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PubMed1983

The developmental and neural determinants of the effects of estrogen on feeding behavior in the rat: a theoretical perspective.

Conceptually, the neural regulation of feeding behavior is proposed to be a function of the activities of a long-term (day to day) and a short-term (meal to meal) control system. Although these two control systems are presumably involved in a continuous and dynamic interaction, they can be behaviorally and anatomically separated by specific regulatory challenges and brain lesions. Utilizing this general regulatory model for the hypothalamic control of feeding behavior, the effects of estrogen on a variety of behavioral indices of energy regulation are reviewed and discussed. The effects of ovarian hormones on the feeding behavior of both prepubertal and adult female rats when faced with a series of regulatory tests shown to provide specific information about the long- and short-term control of feeding behavior leads to the following conclusions. Modulation of feeding behavior by ovarian hormones is detectable well before the time of puberty in the female rat and is expressed in terms of a 4-day periodicity that is very similar to adult animals. Estrogen appears to modulate feeding behavior primarily by modifying the long-term control of feeding behavior or else the manner in which nutrients are integrated into this long-term system. It is further proposed that estrogen acts upon metabolically specific and unique neural elements in the hypothalamus whose function is to translate error signals derived from the long-term integration of body nutrients into appropriate readjustments in feeding behavior. Although this dual-regulatory model for the hypothalamic control of feeding behavior can account for the majority of the effects of estrogen on feeding behavior, further studies suggest that an "extrahypothalamic" mechanism must mediate certain aspects of the neural control of feeding behavior as well as the behavioral effects of estrogen. Specifically, the present model system can account for the role of carbohydrates in the neural control of feeding behavior, but fats and possibly proteins can modify feeding behavior independent of the hypothalamus. Likewise, estrogen can influence the efficiency with which nutrient loads of fats and proteins can modify subsequent feeding behavior and therefore this proposed "extrahypothalamic" mechanism may mediate those effects of estrogen on feeding behavior that cannot be accounted for by the present dual-regulatory model.

Afferent Pathways↗
PubMed2004

The behavioral economics of violence.

From the viewpoint of teleological behaviorism the first question to ask in attempting to understand any behavior, including violent behavior, is: What are its contingencies of reward and punishment? Or, to put the question in economic terms: What are the short-term and long-term costs and benefits that such behavior entails? Let us therefore consider the costs and benefits of youth violence. Among the short-term costs of violent behavior are the physical effort of the act, the possibility of immediate physical retaliation, immediate social disapproval, and the opportunity cost of other social acts that the violent behavior takes the place of (you can't be affectionate and violent at the same time, for instance). Among the immediate benefits of violent behavior are the intrinsic satisfaction of the violent act itself and any extrinsic benefit; if A violently appropriates B's new sneakers then obtaining the sneakers reinforces A's violence. These immediate benefits may well outweigh the costs in many contexts. Among the long-term costs of violent behavior are delayed retaliation, possible social disapproval and loss of social support, rejection from a social group, job loss, and health risks associated with a violent lifestyle. Among the long-term benefits are long-term intimidation of others (your neighbor is less likely to build a fence on your property if you have a reputation for violence), and a possibly exciting lifestyle. These long-term benefits may well be outweighed by the long-term costs. Opposition of long-term net costs to short-term net benefits, where it exists, creates a personal self-control trap: Overall satisfaction may decrease monotonically with rate of the target behavior but, regardless of its rate, the immediate satisfaction of doing it is always higher than that of not doing it. In the case of violent behavior, this trap is exacerbated by the fact that as a person's violence increases, net immediate reinforcement also increases (due to membership in violence-reinforcing subgroups). This contingency fits the "primrose path" addiction model of Prelec and Herrnstein. Violence is thus a paradigm case of behavioral addiction. I consider three ways of controlling such addictive behavior: by punishment, by extinction, and by substitution. The problem with punishment in the case of violence is that physical punishment tends to increase violent behavior while incarceration drives the punished person into the very social subgroup (the prison culture) where violence is maximally reinforced. The problem with extinction is that the immediate benefits of violent behavior are largely intrinsic and some costs (immediate retaliation by unidentified others) are difficult to control. The best way to control violent behavior, as well as other addictive behaviors, is by decreasing the price of economic substitutes. There is much evidence that addictions, such as to cocaine, heroin, alcohol, and tobacco, may be reduced by decreasing the price of social support. The same is predicted for violent behavior--either by providing social support directly or by training in social skills. In addition, in considering control of violent behavior, we need to examine the immediate benefits and long-term costs to society of having violent individuals and violence-reinforcing subcultures among us. And we need to act to reduce our own dependence on those benefits.

Behavior, Addictive↗
PubMed1991

Determinants of health-promotive behavior. A review of current research.

The determinants of health promotive-behavior are proposed by Pender in the HPM. The exact impact of the various variables on singular behaviors or a lifestyle index, however, is far from conclusive. All the proposed factors have been supported through research, at least in part, as either directly or indirectly influencing the intent to participate in different health behaviors. The difficulty in concluding which variables are most critical is perhaps due to the variety of definitions, theoretical approaches (from different disciplines), and research methods. Of primary concern to this author is the overlap of activities among different "patterns" of behavior and the various definitions of such behavioral patterns. Little evidence exists on how specific types of behaviors relate to one another. Thus, knowing the determinants of a lifestyle index, for example, may be insignificant if the goal of nursing is to target priority behaviors that may indeed be influenced by more significant variables. For example, a person's perception of control may be a significant predictor of lifestyle behaviors in general; however, this variable may not impact on the person's decision to engage in changes related to exercise or activity behavior. Hence, because the motives behind various behaviors may be different, it seems more prudent to invest our research efforts on the impact of various factors on singular behaviors rather than lifestyle patterns. Finally, the efforts of nursing research on health behavior have been directed primarily at explaining the impact of various individual perceptions on the likelihood of behavior. Such focus has revealed some evidence of the significance of these variables, yet much unexplained variance remains. Perhaps it would be more prudent to direct attention at those variables such as situational or environmental factors that may impede or act as a cue to healthy behavior. Because the explanation of behavior has been individually focused (perhaps due to an "individualizing" theme in nursing education), the impact of the ecological model of behavior tends to be dismissed or underrated in nursing research. Knowledge of the impact of societal factors on behavior may be more appropriate to planning strategies for various groups rather than the behavioristic approaches that separate people from their social, physical, and economic environments. Thus, personal lifestyles may not be a simple matter of informed choice, and attention to the complex processes of societal opportunities, cultural interpretations, and group-specific attitudes must be studied further.

Health Behavior↗
PubMed2001

Correlation of increased grooming behavior and motor activity with alterations in nigrostriatal and mesolimbic catecholamines after alpha-melanotropin and neuropeptide glutamine-isoleucine injection in the rat ventral tegmental area.

1. We wished to further study the behavioral effects of alpha-melanotropin (alpha-MSH), melanin-concentrating hormone (MCH), and neuropeptide glutamine-isoleucine (NEI). 2. To this effect we administered alpha-MSH, MCH, and NEI in the ventral tegmental area of the rat, a structure where these neuropeptides are highly concentrated. To further elucidate the biochemical mechanisms of the behavioral effect of these neuropeptides, we determined the degree of grooming behavior and the levels of catecholamines. after neuropeptide administration. 3. We preselected those animals responding to the central injection of alpha-MSH with excessive grooming behavior. We administered the neuropeptides at the dose of 1 microg/0.5 microL, in each side of the ventral tegmental area, bilaterally. We studied grooming behavior, locomotor activity, and total behavior scores, 30 and 65 min after administration of the peptides. 4. Three groups of animals were decapitated immediately after the injection of the neuropeptides, and 30 or 65 min after injection. We measured dopamine (DA), noradrenaline (NA), and the dopac/dopamine ratio (DOPAC/DA) to determine steady state levels of catecholamines and an indirect measure of DA release and metabolism, respectively. 5. Injections of alpha-MSH produced significant elevations in grooming behavior, locomotor activity, and total behavior scores, both 30 and 65 min after peptide administration. This was correlated with significant decreases in DA content, increases in DOPAC content, and increases in the DOPAC/DA ratio. In the caudate putamen, changes in catecholamines occurred both at 30 and 65 min after injection. In the nucleus accumbens, changes were present at 65 min after injection. Conversely, there were no alterations in NA content, either in the caudate putamen or in the nucleus accumbens, at any time after the injection. 6. Injections of NEI resulted in significant elevations in grooming behavior, locomotor activity, and total behavior scores, both 30 and 65 min after peptide administration. This was correlated with increased DOPAC/DA ratio in the nucleus caudatus but not in the nucleus accumbens. Conversely, NEI produced increased NA concentrations in the nucleus accumbens, but not in the nucleus caudatus. 7. Injections of MCH did not produce significant changes in behavior or significant changes in nucleus caudatus or nucleus accumbens catecholamines. 8. Our results indicate (a) There is a correlation with alterations in behavior as induced for the neuropeptides injected here, and changes in extrapyramidal catecholamines. (b) There is a correlation between alterations in behavior and increases in DOPAC/DA ratio in the nucleus caudatus. (c) There is a correlation between alterations in behavior and alterations in catecholamines in the nucleus accumbens. In the nucleus accumbens, DOPAC/DA ratio is changed after alpha-MSH, and NA ratio is changed after NEI injection. (d) Absence of alterations in extrapyramidal catecholamines, and in particular in catecholamines in the nucleus accumbens, correlates with absence of behavioral alterations after neuropeptide administration to the ventral tegmental area. 9. In conclusion, the behavioral effect of exogenous administration of neuropeptides in the ventral tegmental area is peptide-specific, and is probably associated with alterations in catecholamine metabolism and release in the nucleus caudatus and the nucleus accumbens. Both alpha-MSH and NEI seem to stimulate the nigrostriatal DA system. While alpha-MSH appears to stimulate the mesolimbic DA system as well, NEI may exert its actions not through the DA, but through the NA mesolimbic system. The precise contribution of DA and NA, and the relative role of the nucleus caudatus and nucleus accumbens in these behaviors remain to be elucidated.

Animals↗
PubMed2001

An analysis of music therapy student practicum behaviors and their relationship to clinical effectiveness: an exploratory investigation.

The purpose of the present study was to investigate specific clinical behaviors exhibited by music therapy students in their 1st through 4th semesters of practicum. A secondary purpose of the study was to determine if a relationship exists between therapy students' behaviors and their assessed clinical success. Participants were instructed to submit 20-minutes of videotape from one practicum session, chosen at random from the current practicum semester. Two trained observers then viewed the videotapes and simultaneously recorded the occurrence and duration of practicum student behaviors using SCRIBE, a data collection computer program. The SCRIBE program was configured to include 5 broad categories of therapist behaviors: musical behaviors (singing, playing, listening), physical behaviors (such as hand-over-hand assistance, cueing, or clapping), verbal behaviors (therapy-related verbal interactions or other), a combination of two of the above, and other nonspecified behaviors. The percentage of time practicum students exhibited behaviors within in each category was calculated for all session segments. These same videotapes were also evaluated by 2 professional board certified music therapists who were unfamiliar with the practicum students. Students were assigned an overall rating for clinical effectiveness. Evaluators were also asked to provide comments related to their ratings. A descriptive analysis of clinical behaviors indicate that students spend nearly 40% of their practicum time engaged in musical behaviors and over 50% of their time engaged in verbal behaviors. No significant differences were found in the behaviors exhibited by students in the various practicum levels; however, behavioral differences were found for individual student therapists. Additionally, no relationship was found between students' behaviors and their clinical effectiveness. An analysis of comments by the evaluators indicates that the quantity of musical behaviors does not affect clinical effectiveness as much as the quality of the musical behaviors. Evaluator comments also indicate that students identified as personable or as having rapport with their clients were also more effective in the practicum setting.

Adult↗
PubMed2004

Unsafe and violent behavior in commercials aired during televised major sporting events.

OBJECTIVE: Injuries are the leading cause of death in children, and media exposure seems to increase children's risk-taking behavior. Televised sports are commonly viewed by children. The objective of this study was to determine the proportion of commercials that depict violence or other unsafe behavior during major televised sporting events that are aired before 9:00 pm. METHODS: We obtained a list of the 50 sports programs that were most highly rated by Nielsen Media Research and that were televised between September 1, 2001, and September 1, 2002. These 50 programs included Winter Olympics events (n = 15), National Football League (NFL) regular season games (n = 14), NFL playoff games (n = 10), Major League Baseball World Series and playoff games (n = 7), the NFL Super Bowl (n = 1), the National Basketball Association Western Conference Final Game (n = 1), the College Football Rose Bowl (n = 1), and the National Collegiate Athletic Association Basketball Championship game (n = 1). Two other events were reviewed as well: the final round of the Masters Golf Championship, because it was the only sporting event rated in the top 50 of the previous year that was not represented by a similar sporting event in the study year, and the Daytona 500 National Association for Stock Car Auto Racing race, because it was the only event rated among the top 75 of the study year that was not represented by a similar event (ie, there were no other golfing or auto racing events reviewed). These events were included because different sporting events may attract different viewers and different advertisements; thus, their inclusion provides a more comprehensive evaluation of the topic. For sporting events with >3 programs in the top 50 (NFL regular season games, NFL playoff games, Winter Olympic events, and Major League Baseball World Series), representative samples of events were assessed. Surrogate events were analyzed for programs that were aired after 9:00 PM (Eastern Time) to control for the reduced likelihood of viewing by children after 9:00 PM. For example, afternoon telecasts of the National Collegiate Athletic Association Regional Final and National Semifinal games were assessed in place of the Championship game, which started after 9:00 PM. Weekend afternoon telecasts of the Winter Olympics (3 successive weekends) were assessed as surrogates for all Olympics telecasts. For the World Series, the Super Bowl, and the National Basketball Association Conference Championship games, which began before 9:00 PM but ended after that time, we evaluated only commercials that aired before 9:00 PM. All commercials that were aired during these programs were reviewed at standard speed for unsafe behavior or violence. Commercials that were aired during pregame, postgame, or halftime periods were not assessed. Commercials were categorized according to the product being advertised. Unsafe behavior was simply defined as any action that could have harmful consequences or that contravened the injury prevention recommendations of national organizations. Violence was defined as any intentional physical contact by an aggressor that had the potential to inflict injury or harm or the legitimate threat of such action. All commercials were reviewed by at least 2 investigators; when the 2 could not agree on the findings, a third investigator was used to resolve differences. The percentage of commercials and of commercial breaks that portrayed violent or unsafe behavior was determined for each category of event and advertised product. A commercial break was defined as a series of commercials shown during a single break from the sporting event. chi2 analysis was used for all analyses, and relative risks with 95% confidence intervals were determined. The proportion of commercials that depicted unsafe behavior and/or violence during each sporting event was compared with the proportion of such commercials that were observed during the Masters Golf Tournament (which had the lowest proportion of commercials depicting such behavior). The proportion of commercials that contained violent/unsafe behavior for each advertised product was compared with the proportion of such commercials that advertised food or nonalcoholic beverages. Food and nonalcoholic beverage commercials were selected as the reference because they are a well-defined, common category of commercial. RESULTS: Of the 1185 commercials assessed, 14% (n = 165) displayed unsafe behavior and 6% (n = 66) depicted violence. Of the 322 commercial breaks, 158 (49%) contained at least 1 commercial showing unsafe behavior or violence. Sixty-three commercials required review by a third investigator to adjudicate violence or unsafe behavior; 20 of 52 were ultimately judged to portray unsafe behavior, and 4 of 11 were ultimately judged to portray violence. Sporting events differed in the proportion of commercials that showed violence or unsafe behavior. The Super Bowl had the highest proportion of such commercials, and the Masters Golf Tournament had the least (relative risk: 4.3; 95% confidence interval: 1.4-12.5). The Masters Golf Tournament was noteworthy for the complete absence of violent commercials. Only 18% of reviewed commercials advertised movies or television programs, yet these commercials accounted for 86% of all violent commercials. Forty-eight percent of commercials that contained violence were for movies, and an additional 38% were for television programs. Nearly two thirds of all commercials for movies contained violence, whereas 15% of all commercials for television programs contained violence, a rate that increased to 22% when commercials for other sporting events were excluded. Several categories of commercials portrayed unsafe behaviors; commercials for automobiles accounted for the most. In 8 different categories, 10% or more of the commercials depicted unsafe behavior, and 7 were significantly more likely to depict such behavior than a food or beverage commercial. CONCLUSIONS: Children who watch televised sports view a significant amount of violent and unsafe behavior. In accordance with American Academy of Pediatrics recommendations for television viewing, parents should both limit and directly supervise children's viewing of these events. Our findings suggest that parents should remain present during commercials or should consider implementing commercial-skipping technology. In addition, efforts should be made to regulate the content of commercials that promote television programs and movies on the basis of the hour at which the sporting event is aired. Moreover, the sports, movie, and television industries should be encouraged to adopt models of advertising that limit or eliminate such content. These efforts could help to ensure that the viewing of televised sporting events is a safe and positive experience for children.

Advertising↗
PubMed2004

Childhood overweight and parent- and teacher-reported behavior problems: evidence from a prospective study of kindergartners.

OBJECTIVES: To determine if there is a relationship between overweight and behavior problems among children as young as 5 years old by studying the association between overweight and behavioral health at entry into kindergarten and to determine whether overweight status is a risk factor for the onset of new behavior problems during the first 2 years in school. DESIGN: We use data from a nationally representative sample of kindergartners in the United States-the Early Childhood Longitudinal Study-Kindergarten class. Data on height, weight, and parent- and teacher-reported behavior problems were collected 3 times during their first 2 years in school for 9949 children. We use a multivariate regression analysis that controls for sociodemographic characteristics, parent-child interaction, birth weight, and mother's mental health. RESULTS: Among girls, but not boys, there is a significant association between overweight and teacher-reported externalizing behavior problems (odds ratio [OR], 1.81; 95% confidence interval [CI], 1.23-2.68), teacher-reported internalizing behavior problems (OR, 1.54; 95% CI, 1.09-2.17), and parent-reported internalizing behavior problems (OR, 1.49; 95% CI, 1.08-2.06) at the beginning of kindergarten. However, overweight status was not a risk factor for the onset of new behavior problems over time for either girls (teacher-reported externalizing behavior problems: OR, 0.58 [95% CI, 0.25-1.33]; teacher-reported internalizing behavior problems: OR, 1.34 [95% CI, 0.88-2.03]; and parent-reported internalizing behavior problems: OR, 1.29 [95% CI, 0.82-2.01]) or boys (teacher-reported externalizing behavior problems: OR, 1.02 [95% CI, 0.67-1.57]; teacher-reported internalizing behavior problems: OR, 1.02 [95% CI, 0.68-1.52]; and parent-reported internalizing behavior problems: OR, 1.42 [95% CI, 0.94-2.15]), whereas low family income and maternal depression were strong predictors of such problems. CONCLUSIONS: Childhood overweight is already associated with behavior problems when girls start school, but not boys. In contrast to common belief, overweight status does not predict the onset of new internalizing or externalizing behavior problems during the first 2 years of school.

Child↗
PubMed2002

Associations between health-related behaviors: a 7-year follow-up of adults.

BACKGROUND: The study examines pairwise associations between smoking, alcohol use, physical activity, dietary behavior and body mass index using long-term follow-up data of Finnish adults. METHODS: Respondents to large nationwide health behavior surveys conducted in 1989/1990 were recontacted in 1997. First, we examined whether each health behavior predicted other behaviors 7 years later. Second, we examined whether changes in each health behavior were accompanied by changes in other behaviors. RESULTS: Smoking at baseline predicted all other health behaviors except body mass index in men. On the other hand, other behaviors tended to predict smoking. Physical inactivity and unhealthy diet were predictive of each other in men. Those with an unhealthy diet at baseline were less likely to be high alcohol users in the follow-up. Baseline body mass index did not predict any of the other behaviors. Concurrent changes in health behaviors involved either smoking or body mass index. Changes in diet and alcohol use were differently related to changes in body mass index in men than in women. CONCLUSIONS: Overall, smoking seemed to play a central role in the associations between health behaviors. Smoking was predictive of most other health behaviors. Concurrent changes in health behaviors related either to smoking or to body weight. The associations between health behaviors were fairly similar for men and women, but the variation in the associations between body mass index and some other health behaviors suggests gender differences in the behavioral response to body weight.

Adult↗
PubMed1990

Demonstration of replicable dimensions of health behaviors.

Health behaviors are known to be multidimensional, but the precise number of dimensions involved and their behavioral content have not been clearly established. Using convergence of factor analyses of 40 health behaviors across two samples as the criterion for identifying both the number and content of health behavior dimensions, the present study showed that individual differences in health behavior can be conceptualized in terms of a hierarchical model. At the most general level, health behaviors formed two broad categories or dimensions, preventive behavior and risk taking behavior. Preventive behavior included two empirically distinct subsets of behaviors, wellness maintenance behaviors and accident control behaviors. Risk taking behavior included subsets comprised of traffic-related risk taking and risk taking through exposure to hazardous substances. This hierarchical model is consistent with important theoretical distinctions in health behavior research, can accommodate the findings of prior studies, and should provide a useful framework for formulating research questions regarding antecedents and consequences of individual differences in health behaviors. Brief scales are proposed for use as reference measures in future studies of health behaviors.

Adolescent↗
PubMed2002

Caloric intake and eating behavior in infants and toddlers with cystic fibrosis.

OBJECTIVE: Infants and toddlers with cystic fibrosis (CF) are at risk for poor growth. Controlled behavioral assessment studies have not focused on this population. This study compared calorie intake, percentage of Recommended Daily Allowance (RDA) per day and per kilogram, and percentage of calories from fat, protein, and carbohydrates between infants and toddlers with CF and healthy peers. Also, eating behaviors, such as meal duration, bites and sips per minute, percentage of meal spent eating, children's problematic eating behaviors, and parents' perceptions of mealtime behaviors were compared between infants and toddlers with CF and controls. Five hypotheses were tested. 1) Infants and toddlers with CF would be comparable to controls on the number of calories consumed per day and the percentage of calories from fat. 2) Infants and toddlers with CF would not meet the CF dietary guidelines for the percentage of RDA for calories or the percentage of calories from fat. 3) Infants and toddlers with CF would have longer meal durations than healthy peers, but would not differ on the pace of eating, the number of calories consumed during the meal, or the percentage of time spent eating during the meal. 4) Parents of infants and toddlers with CF would perceive more problematic mealtime behavior than controls. 5) Parents' perceptions of children's mealtime behavior would positively correlate with meal duration and negatively correlate with the number of calories consumed during the meal. DESIGN: A 2-group comparison study. SETTING/SAMPLE: A clinical sample of 35 infants and toddlers with CF (M = 18.6; standard deviation = 8.1 months; range = 7-35 months) and a community sample of 34 healthy peers matched for age, gender, socioeconomic status, and number of parents and siblings present during mealtimes. MEASUREMENT AND MAIN RESULTS: Children's calorie intake was measured using 3-day diet diaries. The 2 groups did not differ on the total number of calories consumed per day, the percentage of calories derived from fat, or the percentage of RDA consumed per day. Infants and toddlers with CF were not meeting the CF dietary recommendations of 120% to 150% RDA for energy with 40% of calories coming from fat. Using the Dyadic Interaction Nomenclature for Eating, a behavioral coding system, videotaped recordings of children's dinner meals were scored for meal duration, number of bites and sips per minute, number of calories per bite or sip, and the percentage of 10-second intervals with bites and sips. The CF sample had significantly longer mealtimes (20.2 minutes) than the control group (16.4 minutes), but did not differ on calories consumed at the meal, bites and sips per minute, calories per bite and sip, or time spent eating during the meal. On the Behavioral Pediatrics Feeding Assessment Scale, a measure of parental perceptions of mealtime behavior that was completed by a subset of families (39 families), parents of infants and toddlers with CF endorsed a greater number of mealtime behaviors as problems and a higher occurrence of problems than did parents of controls. Examples of these behaviors for the CF sample included problems with their child's willingness to try new foods (48%), eat vegetables (48%), and observations that their child has a poor appetite (32%) and would rather drink than eat (32%). Parents of children with CF chose a greater number of mealtime strategies and feelings as problems and reported more frequently using problematic strategies at mealtimes than did parents of controls. Examples of problematic strategies and feelings for parents of infants and toddlers with CF included feeling anxious/frustrated when feeding their children (37%), not feeling confident that their child eats enough (32%), and using coaxing to get their child to take a bite (26%). For the entire sample, a positive correlation of 0.29 was found between the number of mealtime behavior problems reported by parents and meal duration, suggesting the co-occurrence of problematic mealtime behavior with longer meal duration. No relationship was found between the number of child mealtime behavior problems reported by parents and the number of calories consumed during the filmed meal. For the CF sample, a correlation of -0.26 between children's weight percentile for age and the filmed meal duration was found, suggesting a tendency for meal duration to increase as children's weight for age decreases. Post-hoc analyses were conducted comparing infants and toddlers with previously reported samples of preschool and school-aged children on meal duration. Results demonstrated that in each group, children with CF had longer meals than age-matched controls. CONCLUSIONS: Our findings reveal significant deficits in achieving dietary recommendations for many families of infants and toddlers with CF. Only 11% of infants and toddlers with CF met the CF dietary recommendation of at least 120% of the RDA/day for energy. In addition, infants and toddlers were found to derive only 34% of their daily calories from fat, compared with the recommended 40% needed for a moderate to high fat diet. These results underscore the need for intervention in families of infants and toddlers with CF, who in addition to being at increased risk for malnutrition, may also experience a hastening in the decline of their pulmonary status because of poor nutritional status. Currently, there is limited programmatic research on nutritional and feeding interventions for toddlers and infants with CF. One study, which used a hospital-based behavioral education program to increase the caloric intake of 3 children (ages 10-20 months) who were below the fifth percentile for weight for length, found at least a 54% increase in calories for each child after treatment. Similarly, preliminary findings of 2 parent-based interventions, a nutrition education curriculum and a nutrition education plus behavior parent-training curriculum, found a 22% and 32% increase in daily calories, respectively, at treatment completion. A large-scale clinical trial is needed to evaluate the efficacy of any nutritional intervention before widespread dissemination. Additional assessment-focused research is also needed to identify patients' who may be at greatest risk for malnutrition and to guide the development of interventions to treat them.

Age Factors↗
PubMed2002

Behavior therapy for obsessive-compulsive disorder guided by a computer or by a clinician compared with relaxation as a control.

BACKGROUND: The demand for effective behavior therapy for obsessive-compulsive disorder (OCD) by exposure and ritual prevention exceeds its supply by trained therapists. A computer-guided behavior therapy self-help system (BT STEPS) was created that patients access by telephone from home via interactive voice response technology. This study compared the value of computer-guided behavior therapy value with that of clinician-guided behavior therapy and systematic relaxation as a control treatment. METHOD: After screening by a clinician, 218 patients with DSM-IV OCD at 8 North American sites were randomly assigned to 10 weeks of behavior therapy treatment guided by (1) a computer accessed by telephone and a user workbook (N = 74) or (2) a behavior therapist (N = 69) or (3) systematic relaxation guided by an audiotape and manual (N = 75). RESULTS: By week 10, in an intent-to-treat analysis, mean change in score on the Yale-Brown Obsessive Compulsive Scale was significantly greater in clinician-guided behavior therapy (8.0) than in computer-guided (5.6), and changes in scores with both clinician-guided and computer-guided behavior therapy were significantly greater than with relaxation (1.7), which was ineffective. Similarly, the percentage of responders on the Clinical Global Impressions scale was significantly (p < .05) greater with clinician-guided (60%) than computer-guided behavior therapy (38%), and both were significantly greater than with relaxation (14%). Clinician-guided was superior to computer-guided behavior therapy overall, but not when patients completed at least 1 self-exposure session (N = 36 [65%]). At endpoint, patients were more satisfied with either behavior therapy group than with relaxation. Patients assigned to computer-guided behavior therapy improved more the longer they spent telephoning the computer (mostly outside usual office hours) and doing self-exposure. They improved slightly further by week 26 follow-up, unlike the other 2 groups. CONCLUSION: For OCD, computer-guided behavior therapy was effective, although clinician-guided behavior therapy was even more effective. Systematic relaxation was ineffective. Computer-guided behavior therapy can be a helpful first step in treating patients with OCD when clinician-guided behavior therapy is unavailable.

Adolescent↗
PubMed2000

Implementation of an interdisciplinary Behavior Management Program.

OBJECTIVE: To describe the establishment and utilization of an interdisciplinary Behavior Management Program in a Transitional Care Unit as a new model of Geriatrics Practice. DESIGN: Descriptive Study. SETTING: A 50-bed Transitional Care Unit in a Veterans Affairs Medical Center in Syracuse, New York. PARTICIPANTS: All residents admitted to the Transitional Care Unit were observed for a 6-month period under the Behavior Management Program. PROGRAM STRUCTURE: The Behavior Management Program involved an interdisciplinary team approach to the management of behavioral disturbances. This included development of a Behavior Team and a comprehensive Behavior Observation Record, which readily assisted caregivers in determining and monitoring target behaviors that required modification. Both nonpharmacological and pharmacological interventions were employed to assist in the modification of behavioral disturbances. RESULTS: The Behavior Management Program enhanced the overall care of Transitional Care Unit residents with behavioral disturbances. The more appropriate use of medications for specific target behaviors led to a reduction in behavioral disturbance episodes and increased the earlier diagnosis and treatment of depression. The interdisciplinary nature of the Behavior Management Program promoted educational efforts and camaraderie among staff and created a stronger liaison between the Transitional Care Unit and the Psychiatry Service. In addition, several management improvements were identified as a result of the implementation of the Behavior Management Program. CONCLUSIONS: An interdisciplinary Behavior Management Program can prove to be a valuable asset in the management of behaviors for people with dementia, psychiatric illness, and other medical illnesses. More effective use of nonpharmacological and psychopharmacological interventions enhances the quality of life in a frail older population. This approach has strong potential for successful use in a variety of clinical settings by providers and caregivers alike.

Aged↗
PubMed2000

Adolescent cigarette smoking: health-related behavior or normative transgression?

Relations among measures of adolescent behavior were examined to determine whether cigarette smoking fits into a structure of problem behaviors-behaviors that involve normative transgression-or a structure of health-related behaviors, or both. In an ethnically and socioeconomically diverse sample of 1782 male and female high school adolescents, four first-order problem behavior latent variables-sexual intercourse experience, alcohol abuse, illicit drug use, and delinquency-were established and together were shown to reflect a second-order latent variable of problem behavior. Four first-order latent variables of health-related behaviors-unhealthy dietary habits, sedentary behavior, unsafe behavior, and poor dental hygiene-were also established and together were shown to reflect a second-order latent variable of health-compromising behavior. The structure of relations among those latent variables was modeled. Cigarette smoking had a significant and substantial loading only on the problem-behavior latent variable; its loading on the health-compromising behavior latent variable was essentially zero. Adolescent cigarette smoking relates strongly and directly to problem behaviors and only indirectly, if at all, to health-compromising behaviors. Interventions to prevent or reduce adolescent smoking should attend more to factors that influence problem behaviors.

Adolescent↗
PubMed1998

The association between health risk behaviors and sexual orientation among a school-based sample of adolescents.

OBJECTIVE: This study is one of the first to examine the association between sexual orientation and health risk behaviors among a representative, school-based sample of adolescents. DESIGN: This study was conducted on an anonymous, representative sample of 4159 9th- to 12th-grade students in public high schools from Massachusetts' expanded Centers for Disease Control and Prevention 1995 Youth Risk Behavior Survey. Sexual orientation was determined by the following question: "Which of the following best describes you?" A total of 104 students self-identified as gay, lesbian, or bisexual (GLB), representing 2.5% of the overall population. Of GLB youth, 66.7% were male and 70% were white (not Hispanic). Health risk and problem behaviors were analyzed comparing GLB youth and their peers. Those variables found to be significantly associated with GLB youth were then analyzed by multiple logistic regression models. RESULTS: GLB youth were more likely than their peers to have been victimized and threatened and to have been engaged in a variety of risk behaviors including suicidal ideation and attempts, multiple substance use, and sexual risk behaviors. Four separate logistic regression models were constructed. Model I, Onset of Behaviors Before Age 13, showed use of cocaine before age 13 years as strongly associated with GLB orientation (odds ratio [OR]: 6.10; 95% confidence interval [CI] = 2.45-15.20). Early initiation of sexual intercourse (2.15; 10.6-4.38), marijuana use (1.98; 1.04-4.09), and alcohol use (1.82; 1.03-3.23) also was associated with GLB orientation. Model II, Lifetime Frequencies of Behaviors, showed that frequency of crack cocaine use (1.38; 1.06-1.79), inhalant use (1.30; 1.05-1.61), and number of sexual partners (1.27; 1.06-1.43) was associated with GLB orientation. Model III, Frequency of Recent Behaviors, showed smokeless tobacco use in the past 30 days (1.38; 1. 20-1.59) and number of sexual partners in the previous 3 months (1. 47; 1.31-1.65) were associated with GLB orientation. Model IV, Frequency of Behaviors at School, showed having one's property stolen or deliberately damaged (1.23; 1.08-1.40) and using marijuana (1.29; 1.05-1.59) and smokeless tobacco (1.53; 1.30-1.81) were associated with GLB orientation. Overall, GLB respondents engaged disproportionately in multiple risk behaviors, reporting an increased mean number of risk behaviors (mean = 6.81 +/- 4.49) compared with the overall student population (mean = 3.45 +/- 3.15). CONCLUSION: GLB youth who self-identify during high school report disproportionate risk for a variety of health risk and problem behaviors, including suicide, victimization, sexual risk behaviors, and multiple substance use. In addition, these youth are more likely to report engaging in multiple risk behaviors and initiating risk behaviors at an earlier age than are their peers. These findings suggest that educational efforts, prevention programs, and health services must be designed to address the unique needs of GLB youth.

Adolescent↗
PubMed1992

Maintenance of behavioral change in a cohort of homosexually active men.

OBJECTIVES: To assess associations of perceptions of sexual behavior change with actual risk behaviors and psychosocial variables, and to determine whether perceptions of behavior change predict subsequent behavior. DESIGN: Cohort study of homosexually active men. SETTING: Community health center in Boston, Massachusetts, USA. PATIENTS, PARTICIPANTS: Two hundred and sixty-two cohort members who participated in follow-up in 1989 and who had at least one subsequent visit. INTERVENTIONS: None. MAIN OUTCOME MEASURE: Composite risk behavior variable, based on unprotected anogenital contact and number of partners. RESULTS: Of the 96% who had effected behavior change, 47% perceived that they were able to maintain those changes consistently and 58% wanted to make more changes. Perceptions of consistent maintenance were associated with lower risk behavior, lower perceived riskiness of behaviors and susceptibility to AIDS, and fewer barriers to behavior change. Desire for more change was associated with increased behavioral effort, fewer barriers to condom use, and greater perceived riskiness of current behavior. Among those with lower risk behaviors, perceived inconsistent maintenance predicted relapse to more risky behavior at the following visit. CONCLUSIONS: Perceived maintenance of behavior change is potentially useful in identifying individuals at risk of relapse from safer sex.

Acquired Immunodeficiency Syndrome↗
PubMed1978

Experimental studies on hatching behavior in the chick. IV. Evidence for the role of a noradrenergic mechanism.

In the present experiments we have attempted to determine whether one or more of the biogenic amines are involved in the prehatching and hatching behavior of the chick. Injection of reserpine first induces a depression in ongoing spontaneous motility on day 16 of incubation. Prior to this, reserpine has no apparent effect on embryonic behavior. Reserpine injections on days 17-19 induce a similar behavioral depression that lasts for at least six hours; by 24 hours post-injection the behavior of reserpine-treated embryos is comparable to controls. Injection of reserpine on day 20 (post-pip) delays hatching by about nine hours. Injection of reserpine into the yolk-sac of eggs prior to incubation also delays hatching by eight to nine hours. It is unlikely that the well-known cardiovascular effects of reserpine are involved in the above behavioral results since spinal embryos also exhibit a behavioral depression following reserpine treatment. Biochemical estimation of norepinephrine (NE) in the brain of reserpine-treated embryos suggest that it is release, not depletion, of the catecholamines that is responsible for the behavioral effects. Additional suport for this notion comes from experiments in which 16- or 18-day old embryos were injected with NE, L-dopa or amphetamine. In each case, a behavioral depression similar to that produced by reserpine resulted. Clonidine, a NE agonist induces a depression in certain aspects of embryonic behavior (Types 1 and 2), but also selectively enhances a corrdinated motor pattern (type 3 motility) involved in prehatching behavior (tucking). Clonidine first evokes this behavior pattern one or two days prior to its spontaneous appearance on day 16. After pipping on day 19 or 20 clonidine no longer activates Type 3 behavior, even if injected during the actual hatching process (climax). Since the alpha-adrenergic blocking agent phenoxybenzamine blocks the effect of clonidine on Type 3 tucking behavior, whereas the beta-adrenergic blocker propranolol does not, we suggest that tucking and the attainment of the hatching position are mediated by an alpha-adrenergic mechanism in the brain and/or spinal cord. Furthermore, since clonidine affects the Type 3 behavior associated with tucking, but not the somewhat similar coordinated behavior involved in hatching and emergence from the shell (climax), we propose that this later behavior pattern be given a new name, Type 4 motility.

Amphetamine↗
PubMed1991

[A phenomenological study on mother-infant interacting behavior patterns relating to newborn infant feeding in Korea].

The purpose of this study was to describe mother-infant interacting behavior patterns related to newborn infant feeding and to explore the mother's cultural belief about their infant. The data collection was conducted by observation and interview. Twenty-five mothers and their newborn infants who were normally delivered and were also planned to breastfeed were comprised as the subjects of this study. All subjects were interviewed and observed individually at 1 to 5 days after the delivery at the hospital, mid-wife's clinic, Maternal Child Health Center and their home throughout the country from remote area to big city. The observation data were recorded with symbolic letter on a recording sheet newly developed as a result of preliminary study. The interview data were tape recorded and then recorded in narrative form. Mother-infant interaction behaviors in early-feeding period were analyzed based on 19 analytic sub-categories and their composing elements. Unit of analysis were mother, infant and mother-infant dyad. 8 analytic categories draw from the data. Each were preparation, instrument, interaction inducing, evaluation referred to mother's behavior, preparation, instrument, interaction inducing referred to infant's behavior and synchronic behaviors referred to mother-infant dyad. Frequencies of behavior items based on the categories were converted to percent. The result showed that in mother's preparation behavior, the breast condition of Korean mother can be an affecting factor for mother-infant interaction during feeding, and vocalization behavior was observed most frequently in interaction inducing behavior while the least frequent behavior observed was contacting. Subcultural characteristics of mother-infant interaction behaviors were analyzed for their relationships between groups of mothers who have lived in remote area vs urban area, and who were multipara vs primipara. Using a chi-square test, there were statistically significant relationships in the activity of psychological readiness in preparation behavior and the movement of extremities for the position of instrumental behavior in both groups. However, interaction inducing behaviors were not related with statistical significance in any set of groups. Accomplishment of marriage, bonding and emotional mediation of family members were the categories related to mother's cultural belief about the infant in aspect of functional values. Infant at birth is considered little more than a biological organism without social capabilities. Although the newborn infant is still be attached to his mother, he makes his mother extend her territoriality. The mother's interacting behavior toward her infant based on those beliefs appeared task oriented, separative behavioral series.(ABSTRACT TRUNCATED AT 400 WORDS)

Breast Feeding↗
PubMed2004

Weight-control behaviors among adolescent girls and boys: implications for dietary intake.

OBJECTIVE: To examine associations between healthful and unhealthful weight-control behaviors and dietary intake among adolescents. DESIGN: Cross-sectional survey (Project EAT [Eating Among Teens]).Subjects/Setting The study population included 4144 middle and high school students from Minneapolis/St. Paul public schools from diverse racial and socioeconomic backgrounds. Statistical analyses Dietary intake patterns were compared across adolescent girls and boys reporting unhealthful, only healthful, or no weight-control behaviors in unadjusted analyses and analyses adjusted for sociodemographic factors and energy intake. RESULTS: Among girls, mean intakes differed across weight-control behaviors for all foods and nutrients examined. P values ranged from P=.006 to P<.001. Girls using unhealthful weight-control behaviors had significantly lower intakes of fruit; vegetables; grains; calcium; iron; vitamins A, C, and B-6; folate; and zinc than girls using only healthful weight-control behaviors. Compared with girls reporting no weight-control behaviors, girls using unhealthful weight-control behaviors had lower intakes of grains, calcium, iron, vitamin B-6, folate, and zinc. In contrast to the girls, boys reporting unhealthful weight-control behaviors did not have poorer dietary intakes than boys not using weight-control behaviors or using only healthful behaviors. Among boys, there were no significant differences in mean intakes of vegetables; grains; calcium; iron; vitamins A, C, and B-6; folate; and zinc. Furthermore, boys using unhealthful weight-control behaviors had higher fruit intakes (P=.002) than boys reporting no weight-control behaviors. CONCLUSIONS: Adolescent girls who engage in unhealthful weight-control behaviors are at increased risk for dietary inadequacy. The findings demonstrate a need for interventions to prevent unhealthful weight-control behaviors in adolescent girls, and to promote healthful weight-control behaviors when indicated.

Adolescent↗