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Conditioning affects a wide range of behaviors, far beyond just salivation. One is how we react to painful stimuli. Our bodies work to maintain internal states within safe limits (homeostasis), and conditioning allows us to anticipate painful stimuli, and to take action to counteract them. Conditioning also affects a wide range of emotions, including fear, hunger, sexual arousal, and cravings for alcohol and drugs. And conditioning can also be used to treat problems involving these emotions. In aversion therapy, exposure to alcohol is followed by inducd illness; by creating an aversion to alcohol, this therapy has had considerable success in treating alcoholism. Conditioning has also been used to treat phobias. Phobias often develop through conditioning, and conditioning principles can be used to overcome them. In exposure therapies such as systematic desensitization, the feared stimulus is presented and not followed by harmful consequences (in one variant, virtual reality therapy, the stimuli are presented through virtual reality headsets). The aim is to extinguish the fear, and this treatment too has had considerable success.
This chapter examines the practice of the European Court of Human Rights (ECtHR), the Inter-American Court of Human Rights (IACtHR), the African Court of Human and Peoples’ Rights (ACtHRP) and that of the ECOWAS Court. The analysis centers on comparable cases from their jurisprudence, where human rights claims have been filed due to health injuries allegedly caused by toxic exposure. The chapter addresses inter alia the role of the precautionary principle as a framing technique, applicable causal inquiries, the evidentiary practice of these fora and their deferential standards of review. It extensively criticizes the causal inquiry of the ECtHR, where causal links between toxic emissions and health injuries are apparently assessed based on non-scientific, intuitive proxies. From IACtHR jurisprudence the Human Rights and the Environment Advisory Opinion will also be discussed with respect to the causality-based jurisdiction the court announced.
Virtual reality exposure therapy (VRET) is currently being used to treat social anxiety disorder (SAD); however, VRET's magnitude of efficacy, duration of efficacy, and impact on treatment discontinuation are still unclear.
We conducted a meta-analysis of studies that investigated the efficacy of VRET for SAD. The search strategy and analysis method are registered at PROSPERO (#CRD42019121097). Inclusion criteria were: (1) studies that targeted patients with SAD or related phobias; (2) studies where VRET was conducted for at least three sessions; (3) studies that included at least 10 participants. The primary outcome was social anxiety evaluation score change. Hedges' g and its 95% confidence intervals were calculated using random-effect models. The secondary outcome was the risk ratio for treatment discontinuation.
Twenty-two studies (n = 703) met the inclusion criteria and were analyzed. The efficacy of VRET for SAD was significant and continued over a long-term follow-up period: Hedges' g for effect size at post-intervention, −0.86 (−1.04 to −0.68); three months post-intervention, −1.03 (−1.35 to −0.72); 6 months post-intervention, −1.14 (−1.39 to −0.89); and 12 months post-intervention, −0.74 (−1.05 to −0.43). When compared to in vivo exposure, the efficacy of VRET was similar at post-intervention but became inferior at later follow-up points. Participant dropout rates showed no significant difference compared to in vivo exposure.
VRET is an acceptable treatment for SAD patients that has significant, long-lasting efficacy, although it is possible that during long-term follow-up, VRET efficacy lessens as compared to in vivo exposure.
Bisphenol-A (BPA) is associated with adverse health outcomes and is found in many canned foods. It is not understood if some BPA contamination can be washed away by rinsing. The objective of this single-blinded crossover experiment was to determine whether BPA exposure, as measured by urinary concentrations, could be decreased by rinsing canned beans prior to consumption. Three types of hummus were prepared from dried beans, rinsed, and unrinsed canned beans. Fourteen healthy participants ate two samples of each hummus over six experimental days and collected spot urine specimens for BPA measurement. The geometric mean BPA levels for dried beans BPA (GM = 0.97 ng/ml, 95%CI = 0.74,1.26) was significantly lower than rinsed (GM = 1.89 ng/ml, 1.37,2.59) and unrinsed (GM = 2.46 ng/ml, 1.44,4.19). Difference-in-difference estimates showed an increase in GM BPA from pre- to post-hummus between unrinsed and rinsed canned beans of 1.39 ng/ml, p-value = 0.0400. Rinsing canned beans was an effective method to reduce BPA exposure.
The diversity of experiences among bilingual children is reflected in the variability of abilities in each of their languages. This paper describes the CECER-DLL Child and Family, and Teacher Questionnaires and discusses the utility of these tools. These questionnaires were created to address the need for valid and reliable tools to document contextual characteristics and language experiences of young bilingual children in developmental and educational research. A multi-site validity study using the CECER-DLL Questionnaires demonstrates how children's language skills are influenced by language exposure at home and at school, mothers’ and teachers’ skills in each language, mother's generational status, and languages used during language and literacy activities at home.
It has been speculated that some drugs can be used against SARS-CoV-2. As for antiretrovirals, the follow-up of pre-exposure prophylaxis (PrEP) users during the coronavirus disease 2019 (COVID-19) outbreak may help to understand the potential protective effect of PrEP against SARS-CoV-2. We aimed to identify associations between oral PrEP use and COVID-19-related symptoms self-reporting. Phone call interviews or digital investigation (through WhatsApp® or e-mail) about oral PrEP regular use, social distancing, exposure to suspected or confirmed cases of SARS-CoV-2 infection and COVID-19-related symptoms. Among 108 individuals, the majority were cisgender, white and gay men. Although most of the individuals engaged in social distancing (68.52%), they kept on taking PrEP (75.93%). Few people have had contact with suspected or confirmed cases of COVID-19 (12.04%), but some had COVID-19-related symptoms the month before the interview (27.78%) including rhinorrheoa (56.67%), cough (53.33%), asthaenia (50.00%) and headache (43.33%). Also, oral PrEP was associated with lower self-reporting COVID-19-symptoms (OR 0.26, 95% CI 0.07–0.96, P = 0.04; h = 0.92) even after controlling confounders as social distancing, age, body-mass index and morbidities . In our sample, the regular use of oral PrEP was associated with lower self-reporting of COVID-19-related symptoms during the outbreak in São Paulo, Brazil.
Previous work suggests that child-internal and -external factors influence dual language learning (DLL), although more work is needed – to clarify the role of phonological short-term memory (PSTM) and language exposure in particular. Accordingly, we investigated the role of language exposure and PSTM in phonological awareness and receptive and expressive vocabulary development in the majority language in DLL. PSTM was measured with both a language-specific and language-universal nonword repetition task (NWR). Sixty-five DLL preschoolers were assessed twice, five months apart. Results show that maternal majority-language proficiency as well as language-specific and universal NWR predicted all outcomes, whereas length of exposure to the majority language only predicted receptive and expressive vocabulary. Current exposure did not predict any outcome. The findings extend previous research on child-internal and child-external factors as predictors of DLL to phonological awareness and language-universal NWR.
In session 5, interoceptive exposure is introduced, focusing on dizziness sensations that are induced by head rolling. There is also the creation of positive associations to dizziness sensations and addressing of catastrophic cognitions about them. We use head rolling to educate about dizziness, to create positive reassociations to dizziness and other sensations, to address distress associations to the symptoms, to reduce fears of dizziness, and to act as interoceptive exposure that creates new nonthreatening associations to the symptoms that decreases fear and other negative associations. There is also further training in emotion regulation (emotion flexibility) by practicing certain emotions.
The objective of this study was to examine associations between media contact and posttraumatic stress in a sample with a large number of individuals who were directly exposed to the September 11, 2001 (9/11) attacks and to compare outcomes in exposed and unexposed participants.
Structured interviews and questionnaires were administered to a volunteer sample of 254 employees of New York City businesses 35 months after the attacks to document disaster trauma exposures, posttraumatic stress outcomes, and media contact and reactions.
Media variables were not associated with psychopathological outcomes in exposed participants, but media contact in the first week after the attacks and feeling moderately/extremely bothered by graphic 9/11 media images were associated with re-experiencing symptoms in both the exposed and unexposed participants. Feeling moderately/extremely bothered by graphic media images was associated with hyperarousal symptoms in exposed participants.
The findings suggest that media contact did not lead to psychopathology in exposed individuals, although it was associated with normative distress in both exposure groups. Because of the potential for adverse effects associated with media contact, clinicians and public health professionals are encouraged to discuss concerns about mass trauma media contact with their patients and the public at large.
The present study aimed to investigate the association of early-life exposure to famine with abdominal fat accumulation and function and further evaluate the influence of first-degree family history of diabetes and physical activity on this association. The present work analysed parts of the REACTION study. A total of 3033 women were enrolled. Central obesity was defined as waist circumferences (W) ≥ 85 cm. Chinese visceral adiposity index (CVAI) was used to evaluate visceral adipose distribution and function. Partial correlation analysis showed BMI, W, glycated Hb and CVAI were associated with early-life exposure to famine (both P < 0·05). Logistic regression showed that the risks of overall overweight/obesity and central obesity in fetal, early-childhood, mid-childhood and late-childhood exposed subgroups were increased significantly (all P < 0·05). Compared with the non-exposed group, the BMI, W and CVAI of fetal, early- to late-childhood exposed subgroups were significantly increased both in those with or without first-degree family history of diabetes and in those classified as physically active or inactive, respectively (all P < 0·05). The associations of BMI, W and CVAI with early-life exposure to famine were independent of their associations with first-degree family history of diabetes (all P < 0·01) or physical activity status (all P < 0·001). Early-life exposure to famine contributed to abdominal fat accumulation and dysfunction, which was independent of the influence of genetic background and exercise habits. Physical activity could serve as a supplementary intervention for women with high risk of central obesity.
Understanding the effects of predicted rising sea levels, combined with changes in precipitation and freshwater inflow on key estuarine ecosystem engineers such as the eastern oyster would provide critical information to inform restoration design and predictive models. Using oyster ladders with shell bags placed at three heights to capture a range of inundation levels, oyster growth of naturally recruited spat was monitored over the course of 6 months. Oyster numbers and shell heights were consistently highest in bottom and mid bags experiencing greater than 50% inundation (mid: 63 ± 7%; bottom: 95 ± 3%). Identifying thresholds for optimal oyster growth and survival to enhance restoration engineering would require finer scale evaluation of inundation levels.
While exposure and response prevention (ERP) is the most effective treatment for obsessive compulsive disorder (OCD), less is known about the specific mechanisms underlying symptom change after ERP.
We tested the hypothesis that the frequency of self- and therapist-guided ERP related to the extent of symptom reduction and that this link is mediated by increased self-efficacy.
In a sample of 377 in-patients with a primary diagnosis of OCD receiving in-patient CBT, we assessed symptoms (YBOCS-SR) and self-efficacy (General Self-Efficacy Scale), before and after treatment, as well as the frequency of therapist- and self-guided ERP sessions.
Patients with more therapist-guided ERP sessions during treatment showed more symptom reduction and the association of self-guided ERP on outcome was mediated by enhanced self-efficacy.
These findings highlight the importance of both therapist- and self-guided ERP sessions and suggest that therapists should conduct a sufficient number of ERP sessions to optimise treatment.
The objective of this study was to investigate the relative contributions of university education, exposure specific training, and beliefs about exposure therapy (ET) in relation to the frequency, duration, and intense delivery of ET by Australian psychologists. Associations between clinicians’ use of and theoretical conceptualisation of ET, and attachment style were also evaluated. A total of 115 Australian psychologists (N = 94 females) completed an online survey. Findings revealed that a majority of participants used cognitive behaviour therapy (93%) and ET (88%) to treat anxiety disorders, including obsessive-compulsive disorder. The majority who used ET (90%) reported using therapist-assisted in vivo exposure with clients. Findings also showed that therapists spend 42% of session time on exposure. Moreover, therapists who reported more comprehensive training had more positive beliefs about ET. Positive beliefs about ET, and clearer conceptualisation of treatment, were related to greater use and more intense implementation of ET. Psychologists with a more preoccupied or dismissive attachment style were less likely to deliver intense ET. The findings suggest that ET-specific training may be a powerful medium to improving the adoption and application of ET. Clinician's theoretical conceptualisation of ET and interpersonal attachment style are also worthy targets for future research and training in ET.
With close to 7,000 languages in use around the world today (Lewis, Simons, & Fennig, 2009) and only 195 countries (United Nations, 2018), being completely monolingual is quite rare as multilingualism is often the norm (Grin, 2004). Looking through the research literature, however, it would appear as though bilinguals are a unique population with distinct advantages or disadvantages from monolinguals. Spear (1984) proposed that what infants of all species learn and remember at any time in development is determined by the ecological challenges posed by their current environment and the survival value of responding successfully to them. Learning trajectories of monolingual and bilingual children are more similar than different, with differences reflecting the bilingual brain’s adaptations to the surrounding linguistic conditions. The rate and ease at which children learn language is surprising, as language acquisition is a very complex task, with infants having to quickly learn how to identify patterns within a continuous string of speech sounds (Saffran, Aslin, & Newport, 1996).
Head impact exposure (HIE) in youth football is a public health concern. The objective of this study was to determine if one season of HIE in youth football was related to cognitive changes.
Over 200 participants (ages 9–13) wore instrumented helmets for practices and games to measure the amount of HIE sustained over one season. Pre- and post-season neuropsychological tests were completed. Test score changes were calculated adjusting for practice effects and regression to the mean and used as the dependent variables. Regression models were calculated with HIE variables predicting neuropsychological test score changes.
For the full sample, a small effect was found with season average rotational values predicting changes in list-learning such that HIE was related to negative score change: standardized beta (β) = -.147, t(205) = -2.12, and p = .035. When analyzed by age clusters (9–10, 11–13) and adding participant weight to models, the R2 values increased. Splitting groups by weight (median split), found heavier members of the 9–10 cohort with significantly greater change than lighter members. Additionaly, significantly more participants had clinically meaningful negative changes: X2 = 10.343, p = .001.
These findings suggest that in the 9–10 age cluster, the average seasonal level of HIE had inverse, negative relationships with cognitive change over one season that was not found in the older group. The mediation effects of age and weight have not been explored previously and appear to contribute to the effects of HIE on cognition in youth football players.
This chapter will provide an overview of the various ways in which addictive disorders can be studied using human participants in laboratory settings. Human laboratory research provides an important piece of the translational research chain by enabling researchers to examine addictive behaviors in controlled settings using validated experimental methodologies. This chapter will cover three common laboratory techniques: cue exposure protocols, stress induction protocols, and addictive object self-administration protocols. The primary goal is to provide a methodological guide to conducting research using these approaches, but not extensively review previous research. Therefore, for each technique, we discuss the background and rationale, ethical considerations, strengths and limitations, and representative examples and promising future directions in the use of the technique to study substance and behavioral addictions.
The Developmental Origins of Health and Disease (DOHaD) framework aims to understand how environmental exposures in early life shape lifecycle health. Our understanding and the ability to prevent poor health outcomes and enrich for resiliency remain limited, in part, because exposure–outcome relationships are complex and poorly defined. We, therefore, aimed to determine the major DOHaD risk and resilience factors. A systematic approach with a 3-level screening process was used to conduct our Rapid Evidence Review following the established guidelines. Scientific databases using DOHaD-related keywords were searched to capture articles between January 1, 2009 and April 19, 2019. A final total of 56 systematic reviews/meta-analyses were obtained. Studies were categorized into domains based on primary exposures and outcomes investigated. Primary summary statistics and extracted data from the studies are presented in Graphical Overview for Evidence Reviews diagrams. There was substantial heterogeneity within and between studies. While global trends showed an increase in DOHaD publications over the last decade, the majority of data reported were from high-income countries. Articles were categorized under six exposure domains: Early Life Nutrition, Maternal/Paternal Health, Maternal/Paternal Psychological Exposure, Toxicants/Environment, Social Determinants, and Others. Studies examining social determinants of health and paternal influences were underrepresented. Only 23% of the articles explored resiliency factors. We synthesized major evidence on relationships between early life exposures and developmental and health outcomes, identifying risk and resiliency factors that influence later life health. Our findings provide insight into important trends and gaps in knowledge within many exposures and outcome domains.
Cloth face covering has been recommended by the Centers for Disease Control and Prevention to decrease community viral transmission. This study aims to determine the filtration efficiency and airflow resistance of common household materials available for homemade mask production by comparing numbers of fabrics, various layers, and manipulation.
Common household woven, knitted, and nonwoven fabrics were tested for filtration efficiency using a fit testing setup and airflow resistance with pressure gauge setup. Three different levels of layering (1, 2, and 4) were tested. Some fabric material was further tested after washing and drying. Filtration performance, the area under the fitted curve comparing airflow resistance and filtration efficiency, was calculated for each fabric material and compared.
Layering increased filtration efficiency and airflow resistance (P < 0.0001 and P < 0.01, respectively). Polyester felt demonstrated the highest filtration performance index (P < 0.0001), higher than all tested 100% cotton materials (all P < 0.05) as well as surgical masks (P < 0.05). Washing plus drying did not alter filtration performance significantly (P > 0.05).
A filtration performance of common household fabrics were compared. Homemade mask designers and producers will have improved data to better balance effectiveness, availability, and comfort with the goal of decreasing community viral transmission.
While neurodevelopmental disorders (NDDs) are highly heritable, several environmental risk factors have also been suggested. However, the role of familial confounding is unclear. To shed more light on this, we reviewed the evidence from twin and sibling studies. A systematic review was performed on case control and cohort studies including a twin or sibling within-pair comparison of neurodevelopmental outcomes, with environmental exposures until the sixth birthday. From 7,315 screened abstracts, 140 eligible articles were identified. After adjustment for familial confounding advanced paternal age, low birth weight, birth defects, and perinatal hypoxia and respiratory stress were associated with autism spectrum disorder (ASD), and low birth weight, gestational age and family income were associated with attention-deficit/hyperactivity disorder (ADHD), categorically and dimensionally. Several previously suspected factors, including pregnancy-related factors, were deemed due to familial confounding. Most studies were conducted in North America and Scandinavia, pointing to a global research bias. Moreover, most studies focused on ASD and ADHD. This genetically informed review showed evidence for a range of environmental factors of potential casual significance in NDDs, but also points to a critical need of more genetically informed studies of good quality in the quest of the environmental causes of NDDs.