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PubMed2001

Quality of life after obesity surgery, an evidence-based medicine literature review: how to improve systematic searches for enhanced decision-making and clinical outcomes.

BACKGROUND: Research attests to the exponential sweep of clinical obesity in America. Obesity has become one of the most profound public health concerns, closely linked to increased morbidity, mortality, and social, occupational, and psychological discrimination. It is incumbent for specialists to design treatment and outcome analysis based accurately upon systematic research. Regulators, payors, and most notably, patients, need reliable and effective treatment to determine practical standards, manage cost of care, and protocols. METHODS: A comprehensive evidence-based medicine (EBM) review was done of relevant research on quality-of-life (QoL) outcomes after obesity surgery. The Cochrane Collaboration was the EBM searching resource utilized for this project, accessed via the Internet. A systematic EBM search design was implemented. RESULTS: In the search, QoL reported 3,234 hits, "obesity surgery" reported 33 hits, QoL and obesity surgery" reported 6 hits, and QoL and hypertension reported 288 hits. CONCLUSION: We found that a thorough EBM search can be achieved using the Cochrane Collaboration, which provides an efficient, effective and ethical means to enhance evidence-based clinical decision-making in treating severely obese surgery patients.

Databases, Bibliographic↗
PubMed1968

Effects of required rates of responding upon choice.

Pigeons' responses in the presence of two concurrently available (initial-link) stimuli produced one of two different (terminal-link) stimuli according to identical but independent variable-interval schedules. Responses in the presence of each terminal-link stimulus produced equal frequencies of food reinforcement, but in the presence of one of the stimuli, food depended upon the emission of a response rate either higher or lower than a specified value (differential reinforcement of rates). The measure of preference, the dependent variable, was the distribution of responses in the presence of the concurrently available stimuli of the initial links. Each pigeon, the responding of which was appropriately controlled by the response-rate requirements in the two terminal-link stimuli, consistently preferred the stimulus not associated with a response-rate requirement.

Animals↗
PubMed1972

Control of preference in children by conditioned positive reinforcement.

A preference measure was employed with children to evaluate the conditioned positive reinforcing function of a stimulus that preceded reinforcement. A match-to-sample procedure was arranged in which subjects could respond to either the form or color dimension of a compound sample stimulus. Intermittent token reinforcement was provided equally for color and form matches. Two stimuli were employed (Stimulus A and Stimulus B), each consisting of a distinctive tone and colored light. One of these stimuli (the paired stimulus) preceded each token delivery, and the other did not (nonpaired stimulus). The paired stimulus was dependent upon each response to one match dimension, and the nonpaired stimulus followed each response to the other dimension. Three of the five subjects responded primarily to the dimension that was followed by the paired stimulus. This effect was obtained regardless of which stimulus (A or B) was paired and on which match dimension (color or form) the paired stimulus was dependent. These results were unaltered by discontinuing the nonpaired stimulus. The other two subjects demonstrated consistent preferences for the form dimension and Stimulus A, respectively.

Acoustic Stimulation↗
PubMed1985

Human observing: maintained by negative informative stimuli only if correlated with improvement in response efficiency.

Two experiments investigated the effect of observing responses that enabled college students to emit more efficient distributions of reinforced responses. In Experiment 1, the gains of response efficiency enabled by observing were minimized through use of identical low-effort response requirements in two alternating variable-interval schedules. These comprised a mixed schedule of reinforcement; they differed in the number of money-backed points per reinforcer. In each of three choices between two stimuli that varied in their correlation with the variable-interval schedules, the results showed that subjects preferred stimuli that were correlated with the larger average amount of reinforcement. This is consistent with a conditioned-reinforcement hypothesis. Negative informative stimuli--that is, stimuli correlated with the smaller of two rewards--did not maintain as much observing as stimuli that were uncorrelated with amount of reward. In Experiment 2, savings in effort made possible by producing S- were varied within subjects by alternately removing and reinstating the response-reinforcement contingency in a mixed variable-interval/extinction schedule of reinforcement. Preference for an uncorrelated stimulus compared to a negative informative stimulus (S-) decreased for each of six subjects, and usually reversed when observing permitted a more efficient temporal distribution of the responses required for reinforcement; in this case, the responses were pulls on a relatively high-effort plunger. When observing the S- could not improve response efficiency, subjects again chose the control stimulus. All of these results were inconsistent with the uncertainty-reduction hypothesis.

Attention↗
PubMedDate not supplied

Meditation can reduce habitual responding.

CONTEXT: Although cognitive aspects of meditation underlie much of its clinical application, very little research has examined meditation's cognitive consequences. This investigation provides experimental support for the idea that meditation leads to a reduction in habitual responding using randomly selected subjects, a secular form of meditation, and a full experimental design. OBJECTIVE: To test the hypothesis that meditation leads to a reduction in habitual responding. DESIGN: Studies 1 and 2 each incorporated pre-test and post-test designs with a 20-minute intervening attention task (meditation, rest, or a cognitive control). SETTING: Yale University in New Haven, Conn, and the University of California, Berkeley. PARTICIPANTS: One hundred and twenty and 90 undergraduates participated in Studies 1 and 2, respectively. MAIN OUTCOME MEASURES: Stroop and Word Production (category generation and stem-completion) tasks assessed habitual responding in Study 1. Galvanic Skin response measured arousal in Study 1. The category generation task assessed habitual responding in Study 2. Tellegen's Absorption Scale (TAS) measured attention ability. RESULTS: In Study 1, meditation participants showed a reduction in habitual responding on the Stroop task as compared to controls. Study 1 revealed no statistically significant effects in the word production task. Stroop task performance was not mediated by arousal reduction. In Study 2, meditation participants showed a reduction in habitual responding on the category production task. Specifically, when participants generated either typical or atypical items, on average, meditation participants produced more atypical items than controls. Category production performance was not mediated by Tellegen's Absorption Scale (TAS) scores. Overall, high TAS scores were related to atypical responding. CONCLUSION: Across cognitive tasks, when participants understood that the goal was to respond non-habitually, meditation reduced habitual responding.

Adult↗
PubMed1974

Sensory generalization in instrumental defensive reflexes in dogs.

Five dogs were preliminarily trained in the situation of classical defensive conditioned reflexes. The training sharply impeded the subsequent instrumental avoidance conditioning (with the stimulus applied to one leg and the avoidance movement accomplished by another leg). However, following the elaboration of the instrumental avoidance to one of the signals previously used in the classical situation, the other signals of the classical conditioned reflex evoked the instrumental avoidance reaction at once, without any preliminary training. When the animals which had been trained under "instrumental" conditions were brought back to classical situation they revealed an extreme inertness of manifestation of the instrumental avoidance reflex. In another experimental series the same dogs were trained to perform an escape reaction. When the stimulating electrodes were displaced to new receptive areas, most dogs made use of their previous experience and performed the acquired instrumental movement, thus escaping the electric shock.

Acoustic Stimulation↗