Nutritional evaluation of stage 5 chronic kidney disease patients on dialysis

CONTEXTO E OBJETIVO: Portadores de insuficiência renal crônica em diálise apresentam alta prevalência de desnutrição proteico-energética. Não existe ainda um método uniforme para avaliar o estado nutricional desses pacientes. Recomenda-se a aplicação de um conjunto de métodos subjetivos e objetivos para se chegar aos diagnósticos nutricionais adequados. O objetivo deste estudo é traçar o perfil nutricional de pacientes submetidos a hemodiálise. TIPO DE ESTUDO E LOCAL: Estudo transversal descritivo realizado na Unidade de Tratamento Dialítico de Araraquara, São Paulo, Brasil, em 2008. MÉTODOS: 48 pacientes tiveram seus indicadores antropométricos e bioquímicos caracterizados, sendo também submetidos ao questionário Avaliação Global Subjetiva modificada (SGAm), verificando-se possíveis correlações entre esses indicadores. RESULTADOS: A frequência de desnutrição moderada e grave variou de 22% a 54%, de acordo com o parâmetro utilizado. Com relação à adequação do peso ideal, 29% da amostra estavam com porcentagem de adequação abaixo do percentil 75, classificados como portadores de desnutrição moderada e grave. As correlações mais significativas foram observadas entre índice de massa corporal (IMC) e adequações de prega triciptal (PCT), circunferência do braço (CB) e circunferência muscular do braço (CMB); e entre o SGAm e adequações de CB e CMB. CONCLUSÃO: A desnutrição apresentou grande variabilidade de frequência entre os pacientes de acordo com o critério escolhido para avaliação. O acompanhamento nutricional de rotina e a validação de métodos que avaliem a composição corporal desses pacientes são de extrema importância para diagnosticar precocemente a desnutrição e assim prevenir complicações e reduzir as taxas de morbimortalidade nesta população.

Ver, lembrar e narrar: a conformação das memórias sobre a ditadura militar na recepção assistida do audiovisual

Subjective and socially constructed instance, the memory is not a natural phenomenon, but an area of contention between various social organizations for control and legitimation of a past. With the development of writing and the advent of new technical devices, it creates new ways to store and transport information. The memory is no longer restricted to the limits of the here and now of the subject and undergoes transformations. In this scenario, the media start to play an important role in publicizing and construction of embodiments of memory. This study aims to analyze the conformation of the memory of political groups during the process of receiving audiovisual fiction. For this purpose, a corpus of four chapters of the soap opera Love and Revolution was used as a cognitive device for remembering. The television series, broadcast by SBT between April 2011 and January 2012, went back to the beginning and development of the military dictatorship in Brazil, in the cities of Rio de Janeiro and São Paulo. Three militants of various affiliations Communists who acted against the regime in Rio Grande do Norte and neighboring states, were participants in this study. Using the method of oral history, the research was divided into two stages: in-depth interviews, which dealt with the history of life of employees with the militancy in the Communist parties and other social movements, and the assistance of a drive dramatic soap opera Love and Revolution. Comparing these two phases of the study, we analyze the flow of mediations that crossed memories of militancy and media framework; shifts the narrative of remembrance during reception, and the opposition between memory and represented the experiences of the receivers

Bases neurofisiológicas da dependência do tabaco

A maioria dos estudos pré-clínicos e clínicos aponta a nicotina como o principal agente responsável pelo desenvolvimento da dependência ao tabaco. Muitos trabalhos têm demonstrado que as bases neurais da dependência à nicotina são semelhantes àquelas das outras drogas de abuso. A nicotina induz preferência condicionada por lugar e auto-administração e, portanto, atua como reforçador positivo, esse efeito parece ser mediado pelo sistema dopaminérgico mesolímbico. A nicotina também induz à sensibilização comportamental que é provavelmente resultante de alterações da expressão gênica do núcleo acumbens induzidas pela exposição prolongada a essa substância. A suspensão do uso de nicotina resulta em síndrome de abstinência. As evidências indicam que esses sinais e sintomas sejam mediados por receptores colinérgicos nicotínicos centrais e periféricos. Outros neurotransmissores, como por exemplo a serotonina e os peptídeos opióides, também podem estar envolvidos na mediação da dependência e síndrome de abstinência à nicotina. A revisão da literatura mostra a complexidade dos efeitos da nicotina no organismo. A integração entre as abordagens comportamental, neuroquímica e molecular possibilitará a compreensão dos mecanismos neurais da dependência ao tabaco e fornecerá as bases para o desenvolvimento racional de agentes terapêuticos que possam ser utilizados para o tratamento da dependência e síndrome de abstinência ao tabaco.

Correlação entre torque, equlíbrio e função do joelho após reconstrução do LCA

Background: Several studies emphasize the importance of assessing the knee function after anterior cruciate ligament (ACL) reconstruction. The influence of several variables on the function of these patients has been analyzed, but there is no consensus in the science literature. Purpose: To evaluate the correlation between the torque and balance on the knee function after ACL reconstruction. Methods: 23 males patients with ACL reconstruction were tested. The procedures of the study included analysis of concentric peak torque at 60o/s and 180o/s of quadriceps femoris and hamstring muscle with a isokinetic dynamometer. The balance in single-limb stance was measured with stabilometry. The functional performance were performed by two hop tests. To estimate the subjective function of the patients was applied Lysholm Knee Scoring Scale and a Global Rating scale. Results: The analysis of data showed a moderate positive correlation between knee extensor torque and functional performance tests (r= 0,48; p=0,02). A moderate negative correlation was found between the two variables of the stabilometry center of pressure and average speed of centre of pressure and the Global Rating scale (r = -0.4, p = 0,04 and r = -0,49, p = 0 ,02, respectively). No correlation was found between peak torque and balance in single-limb stance. Conclusion: The results of the present study suggest that knee extensor strength and postural balance have some influence on knee function in patients after ACL reconstruction

Efeitos da inclinação da esteira na marcha de crianças com síndrome de down

Background: Down syndrome (DS) is a genetic alteration characterized by being a nonprogressive congenital encephalopathy. Children with DS have hypotonia and developmental delays that interfere in the movement`s acquisition for these children. Objective: Analyze the effects of treadmill inclination on angle and spatiotemporal gait characteristics of these individuals. Methodology: We studied 23 subjects of both sexes, with ages ranged between 05 and 11 years, they presented ability to walk on level 5 classified according to the Functional Ambulation Category (FAC). Initially held a subjective evaluation of balance through a questionnaire (Berg Balance Scale-BBS) then the kinematic gait analysis was realized on a treadmill first, without inclination and then, with inclination of 10%, using the motion system analysis Qualisys System. Data analysis was done using BioStat 5.0 attributing significance level of 5%. Normality of data was verified using D'Agostino test and later was applied paired t-test to compare data in two experimental conditions. Results: There was a statistically significant difference in the spatiotemporal variables: reduction in the cadence (from 108.92 ± 39.07 to 99.11 ± 27.51, p <0.04), increase in cycle time (from 1.24 ± 0.27 to 1.36 ± 0.34, p = 0.03 ) and increase in time to take stock (from 0.77 ± 0.15 to 0.82 ± 0.18, p <0.001). Angular variables that showed statistically significant increasing were: the hip in the initial contact (12.23 ± 4.63 to 18.49 ± 5.17, p <0.0001) and max. flexion in balance (12.96±4:32 to 19.50 ± 4.51, p <0.0001 ), knee in the initial contact (15.59 to ± 6.71 to 21.63 ± 6.48, p <0.0001), the ankle in the initial contact (-2.79 ± 9.8 to 2.25 ± 8.79, p <0.0001), max dorsiflexion in stance (4.41 ± 10.07 to 7.13 ± 11.58, p <0.0009), maximum plantar flexion in the pre-assessment of the ankle joint (increase of -6.33 ± 8.77 to -2.69 ± 8.62, p <0.0004).Conclusions: The inclination acts in a positive way for angular and spatiotemporal features gait of children with Down syndrome, demonstrating possible benefit of using this surface in the gait rehabilitation of children with Down Syndrome

Exercícios respiratórios para asma: revisão sistemática com metanálise

Introdução: A asma se tornou um problema de saúde pública devido aos seus grandes custos em cuidados de saúde. Os exercícios respiratórios constituem uma intervenção não farmacológica de baixo custo e baixo risco que vem sendo utilizada por fisioterapeutas em diferentes países no tratamento de pacientes asmáticos. Objetivo: Avaliar a eficácia dos exercícios respiratórios no tratamento de pacientes adultos com asma nos seguintes desfechos: qualidade de vida, sintomas da asma, número de exacerbações agudas, episódios de hospitalização, mensurações fisiológicas (função pulmonar e capacidade funcional), número de consultas médicas, número de faltas no trabalho devido a exacerbações da doença, avaliação subjetiva do paciente em relação à intervenção. Método: Revisão sistemática de estudos controlados randomizados com metanálise realizada em parceria com a Colaboração Cochrane. As seguintes bases de dados foram consultadas: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, e PsycINFO, além de busca manual em revistas da área e em resumos de congressos. Os seguintes termos foram utilizados: (breath*) and (exercise* or retrain* or train* or re-educat* or educat* or physiotherap* or "physical therap*" or "respiratory therapy" or buteyko ). As listas de referências dos estudos selecionados e registros de ensaios clínicos também foram consultados. A seleção dos estudos e a avaliação do risco de viés dos estudos incluídos foram realizadas de maneira independente por dois revisores. O software Review Manager foi utilizado para análise dos dados, no qual o modelo de efeito fixo foi utilizado. As variáveis contínuas foram expressas como diferença de média ponderada com um intervalo de confiança de 95%. A heterogeneidade dos resultados dos estudos incluídos foi realizada por meio da análise dos Forest plots. O teste qui-quadrado (Chi2) com um P valor de 0.10 foi utilizado para indicar significância estatística. O Índice de heterogeneidade (I2) foi implementado com um valor acima de 50% como um nível substancial de heterogeneidade. Resultados: 13 estudos envolvendo 906 pacientes estão atualmente incluídos na revisão. Os seguintes desfechos foram mensurados pelos estudos incluídos: qualidade de vida, sintomas da asma, número de exacerbações agudas e função pulmonar. Os estudos relataram uma melhora na qualidade de vida, sintomas da asma e número de exacerbações agudas. Seis dos onze estudos que avaliaram função pulmonar mostraram uma diferença significativa favorável aos exercícios respiratórios. Não houve relato de efeitos adversos. Devido à heterogeneidade substancial encontrada entre os estudos, metanálise foi possível apenas para sintomas da asma, a qual incluiu dois estudos e mostrou uma diferença significativa favorável aos exercícios respiratórios. A avaliação do risco de viés foi prejudicada devido ao relato incompleto de aspectos metodológicos pela maioria dos estudos incluídos. Conclusão: Embora os resultados encontrados pelos estudos incluídos demonstraram individualmente que os exercícios respiratórios podem ser importantes no tratamento da asma, não há evidência conclusiva nesta revisão para suportar ou refutar a eficácia desta intervenção no tratamento de pacientes asmáticos. Este fato foi devido às diferenças metodológicas entre os estudos incluídos e à ausência de relato de aspectos metodológicos por parte da maioria dos estudos incluídos. Não há dados disponíveis em relação aos efeitos dos exercícios respiratórios nos seguintes desfechos: episódios de hospitalização, número de consultas médicas, número de faltas no trabalho devido a exacerbações da doença, e avaliação subjetiva do paciente em relação à intervenção

Análise da relação entre alterações do padrão do sono e dor lombo-pélvica em mulheres no segundo trimestre gestacional

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

O pai presente: o desvelar da paternidade em uma família contemporânea

O objeto deste estudo é a figura concreta de um pai, presente em sua corporalidade e afetividade, que se depara com a demanda subjetiva, advinda da exigência de revisão de seu papel no mundo contemporâneo. Buscamos encontrar a paternidade que acolhe e convive com o processo de transformações em marcha: o pai que transita entre valores novos e arcaicos. O acesso a este conhecimento se deu através do método clínico de pesquisa, com apoio da psicanálise. Sem submeter os participantes ao tratamento psicanalítico, aplica seus conceitos na interpretação de fenômeno que tem dimensão subjetiva e também, social. Adotamos a entrevista como principal instrumento e a análise qualitativa enquanto estratégia, por permitir relevância à fala do entrevistado e dela extrair o dado significativo para nossas indagações.

Percepção dos idosos sobre saúde bucal

The assessment of oral health status in elderly patients is essential for the development of specific health policies. The prevalence of oral diseases is high in this population. The self-perception of oral health conditions influences the demand for oral care and quality of life for seniors. The aim of this study was to assess self-perception of oral health status in 100 elderly of both sexes, aged 60 years or older and functionally independent the Basic Health Unit of Felipe Camarão II, Natal, Brazil. For comparison of self-perception data was collected in Bom Pastor, Natal / RN. In this research data were collected a questionnaire grouped into two parts. The first part with the socio-demographic data, subjective and objective condition of oral health and access to the service, the second part GOHAI Index. This index consists of 12 items that make it possible to obtain information involving aspects of chewing, speech, phonation, and self-assessed oral health. The results were subjected to statistical tests of Mann-Whitney and Kruskal-Wallis test (α = 0.05), to identify possible predictors of self-evaluation. As a result, 69% were female, ages ranged from 60 to 86 years, with a median of 65 years. In relation to marital status 48% were married. For the years of study, the sample had an average of 3 years. For the last visit to the dentist, only 27% of seniors had visited the Dentist for less than a year. Regarding the questions about the presence of gingival and dental problems were answered by 46% and 21% respectively. The data on the perception of your teeth and gums, 44%. The index showed GOHAI value for self-perception of 30 points to Felipe Camarão and 28 points for the Bom Pastor, both considered a low perception. We identified predictors of self-rated number of people in the room, participate in any associational activity, there is problems with your teeth and your gums. Concluded a negative self-perception of oral health condition by Gone in both areas, influenced by socioeconomic and cultural issues, although they realize the importance given to oral health, but by the misfortunes of other prominent favored little valuing of oral health

Dinâmica populacional e alimentar de Stegastes fuscus, (Osteichthyes:pomacentridae) em arrecifes da praia de Búzius, no Rio Grande do Norte

The damselfish, Stegastes fuscus Cuvier, 1830 (Osteichthyes: Perciformes: Pomacentridae), is abundant in the coastal reefs of Búzios Beach, Rio Grande do Norte, Brazil and they play an important role in the reef community ecology. The present study investigated the feeding strategy of this species considering the food habits and morfo-histology of the digestive tract. Influence of the environmental correlates such as temperature, rainfall and luminosity in the tidal rock pools were studied. The fish were captured on a monthly basis from September 2004 to August 2005, during which period 842 individuals of S. fuscus were captured, 125 males, 437 females and 280 individuals without sex identification. The sex ratio observed was 1 M : 3,5 F. The total body length of males varied from 3.6 to 11.3 cm, with a mean of 7.77 cm; that of females varied from 2.9 to 11.4 cm, with a mean of 7.85 cm, and that of sex grouped individuals varied from 2.9 to 11.4 cm, with a mean of 7.83. However, there was no difference between males and females in total body length. This species presented a positive alometric growth and the equations obtained for the relation between body mass and total body length were: Wt =0,0174Lt 3,1123 for males; Wt =0,0137Lt 3,2294 for females and Wt = 0,0148Lt 3.1928 for sex grouped individuals. The relation between total body length and standard length was L t = 1 ,3223Ls + 0,1527 for sex grouped individual s. February to August was associated to a long period of gonadal resting. The fish spawned during January and in September -October. The frequency of fish with empty stomachs occurred during August to December, whereas frequency of fish with food contents i n stomachs occurred during January to July. This species is considered as a preferential herbivore based on the volume of macroalgae in its diet composition. The morfo -histological aspects of S. fuscus confirm herbivory. Among the environmental factors con sidered only rainfall showed a correlation with the feeding habits of this species

Escolha de parceiros na adolescência

Mate choice is a component of sexual selection. Trying to understand the patterns of this process, several studies have emphasized the adaptive value of sexual differences and their influence on the assessment of the market value. The pattern for adults presented on the scientific literature, which is based on the preference for certain characteristics, shows that men search a partner who shows high value of fecundity and fertility, thus looking for partners with the ability of being pregnant and nursing their offspring. On the other hand, women look for partners with high socioeconomic status, which is strongly associated with the ability to protect and provide resources for them and their offspring. Surprisingly, there is few works that investigated the mate choice patterns during the beginning of the period of sexual differentiation on the morphological, physiological and behavioral traits. The aim of this study was to investigate mate choice patterns in adolescence in order to describe their preferences and contribute to the understanding of human reproductive behavior. Took part of this research 1,232 students from educational institutions of Natal, Brazil, and visitors to the Scientific, Technological and Cultural Fair UFRN. In the Experimental Study 1, we applied a questionnaire to evaluate the importance of certain characteristics, assessed the degree of romantic involvement and real and ideal partners age preference. In the Experimental Study 2, we did a survey of characteristics considered relevant and evaluate the importance of these characteristics in mate choice. The Experimental Study 3 brought an investigation of mate choice patterns based on self-assessment of adolescents, evaluating ideal partner for a short-term and long-term relationships and actual partner. We found that adolescents are motivated to live romantic experiences. We also observed a preference for partners of similar age to that described for adults. Finally, we found similarities and differences in the preferences for characteristics in real and ideal partners in relation to the adult pattern. In addition, we observed high similarity on the self-assessment and assessment of real and ideal partners. We suggest that in the mate choice, adolescents are similar to young adults in some aspects but not all. Our results show the relevance of the reproductive behavior investigation in this human developmental period and reinforce that further studies should contribute to the understanding of human behavior in terms of ontogenetic development and their evolutionary history.

Atividades comportamentais e comportamento alimentar de rã touro, Lithobates catesbeianus (Shaw, 1802), de pigmentação normal e albina em cativeiro

The behavior of bullfrogs reared in captivity must be well understood to support management practices that use efficient feeding regimes. In general, bullfrogs reared in captivity have normal pigmentation, but to develop an enhanced product, some studies have investigated the introduction of albino individuals in frog farms. The present study characterized the behavior of both pigmented and albino bullfrogs reared in captivity. In an initial experiment, 48 bullfrogs (70.5 ± 25.6 g) housed in small stalls were fed once a day at random times. Frogs were filmed and the images showed that both the pigmented and albino varieties behaved similarly: food intake was more frequent at dawn followed by light periods; moving and resting in dry areas may be associated to feeding events; frogs appeared to anticipate feeding time and to rest in the water more frequently in periods other than feeding time; daylight is the recommended period for feeding both pigmented and albino frogs. In a second experiment, 72 albino bullfrogs were fed at fixed times (10 a.m. or 4 p.m.) in small stalls. An initial weight of 23.8 ± 7.6 g was considered to evaluate frog performance, and after the animals reached 60.0 ± 20.0 g, they were filmed for behavior analyses. Food intake varied as a function of feeding time, and frogs were more likely to eat during the early hours of the day and immediately after receiving fresh food. Frogs fed only in the afternoon changed their behavior. Food supplied twice a day stimulated the albino frogs to eat at different times, but did not increase growth. Although fresh food stimulated feeding behavior, food intake was more frequent at dawn. Food supplied at this time of day should therefore be further investigated. The results did not indicate a more suitable feeding time (10 a.m. or 4 p.m.) for albino bullfrogs, or any advantage in using two feedings per day. The results provide xvi important information about bullfrogs in terms of food supply regime and activity preferences throughout the day. This novel information will contribute to future studies in this area

Comportamento do camarão de água doce macrobrachium rosenbergii (De Man, 1879) em cultivos misto e monossexo

Understanding the behavioral activities of freshwater shrimp in captivity is of paramount importance for the appropriate management of the species. In Brazil, the shrimp Macrobrachium rosenbergii is currently the most widely used species in the freshwater shrimp culture due to its high potential for cultivation and good market acceptance. Thus, the present study aimed to describe and characterize the behavioral activities of M. rosenbergii in monosex and in mixed (male and female) (manuscript 1, 2 and 3) populations and the growth performance of this species in restrictive feeding conditions and in different feeding management (manuscript 4 and 5, respectively) . Juvenile and adult shrimps were collected from ponds of the Aquaculture Station - Unidade Especializada em Ciências Agrárias - Universidade Federal do Rio Grande do Norte (UFRN), Macaíba/RN and then transferred to the Laboratório de Estudos do Comportamento do Camarão LECC (Laboratory for Shrimp Behavioral Studies) of the Universidade Federal do Rio Grande do Norte (UFRN). For each treatment , eight aquaria of 250 L (50 cm x 50 cm x 100 cm) were used in a closed recirculating water system with artificial lighting, constant aeration , continuous filtration through a biochemical and biological filter (canister filter), and fine sand as substrate . The water quality was monitored daily. The lab consisted of two rooms with artificial lighting system , controlled by a timer with dark / light cycle of 12:12 h . In manuscript 1, the behavioral categories of the species were presented through an ethogram, which described 31 behaviors, subdivided into general and agonistic behaviors. Manuscript 2 compared the behavioral profile of shrimps in male and in female monosex and mixed populations over 24 hours in laboratory. In three types (mixed, male monosex and female monosex) of populations during the light and dark phases of the 24 hour cycle, the shrimps showed higher occurrence of cleaning behavior. Manuscript 3 examined the influence of the color of the shelter on the frequency of its use and behavioral activities of shrimp in mixed, in male monosex and in female monosex populations over 24 hours. We observed that the shrimp M. rosenbergii burrow more frequently during the light phase in male monosex and mixed populations; they also tend to choose the black shelters. Female monosex populations tend to use red and orange shelters. In manuscript 4, we evaluated in laboratory the behavioral activities and growth performance of juvenile shrimps under food restriction. We observed that a mild food restriction may be used since there is no loss concerning the growth of the animals; feeding management on alternate days , compared to daily management can be financially productive both reducing labor costs and reducing the amount of feed used . Manuscript 5 evaluated the behavior of shrimps in monosex and in mixed populations, as well as the latency of reach the food according to feed offer (tray or food dispersal) . Our results indicate that animals adjust to both types of feed offer food dispersal as much as tray, but they spend more time to reach the feed when it is offered in trays (feeders). Comparing culture types (mixed, male monosex and female monosex), the latency to reach the food was lower for female monosex population. The data obtained in this study demonstrate the importance of identifying different pressures and environmental stimuli on the behavioral responses of this species. This knowledge would support management improvement to optimize the levels of animals‟ welfare, resulting in a better zootecnical performance

Implicações do odor na percepção e escolha de parceiro

Why are we attracted to some people but not to other ones? How is this attraction established? Which signs are characteristic of a good partner? These and many other questions concerning how mate attraction and mate selection work out among humans have been intriguing behavioral scientists. It is well-known that beauty indicates something about a potential mate s health. The odor may indicate a similar assessment, if we can assess how pheromones are integrated into human sexual behavior. However, what is the relation between age preference and body scent evaluation? In order to investigate this question, this study´s objective was identifying evidences which show that olfactory cues might reveal the potential mate s age and that it coincides with the ideal mate s profile. To produce the stimuli, men and women had to wear cotton t-shirts for three nights in order to have their body odor impregnated. After that, opposite-sex individuals evaluated the intensity and attractivity of these odor impregnated tshirts according to two Likert scales (4 points scale for intensity; 7 points scale for attractivity). We found differences between men and women on body scent perception, that indicates a better scent discrimination for women when it concerns the perception of potential mate s age. Another finding was the negative correlation between intensity and attractiveness perception for both sexes. We also verified that mate selection strategies are plural, more than one tactic simultaneously fitting in the same strategy, but all of them are related to differential investment of each sex on their own reproductive success

Aprendizado espacial-temporal em um ambiente complexo sem restrição alimentar em ratos

Timeplace learning is the capacity of organisms to associate both space and time with a biological relevant stimulus such as food. Experiments are usually done with food restricted animals due to the belief that food system activation is necessary for timeplace learning. Another line of thought suggest that, in addition to food system activation, response cost should be increased to effectively allow timeplace discrimination. The purpose of this experiment was to test whether a complex environment, which presumably implied in a heightened response cost, would facilitate timeplace association in satiated rats using a highly palatable food as reward. Nine rats were trained in a timeplace task for 30 nonconsecutive days. A large experimental box (1x1m) divided in four compartments was used. To access each compartment the animal had to overcome a series of obstacles such as ramps, staircases and mazes. Two feeders localized in opposite compartments were rewarded with sunflower seeds in two daily sessions. One feeder offered the reward during the morning sessions while the second feeder in afternoon sessions. After the 15th day of training, the animals began to show a preference for the correct feeder during the correct time of day expressed by increased frequency of visits as well as lower latency to access the feeders. These results suggest that satiated animals are also capable of learning a timespace task as far as the experimental context is complex enough to result in a higher response cost