Uso de la técnica de economía de fichas para incrementar conductas de tratamiento en adultos mayores con sarcopenia / Use of a token economy to increase target behaviors in older people with sarcopenia

La sarcopenia está caracterizada por la baja masa y fuerza muscular en los adultos mayores. La implementación de técnicas de modificación de la conducta como la técnica de economía de fichas (TEF) puede fungir como estrategia para mejorar la adherencia al tratamiento. El objetivo fue evaluar el efecto de la TEF sobre las conductas de tratamiento: realizar la rutina de ejercicio de resistencia, consumir el suplemento de proteína y consumir el suplemento de vitamina D. Se realizó un estudio de caso de múltiples sujetos en ocho adultos mayores con sarcopenia. El estudio estuvo conformado por tres fases: pre-intervención, intervención conductual y post-intervención conductual. Se evaluó la frecuencia de las conductas de tratamiento en las tres fases, además de los cambios en masa y fuerza muscular. El análisis de los datos se realizó por medio de estadística descriptiva. Los resultados mostraron que la frecuencia de las conductas de tratamiento aumentó en el 100% de los participantes en la etapa de intervención conductual al comparar con la fase pre-intervención, valores que no regresaron a cero en la fase post-intervención conductual. El 83.3 % de los participantes dejaron de tener el diagnóstico de sarcopenia con base en los cambios de masa y fuerza muscular.

Sarcopenia is characterized by low muscle mass and strength in older adults. It is caused by decreased physical activity and quality of dietary intake. Therefore, the implementation of behavior modification techniques such as the token economy technique can serve as a strategy to improve treatment. The aim of the current study was to evaluate the effect of the token economy technique on treatment behaviors. A multiple case studies with an ABC-type design was conducted in eight older adults with sarcopenia. The intervention consisted of modification of treatment-related behaviors; in addition, changes in muscle mass and strength were assessed. The results showed that the frequency of target behaviors increased in 100% of the participants in the intervention stage compared to baseline. The frequency of the target behaviors did not return to the obtained baseline compared to the maintenance stage. 83.3% of the participants changed their sarcopenia diagnosis.

Papel de la motivación sobre la memoria emocional durante la etapa preescolar: un análisis preliminar. Papel de la motivación sobre la memoria emocional durante la etapa preescolar: un análisis preliminar / Role of motivation on emotional memory during preschooler stage: A preliminary analysis

La memoria emocional es una memoria de largo término con contenido emocional, positivo o negativo, donde los eventos emocionales se recuerdan mejor que los neutros. La motivación se define como un impulso para comportarse de una manera determinada, y puede dividirse en intrínseca (sin recompensas) y extrínseca (dirigida a metas). Debido a que los procesos cognitivos son favorecidos por la motivación, el objetivo de este trabajo fue analizar la interacción entre motivación y memoria de imágenes negativas, neutras y positivas, en dos grupos de niñas y niños de 5 años (recompensado y no recompensado). Los grupos no difirieron en el recuerdo de las imágenes de las tres valencias. Sólo en el grupo recompensado, las imágenes negativas fueron mayormente recordadas, lo cual indicaría que la recompensa luego de la tarea, favoreció la evocación posterior, y que este recuerdo fue diferencial en función del contenido emocional de las imágenes.

Emotional memory is defined as a long-term memory with emotional content, positive or negative, where emotional events are better remembered than neutral ones. Motivation is defined as an impulse to behave in a certain way, and can be divided into intrinsic (without rewards) and extrinsic (goal oriented). Cognitive processes are favored by motivation, so the objective of this work was to analyze the interaction between motivation and memory of images with different emotional valence in two groups of 5-year-old children (rewarded and not rewarded). The groups did not differ in the recall of any of the three valences. Only in the rewarding group did the negative images be remembered, which would indicate that the reward after the task favored the later evocation and that this memory was differential according to the emotional content of the images.

Estado da arte sobre recompensas em organizações no Brasil: uma análise bibliométrica da literatura nacional de 2000-2011 / Rewards in organizations: a bibliometric analysis of Brazilian literature from 2000-2011

Este artigo demonstra como o construto recompensas em organizações está sendo definido e operacionalizado pela comunidade científica nacional. A abordagem bibliométrica foi utilizada para o planejamento, a coleta e a análise de dados. Foram mapeadas as publicações com "recompensa" no título, no resumo ou nas palavras- - chave, em 24 periódicos científicos nacionais de psicologia e de administração, e em anais de três eventos dessas áreas no período de 2000 a 2011. Os resultados apontaram 101 publicações. A leitura integral das publicações gerou as seguintes análises: número de autores, distribuição da frequência de publicações por ano; percentual de publicações em periódicos e anais de eventos, e definições de recompensas utilizadas. O artigo também categorizou as publicações sobre recompensas em função de seu tema: "determinantes organizacionais", "consequentes individuais", "justiça organizacional", "consequentes organizacionais", "recompensas internacionais", "recompensas de executivos", "determinantes de gênero", "processos psicossociais relacionados às recompensas" e como uma "dimensão em escala de outros construtos". O artigo realiza uma síntese destas análises e indica áreas para o desenvolvimento de novas pesquisas na área de recompensas em organizações de trabalho no Brasil...

This paper analyzes how the construct "rewards in organizations" is defined and operationalized by the Brazilian scientific community. A bibliometric approach was used to plan for, collect, and analyze the data. We searched for papers with the term "reward" in the title, abstract, or keywords, in twenty-four Psychology and Business Administration journals and three conference proceedings published in Brazil in the 2000-2011 period. The results pointed to 101 articles. A full reading of the articles generated analysis of the following aspects: number of authors, articles per year, percentage of articles in journals and conference proceedings of psychology and business administration; and definitions of "rewards in organizations" in the articles. Papers were also categorized based on the focus of the study: organizational determinants; individual outcomes; organizational justice; organizational outcomes; international rewards; executive rewards; gender determinants; rewards psychology; and as a dimension in scales of other constructs. The paper also indicates areas for further research regarding rewards in organizations in Brazil...

Modification of Severe Violent and Aggressive Behavior among Psychiatric Inpatients through the Use of a Short-Term Token Economy

PURPOSE: Meager research has been carried out to determine the effectiveness of the token economy among patients behaving violently in mental hospitals. The purpose of this study was to examine the effectiveness of the Short-Term Token Economy (STTE) on violent behavior among chronic psychiatric in-patients. METHODS: A nonequivalent control group design method was utilized. Participants in an experimental group (n=22) and control group (n=22) took part in this study from January to April, 2008. Observation on aggressive behavior among male in-patients in one hospital as a baseline was made during the week before the behavior modification program and measurement of aggressive behavior was done using the Overt Aggression Scale (OAS), which includes verbal attacks, property damage and physical attacks. RESULTS: The aggressive behavior scores of the experimental group decreased, those of the control group, scores showed an increase after the eight-week behavior modification program utilizing STTE. CONCLUSION: The results of the study indicate that STTE is effective in reducing the incidence of aggressive behavior among male in-patients in psychiatric hospitals. The outcome of this study should be helpful in reducing the use of coercive measures or psychoactive medication in controlling the violent behavior among in-patients in hospitals.

effect of social and token economy reinforcements on academic achievement of students with intellectual disabilities

This study investigates the effect of social and token economy reinforcements on academic achievement of 9th grade boy students with intellectual disabilities in an experimental science class in Tehran Province. The method used for this study was experimental by pre-test, post- test with a control group. The boy students with intellectual disabilities from three junior high schools participated in this study. The sample consisted of thirty, 9th grade boy students with intellectual disabilities in the selected schools; the schools were chosen by the multistage cluster method. To measure the progress of students in the science class, a teacher made test and the Wechsler intelligence test for matching the groups for IQ were used. To ensure validity, the content validity criteria depended tests calculated by the Lashe method and teachers' perspective were used. The reliability coefficient was obtained by the reliability coefficient of related tests; the percent agreement method and the obtained data were analyzed using one-way variance analysis and Shefe prosecution test. The results showed that there was a significant increase in academic achievement of students with intellectual disabilities when using token economy than using social reinforcements compared with the control group. Also, when using social reinforcements, the academic achievement of students was more than the control group. Token economy and social reinforcements increased the academic achievement of students with intellectual disabilities in the science class; and also the effect of token economy reinforcements was more than social reinforcements on the subjects

Efeitos de manipulações de propriedades formais de estímulos verbais sobre o comportamento / Effects of manipulation of formal properties of verbal stimuli on behavior

Objetivando avaliar os efeitos de estímulos antecedentes verbais sobre o comportamento, 24 estudantes universitários foram expostos a um procedimento de escolha segundo o modelo; a tarefa consistia em apontar para cada um dos três estímulos de comparação. O comportamento correto era reforçado em razão fixa 6. Na Condição 1, a ordem de apresentação dos estímulos nas Fases 2, 3, 4 e 5 era: instrução correspondente, instrução mínima, pergunta correspondente, pergunta mínima, respectivamente. As oito condições diferiam quanto à ordem de apresentação das instruções e perguntas. A instrução e a pergunta correspondente estabeleceram o comportamento correto em 95 por cento e 33 por cento dos casos, respectivamente. A instrução e a pergunta mínima não estabeleceram o comportamento correto. Os resultados têm implicações para as definições de regras.

Aiming to investigate the effects of antecedent verbal stimuli on behavior, twenty-four students were exposed to a match to sample procedure. The task consisted of pointing out to each of three comparison stimuli. The correct behavior was reinforced in fixed ratio 6. In Condition 1, the order of the presentation of the stimuli at the beginning of phases 2, 3, 4 and 5 was: corresponding instruction, minimal instruction, corresponding question, minimal question, respectively. The eight conditions differed only in the order in which the verbal stimuli were presented. The corresponding stimuli and corresponding question established the correct behavior in 95 percent and 33 percent of the cases, respectively. The minimal stimuli didn't establish the correct behavior. The results have implications on the defining of rules.

A Study on Health Education Program Development of Respiratory Communicable Disease Prevention for Preschool Children and the Measurement of It's Effects / 아동간호학회지

PURPOSE: The purpose of this study were to develop a respiratory communicable disease prevention program for preschoolers and measure it's effects. METHOD: The respiratory communicable disease prevention program for preschoolers consisted of texts, cartoons, photographs, discussions, demonstrations, puzzle games, die games, compensation/reinforcement, and token economy which were directed under the systematic design of instruction by Dick & Carey. This study was a quasi experimental study under the nonequivalent control group with pretest-posttest design. The subjects of this study were 45 preschool children who are attending 3 different district nursery schools and they were matched by the age, pretest knowledge, and pretest behavior. The instrument used in this study was criterion referenced test items that were developed by a researcher for evaluating the subject's knowledge, attitude, and behavior about respiratory communicable disease prevention. A pretest was administered a week before treatment. Experimental group I was administered by the treatment of respiratory communicable disease prevention program. Experimental group II was administered by above program with token economy program. The posttest was conducted on the eighth day. The third test for behavior was completed 15th day. To determine the effect of the program, the data were analyzed by the SAS 6.12 program with Kruskal Wallis test, ANCOVA, ANOVA, Duncan's test and paired t-test. RESULT: 1) There was a significant difference in knowledge between the experimental groups and control group(F=5.89, P=0.0197). 2) There was a significant difference in attitude between the experimental groups and control group(F=3.29, P=0.0469). 3) There was a non-significant difference in behavior between the experimental groups and control group(F=0.00, P=0.9512). 4) In the experimental group II, there was highly significant increase in behavior after token economy(t=4.5252, P=0.0005). CONCLUSION: It was found that the respiratory communicable disease prevention program for preschool children was effective in changing the preschoolers' knowledge and attitude on the respiratory communicable disease prevention, but not enough for changing the preschoolers' behavior. Token economy was improved as an effective and strong method for inducing desirable changes of preschoolers' behavior.

Magnitude, atraso e probabilidade de reforço em situações hipotéticas de risco / Magnitude, delay and probability of reinforcer in hypothetical risk situations

O presente trabalho investigou os efeitos de quantias de dinheiro descritas como a alternativa de risco e da instrução sobre o valor subjetivo do reforço. Oito estudantes realizaram escolhas hipotéticas entre quantias de dinheiro certas ou imediatas que eram ajustadas de acordo com o comportamento dos sujeitos, e cinco quantias de magnitudes maiores (V = R$10,00 a R$100.000,00) atrasadas (uma semana a 50 anos) ou probabilísticas (0,05 a 0,95). A instrução positiva descrevia as chances ou o atraso para receber cada quantia, enquanto a instrução negativa descrevia as chances de perder ou o tempo de espera para não perder as quantias. O valor subjetivo diminuiu com o aumento de V provável, e aumentou com o aumento de V atrasado. Os resultados individuais foram melhor descritos por uma função potência do que pela hiperbólica. A variação da instrução não produziu diferenças sistemáticas. Os resultados são evidências para uma interpretação diferente do efeito da magnitude do reforço sobre o desconto de quantias prováveis ou atrasadas.

The Effectiveness of Token economy on Oral Medication for Discharged Children / 아동간호학회지

Oral medication is the most frequent treatment measure for follow up treatment, which is leading by childrens' parents for them. In medication for preoperational children, they tend to concentrate the result rather than the motivation or cause. So, they frequently refuse medication which has bitter taste. So this study was attempted to develop token economy program which promote children's medication and help their parents, and to evaluate its' effect to construct the experimental ground. This study was a quasi experimental study under the nonequivalent control group posttest only design. The subjects of this study were 36 children who were aged 3-6 years and admitted pediatric ward because of their respiratory disease. Token economy program was consisted of cartoon record paper with stickers which expresses the better medication is taken the more germs die, and gift was given for back up reinforcer. To evaluate this program, time for oral medication was measured to both experimental group and control group. To determine the effect of the program, the data were analyzed by the SAS 6.12 program with t-test. The results of this study were as follows: 1. Between experimental group and control group, there was no significant difference (t=-1.2411, P=0.2374). Therefore, the hypothesis of this study was rejected. In conclusion, the token economy program for follow up care didn't change the children's behavior of oral medication. But it was found that the cartoon on recording paper gave a pleasure to participated children. Parents who were in experimental group expressed their appreciation for token economy program. So it can be said that the token economy program for follow up care was effective in inducing the children's pleasure and parents' satisfaction even though it wasn't successful in experiment. If the measuring tools for token economy program was made with well planned design and high reliability, it can be improved the effectiveness of that To develope the theoretical bases of nursing care, the well planned programs and measuring tools for them should be developed.

A Study of the Effectiveness of Token Economy on Children's Behaviors for Oral Medication / 아동간호학회지

Oral medication is one of the most frequent treatment in clinical care, and frequently refused by children. Children's refusal spends unuseful time and require nurses' patience. So this study was attempted to develop token economy program which promote children's medication, and to evaluate its' effect to construct the experimental ground. This study was a quasi experimental study under the nonequivalent control group non-synchronized design. The subjects of this study were 48 children who were aged 3-12 years and admitted pediatric ward because of their respiratory disease. Token economy program was consisted of cartoon record paper with stickers which expresses the better medication is taken the more germs die, and gift was given for back up reinforcer. To evaluate this program, time spent for oral medication was measured six time to both experimental group and control group, and measured the perceived effectiveness of this program by nurses. To determine the effect of the program, the data were analyzed by the SAS 6.12 program with t-test and mean, standard deviation. The results of this study were as follows: 1. In experimental group, time spent for oral medication was significantly shorter than in control group(t=5.24, p=0.0001). Therefore, the hypothesis of this study was strongly accepted. 2. Nurses perceived this program as an effective one(mean=3.125 ~ 3.792). The effectiveness occurred before, during and after medication as well as in parental responses, especially in using verbal dissatisfaction after medication. In conclusion, it was found that the token economy program for admitted children was effective in inducing the children's behavior of oral medication. There was no effectiveness in very highly anxious children. Whereas, it is recommended that this program should not be used for such children until they settle down. If the token economy program was made in various situation with creative thinking, it will be very useful nursing measurement, especially in caring for children. To improve the quality of nursing care, the various programs, which can give joyfulness to stressed patients should be developed.

Efeito de mudanças nas contingências programadas sobre o comportamento verbal e näo verbal de crianças / Effects of changes in programmed contingencies on verbal and non verbal behavior in children

O estudo investigou se comportamentos verbais e näo verbais mudam acompanhando as mudanças nas contingências programadas para o näo verbal. Trinta e três crianças, entre 7 e 8 anos, foram expostas a um procedimento de escolha segundo o modelo. Em cada tentativa, o experimentador apresentava, simultaneamente, um estímulo modelo e dois de comparaçäo e em seguida acendia uma luz. Na presença desses estímulos, o sujeito deveria tocar um de comparaçäo. O Experimento I foi constituído de duas condiçöes. Na Condiçäo Reforçamento Diferencial, as respostas näo verbais reforçadas durante a fase 1 näo foram instruídas. Na Condiçäo Instruçäo, foram previamente instruídas. Foram reforçadas as respostas näo verbais de escolher o estímulo igual na presença da luz verde e o diferente na presença da vermelha na Fase 1, o diferente na presença da luz verde e o igual na presença da vermelha na Fase 2, e o igual na presença da verde e o diferente na presença da vermelha na Fase 3. A transiçäo de uma fase para outra näo foi sinalizada. Durante as três fases, perguntava-se ao sujeito o que deveria fazer para ganhar ficha. As respostas näo verbais foram reforçadas continuamente (com fichas trocáveis por brinquedos) e as verbais näo foram reforçadas diferencialmente. Cada condiçäo durou uma única sessäo de 45 minutos, aproximadamente. O Experimento II foi constituído de três condiçöes. Replicopu as duas descritas no Experimento I e acrescentou a Condiçäo Múltiplas Instruçöes, que diferiu das demais na Fase 1. Essa fase foi constituída de três passos. Cada passo foi iniciado por uma instruçäo diferente, correspondente às contingências. Foram reforçadas as respostas näo verbais de escolher o estímulo igual na presença da luz verde e o diferente na presença da amarela no Passo 1, o igual na presença da amarela e o diferente na presença da vermelha no Passo 2 e o igual na presença da verde e o diferente na presença da vermelha no Passo 3. Os resultados mostraram que, nos dois experimentos, a correspondência entre o comportamento näo verbal e o verbal observada na Fase 1, mudou de acordo com as mudanças nas contingências nas Fases 2 e 3, quando o comportamento näo verbal foi estabelecido por reforçamento diferencial, e permaneceu inalterada, quando foi estabelecido por instruçöes. Isto foi observado mesmo quando as instruçöes geraram variaçäo comportamental antes das mudanças nas contingências. Esses resultados estendem para o comportamento verbal algumas conclusöes baseadas ...

Efforts and Therapeutic Factors of Short-term Token Economy for Negative Symptoms of Schizophrenic In-patients / 신경정신의학

OBJECTIVE: The negative symptoms of schizophrenia usually are not responsive to drug therapy to persist and make schizophrenics more difficult in their rehabilitation. The authors investigated the therapeutic effect of token economy(TET) for negative symptoms of schizophrenic patients, and attempted to develop a TET program f3r psychiatric wards in general hospital. METHODS: Negative subscale of PANSS was rated for 35 schizophrenics with negative symptoms as their main problems before and after short-term TET(less than 3 months). Therapeutic factors were identified by comparing patient and program variables between the achieved and the non-achieved group of each level of target behaviors. RESULTS: 1) Subtotal of negative subscale of PANSS was decreased from 31.57+/-4.32 at baseline to 20.66+/-4.63 artier treatment. With TET, symptoms of difficulty in abstract thinking' and 'stereotypic thinking' were less responsive than the other 5 items of the scale Also the dose of antipsychotics prescribed was reduced to 291.21+/-287.74mg/day from 487.58+/-372.79mg/day. 2) The achievement rate of level I (self-help) was 75%, level II (ward-activity) 78%, and level III (social activity/occupation) 68%, resulting in average 74% for all target behaviors. 3) On level II, dose of antipsychotics was lower, and on level III, number of admission was lower and female sex was more frequent in achieving patient group than nonachieving group. The rate of achievement was higher in case of special flood, reception, and outing with family applied as a reinforcer on level I, and reception on level II . CONCLUSION: These results showed that TET was effective for schizophrenic patients with negative symptoms in psychiatric ward. Further investigations to refine the individual program of TET will be needed far enhancement of it s therapeutic efficacy and smart application of it.

The effects of token economy program for a psychiatric patient with regressive behavior / 신경정신의학

No abstract available.

El Token Economy en la rehabilitación: comportamiento y apreciaciones de pacientes esquizofrénicos y alcohólicos / Token Economy in rehabilitation: behavior and appraisal of schizophrenic and alcoholic patients

El estudio mediante entrevistas estructurada a grupos respectivos de pacientes esquizofrénicos, pacientes alcohólicos y alumnas de terapia ocupacional y el seguimiento durante cuatro semanas del comportamiento de los grupos referidos de pacientes incluidos en una comunidad terapéutica donde se utiliza una variante del sistema de reforzamiento por fichas (Token Economy), evidenció en los tres grupos una apreciación adecuada de los objetivos y criterios muy favorables sobre su utilidad, factibilidad y nivel de exigencia, así como el consenso de que el personal idóneo para el otorgamiento de méritos era el de Terapia Ocupacional. Por otra parte, los grupos de pacientes evidenciaron mayor nivel de información sobre el sistema que el grupo de alumnas. Los pacientes alcohólicos lograron mayor promedio de méritos acumulados que los esquizofrénicos, pero fueron menos frecuentemente elegidos para cargos de autogobierno. Las alumnas evidenciaron juicios de valor muy positivos sobre el sistema y consideraron que la variante idónea era la de la tarjeta personal con señalización de méritos con gomígrafo

El Token economy: resultados de su utilización en una comunidad terapéutica / Token economy: results of its use in a therapeutic community

Se plantea la hipótesis de que con la aplicación de una variante del sistema de reforzamiento por fichas, podría incrementarse la participación de los pacientes en las actividades desarrolladas en una comunidad terapéutica para psicóticos y alcohólicos, y de que su aplicación era factible dentro de la estructura organizativa mantenida en los tres últimos años de trabajo. Para lograr estos objetivos se llevó a cabo una investigación desarrollada en tres etapas de tres meses cada una, y se controló durante las mismas el comportamiento de los pacientes en cuanto a: asistencia diaria a la reuníon matutina: cumplimiento del horario establecido para levantarse; y otros indicadores utilizados como control por no contemplarse en el sistema de gratificaciones. Durante la primera etapa se mantuvo la estructura anterior, basada exclusivamente en gratificaciones morales; durante la segunda, se ensayaron diferentes tipos de premios, donde se incluyeron excursiones, premios en efectivo y artículos de artesanía, así como pases especiales a los pacientes destacados. En la tercera etapa se estableció el otorgamiento del pase de fin de semans mediante la acumulación de puntos ganados por conductas positivas y anotados mediante gomígrafo en una tarjeta individual que se renovaría semanalmente. Los resultados evidenciaron un incremento importante de los indicadores contemplados en el sistema de gratificaciones, y poca modificación en aquellos que se utilizaron como controles y para valorar la influencia indirecta de otras conductas positivas. Se consideró que sus resultados apoyan las dos hipótesis planteadas, y que el pase de fin de semana otorgado mediante puntos acumulados contituye el premio de interés general más adecuado. Se concluye que la experiencia acumulada hizo incorporar dicho sistema a la estructura comunitaria del servicio docente "Rogelio Paredes", del Hospital Psiquiátrico de La Habana, y añadirlo al sistema previo de estimulaciones morales, exclusivamente