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Neuropsychological assessment for detecting adverse effects of volatile organic compounds on the central nervous system.

Because there are no direct biological markers for the substances implicated in indoor air exposure, it is impossible to directly measure if an individual or group of individuals has been exposed to a potentially neurotoxic substance in the workplace. Behavioral changes may be the earliest and only manifestation of central nervous system (CNS) effects and are often too subtle to be revealed by routine physical or neurological examination. Neuropsychological techniques are sensitive to subtle behavioral/cognitive changes that can result from exposure to neurotoxins. These techniques consist of oral and written tests that are administered by a trained examiner on a one-to-one basis. In general, a wide variety of cognitive domains are evaluated. The typical battery generally includes assessing orientation, attention, intelligence, language, visual memory, verbal memory, perception, visuoconstruction, simple motor speed, psychomotor speed, and mood. As with most assessment techniques, the neuropsychological methods have limitations. One major drawback is the availability of appropriate norms that are used to compare the results of a specific individual. Because these tasks are greatly affected by age, intelligence, and in some instances sex, the availability of appropriate norms is mandatory to determine if the CNS has been effected. Although neuropsychological tests are sensitive to the presence of CNS involvement, they are not specific. Patterns of performance seen with specific instances of neurotoxic exposure may also be seen with a number of other diseases of the CNS such as dementia, cerebrovascular disease, hydrocephalus, or normal aging. In addition, neuropsychiatric symptoms such as anxiety and/or depression are often manifested as cognitive difficulties that will mimic the cognitive dysfunction seen with toxicity of the CNS.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain↗

Adolescent pregnancy: an interpersonal skill training approach to prevention.

The research literature reports numerous negative consequences of adolescent pregnancy. Unfortunately, contemporary approaches to preventing teenage pregnancies have been largely unsuccessful. Recent evidence, however, suggests that interpersonal communication skill training may represent an important step in helping adolescents deal with their sexual and contraceptive behavior. This describes a pilot study of an interpersonal skill training model for sexually active inner-city teenagers. Results show that this training model is a feasible and attractive approach to modifying the youths' communication patterns. Findings indicate that such training is a fruitful direction for future pregnancy prevention research with the adolescent target population.

Adolescent↗

Rehabilitation experiences of women ex-addicts in methadone treatment.

In-depth interviews were conducted with 16 female "hard-core" heroin addicts on a methadone maintenance treatment program 1 year or longer to learn what the rehabilitation process is like for women and how their life-styles had changed since being in treatment. The paper describes the adjustments and special difficulties experienced by women through patients' own accounts. Behavioral changes were verified by clinic records and staff. Cessation of criminal behaviors, regulation of daily living patterns on methadone, increased social productivity, and adoption of new social values were noted. Persisting problems include loneliness, motivational difficulties, and an incomplete transition to ordinary society.

Adult↗

Complementary vertebrate Wac models exhibit phenotypes relevant to DeSanto-Shinawi Syndrome.

Monogenic syndromes are associated with neurodevelopmental changes that result in cognitive impairments and neurobehavioral phenotypes, including autism and seizures. Limited studies and resources are available to make meaningful headway into the underlying molecular mechanisms that result in these symptoms. One such example is DeSanto-Shinawi Syndrome (DESSH), a rare disorder caused by pathogenic variants in the WAC gene. Individuals with DESSH syndrome exhibit a recognizable craniofacial gestalt, developmental delay/intellectual disability, neurobehavioral symptoms that include autism, ADHD, behavioral difficulties, and seizures. However, no thorough studies from a vertebrate model exist to understand how these changes occur. To overcome this, we developed both murine and zebrafish Wac/wac deletion mutants and studied whether their phenotypes recapitulate those described in individuals with DESSH syndrome. We first show that the two Wac models exhibit craniofacial and behavioral changes, reminiscent of abnormalities found in DESSH syndrome. In addition, each model revealed impacts on GABAergic neurons and further studies showed that the mouse mutants are susceptible to seizures, changes in brain volumes that are different between sexes and relevant behaviors. Finally, we uncovered transcriptional impacts of Wac loss-of-function in mice that will pave the way for future molecular studies into DESSH. These studies present two new vertebrate models that begin to uncover biological underpinnings of DESSH syndrome and elucidate the biology of Wac.

Animals↗

The relative autonomy of schools and educational interventions for substance abuse prevention, sex education, and gender stereotyping.

This paper evaluates intervention programs in schools using the theoretical framework of the critical sociology of education, and most specifically, the extent to which schools are autonomous from the larger society. Three different types of intervention programs are reviewed: drug abuse prevention, sex education, and programs to change gender stereotypes, all of which were found to have limited effectiveness. Schools appear unable to change behaviors which are prevalent in a culture because they themselves are strongly influenced by that culture, and because adolescents are influenced by forces outside school. To be effective, such interventions would seem to require governmental agencies, community groups, and the media to work with the schools in order to influence the culture and thus produce behavioral changes in individuals.

Adolescent↗

Publicly funded HIV counseling and testing--United States, 1991.

Human immunodeficiency virus (HIV) counseling and testing (CT) services provided by health departments are a major component of the national HIV-prevention program. The purpose of HIV CT is to 1) reinforce perception of risk by those who are unaware or uninformed, 2) help uninfected persons initiate and sustain behavior changes that reduce their risk for becoming infected, and 3) identify HIV-infected persons who can be referred for early medical care and counseled to practice safer behaviors. The use of publicly funded HIV CT has steadily increased; in 1991, nearly 2,091,000 HIV-antibody tests were performed, compared with approximately 79,000 tests in 1985. CT services are provided by health departments in 65 HIV-prevention project areas including the 50 states, the District of Columbia, six cities, and eight territories. Each calendar quarter, the programs report to CDC data regarding the number of pretest counseling sessions. HIV-antibody tests, positive tests, and posttest counseling sessions. Information is also provided on self-reported risk category, age group, sex, and race/ethnicity. This report summarizes data reported for 1991.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS Serodiagnosis↗

AIDS knowledge and attitudes among injection drug users: the issue of reliability.

Among injection drug users (IDUs), AIDS-related knowledge and attitudes have not consistently predicted AIDS risk behavior. This may be due in part to the limited reliability of indexes used to measure drug users' AIDS knowledge and attitudes. In addition, the substantive interpretation of findings is confounded if index reliability is lower for particular demographic groups (e.g., ethnic populations and women). This report is based on 8 measures of AIDS-related knowledge and attitudes in a sample of 332 injection drug users in Los Angeles. The reliability of knowledge and attitude indexes for the overall sample is generally acceptable for the purpose of group comparison (average alpha = .60). But reliability is consistently lower for respondents who are Hispanic (average alpha = .49) and respondents with less formal education (alpha = .56). The reliability of 2 measures of sex-related attitudes is lower for female respondents. It is therefore important that the reliability of knowledge and attitude indexes be assessed not just for drug-user samples as a whole, but also within demographic groups of substantive interest.

Acquired Immunodeficiency Syndrome↗

Common sleep disorders in the elderly: diagnosis and treatment.

Insomnia and daytime sleepiness in an elderly patient may be a normal consequence of aging, the result of a primary sleep disorder, or an adverse effect of medication or medical illness. Effective management requires a differential diagnosis. Adjustment sleep disorder, primary snoring, inadequate sleep hygiene, and mood disorders are common in the aged. The physician needs to review the patient history, including stressful events, medications, medical illness, and the possible presence of a psychiatric disorder. Treatment often involves behavioral changes and conservative use of medications, including antidepressants or benzodiazepines.

Aged↗

Changes in acquired immunodeficiency syndrome-related risk behavior after adolescence: relationships to knowledge and experience concerning human immunodeficiency virus infection.

This paper explores the extent of change in acquired immunodeficiency syndrome (AIDS) risk level and in the numbers of AIDS-related risk behaviors in 602 inner-city adolescents as they enter young adulthood. Youths' risk level for human immunodeficiency virus (HIV) infection during adolescence was categorized as high (engaging in prostitution, male homosexual or bisexual activity, or injectable drug use or having ulcerative sexually transmitted diseases), moderate (having six or more sex partners in a 1-year period or nonulcerative sexually transmitted diseases), or low (none of the above). Although a proportion at high or moderate risk during adolescence did move to lower risk levels by young adulthood, the overall risk level stayed fairly stable: 45% were at high or moderate risk levels during adolescence, and 35% were at those levels by young adulthood. Then change in the total number of risk behaviors engaged in by the youths was examined. Knowledge about AIDS or HIV infection and its prevention was not associated with any change in risk behavior, nor were the number of sources of information about the epidemic, acquaintance with those who are infected, estimates of personal risk, or exposure to HIV-test counseling. In fact, youths whose risk behaviors increased the most were more likely to know someone who had died of AIDS and to estimate their own risk as high. Most youths reported that they did not use condoms regularly, disliked them, and had little confidence in their protective ability. Changes in preventive strategies and further research on the causes of behavior change are needed.

Acquired Immunodeficiency Syndrome↗

Changes in sexual behavior and condom use associated with a risk-reduction program--Denver, 1988-1991.

Human immunodeficiency virus (HIV) risk-reduction programs have been developed to discourage homosexual/bisexual men (i.e., men who have sex with men) from engaging in anal and oral sexual intercourse with partners who are infected with HIV or whose infection status is unknown (1). The consistent and proper use of latex condoms with adequate lubrication may reduce the risk for HIV transmission during intercourse (2). To assist these men in understanding and following "safer" sexual behaviors, the Denver Disease Control Service conducted a longitudinal cohort study as part of CDC's Demonstration Projects for HIV Prevention and Risk Reduction. This report describes the effects of individual counseling sessions--including a basic introduction to the availability and proper use of condoms and lubricants--on short- and long-term behavior change among a group of homosexual/bisexual men in Denver during 1988-1991.

Bisexuality↗

Demographic and health characteristics of participants and nonparticipants in a work site health-promotion program.

Work site health-promotion programs represent an increasingly common attempt by industry to improve the health of employees. The potential impact of programs is limited by nonparticipation, especially among demographic subgroups and those who could most benefit from health behavior change. The present study prospectively examined the relationship of personnel data and self-reported health habits and health status to participation in the health-promotion program at a research and development work site. Thirty-four percent of the 505 employees enrolled in the health-promotion program. White employees were 2.47 times as likely to participate as nonwhites (95% confidence interval, 1.59, 3.83). Those with health maintenance organization health insurance were 1.43 times as likely to participate as were employees with fee-for-service insurance (1.11, 1.84). There was no difference between participants and nonparticipants in self-reported health status, and only slightly more positive health habits were noted among participants. Seatbelt use was 1.65 times more common among participants (1.10, 2.49). The study results are reassuring that such programs do not enroll only the very healthy or those with healthy habits. However, the diminished enrollment of nonwhite employees supports concern that health-related programs may not equally reach all segments of the work force.

Adult↗

Evaluation of a chimpanzee enrichment enclosure.

A large, three-part playground for captive chimpanzees was constructed and evaluated in terms of area use and behavior changes. Comparative behavioral samples were obtained on 38 subjects in the existing indoor-outdoor run and in the enclosure. The chimpanzees used the inside run, connective chute, concrete slab, and grass areas most. Activity and environmental manipulation increased in the enclosure while abnormal and self-directed behaviors decreased.

Age Factors↗

West Texas teenagers and AIDS: a survey of their knowledge, attitudes, behavioral changes, and information sources.

We conducted this study to determine the knowledge, attitudes, behaviors, and sources of AIDS information among teenagers in West Texas. We also examined differences by gender, ethnicity, and rural/urban status. Results were divided into the following categories: general knowledge of AIDS, AIDS-related attitudes, behavior changes caused by AIDS, and AIDS information sources. The 289 ninth-grade students revealed a greater knowledge of AIDS than had been shown in studies in other states. However, there were group differences with Anglo students exhibiting greater knowledge of AIDS. There were also some differences between rural and urban students, with urban students scoring higher on knowledge. Finally, doctors were regarded as the most reliable source of AIDS information. There were many implications related to AIDS education from these results and from the other findings in this study.

Acquired Immunodeficiency Syndrome↗

AIDS prevention program for Puerto Rican women.

Historically women are considered the family's primary care provider and biologically, they are the link in the transmission of the Human Immunodeficiency Virus. Because of this dual role, they need programs that are culturally sensitive and effective. Many Latinas do not perceive themselves to be at risk despite the educational resources available to them. This article examines cultural factors that influence risk perception and behavioral changes in response to educational intervention. Interviews and literature review were used in assessing availability, applicability and cultural sensitivity of AIDS prevention programs. Effective programs need to be culturally sensitive to gender role expectation and the role of motherhood for Latinas. Educators expressed the belief that women benefit most from programs that help them implement the behaviors that will help protect them. Programs must be cognizant of the cultures' demand for respect and modesty while providing factual information/instruction.

Acquired Immunodeficiency Syndrome↗

Promoting AIDS risk reduction via behavioral training.

The present study employed behavioral techniques to teach assertive strategies designed to reduce the risk of contracting AIDS and to promote "safer-sex" behaviors. A total of 79 university students (38 male and 41 female) were included in the final data analysis. Subjects participated in three one-hour training sessions which included live modeling of assertive interactions, role-playing, behavior shaping, corrective feedback, verbal reinforcement, assertiveness training, and an AIDS educational lecture. Dependent measures included ratings of the key components of assertive behavior from videotaped role-plays at pre- and posttests. Behavioral training had a positive effect on participants' assertive behavior. On the role-play ratings, experimental subjects were rated higher on overall assertiveness than the controls. Even brief behaviorally based educational interventions can produce increases in assertive behaviors known to be related to AIDS prevention, for example, insisting on condom use and requesting information about a prospective partner's sexual and drug use histories. Behavior changes extended to in vivo situations, of course, remain less assured.

Acquired Immunodeficiency Syndrome↗

Behavioral and neurochemical effects of orally administered MDMA in the rodent and nonhuman primate.

MDMA (methylenedioxymethamphetamine) is a recreational drug of abuse known as "Ecstasy" which markedly decreases regional brain serotonin (5-HT) content and produces 5-HT nerve terminal degeneration in forebrain areas of the rat. In order to determine the acute and chronic behavioral effects of MDMA, adult rats were given MDMA at 0, 5 or 10 mg/kg, po for 4 consecutive days. Alternatively, parachloroamphetamine (PCA) at 5 mg/kg was administered under the same regimen. Within 30 min after the first dose, the MDMA-treated rats exhibited the serotonin motor syndrome consisting of straub tail and splayed hindlimbs comparable to that seen in the PCA-treated rats. This serotonin motor syndrome, with a duration of about 2 hr, was less pronounced after subsequent doses. At 2-4 wk after the last dose, no significant differences between control and treated rats were seen in emergence, hot plate response, auditory startle response or complex maze behavior even though a significant dose-related decrease (50%) in 5-HT concentration was observed in the frontal cortex and hippocampus of these rats 4 wks after the last dose. Adult female monkeys dosed po with 5 or 10 mg/kg of MDMA twice/day for 4 consecutive days demonstrated no spontaneous behavioral changes or weight loss compared to controls, but forebrain 5-HT concentration was reduced by 80% 1 mon after dosing. These data indicate that at doses only 2-3 times the human dose, MDMA produces significant forebrain 5-HT decreases but does not produce detectable residual behavioral alterations as assessed by these behavioral paradigms.

3,4-Methylenedioxyamphetamine↗

Changes in social dynamics associated to the menstrual cycle in the vervet monkey (Cercopithecus aethiops).

Behavioral changes associated to the menstrual cycle in a social group of vervet monkeys (Cercopithecus aethiops) were studied. Three adult females were used as experimental subjects and in these, vaginal smears were taken every other day in order to detect their menstrual cycles. Only the dominant and the mid-ranking female showed regular cycles while the low-ranking female showed amenorrhea. The menstrual cycles were divided into five periods (menstrual, premenstrual, luteal, ovulatory and follicular) which were related to the behavioral data. Social behavior recordings were taken during one hour daily for five consecutive months; the data were adjusted twice in order to follow the cycles of the females with regular menstruations. By plotting in a matrix the relative frequencies of joins and displacements, the social position of each animal as well as the group's social organization and dynamics were evaluated. A clear tendency towards social rejection (emitting less joins and increasing the amount of displacements) was detected during the premenstrual periods of the dominant female which abruptly changed towards affiliation during menstruation. This observation was detected in all group members no matter their age-sex class or social position during the five months of observation. When the data were analyzed following the mid-ranking female's cycle, no consistent changes were apparent. The importance of social stimuli in the modulation and expression of hormone-related behavior is stressed, as well as the need of using social settings in the experimental analyses of premenstrual mood and behavior disorders.

Animals↗

HIV infection among intravenous drug users: epidemiology and risk reduction.

Research on the epidemiology of HIV infection among IV drug users is still at a relatively early stage. Multilocation studies that would permit better geographic comparisons are greatly needed. Multi-method studies within single geographic areas are also needed to assess possible biases with respect to sample recruitment and data collection procedures. The continuation of the epidemic provides a changing historical context that complicates any comparisons. Despite these problems, there are some consistencies that can be seen across studies. Studies of HIV seroprevalence among IV drug users show wide variation among cities in the United States and Europe. The time that the virus was introduced into the IV drug using group within the city is one factor in explaining these differences; other cross-city factors have yet to be identified. Once HIV has been introduced into the IV drug use group within a particular geographic area, there is the possibility of rapid spread up to seroprevalence levels of 50% or greater. Thus, a currently low seroprevalence rate should not be seen as a stable situation. Frequency of injection and sharing of equipment with multiple other drug users (particularly at shooting galleries) have been frequently associated with HIV exposure. Being female, ethnicity (in the USA) and engaging in prostitution also may be associated with increased risk for HIV exposure, suggesting that prevention programs should include special consideration of sex and ethnic differences. Studies of AIDS risk reduction show that substantial proportions of IV drug users are changing their behavior to avoid exposure to HIV. This risk reduction is probably more advanced in New York, with its high seroprevalence and incidence of cases, but is also occurring in cities with lower seroprevalence and limited numbers of cases. The primary forms of risk reduction are increasing the use of sterile equipment, reducing the number of needle sharing partners, and reducing the frequency of injection. These behavior changes are very similar to the frequently identified behavioral risk factors associated with HIV exposure, suggesting that they should be effective in at least slowing the spread of HIV among IV drug users. No linkage of risk reduction to decreases in seroconversion has yet been shown, however, and greater risk reduction is clearly required. A variety of prevention strategies will probably be needed to reduce the spread of HIV among IV drug users. Prevention of initiation into drug injection is an undeniable long-term goal for the control of HIV infection, but there is very little research being conducted in this area.

Acquired Immunodeficiency Syndrome↗