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Methadone-induced behavioral changes: circular movements, aggression, and electrophysiological aspects.

Behavioral changes are induced in animals by methadone administration. The dose-dependent CM effect is present 2 to 3 minutes after methadone administration. This effect can be partially blocked by nalline. A Complete blockade occurs when the naline-reserpine combination is given prior to the administration of methadone. Atropine sulfate dose not block the CM effect. Methadone withdrawal produces mild symptoms of aggression, and they can be intensified by amphetamine and apomorphine. During the process of development of tolerance and addiction, electrophysiological changes are produced. These changes can be intensified by apomorphine treatment in the methadone-withdrawal animals. On the basis of pharmacological manipulation in our experimental conditions, the involvement of cerebral biogenic amines, especially dopamine, is proposed.

Aggression↗

The impact of the preventive medical message on intention to change behavior.

Clinicians counsel patients to adopt behaviors to reduce health risks. We studied, in the case of coronary artery disease, the impact of those parts of the preventive medical message clinicians can vary. We asked 150 French people (86 aged 20-30, 64 aged 60-80) to rate their intention to adopt a specific behavior-take medication, change their diet, or start exercising-in 64 scenarios, composed of two severities of disease manifestations (angina pectoris or heart attack); four levels of its probability of occurrence (5, 10, 15, or 20%) and the associated time horizon (20, 15, 10, or 5 years, respectively); and two levels of controllability of the risk (entirely under your control or not much you can do to reduce it). We found that all four parts of the message had significant main effects and did not interact with each other. Older participants had greater intention to adopt preventive behavior when the time horizon was short and younger ones when it was long. The only gender effect was that older women were more sensitive to time horizon. The message's parts were combined additively. Participants intended to change behavior even when told this would be of little use. We concluded that clinicians should, when possible, discuss all key parts of the preventive medical message; that they can, however, focus on one without reducing the others' impact; and that, at least for outcomes such as angina and heart attack, they should speak of risk with young patients using a long time horizon, with old patients using a short time horizon.

Adult↗

Evaluation of an instrument for assessing behavioral change in sedentary women.

PURPOSE: To construct and evaluate a psychometric instrument for the assessment of behavioral change as a means for gaining insight into the development of more effective programs for promoting physical activity in women. DESIGN: A 16-item questionnaire was created and was administered three times (0, 6, and 12 months) to 181, 90, and 82 women, respectively, to determine the validity and reliability of the instrument. Participants were women 30-60 years of age, literate in English, and sedentary. METHODS: The data were analyzed using factor analysis to determine the most appropriate model for evaluating three theoretical constructs: (a) goal setting, (b) restructuring plans, and (c) relapse prevention and maintenance. RESULTS: A 3-factor model was shown to be appropriate; the instrument adequately distinguished the constructs goal setting and relapse prevention and maintenance, but did less well with the concept of restructuring plans, indicating that this concept may not be a separate entity. CONCLUSIONS: This study showed that this new instrument to evaluate behavioral change has important empirical applications. Each subscale can be used independently, depending on the needs of the investigator. This instrument will be useful for public health programs promoting physical activity in a sedentary population.

Adult↗

Interictal behavioral changes in epilepsy.

Common behavioral alterations associated with epilepsy include increased interest in philosophical and religious concerns, increased and extensive writing of a cosmic or philosophical nature, changes in sexual behavior, and aggressiveness. Psychological stress, the effects of anticonvulsant therapy, and the actual occurrence of seizures or convulsions can be ruled out as possible causes of the syndrome. It is speculated that these behavioral alterations are the result of an intermittent spike focus in the temporal lobe that leads to an alteration in the responsiveness of the limbic system. Thus, there is a heightened emotional response to many stimuli as well as a decrease in sexual responsiveness. In an effort to discover the cause of the high incidence of sexual alterations, abnormalities in response to luteinizing hormone-releasing hormone (LHRH) were found in a group of patients with partial complex seizures, some of whom had no overt sexual dysfunction and had never received anticonvulsant therapy.

Behavior↗

Groningen Active Living Model (GALM): stimulating physical activity in sedentary older adults; validation of the behavioral change model.

BACKGROUND: A significant proportion of older adults in The Netherlands do not participate regularly in leisure-time physical activity. The Groningen Active Living Model (GALM) was developed to change this situation for the better. Longitudinal results of the validation of the GALM behavioral change model are presented. METHODS: We obtained data on potentially mediating variables of physical activity behavior change (self-efficacy, social support, perceived fitness, and enjoyment) from 96 participants in a prospective study during the 18 months the GALM strategy lasted. RESULTS: Prospective analyses revealed significant differences in several potentially mediating variables, although some of these differences were contrary to our hypothesis. Discriminant analysis resulted in canonical correlations of 0.50 after 6 months and 0.66 after 18 months of program participation between adherers and nonadherers, respectively; 73.8 and 80.0% of the subjects were classified correctly. CONCLUSIONS: Based on the results, it can be concluded that we partially succeeded in manipulating the potentially mediating variables by means of our GALM strategy. Several mediating variables were identified that reliably discriminated long-term adherers from nonadherers, expanding the generalizability of social cognitive theory-driven variables to a Dutch population.

Aged↗

Complex sensorimotor behavioral changes after terminal striatal 6-OHDA lesion and transplantation of dopaminergic embryonic micrografts.

In this study sensorimotor behavioral changes were monitored in rats following bilateral 6-hydroxydopamine (6-OHDA) axon terminal lesion and uni- or bilateral implantation of embryonic dopaminergic (DA) micrografts. A total of 28 microg of 6-OHDA was distributed over four injection tracts in the dorsolateral part of the caudate-putamen (CPU) bilaterally followed 4 months later by the implantation of DA micrografts spread over seven implantation tracts placed within the denervated area. Bilaterally 6-OHDA-lesioned animals exhibited significantly reduced behavioral performance scores in tests of explorational and stepping behavior as well as in skilled forelimb use. However, in contrast to the established medial forebrain bundle (MFB) lesion model of PD, these animals showed a spontaneous recovery in the side falling and skilled forelimb behavior and no deficits in overnight locomotor activity at 6 months after the lesion. Unilateral DA micrografts elicited a substantial amphetamine-induced rotational bias contralateral to the graft, but led to a significant impairment of contralateral skilled forelimb use and reduced scores in overnight locomotor activity. Bilateral DA micrografts caused a significant, though partial, increase in explorational and backhand stepping behavior, but resulted also in a significant decrease in performance levels in overnight locomotor activity and skilled forelimb use on both paws. In conclusion, DA grafts placed ectopically in the CPU in the partial lesion model of PD result in a double innervation of the GABAergic striatal neurons, arising from the residual nigrostriatal DA projections of the host and from the graft-derived DA efferent fibers. These two DA fiber systems may indeed function in a cooperative and competitive manner depending on their respective and different afferent and efferent connections, which, in turn, may lead to positive or negative influences on basal ganglia function and behavioral performances. The different patterns of 6-OHDA lesion and transplant-induced behavioral changes demonstrated in the present study compared to the "classical" MFB lesion model of PD may thus provide further insights in the complex functional organization of the basal ganglia and, thereby, may help to further optimize restorative strategies for neurodegenerative diseases, such as Parkinson's disease.

Animals↗

Community-wide HIV counselling and testing in central Massachusetts: who is retested and does their behavior change?

HIV counselling and testing was provided to 4267 individuals between September 1987 and June 1992 at a multi-site program, including community clinics, drug treatment programs, and a men's prison in central Massachusetts. Half of those tested reported the risk behaviors targeted by the programs: injection drug use (38.1%) and sexual contact with a drug injector (12.6%). The objectives of this study were to examine 1) factors associated with repeat HIV testing among these initially seronegative, and 2) behavior change following counselling and testing. Initially 7.4% were HIV positive, and 12.4% of those testing negative were retested within one year. Risk behavior was the only strong independent predictor of retesting (odds ratios of 3.8 and 4.2 for men reporting sex with men and recent drug injectors, respectively). Changes in risk behaviors between the time of the initial test and the second test were assessed (n = 207). Among those who continued to inject drugs at follow-up there was a reduction in the percent visiting shooting galleries (p = 0.05); no other significant behavior changes were reported. While selection bias may be responsible in part for the minimal behavior change observed, continued monitoring of risk behavior and counselling are warranted.

Adolescent↗

Predicting behavioral changes associated with age-related cognitive impairment in dogs.

OBJECTIVE: To monitor the progression of age-related behavioral changes in dogs during a period of 6 to 18 months and to determine whether signs of dysfunction in any of 4 behavioral categories can be used to predict further impairment. DESIGN: Age-stratified cohort study. ANIMALS: 63 spayed female and 47 castrated male dogs 11 to 14 years of age. PROCEDURE: Data were collected from randomly selected dog owners who were interviewed by telephone twice at a 12- to 18-month interval; data were included if the dog had lived > or = 6 months between interviews. The interview focused on signs of impairment in the following behavioral categories: orientation in the home and yard, social interactions with human family members, house training, and the sleep-wake cycle. Dogs were determined to have impairment in 0 behavioral categories (on the basis of < or = 1 sign for each category), impairment in 1 category (> or = 2 signs of dysfunction in that category), or impairment in > or = 2 categories. RESULTS: Between interviews, 22% (16/73) of dogs that did not have impairment in a category at the time of the first interview developed impairment in that category by the time of the second interview. Forty-eight percent (13/27) of dogs that had impairment in 1 category at the time of the first interview developed impairment in > or = 2 categories by the time of the second interview and were significantly more likely to develop impairment in > or = 2 categories, compared with dogs that initially had impairment in 0 categories. Dogs with 1 sign of dysfunction in orientation were significantly more likely to develop impairment in that category, compared with dogs that had 0 signs of dysfunction in orientation. CONCLUSIONS AND CLINICAL RELEVANCE: Age-related behavioral changes in dogs are progressive. Clinicians should consider trying to predict which dogs are most likely to become progressively impaired during the subsequent 6 to 18 months.

Age Factors↗

[Cardiovascular prevention and attitude of people towards behavior changes: state of the art].

In recent years the main focus of cardiovascular prevention has been to identify people without clinical evidence of coronary disease, but with a high risk of developing a clinical event. Long term follow up studies show that a young person with a high "Relative Risk" of presenting a cardiovascular event becomes an adult with a high "Absolute Risk" of suffering it. The aim of primary prevention is to avoid the appearance of cardiovascular diseases, delaying the development of atherosclerosis and its consequences. In this scenario, the first step is to increase awareness among healthy people of their own cardiovascular risk, enhancing their knowledge of their risk parameter values and generating a correct perception of the risk burden that those values mean. Literature review reveals that significant percentages of healthy individuals are unaware of their own values of blood pressure, total cholesterol and blood glucose. Furthermore, people aware of having abnormal parameters have low treatment compliance rates or evidence inconsistency between knowledge and behavior. This paper reviews educational strategies and other factors that influence this knowledge-behavior gap, such as the stages of behavior changes of the Prochaska and Diclemente Model. Evidence has shown that knowledge about cardiovascular risk factors is not enough to influence behavior and that the degree of preparation of people towards behavior changes is a strong predictor of the success of educational and counseling interventions. Local Chilean data from the RICAR project also shows that the profile of behavior change is different for each modifiable cardiovascular risk factor.

Cardiovascular Diseases↗

[Exudative bilateral retinal detachment and behavior changes in a patient with neurosyphilis: case report].

PURPOSE: To report a case of bilateral retinal detachment associated with behavior changes. RESULTS: A 62-year-old, female patient presented agitated, complaining of progressive bilateral low vision for the 3 past months, along with anxiety and behavior changes. On examination, she had visual acuity of light perception in the right eye and conting fingers at 30 cm in the left eye; anterior chamber reaction; bilateral hyperemic and edematous optic disc and bilateral serous retinal detachment, yellow-white subretinal peripapillary plaques and subretinal and intraretinal exudation. On laboratory work-up, the patient had positive VDRL and FTA-Abs tests. Lumbar puncture was done; she had positive FTA-Abs and hemagglutination treponemal test on spinal fluid analysis. Neurosyphilis diagnosis was established, and the patient was admitted to the hospital for an intravenous penicillin course associated with oral prednisone (0.5 mg/kg). After 2 weeks, the patient showed marked improvement of her retinal findings, with reatachment of the retina and also an improvement of visual acuity. CONCLUSION: Syphilis is a pleomorphical disease, and may present as diffuse uveitis associated with bilateral exudative retinal detachment. Central nervous system involvement must always be evaluated and discarded; proper treatment may lead to visual function improvement and diminished sequelae.

Anti-Inflammatory Agents↗

Initiation and maintenance of patient behavioral change: what is the role of the physician?

If the physician is to help a patient adopt and maintain "preventive behaviors," the processes that influence and shape both patient and physician behaviors must be understood, the physician's role in the behavioral change process must be acceptable to both the patient and the physician, and an environment that both permits the physician to act and reinforces the physician for acting appropriately must be designed for the physician. A physician's role that is acceptable to both the patient and the physician can be seen as six obligations. The physician must 1) evaluate the medical literature on prevention to determine which services are indicated for which types of patients, 2) when seeing an individual patient, identify the services and behaviors needed by that patient, and 3) advise the patient of the need for action. As the patient responds positively to the physician's advice, the physician must 4) enable and assist the patient to have the indicated tests or procedures and accomplish the suggested behavioral changes, and 5) reinforce the patient's new and ongoing preventive behaviors. The sixth obligation of the physician is to establish, support, and maintain a system to facilitate tasks 2 through 5.

Attitude to Health↗

Office system interventions supporting primary care-based health behavior change counseling.

CONTENT: This article reviews the literature on the effectiveness of office system interventions to improve behavior-change counseling in primary care. These instructions consist of two principle components: tools and teamwork. Tools have been developed to assist providers with health risk assessment (questionnaires, health risk appraisals), prompting and reminding (chart stickers, checklists, flow charts, reminder letters), and education (manuals and handbooks). Teamwork entails the coordination and delegation of tasks between providers and staff. CONCLUSIONS: A number of clinical trials, particularly in the area of smoking cessation, have demonstrated the effectiveness of tools and teamwork for increasing counseling rates and counseling effectiveness. Although no one type of tool or method of teamwork is consistently more effective than another-with effectiveness varying according to practice, provider, and patient characteristics-the use of different tools and teamwork approaches leads to additive improvements in counseling and patient behavior-change rates. More high-quality research is needed, particularly in the areas of health risk assessment and electronic reminder systems, to develop effective office interventions that can be readily implemented into a wide variety of primary care practices.

Counseling↗

Membrane depolarization accumulates during acquisition of an associative behavioral change.

Long-lasting electrical changes of identified Hermissenda neurons, the type B photoreceptors, can account for concomitant associative behavioral changes. Depolarization of the type B cells after paired light and rotation accumulates (as monitored with intracellular electrodes) with reptition. This accumulation was specific to stimulus pairing (versus light alone or explicitly unpaired stimuli) and to the orientation of the nervous system with respect to the center of rotation; it provides a neural step in the acquisition of associative behavioral changes for gastropod mollusks and possibly other species.

Animals↗

Are current health behavioral change models helpful in guiding prevention of weight gain efforts?

Effective procedures are needed to prevent the substantial increases in adiposity that have been occurring among children and adults. Behavioral change may occur as a result of changes in variables that mediate interventions. These mediating variables have typically come from the theories or models used to understand behavior. Seven categories of theories and models are reviewed to define the concepts and to identify the motivational mechanism(s), the resources that a person needs for change, the processes by which behavioral change is likely to occur, and the procedures necessary to promote change. Although each model has something to offer obesity prevention, the early promise can be achieved only with substantial additional research in which these models are applied to diet and physical activity in regard to obesity. The most promising avenues for such research seem to be using the latest variants of the Theory of Planned Behavior and Social Ecology. Synergy may be achieved by taking the most promising concepts from each model and integrating them for use with specific populations. Biology-based steps in an eating or physical activity event are identified, and research issues are suggested to integrate behavioral and biological approaches to understanding eating and physical activity behaviors. Social marketing procedures have much to offer in terms of organizing and strategizing behavioral change programs to incorporate these theoretical ideas. More research is needed to assess the true potential for these models to contribute to our understanding of obesity-related diet and physical activity practices, and in turn, to obesity prevention.

Choice Behavior↗

Behavioral change in preventive medicine. An efficacy assessment of a physician education module.

We designed and evaluated a program to teach internal medicine residents behavioral counseling skills for multiple risk factor modification. Integrating physician-patient communication, negotiation skills, and the transtheoretical model of behavior change, we used small group discussion and standardized patients. The 18 participating residents increased their ability to modify patient behavior during videotaped interviews, mean pretest/posttest score: 33.1/40.1 (Student's paired t test, p < .0001). Physician self-efficacy in screening for risk factors and effecting behavioral change in patients was increased (p < .0001), as were positive attitudes toward psychosocial factors (p < .003). Our teaching effectively increased the residents' self-efficacy and performance of behavioral counseling.

Behavior Therapy↗

Adolescent survivors: a secondary analysis of a clinical trial targeting behavior change.

BACKGROUND: The late effects of radiation and chemotherapy increase childhood cancer survivors' risk of chronic health problems. Survivors' behavior is important in modifying this risk, yet adolescent and young adult survivors fail to engage in important health-promoting behaviors and frequently practice high-risk behaviors. This secondary analysis re-evaluated a multi-component behavior-change intervention that had previously demonstrated no impact in adolescent survivors of childhood cancer. PROCEDURE: The parent trial compared 132 adolescent survivors in the intervention arm with 135 in the standard-care arm at baseline and at 1 year for disease and treatment knowledge, perception of late effects risk, and the frequency of health-risk and health-protective behaviors (combined as a single summative measure). In contrast, the secondary analysis examined each of the 14 behaviors separately. Additionally, an analysis of covariance (ANCOVA) was conducted to examine the change in health behaviors while statistically controlling for age, gender, and the wide variation in baseline behaviors. RESULTS: Knowledge (P = 0.038), breast self-examination (BSE) (P < or = 0.0001) and testicular self-examination (P = 0.004) increased, as did perceptions about the need to change behavior (P = 0.004) and the effort needed to stay healthy (P < or = 0.0001). In the treatment group, junk food consumption decreased (P = 0.052) and smoking abstinence was maintained (P = 0.088). Significant interactions between gender and treatment group were demonstrated. CONCLUSIONS: Health-risk and health-protective behaviors cannot be effectively combined in a one-dimensional measure. Gender and age influence the impact of interventions targeting health behavior in survivors. Future trials should include observation of the patient-clinician encounter, more complex sampling methods, and pre-trial knowledge of the distribution of the study behaviors.

Adolescent↗

The information architecture of behavior change websites.

The extraordinary growth in Internet use offers researchers important new opportunities to identify and test new ways to deliver effective behavior change programs. The information architecture (IA)-the structure of website information--is an important but often overlooked factor to consider when adapting behavioral strategies developed in office-based settings for Web delivery. Using examples and relevant perspectives from multiple disciplines, we describe a continuum of website IA designs ranging from a matrix design to the tunnel design. The free-form matrix IA design allows users free rein to use multiple hyperlinks to explore available content according to their idiosyncratic interests. The more directive tunnel IA design (commonly used in e-learning courses) guides users step-by-step through a series of Web pages that are arranged in a particular order to improve the chances of achieving a goal that is measurable and consistent. Other IA designs are also discussed, including hierarchical IA and hybrid IA designs. In the hierarchical IA design, program content is arranged in a top-down manner, which helps the user find content of interest. The more complex hybrid IA design incorporates some combination of components that use matrix, tunnel, and/or hierarchical IA designs. Each of these IA designs is discussed in terms of usability, participant engagement, and program tailoring, as well as how they might best be matched with different behavior change goals (using Web-based smoking cessation interventions as examples). Our presentation underscores the role of considering and clearly reporting the use of IA designs when creating effective Web-based interventions. We also encourage the adoption of a multidisciplinary perspective as we move towards a more mature view of Internet intervention research.

Behavior Control↗

Applying a transtheoretical behavioral change model to HIV/STD and pregnancy prevention in adolescent clinics.

PURPOSE: To evaluate the application of a transtheoretical model (TTM) of behavioral change to adolescent reproductive health counseling. METHODS: Family planning counselors in Boston Metro school-based and community health centers used a TTM for pregnancy and human immunodeficiency virus/sexually transmitted disease (HIV/STD) prevention. Data were collected from September 2000 through December 2001. Bivariate analyses using chi-square statistics and multivariate analyses using logistic regression were performed to identify the differences between stage of change (SOC) groups and the predictive variables for SOC movement. RESULTS: Data on 539 sexually experienced clients were examined. Site, client's gender, race, proximity of sexual activity, sexual partner status, level of partner support, and target behavior were significantly associated with initial SOC for both pregnancy and disease prevention (p < .01). For clients meeting stage movement analysis criteria (n = 86 for pregnancy prevention; 128 for disease prevention), there was suggestive evidence that older ones were more likely to move forward for both pregnancy and disease prevention (p = .08 and p = .07, respectively) between their first and second visits. For disease prevention, those initially in the precontemplation/contemplation stages were more likely than those in the action/maintenance stages to be forward movers (odds ratio = 3.89, p = .06). Counselors/supervisors reported that the TTM helped structure an integrated message and increased client engagement. CONCLUSIONS: Efforts to prevent teen pregnancy and HIV/STDs should acknowledge the roles of partner support and age in SOC. Adolescents in preparation may need specific skill-building for behavioral change. Overall, TTM represents a promising approach to promoting integrated pregnancy and disease prevention in family planning counseling.

Adolescent↗