Introducing systems change in the schools: the case of school luncheons and vending machines

A major public health crisis facing America’s society is the increase in child and youth obesity, which has seen a fourfold increase in the last four decades. Major concerns include what children eat for school lunch and what other foods are available in schools. This paper illustrates efforts towards systems change in the luncheon program and food vending machines in the Chicago Public Schools. We discuss the different factors that lead to such changes using the framework of the social ecological model and the soft systems methodology, and we analyze how the resulting innovation was implemented and evaluated. First, we present a theoretical perspective to explain factors that influence children’s eating patterns from a systems approach. Second, we discuss the antecedent factors that lead to systems change. Finally, we examine challenges to systems change, such as resistance to change, different stakeholder priorities, lack of resources, institutional bureaucracy, and unrealistic funder expectations.     

Supportive interventions and nonsymbolic mental functioning

The author aims to show how supportive interventions are the analyst's most relevant therapeutic means to helping patients with a feeble symbolic system transform nonsymbolic episodes and reestablish symbolic mental functioning. Symbolic and nonsymbolic modes of mental functioning are first outlined. Supportive interventions are redefined as an analyst's effort at improving a patient's nonsymbolic mental functioning, by using principally pragmatic or interactive aspects of communication to deal with her or his patient's nonsymbolic in-session experiences. These interventions are psychoanalytic when transference focused, in so far as they foster the symbolization and transformation of more primitive (nonsymbolic) layers of the transference. Some probable mechanisms underlying the effect of supportive interventions on nonsymbolic functioning include the modification of mental procedures. Supportive interventions also help restore symbolic mental elaboration through the gratification of a basic ego or self-need, bringing about a temporary relief from psychic pain, with increased affect tolerance and a renewed capacity to use symbols. This soothing effect accounts for a missing link in Bion's model of the elaborative effect of the analyst's reverie.     

Relationship of pain tolerance with human aggression

In research with animals as well as samples of chronic pain patients and elderly persons, pain has been positively correlated with measures of irritability, hostility, and aggression. The present investigation examined the relationship of pain tolerance with aggression. 72 men participated in the Response Choice Aggression Paradigm, described previously by Zeichner and colleagues, in which aggressive response to provocation was possible but not required of participants. Subjective pain tolerance, defined as maximal electrical shock willingly tolerated by participants, was assessed. Significant but small Pearson product-moment correlations between pain tolerance and aggression ranged between .21 and .32, with the largest accounting for 9% of variance.     

Sharing <Emphasis Type="Italic">GJB2</Emphasis>/<Emphasis Type="Italic">GJB6</Emphasis> Genetic Test Information with Family Members

Although GJB2/GJB6 genetic testing for non-syndromic hearing loss is available, there is no information regarding sharing of test results with family members. A qualitative study was conducted to elucidate if, how, and why parents of a child with hearing loss share GJB2/GJB6 test results with relatives. Parents whose child had testing (n = 7 positive, n = 4 negative, n = 1 inconclusive results) participated in a semi-structured interview and responses were analyzed using qualitative methods. All participants shared the test result with at least one relative, but selective non-disclosure also was observed. Reasons for, and reactions to, sharing were diverse and differed as a function of test result. In comparing the results from this study to published literature, similarities and differences were identified with regards to disclosure of genetic test results for hearing loss versus other conditions. Differences suggest that hearing loss may have unique attributes that influence responses to genetic test information. Further research is needed to replicate these findings.     

Self-consciousness in non-communicative patients

The clinical and para-clinical examination of residual self-consciousness in non-communicative severely brain damaged patients (i.e., coma, vegetative state and minimally conscious state) remains exceptionally challenging. Passive presentation of the patient's own name and own face are known to be effective attention-grabbing stimuli when clinically assessing consciousness at the patient's bedside. Event-related potential and functional neuroimaging studies using such self-referential stimuli are currently being used to disentangle the cognitive hierarchy of self-processing. We here review neuropsychological, neuropathological, electrophysiological and neuroimaging studies using the own name and own face paradigm obtained in conscious waking, sleep, pharmacological coma, pathological coma and related disorders of consciousness. Based on these results we discuss what we currently do and do not know about the functional significance of the neural network involved in "automatic" and "conscious" self-referential processing.     

Working memory deficits in transgenic rats overexpressing human adenosine A2A receptors in the brain

Adenosine receptors in the central nervous system have been implicated in the modulation of different behavioural patterns and cognitive functions although the specific role of A(2A) receptor (A(2A)R) subtype in learning and memory is still unclear. In the present work we establish a novel transgenic rat strain, TGR(NSEhA2A), overexpressing adenosine A(2A)Rs mainly in the cerebral cortex, the hippocampal formation, and the cerebellum. Thereafter, we explore the relevance of this A(2A)Rs overexpression for learning and memory function. Animals were behaviourally assessed in several learning and memory tasks (6-arms radial tunnel maze, T-maze, object recognition, and several Morris water maze paradigms) and other tests for spontaneous motor activity (open field, hexagonal tunnel maze) and anxiety (plus maze) as modification of these behaviours may interfere with the assessment of cognitive function. Neither motor performance and emotional/anxious-like behaviours were altered by overexpression of A(2A)Rs. TGR(NSEhA2A) showed normal hippocampal-dependent learning of spatial reference memory. However, they presented working memory deficits as detected by performance of constant errors in the blind arms of the 6 arm radial tunnel maze, reduced recognition of a novel object and a lack of learning improvement over four trials on the same day which was not observed over consecutive days in a repeated acquisition paradigm in the Morris water maze. Given the interdependence between adenosinic and dopaminergic function, the present results render the novel TGR(NSEhA2A) as a putative animal model for the working memory deficits and cognitive disruptions related to overstimulation of cortical A(2A)Rs or to dopaminergic prefrontal dysfunction as seen in schizophrenic or Parkinson's disease patients.     

Psychosocial stress evoked by a virtual audience: relation to neuroendocrine activity.

A modified version of the Trier Social Stress Test (TSST) was employed to determine whether exposure to a virtual audience using virtual reality (VR) technology would prompt an increase of neuroendocrine activity comparable to that prompted by a real audience. Following an anticipatory period, participants completed a speech or a speech-plus-math challenge in front of either a virtual audience, a panel of judges they were led to believe was behind a one-way mirror, or an audience comprised of confederates. An additional group that had prepared a speech was simply directed to observe the virtual audience but did not deliver the speech. Finally, a control group completed questionnaires for the duration of the experiment. Cortisol samples were obtained upon arrival to the laboratory, just before the challenge, and 15 and 30 minutes after the task. Participants also completed a measure assessing stressor appraisals of the task before and after the challenge. Anticipation of the task was associated with a modest increase of cortisol levels, and a further rise of cortisol was evident in response to the challenge. The neuroendocrine changes evoked by the virtual audience were comparable to those elicited by the imagined audience (behind the one-way mirror) but less than changes evoked by the panel of confederates. Stressor appraisals were higher post-challenge compared to those reported prior to the task; however, appraisals were similar across each group. These data suggest that VR technology may be amenable to evaluating the impact of psychosocial stressors such as the TSST.     

The impact of national integration policies on prejudice and psychological well-being: The fundamental role of the clarity and coherence of integration policies

Recent advances in social psychological research have shown that national integration policies influence how immigrants are perceived and treated by the mainstream population. However, the processes by which these policies come to have an impact on prejudice and well-being of the general population are largely unknown. Moreover, past research has often relied on unrepresentative samples limiting generalizability. The present research proposes that when the national integration policies of a given society are perceived as clearly defined and coherent, they have a direct impact on the perceived cultural norm related to those national integration policies. In turn, the perceived cultural norm affects personal attitudes toward cultural norms (i.e., the degree to which individuals support a given policy), which influence the level of anti-immigrant prejudice as well as psychological well-being. Findings from two correlational studies with representative samples of the mainstream population conducted in France on the policy of secularism (N = 940) and in Québec on the policy of interculturalism (N = 912) supported the proposed theoretical model.     

Resident-Led Neighborhood Development to Support Health: Identifying Strategies Using CBPR

Evidence suggests that where people live, learn, work, and play affects a range of health outcomes for children and adults. Differential access to social, economic, and environmental supports puts some community members at greater risk, leading to disparities in health and well-being. The 2014 release of the For the Sake of All report highlighted persistent health disparities for African Americans in St. Louis, Missouri, and their social and economic impacts on the St. Louis region. This study extends this work by developing partnerships with community organizations and neighborhood residents to address health disparities. Community-based participatory research (CBPR) methods were utilized to engage partners in a 10-month research process to address community concerns that impact health. Seven community residents, neighborhood researchers, engaged in workshops to learn about the research process and used techniques to gather information to implement action strategies. Neighborhood researchers selected 14 vacant lots to implement their action plan, which included visions for repurposing the land into a community park, produced a report for dissemination, and organized a community action forum to communicate their findings. This study highlights a promising approach to promote healthy communities and health equity by empowering neighborhood residents using participatory methodologies.