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PubMedDate not supplied

Compliance and adherence are dysfunctional concepts in diabetes care.

Recognizing that adherence and compliance are dysfunctional concepts is not a passing fad or the latest trend in behavioral approaches to diabetes care and education. Shifting from the acute-care/compliance-focused paradigm to an empowerment/collaborative approach requires a new vision of diabetes education and a new definition and enactment of the roles of educators and patients. Our practice is always an expression of our vision; therefore, if our vision is transformed, our practice will most likely change to reflect our vision. Eliminating the concepts of adherence and compliance makes it possible for our patients to discover and actualize their personal responsibility for their diabetes self-management. Also, it helps us to practice diabetes education as win-win collaboration among equals.

Choice Behavior↗
PubMed1999

Marital food interaction and dietary behavior.

The objective of this investigation is to consider the role of family food interaction in healthful dietary activity. A theoretical model is proposed in which three sets of determinate variables are specified as leading to interaction in the family on food issues which, in turn, is predicted to have a positive effect on four indicators of dietary quality. 155 married couples from a midwestern US state were randomly selected and interviewed. The findings provide clear evidence of the importance of family food interaction for the quality of marital partners' diet. Also differences found between husbands and wives indicate that wives contribute more to husbands' dietary quality than the reverse, suggesting again the dominant status of wives in family food selection and preparation.

Adult↗
PubMed2002

Research on the influence that communication in psychiatric encounters has on treatment.

OBJECTIVE: The purpose of this article is to inform mental health professionals about the empirical literature on medical and psychiatric encounters and the influence of communicative behaviors on specific encounter outputs and treatment outcomes. METHODS: A comprehensive review of the health communications literature from 1950 to 2001, using MEDLINE and PsycINFO, was conducted to identify relevant articles on the communication skills of psychiatrists and other physicians. These searches were augmented by personal correspondence with experts on changes in practice patterns in psychiatry and on medical and psychiatric communications research. A review of references within each article and information from the experts identified other relevant articles. Selection was then narrowed to include reports of studies that used structured written instruments that captured relevant physician and patient perceptions of the physician-patient relationship, content analysis of audio- or videotapes of communication in medical or psychiatric encounters, or interaction analysis systems used to categorize audio- or videotaped communicative behaviors in medical or psychiatric encounters. RESULTS AND CONCLUSIONS: Twenty-five articles in medicine and 34 articles in psychiatry were selected. Medical communication researchers have observed associations between physicians' communicative skills and patients' satisfaction, patients' adherence to treatment recommendations, treatment outputs, and patients' willingness to file malpractice claims. The research has also shown that primary care physicians can be more responsive to patients' concerns without lengthening visits. In psychiatry, the literature can be organized into four discrete categories of research: negotiated treatment and the customer approach, therapeutic alliance, Gottschalk-Gleser content analysis of patients' speech, and content analysis of psychiatric interviews.

Antidepressive Agents↗
PubMed2006

Visual and oculomotor selection: links, causes and implications for spatial attention.

Natural scenes contain far more information than can be processed simultaneously. Thus, our visually guided behavior depends crucially on the capacity to attend to relevant stimuli. Past studies have provided compelling evidence of functional overlap of the neural mechanisms that control spatial attention and saccadic eye movements. Recent neurophysiological work demonstrates that the neural circuits involved in the preparation of saccades also play a causal role in directing covert spatial attention. At the same time, other studies have identified separable neural populations that contribute uniquely to visual and oculomotor selection. Taken together, all of the recent work suggests how visual and oculomotor signals are integrated to simultaneously select the visual attributes of targets and the saccades needed to fixate them.

Attention↗
PubMed2006

Evidence for multiple sites within rat ventral striatum mediating cocaine-conditioned place preference and locomotor activation.

Considerable evidence suggests that psychostimulants can exert rewarding and locomotor-stimulating effects via increased dopamine transmission in the ventral striatum. However, the relative contributions of ventral striatal subregions to each of these effects have been little investigated. In the present study, we examined the contribution of different ventral striatal sites to the rewarding and locomotor-activating effects of cocaine. Initially, the effects of bilateral 6-hydroxydopamine lesions of the nucleus accumbens core or medial shell on cocaine-induced locomotor stimulation (0.5-1.5 mg/kg i.v. or 5-20 mg/kg i.p.) and conditioned place preference (0.5 mg/kg i.v. or 10 mg/kg i.p.) were examined. In a subsequent study, we investigated the effects of olfactory tubercle versus medial shell lesions on cocaine-conditioned place preference and locomotor activity (0.5 mg/kg i.v.). Dopaminergic lesion extent was quantified by radioligand binding to the dopamine transporter. Multiple linear regression was used to identify associations between behavioral effects and residual dopamine innervation in ventral striatal subregions. On this basis, the accumbens core was associated with the locomotor stimulant effects of i.v. and i.p. cocaine. In contrast, the medial shell was associated with the rewarding effect of i.v. cocaine, but not of i.p. cocaine. Finally, the olfactory tubercle was identified as an additional site contributing to conditioned place preference produced by i.v. cocaine. Overall, these findings provide additional evidence that the locomotor stimulant and rewarding effects of systemically administered psychomotor stimulant drugs are segregated within the ventral striatum.

Animals↗
PubMed2003

Observational assessment of toy preferences among young children with disabilities in inclusive settings. Efficiency analysis and comparison with staff opinion.

Numerous investigations have demonstrated means of assessing preferences among students and adults with disabilities. In contrast, there has been little attention on preference identification among young children. We evaluated a preference assessment with 7 toddlers and preschoolers with disabilities in inclusive programs. First, identification of toy-play preferences was compared across three assessments that varied in amount of toy-play behavior sampled and time required for implementation (5-, 10-, and 15-session assessments). Second, results of the assessments were compared to staff opinion. Results indicated the most efficient assessment identified preferences that generally were consistent with preferences identified with the less time-efficient assessments. Results also indicated staff reports did not consistently indicate which toys were played with most frequently. Overall, results demonstrate an efficient means of determining preferences among young children with disabilities in inclusive settings. Results also suggest that staff opinion should not be relied on exclusively to determine preferences.

Child Development Disorders, Pervasive↗
PubMed2006

Modification of slot-machine preferences through the use of a conditional discrimination paradigm.

The present experiment investigated the impact of contextually trained discriminations on gambling behavior. Nine recreational slot-machine players were initially exposed to concurrently available computerized slot machines that were each programmed on random-ratio schedules of reinforcement and differed only in color. All participants distributed responding equally across the two slot machines. A conditional discrimination procedure was then used to teach the contextual cues representing the arbitrary relations of "greater than" and "less than." Following contextual cue training, participants were reexposed to the concurrent slot-machine task. After training of the contextual cues, a higher proportion of responses were made to the slot machine that shared formal properties (i.e., color) with the contextual cue representing "greater than."

Choice Behavior↗
PubMed1979

Performance of rats on the Maier three-table task following septal lesions occurring 24 hours after birth.

The purpose of this study was to determine whether behavioral sparing would be demonstrated when septal lesions occurred prior to the age at which the tested behavior first appears in normal rats. Rats given septal lesions at 1 day or 7 days after birth performed at approximately chance on the Maier three-table task when tested at 90 days of age. Rats that had control electrode insertions at the same ages performed at a level similar to normal animals. Animals given septal lesions at either age explored significantly more than did control animals. Results are discussed in terms of the constancy over time of the septal contribution to performance on the three-table task and the involvement of the septum and hippocampus in the processing of spatial information.

Age Factors↗
PubMed1982

Preferences for mothers and security blankets and their effectiveness as reinforcers for young children's behaviors.

Preferences for attachment agents and the reinforcing efficacy of their individual components were assessed in 100 pre-school-aged children. In the first study, mothers were selected more often than the blanket or control; however, those children rated by their mothers as being blanket-attached approached their blanket more than no object. In the second study, children responded more frequently for their mother than for the blanket or no object. However, visual presentations of the blanket were more effective reinforcers for blanket-attached than for non-attached children. In the third study, auditory and visual features of the mother were tested as reinforcers. Control over responding was consistently achieved with contingent presentations of the mother's voice or her televised image, but not with corresponding presentations of an unfamiliar woman.

Child, Preschool↗
PubMed2005

Effortless control: executive attention and conscious feeling of mental effort are dissociable.

Recruitment of executive attention is normally associated to a subjective feeling of mental effort. Here we investigate the nature of this coupling in a patient with a left mesio-frontal cortex lesion including the anterior cingulate cortex (ACC), and in a group of comparison subjects using a Stroop paradigm. We show that in normal subjects, subjective increases in effort associated with executive control correlate with higher skin-conductance responses (SCRs). However, our patient experienced no conscious feeling of mental effort and showed no SCR, in spite of exhibiting normal executive control, and residual right anterior cingulate activity measured with event-related potentials (ERPs). Finally, this patient demonstrated a pattern of impaired behavior and SCRs in the Iowa gambling task-elaborated by Damasio, Bechara and colleagues-replicating the findings reported by these authors for other patients with mesio-frontal lesions. Taken together, these results call for a theoretical refinement by revealing a decoupling between conscious cognitive control and consciously reportable feelings. Moreover, they reveal a fundamental distinction, observed here within the same patient, between the cognitive operations which are depending on normal somatic marker processing, and those which are withstanding to impairments of this system.

Adult↗
PubMed1992

Relationship between health utility and psychometric health status measures.

This study examined the relationship between health utility and psychometric health status measures. Utility scores derived by standard gamble and categorical rating methods were also compared to determine if they produce equivalent preference scales. Health status and utility was assessed in 73 chronic renal disease patients with anemia (hematocrit less than or equal to 30) participating in a 48-week clinical study. Patient preferences for current health and three hypothetical states were assessed using standard gamble and categorical rating procedures. Standard gamble utility was related to home management (P less than .05); categorical rating utility was related to home management (P less than .05), energy (P less than .05), alertness behavior (P less than .05), social interaction (P less than .05), and life satisfaction scale scores (P less than .05). Only 25-27% of the variance in utility scores was explained by the health status measures. Standard gamble utilities were consistently higher than categorical rating values for end-stage renal disease with hemodialysis (P less than .0001) and severe anemia requiring blood transfusions (P less than .0001). Patient preferences for current health may be influenced in part by their functional status and well-being, risk aversion or risk-taking attitudes, and the cognitive evaluation processes involved in making judgments necessary for the measurement task, as well as their actual preferences.

Choice Behavior↗
PubMed2004

Reduction of single-neuron firing uncertainty by cortical ensembles during motor skill learning.

Motor skill learning is usually characterized by shortening of response time and performance of faster, more stereotypical movements. However, little is known about the changes in neural activity that underlie these behavioral changes. Here we used chronically implanted electrode arrays to record neuronal activity in the rat primary motor cortex (MI) as animals learned to execute movements in two directions. Strong modulation of MI single-neuron activity was observed while movement duration of the animal decreased. Despite many learning-induced changes, the precision with which single neurons fire did not improve with learning. Hence, prediction of movement direction from single neurons was bounded. In contrast, prediction of movement direction using neuronal ensembles improved significantly with learning, suggesting that, with practice, neuronal ensembles learn to overcome the uncertainty introduced by single-neuron stochastic activity.

Acoustic Stimulation↗
PubMedDate not supplied

Reproductive motivation and family-size preferences among Nigerian men.

Data collected from 3,073 couples in four Nigerian cities and one semi-urban settlement were used to examine reproductive decision-making and male motivation for large family size. The report concludes that the characteristic male-dominant and patrilineal traditions support large family size and that men's reproductive motivation, to a large extent, affects the reproductive behavior of their wives. Therefore, the factors influencing men's reproductive outcomes and intentions are considered important for fertility transition in Nigeria. Male education, age at marriage, monogamy, interspousal communication, and intention not to rely on children for old-age support are significantly related to smaller actual family size and preferences for smaller families, while being in a male-dominant family setting has a strong relation with large family size and preferences for larger families. The policy implication of this study is the need for programs targeted at men and designed to change their attitudes about population matters and motivate them, and hence their wives, to produce smaller families.

Adult↗
PubMed2002

Children's predictions of consistency in people's actions.

Past research suggests that young children are often reluctant to generalize about people's behavior. Three experiments involving 102 4-5-year-olds, 84 7-8-year-olds, and 107 adults explored the conditions under which inductive inferences about people are made. There was an age-based increase in propensity to predict consistency in psychological/intentional causal relations. Children often predicted change; people would behave differently in the future than they did in the past. Younger children limited predictions of consistency to non-psychological contexts. Older children showed some appreciation of stable motivations (e.g. traits, preferences). The results are consistent with the hypothesis that children's theories of mind emphasize situational influences, with personal influences appearing in middle-childhood.

Awareness↗
PubMed2004

Selection from perceptual and conceptual representations.

The lateral prefrontal cortex has been implicated in a wide variety of functions that guide our behavior, and one such candidate function is selection. Selection mechanisms have been described in several domains spanning different stages of processing, from visual attention to response execution. Here, we consider two such mechanisms: selecting relevant information from the perceptual world (e.g., visual selective attention) and selecting relevant information from conceptual representations (e.g., selecting a specific attribute about an object from long-term memory). Although the mechanisms involved in visual selective attention have been well characterized, much less is known about the latter case of selection. In this article, we review the relevant literature from the attention domain as a springboard to understanding the mechanisms involved in conceptual selection.

Attention↗
PubMed2004

The relationship between motor coordination, executive functioning and attention in school aged children.

Given the high level of comorbidity of attention deficit hyperactivity disorder (ADHD) and developmental coordination disorder (DCD), deficits in executive function (EF), shown to be present in children with ADHD, may also be implicated in the motor coordination deficits of children with DCD. The aim of this study was to explore the relationship between EF and motor ability. A sample of 238 children, 121 girls and 117 boys, aged between 6 and 15 years was recruited for this project. Motor ability was assessed using the McCarron Assessment of Neuromuscular Development (MAND), level of inattention using the Child Behavior Checklist (CBCL), and Verbal IQ (VIQ) was estimated using subtests of the WISC-III. A reaction time task and three EF tasks measuring response inhibition, working memory and the ability to plan and respond to goal-directed tasks were administered. It was found that motor ability significantly accounted for variance in tasks measuring speed of performance, whereas inattention appeared to influence performance variability. Despite past evidence linking poor motor ability with inattention, there was little overlap in the processes that are affected in children with motor coordination or attention problems.

Adolescent↗
PubMed2005

Self-efficacy in patients with clinical manifestations of vascular diseases.

OBJECTIVE: Patients with established cardiovascular disease are at high risk of developing new vascular events or death. This risk can be reduced by lifelong treatment of risk factors and by permanent changes in lifestyle. Self-efficacy is important for achieving behavior change by self-management. The self-efficacy of different vascular risk factors subgroups in patients with clinical manifestations of atherosclerotic vascular diseases was investigated. METHODS: From January 2001 to September 2003, 192 patients with recently established clinically manifest atherosclerotic disease with > or = 2 modifiable vascular risk factors were selected for the study. The mean self-efficacy scores were calculated for vascular risk factors (age, sex, vascular disease, weight, diabetes mellitus, smoking behavior, hypercholesterolemia, hypertension, and hyperhomocysteinemia). RESULTS: Diabetes, overweight, and smoking, but none of the other risk factors, were significantly associated with the level of self-efficacy in these patients. CONCLUSIONS: Patients with vascular diseases appear to have high levels of self-efficacy regarding medication use, exercise, and controlling weight. In patients with diabetes, overweight, and in smokers, self-efficacy levels were lower. PRACTICE IMPLICATIONS: In nursing care and research on developing self-efficacy based interventions, lower self-efficacy levels can be taken into account for specific vascular patient groups.

Aged↗
PubMed2003

[Area distribution of out-issued prescriptions from Saiseikai Kurihashi Hospital and behavior patterns of outpatients for selection of pharmacy].

The area distribution of out-issued prescriptions for outpatients in Saiseikai Kurihashi Hospital was surveyed over 6 months from the first day of out-issue. Behavior patterns of outpatients in the selection of pharmacy were also investigated. Our survey included the out-issued prescriptions in eight surrounding newly established pharmacies together with the first out-issue. Computer simulation indicated that 70% of the outpatients selected the surrounding pharmacies when they received their out-issued prescriptions the first time. However, the percentage of surrounding pharmacies selected by the patients decreased to 60% the second time, and then again increased to 80% the third time. The results suggest that most outpatients use surrounding pharmacies, although they try to use the pharmacies near their homes for a time.

Choice Behavior↗