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Endorphinergic modulation of neural reward systems indicated by behavioral changes.

Experiments were performed in rats expecting and/or having received rewards to see if naloxone-antagonizable changes occur in behavior. It was found that rats expecting to receive candy display a naloxone-blockable increase in nociceptive thresholds and a naloxone-sensitive increase in rearing. Similarly, water-deprived rats expecting to receive water show a naloxone-blockable increase in rearing, whereas thirsty animals not expecting water show no changes in nociception or activity. Naloxone was also found to reduce the consumption of a highly palatable food and to diminish the performance of rats trained to wait in one place to receive candy. The latter indicates that the naloxone effect upon goal seeking is not dependent upon a decrease in general activity. Experiments in highly morphine-tolerant rats maintained on relatively constant morphine concentrations showed that these rats drink chocolate milk in the same way as placebo-treated animals. The same rats were found to fail to decrease their intake to the same extent as placebo-controls when water is substituted for the first time for chocolate milk given regularly every day. This points to the possibility that a negative action of endorphins, that is a decrease in release, decreasing consumption, upon a reduction in the palatability of an expected food, might be absent in highly tolerant animals. It is suggested that endogenous opiate(s) regulate mood as defined by the level of goal-seeking behavior, sensitivity to noxious stimuli and general activity.

Analgesics↗

Continuous intravenous infusion of naloxone does not change behavioral, cardiovascular, or inflammatory responses to subcutaneous formalin in the rat.

The opioid antagonist, naloxone, produces equivocal effects on the magnitude of nociceptive responses in several animal models of persistent pain, including the formalin test. Hindpaw injection of dilute formalin produces not only inflammation but also phasic (Phase 1) and persistent (Phase 2) behavioral and cardiovascular nociceptive responses in the rat. To test the hypothesis that endogenous opioid systems contribute to the magnitude of responses to intraplantar formalin injection, we evaluated the effects of continuous naloxone administration (0.01-100 mg/kg per h, i.v.) on formalin-evoked hindpaw inflammation, on behavioral indices of pain, flinching and licking pain behavior, and on changes in mean arterial pressure and heart rate. We report that naloxone, at doses less than 100 mg/kg per h, did not change any formalin-evoked response. Although the 100 mg/kg per h dose significantly decreased these responses, it also produced muscle rigidity and profound bradycardia. We conclude that endogenous opioids do not significantly modulate the nociceptive processing induced by subcutaneous formalin.

Animals↗

Behavioral changes in mice following benzene inhalation.

Although benzene is an important occupational health hazard and a carcinogen, the possibility that behavioral changes may forewarn of the later-occurring hematological changes has not been investigated. A time-sampling protocol was used to quantify the occurrence of 7 categories of behavior in the homecage following daily 6-hr exposures to two strains of adult mice (CD1 and C57BL/6J). The behavioral categories were stereotypic behavior, sleeping, resting, eating, grooming, locomotion, and fighting. The inhalation exposures were designed to reflect occupational exposure. Dynamic vapor exposure techniques in standard inhalation chambers were employed. Exposure to 300 or 900 ppm benzene increased the occurrence of eating and grooming and reduced the number of mice that were sleeping or resting. The responses to benzene of both the CD1 and the C57 strains were similar. The positive findings with benzene inhalation indicate the utility of behavioral investigations into the toxicology of inhaled organic solvents. The methods described herein illustrate an objective observation of animal behavior that is capable of documenting toxicity and of guiding detailed follow-up studies aimed at mechanism of action.

Animals↗

Modelling the effect of treatment and behavioral change in HIV transmission dynamics.

In this paper we analyze a model for the HIV-infection transmission in a male homosexual population. In the model we consider two types of infected individuals. Those that are infected but do not know their serological status and/or are not under any sort of clinical/therapeutical treatment, and those who are. The two groups of infectives differ in their incubation time, contact rate with susceptible individuals, and probability of disease transmission. The aim of this article is to study the roles played by detection and changes in sexual behavior in the incidence and prevalence of HIV. The analytical results show that there exists a unique endemic equilibrium which is globally asymptotically stable under a range of parameter values whenever a detection/treatment rate and an indirect measure of the level of infection risk are sufficiently large. However, any level of detection/treatment rate coupled with a decrease of the transmission probability lowers the incidence rate and prevalence level in the population. In general, only significant reductions in the transmission probability (achieved through, for example, the adoption of safe sexual practices) can contain effectively the spread of the disease.

HIV Infections↗

Translating the Dietary Approaches to Stop Hypertension diet from research to practice: dietary and behavior change techniques. DASH Collaborative Research Group.

The Dietary Approaches to Stop Hypertension (DASH) clinical trial demonstrated that a diet that emphasizes fruits, vegetables, and low-fat dairy products, includes whole grains, nuts, fish, and poultry, and is reduced in fats, red meats, sweets, and sugar-containing beverages can be highly effective in lowering blood pressure. The National High Blood Pressure Education Program now suggests the DASH diet for preventing and managing hypertension. For persons modifying their diets, the DASH diet offers varied choices. However, simultaneously modifying several dimensions of a diet can be challenging, even for knowledgeable and motivated persons. Persons who are uncertain about modifying their diet may become overwhelmed by the needed dietary changes. Dietitians and other health care practitioners can help patients adopt the DASH diet by exploring possible ambivalence, increasing motivation, and strengthening commitment to change; encouraging patients to select dietary modifications that will fit their lifestyle; and, finally, offering information about how to change their eating behavior. In this article, we offer dietary advice and counseling suggestions for tailoring interventions to match patients' readiness for adopting the DASH diet.

Behavior↗

Sexual behavior change among human immunodeficiency virus-infected adolescents with hemophilia. Adolescent Hemophilia Behavioral Intervention Evaluation Project Study Group.

PURPOSE: To determine the factors associated with the adoption or maintenance of consistent safer sexual behaviors among human immunodeficiency virus-positive adolescents and young adults with hemophilia. METHODS: One hundred eleven adolescents at 10 hemophilia care sites participated in an intervention program designed to increase safer sexual behaviors (abstinence, condom use, or nonpenetrative behavior). The theory-based intervention spanned 1 year. Adolescents attended individual sessions, small group activities, and an intensive group retreat. RESULTS: Patients who maintained or improved safer sexual behaviors were compared with those who relapsed or did not improve. Logistic regression analyses found that improvement and maintenance of safer sexual behavior were significantly associated with perceived peer support for outercourse (odds ratio [OR]: 5.47; confidence interval [CI]: 1.4-20.8), perceived peer support for abstinence (OR: 5.08; CI: 1.2-20.1), and decreased general emotional distress (OR: 4.65; CI: 1.04-20.6). Perceived health status and previous sexual behavior were unrelated to change in safer sexual behavior. CONCLUSIONS: These longitudinal data indicate that improvement and maintenance of safer sexual behavior among adolescents during an intervention is strongly associated with perceptions of peer support for safer sex and lesser degrees of emotional distress. Programs for human immunodeficiency virus-infected adolescents may require developmentally appropriate social and psychological approaches to impact peer norms and emotional well-being.

Adolescent↗

Behavioral changes as a result of dotarizine or flunarizine influence on dopaminergic neurotransmission in the striatum.

In experiments on rats, we studied the changes in stereotypy induced by apomorphine (2.5 mg/kg i.p.) or amphetamine (2 mg/kg i.p.) and in haloperidol (1 mg/kg i.p.) catalepsy in rats treated with dotarizine (25 mg/kg orally), flunarizine (25 mg/kg) or vehicle for 10 days. Dotarizine did not induce any significant changes in the intensity and duration of apomorphine- or amphetamine-induced stereotypy nor in haloperidol-induced catalepsy. The flunarizine-induced changes in the behavioral effects of apomorphine, amphetamine and haloperidol suggest the decrease of striatal dopaminergic neurotransmission, whereby the risk of occurrence of extrapyramidal side effects of the drug when used in clinical practice. Dotarizine is not associated with such a risk.

Administration, Oral↗

Life-style and cancer: from epidemiological evidence to public behavior change to mortality reduction of target cancers.

Cigarette smoking, alcohol consumption, and diet are of essential importance in modulating risks of cancer of selected sites, as demonstrated by various epidemiological methods. Examples include demographic studies on changing cancer risk, correlation studies on dietary fat and cancers of breast and colon, and case-control studies on highly salted food and gastric cancer. Evidence was also obtained by cohort studies including a census-population-based large-scale prospective study in Japan. Results included elevated risk from cigarette smoking for cancers of most sites; from alcohol consumption for cancers of the upper and lower digestive tract, liver, and prostate; and from daily meat consumption for cancers of the pancreas, colon, lung, and breast. Daily consumption of green-yellow vegetables reduced risk for cancer of the stomach, colon, lung, cervix, and prostate. Reports of these results and intensive public education and public guidance by governmental and nongovernmental organizations such as cancer societies, consumer groups, and mass media resulted in a notable change in public behavior in most cases in Japan.

Adult↗

Impact of social problem-solving training on aggressive boys: skill acquisition, behavior change, and generalization.

This study examined the impact of social problem-solving training on the behavior of five aggressive boys. Acquisition of problem-solving skills and changes in classroom behavior were evaluated using multiple-baseline designs within and across subjects. A generalization-programming procedure to promote the use of problem-solving skills in the natural environment was introduced across children in multiple-baseline fashion. Direct observation and behavior ratings were used to evaluate the treatment. Results indicated that each subject acquired the problem-solving skills at levels comparable to well-adjusted peers. Only one child showed behavioral improvement coincident with problem-solving skill acquisition. Three others showed moderate behavior change after the generalization-programming procedure was introduced. Only one child's gains on teacher ratings were maintained at the 6-month followup. The results suggest that cognitive-behavioral treatment of childrens' aggressive behavior may produce changes of limited magnitude and durability.

Aggression↗

Client characteristics associated with behavior change for treated and untreated aggressive boys.

This study examined the relationship between subject characteristics of aggressive boys and their behavioral changes during a school year. Seventy-six boys in the fourth, fifth, and sixth grades were identified by their teachers as the most disruptive and aggressive in their classes. These boys were assigned to untreated control, anger-coping, anger-coping plus goal-setting treatment, and minimal treatment goal-setting cells. The anger-coping treatment was based on cognitive behavioral procedures. In both anger-coping cells, greater reductions in rates of disruptive/aggressive off-task classroom behavior was predicted by having higher rates of these behaviors initially, and greater reductions in parents' ratings of aggression was predicted by having poor social problem-solving skills initially. Additional predictors of reductions in parents' ratings of aggression in one, but not both, anger-coping cells included having higher rates of somatic symptoms and poorer social acceptance by peers. In contrast to the other cells, those boys in the no-treatment group who demonstrated the greatest spontaneous improvement on these change measures were the ones who initially were the best problem-solvers and who had higher levels of self-esteem. This cognitive-behavioral treatment appeared to have most impact with those boys who were the most in need of intervention.

Aggression↗

Counseling strategies for dietary management: expanded possibilities for effecting behavior change.

Successful nutrition counseling culminates when a client develops a sound working knowledge and practice of good health behaviors, compatible with his/her capabilities and environment. Attainment of that goal requires the cooperation and active participation of both the nutrition counselor and the client. Counseling methodologies abound. The incorporation of strategies and techniques from different approaches into the treatment protocol, using a multidisciplinary approach, may enhance the effectiveness of nutrition counseling in facilitating dietary behavior change. A schematic model of nutrition counseling is presented, and varying counseling theories are introduced that could be incorporated into the model.

Attitude to Health↗

Predicting children's presurgical anxiety and subsequent behavior changes.

Addressed, in two studies, issues of children's medical anxiety having implications for efficient psychological preparation. Study 1 assessed behavioral distress and physiological arousal of 4- to 10-year-old, unprepared, nonsedated children (N = 50) as they separated from parents, waited in the operating room, and were given general anesthesia for minor surgery. Anxiety intensity varied widely among children and was most intense at mask presentation. Mother's prediction of uncooperative behavior and a history of prior surgery were the best predictors. Study 2 examined anxiety of 37 children prior to surgery and behavior changes 2 weeks later. At follow-up, minor or transient problems were common; 4 children developed significant problems. Elevated presurgical anxiety predicted later problems, but only among children hospitalized after surgery. Findings suggest that presurgical anxiety and later behavior problems are partially predictable.

Age Factors↗

The role of feedback in the process of health behavior change.

OBJECTIVE: To offer a taxonomy of types of feedback and describe potential mechanisms of action particularly in the area of addictive behaviors. METHOD: Reviewed the literature to examine support for types-Generic, Targeted, and Personalized-and for mechanisms of feedback. RESULTS: Although it is not clear how it works, feedback is thought to offer important information, to create a sense of caring and helping relationship, to reach more directly decisional considerations, to increase engagement in the materials, to increase motivation, or to provide social comparison and norms. CONCLUSIONS: Avenues for future research in search of the most effective manner of using feedback to promote health behavior change are discussed.

Behavior, Addictive↗

Behavior change intervention research in community settings: how generalizable are the results?

This review examines the extent to which recent behavioral intervention studies conducted in community settings reported on elements of internal and external validity, with an emphasis on whether research has been conducted in representative settings with representative populations. A targeted review was conducted on community-based intervention studies that promoted good nutrition, physical activity or smoking cessation/prevention, and were published in 11 leading health behavior journals between 1996 and 2000. The RE-AIM framework (reach, efficacy, adoption, implementation and maintenance) was used to evaluate the extent to which each paper reported on elements of reach, efficacy/effectiveness, adoption, implementation and maintenance. A total of 27 publications were reviewed. Although most studies (88%) reported participation rates among eligible members of the target audience ('reach'), only 11% of studies reported the participation rate ('adoption') among eligible community-based organizations or settings. Few studies reported if participating individuals or settings were representative of those found in the broader population. Although a majority of studies (59%) reported whether the intervention was delivered ('implementation'), few reported whether individuals maintained behavior change (30%) or whether organizations maintained or institutionalized interventions (0%). To increase the potential to translate community research findings to practice, studies should place a greater emphasis on obtaining and reporting external validity information, such as representativeness. The lack of external validity information limits researchers' and practitioners' ability to judge the generalizability of effects and the comparative utility of interventions. Improved reporting will facilitate implementation of proven and broadly applicable intervention strategies in communities. To make significant progress, all parties, including researchers, reviewers, editors and funders, need to take responsibility for increased emphasis on external validity information and ask what role they can best play to facilitate this process.

Adolescent↗

An observational study of intergenerational activities and behavior change in dementing elders at adult day care centers.

This study investigated whether dementing adult day care clients demonstrate consistent positive behaviors (i.e., eye contact, smiling, attentiveness, etc.) during structured, weekly activities with young children that these adults do not demonstrate during similar activities when the young children are not present. The study built on a preliminary informal study conducted in conjunction with an intergenerational adult day care project. Participants for the study were twenty-one adult day care clients who have behavioral characteristics of Alzheimer's or related disorders. The study involved five consecutive weeks of planned, structured music activities prepared by a musical therapist as part of the regular intergenerational activities of the adult day care center. The same activities were repeated twice in the same day at each site, once with children present and once without them present. Two fixed videotape cameras recorded client behaviors in three-minute segments. Scoring was completed by trained, "blind" scorers. The scorers tallied positive behaviors by individuals for randomly selected ten-second segments of the taped intervals. Sessions with and without children were compared using non-parametric tests. Categories of behaviors were compared and specific observed behavioral changes were reported.

Aged↗

HIV sex and drug risk behavior and behavior change in a national sample of injection drug and crack cocaine using women.

This paper describes HIV sex and drug risk behavior and behavior change of injection drug and crack cocaine using women enrolled in a national multi-site Cooperative Agreement program. Baseline data on the 1,403 women who were randomly assigned to a two session intervention that was standardized across sites indicate that sex and drug risk behavior for becoming infected with HIV was considerable. Six-month post intervention follow-up data for the same sample of women show that significant reductions in sex and drug risk behavior were observed for the entire sample of women for the risk variables under study. Significant reductions were also demonstrated for various sub-groups of women enrolled in the study on most of the sex and drug risk variables. Given these findings, it appears that the standard intervention was effective in assisting drug using women reduce their behaviors that put them at risk of becoming infected with HIV. Further research in needed on the development and evaluation of HIV interventions that target specific risk behaviors and various HIV risk behavior profiles of women.

Adult↗

Understanding the relationship of maternal health behavior change and intervention strategies in a Nicaraguan NGO network.

Few studies of community interventions examine independent effects of investments in: (1) capital (i.e., physical, human and social capital), and (2) management systems (e.g., monitoring and evaluation systems (M&E)) on maternal and child health behavior change. This paper does this in the context of an inter-organizational network. In Nicaragua, international non-governmental organizations (NGOs) and local NGOs formed the NicaSalud Federation. Using Lot Quality Assurance Sampling (LQAS), 14 member organizations took baselines measures of maternal safe motherhood and child health behavior indicators during November 1999 and August 2000, respectively, and final evaluation measures in December 2001. In April 2002, retrospective interviews were conducted with supervisors and managers in the 14 organizations to explore changes made to community health strategies, factors associated with the changes, and impacts they attributed to participating in NicaSalud. Physical capital (density of health huts), human capital (density and variety of paramedical personnel) and social capital (density of health committees) were associated with pregnant women attending antenatal care (ANC) 3+ times, and/or retaining ANC cards. The variety of paramedic personnel was also associated with women making post-partum visits to clinics. Physical capital (density of health huts) and social capital (density of health committees and mothers' clubs) were associated with child diarrhea case management indicators. One safe motherhood indicator (delivery of babies by a clinician) was not associated with intervention strategies. At the management level, NicaSalud's training of members to use LQAS for M&E was associated with the number of strategic and tactical changes they subsequently made to interventions (organizational learning). Organizational learning was related to changes in maternal and child health behaviors of the women (including changes in the proportion using post-partum care). As the latter result would not have occurred without NicaSalud, we conclude that this inter-organizational network provided added value by instigating organizational learning.

Female↗