Behavioral Economics and Physician Behavior

This study seeks to answer whether the availability heuristic leads physicians to utilize more medical care than is economically efficient. Do rare, salient events alter physicians' perceptions about the probability of patient harm? Do these events lead physicians to overutilize certain medical procedures? This study uses Pennsylvania inpatient hospital admissions data from 2009 aggregated at the physician level to investigate these questions. The data come from the 2009 Pennsylvania Health Care Cost Containment Council (PHC4). The study is divided into two parts. In Part I, we examine whether bad outcomes during childbirth (defined as maternal mortality, an obstetric fistula or a uterine rupture) lead physicians to utilize more cesarean sections on future patients. In Part II, we examine whether bad outcomes associated with appendicitis (defined as patient death, a perforated or ruptured appendix or sepsis) lead physicians to perform more negative appendectomies (appendectomies performed when the patient did not have appendicitis) on future patients. Overall the study does not find evidence to support the claim that the availability heuristic leads physicians to overutilize medical care on future patients. However, the study does find evidence that variations in health care utilization are strongly correlated with individual physician practice patterns. The results of the study also imply that physicians' financial incentives may be a source of variation in health care utilization.

Thought-Action Fusion and Neutralization Behavior

This study presents a new inventory to assess thought-action fusion (TAF). 160 college students ages 18 to 22 (M = 19.17, SD = 1.11) completed the new Modified Thought Action Scale (MTAFS). Results indicated high internal consistency in the MTAFS (Cronbach’s α = .95). A principal component analysis suggested a three factor solution of TAF-Moral (TAFM), TAFLikelihood (TAFL), and TAF-Harm avoidance-Positive (TAFHP) all with eigenvalues above 1, and factor loadings above .4. A second study examined the association between TAF, obsessivecompulsive and anxiety tendencies after the activation of TAF-like thought processes in a nonclinical sample (n=76). Subjects were randomly assigned to one of three treatment groups intended to provoke TAFL-self, TAFL-other, and TAF moral thought processes. Stepwise regression analyses revealed: 1) the Obsessive-Compulsive Inventory subscales Neutralizing and Ordering significantly predicted instructed neutralization behavior (INB) in non-clinical participants; 2) TAF-Likelihood contributed significant unique variance in INB. These findings suggest that the provocation of neutralization behavior may be mediated by specific subsets of TAF and obsessive-compulsive tendencies.

Spatial Learning and Stress Response of Male Rats Prenatally Exposed to Dexamethasone

Dexamethasone is routinely administered to women at risk for a preterm birth in order to enhance fetal lung development and reduce uterine contractions. Research has demonstrated possible behavioral abnormalities in adulthood as a result of dexamethasone treatment. Using nonlinear mixed effects modeling, this study found thatprenatal dexamethasone treatment impaired spatial learning and memory of adult male Sprague-Dawley rats. Prenatal dexamethasone treatment also led to more anxiety related behaviors on Elevated Plus Maze testing 1.5 hours after a stress challenge. Because theassumptions underlying the independent samples t-test were violated, the randomization test was used to compare groups on the Elevated Plus Maze.

The contexts of scratching behavior and postconflict behavior in squirrel monkeys (Saimiri sciureus)

Self-directed behavior (SDB), such as scratching, is a reliable indicator of emotional arousal in non-human primates. In contrast, affiliative behavior, such as social grooming, has been shown to have a calming effect in primates and reduce arousal. In order to test whether the expression of SDB was related to arousal, the scratching behavior of eight captive squirrel monkeys (Saimiri sciureus) was compared across four social contexts (huddling, proximity to others, solitary and post-conflict). In addition,rates of scratching were examined before and after affiliative behavior during the postconflict context. I tested for this effect by using the post-conflict/matched control(PC/MC) method in which post-conflict (PC) behavior of an animal is compared to thebehavior of the same animal in a baseline, nonaggressive situation or a matched control(MC). Context and associated scratching data were obtained from a total of 98 hours of focal sample data. Scratching was significantly lower while animals were huddling thanthe other two contexts. Scratching rates while solitary were significantly higher than those occurring while animals were in proximity. Scratching was also higher in PC than MC. Following conflict, animals were significantly more likely to make contact withthird parties not involved in aggression. Most of these (79%) were a third party approaching a combatant. Further, scratching rates decreased following post-conflict third party contacts and the decrease was not due to a general decrease in scratching thatmight have been occurring after the aggressive interaction. Huddling behavior appears to reduce arousal in squirrel monkeys and may act as a tension-reduction mechanism. The elevated scratching in the solitary context may suggest that squirrel monkeys may be engaged in activities while solitary, such as vigilant behavior that may increase arousal. The third party post conflict affiliative contacts observed were the first such interactions observed in squirrel monkeys. The fact that these third contacts reduced scratching ratesin the combatants indicates that 'consolation' may have been demonstrated in this species. The overall pattern of results suggested that scratching was reliable behavioral indicator of anxiety in squirrel monkeys. These results indicate that overt behavior can be used to assess emotional states in this and other species, acting as a mediator to understanding how emotions regulate social behavior.

International Service-Learning and the Development of Civic Identity: Understanding the Role of Short-Term International Service-Learning and its Influence on the Development of Civic Identity in College Students Using a Mixed Methodological Approach

Higher education has a responsibility to educate a democratic citizenry and recent research indicates civic engagement is on the decline in the United States. Through a mixed methodological approach, I demonstrate that the potential exists for well structured short-term international service-learning programming to develop college students’ civic identities. Quantitative analysis of questionnaire data, collected from American college students immediately prior to their participation in a short-term service-learning experience in Northern Ireland and again upon their return to the United States, revealed increases in civic accountability, political efficacy, justice oriented citizenship, and service-learning. Subsequent qualitative analysis of interview transcripts, student journals, and field notes suggested that facilitated critical reflection before, during, and after the experience promoted transformational learning. Emergent themes included: (a) responsibilities to others, (b) the value of international service-learning, (c) crosspollination of ideas, (d) stepping outside the daily routine to facilitate divergent thinking, and (e) the necessity of precursory thinking for sustaining transformations in thinking. The first theme, responsibilities to others, was further divided into subthemes of thinking beyond oneself, raising awareness of responsibility to others, and voting responsibly.

Maternal and Postweaning High-Fat Diets Disturb Hippocampal Gene Expression, Learning, and Memory Function

We tested the hypothesis that excess saturated fat consumption during pregnancy, lactation, and/or postweaning alters the expression of genes mediating hippocampal synaptic efficacy and impairs spatial learning and memory in adulthood. Dams were fed control chow or a diet high in saturated fat before mating, during pregnancy, and into lactation. Offspring were weaned to either standard chow or a diet high in saturated fat. The Morris Water Maze was used to evaluate spatial learning and memory. Open field testing was used to evaluate motor activity. Hippocampal gene expression in adult males was measured using RT-PCR and ELISA. Offspring from high fat-fed dams took longer, swam farther, and faster to try and find the hidden platform during the 5-day learning period. Control offspring consuming standard chow spent the most time in memory quadrant during the probe test. Offspring from high fat-fed dams consuming excess saturated fat spent the least. The levels of mRNA and protein for brain-derived neurotrophic factor and activity-regulated cytoskeletal-associated protein were significantly decreased by maternal diet effects. Nerve growth factor mRNA and protein levels were significantly reduced in response to both maternal and postweaning high-fat diets. Expression levels for the N-methyl-D-aspartate receptor (NMDA) receptor subunit NR2B as well as synaptophysin were significantly decreased in response to both maternal and postweaning diets. Synaptotagmin was significantly increased in offspring from high fat-fed dams. These data support the hypothesis that exposure to excess saturated fat during hippocampal development is associated with complex patterns of gene expression and deficits in learning and memory.

AAC&U's Integrative Liberal Learning and the CAS Standards: Advising for a 21st Century Liberal Education

The Association of American Colleges and Universities presented and promoted integrative liberal learning as a collaborative goal that all institutions of higher education must strive to achieve. The similarities between the goals of integrative liberal learning and the Standards for Academic Advising by the Council for the Advancement of Standards in Higher Education are discussed with emphasis placed on the critical role that academic advising plays in support of an integrative liberal learning education, and in turn, future success for all students.