Investigation and management of chronic cough using a probability-based algorithm

Chronic cough is a common and distressing symptom. A novel algorithm has been developed for the management of chronic cough, in which an assessment of clinical probability of disease determines the need to proceed to investigation. In this study, the performance of this algorithm in clinical practice was prospectively evaluated. A total of 131 consecutively referred patients (86 females) whose principal presenting symptom was a cough of duration >8 weeks were studied. Their age (median (range)) was 60 (16-88) yrs and cough duration 5.9 (0.2-65) yrs. A cause of cough was established in 93% of cases. The most frequent diagnoses were asthma (24% of cases), gastro-oesophageal disease (22%), post-viral cough (8%), bronchiectasis (8%) and interstitial lung disease (8%). Primary pulmonary disease was significantly more likely in patients with a productive cough and in patients with an abnormal chest radiograph. Only a small proportion (<8%) of patients had multiple causes of cough. The probability of treatment started on the basis of a high clinical suspicion of either asthma, gastro-oesophageal disease or rhinitis being successful was 74%. Overall, 26% of the patients were managed successfully without the need for any form of investigation other than chest radiography and spirometry. Use of the algorithm resulted in identification of the cause of cough and successful treatment in the large majority of cases. It is concluded that this protocol has the potential to improve management by providing a structured approach, reducing the number of investigations performed, and minimising unnecessary delays in treatment.

A descriptive analysis of social consequences following problem behavior

The social consequences delivered for problem behavior during functional analyses are presumed to represent common sources of reinforcement; however, the extent to which these consequences actually follow problem behavior in natural settings remains unclear. The purpose of this study was to determine whether access to attention, escape, or tangible items is frequently observed as a consequence of problem behavior under naturalistic conditions. Twenty-seven adults who lived in a state residential facility and who exhibited self-injurious behavior, aggression, or disruption participated. Observers recorded the occurrence of problem behavior by participants as well as a variety of consequences delivered by caregivers. Results indicated that attention was the most common consequence for problem behavior and that aggression was more likely to produce social consequences than were other forms of problem behavior.

Cessation of prophylactic antibiotics for managing persistent vesicoureteral reflux

PURPOSE

We reviewed our experience with patients with vesicoureteral reflux treated off prophylactic antibiotics.

MATERIALS AND METHODS

We retrospectively reviewed the records of patients with vesicoureteral reflux treated off prophylactic antibiotics, noting the intervals on and off antibiotics, urinary tract infection, signs and symptoms associated with urinary tract infection, and renal ultrasound and dimercapto-succinic acid scan findings.

RESULTS

We identified 196 patients with vesicoureteral reflux treated off prophylactic antibiotics, including 122 who were infection-free while on and 124 who had no urinary tract infection while off prophylactic antibiotics. The infection rate on and off prophylactics was 0.29 and 0.24 urinary tract infections per patient per year, respectively. New scars were identified in 5 patients while on prophylactics and in 7 after antibiotics were discontinued. Comparing different subgroups off prophylactic antibiotics showed that children who presented with scarring had statistically fewer new scars than those with normal initial dimercapto-succinic acid imaging (p <0.043). Girls had significantly more urinary tract infections than boys while off prophylactics (p <0.01) despite the older age at antibiotic cessation. However, after infection occurred while off prophylactic antibiotics, new renal scars developed at about the same rate in boys and girls. Because most patients did not have a urinary tract infection while off prophylactic antibiotics, new renal scars developed in only 2.2% of all boys and 4% of all girls.

CONCLUSIONS

Our findings imply that discontinuing antibiotics is reasonable and safe in patients in whom vesicoureteral reflux fails to resolve.

Reinforcement schedule thinning following treatment with functional communication training

We evaluated four methods for increasing the practicality of functional communication training (FCT) by decreasing the frequency of reinforcement for alternative behavior. Three participants whose problem behaviors were maintained by positive reinforcement were treated successfully with FCT in which reinforcement for alternative behavior was initially delivered on fixed-ratio (FR) 1 schedules. One participant was then exposed to increasing delays to reinforcement under FR 1, a graduated fixed-interval (FI) schedule, and a graduated multiple-schedule arrangement in which signaled periods of reinforcement and extinction were alternated. Results showed that (a) increasing delays resulted in extinction of the alternative behavior, (b) the FI schedule produced undesirably high rates of the alternative behavior, and (c) the multiple schedule resulted in moderate and stable levels of the alternative behavior as the duration of the extinction component was increased. The other 2 participants were exposed to graduated mixed-schedule (unsignaled alternation between reinforcement and extinction components) and multiple-schedule (signaled alternation between reinforcement and extinction components) arrangements in which the durations of the reinforcement and extinction components were modified. Results obtained for these 2 participants indicated that the use of discriminative stimuli in the multiple schedule facilitated reinforcement schedule thinning. Upon completion of treatment, problem behavior remained low (or at zero), whereas alternative behavior was maintained as well as differentiated during a multiple-schedule arrangement consisting of a 4-min extinction period followed by a 1-min reinforcement period.

Spatial, cellular and temporal basis of vasopressin potentiation of norepinephrine-induced cAMP formation

This study investigated the spatial distribution of vasopressin V(1) and beta(1)-adrenoceptors within hippocampal subfields and lamina in an attempt to localize the site(s) of interaction between these two receptor systems. In addition, the cell types, neuronal and glial, in which the vasopressin-induced neuromodulation occurs, were identified. Lastly, the temporal constraints of the potentiation induced by vasopressin were investigated. Results of these analyses demonstrated multiple sites within the hippocampus where the interaction between vasopressin and norephinephrine could occur. Moreover, vasopressin-induced potentiation of adrenergic stimulated cyclase occurred in both hippocampal neurons and glia whereas it did not occur in undifferentiated neurons. Analysis of the temporal constraints of vasopressin-induced potentiation revealed that pre-activation of the vasopressin V(1) receptor for 1 min yielded greater potentiation than simultaneous exposure to vasopressin and norepinephrine. These data provide insights into the spatial and temporal characteristics for the interaction between the vasopressin receptor and adrenoceptor systems and provide a cellular and biochemical rationale for the behavioral findings of Kovács and De Wied.

Response acquisition under direct and indirect contingencies of reinforcement

We compared the effects of direct and indirect reinforcement contingencies on the performance of 6 individuals with profound developmental disabilities. Under both contingencies, completion of identical tasks (opening one of several types of containers) produced access to identical reinforcers. Under the direct contingency, the reinforcer was placed inside the container to be opened; under the indirect contingency, the therapist held the reinforcer and delivered it to the participant upon task completion. One participant immediately performed the task at 100% accuracy under both contingencies. Three participants showed either more immediate or larger improvements in performance under the direct contingency. The remaining 2 participants showed improved performance only under the direct reinforcement contingency. Data taken on the occurrence of "irrelevant" behaviors under the indirect contingency (e.g., reaching for the reinforcer instead of performing the task) provided some evidence that these behaviors may have interfered with task performance and that their occurrence was a function of differential stimulus control.

A component analysis of "stereotypy as reinforcement" for alternative behavior

Results from several studies have suggested that the opportunity to engage in stereotypic behavior may function as reinforcement for alternative, more socially desirable behaviors. However, the procedural components of this intervention include several distinct operations whose effects have not been analyzed separately. While measuring the occurrence of stereotypy and an alternative behavior (manipulation of leisure materials), we exposed 3 participants to three or four components of a "stereotypy as reinforcement" contingency: (a) continuous access to materials, (b) prompts to manipulate materials, (c) restricted access to stereotypy (i.e., response blocking), and (d) access to stereotypy contingent on manipulating the materials. Continuous access to materials and prompting (a and b) produced negligible results. Restriction of stereotypy (c) produced a large increase in the alternative behavior of 2 participants, suggesting that response restriction per se may occasion alternative behavior. However, contingent access to stereotypy (d) was necessary to increase the 3rd participant's object manipulation; this finding provided some support for the use of stereotypy as reinforcement for alternative behavior. Finally, when transfer of the effects of intervention was assessed during periods in which active intervention components were withdrawn, the alternative behavior was maintained for 1 participant.

A method for identifying satiation versus extinction effects under noncontingent reinforcement schedules

We evaluated one method for determining whether response suppression under noncontingent reinforcement (NCR) is a function of satiation or extinction. Three individuals with developmental disabilities who engaged in self-injurious behavior (SIB) or aggression participated. Results of functional analyses indicated that their problem behavior was maintained by social-positive reinforcement. NCR procedures, individualized for each participant, were implemented in a multiple baseline across subjects design and were associated with decreases in all participants' problem behavior. Identification of the mechanism by which NCR produced these effects was based on examination of cumulative records showing response patterns during and immediately following each NCR session. Satiation during NCR should lead to a temporary increase in responding during the post-NCR (extinction) period due to a transition from the availability to the unavailability of reinforcement (satiation to deprivation). Alternatively, extinction during NCR should reveal no increase in responding during the extinction period because the contingency for the problem behavior would remain unchanged and the transition from satiation to deprivation conditions would be irrelevant. Results suggested that the operative mechanisms of NCR were idiosyncratic across the 3 participants and appeared to change during treatment for 1 of the participants.

Skill acquisition in the implementation of functional analysis methodology

Functional analysis methodology is a powerful assessment tool for identifying contingencies that maintain a wide range of behavior disorders and for developing effective treatment programs. Nevertheless, concerns have been raised about the feasibility of conducting functional analyses in typical service settings. In this study, we examined the issue of skill acquisition in implementing functional analyses by evaluating an instructional program designed to establish a basic set of competencies. Eleven undergraduate students enrolled in a laboratory course in applied behavior analysis served as participants. Their performance was assessed during scripted simulations in which they played the roles of "therapists" who conducted functional analyses and trained graduate students played the roles of "clients" who emitted self-injurious and destructive behaviors. To approximate conditions under which an individual might conduct an assessment with limited prior training, participants read a brief set of materials prior to conducting baseline sessions. A multiple baseline design was used to assess the effects of training, which consisted of reading additional materials, watching a videotaped simulation demonstrating correct procedural implementation, passing a written quiz, and receiving feedback on performance during sessions. Results showed that participants scored a relatively high percentage of correct therapist responses during baseline, and that all achieved an accuracy level of 95% or higher following training that lasted about 2 hr. These results suggest that basic skills for conducting functional analyses can be acquired quickly by individuals who have relatively little clinical experience.

Differential responding in the presence and absence of discriminative stimuli during multielement functional analyses

We evaluated the extent to which discriminative stimuli (S(D)s) facilitate differential responding during multielement functional analyses. Eight individuals, all diagnosed with mental retardation and referred for assessment and treatment of self-injurious behavior (SIB) or aggression, participated. Functional analyses consisted of four or five assessment conditions alternated in multielement designs. Each condition was initially correlated with a specific therapist and a specific room color (S(D)s), and sessions continued until higher rates of target behaviors were consistently observed under a specific test condition. In a subsequent analysis, the programmed S(D)s were removed (i.e., all conditions were now conducted by the same therapist in the same room), and sessions continued until differential responding was observed or until twice as many sessions were conducted with the S(D)s absent (as opposed to present), whichever came first. Results indicated that the inclusion of programmed S(D)s facilitated discrimination among functional analysis conditions for half of the participants. These results suggest that the inclusion of salient cues may increase either the efficiency of functional analyses or the likelihood of obtaining clear assessment outcomes.

Relative influences of establishing operations and reinforcement contingencies on self-injurious behavior during functional analyses

In the typical functional analysis in which the antecedent and consequent events associated with problem behavior are manipulated, the control condition involves elimination of both the relevant establishing operation (EO) and its associated contingency through a schedule of noncontingent reinforcement (usually fixed-time [FT] 30 s). In some functional analyses, however, antecedent events are manipulated in the absence of differential consequences, and a common test condition in such analyses also involves the delivery of reinforcement on an FT 30-s schedule. Thus, the same schedule of reinforcement (FT 30 s) is not considered to be an EO in the former type of analysis but is considered to be an EO in the latter. We examined the relative influences of EOs and reinforcement contingencies on problem behavior by exposing 6 individuals who engaged in self-injurious behavior (SIB) to four combinations of functional analysis conditions: EO present/contingency present, EO absent/contingency present, EO present/contingency absent, and EO absent/contingency absent. Results indicated that the only condition in which high rates of SIB were observed consistently was one in which the EO and the reinforcement contingency were both present. Implications of these results for the design of functional analysis test and control conditions are discussed.

Facilitating tolerance of delayed reinforcement during functional communication training

Few clinical investigations have addressed the problem of delayed reinforcement. In this investigation, three individuals whose destructive behavior was maintained by positive reinforcement were treated using functional communication training (FCT) with extinction (EXT). Next, procedures used in the basic literature on delayed reinforcement and self-control (reinforcer delay fading, punishment of impulsive responding, and provision of an alternative activity during reinforcer delay) were used to teach participants to tolerate delayed reinforcement. With the first case, reinforcer delay fading alone was effective at maintaining low rates of destructive behavior while introducing delayed reinforcement. In the second case, the addition of a punishment component reduced destructive behavior to near-zero levels and facilitated reinforcer delay fading. With the third case, reinforcer delay fading was associated with increases in masturbation and head rolling, but prompting and praising the individual for completing work during the delay interval reduced all problem behaviors and facilitated reinforcer delay fading.

Effects of continuous and intermittent reinforcement for problem behavior during functional communication training

We evaluated the effectiveness of functional communication training (FCT) in reducing problem behavior and in strengthening alternative behavior when FCT was implemented without extinction. Following the completion of functional analyses in which social-positive reinforcement was identified as the maintaining variable for 5 participants' self-injurious behavior (SIB) and aggression, the participants were first exposed to FCT in which both problem behavior and alternative behavior were reinforced continuously (i.e., on fixed-ratio [FR] 1 schedules). During subsequent FCT conditions, the schedule of reinforcement for problem behavior was made more intermittent (e.g., FR 2, FR 3, FR 5, etc.), whereas alternative behavior was always reinforced according to an FR 1 schedule. Results showed that 1 participant's problem behavior decreased and alternative behavior increased during FCT when both behaviors were reinforced on FR 1 schedules. The remaining 4 participants shifted response allocation from problem to alternative behavior as the schedule of reinforcement for problem behavior became more intermittent. These results suggest that individuals might acquire alternative responses during FCT in spite of inconsistencies in the application of extinction, although even small errors in reinforcement may compromise treatment effects.

Noncontingent reinforcement: effects of satiation versus choice responding

Recent research findings suggest that the initial reductive effects of noncontingent reinforcement (NCR) schedules on destructive behavior result from the establishing effects of an antecedent stimulus (i.e., the availability of "free" reinforcement) rather than extinction. A number of authors have suggested that these antecedent effects result primarily from reinforcer satiation, but an alternative hypothesis is that the individual attempts to access contingent reinforcement primarily when noncontingent reinforcement is unavailable, but chooses not to access contingent reinforcement when noncontingent reinforcement is available. If the satiation hypothesis is more accurate, then the reductive effects of NCR should increase over the course of a session, especially for denser schedules of NCR, and should occur during both NCR delivery and the NCR inter-reinforcement interval (NCR IRI). If the choice hypothesis is more accurate, then the reductive effects of NCR should be relatively constant over the course of a session for both denser and leaner schedules of NCR and should occur almost exclusively during the NCR interval (rather than the NCR IRI). To evaluate these hypotheses, we examined within-session trends of destructive behavior with denser and leaner schedules of NCR (without extinction), and also measured responding in the NCR interval separate from responding in the NCR IRI. Reductions in destructive behavior were mostly due to the participants choosing not to access contingent reinforcement when NCR was being delivered and only minimally due to reinforcer satiation.

Effects of reinforcement for alternative behavior during punishment of self-injury

A number of variables influence the effectiveness of punishment and may determine the extent to which less intrusive forms of punishment may be used as alternatives to more intrusive interventions. For example, it has been suggested that response suppression during punishment may be facilitated if reinforcement is concurrently available for an alternative response. However, results of basic research demonstrating this finding have not been replicated with interventions more commonly prescribed as treatments for problem behavior. We evaluated the effects of relatively benign punishment procedures (reprimands or brief manual restraint) on the self-injurious behavior of 4 individuals who had been diagnosed with mental retardation, when access to reinforcement for alternative behavior (manipulation of leisure materials) was and was not available. In all cases, punishment produced greater response suppression when reinforcement for an alternative response was available.

Reinforcement of compliance with respiratory treatment in a child with cystic fibrosis

An 8-year-old boy with cystic fibrosis (CF), mental retardation, and autism exhibited noncompliance with respiratory treatments that were essential for the management of his CF. A treatment involving shaping cooperation while still allowing escape for aggression and avoidance behavior resulted in increases compliance with respiratory treatments and decreases in problem behavior. Treatment gains were maintained over 3 months.

Organization of inputs to the dorsomedial nucleus of the hypothalamus: a reexamination with Fluorogold and PHAL in the rat

Possible inputs to the DMH were studied first using the fluorescent retrograde tracer Fluorogold, and identified cell groups were then injected with the anterograde tracer PHAL to examine the distribution of labeled axons in and around the DMH. From this work, we conclude that the majority of inputs to the DMH arise in the hypothalamus, although there are a few significant projections from the telencephalon and brainstem. With few exceptions, each major nucleus and area of the hypothalamus provides inputs to the DMH. Telencephalic inputs arise mainly in the ventral subiculum, infralimbic area of the prefrontal cortex, lateral septal nucleus, and bed nuclei of the stria terminalis. The majority of brainstem inputs arise in the periaqueductal gray, parabrachial nucleus, and ventrolateral medulla. In addition, it now seems clear that inputs to the DMH use only a few discrete pathways. Descending inputs course through a periventricular pathway through the hypothalamic periventricular zone, a medial pathway that follows the medial corticohypothalamic tract, and a lateral pathway traveling through medial parts of the medial forebrain bundle. Ascending inputs arrive through a midbrain periventricular pathway that travels adjacent to the cerebral aqueduct in the periaqueductal gray, and through a brainstem lateral pathway that travels through central and ventral midbrain tegmental fields and enters the hypothalamus, and then the DMH from more lateral parts of the medial forebrain bundle. The results are discussed in relation to evidence for involvement of the DMH in ingestive behavior, and diurnal and stress-induced corticosterone secretion.

Evaluating the reinforcing effects of choice in comparison to reinforcement rate

A concurrent-operants arrangement was used to evaluate a boy's preference for a choice condition (in which he chose the reinforcement) over a no-choice condition (in which the therapist selected the reinforcement for him) when (a) these conditions produced equal rates of reinforcement and (b) lower rates of reinforcement were associated with the choice condition. The boy preferred the choice condition even when it resulted in a much less favorable rate of reinforcement than the no-choice condition (up to 4000% less).

The evaluation and treatment of aggression maintained by attention and automatic reinforcement

In the current investigation, we used direct and indirect methods to assess and treat several topographies of aggression that were hypothesized to have separate operant functions in a young boy with severe mental ratardation and pervasive developmental disorder. First, a functional analysis of aggression, using the methods described by Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994), was conducted and produced inconclusive results. Next, indirect methods were used to develop a second functional analysis, which showed that chin grinding (firmly pressing and grinding his chin against the skin and bones of others) persisted independent of social contingencies and that the other topographies of aggression (e.g., hitting, kicking) were maintained by social positive reinforcement (attention). A treatment designed to decrease aggression maintained by attention--functional communication training with extinction--reduced all forms of aggression except chin grinding. This latter topography of aggression, which we hypothesized was maintained by automatic reinforcement, was reduced when the response--reinforcer relation was interrupted through response blocking and the child was provided with an alternative form of chin stimulation.

Functional analysis and treatment of destructive behavior maintained by termination of "don't" (and symmetrical "do") requests

We used descriptive assessment information to generate hypotheses regarding the function of destructive behavior for 2 individuals who displayed near-zero rates of problem behavior during an experimental functional analysis using methods similar to Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994). The descriptive data suggested that destructive behavior occurred primarily when caregivers issued requests to the participants that interfered with ongoing high-probability (and presumably highly preferred) behaviors (i.e., a "don't" or a symmetrical "do" request). Subsequent experimental analyses showed that destructive behavior was maintained by contingent termination of "don't" and symmetrical "do" requests but not by termination of topographically similar "do" requests. These results suggested that destructive behavior may have been maintained by positive reinforcement (i.e., termination of the "don't" request allowed the individual to return to a highly preferred activity). Finally, a treatment (functional communication training plus extinction) developed on the basis of these analyses reduced destructive behavior to near-zero levels.

Reductions in self-injury produced by transcutaneous electrical nerve stimulation

Transcutaneous electrical nerve stimulation is used to reduce pain but also may be useful for self-injurious behavior (SIB). In the current investigation, a microcurrent electromedical device, classified as a transcutaneous electrical nerve stimulator (TENS), was applied with a man with Down syndrome who displayed SIB that persisted in the absence of social contingencies. Although clinically significant results were not maintained, a clear difference in the rates of SIB during active and inactive TENS was observed.

Establishing discriminative control of responding using functional and alternative reinforcers during functional communication training

Functional communication training (FCT) is a popular treatment for problem behaviors, but its effectiveness may be compromised when the client emits the target communication response and reinforcement is either delayed or denied. In the current investigation, we trained 2 individuals to emit different communication responses to request (a) the reinforcer for destructive behavior in a given situation (e.g., contingent attention in the attention condition of a functional analysis) and (b) an alternative reinforcer (e.g., toys in the attention condition of a functional analysis). Next, we taught the participants to request each reinforcer in the presence of a different discriminative stimulus (SD). Then, we evaluated the effects of differential reinforcement of communication (DRC) using the functional and alternative reinforcers and correlated SDs, with and without extinction of destructive behavior. During all applications, DRC (in combination with SDs that signaled available reinforcers) rapidly reduced destructive behavior to low levels regardless of whether the functional reinforcer or an alternative reinforcer was available or whether reinforcement for destructive behavior was discontinued (i.e., extinction).

Assessment and treatment of destructive behavior maintained by stereotypic object manipulation

In the current investigation, 2 participants with mental retardation displayed property destruction and stereotypy, and both responses involved the same materials (e.g., breaking and tapping plastic objects). Three experiments were conducted (a) to indirectly assess the functions of these two responses, (b) to determine their relation to one another, and (c) to develop a treatment to reduce the more serious behavior, property destruction. In Experiment 1, previously destroyed materials were either present or absent, and their presence reduced property destruction but not stereotypy. In Experiment 2, matched toys (ones that produced sensory stimulation similar to stereotypy) were either present or absent, or were replaced by unmatched toys (for 1 participant). Matched toys produced large reductions and unmatched toys produced small reductions in property destruction and stereotypy. In Experiment 3, attempts to pick up undestroyed objects were either blocked or not blocked while matched toys were continuously available. Response blocking reduced property destruction (and attempts), prevented stereotypy, and increased manipulation of matched toys. These results suggest that the two aberrant responses formed a chain (e.g., breaking and then tapping the object), which was maintained by the sensory consequences (e.g., auditory stimulation) of the terminal response, and that previously destroyed material or matched toys made the initial response (property destruction) unnecessary.

The structural organization of connections between hypothalamus and cerebral cortex

Motivated behavior requires coordinated somatic, autonomic, and endocrine responses, and may be divided into initiation, procurement, and consummatory phases (Swanson, L.W. and Mogenson, G.J., Neural mechanisms for the functional coupling of autonomic, endocrine and somatomotor responses in adaptative behavior, Brain Res. Rev., 3 (1981) 1-34). Obviously, such behavior may involve the entire central nervous system, although it is important to identify circuitry or systems that mediate the behavior directed toward specific goal objects. This problem has recently been clarified by the identification of hypothalamic subsystems important for the execution of instinctive behaviors related to ingestion, reproduction, and defense. These subsystems are modulated by sensory (reflex), central control (e.g., circadian), and voluntary (cortical) inputs. The latter are dominated by inputs from the ventral temporal lobe and medial prefrontal region, which are both direct and via associated parts of the basal nuclei (ganglia). Hypothalamic output is characterized by descending projections to brainstem and spinal motor systems, and by projections back to the cerebral cortex, which are both direct and via a continuous rostromedial part of the dorsal thalamus. This thalamic region includes the anterior, medial, and midline groups, which in turn innervate a continuous ring of cortex that includes the hippocampal formation and the cingulate, prefrontal, and insular regions. Parts of this thalamic region also innervate the ventral striatum, which receives a massive input from the cortical rings as well.

Database challenges and solutions in neuroscientific applications

In the scientific community, the quality and progress of various endeavors depend in part on the ability of researchers to share and exchange large quantities of heterogeneous data with one another efficiently. This requires controlled sharing and exchange of information among autonomous, distributed, and heterogeneous databases. In this paper, we focus on a neuroscience application, Neuroanatomical Rat Brain Viewer (NeuART Viewer) to demonstrate alternative database concepts that allow neuroscientists to manage and exchange data. Requirements for the NeuART application, in combination with an underlying network-aware database, are described at a conceptual level. Emphasis is placed on functionality from the user's perspective and on requirements that the database must fulfill. The most important functionality required by neuroscientists is the ability to construct brain models using information from different repositories. To accomplish such a task, users need to browse remote and local sources and summaries of data and capture relevant information to be used in building and extending the brain models. Other functionalities are also required, including posing queries related to brain models, augmenting and customizing brain models, and sharing brain models in a collaborative environment. An extensible object-oriented data model is presented to capture the many data types expected in this application. After presenting conceptual level design issues, we describe several known database solutions that support these requirements and discuss requirements that demand further research. Data integration for heterogeneous databases is discussed in terms of reducing or eliminating semantic heterogeneity when translations are made from one system to another. Performance enhancement mechanisms such as materialized views and spatial indexing for three-dimensional objects are explained and evaluated in the context of browsing, incorporating, and sharing. Policies for providing the system with fault tolerance and avoiding possible intellectual property abuses are presented. Finally, two existing systems are evaluated and compared using the identified requirements.

Toward the development of structured criteria for interpretation of functional analysis data

Using functional analysis results to prescribe treatments is the preferred method for developing behavioral interventions. Little is known, however, about the reliability and validity of visual inspection for the interpretation of functional analysis data. The purpose of this investigation was to develop a set of structured criteria for visual inspection of multielement functional analyses that, when applied correctly, would increase interrater agreement and agreement with interpretations reached by expert consensus. In Study 1, 3 predoctoral interns interpreted functional analysis graphs, and interrater agreement was low (M = .46). In Study 2, 64 functional analysis graphs were interpreted by a panel of experts, and then a set of structured criteria were developed that yielded interpretive results similar to those of the panel (exact agreement = .94). In Study 3, the 3 predoctoral interns from Study 1 were trained to use the structured criteria, and the mean interrater agreement coefficient increased to .81. The results suggest that (a) the interpretation of functional analysis data may be less reliable than is generally assumed, (b) decision-making rules used by experts in the interpretation of functional analysis data can be operationalized, and (c) individuals can be trained to apply these rules accurately to increase interrater agreement. Potential uses of the criteria are discussed.

On the relative reinforcing effects of choice and differential consequences

Research on the reinforcing effects of providing choice-making opportunities to individuals with developmental disabilities (i.e., allowing them to choose reinforcers or tasks) has produced inconsistent results, perhaps because the mechanisms underlying such effects remain unclear. Choice may produce a reinforcement effect because it is correlated with differential consequences (i.e., choice may increase one's access to higher preference stimuli), or it may have reinforcement value independent of (or in addition to) the chosen stimulus. In Experiment 1, we used a concurrent-operants arrangement to assess preference for a choice condition (in which participants selected one of two available reinforcers) relative to a no-choice condition (in which the therapist selected the same reinforcers on a yoked schedule). All 3 participants preferred the choice option. In Experiment 2, we altered the schedules so that the participant selected one of two lower preference reinforcers in the choice condition, whereas the therapist selected a higher preference stimulus for the participant either half or all of the time in the no-choice condition. Participants typically allowed the therapist to select reinforcers for them (i.e., they allocated responding to the no-choice condition) when it resulted in greater access to higher preference stimuli.

On the relation of mands and the function of destructive behavior

When standard analogue functional analysis procedures produce inconclusive results in children with conversational speech, the child's mands may help to identify the function of destructive behavior. In the current investigation, functional analyses conducted with 2 children who exhibited self-injury, aggression, and property destruction were undifferentiated across conditions. Based on informal observations and school and parental report, an analysis was conducted using mands to help determine the function of the destructive behavior. Using a multielement design, the therapist's compliance with the child's mands occurred either on a fixed-ratio (FR) 1 schedule or contingent on destructive behavior. Destructive behavior occurred at high and consistent levels when reinforcement of mands was contingent on destructive behavior and at near-zero levels when reinforcement of mands occurred on the FR 1 schedule. Based on these results, a second analysis was conducted in which compliance to mands occurred only when the child appropriately requested it (i.e., functional communication training plus extinction) and, for 1 child, compliance with mands was terminated contingent upon destructive behavior (i.e., functional communication training plus response cost). For both children, the rates of destructive behavior decreased markedly. The results suggest that assessing the child's mands may be useful in decreasing destructive behavior when a functional analysis is inconclusive.

Organization of projections from the dorsomedial nucleus of the hypothalamus: a PHA-L study in the rat

The axonal projections of the dorsomedial nucleus of the hypothalamus were investigated by using Phaseolous vulgaris-leucoagglutinin. The main conclusion of this work is that these projections are largely intrahypothalamic, with smaller components directed toward the brainstem and telencephalon. Although the intrahypothalamic pathways are very complex and intermix at various levels, we conclude that dorsomedial nucleus outputs follow three distinct ascending pathways: periventricular, coursing through the hypothalamic periventricular zone; ventral, traveling beneath the medial zone; and lateral, ascending in medial parts of the lateral hypothalamic area. Within the hypothalamus, the most densely innervated areas are the paraventricular nucleus, other dorsal regions of the periventricular zone, the preoptic suprachiasmatic nucleus, and the parastrial nucleus. Other significant terminal fields include the median preoptic, anteroventral periventricular, lateral part of the medial preoptic, and anteroventral preoptic nuclei; and the retrochiasmatic (including perisuprachiasmatic) area. Descending projections follow two pathways that also converge at various levels: a dorsal pathway in the midbrain periventricular system travels through, and primarily innervates, the periaqueductal and pontine gray, and a ventral pathway extends through ventromedial regions of the brainstem. Although sparse, fibers in the later pathway can be traced as far caudally as the nucleus of the solitary tract. The results are discussed relative to the pathways and properties of nearby hypothalamic medial zone nuclei. Dorsomedial nucleus projections are similar to certain other nuclei (e.g., anteroventral periventricular and parastrial) with predominantly intrahypothalamic projections, and different from those arising in the medial zone nuclei (medial preoptic, anterior hypothalamic, ventromedial, and mammillary.

Evaluation of soil radioactivities using pedologically based sampling techniques

A new type of soil sampling protocol is suggested which has applicability to surveys of environmental radioactivity. Often there is a higher concentration of radionuclides in the lower B horizon than in the upper A horizon of well-drained, well-developed soils. It is recommended that soils be sampled pedologically, i.e., by soil horizon, rather than incrementally in depth. An example is given from a site in northern Louisiana where surface and/or the classical 15 cm ("six-inch") deep sampling could lead to erroneous conclusions regarding anthropogenic contamination.

Efferent connections of the medial prefrontal cortex in the rabbit

The different cytoarchitectonic regions of the medial prefrontal cortex (mPFC) have recently been shown to play divergent roles in associative learning in rabbits. To determine if these subareas of the mPFC, including areas 24 (anterior cingulate cortex), 25 (infralimbic cortex), and 32 (prelimbic cortex) have differential efferent connections with other cortical and subcortical areas in the rabbit, anterograde and retrograde tracing experiments were performed using the Phaseolus vulgaris leukoagglutinin (PHA-L), and horseradish peroxidase (HRP) techniques. All three areas showed local dorsal-ventral projections into each of the other areas, and a contralateral projection to the homologous area on the other side of the brain. All three also revealed a trajectory through the striatum, resulting in heavy innervation of the caudate nucleus, the claustrum, and a lighter projection to the agranular insular cortex. The thalamic projections of areas 24 and 32 were similar, but not identical, with projections to the mediodorsal nucleus (MD) and all of the midline nuclei. However, the primary thalamic projections from area 25 were to the intralaminar and midline nuclei. All three areas also projected to the ventromedial and to a lesser extent to the ventral posterior thalamic nuclei. Projections were also observed in the lateral hypothalamus, in an area just lateral to the descending limb of the fornix. Amygdala projections from areas 32 and 24 were primarily to the lateral, basolateral and basomedial nuclei, but area 25 also projected to the central nucleus. All three areas also showed projections to the midbrain periaqueductal central gray, median raphe nucleus, ventral tegmental area, substantia nigra, locus coeruleus and pontine nuclei. However, only areas 24 and the more dorsal portions of area 32 projected to the superior colliculus. Area 25 and the ventral portions of area 32 also showed a bilateral projection to the parabrachial nuclei and dorsal and ventral medulla. The dorsal portions of area 32, and all of area 24 were, however, devoid of these projections. It is suggested that these differential projections are responsible for the diverse roles that the cytoarchitectonic subfields of the mPFC have been demonstrated to play in associative learning.

Neuronal activity in the midline thalamic nuclei during Pavlovian heart rate conditioning

Multiple unit activity (MUA) was recorded from chronically implanted electrodes in the midline nuclei of the thalamus in rabbits receiving either Pavlovian heart rate (HR) conditioning, or explicitly unpaired presentations of the conditioned stimulus (CS) and unconditioned stimulus. Animals receiving paired training demonstrated increases in CS-evoked MUA compared to animals receiving unpaired training; however, these increases were small and only weakly correlated with the HR conditioned response, suggesting that the midline nuclei are only minimally, if at all, involved in associative learning.

A simplified alternative to the AOAC official method for cholesterol in multicomponent foods

An AOAC official method for quantitating cholesterol in multicomponent foods, which was first published in the 13th edition of the Official Methods of Analysis, is rarely used. The method includes so many operations and manipulations--all described in excruciating detail--that most laboratories shun it altogether. Intent on finding an alternative, laboratories have developed their own methods for specific foods. As a result, new methods have proliferated, but still no practical method has been developed for the broader categories of multicomponent foods. The aim of AOAC, which is to promote greater accuracy and uniformity of analytical results primarily through collaborative testing, has not been well served under these circumstances. A different approach guided the work reported in the present paper. This approach was directed toward updating and dramatically simplifying the existing AOAC official method. The method's chloroform-methanol-water mixed-solvent extraction is preserved; however, all the remaining steps have been streamlined, updated, or eliminated by using newer technology. Cholesterol is quantitated with highly specific capillary gas-liquid chromatography using the internal standardization technique. The lipid extract is prepared for the chromatography step by a brief saponification carried out in a culture tube. The resulting method has been validated by using Standard Reference Materials and the standard addition method. Because a simplified method is now available for quantitating cholesterol in the lipid extracts, the expectation is that more attention can be given to the development of improved and efficient extraction methods. This step remains as the central difficulty in any number of methods of analysis for lipid analytes.

Research on children's behavior after hospitalization: a review and synthesis

Despite the presence of considerable research on techniques for reducing distress associated with childhood hospitalization, few studies have examined the more basic issue of whether the event negatively affects children after discharge. A meta-analysis was conducted of studies using the Posthospital Behavior Questionnaire (the most commonly used method of examining posthospital behavior) to determine whether hospitalization results in negative behavioral change, the duration of this reaction, if detected, and factors potentially related to its strength. The mean weighted effect size was +.29 (Confidence interval .95 = +/- .07). Thus, in the absence of interventions, negative behavior tends to increase significantly after discharge (z = +3.99; p < .00006). However, this response diminishes with time and has largely disappeared after 2 weeks. Contrary to expectations, neither age of subjects nor their medical condition was related to their degree of upset. Subjects hospitalized for periods of 2 to 3 days exhibited more behavioral distress than did those hospitalized for either shorter or longer periods.

Research on the effect of experimental interventions on children's behavior after hospitalization: a review and synthesis

Despite continued interest in ameliorating the posthospital psychological effects of hospitalization on children, there have been no analytic reviews of the research on this topic. The present study synthesized all known research that evaluated experimental interventions through the use of the Posthospital Behavior Questionnaire (PHBQ), by far the most commonly used method of examining posthospital behavior. The mean weighted effect size (ES) was +.44, Confidence Interval (CI).95 = +/- .10. Thus, on the average, children who received experimental interventions tended to change their behavior in the direction of psychological upset less than children who did not (z = +4.81; p < .00006). Analyses of ES moderators indicated significant variations (p < .05) associated with (1) the year of the report, (2) questionnaire format, (3) study design, (4) variations in experimental treatment, (5) subject's age, and (6) length of hospitalization. Psychoeducational preparation was not effective with younger children. The benefits of experimental interventions persisted up to 4 weeks after discharge.

A comparison of fatty acid profiles and carcass characteristics of feedlot steers fed canola seed and sunflower seed meal supplements protected from metabolism in the rumen

The effect of feeding protected canola seed (PCS) and protected sunflower seed meal (PSM) supplements on the fatty acid profile and carcass characteristics of feedlot steers was examined. Fifty Hereford cross steers, average weight of 290 kg, were assigned to five groups of 10 and fed the following barley based concentrate rations for 133 days: I, control (containing 15% untreated sunflower seed meal (SSM)); 11, PSM 15%; 111, PCS 10%; IV, PSM 15% plus PCS 10%; V, PSM 15% plus PCS 15%. The inclusion of PCS, with and without PSM, increased the proportion of Cis unsaturated fatty acids in the subcutaneous, perirenal and omental fats; there were threefold increases in the proportion of linoleic (18: 2) acid, fivefold increases in linolenic (18 : 3) acid and smaller increases in the proportion of oleic acid (18 : 1). There was a 20-25% reduction in the proportion of palmitic acid, and the largest decrease was observed in the adipose tissue of steers receiving 15% PCS in the diet. Joint feeding of PCS and PSM significantly increased the dressing percentage of carcasses in Groups IV and V and fat depth in Group IV.

Mediodorsal thalamic lesions and Pavlovian conditioning of heart rate and eyeblink responses in the rabbit

Rabbits received ibotenic acid lesions of the mediodorsal nucleus of the thalamus (MD) or sham lesions. These animals were compared on 4 sessions of Pavlovian eyeblink and heart rate conditioning, in which a tone was the conditioned stimulus and a paraorbital electrical shock was the unconditioned stimulus. Lesions of MD retarded acquisition of the eyeblink conditioned response and abolished the late-occurring tachycardiac component of the heart rate conditioned response. The data are compatible with previous experiments suggesting that MD participates in the sympathetic control associated with somatomotor learning.

Differential inhibition by nedocromil sodium of superoxide generation elicited by platelet activating factor in human neutrophils

Nedocromil sodium (10(-10) - 10(-9) M) produced a dose-related inhibition of superoxide anion generation induced by platelet activating factor (PAF) in human polymorphonuclear leukocytes (PMNs). At a higher concentration (3 x 10(-7) M), nedocromil sodium significantly inhibited superoxide generation elicited by N-formyl-methionyl-leucylphenylalanine, but was unable to block the response to phorbol dibutyrate. Nedocromil sodium (10(-11) - 10(-5) M) enhanced PAF-stimulated lysozyme release in a non-concentration-dependent manner, and was completely ineffective in depressing PAF-induced release of [3H]arachidonic acid and the rise in cytosolic Ca2+. The preferential inhibitory effects of nedocromil sodium on PAF-induced activation of superoxide generation may provide insight into the therapeutic action of this drug as an anti-asthmatic agent.

Characterization of phospholipase A2 and acyltransferase activities in purified zymogen granule membranes

Phospholipase A2 and acyltransferase activities were identified in membranes associated with purified pancreatic zymogen granules. In homogenate and granule membranes, phospholipase activity was linearly related to protein concentration and was Ca2(+)-dependent with an alkaline pH optimum. The Ca2+ sensitivity was observed over the range of concentrations through which intracellular ionic Ca2+ is elevated by physiological stimuli in intact cells. Intact zymogen granules and granule membranes also demonstrated reacylating activity in the presence and absence of an exogenous acceptor. Reacylating activity was related to the concentration of lyosphospholipid added and was optimally activated at alkaline pH. A more rapid rate of reacylation was observed when [14C]arachidonoyl CoA was employed as the donor molecule rather than [3H]arachidonate (plus coenzyme A); this suggests the absence of acyl-CoA synthetase in the purified granule membranes. We conclude that granule membrane phospholipase A2 and acyltransferases may be involved in arachidonic acid turnover in exocrine pancreas and perhaps in membrane fusion events associated with exocytosis.