Intentional and unintentional nonadherence in patients prescribed HAART treatment regimens

The objective was to investigate intentional and unintentional nonadherence to anti-HIV treatment regimens from a decision-making perspective. The participants (n?=?117) being treated with anti-HIV medication completed a questionnaire asking about nonadherence; reasons for and against taking the medication; and medical consultation style. Thirty-three participants (29%) reported intentionally missing or altering doses of medication at least 5% of the time; 59 participants (50%) reported forgetting to take medication at least 5% of the time. Intentional nonadherence was associated with the balance of the perceived benefits and losses of taking medication, and extent to which participants were 'prepared for the effects of the medication'. Unintentional nonadherence was associated with demographic and clinical variables. The research highlights the importance of (i) treating intentional and unintentional nonadherence as separate entities; (ii) assessing individuals' idiosyncratic beliefs and internal logic when considering intentional nonadherence; and (iii) ensuring that individuals feel prepared for the effects of their medications.     

Applying Utilization Management Principles to a Comprehensive Service System for Children with Emotional and Behavioral Disorders and Their Families: A Feasibility Study

The Comprehensive Services Act for At Risk Youth and Families of Virginia (CSA), is a service, funding, and organizational reform initiative designed to improve the provision of child centered and family focused services within a community setting. We conducted this study in order to assess the feasibility of applying utilization management principles to the CSA in order to improve the appropriateness, quality, and cost effectiveness of this service delivery system. Data were gathered through focus groups, surveys, clinical profiling, and analysis of costs, and service utilization. While overall program costs increased since inception of the program, the costs per child served rose less than the rate of inflation. CSA appeared to be serving children with a high degree of emotional and behavioral difficulties. There was considerable variation among localities in placement patterns. A majority of survey and focus group respondents were willing to consider the application of utilization management principles to the CSA as long as decision making remained within localities. We concluded that there is a constructive role for utilization management approaches to improve the appropriateness and quality of services as well as enhancing efficiency in child mental health.     

Interactive learning in the paradise fish (Macropodus opercularis): an ethological interpretation of the second-order conditioning paradigm

This study was aimed at the examination of ‘mental construction’ in paradise fish by interactive learning, which is suggested as an alternative hypothesis for backward or second-order conditioning. Avoidance of goldfish was established in paradise fish by presenting a harmless goldfish (a novel stimulus) after an aversive event (mild electric shocks) in the dark compartment of a shuttle tank. It was found that this avoidance depended on context pre-exposure. Experiment 1 was designed to study the effect of mild shocks on shuttling activity in a familiar context. Experiment 2 aimed at establishing fear-conditioning to the goldfish in a higher-order conditioning paradigm. In the course of training, unpaired stimuli were presented in the dark compartment of the shuttle tank in such a manner that the presentation of mild shocks (20 mA) preceded the encounter with a harmless fish (goldfish). Experiment 3 demonstrated the role of context pre-exposure in interactive learning. Results indicate that (1) while 60 mA shocks resulted in avoidance of the dark compartment, the 20 mA mild shocks affected exploratory behaviour; (2) after pre-exposure to the training environment, paradise fish avoided the dark compartment containing goldfish provided that subjects had previously encountered mild, explorative shocks there; (3) this conditioned fear, a ‘mental construction’ of a potential danger, was proved to be transferable to another context and was consequently aimed specifically at the goldfish, a living being, rather than the training context; (4) the pre-exposure to the shuttle tank was an important part of this training procedure, that is, only subjects habituated to the shuttle tank avoided the goldfish. Results are discussed in the framework of the Interactive Learning Hypothesis, which has been developed as an ethological approach to a higher-order conditioning paradigm. Received: 15 January 1999 / Accepted after revision: 18 August 1999     

Analyzing Models of Career Decision Self-Efficacy: First-Order,Hierarchical, and Bifactor Models of the Career Decision Self-Efficacy Scale

The goal of the study was to examine the dimensionality of the Career Decision Self-Efficacy Scale Short Form (CDSES-SF, Betz et al. 1996). Integrating several previous findings from different cultures, we found that the bifactor structure of the CDSES-SF on a Hungarian sample of 649 respondents showed the best model fit. This structure includes a general CDSE factor covering 15 items and the original five specific factors (self-appraisal, occupational information, goal selection, planning, and problem solving) covering three items each. This short form of CDSES shows an acceptable model fit and appropriate reliability in terms of the Cronbach’s alpha and omega values. Regarding career decision self-efficacy, a large proportion of variance was explained by the general factor and to a smaller extent by the specific factors. These results can be considered as a first step in resolving the paradox of the dimensionality of CDSES-SF.     

Semantic priming effects from single words in a lexical decision task

The present research examines the semantic priming effects of a centrally presented single prime word to which participants were instructed to either "attend and remember" or "ignore". The prime word was followed by a central probe target on which the participants made a lexical decision task. The main variables manipulated across experiments were prime duration (50 or 100 ms), the presence or absence of a mask following the prime, and the presence (or absence) and type of distractor stimulus (random set of consonants or pseudowords) on the probe display. There was a consistent interaction between the instructions and the semantic priming effects. Relative to the "attend and remember" instruction, an "ignore" instruction produced reduced positive priming from single primes presented for 100 ms, irrespective of the presence or absence of a prime mask, and regardless of whether the probe target was presented with or without distractors. Additionally, reliable negative priming was found from ignored primes presented for briefer durations (50 ms) and immediately followed by a mask. Methodological and theoretical implications of the present findings for the extant negative priming literature are discussed.     

The Elusive Nature of Executive Functions: A Review of our Current Understanding

Executive functions include abilities of goal formation, planning, carrying out goal-directed plans, and effective performance. This article aims at reviewing some of the current knowledge surrounding executive functioning and presenting the contrasting views regarding this concept. The neural substrates of the executive system are examined as well as the evolution of executive functioning, from development to decline. There is clear evidence of the vulnerability of executive functions to the effects of age over lifespan. The first executive function to emerge in children is the ability to inhibit overlearned behavior and the last to appear is verbal fluency. Inhibition of irrelevant information seems to decline earlier than set shifting and verbal fluency during senescence. The sequential progression and decline of these functions has been paralleled with the anatomical changes of the frontal lobe and its connections with other brain areas. Generalization of the results presented here are limited due to methodological differences across studies. Analysis of these differences is presented and suggestions for future research are offered.     

Finitary Polyadic Algebras from Cylindric Algebras

It is known that every α-dimensional quasi polyadic equality algebra (QPEA _α ) can be considered as an α-dimensional cylindric algebra satisfying the merrygo- round properties . The converse of this proposition fails to be true. It is investigated in the paper how to get algebras in QPEA from algebras in CA. Instead of QPEA the class of the finitary polyadic equality algebras (FPEA) is investigated, this class is definitionally equivalent to QPEA. It is shown, among others, that from every algebra in a β-dimensional algebra can be obtained in QPEA _β where , moreover the algebra obtained is representable in a sense. Presented by Daniele Mundici Supported by the OTKA grants T0351192, T43242.     

Sensitivity of the 16 PF Motivational Distortion Scale to response bias

The shortened versions of the 16 PF (Forms C or D) were given to 227 college students (who took Form D twice), 33 prisoners (who took Forms C and D), and 95 substance abusers (who took Form C twice). All were asked to answer honestly, then retake these tests to appear in a better light. Significant differences in Motivational Distortion scores were found between test and retest in each group.