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4-Hydroxycyclopentenones represent a privileged scaffold in chemical synthesis. A dysprosium(III) trifluoromethanesulfonate catalyzed rearrangement of furylcarbinols to 4-hydroxycyclopentenones via a 4π electrocyclization has been developed. The catalytic Piancatelli rearrangement affords a single trans-diastereomer from both aryl and alkyl substituted furylcarbinols.

The purpose of this descriptive field study is to determine what factors influence staff nurses' decisions for non-documentation of patient's response to analgesic administration. The study, based on Herbert Simon's descriptive model of decision making, has two components (a) to determine staff nurses' perceptions of the factors that influence their documentation as well as how frequently they document analgesic administration and (b) to determine the actual frequency of nurses' documentation. Data collected from 67 staff nurses using a questionnaire designed for this study and through an audit of 65 patients' charts allowed comparison of nurses' perceptions with their actual practice. Analysis involved both quantitative and qualitative approaches. The results of the study have implications for nurse educators and nurse administrators. [ABSTRACT FROM AUTHOR]

Antibody screening alone may fail to detect human immunodeficiency virus (HIV) in recently infected individuals. By U.S. Army regulation, HIV-infected soldiers are not permitted to deploy to areas of conflict, including Iraq and Afghanistan. We report here the first case of acute HIV infection (AHI) in a soldier in a combat area of operation detected by an enhanced U.S. Army HIV testing algorithm and discuss features of the tests which aided in clinical diagnosis. We tested the sample from the AHI case with a third generation HIV-1/HIV-2 plus O enzyme immunoassay, HIV-1 Western Blot, and a qualitative HIV-1 ribonucleic acid molecular diagnostic assay. Risk factors for HIV acquisition were elicited in an epidemiologic interview. Evaluation of the blood sample for AHI indicated an inconclusive serologic profile and a reactive HIV-1 ribonucleic acid result. The main risk factor for acquisition reported was unprotected sexual intercourse with casual strangers in the U.S. while on leave during deployment. The clinical diagnosis of AHI in a combat area of operation is important. Diagnosis of HIV is key to preventing adverse effects to the infected soldier from deployment stressors of deployment and further transmission via parenteral or sexual exposures. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding is vital for infant nutrition, especially for multiple babies (twins) born prematurely, yet breastfeeding rates among mothers of twins are lower compared with mothers of singleton babies. This review presents a synthesis of research findings on breastfeeding challenges experienced by mothers following twins' births. Methods: The electronic databases of CINAHL, MEDLINE, PsycINFO, EMBASE, and Web of Science were systematically searched in August 2023. All eligible quantitative, qualitative, and mixed-methods studies reported on breastfeeding challenges experienced by mothers of twins were included. The review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and followed Lucas et al.'s framework for thematic synthesis. Two reviewers independently screened all studies by title, abstract, and full text. The methodological quality of studies was independently assessed by two reviewers using the Joanna Briggs Institute critical appraisal tool and mixed-methods appraisal tool based on study design. Results: The review included 16 studies: quantitative ( n = 5), qualitative ( n = 8), and mixed methods ( n = 3), published between 1980 and 2022, involving 3,351 mothers from 16 countries. Three main themes were generated as follows: (1) transitioning to a new role, finding the balance between self and the newborns' needs; (2) the inevitability of emotional challenges; and (3) navigating support and information. Conclusion: The integrated findings of quantitative, qualitative, and mixed-methods studies on challenges experienced by mothers of twins will have scope for researchers to address the challenges through tailored intervention, education, and support and can help health care professionals revisit policy and practices to extend support services for mothers of twins beyond the initial postpartum and to the community for improving breastfeeding practices among mothers following multiple births.

Background: Benzodiazepines bind to γ-aminobutyric acid type A (GABA A ) receptor subtypes identified by different α subunits (i.e., α1GABA A , α2GABA A , α3GABA A , and α5GABA A ). Sedative-motor effects of benzodiazepines are thought to involve α1GABA A and α3GABA A subtypes., Aims: We evaluated observable measures of sedative-motor effects and species-typical behaviors in monkeys following acute administration of novel GABAkines (positive allosteric modulators of GABA A receptors), with varying degrees of selective efficacy at different GABA A receptor subtypes. We predicted that the induction of sedative-motor effects would depend on the degree of α1GABA A and α3GABA A efficacy., Methods: Adult female rhesus monkeys ( N  = 4) were implanted with chronic indwelling i.v. catheters. Quantitative behavioral observation was conducted by trained observers following administration of multiple doses of the conventional benzodiazepine alprazolam and the GABAkines MP-III-80 (preferential efficacy at α2/α3/α5GABA A subtypes), KRM-II-81, MP-III-24 (both with preferential efficacy for α2/α3GABA A subtypes), and MP-III-22 (preferential potency and efficacy for α5GABA A subtypes)., Results: As with alprazolam, all GABAkines induced significant levels of mild sedation ("rest/sleep posture"). Deep sedation was observed with alprazolam, MP-III-80, and MP-III-22; motoric effects (observable ataxia) were obtained with alprazolam, KRM-II-81, and MP-III-22 only. Surprisingly, the order of potency for rest/sleep posture was significantly associated only with potency at α5GABA A subtypes., Conclusions: GABAkines with preferential efficacy at α2/α3GABA A and/or α5GABA A subtypes engendered sedative-motor effects in monkeys, although only compounds with α5GABA A activity engendered deep sedation. Moreover, the significant relationship between potency obtained with in vitro electrophysiology data and the rest/sleep posture measure suggests a role for the α5GABA A subtype in this milder form of sedation., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Science, technology, engineering, and mathematics (STEM) education can be stressful, but uncertainty exists about (a) whether stressful academic settings elevate cortisol, particularly among students from underrepresented racial/ethnic groups, and (b) whether cortisol responses are associated with academic performance. In four classes around the first exam in a gateway college STEM course, we investigated participants' ( N = 271) cortisol levels as a function of race/ethnicity and tested whether cortisol responses predicted students' performance. Regardless of race/ethnicity, students' cortisol, on average, declined from the beginning to the end of each class and across the four classes. Among underrepresented minority (URM) students, higher cortisol responses predicted better performance and a lower likelihood of dropping the course. Among non-URM students, there were no such associations. For URM students, lower cortisol responses may have indicated disengagement, whereas higher cortisol responses may have indicated striving. The implication of cortisol responses can depend on how members of a group experience an environment., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: The objective of this review is to explore critical illness survivors' experiences of attending an intensive care unit (ICU) follow-up service., Introduction: A significant proportion of critical illness survivors will require ICU follow-up care to support adverse symptoms in health domains, including cognition, mental health, and physical and social function. While there is consensus on the need for ICU follow-up services, systematic reviews to date have not identified any significant impact of ICU follow-up services on clinical health outcomes. An understanding of survivors' experiences of attending an ICU follow-up service may improve the effectiveness and design of such services., Inclusion Criteria: This review will include studies that explore the experiences of adult ( 18 years of age) critical illness survivors who attended an ICU follow-up service following discharge from an ICU, regardless of the admitting diagnosis or ICU length of stay., Methods: This review will be conducted in line with the JBI methodological framework for qualitative systematic reviews. Electronic databases, including MEDLINE, CINAHL, PsycINFO, Embase, and Web of Science Core Collection, will be searched to identify relevant studies for inclusion in the review. Studies will be screened by 2 independent reviewers. Critical appraisal, data extraction, and data synthesis will be completed by 2 independent reviewers using a meta-aggregation method for data synthesis. Confidence in the research findings will be assessed and assigned a ConQual score., Review Registration: PROSPERO CRD42023404585., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 JBI.)

Introduction: Benzodiazepines (BZs) are prescribed as anxiolytics, but their use is limited by side effects including abuse liability and daytime drowsiness. Neuroactive steroids are compounds that, like BZs, modulate the effects of GABA at the GABA A receptor. In a previous study, combinations of the BZ triazolam and neuroactive steroid pregnanolone produced supra-additive (i.e., greater than expected effects based on the drugs alone) anxiolytic effects but infra-additive (i.e., lower than expected effects based on the drugs alone) reinforcing effects in male rhesus monkeys, suggestive of an improved therapeutic window., Methods: Female rhesus monkeys ( n =4) self-administered triazolam, pregnanolone, and triazolam-pregnanolone combinations intravenously under a progressive-ratio schedule. In order to assess characteristic sedative-motor effects of BZ-neuroactive steroid combinations, female rhesus monkeys (n=4) were administered triazolam, pregnanolone, and triazolam-pregnanolone combinations. Trained observers, blinded to condition, scored the occurrence of species-typical and drug-induced behaviors., Results: In contrast to our previous study with males, triazolam-pregnanolone combinations had primarily supra-additive reinforcing effects in three monkeys but infra-additive reinforcing effects in one monkey. Scores for deep sedation (i.e., defined as atypical loose-limbed posture, eyes closed, does not respond to external stimuli) and observable ataxia (any slip, trip, fall, or loss of balance) were significantly increased by both triazolam and pregnanolone. When combined, triazolam-pregnanolone combinations had supra-additive effects for inducing deep sedation, whereas observable ataxia was attenuated, likely due to the occurrence of robust sedative effects., Discussion: These results suggest that significant sex differences exist in self-administration of BZ-neuroactive steroid combinations, with females likely to show enhanced sensitivity to reinforcing effects compared with males. Moreover, supra-additive sedative effects occurred for females, demonstrating a higher likelihood of this adverse effect when these drug classes are combined., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Cook, Platt, Rüedi-Bettschen and Rowlett.)

To advance understanding of doctoral student experiences and the high attrition rates among Science, Technology, Engineering, and Mathematics (STEM) doctoral students, we developed and examined the psychological profiles of different types of doctoral students. We used latent class analysis on self-reported psychological data relevant to psychological threat from 1,081 incoming doctoral students across three universities and found that the best-fitting model delineated four threat classes: Lowest Threat, Nonchalant, Engaged/Worried, and Highest Threat. These classes were associated with characteristics measured at the beginning of students' first semester of graduate school that may influence attrition risk, including differences in academic preparation (e.g., amount of research experience), self-evaluations and perceived fit (e.g., sense of belonging), attitudes towards graduate school and academia (e.g., strength of motivation), and interpersonal relations (e.g., perceived social support). Lowest Threat students tended to report the most positive characteristics and Highest Threat students the most negative characteristics, whereas the results for Nonchalant and Engaged/Worried students were more mixed. Ultimately, we suggest that Engaged/Worried and Highest Threat students are at relatively high risk of attrition. Moreover, the demographic distributions of profiles differed, with members of groups more likely to face social identity threat (e.g., women) being overrepresented in a higher threat profile (i.e., Engaged/Worried students) and underrepresented in lower threat profiles (i.e., Lowest Threat and Nonchalant students). We conclude that doctoral students meaningfully vary in their psychological threat at the beginning of graduate study and suggest that these differences may portend divergent outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Stevens et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: The purpose of this study was to explore the lived experience of parents who care for children with cerebral palsy who function at a Gross Motor Function Classification System Level V, their beliefs about pain and non-pain-related emotional distress, and what it means to provide care and comfort., Methods: A phenomenological research design was used. Eleven participants were involved in this study. Pilot interviews informed the interview guide. Data were collected via participant journals and semi-structured interviews and analyzed using van Manen's framework for understanding experience. Trustworthiness criteria were met through a variety of strategies to ensure a rigorous research process., Results: Four themes were revealed in this study: "life is hard, heavy with burden, worry, and love," "remarkable," "identity transformation and empowerment," and "living a life that is planned, forced with structure and without spontaneity.", Conclusion: Caring for a child with lifelong needs is complex and requires a sensitive awareness of the contextual factors that impact daily decisions and routines. Understanding the lived experiences of parents who care for children with cerebral palsy Gross Motor Function Classification System Level V is necessary to provide psychologically informed, family-centered care. Comfort theory is presented as a framework for understanding what factors influence comfort and well-being. Understanding the complex nature of comfort for an individual can lead to greater understanding and empathy-driven care. These results will provide a foundation for future studies that aim to enhance pediatric physical therapist care through provider empathy and understanding., Impact: Caregiving parent experiences are impactful and play a large role in the life of children with developmental disabilities. Research exploring the lived experience of caregivers may enhance empathy-driven, psychologically informed, family-centered physical therapist care throughout the life course., Lay Summary: If you are a parent who cares for a child with severe cerebral palsy, you have unique experiences that impact day-to-day activities and lifelong planning for your family and child., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

What role does intergroup contact play in promoting support for social change toward greater social equality? Drawing on the needs-based model of reconciliation, we theorized that when inequality between groups is perceived as illegitimate, disadvantaged group members will experience a need for empowerment and advantaged group members a need for acceptance. When intergroup contact satisfies each group's needs, it should result in more mutual support for social change. Using four sets of survey data collected through the Zurich Intergroup Project in 23 countries, we tested several preregistered predictions, derived from the above reasoning, across a large variety of operationalizations. Two studies of disadvantaged groups (Ns = 689 ethnic minority members in Study 1 and 3,382 sexual/gender minorities in Study 2) support the hypothesis that, after accounting for the effects of intergroup contact and perceived illegitimacy, satisfying the need for empowerment (but not acceptance) during contact is positively related to support for social change. Two studies with advantaged groups (Ns = 2,937 ethnic majority members in Study 3 and 4,203 cis-heterosexual individuals in Study 4) showed that, after accounting for illegitimacy and intergroup contact, satisfying the need for acceptance (but also empowerment) is positively related to support for social change. Overall, findings suggest that intergroup contact is compatible with efforts to promote social change when group-specific needs are met. Thus, to encourage support for social change among both disadvantaged and advantaged group members, it is essential that, besides promoting mutual acceptance, intergroup contact interventions also give voice to and empower members of disadvantaged groups. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The COVID-19 pandemic has extensively changed the state of psychological science from what research questions psychologists can ask to which methodologies psychologists can use to investigate them. In this article, we offer a perspective on how to optimize new research in the pandemic's wake. Because this pandemic is inherently a social phenomenon-an event that hinges on human-to-human contact-we focus on socially relevant subfields of psychology. We highlight specific psychological phenomena that have likely shifted as a result of the pandemic and discuss theoretical, methodological, and practical considerations of conducting research on these phenomena. After this discussion, we evaluate metascientific issues that have been amplified by the pandemic. We aim to demonstrate how theoretically grounded views on the COVID-19 pandemic can help make psychological science stronger-not weaker-in its wake.

The effects of local periods of extinction on resurgence following transitions from variable-interval (VI) to fixed-interval (FI) schedules were studied using four pigeons exposed to a within-session resurgence procedure. Each session was divided into a Training (T) Alternative-Reinforcement (AR), and Resurgence Test (RT) phase. During the T phase, key pecking was reinforced under a VI 60-s schedule on one key. In the AR phase, responses reinforced in the T phase were extinguished, while responses to a different key were reinforced under a VI 90-s schedule. Next, responding to the same key that produced reinforcers in the AR phase was reinforced according to four different RT conditions: RT phase I (FI 90 s), RT phase II (FI 180 s), RT phase III (FI 45 s), or RT phase IV (extinction). The frequency of resurgence generally was an inverse function of the rate of reinforcement in the RT phase. Resurgence occurred less often when reinforcers were delivered under the FI 45-s schedule and more often under leaner schedules in the RT phase, peaking under extinction. The results show that resurgence may occur during local periods of extinction, with larger and more consistent effects occurring when the rate of reinforcement in the RT condition is leaner than it was during the preceding AR phase., (Published by Elsevier B.V.)

Objective: The objective of this review is to identify and synthesize the best available evidence on parents' and health professionals' experiences and perceptions of blended feeding in tube-fed children in order to promote effective decision-making on its use., Introduction: Blended feeding is not a new concept, despite the fact that commercial formulas have displaced its use in recent years. As feeding is viewed as an intimate experience between a parent and child, the choice of individualized blended feeds is something to be considered; however, professionals find there is a lack of evidence and discussion to support the use of blended feeding in practice. Therefore, the findings of this review may be beneficial, especially for professionals, and inform or promote more effective decision-making on the use of blended feeding., Inclusion Criteria: This review will consider studies that investigate parents and/or health professionals' experiences and perceptions of total or partial blended feeding in tube-fed children. Studies published in English that focus on qualitative data will be considered. There will be no restrictions on year or publication., Methods: The key information sources to be searched are: CINAHL Complete, MEDLINE, PsycINFO, Embase, Web of Science, WHO Library Database (GIM), and Google Scholar, along with several sources of gray literature. Two reviewers will independently screen titles and abstracts against the inclusion criteria, and will retrieve full text studies, assess methodological quality, and extract data. Findings will be pooled using meta aggregation, and a ConQual Summary of Findings will be presented., Systematic Review Registration Number: PROSPERO (CRD42020160357)., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 JBI.)

A growing empirical literature supports contingency management (CM) as an efficacious treatment for substance use disorders, especially when reinforcers are immediate, frequent, and of sufficient magnitude on escalating schedules. However, in real world-practice, CM is often conducted in ways that are inconsistent with research protocols. One reason for these inconsistencies may be due to pragmatic challenges inherent in conducting CM. In this article, we described an outpatient CM treatment program for drug use disorders and several specific challenges associated with adherence to CM parameters from research protocols. Finally, we propose possible solutions for these challenges and discuss implications for practice.

Following lever-press training on variable-interval 30-s schedules, rats were exposed to three types of schedules designed to eliminate lever pressing. The first two were variations on what is called a differential-reinforcement-of-other-behavior (DRO, "zero rate", or [target response] omission schedule) schedule. Under both variations, reinforcers were scheduled to occur in different conditions after either fixed or variable inter-reinforcer intervals (IRIs). Under one variation each lever press reset the time interval (i.e., "resetting DRO") and under the other a reinforcer delivery scheduled at the end of an IRI was cancelled by the first response during the IRI (i.e., "cycle DRO"). In another condition reinforcers were delivered independently of responding after fixed or variable time periods. Each of the DRO procedures reduced response rates quickly and to near zero across ten sessions. The time schedules also reduced responding, albeit at a slower rate. The results extend the analogy of omission training to freeoperant avoidance to shock-deletion avoidance schedules., (Copyright © 2020 Elsevier B.V. All rights reserved.)

We report a case of a 15-year-old female presenting with a serious multisystemic inflammatory illness during a surge of SARS-CoV-2 (COVID-19) cases in our county. The initial clinical findings of sore throat and neck stiffness, followed by signs of sepsis, raised suspicion of Lemierre syndrome early in her hospital course. However, the presence of severe respiratory distress, multifocal pneumonia with pleural effusion on chest radiograph, acute kidney injury, and the discovery of coronary artery ectasia, pointed to the new entity "multisystem inflammatory syndrome in children (MIS-C)." Immune modulatory treatment was thus considered. However, progressive neck pain and swelling, coupled with the eventual growth of Fusobacterium necrophorum on blood culture, eventually led to the correct diagnosis of Lemierre syndrome.

Retaining students in science, technology, engineering, and math (STEM) fields is critical as demand for STEM graduates increases. Whereas many approaches to improve persistence target individuals' internal beliefs, skills, and traits, the intervention in this experiment strengthened students' peer social networks to help them persevere. Students in a gateway biology course were randomly assigned to complete a control or values affirmation exercise, a psychological intervention hypothesized to have positive social effects. By the end of the term, affirmed students had an estimated 29% more friends in the course on average than controls. Affirmation also prompted structural changes in students' network positions such that affirmed students were more central in the overall course friendship network. These differing social trajectories predicted STEM persistence: Affirmed students were 11.7 percentage points more likely than controls to take the next course in the bioscience sequence, an effect that was statistically mediated by students' end-of-semester friendships., (Copyright © 2020 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution NonCommercial License 4.0 (CC BY-NC).)

The occurrence of extinction bursts-transient increases in response rate in excess of those observed in baseline during the period immediately following discontinuation of reinforcement of a response-was examined. In Experiment 1, key pecking of pigeons was reinforced according to a multiple schedule in which a variable-ratio schedule alternated with an interval schedule in which the reinforcers were yoked to the preceding variable-ratio component. In Experiments 2 and 3, rats were screened such that the lever-press response rates of different rats maintained by variable-interval schedules were either relatively high or relatively low. Following these baseline conditions, in Experiments 1 and 2 responding was extinguished by eliminating the food reinforcer and in Experiment 3 by removing the response-reinforcer dependency. Responses immediately following extinction implementation were examined. Response increases relative to baseline during the first 20 min of a 324.75-min extinction session (Experiment 1) or during the first 30-min extinction session (Experiments 2 and 3) were rare and unsystematic. The results (a) reinforce earlier meta-analyses concluding that extinction bursts may be a less ubiquitous early effect of extinction than has been suggested and (b) invite further experimentation to establish their generality as a function of preceding reinforcement conditions., (© 2020 Society for the Experimental Analysis of Behavior.)

Guided by the early findings of social scientists, practitioners have long advocated for greater contact between groups to reduce prejudice and increase social cohesion. Recent work, however, suggests that intergroup contact can undermine support for social change towards greater equality, especially among disadvantaged group members. Using a large and heterogeneous dataset (12,997 individuals from 69 countries), we demonstrate that intergroup contact and support for social change towards greater equality are positively associated among members of advantaged groups (ethnic majorities and cis-heterosexuals) but negatively associated among disadvantaged groups (ethnic minorities and sexual and gender minorities). Specification-curve analysis revealed important variation in the size-and at times, direction-of correlations, depending on how contact and support for social change were measured. This allowed us to identify one type of support for change-willingness to work in solidarity- that is positively associated with intergroup contact among both advantaged and disadvantaged group members.

Background: In recent years, pharmacological strategies have implicated α3 subunit-containing GABA A (α3GABA A ) receptor subtypes in the anxiety-reducing effects of benzodiazepines, whereas transgenic mouse approaches have implicated α2 or α5 subunit-containing GABA A receptors., Aims: We investigated the role of α3GABA A subtypes in benzodiazepine-induced behaviors by evaluating the anti-conflict, reinforcing, and sedative-motor effects of the novel compound YT-III-31, which has functional selectivity for α3GABA A receptors., Methods: Female and male rhesus monkeys were trained under a conflict procedure ( n  = 3), and a progressive-ratio schedule of reinforcement with midazolam as the training drug ( n  = 4). Sedative-like behavior was assessed using a quantitative behavioral observation procedure ( n  = 4). A range of doses of YT-III-31 was administered in all tests using the i.v. route of administration., Results: In the conflict procedure, increasing doses of YT-III-31 resulted only in dose-dependent attenuation of non-suppressed responding. In the progressive-ratio model of self-administration, YT-III-31 maintained average injections/session above vehicle levels at 0.1 and 0.18 mg/kg/injection. In quantitative observation procedures, YT-III-31 engendered mild sedative effects ("rest/sleep posture"), and deep sedation at the highest dose tested (5.6 mg/kg, i.v.), along with a suppression of tactile/oral exploration and increased observable ataxia. In contrast to other benzodiazepine-like ligands, YT-III-31 uniquely engendered a biphasic dose-response function for locomotion and suppressed self-groom., Conclusions: The finding that YT-III-31 lacked anti-conflict properties is in accordance with transgenic mouse research indicating no role for α3GABA A subtypes in benzodiazepine-mediated anxiety reduction. Instead, our results raise the possibility of a role for α3GABA A receptors in the abuse potential and sedative effects of benzodiazepine-type drugs.

Resurgence may be a mechanism of relapse in alcohol use disorder patients upon discharge from treatment as part of an abuse-treatment-relapse cycle. Adjunctive pharmacotherapies may be a means to facilitate behavioral treatments and block resurgence. Experiments were conducted using a model of alcohol self-administration to assess the repeatability of the elimination and resurgence of alcohol-maintained behavior and the effects of naltrexone. Experiments had three phases. In Phase 1, behavior was maintained by oral alcohol under a fixed-ratio schedule. In Phase 2, behavior was extinguished via condensed milk delivery under a differential-reinforcement-of-other-behavior (DRO) schedule. In Phase 3, the DRO schedule was eliminated. In Experiment 1, this 3-phase cycle was replicated 4 times. Across replications, response rates and dose of alcohol consumed did not differ in Phase 1, alcohol-maintained behavior was eliminated more rapidly in Phase 2, and the resurgence effect was generally stable in Phase 3. In Experiment 2, naltrexone was administered in Phase 2, Phase 3, or both Phases 2 and 3, to separate groups of rats. Naltrexone facilitated the elimination of alcohol-maintained behavior in Phase 2 and, the resurgence of alcohol-maintained behavior was reduced only for those rats that received naltrexone in both phases. Together, these experiments demonstrate that the resurgence of alcohol-maintained behavior is replicable within-subjects and, further, resurgence of alcohol-maintained behavior may be a useful model to evaluate pharmacological interventions to facilitate behavioral treatments and reduce the likelihood of relapse. Results with naltrexone support the use of medication-assisted therapy approaches to reduce relapse risk in patients. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Background: Most people with multiple sclerosis (MS) experience social stigma at mild-to-moderate levels, with potential implications for their health. However, little is known about how adults adapt to social stigma across their lives, or with respect to MS stigma in particular. Using a large national database and controlling for confounding demographic and health-related variables, this study examined whether longer MS duration was associated with reports of stigma in people with MS., Methods: Data were available from 6771 participants enrolled in the semiannual survey conducted by the North American Research Committee on Multiple Sclerosis (NARCOMS). Participants completed measures of MS stigma and reported on demographic and health-related covariates., Results: With disability level, age, and other demographic and health-related covariates taken into account, the longer respondents had lived with MS, the less stigma they felt. Results were similar for people's anticipation of stigma and their feelings of isolation because of stigma., Conclusions: As people gain experience living with MS, their adaptations to the social aspects of their illness may allow them to structure their lives so that they can mitigate the impact of stigma. Doctors, therapists, and other health care personnel should consider that patients with MS might be especially concerned and distressed by stigma earlier in the course of their illness., Competing Interests: The authors declare no conflicts of interest., (© 2019 Consortium of Multiple Sclerosis Centers.)

High rates of discipline citations predict adverse life outcomes, a harm disproportionately borne by Black and Latino boys. We hypothesized that these citations arise in part from negative cycles of interaction between students and teachers, which unfold in contexts of social stereotypes. Can targeted interventions to facilitate identity safety-a sense of belonging, inclusion, and growth-for students help? Experiment 1 combined social-belonging, values-affirmation , and growth-mindset interventions delivered in several class sessions in 2 middle schools with a large Latino population ( N = 669). This treatment reduced citations among negatively stereotyped boys in 7th and 8th grades by 57% as compared with a randomized control condition, 95% CI [-77%, -20%]. A growth-mindset only treatment was also effective (70% reduction, 95% CI [-84%, -43%]). Experiment 2 tested the social-belonging intervention alone, a grade earlier, at a third school with a large Black population and more overall citations ( N = 137 sixth-grade students). In 2 class sessions, students reflected on stories from previous 7th-grade students, which represented worries about belonging and relationships with teachers early in middle school as normal and as improving with time. This exercise reduced citations among Black boys through the end of high school by 65%, 95% CI [-85%, -15%], closing the disparity with White boys over 7 years by 75%. Suggesting improved interactions with teachers, longitudinal analyses found that the intervention prevented rises in citations involving subjective judgments (e.g., "insubordination") within 6th and 7th grades. It also forestalled the emergence of worries about being seen stereotypically by the end of 7th grade. Identity threat can give rise to cycles of interaction that are maladaptive for both teachers and students in school; targeted exercises can interrupt these cycles to improve disciplinary outcomes over years. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A three-year field experiment at an ethnically diverse middle school (N = 163) tested the hypothesis that periodic self-affirmation exercises delivered by classroom teachers bolsters students' school trust and improves their behavioral conduct. Students were randomly assigned to either a self-affirmation condition, where they wrote a series of in-class essays about personally important values, or a control condition, where they wrote essays about personally unimportant values. There were no behavioral effects of affirmation at the end of 6th grade, after students had completed four writing exercises. However, after four additional exercises in 7th grade, affirmed students had a significantly lower rate of discipline incidents than students in the control condition. The effect continued to grow and did not differ across ethnic groups, such that during 8th grade students in the affirmation condition on average received discipline at a 69% lower rate than students in the control condition. Analyses of student climate surveys revealed that affirmation was associated with higher school trust over time, a tendency that held across ethnic groups and partially mediated the affirmation effect on discipline. Repeated self-affirmation can bolster students' school trust and reduce the incidence of discipline in middle school, findings with both theoretical and practical implications., (Copyright © 2019 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.)

This study employed an intersectional approach (operationalized as the combination of more than one social identity) to examine the relationship between aspects of social identity (i.e., race, gender, age, SES), self-reported level of mistreatment, and attributions for discrimination. Self-reported discrimination has been researched extensively and there is substantial evidence of its association with adverse physical and psychological health outcomes. Few studies, however, have examined the relationship of multiple demographic variables (including social identities) to overall levels self-reported mistreatment as well the selection of attributions for discrimination. A diverse community sample ( N = 292; 42.12% Black; 47.26% male) reported on experiences of discrimination using the Everyday Discrimination Scale. General linear models were used to test the effect of sociodemographic characteristics (i.e., race, gender, age, SES) on total discrimination score and on attributions for discrimination. To test for intersectional relationships, we tested the effect of two-way interactions of sociodemographic characteristics on total discrimination score and attributions for discrimination. We found preliminary support for intersectional effects, as indicated by a significant race by age interaction on the selection of the race attribution for discrimination; gender by SES on the age attribution; age by gender on the education attribution; and race by SES on the economic situation attribution. Our study extends prior work by highlighting the importance of testing more than one factor as contributing to discrimination, particularly when examining to what sources individuals attribute discrimination., Competing Interests: The authors declare that they have no conflict of interest.

A subset of colorectal cancer (CRC) cases are attributable to Lynch syndrome (LS), a hereditary form of CRC. Effective evaluation for LS can be done on CRC tumors to guide diagnostic testing. Increased diagnosis of LS allows for surveillance and risk reduction, which can mitigate CRC-related burden and prevent cancer-related deaths. We evaluated participation in LS screening among newly diagnosed adult CRC patients. Some cases were referred for genetics evaluation prior to study recruitment (selective screening). Those not referred directly were randomized to the intervention or control (usual care) arms. Control cases were observed for one year, then given information about LS screening. Patients who declined participation were followed through the medical record. Of 601 cases of CRC, 194 (32%) enrolled in our study and were offered LS screening, 43 (7%) were followed as a control group, 148 (25%) declined participation and 216 (36%) were ineligible [63 (10%) of which received prior selective screening]. Six and nine cases of LS were identified through the intervention and selective screening groups, respectively. Overall, a higher proportion of PMS2 variants were identified in the intervention (3/6, 50%) versus selective screening groups (2/9, 22%) (not statistically significant). Eighty-eight percent and 23% of intervention and control patients, respectively, received LS screening. No control patients were found to have LS. Systems-based approaches are needed to ensure we fully identify LS cases. The proportion of LS cases from this program was 4% of newly diagnosed cases of CRC, similar to other programs.

Background: Previous studies have investigated α1GABA A and α5GABA A receptor mechanisms in the behavioral effects of ethanol (EtOH) in monkeys. However, genetic studies in humans and preclinical studies with mutant mice suggest a role for α2GABA A and/or α3GABA A receptors in the effects of EtOH. The development of novel positive allosteric modulators (PAMs) with functional selectivity (i.e., selective efficacy) at α2GABA A and α3GABA A receptors allows for probing of these subtypes in preclinical models of the discriminative stimulus and reinforcing effects of EtOH in rhesus macaques., Methods: In discrimination studies, subjects were trained to discriminate EtOH (2 g/kg, intragastrically) from water under a fixed-ratio (FR) schedule of food delivery. In oral self-administration studies, subjects were trained to self-administer EtOH (2% w/v) or sucrose (0.3 to 1% w/v) under an FR schedule of solution availability., Results: In discrimination studies, functionally selective PAMs at α2GABA A and α3GABA A (HZ-166) or α3GABA A (YT-III-31) receptors substituted fully (maximum percentage of EtOH-lever responding ≥80%) for the discriminative stimulus effects of EtOH without altering response rates. Full substitution for EtOH also was engendered by a nonselective PAM (triazolam), an α5GABA A -preferring PAM (QH-ii-066) and a PAM at α2GABA A , α3GABA A , and α5GABA A receptors (L-838417). A partial (MRK-696) or an α1GABA A -preferring (zolpidem) PAM only engendered partial substitution (i.e., ~50 to 60% EtOH-lever responding). In self-administration studies, pretreatments with the functionally selective PAMs at α2GABA A and α3GABA A (XHe-II-053 and HZ-166) or α3GABA A (YT-III-31 and YT-III-271) receptors increased EtOH, but not sucrose, drinking at doses that had few, or no, observable sedative-motor effects., Conclusions: Our results confirm prior findings regarding the respective roles of α1GABA A and α5GABA A receptors in the discriminative stimulus effects of EtOH and, further, suggest a key facilitatory role for α3GABA A and potentially α2GABA A receptors in several abuse-related effects of EtOH in monkeys. Moreover, they reveal a potential role for these latter subtypes in EtOH's sedative effects., (© 2019 by the Research Society on Alcoholism.)

Ketamine is one of the most commonly used anesthetics in human and veterinary medicine, but its clinical effectiveness is often compromised due to tolerance to its anesthetic effects. Although ketamine tolerance has been demonstrated in a number of behavioral measures, no published work has investigated tolerance to ketamine's anesthetic effects other than duration of anesthesia. In addition, a reported practice in anesthesiology is to alter anesthetic doses for procedures when the patient has a history of drug abuse. Empirically investigating the effects of administration of a drug of abuse on ketamine's potency and efficacy to produce anesthesia could help in the creation of anesthetic plans that maximize safety for both clinicians and patients. The goal of the current study was to test the effects of repeated administration of ketamine, morphine, or cocaine on ketamine's ability to produce anesthesia. In 2 studies, male Sprague-Dawley rats received daily injections of ketamine (32 or 100 mg/kg IP), morphine (3.2 or 5.6 mg/kg IP), or cocaine (3.2 or 10 mg/kg IP) for 14 consecutive days and then were tested on day 15 for ketamine-induced anesthesia by using a cumulative-dosing procedure (32 to 320 mg/kg IP). Chronic treatment with either ketamine or morphine-but not cocaine-produced tolerance to ketamine's anesthetic effects in a dose-dependent manner. These results suggest that ketamine's clinical effectiveness as an anesthetic will vary as a function of its history of use. Furthermore, given that chronic morphine administration produced tolerance to ketamine's anesthetic effects, various pain medications may reduce ketamine's effectiveness for anesthesia.

Resurgence is a reliable, transient effect that only occasionally is replicated more than once within a single experiment or subject. In the present experiments, within-session resurgence was generated repeatedly by dividing individual sessions into three phases (Training, Alternative-Reinforcement, and Resurgence-Test). In Experiments 1 and 2, resurgence reliably occurred in most of the 22-30 daily sessions when responding was reinforced on, respectively, fixed- and variable-interval schedules. Resurgence magnitude and duration did decrease across replications for some subjects, but not for others. To examine the utility of the procedure in studying the effects of an independent variable on resurgence, in Experiment 3 the effects of rich and lean baseline and alternative reinforcement rates on resurgence were compared. The target response was eliminated more rapidly, resurgence occurred more often, and usually was greater following rich alternative reinforcement rates. Resurgence was of greater magnitude when the baseline reinforcement rate was relatively lean compared to the alternative reinforcement rate. These experiments provide a reliable method for generating resurgence within individual sessions, instead of across multiple-session conditions, that can be repeated over many successive sessions., (© 2019 Society for the Experimental Analysis of Behavior.)

Rationale: People living with MS often report feeling stigmatized, but little research has examined the psychological impact of this, which is important considering the high prevalence of depression in this population., Objectives: The aim of this study was to assess, concurrently and prospectively, the association between stigma and depression in people living with MS., Methods: Data were available from 5369 participants enrolled in the semi-annual survey conducted by the North American Research Committee on Multiple Sclerosis (NARCOMS). Participants reported their MS stigma and depression in the spring 2013 update survey (T1) and their depression again one year later (T2). Demographic and health-related covariates were also assessed., Results: People experiencing higher levels of stigma reported more depression symptoms and were more likely to meet the threshold for clinical depression at both times, even controlling for covariates. Higher levels of stigma also predicted T2 depression, controlling for T1 depression (and covariates), suggesting a possible causal association. Greater psychosocial reserve, a composite of measures assessing participants' feelings of belonging, social support, and sense of control, attenuated the association between stigma and depression., Conclusions: Stigma is an important but understudied predictor of depression in people living with MS, but greater psychosocial reserve provides a buffer., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

The effect of response rates on resistance to change, measured as resistance to extinction, was examined in two experiments. In Experiment 1, responding in transition from a variable-ratio schedule and its yoked-interval counterpart to extinction was compared with pigeons. Following training on a multiple variable-ratio yoked-interval schedule of reinforcement, in which response rates were higher in the former component, reinforcement was removed from both components during a single extended extinction session. Resistance to extinction in the yoked-interval component was always either greater or equal to that in the variable-ratio component. In Experiment 2, resistance to extinction was compared for two groups of rats that exhibited either high or low response rates when maintained on identical variable-interval schedules. Resistance to extinction was greater for the lower-response-rate group. These results suggest that baseline response rate can contribute to resistance to change. Such effects, however, can only be revealed when baseline response rate and reinforcement rate are disentangled (Experiments 1 and 2) from the more usual circumstance where the two covary. Furthermore, they are more cleanly revealed when the programmed contingencies controlling high and low response rates are identical, as in Experiment 2., (© 2017 Society for the Experimental Analysis of Behavior.)

For almost 50 years, psychologists have been theorizing about and measuring religiosity essentially the way Gordon Allport did, when he distinguished between intrinsic and extrinsic religiosity. However, there is a historical debate regarding what this scale actually measures, which items should be included, and how many factors or subscales exist. To provide more definitive answers, we estimated a series of confirmatory factor analysis models comparing four competing theories for how to score Gorsuch and McPherson's commonly used measure of intrinsic and extrinsic religiosity. We then formally investigated measurement invariance across U.S. Protestants, Irish Catholics, and Turkish Muslims and across U.S. Protestants, Catholics, and Muslims. We provide evidence that a five-item version of intrinsic religiosity is invariant across the U.S. samples and predicts less warmth toward atheists and gay men/lesbians, validating the scale. Our results suggest that a variation of Gorsuch and McPherson's measure may be appropriate for some but not all uses in cross-cultural research.

A review of different investigators' definitions of resurgence revealed several common features: First, characteristics of the resurgent, or target, response, such as its transience; magnitude; time course within and across sessions; and relativity to a baseline response rate are not mentioned. Second, the target response is described as being established through its reinforcement in the first, or Training, phase of a resurgence procedure. Third, the target response must be eliminated as an alternative response is reinforced in the second, Alternative Reinforcement, phase of a resurgence procedure. Fourth, the alternative response must be extinguished during the Resurgence Test phase. Fifth, none of the definitions allude to any contribution of stimulus variables to resurgence. When reconsidered in light of contemporary research germane to these features, none of the reviewed definitions sufficiently reflect important variables in the generation and assessment of resurgence. The review concludes with a proposed working definition that takes into account contemporary research involving all of the aforementioned factors., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Small but timely experiences can have long-term benefits when their psychological effects interact with institutional processes. In a follow-up of two randomized field experiments, a brief values affirmation intervention designed to buffer minority middle schoolers against the threat of negative stereotypes had long-term benefits on college-relevant outcomes. In study 1, conducted in the Mountain West, the intervention increased Latino Americans' probability of entering a college readiness track rather than a remedial one near the transition to high school 2 y later. In study 2, conducted in the Northeast, the intervention increased African Americans' probability of college enrollment 7-9 y later. Among those who enrolled in college, affirmed African Americans attended relatively more selective colleges. Lifting a psychological barrier at a key transition can facilitate students' access to positive institutional channels, giving rise to accumulative benefits., Competing Interests: The authors declare no conflict of interest.

Universal screening for Lynch syndrome (LS) among all cases of colorectal cancer (CRC) could increase the diagnosis of LS and reduce morbidity and mortality of LS-associated cancers. Given universal screening includes all patients, irrespective of high risk factors such early age at onset or family history of CRC, it is important to understand perspectives of all patients and not just those at high risk. As part of a study to assess the feasibility and implementation of universal screening, 189 patients newly diagnosed with CRC were surveyed about their interest in screening for LS and communication of results with at-risk family members. Overall, participants responded positively regarding screening for LS, with most wanting to know their genetic risks in general (86%) and risk of hereditary CRC (93%). Prior to receiving screening results, most participants stated they intended to share their screening results with parents (89%), siblings (96%), and children (96%). Of the 28 participants who received a positive LS screening result, 26 (93%) reported sharing their result with at least one first-degree family member. Interest in screening for LS and communication of screening results with family members was not associated with high risk factors. This study indicates that patients are interested in being screened for LS and that sharing information on the risk of LS with at-risk family members is not a significant barrier. These findings provide novel insight into patient perspectives about screening for LS and can guide successful implementation of universal screening programs.