-ATTENDING, the physician first inputs medical information describing a patient, a current set of arterial blood gas results, the current ventilator settings, and a proposed set of new ventilator settings. VQ-ATTENDING then critiques the appropriateness of the proposed settings. In its current developmental implementation, VQ-ATTENDING explores a particular expert system designed feature: the ability to assess appropriate treatment goals, and to use those goals to guide the system's critiquing analysis.

Artificial Intelligence↗
PubMed1977

Certain select variables as predictors of goal achievement in speech therapy.

A previous factor-analytic investigation indicated that 18 variables, structured within interpersonal and technical skill dimensions, contribute most significantly to supervisor's evaluations of student clinicians engaged in speech therapy. The present study was designed to extend that investigation by determining the relative contribution of the variables to the clinicians' accomplishment of the goals of the therapy session. Using the previously collected data, 17 of the resultant variables were regressed in stepwise fashion against the clinicians' accomplishment of the session's goals. The regression solution yielded a three-variable prediction system, which accounted for approximately two-thirds of the criterion variance. All three variables were related to clinicians' technical skills. The "schedule of reinforcement" variable was the single most valid predictor and accounted for half of the criterion variance. The other two technical skill variables were "implements carryover procedures in therapy" and "changes therapeutic procedure to meet client needs." Implications for inclusion of these variables in interactive and microtherapy methodologies of clinical training are discussed.

Achievement↗