A growing body of research has demonstrated the effectiveness of integrating mental/behavioral healthcare with primary care in improving health outcomes. Despite this rich literature, such demonstration programs have proven difficult to maintain once research funding ends. Much of the discussion regarding maintenance of integrated care has been focused on lack of reimbursement. However, provider factors may be just as important, because integrated care systems require providers to adopt a very different role and operate very differently from traditional mental health practice. There is also great variability in definition and operationalization of integrated care. Provider concerns tend to focus on several factors, including a perceived loss of autonomy, discomfort with the hierarchical nature of medical care and primary care settings, and enduring beliefs about what constitutes "good" treatment. Providers may view integrated care models as delivering substandard care and passively or actively resist them. Dissemination of available data regarding effectiveness of these models is essential (e.g. timeliness of treatment, client satisfaction). Increasing exposure and training in these models, while maintaining the necessary training in traditional mental health care is a challenge for training at all levels, yet the challenge clearly opens new opportunities for psychology and psychiatry.

Eighteen rats were taught to press a lever for food using either an observational technique or a shaping technique. The median number of sessions taken to learn was smaller when the observational technique was used.Two systems are widely used in teaching a rat to press a lever for food, in one the experimenter shapes the behavior and in the other he simply puts the hungry animal in the box and waits for him to learn spontaneously. The problems with shaping include differences in skill and technique as well as the change in the experimenter's performance as he becomes fatigued. On the other hand the problem noticed in this laboratory with the technique of leaving the animal alone is that some will not learn at all (e.g., 6 out of 20 had not learned after 15 90 min. sessions).Since rats learn to imitate or follow other rats in mazes (Church, 1957; Stimbert et aI, 1966) and since higher animals are capable of observational learning (Herbert & Harsh, 1944;Darby & Riopelle, 1959), an attempt was made to use an observational technique in teaching rats to press a lever. MethodThe Ss in this experiment were 18 naive male hooded rats weighing 200 to 225 gm. Ss were maintained on a 22-hr. food deprivation schedule. The apparatus was a standard operant conditioning box enclosed in a sound resistant case (Foringer small animal test chamber). A lever and pellet receptacle protruded from one side of the box. The apparatus was set to deliver one pellet for each press of the lever. Ss were handled for 15 min. each day during the first three days in the laboratory. At the beginning of the first experimental day S was placed in the conditioning box with a similarly deprived sophisticated lever presser (an animal previously trained to press at least 75 times per 15 min. session). Following 15 min. of exposure to the pressing and eating of the sophisticated demonstrator rat, the S was tested alone for 15 min.These two situations (observation and test) were repeated three times per day until S was pressing at the rate of 50 or more times in a 15 min. test session. Thus, the time spent in the apparatus on any day totalled no more than 90 min. Twelve rats were trained in this way, each paired with one of five sophisticated rats throughout. The other six rats were trained to press the lever using a shaping technique. Since instructions for shaping were not found in the literature, the experimenter operated the food magazine in an attempt to train S successively to eat from the pellet receptacle, to approach the receptacle after hearing the magazine operate, to approach the lever in order to make the magazine operate and finally to press the lever in order to make the magazine operate. These animals were shaped in 20 min. daily sessions until they had reached the criterion of 50 presses in a 15 min. period. The shaping sessions were limited to 20 rom. because of experimenter fatigue and an apparent stereotyping of subject behavior which had been observed in longer pilot sessions. Results and Discussion

Yeast ribonucleic acid (RNA) was first mentioned as having beneficial effects on memory by Cameron and co-workers (1961, 1963) who reported that RNA administered in tablet form or by intravenous injection produced clinical improvement in patients suffering from senile memory impairmenL This effect was later studied by Cook et al (1963) who showed that yeast RNA (160 mg/kg I.P.) increased the rate at which rats learn the response of climbing a pole to escape shock. Recently, however, the suggestion that RNA produces a general improvement in learning or memory processes has been questioned by Wagner et al (1966). These workers repeated the experiment reported by Cooketal and obtained essentially the same results. They then went on to test the effects of yeast RNA injections on learning of a food motivated brightness discrimination, on shock sensitivity and on general activity and found that RNA did not change performance in these situations. Similarly, Luttges et al (1966) have shown that rats injected with rat brain RNA were not superior to a saline injected control group in various learning situations, including a water "Y" maze and a Lashley III maze.Luttges et al also found that IP injections of p32 labeled RNA did not result in significant amounts of radioactivity being found in the brain. This result has also been obtained by Sved (1965), and by Eist & Seal (1965) using a tracer technique, and by Enesco (1966), using radioautography, and suggests that any effects of exogenous RNA are not due to a direct incorporation of RNA into brain tissue.The present study was undertaken in an attempt to determine the basis of the effect of RNA injections on shock motivated pole-climbing behavior and to examine the effects of these injections on behavior in other situations. The Ss were required to learn a spatial discrimination and reversal in an electrified two-choice discrimination box which was divided into five sections: start area, choice area, two threshold areas and a goal area. All but the goal area had grid floors which could be electrified by the experimenter. A detailed description of the apparatus and technique has been given elsewhere (Corson, 1965). On the first training day the Ss learned to go quickly from the start to the goal (the start grid was electrified at 5 sec. and all grids were electrified at 30 sec.), through either door, to avoid shock. Having reached a criterion of three consecutive unshocked runs, they then learned to enter the goal by crossing the threshold area on one side. During this phase the incorrect door was locked and its threshold area was electrified. On the following day, the 0ppcsite door was correct.The results show that neither of the experimental groups was different from the controls in any of the measures taken (start latency, total latency, number of trials to criterion in each phase, and number of errors in each phase). The Mann-Whitney U test (two-tailed) was used in all cases.It is important to note that the first phase of this experiment, when the animals had not yet ...

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The Dartmouth Pain Questionnaire is presented as an adjunct to the McGill Pain Questionnaire. It adds assessment of 4 objective measurements (pain complaints, somatic interventions, impaired functioning, and remaining positive aspects of function) and 1 subjective measure (changes in self-esteem since onset of pain). The entire device fits on one piece of paper and patients easily learn to self-administer it. Standardization results show acceptable levels of reliability and validity.