Ipsilesional arm training in severe stroke to improve functional independence (IPSI): phase II protocol.

BACKGROUND: We previously characterized hemisphere-specific motor control deficits in the ipsilesional, less-impaired arm of unilaterally lesioned stroke survivors. Our preliminary data indicate these deficits are substantial and functionally limiting in patients with severe paresis. METHODS: We have designed an intervention ("IPSI") to remediate the hemisphere-specific deficits in the ipsilesional arm, using a virtual-reality platform, followed by manipulation training with a variety of real objects, designed to facilitate generalization and transfer to functional behaviors encountered in the natural environment. This is a 2-site (primary site - Penn State College of Medicine, secondary site - University of Southern California), two-group randomized intervention with an experimental group, which receives unilateral training of the ipsilesional arm throughout 3 one-hour sessions per week for 5 weeks, through our Virtual Reality and Manipulation Training (VRMT) protocol. Our control group receives a conventional intervention on the contralesional arm, 3 one-hour sessions per week for 5 weeks, guided by recently released practice guidelines for upper limb rehabilitation in adult stroke. The study aims to include a total of 120 stroke survivors (60 per group) whose stroke was in the territory of the middle cerebral artery (MCA) resulting in severe upper-extremity motor impairments. Outcome measures (Primary: Jebsen-Taylor Hand Function Test, Fugl-Meyer Assessment, Abilhand, Barthel Index) are assessed at five evaluation points: Baseline 1, Baseline 2, immediate post-intervention (primary endpoint), and 3-weeks (short-term retention) and 6-months post-intervention (long-term retention). We hypothesize that both groups will improve performance of the targeted arm, but that the ipsilesional arm remediation group will show greater improvements in functional independence. DISCUSSION: The results of this study are expected to inform upper limb evaluation and treatment to consider ipsilesional arm function, as part of a comprehensive physical rehabilitation strategy that includes evaluation and remediation of both arms. TRIAL REGISTRATION: This study is registered with ClinicalTrials.gov (Registration ID: NCT03634397 ; date of registration: 08/16/2018).

Newly Identified Gross Human Anatomy: Eight Paired Vestigial Breast Mounds Run along the Embryological Mammary Ridges in Lean Adults.

Although isolated accessory breasts have been reported in many locations on the torso, we noted that lean men presenting for liposuction had mounds of fullness in a curvilinear array (axilla to groin) consistent with the configuration of the embryological mammary ridge. We hypothesized that grid mapping and pinch testing would elucidate the pattern of fullness and its relation to the "milk line." METHODS: Twenty lean participants (10 men, 10 women) each underwent standardized photography and grid mapping of anterior torsos. We then pinch-tested each for subcutaneous fullness in 250 standardized loci. We used plotted pinch values and OLS regression models to determine if focal fullness corresponded to published configurations of the embryologic mammary ridge. RESULTS: We identified a pattern of paired mounds in all participants running bilaterally in curved linear arrays from axillae to groin in the exact form of milk lines. Regression models applied to the male and female pinch data indicated that focal thickness matched mammary ridge configurations in all subjects (P = 0.023 for men, <0.001 for women). Fatty fullness never appeared elsewhere on the anterior torsos. CONCLUSIONS: The linear pattern of paired focal fat mounds present on the anterior torsos is consistent with the paths of embryological mammary ridges, suggesting these focal fat pads are of breast origin. The consistent mounds are distinct from general subcutaneous fullness and therefore represent a new finding of gross human anatomy. We recommend further research to define differential physiology of distinct subpopulations of yellow fat and clinical implications.

Remedial Training of the Less-Impaired Arm in Chronic Stroke Survivors With Moderate to Severe Upper-Extremity Paresis Improves Functional Independence: A Pilot Study.

The ipsilesional arm of stroke patients often has functionally limiting deficits in motor control and dexterity that depend on the side of the brain that is lesioned and that increase with the severity of paretic arm impairment. However, remediation of the ipsilesional arm has yet to be integrated into the usual standard of care for upper limb rehabilitation in stroke, largely due to a lack of translational research examining the effects of ipsilesional-arm intervention. We now ask whether ipsilesional-arm training, tailored to the hemisphere-specific nature of ipsilesional-arm motor deficits in participants with moderate to severe contralesional paresis, improves ipsilesional arm performance and generalizes to improve functional independence. We assessed the effects of this intervention on ipsilesional arm unilateral performance [Jebsen-Taylor Hand Function Test (JHFT)], ipsilesional grip strength, contralesional arm impairment level [Fugl-Meyer Assessment (FM)], and functional independence [Functional independence measure (FIM)] (N = 13). Intervention occurred over a 3 week period for 1.5 h/session, three times each week. All sessions included virtual reality tasks that targeted the specific motor control deficits associated with either left or right hemisphere damage, followed by graded dexterity training in real-world tasks. We also exposed participants to 3 weeks of sham training to control for the non-specific effects of therapy visits and interactions. We conducted five test-sessions: two pre-tests and three post-tests. Our results indicate substantial improvements in the less-impaired arm performance, without detriment to the paretic arm that transferred to improved functional independence in all three posttests, indicating durability of training effects for at least 3 weeks. We provide evidence for establishing the basis of a rehabilitation approach that includes evaluation and remediation of the ipsilesional arm in moderately to severely impaired stroke survivors. This study was originally a crossover design; however, we were unable to complete the second arm of the study due to the COVID-19 pandemic. We report the results from the first arm of the planned design as a longitudinal study.

Motor Deficits in the Ipsilesional Arm of Severely Paretic Stroke Survivors Correlate With Functional Independence in Left, but Not Right Hemisphere Damage.

Chronic stroke survivors with severe contralesional arm paresis face numerous challenges to performing activities of daily living, which largely rely on the use of the less-affected ipsilesional arm. While use of the ipsilesional arm is often encouraged as a compensatory strategy in rehabilitation, substantial evidence indicates that motor control deficits in this arm can be functionally limiting, suggesting a role for remediation of this arm. Previous research has indicated that the nature of ipsilesional motor control deficits vary with hemisphere of damage and with the severity of contralesional paresis. Thus, in order to design rehabilitation that accounts for these deficits in promoting function, it is critical to understand the relative contributions of both ipsilesional and contralesional arm motor deficits to functional independence in stroke survivors with severe contralesional paresis. We now examine motor deficits in each arm of severely paretic chronic stroke survivors with unilateral damage (10 left-, 10 right-hemisphere damaged individuals) to determine whether hemisphere-dependent deficits are correlated with functional independence. Clinical evaluation of contralesional, paretic arm impairment was conducted with the upper extremity portion of the Fugl-Meyer assessment (UEFM). Ipsilesional arm motor performance was evaluated using the Jebsen-Taylor Hand Function Test (JTHFT), grip strength, and ipsilesional high-resolution kinematic analysis during a visually targeted reaching task. Functional independence was measured with the Barthel Index. Functional independence was better correlated with ipsilesional than contralesional arm motor performance in the left hemisphere damage group [JTHFT: [r (10) = -0.73, p = 0.017]; grip strength: [r (10) = 0.64, p = 0.047]], and by contralesional arm impairment in the right hemisphere damage group [UEFM: [r (10) = 0.66, p = 0.040]]. Ipsilesional arm kinematics were correlated with functional independence in the left hemisphere damage group only. Examination of hemisphere-dependent motor correlates of functional independence showed that ipsilesional arm deficits were important in determining functional outcomes in individuals with left hemisphere damage only, suggesting that functional independence in right hemisphere damaged participants was affected by other factors.

Functional Deficits in the Less-Impaired Arm of Stroke Survivors Depend on Hemisphere of Damage and Extent of Paretic Arm Impairment.

Background. Previous research has detailed the hemisphere dependence and specific kinematic deficits observed for the less-affected arm of patients with unilateral stroke. Objective. We now examine whether functional motor deficits in the less-affected arm, measured by standardized clinical measures of motor function, also depend on the hemisphere that was damaged and on the severity of contralesional impairment. Methods. We recruited 48 left-hemisphere-damaged (LHD) participants, 62 right-hemisphere-damaged participants, and 54 age-matched control participants. Measures of motor function included the following: (1) Jebsen-Taylor Hand Function Test (JHFT), (2) Grooved Pegboard Test (GPT), and (3) grip strength. We measured the extent of contralesional arm impairment with the upper-extremity component of the Fugl-Meyer (UEFM) assessment of motor impairment. Results. Ipsilesional limb functional performance deficits (JHFT) varied with both the damaged hemisphere and severity of contralesional arm impairment, with the most severe deficits expressed in LHD participants with severe contralesional impairment (UEFM). GPT and grip strength varied with severity of contralesional impairment but not with hemisphere. Conclusions. Stroke survivors with the most severe paretic arm impairment, who must rely on their ipsilesional arm for performing daily activities, have the greatest motor deficit in the less-affected arm. We recommend remediation of this arm to improve functional independence in this group of stroke patients.

Menstrual Disruption with Exercise Is Not Linked to an Energy Availability Threshold.

INTRODUCTION: Chronic reductions in energy availability (EA) suppress reproductive function. A particular calculation of EA quantifies the dietary energy remaining after exercise for all physiological functions. Reductions in luteinizing hormone pulse frequency have been demonstrated when EA using this calculation is <30 kcal·kg·fat-free mass (ffm)·d. PURPOSE: We determined whether menstrual disturbances (MD) are induced when EA is <30 kcal·kg ffm·d. METHODS: Thirty-five sedentary, ovulatory women age 18 to 24 yr (weight, 59.0 ± 0.8 kg; body mass index, 21.8 ± 0.4 kg·m) completed a diet and exercise intervention over three menstrual cycles. Participants were randomized to groups that varied in the magnitude of negative energy balance created by the combination of exercise and energy restriction. Menstrual disturbances were determined using daily urinary estrone-1-glucuronide and pregnanediol glucuronide, midcycle luteinizing hormone, and menstrual calendars. In a secondary analysis, we calculated EA from energy balance data and tested the association of EA with MD. RESULTS: A generalized linear mixed-effects model showed that the likelihood of a MD decreased by 9% for each unit increase in EA (odds ratio, 0.91; 95% confidence interval, 0.84-0.98; P = 0.010). No specific value of EA emerged as a threshold below which MD were induced. When participants were partitioned into EA tertile groups (low EA, 23.4-34.1; n = 11; moderate EA, 34.9-40.7; n = 12, and high EA, 41.2-50.1; n = 12 [kcal·kg ffm·d]), estrone-1-glucuronide (P < 0.001), pregnanediol glucuronide (P < 0.001), and luteal phase length (P = 0.031) decreased significantly, independent of tertile. CONCLUSIONS: These findings do not support that a threshold of EA exists below which MD are induced but do suggest that MD increase linearly as EA decreases. Menstrual disturbances can likely be prevented by monitoring EA using a simplified assessment of metabolic status.

Limb position drift results from misalignment of proprioceptive and visual maps.

Previous work (Brown et al., 2003a,b) has shown that limb position drifts when individuals make repetitive movements in the absence of visual feedback. The purpose of this study was to examine whether limb position drift might reflect a misalignment in visual and proprioceptive maps by examining the nature of information used to specify new movements from a drifted limb position. In a virtual reality (VR) environment, participants made continuous movements with their dominant right hand between two targets positioned 15cm apart, paced by a 0.625-Hz metronome. After 5 cycles, cursor feedback of the hand was removed for the next 44 cycles, which induced an average drift in hand position of roughly 5cm. On the 50th cycle, participants were required to move to one of 6 new targets from the drifted hand position. Kinematic analysis indicated that movement direction was unambiguously determined by the visual input marked by the original start position, or the last-seen hand position. Forward dynamics analysis revealed that current limb configuration was used to inform joint torques to produce this parallel direction. For new movement specification, accurate proprioceptive information about the drifted limb position was used, even though it was apparently not available for detecting drift in the first place. Movement distance varied directly with the extent of limb drift, although the differentiation of visual and proprioceptive control of distance could not be analyzed, as our control conditions were not significantly different for this measure. We suggest that movement drift, in the absence of visual feedback during cyclic repetitive movements, reflects a misalignment between largely accurate visual and proprioceptive maps, rather than a weighted fusion of the two modalities.

A week in the life of lung cancer survivors: Daily reports of stress, worry, mood, and symptoms.

This study examined the day-to-day lives of early stage lung cancer survivors who were discharged from treatment between 2 and 24 months prior to the study. Lung cancer survivors were called on eight consecutive nights and completed an interview about their daily experiences. Repeated measures, multilevel analysis of the phone interview data was conducted. Survivors reported few daily stressor exposures or somatic symptoms. Daily moods were generally positive, and survivors reported living quite independently. Lung cancer survivors did not report experiencing health-related worry on a daily basis. The findings from this study create a much more positive picture of lung cancer survivorship relative to prior studies.

The impact of weight loss on the 24-h profile of circulating peptide YY and its association with 24-h ghrelin in normal weight premenopausal women.

Peptide YY (PYY) and ghrelin exhibit a reciprocal association and antagonistic physiological effects in the peripheral circulation. Research has yet to clarify the effect of weight loss on the 24h profile of PYY or its association to 24h ghrelin. We sought to determine if diet- and exercise-induced weight loss affects the 24h profile of PYY and its association with 24h ghrelin in normal weight, premenopausal women. Participants (n = 13) were assessed at baseline (BL) and after a 3-month diet and exercise intervention (post). Blood samples obtained q10 min for 24h were assayed for total PYY and total ghrelin q60 min from 0800 to 1000 h and 2000 to 0800 h and q20 min from 1000 to 2000 h. The ghrelin/PYY ratio was used as an index of hormonal exposure. Statistical analyses included paired t-tests and linear mixed effects modeling. Body weight (-1.85 ± 0.67 kg; p = 0.02), and body fat (-2.53 ± 0.83%; p = 0.01) decreased from BL to post. Ghrelin AUC (5252 ± 2177 pg/ml/24h; p=0.03), 24h mean (216 ± 90 pg/ml; p = 0.03) and peak (300 ± 134 pg/ml; p = 0.047) increased from BL to post. No change occurred in PYY AUC (88.2 ± 163.7 pg/ml; p = 0.60), 24h mean (4.8 ± 6.9 pg/ml; p = 0.50) or peak (3.6 ± 6.4 pg/ml; p = 0.58). The 24h association between PYY and ghrelin at baseline (p = 0.04) was weakened at post (p = 0.14); however, the ghrelin/PYY lunch ratio increased (p = 0.01) indicating the potential for ghrelin predominance over PYY in the circulation. PYY and ghrelin are reciprocally associated during a period of weight stability, but not following weight loss. An "uncoupling" may have occurred, particularly at lunch, due to factors that modulate ghrelin in response to weight loss.

24-hour profiles of circulating ghrelin and peptide YY are inversely associated in normal weight premenopausal women.

Peptide YY (PYY) and ghrelin (GHR) may modulate one another's actions within the hypothalamus. Peripheral infusion of PYY in humans acutely suppresses circulating concentrations of GHR. Whether an association between PYY and GHR exists in the peripheral circulation of humans over 24h is unknown. The purpose of this study was to determine if circulating concentrations of PYY and GHR were significantly associated over 24h in humans. Participants (n=13) were normal weight, moderately active, women ages 18-24 yr. Blood samples were obtained q10 min for 24 h and assayed using RIA for total PYY and total GHR hourly from 0800 to 1000 h and 2000 to 0800 h and q20 min from 1000 to 2000 h. Dietary intake during the 24 h procedure was comprised of 55% carbohydrates, 30% fat, and 15% protein (three meals and a snack). Statistical analyses included linear mixed-effects modeling to test whether PYY predicted GHR concentrations over 24h. Participants weighed 57.0±1.5 kg and had 26.1±1.5% body fat (15.0±1.1 kg), 42.1±1.1 kg fat free mass, a BMI of 21.3±0.5 kg/m(2) and RMR of 1072±28 kcal/24 h. Visually, PYY and GHR exhibited an inverse association over nearly the entire 24h period. Statistically, circulating concentrations of 24 h PYY predicted 24 h GHR (ghrelin=1860.51-2.14*PYY; p=0.04). Circulating concentrations of PYY are inversely associated with GHR over 24 h. These data provide evidence that PYY may contribute to the modulation of the secretion of GHR in normal weight, premenopausal women over a 24 h period and supports similar inferences from experimental studies in animals and humans.

Associations of food group and nutrient intake, diet quality, and meal sizes between adults and children in the same household: a cross-sectional analysis of U.S. households.

BACKGROUND: One might assume that individuals living in the same household have similar dietary intakes of food groups and nutrients. However, the manner in which an adult's dietary intake affects children's food consumption, diet quality (defined as meeting intake recommendations), and meal sizes is understudied to date. The objective of this study was to estimate these relationships between minor children and the female or male head of household. METHODS: Dietary intakes of one randomly selected child of each age group (2-5, 6-11, or 12-18 years old (n = 2,380)) and that of the female/male head of household ((HH), proxy for mother and father) using multiple 24-hour recalls from the Continuing Survey of Food Intake by Individuals (CSFII) 1994-1996 was coded to reflect food group and nutrient density (servings/grams per 1,000 kcal). Linear or logistic regression models were used to determine the association between intakes, whether individuals' diets trended toward meeting her/his intake recommendations, and whether individuals were in the highest quintile for food group densities at four distinct eating occasions (breakfast, brunch/lunch, supper/dinner, or other) in each subject group. Stata's survey commands were used to fit linear or logistic regression models and obtain adjusted regression coefficients or odds ratios. RESULTS: Associations between food group/nutrient densities were significant but weak to moderate. Adults with diets that trended toward meeting their intake recommendations doubled the odds for children to have diets that trended toward meeting the recommendations; for many meals, adults consuming in the highest quintile for food group density predicted that children's intakes were also in the highest quintile. CONCLUSIONS: Female and male adults living in the same household significantly affect children's food group and nutrient intakes, diet quality, and meal sizes. There is an urgent need for in-depth analysis to elucidate the underlying mechanisms, especially for studies involving both the female and male HH.

Behavioral profiles associated with auditory processing disorder and specific language impairment.

PURPOSE: To describe and compare behavioral profiles associated with auditory processing disorder (APD) and specific language impairment (SLI) in school-age children. METHOD: The participants in this cross-sectional observational study were 64 children (mean age 10.1 years) recruited through clinician referrals. Thirty-five participants had a clinical diagnosis of APD and 29 were receiving services for language impairment. Participants completed 18 behavioral measures of spoken language, auditory processing, reading, memory, and motor speed. Responses were used to classify children as affected/not affected with APD, and affected/not affected with SLI. Comparisons were made between children with and without an APD diagnosis, and between children assigned to the APD/not APD and SLI/not SLI groups. Agreement between clinical status and test-based classifications is also reported. RESULTS: There were no group mean differences between children with and without a clinical diagnosis of APD. Group mean differences on Cube Design and reading fluency were observed for children classified as APD/not APD; and group mean differences on nonword repetition, spatial working memory, and two auditory processing tests were observed for children classified as SLI/not SLI. CONCLUSIONS: The behavioral profiles of children with APD and SLI were very similar. Although group mean differences were found, they were difficult to interpret in terms of current theories. LEARNING OUTCOMES: The reader will be able to: (1) describe similarities and differences found between children with SLI and children with APD and (2) discuss assessment problems posed by overlapping behavioral characteristics of SLI and APD.

Effects of the 5th and 7th grade enhanced versions of the keepin' it REAL substance use prevention curriculum.

This study assessed the outcomes of adapting the culturally-grounded, middle school, substance-use prevention intervention, keepin ' it REAL (kiR), to target elementary school students and to address acculturation. At the beginning of 5th grade, 29 schools were randomly assigned to conditions obtained by crossing grade of implementation (5th, 7th, 5th + 7th, and control/comparison) by curriculum version [kiR-Plus vs. kiR-Acculturation Enhanced (AE)]. Students (n = 1984) completed 6 assessments through the end of 8th grade. The kiR curricula generally appear no more effective than the comparison schools' programming. Students receiving either version of the kiR intervention in only the 5th grade report greater increases in substance use than did control students. Receiving the kiR-AE version twice (both 5th and 7th grades) has benefits over receiving it once.

Mexican-heritage preadolescents' ethnic identification and perceptions of substance use.

This paper examines the relationship between ethnic identification and substance use for 1,346 Mexican-heritage preadolescents in a National Institute on Drug Abuse-funded study in Phoenix, Arizona (2004-2005). Participants ranged from 9 to 13 years old, 49% reported their gender as male, 33% self-identified as Mexican, and 67% as Mexican American, and 91% of the students reported taking part in the free or reduced-price lunch program. Questionnaire responses were analyzed by fitting regression models. Analyses showed that ethnic identification may play a protective role, with stronger ethnic identification related to more antidrug norms, less positive drug expectations, stronger refusal efficacy, and less intent to use substances. While gender did not significantly moderate the relationships, ethnic identification appears more broadly related to antisubstance-use norms for Mexican-born than U.S.-born participants. This study presents important implications for substance-use prevention research among Mexican heritage preadolescents. Finally, limitations of the study are noted.

Using a nonparametric bootstrap to obtain a confidence interval for Pearson's r with cluster randomized data: a case study.

A nonparametric bootstrap was used to obtain an interval estimate of Pearson's r, and test the null hypothesis that there was no association between 5th grade students' positive substance use expectancies and their intentions to not use substances. The students were participating in a substance use prevention program in which the unit of randomization was a public middle school. The bootstrap estimate indicated that expectancies explained 21% of the variability in students' intentions (r = 0.46, 95% CI = [0.40, 0.50]). This case study illustrates the use of a nonparametric bootstrap with cluster randomized data and the danger posed if outliers are not identified and addressed. EDITORS' STRATEGIC IMPLICATIONS: Prevention researchers will benefit from the authors' detailed description of this nonparametric bootstrap approach for cluster randomized data and their thoughtful discussion of the potential impact of cluster sizes and outliers.

Eating late in the evening is associated with childhood obesity in some age groups but not in all children: the relationship between time of consumption and body weight status in U.S. children.

BACKGROUND: Some studies in adults indicate a positive correlation between eating later in the day and overall energy intake as well as body weight status. Thus, the time of food intake may be a risk factor in childhood obesity. This study was designed to describe the proportion of energy consumed in the time from 4 pm to midnight measured in two-hour increments and to determine a potential association between the time of proportion of energy consumed and body weight status. METHODS: Dietary, anthropometric, and socio-demographic data of 2-18 year olds (N = 11,072) of the National Health and Nutrition Examination Survey (NHANES) 1999-2004 was examined to describe the proportion of total energy consumed within two-hour time periods between 4 pm and midnight. To examine the potential association between eating later in the day and body weight status, generalized estimating equations (GEE) models were used to quantify the effect of time trends (proportion of total energy consumed in each 2-hour time period from 4 pm to 11.59 pm) on body weight status. Analysis was conducted in the total sample and in subgroups stratified by sex, ethnic group (Non-Hispanic white, Non-Hispanic black, Mexican American, Other Hispanic, and Other Race including multi-racial) and age group (2-5, 6-11, and 12-18 year olds). Complex sample survey analysis were used to assess differences at a significance level of p-value < 0.05. RESULTS: Proportion of energy consumed varied by sex, ethnic group, and age groups between 4 pm and 11.59 pm. Compared to healthy weight children, overweight school-age children consumed significantly higher while overweight adolescents consumed significantly lower proportions of total daily energy with each advancing two-hour time increment. CONCLUSION: The association between the circadian rhythm of eating and body weight status needs to be investigated further to examine the effect of time of consumption on the risk of childhood obesity. Especially longitudinal studies in diverse child populations would help elucidate the importance of time of eating on obesity.

A preliminary study of active compared with passive imputation of missing body mass index values among non-Hispanic white youths.

BACKGROUND: Addressing missing data on body weight, height, or both is a challenge many researchers face. In calculating the body mass index (BMI) of study participants, researchers need to impute the missing data. OBJECTIVE: A multiple imputation through a chained equations approach was used to determine whether one should first impute the missing anthropometric data and then calculate BMI or use an imputation model to obtain BMI. DESIGN: The present study used computer simulation to address the question of how to calculate BMI when there is missing data on weight and height. The simulated data reflected data gathered on non-Hispanic white youths (n = 905) aged 2-18 y, who participated in the 1999-2000 National Health and Nutrition Examination Survey (NHANES). RESULTS: The simulation indicated that it made little difference in the accuracy with which the youths' mean BMIs were estimated when the data were missing completely at random. However, the use of a model to impute BMI was favored slightly when the data were missing at random and the imputation model included the variable used to determine missingness. CONCLUSION: The present findings extend the use of passive imputation and the use of multiple imputation through a chained equations approach to an area of critical public health importance.

A six-wave study of the consistency of Mexican/Mexican American preadolescents' lifetime substance use reports.

In the Fall of 2004, 1,948 5th grade students from Phoenix, AZ enrolled in an evaluation of a school-based, substance use prevention intervention. To assess the consistency of Mexican and Mexican-American students' self-reports of lifetime substance use, the present study analyzed data reported by 1,418 students who reported Mexican ancestry and completed 2 to 6 questionnaires administered over a 40-month period. By wave 6, which was completed in March 2008, lifetime alcohol, cigarette, marijuana, and inhalant use rates were 86.0%, 65.0%, 64.5%, and 62.1%, respectively. Corresponding rescission rates were 24.0%, 9.6%, 5.8%, and 9.2%. Reporting patterns with one "Yes-No" sequence accounted for more than 88% of the inconsistent self-reports. This finding suggests that the majority of Mexican/Mexican-American preadolescents participating in a substance use prevention intervention provided logically consistent self-reports of lifetime substance use.

Substance use, resistance skills, decision making, and refusal efficacy among Mexican and Mexican American preadolescents.

This article examines the relationships among resistance skills, refusal efficacy, decision-making skills, and substance use for a sample of Mexican and Mexican American 5th grade students who were attending public schools in Phoenix, Arizona. An analysis of self-report questionnaire data indicated that the likelihood that male students reported ever having used one or more substances increased as they reported a greater willingness to use passive decision-making (e.g., going along) and decreased as they reported greater refusal efficacy and a greater willingness to utilize active decision making (e.g., thoughtful processing). No significant relationships emerged between the 4 predictors and lifetime substance use among the girls. These findings support the role of social skills in substance use prevention, shed light on an understudied group, and suggest the importance of continuing to examine gender differences in skills-based interventions.