Behavioral Intervention

The aim of this study was to identify longitudinal trajectories of conjoint development of executive function (EF) and obesity among a diverse sample of poor, rural youth and to evaluate individual differences in infant growth, parental BMI, and cumulative risk. Methods: Participants included 948 youth from the Family Life Project. Child anthropometrics were measured at 2 and 6 months and at 2, 3, 4, 5, 7, and 12 years. EF tasks were administered at 3, 4, and 5 years. Mothers reported youth birth weight, parental height and weight, and cumulative risk indicators. Results: Multidimensional growth mixture modeling identified three classes: "High EF-High Obesity Resilience"; "Low EF-Delayed-Onset Severe Obesity"; and "Low EF-Early-Onset Severe Obesity." Youth in the low-EF, early-onset class displayed higher birth weight and BMI at 6 months, whereas the low-EF, delayed-onset class had rapid weight gain during infancy, parents with class II obesity, and greater cumulative risk and was more likely to be Black and female. Conclusions: Despite increased obesity risk among this sample, the majority of youth exhibited higher EF and some degree of obesity resilience. Youth with EF deficits displayed the greatest risk for severe obesity but had differing BMI trajectories and obesity risk profiles, which has implications for obesity intervention.

Patients who have been relieved of cardiac symptoms following angioplasty may not be sufficiently motivated to initiate behavior changes that can reduce risk of subsequent cardiac events. Finding an effective means to help patients modify their behavior thus presents a unique challenge. This paper describes an innovative behavioral intervention whose theoretical underpinning is net-present value economic theory. This intervention is being evaluated in a randomized controlled trial in which all patients complete a computerized baseline health assessment of 14 cardiovascular risk factors. Each patient is presented with an individualized risk-factor profile and asked to choose risk factors for modification. In the experimental group, each risk factor is presented with a corresponding numerical biologic age value that represents the relative potential to benefit from modifying each risk factor. Risk reduction for these patients is framed as the opportunity to reduce present biologic age (the net-present value), and improve current health status and quality of life. In the control group,

This study examines teachers' perceptions of classroom-based accommodation for children at risk for ADHD in four inclusive primary schools. The research involved a sample of 20 teachers and 27 students aged 3 to 7 years, identified using an adapted version of the DSM-5 checklist. Following a two-week professional development for selected teachers focused on ADHD classroom-based management, an eight-week intervention was implemented. A teacher's feedback survey and classroom observation were used to collect data. The findings reveal that teachers across all three intervention groups perceived noticeable improvements in students' level of concentration, socialization with peers, and academic outcomes. Moreover, a combined intervention approach that integrated both environmental modifications and behavior management was the most impactful strategy, with approximately 90% of teachers rating it as effective. The study offers important implications for inclusive classroom practices that support students with or at risk of ADHD, particularly in inclusive primary classrooms in the Cameroon school context and provides recommendations for future research.

reduced by 4.42 cm , calf significantly reduced by 2.49 cm and waist to hip circumference ratio was also reduced by 0.01. On the other hand, the control group slightly increased in neck, chest, bicep, forearm, waist, thigh, hips, calf, waist to hip ratio.

HCV infection continues to spread at an alarming rate among IDU populations. The available evidence suggests that HCV is acquired relatively quickly following onset of injection. However, there are few prospective studies of HCV acquisition, particularly among IDU populations in resource-poor settings. A sample of young male heroin injectors with recent onset of injection (G4 years) was recruited in Hanoi, Vietnam for a prospective assessment of the early course of injection (n=179). Both behavioral and biological assessments (including detailed retrospective assessment of injection initiation) were conducted at baseline and repeated at 6-month intervals for a period of 16 months. Variables associated with HCV infection (p valueG0.05) in bivariate analyses were considered for inclusion in logistic regression models to identify risk factors independently associated with HCV infection. HCV incidence was calculated by using the incidence density approach and was expressed in terms of person-years of observation. The baseline of prevalence of HCV was 46%. HCV significantly increased in relation to time since first injection, from 30% in subjects with ≤10 months of injection risk to 70% in subjects with ≥30 months injection risk (p value=0.0005). In multivariate logistic regression analysis, increasing age, incarceration in a drug detention facility (OR=2.54; 95%CI 1.05, 6.15), and time since first injection remained significantly associated with HCV infection. Use of injection as primary mode of administration (OR=2.56; 95%CI 0.98, 6.69) achieved marginal significance. After 16 months of follow-up, the incidence rate of HCV was 23.35 per 100 person-years and the mean time between first injection and first positive HCV test was 1.2 years. HCV is acquired much more rapidly among new injector populations than previously recognized, demonstrating the need for early behavioral intervention among new heroin-user populations. Particularly critical are interventions that target new heroin user populations, including interventions that improve understanding of viral transmission dynamics, that promote alternative strategies for drug sharing, and that delay initiation of injection.

This meta-analysis synthesized 34 HIV prevention interventions (from 27 studies) that were evaluated in Latin American and Caribbean nations. These studies were obtained through systematic searches of English, Spanish, and Portuguese-language databases available as of January 2009. Overall, interventions significantly increased knowledge (d = 0.51) and condom use (d = 0.28) but the effects varied widely. Interventions produced more condom use when they focused on high-risk individuals, distributed condoms, and explicitly addressed socio-cultural components. The best-fitting models utilized factors related to geography, especially indices of a nations' human development index (HDI) and income inequality (i.e., Gini index). Interventions that provided at least three hours of content succeeded better when HDI and income inequality were lower, suggesting that intensive HIV prevention activities succeed best where the need is greatest. Implications for HIV intervention development in Latin America and the Caribbean are discussed.

Statistical data from the Centers for Disease Control (2018) indicated autism spectrum disorder (ASD) affects 1 out of 59 children in American schools. The purpose of this study was to explore the perceptions of special education teachers regarding teaching social skills for K-5 students with ASD; specifically, to see how teachers viewed the effective use of two promising practices (i.e., peer-mediated interventions and social stories) and one evidence-based intervention (i.e., video modeling). The experiences of special education teachers regarding teaching social skills to K-5 students with ASD were explored. Seven special education teachers from school districts in Colorado were interviewed and their responses were coded. After reading the transcripts and reviewing the responses to the questions as demonstrated above, the researcher found the following themes emerged from the contextual descriptions: collaboration, using pictures, using peers, equipment, training, and using socia...

Tavoitteet. Aiempien tutkimusten mukaan sekä hidas hengitys että musiikin kuuntelu ennen nukkumaanmenoa voivat vähentää koehenkilöiden kokemusta levottomasta ja katkonaisesta yöunesta. Onkin ehdotettu, että unettomuuspotilaille tyypillinen kokemus katkonaisista ja huonosti palauttavista yöunista voisi selittyä REM-unen aikaisilla lyhyillä heräämisillä. Kuitenkaan sitä, voidaanko unta edeltävällä rentoutumisella vaikuttaa REM-unen katkonaisuuteen, ei ole tutkittu objektiivisella mittauksella aiemmin. Tämän tutkimuksen tavoitteena oli selvittää unipolygrafia-mittauksella, voidaanko unta edeltävällä rentoutumisella parantaa REM-unen laatua sekä vähentää REM-unen katkonaisuutta. Menetelmät. Tutkimus oli satunnaistettu kontrolloitu tutkimus, jossa 20 koehenkilöä jaettiin kahteen koeryhmään. Toinen ryhmä hengitti viisi hengitystä minuutissa puolen tunnin ajan, kun taas toinen ryhmä kuunteli rauhallista musiikkia puolen tunnin ajan ennen nukkumaanmenoa. Koehenkilöiden unta mitattiin kahten...

Objective-Negative affect is a significant predictor of alcohol relapse, and the relation between negative affect and drinking has been shown to be strongly mediated by alcohol craving. Thus, targeting craving during treatment could potentially attenuate the relation between negative affect and drinking. Method-The current study is a secondary analysis of data from the COMBINE study, a randomized clinical trial that combined pharmacotherapy with behavioral intervention in the treatment of alcohol dependence. The goal of the current study was to examine whether a treatment module that targeted craving would predict changes in negative mood during the 16week Combined Behavioral Intervention (CBI; n=776) and the relation between changes in mood, craving, and changes in heavy drinking during treatment and one year posttreatment. Results-Changes in negative mood were significantly associated with changes in heavy drinking during treatment (f 2 =0.78). Participants (n=432) who received the craving module had significantly fewer heavy drinking days during treatment (d = 0.31) and receiving the module moderated the relation between negative mood and heavy drinking during treatment (f 2 =0.92) and one year posttreatment (f 2 =0.03). Moderating effects of the craving module were mediated by changes in craving during treatment. Within subject analyses indicated significant pre-to postmodule reductions in negative mood. Additionally, post-module craving significantly mediated the association between negative mood and heavy drinking during treatment and posttreatment. Conclusions-The craving module of CBI may weaken the relation between negative affect and heavy drinking by fostering greater decreases in craving during treatment.

DEBI, or the Diffusion of Effective Behavioral Interventions is the largest centralized effort to diffuse evidence-based prevention science to fight HIV/AIDS in the United States. DEBI seeks to ensure that the most effective science-based prevention interventions are widely implemented across the country in community-based organizations. Thus, this is a particularly timely juncture in which to critically reflect on the extent to which known principles of community collaboration have guided key processes associated with the DEBI rollout. We review the available evidence on how the dissemination of packaged interventions is necessary but not sufficient for ensuring the success of technology transfer. We consider additional principles that are vital for successful technology transfer, which were not central considerations in the rollout of the DEBI initiative. These issues are: (1) community perceptions of a top-down mode of dissemination; (2) the extent to which local innovations are being embraced, bolstered, or eliminated; and (3) contextual and methodological considerations that shape community preparedness. Consideration of these additional factors is necessary in order to effectively document, manage, and advance the science of dissemination and technology transfer in centralized prevention efforts within and outside of HIV/AIDS.

Objective-We tested the efficacy of a cognitive-behavioral intervention in reducing environmental tobacco smoke exposure (ETSE) and improving pregnancy outcomes among African-American women. Methods-We recruited 1,044 women to a randomized controlled trial during 2001-2004 in Washington, DC. Data on 691 women with self-reported ETSE were analyzed. A subset of 520 ETSE women and salivary cotinine levels (SCLs) <20 ng/ml was also analyzed. Individually tailored counseling sessions adapted from evidence-based interventions for ETSE and other risks, were delivered to the intervention group. The usual care group received routine prenatal care as determined by their provider. Logistic regression models were used to predict ETSE before delivery and adverse pregnancy outcomes. Results-Women in the intervention were less likely to self-report ETSE before delivery when controlling for other covariates (OR=0.50, 95%CI=0.35-0.71). Medicaid recipients were more likely to have ETSE (OR=1.97, 95%CI=1.31-2.96). With advancing maternal age, the likelihood of ETSE was less (OR=0.96, 95%CI=0.93-0.99). For women in the intervention the rates of very low birth weight (VLBW) and very preterm birth (VPTB) were significantly improved (OR=0.11, 95%CI=0.01-0.86; OR=0.22, 95%CI=0.07-0.68, respectively). For women with SCL <20 ng/ml, maternal age was not significant. Intimate partner violence at baseline significantly increased the chances of VLBW and VPTB (OR=3.75, 95%CI=1.02-13.81; OR=2.71, 95%CI=1.11-6.62, respectively). These results were true for mothers who reported ETSE overall and for those with SCL <20 ng/ml. Conclusions-This is the first randomized clinical trial demonstrating efficacy of a cognitivebehavioral intervention targeting ETSE in pregnancy. We significantly reduced ETSE as well as VPTB and VLBW, leading causes of neonatal mortality and morbidity in minority populations. This intervention may reduce health disparities seen in reproductive outcomes.

Background-This study examines whether an integrated behavioral intervention with proven efficacy in reducing psycho-behavioral risks (smoking, environmental tobacco smoke exposure (ETSE), depression, and intimate partner violence (IPV)) in African-Americans is associated with improved pregnancy outcomes Methods-A randomized controlled trial targeting risks during pregnancy was conducted in the District of Columbia. African-American women were recruited if reporting at least one of the risks mentioned above. Randomization to intervention or usual care was site and risk specific. Sociodemographic, health risk and pregnancy outcome data were collected. Data on 819 women, and their singleton live born infants were analyzed using an intent-to-treat approach. Bivariate analyses preceded a reduced logistical model approach to elucidate the effect of the intervention on the reduction of prematurity and low birth weight. Results-The incidence of low birthweight LBW was 12% and very low birthweight VLBW was 1.6%. Multivariate logistic regression results showed that depression was associated with LBW (OR=1.71, 95%CI=1.12-2.62). IPV was associated with PTB and VPTB (OR 1.64, OR=2.94, respectively). The occurrence of VPTB was significantly reduced in the intervention compared to the usual care group (OR=0.42, 95%CI=0.19-0.93). Conclusions-Our study confirms the significant associations between multiple psychobehavioral risks and poor pregnancy outcomes, including LBW and PTB. Our behavioral intervention with demonstrated efficacy in addressing multiple risk factors simultaneously reduced VPTB within an urban minority population.

Background and Purpose — Only a small minority of acute stroke patients receive approved acute stroke therapy. We performed a community and professional behavioral intervention project to increase the proportion of stroke patients treated with approved acute stroke therapy. Methods — This study used a quasi-experimental design. Intervention and comparison communities were compared at baseline and during educational intervention. The communities were based in 5 nonurban East Texas counties. The multilevel intervention worked with hospitals and community physicians while changing the stroke identification skills, outcome expectations, and social norms of community residents. The primary goal was to increase the proportion of patients treated with intravenous recombinant tissue plasminogen activator (rTPA) from 1% to 6% of all cerebrovascular events in the intervention community. Results — We prospectively evaluated 1733 patients and validated 1189 cerebrovascular events. Intravenous r...

Aims.  To determine the effect of music therapy and verbal relaxation on state anxiety and anxiety‐induced physiological manifestations among patients with cancer before and after chemotherapy.Background.  Cancer and its treatment provoke a series of changes in the emotional sphere of the patient’s anxiety. Music therapy and verbal relaxation had reported the anxiety reduction effect on patients with cancer receiving chemotherapy. Few studies have been undertaken comparing music therapy and verbal relaxation in differentiating high–normal state anxiety subsample.Design.  A randomised controlled trial and permuted block design were used. Outpatient chemotherapy clinic operated by a University medical centre in southern Taiwan.Methods.  Ninety‐eight patients were randomised into three groups: the music therapy group received one‐hour single music session; the verbal relaxation group received 30 minutes of guided relaxation; the control group received usual care. Spielberger State‐Trai...

The definition of “boundary ” in the context of multiorganizational information sharing and integration initiatives is developed in the paper. Both current literature and a case study of the product safety inspection environment are used to drive the development of a dual-directional, multi-dimensional and non-linear framework for understanding the meaning of “boundary”. The two directions are the vertical and horizontal directions and the multidimensions include organizational, geographic, personal, development phase, and process. The framework can be used both as a theoretical model for researchers and a comprehensive analytic tool for practitioners. 1.

Results There were 610 participants (mean age: 14.2 years [SD: 1.5]; 49.5% cisgender women, 48.9% cisgender men, 1.6% transgender persons); three-quarters (n=447; 73.3%) were Indigenous. One-quarter (n=144; 23,6%) reported food insecurity and nearly one-fifth (n=111; 18.2%) IPV. Among young women, food insecurity (b: -1.89[CI: -2.98, -0.80], p=0.001) and IPV (b: -1.31[CI: -2.53, -0.09], p=0.036) were associated with lower SSE in adjusted analyses, and currently dating was associated with increased SSSE (b: 1.17[CI: 0.15, 2.19], p=0.024). Among young men, food insecurity (b: -2.27 [CI: -3.39, -1.15), p=0.014) was associated with reduced SSE. Among sexually active participants (n=115), increased SSE was associated with increased condom use among young women (b: 1.40[0.19, 2.61], p=0.024) and men (b: 2.14 [0.14, 4.14], p=0.036). No differences emerged by Indigenous identity across analyses. Conclusion Food insecurity and IPV emerged as syndemic factors associated with lower SSE-a protective factor associated with condom use among Northern and Indigenous adolescents in the NWT. Poverty and violence compromise Indigenous and Northern youth's sexual agency and in turn contribute to STI vulnerabilities, requiring urgent attention. Disclosure No significant relationships.

Background : Parenting style can influence the occurrence of obesity in children through their attitudes, habits, choices, and diet patterns. School-age children require a balanced nutritional intake to support their growth and development. Therefore, parents need to pay great attention to their child&#39;s nutrition to ensure that their growth and development processes are not disrupted and to prevent various illnesses. The purpose of this study was to determine the relationship between parenting style and diet patterns with the incidence of obesity in school-age children at Muhammadiyah University Elementary School, Purwokerto Methods : This research used a cross-sectional design with purposive sampling. The total number of respondents in this study was 46 students. The Parenting Styles and Dimensions Questionnaire (PSDQ) was used to assess parenting styles, while the Food Frequency Questionnaire was used to determine the diet patterns of the respondents.The data analysis used in ...

Background-Seeking screening and treatment for chlamydia (CT) and gonorrhea (GC) by young women is critical to reduction of asymptomatic cervicitis and its complications. Objectives-To evaluate the efficacy of a client-centered motivational behavioral intervention (MBI), to promote seeking of STI check-ups by young women. Methods-376 of 770 eligible sexually active, non-pregnant, English-speaking women (mean age 18.5 years) were recruited from an urban reproductive health clinic and randomized to two groups: intervention plus standard care (MBI) or standard-care alone (SC). MBI (two sessions plus booster) was based on the Transtheoretical Model of Change and employed motivational interviewing. Outcome measures monitored for 12 months included: client-initiated clinic visits for STI check-ups in response to seven high-risk sexual behaviors by self report (primary), consistent condom use, number of CT and GC episodes, and movement along the stages of change obtained at baseline and 6-and 12-month follow-up assessments (secondary). Analyses included chi square, logistic regression and generalized estimating equations. Results-At baseline >70% endorsed the action stage of change for seeking STI check-ups for three of seven high-risk sexual behaviors. No significant differences were noted between the two groups for the primary or secondary outcomes. Across groups, having multiple partners and being pregnant or thinking one might be pregnant were associated with STI check-ups. Conclusions-This is the first known client-centered clinical trial to promote STI screening. Risktaking and health seeking behaviors are complex and interrelated with STI and pregnancy-concerns.

Background Cognitive behavioural therapy (CBT) is the recommended first-line treatment for children and adolescents with obsessive-compulsive disorder (OCD), but evidence concerning treatment-specific benefits and harms compared with other interventions is limited. Furthermore, high risk-of-bias in most trials prevent firm conclusions regarding the efficacy of CBT. We investigate the benefits and harms of family-based CBT (FCBT) versus family-based psychoeducation and relaxation training (FPRT) in youth with OCD in a trial designed to reduce risk-of-bias. Methods This is an investigator-initiated, independently funded, single-centre, parallel group superiority randomised clinical trial (RCT). Outcome assessors, data managers, statisticians, and conclusion drawers are blinded. From child and adolescent mental health services we include patients aged 8–17 years with a primary OCD diagnosis and an entry score of ≥16 on the Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). We ...

The purpose of this research was to determine the extent to which women of African ancestry manifested power in their relationships regarding sexual activities and to examine the influence that specific variables had on their sexual partnerships. A sample (N ¼ 200) of midlife women aged 40-65, who lived in the Midwest participated in this research. The Sexual Relationship Power Scale was used to examine these relationships. Face-to-face interviews occurred in community settings. Multiple regression equations were used to examine the potential impact of specific variables on sexual functioning. Results of the analysis revealed that variables such as mental quality of life, decision-making, and health promotion were positively associated with sexual relationships. Conversely, depression and life stress scores were negatively linked to sexual relationships. Knowledge gained from this research could be used to explore the phenomena of power as expressed in the daily lives of women of African descent. The research can also be discussed from the perspective of a "Black tax," that has burdened Black women for centuries and is manifested through years of discrimination, bias, and the lack of equity in most domains of American institutions.

Background Estimates suggest the prevalence of Autism Spectrum Disorders affects one in every 110 children. While early behavioral intervention based on Applied Behavior Analysis (ABA) has strong empirical support, few parents are equipped to manage the variety and intensity of services their children will require. Method Focus groups with parents and service providers helped to inform the development of Discovering Behavioral Intervention: A Parent&#39;s Interactive Guide to ABA. Introduction Autism Spectrum Disorders is a neurodevelopmental disorder characterized by severe deficits in social and language development that affect a person&#39;s ability to communicate, form social relationships and respond appropriately to the environment. ABA treatment can result in meaningful and functional changes in language, social behavior and adaptive functioning. Findings DBI resulted in significant increases in knowledge and parents found the material to be engaging, practical, and relevant ...

Abstract Behavioral Intervention in Autism (BIA) is a four-course, internet-based curriculum designed to provide early intervention personnel and parents with comprehensive,training in behavioral intervention. This paper presents findings from field-testing of the first two courses in the curriculum series. Students enrolled in either an online or face-to-face version of the courses were asked by an external evaluator to complete three surveys during each course. Survey results, along with pre- and post-test data, suggest that students in both course types successfully learned the material and were quite satisfied with both the content of their courses and their course instructors. Results are discussed with a special emphasis on the experimental design difficulties of the online versus face-to-face comparison,as well as the features that made the courses successful. Weissman, et al 3

Despite the availability of well-established psychosocial and pharmacological treatments for attention-deficit/hyperactivity disorder (ADHD), it remains a disorder with substantial impact on public health and individual families. Though the rate of adherence to ADHD medication is similar to that of other pediatric chronic conditions, research with this population is more limited. The current study explored the hypothesis that recognition by caregivers of child functional impairment, and caregiver perception of the doctor's medication recommendation as "hasty" would account for statistically significant variance in adherence to ADHD medication. Fourteen caregivers of children between the ages of 6 and 12 years diagnosed with ADHD and prescribed an index medication within 6 months of recruitment participated in the current study. Measures included medication recommendation visual analog scale, Southampton ADHD Medication Behaviour and Attitudes Scale, Stimulant Adherence Measure, Vanderbilt ADHD Diagnostic Parent Rating Scale, and pharmacy data (i.e., medication possession ratios [MPR]). We found significant correlations between adherence (i.e., MPR) and the following: number of days included in the MPR, τ = -.41, p (one-tailed) = .05, percent of children at Title 1 school considered low-income, τ = -.50, p (two-tailed) = .07, and highest grade-level completed by participant being greater than high school, τ = -.41, p (two-tailed) = .10. While the hypothesis was not supported, the relationships were in the hypothesized direction and warrant further investigation with a larger sample size. Clinicians who wish to improve adherence to ADHD medication in children may do so by working toward improving interactions between physician and caregivers (e.g., increasing shared decision-making between physician and caregivers).

Background: Although school-based behavioral interventions for increasing physical activity (PA) in children and adolescents have been conducted, little evidence suggests that these curriculum-based approaches lead to increases in overall activity outside of program days. The overall goal of the "Active by Choice Today" (ACT) trial is to expand the body of knowledge concerning the factors that influence long-term increases in PA in underserved adolescents (low socioeconmic status, minorities) during their middle school years. Design and setting: An overview of the ACT study design, theoretical framework, process evaluation, and primary hypotheses is presented. The trial involves twenty-four middle schools (1560 6th graders) in South Carolina that are randomly assigned to one of two after-school programs (motivational and life skills intervention, or general health education). The intervention integrates constructs from Self-Determination and Social Cognitive Theories to enhance intrinsic motivation and behavioral skills for PA. The intervention targets skill development for PA outside of program days and the after-school program social environment

Subjective loneliness describes people who feel a disagreeable or unacceptable lack of meaningful social relationships, both at the quantitative and qualitative level. The studies to be presented tested an Italian 18-items self-report loneliness measure, that included items adapted from scales previously developed, namely a short version of the UCLA , and the 11-items Loneliness scale by De Jong-Gierveld & Kamphuis (JGLS; 1985). The studies aimed at testing the developed scale and at verifying whether loneliness is better conceptualized as a unidimensional (so-called 'general loneliness') or a bidimensional construct, namely comprising the distinct facets of social and emotional loneliness. The loneliness questionnaire included 2 singleitem criterion measures of sad mood, and social contact, and asked participants to supply information on a number of socio-demographic variables. Factorial analyses of responses obtained in two preliminary studies, with 59 and 143 Italian participants respectively, showed good factor loadings and subscale reliability and confirmed that perceived loneliness has clearly two components, a social and an emotional one, the latter measured by two subscales, a 7-item 'general' loneliness subscale derived from UCLA, and a 6-item 'emotional' scale included in the JGLS. Results further showed that type and amount of loneliness are related, negatively, to frequency of social contacts, and, positively, to sad mood. In a third study data were obtained from a nation-wide sample of 9.097 Italian subjects, 12 to about 70 year-olds, who filled the test on-line, on the Italian web site of a large-audience magazine, Focus. The results again confirmed the reliability of the component subscales, namely social, emotional, and 'general' loneliness, and showed that they were highly correlated with each other, especially the latter two. Loneliness scores were significantly predicted by sex, age, education level, sad mood and social contact, and, less so, by other variablese.g., geographical area and profession. The scale validity was confirmed by the results of a fourth study, with elderly men and women (N 105) living at home or in residential care units. The three subscales were significantly related, among others, to depression, and to various measures of the extension of, and satisfaction with, social contacts with relatives and friends. Finally, a fifth study with 315 career-starters showed that social and emotional loneliness correlate with life satisfaction, and with measures of emotional intelligence. Altogether the results showed a good validity and reliability in the tested samples of the entire scale, and of its components.

This review concluded that cognitive-behavioural therapy was efficacious in reducing anxiety sensitivity in both treatment-seeking patients and those at risk. There were a number of limitations in the review which suggest that the authors' conclusions should be treated with caution.

This study examined the effects of a structured maternal subjective well-being intervention based on rational emotive behavior therapy on mothers' subjective well-being and self-perception of the parental role. The study used a quasi-experimental design and included two groups (experimental and control) and three measures (pretest, posttest, and follow-up test). Participants included 62 mothers of children aged 36 to 72 months from rural areas in North Cyprus who were recruited via voluntary sampling and randomly assigned to the experimental (n = 32) or control (n = 30) group. The developed intervention was administered to the experimental group over six sessions. Data were collected using the Self-Perception of Parental Role Scale and Subjective Well-Being Scale. A mixed ANOVA showed that the intervention significantly increased the experimental group's subjective well-being and self-perception of the parental role, and this effect continued throughout the 27-day follow-up assessment period. These results demonstrate the potential benefits of the intervention for maternal mental health.

Background-Sexually transmitted disease (STD) patients are more likely to experience a future STD including HIV. Purpose-To examine the efficacy of behavioral interventions to reduce sexual risk behavior and incident STDs among patients attending STD clinics in the United States. Methods-Meta-analysis of 32 studies with 48 separate interventions targeting STD patients (N = 67,538). Independent raters coded study, sample, and intervention characteristics. Effect sizes, using both fixed-and random-effects models, were calculated. Potential moderators of intervention efficacy were assessed. Results-Relative to controls, intervention participants increased their condom use and had fewer incident STDs, including human immunodeficiency virus (HIV), across assessment intervals (d +s ranging from 0.05 to 0.64). Several sample (e.g., age, ethnicity) and intervention features (e.g., targeting intervention to a specific group) moderated the efficacy of the intervention. -Behavioral interventions targeted to STD clinic patients reduce sexual risk behavior and prevent HIV/STDs. Widespread use of behavioral interventions in STD clinics should be a public health priority.

We evaluated the outcome of early behavioral intervention for children with Autism Spectrum Disorders (ASD) as it was provided through public service providers in Norway. A group of 21 children received low-intensity intervention (11.1 weekly hours), a second group of 26 children higher intensity intervention (18.1 weekly hours), and a third group of 17 children received eclectic special education. Group assignment was based on independent referrals. We compared outcomes on adaptive behavior, ASD severity, and intellectual functioning after one year. The lower and higher intensity behavioral intervention groups received fewer hours than what is recommendedbut did significantly better than the eclectic group. Moreover, the higher intensity behavioral group did better than the lower intensity behavioral group. Nevertheless, gains in both groups were more modest than what is reported for intervention that is more intensive. We describe the model of service delivery, discuss challenges with it, and propose improvements.

Women with substance use disorders (SUDs) experience high rates of violence exposure and posttraumatic stress disorder (PTSD), which are associated with parenting anxiety and lower parenting satisfaction among mothers. Although social support may buffer the impact of violence and PTSD on parenting, violence exposure and PTSD may impair mothers’ ability to create, perceive, and utilize social support. We examined the impact of violence exposure, trauma symptoms, and interpersonal support on parenting competence among 291 mothers with substance dependence, using ordinary least squares regression and path analysis. Greater violence exposure and trauma symptoms were associated with lower parenting competence. Greater interpersonal support was associated with greater parenting competence. Trauma symptoms and interpersonal support sequentially mediated the impact of violence exposure on parenting competence, suggesting one pathway through which violence exposure may affect parenting among...

There is very little published in the animal behavior consulting literature that directly addresses the topic of how consultants should decide whether or not to use aversive stimulation, and under what circumstances any particular level of aversiveness is justified. This is surprising, considering how important the topic is and how much it is discussed and debated in public and professional forums. In this essay, I will propose a best-practices model, including a decision-making algorithm and a levels of intrusiveness table, regarding the use of aversive stimulation. I will discuss in detail how to work through the decision-making process. This process will be referred to as the Least Intrusive Effective Behavior Intervention (LIEBI) model. There are widely differing opinions on the topic. While recognizing that there may be instances when aversive stimulation is called for, this particular algorithm will emphasize how to implement the least intrusive effective intervention possible...

Alcoholism and nicotine dependence share many neurobiological underpinnings; the presence of one drug can cause a person to crave the other. Depressive illness can complicate comorbid alcohol and nicotine dependence by exacerbating the negative affect encountered during attempts to abstain from one or both drugs. Given the morbidity and mortality associated with cigarette smoking, it is imperative to identify treatments to promote smoking cessation and address comorbid psychiatric conditions contemporaneously. Pharmacotherapeutic options demonstrating varying degrees of efficacy and promise in preclinical and clinical studies include nicotine replacement therapy (NRT), selective serotonin reuptake inhibitors (SSRIs), bupropion, varenicline, tricyclic antidepressants, and bupropion plus NRT. Topiramate has shown potential for promoting smoking cessation in alcoholics, although its safety in depressed patients has not been fully explored. The efficacy of medications for treating nicot...

BOUT 8 MILLION INDIVIDUALS IN the United States currently meet diagnostic criteria for alcohol dependence, a leading preventable cause of morbidity and mortality and a major contributor to health care costs. In primary care settings, the prevalence of alcohol use disorders ranges from 20% to 36% 5 ; most of those patients are never treated and, if they are See also p 2075 and Patient Page.

Language is a means of communication that gives symbols and meaning to thoughts and feelings to convey messages or information to others, but children with autism have difficulty in expressive language communication. This happened to children with autism in one of the special schools in the city of Sidoarjo who felt it was necessary to intervene with fading stimulus to reduce behavioral and expressive language disorders in childre n with autism. This study aims to determine the effectiveness of fading when applied to children with autism who have expressive language disorders. Identification of the subject, the subject in this study was a boy aged 12 years old who had an autistic spectrum disorder, specifically DSM V. The research instrument used is the observation technique of tally ing behavior and rating scale to measure the behavior of autistic children who experience expressive language barriers. Observation guidelines were compiled based on the characteristics of autism contained in DSM V. Th is research method used a quantitative approach with experimental methods and used an experimental single -case design. Experiments were carried out by providin g Fading intervention on autism subjects who had behavioral and expressive language disorders. The intervention was carried out in 5 sessions (1 -2 hours per session, depending on the subject's response) within 10 days. The data analysis technique that has been collected is analyzed descriptively to describe behavioral changes that show symptoms of expressive language behavior disorders in children with autism. So that it can be concluded. Based on the results of the descriptive analysis, it can be concluded that the fading stimulus can provide a positive response to child ren with autism who experience expressive language behavior disorders. In this study, after being given the intervention for approximately 10 days, the subjects showed a decrease. Suggest ions Th is research has limitations in its implementation, namely the teacher is less cooperative in carrying out the intervention process. Even so, this study showed a positive change experienced by the subject after giv ing the intervention for 5 sessions.

Florida has the highest number of PLWH in the USA, with the highest incidence being among young African-Americans. The purpose of this qualitative inquiry was to gain an understanding of the knowledge and attitudes to HIV/AIDS among Afro-Caribbean adolescents. Using a faith-based community, we conducted four focus group sessions with 40 Afro-Caribbean teens. Descriptive content and thematic analyses were used to examine the data. Themes identified include awareness gap, temptation everywhere, testing anxiety and stigma. Recommendations include continued exploration and interventions to address stigma in faith-based communities. Implications are discussed.

The likelihood of initiating addictive behaviors is higher during adolescence than during any other developmental period. The differential developmental trajectories of brain regions involved in motivation and control processes may lead to adolescents' increased risk taking in general, which may be exacerbated by the neural consequences of drug use. Neuroimaging studies suggest that increased risk-taking behavior in adolescence is related to an imbalance between prefrontal cortical regions, associated with executive functions, and subcortical brain regions related to affect and motivation. Dual-process models of addictive behaviors are similarly concerned with difficulties in controlling abnormally strong motivational processes. We acknowledge concerns raised about dual-process models, but argue that they can be addressed by carefully considering levels of description: motivational processes and top-down biasing can be understood as intertwined, co-developing components of more versus less reflective states of processing. We illustrate this with a model that further emphasizes temporal dynamics. Finally, behavioral interventions for addiction are discussed. Insights in the development of control and motivation may help to better understand -and more efficiently intervene in -vulnerabilities involving control and motivation.

Suicide behavior is a serious clinical problem worldwide, and understanding ways of reducing it is a priority. A systematic review and meta-analysis were carried out to investigate whether Cognitive-behavioral therapies (CBTs) would reduce suicide behavior. From 123 potential articles, 28 studies met the entry criteria. Overall, there was a highly significant effect for CBT in reducing suicide behavior. Subgroup analysis indicates a significant treatment effect for adult samples (but not adolescent), for individual treatments (but not group), and for CBT when compared to minimal treatment or treatment as usual (but not when compared to another active treatment). There was evidence for treatment effects, albeit reduced, over the medium term. Although these results appear optimistic in advocating the use of CBT in ameliorating suicidal thoughts, plans, and behaviors, evidence of a publication bias tempers such optimism.

A survey of 1220 street-recruited crack cocaine smokers revealed that crack smokers may turn to drug injection to ease crack withdrawal. Crack smokers who later injected tended to smoke crack more heavily and for longer periods than those who did not inject. The initiation of injection was significantly associated with ever snorting heroin (prevalence ratio [PR] = 3.4, 95% confidence interval [CI] = 2.0-5.9) or snorting heroin specifically while smoking crack (PR = 2.3, 95% CI = 1.3-4.0), suggesting that snorted heroin use may mediate the transition to injection among crack smokers. Programs to prevent and treat crack dependence may prevent later injection and injection-related infections including HIV.

The United States has the highest incarceration rate in the world. Incarceration can increase HIV risk behaviors for individuals involved with the criminal justice system and may be a driver of HIV acquisition within the community. We used an agent-based model to simulate HIV transmission in a sexual-contact network representing heterosexual African American men and women in Philadelphia to identify factors influencing the impact of male mass incarceration on HIV acquisition in women. The model was calibrated using surveillance data and assumed incarceration increased the number of sexual contacts and decreased HIV care engagement for men post-release. Incarceration of a partner increased the number of sexual contacts for women. We compared a counterfactual scenario with no incarceration to scenarios varying key parameters to determine what factors drove HIV acquisition in women. Results: Setting the duration of male high-risk sexual behavior to two years post-release increased the number of HIV transmissions to women by more than 20%. Decreasing post-release HIV care engagement and increasing HIV acquisition risk attributable to sexually transmitted infections (STIs) also increased the number of HIV transmissions to women. Changing the duration of risk behavior for women, the proportion of women engaging in higher risk behavior, and the relative risk of incarceration for HIV-infected men had minimal impact. The mass incarceration of African American men can increase HIV acquisition in African American women on a population-level through factors including post-release high-risk behaviors, disruption of HIV care engagement among formerly incarcerated men, and increased STI prevalence. These findings suggest that the most influential points of intervention may be programs seeking to reduce male risk behaviors and promote HIV care engagement post-release, as well as STI testing and treatment programs for recently incarcerated men, as well as women with incarcerated partners.

Early intensive behavior intervention (EIBI) is offered as a service in some specialist health services in Norway. These services are typically offered to families with children diagnosed with autism specter disorders (ASD) in pre-school age and provided in the child's pre-school (

BackgroundNon-fluent/agrammatic variant of Primary Progressive Aphasia (avPPA) is primarily characterized by language impairment due to atrophy of the inferior frontal gyrus and the insula cortex in the dominant hemisphere. The Screening for Aphasia in NeuroDegeneration (SAND) battery has been recently proposed as a screening tool for PPA, with several tasks designed to be specific for different language features. Applying multivariate approaches to neuroimaging data and verbal fluency tasks, Aachener Aphasie Test (AAT) naming subtest and SAND data may help in elucidating the neuroanatomical correlates of language deficits in avPPA.ObjectiveTo investigate the neuroanatomical correlates of language deficits in avPPA using verbal fluency tasks, AAT naming subtest and SAND scores as proxies of brain structural imaging abnormalities.MethodsThirty-one avPPA patients were consecutively enrolled and underwent extensive neuropsychological assessment and MRI scan. Raw scores of verbal fluenc...

Intervening with depressed women during their childbearing years, especially with those on low incomes, is critically important. Not only do mothers and expectant mothers suffer unnecessarily, but their untreated depression has critical negative consequences for their families. Despite this, these women have proven especially difficult to engage in psychotherapy. In this paper we describe several adaptations and additions we have made to a brief form of Interpersonal Psychotherapy (IPT) to meet the needs of mothers and expectant mothers living on low incomes in the community who suffer from depression, but face significant practical, psychological, and cultural barriers to engaging in and staying in treatment. In addition, we present some preliminary data on the extent to which our enhanced, brief IPT approach promotes improvements in treatment engagement and retention relative to usual care for expectant mothers on low incomes.

To determine the extent to which current United States based human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) prevention and risk reduction interventions address and include aspects of cultural beliefs in definitions, curricula, measures and related theories that may contradict current safer sex messages. A comprehensive literature review was conducted to determine which published human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) prevention and risk reduction interventions incorporated aspects of cultural beliefs. This review of 166 human immunodeficiency virus (HIV) prevention and risk reduction interventions, published between 1988 and 2010, identified 34 interventions that varied in cultural definitions and the integration of cultural concepts. human immunodeficiency virus (HIV) interventions need to move beyond targeting specific populations based upon race/ethnicity, gender, sexual, drug and/or risk behaviors and incorporate ...

Obesity has become a worldwide epidemic. Its prevalence is increasing in developing countries. This study aims to estimate the prevalence, and associated risk factors of obesity and overweight among preschool children. A cross-sectional study was conducted in Mansoura district. The researcher took the anthropometric measurements of preschool children. A questionnaire included questions related to socioeconomic characteristics and maternal feeding behavior toward preschool children was used. 52% of studied children were males, mostly from urban areas. Overweight and obesity were significantly higher among females, children of highly educated mothers, children of over birth weight, among breast fed for at least 3, children consuming &gt; two sugary juice bottles / day.

Objective To evaluate the reliability and validity of a commonly used measure of health-related quality of life (HRQOL), the Pediatric Quality of Life Inventory (PedsQL™ 4.0), in a sample of children with a recurrent headache syndrome. Methods Participants were 40 children aged 7-12 who completed measures of HRQOL, headache-related disability, and headache activity during a baseline period and following a self-directed cognitive-behavioral intervention. Results The data are supportive of the reliability (internal consistency and test-retest) and validity (criterion related, convergent, known-groups, and responsiveness to intervention) of the PedsQL™ 4.0 within a pediatric headache sample. Conclusions We conclude that the PedsQL™ 4.0 is a reliable and valid measure of HRQOL in children with recurrent headache and captures important information not routinely evaluated in chronic pain populations.

Objectives. We examined the efficacy of a brief behavioral intervention to promote condom use among female sex workers in Tijuana and Ciudad Juarez, Mexico. Methods. We randomized 924 female sex workers 18 years or older without known HIV infection living in Tijuana and Ciudad Juarez who had recently had unprotected sex with clients to a 30-minute behavioral intervention or a didactic control condition. At baseline and 6 months, women underwent interviews and testing for HIV, syphilis, gonorrhea, and chlamydia. Results. We observed a 40% decline in cumulative sexually transmitted illness incidence (P = .049) in the intervention group. Incidence density for the intervention versus control groups was 13.8 versus 24.92 per 100 person-years for sexually transmitted illnesses combined (P = .034) and 0 versus 2.01 per 100 person-years for HIV (P &lt; .001). There were concomitant increases in the number and percentage of protected sex acts and decreases in the number of unprotected sex ac...