Ecological momentary assessment of postpartum outcomes in mothers of multiples: lower maternal-infant bonding, higher stress, and more disrupted sleep.

Research on mental health in mothers of multiples has neglected important outcomes like postpartum bonding and relationship satisfaction and is limited by reliance on single-administration, retrospective measures. This study fills these gaps by assessing previously unexamined variables and using ecological momentary assessment (EMA), wherein participants answer repeated, brief surveys to measure real-world, real-time outcomes. This online study recruited 221 women and compared outcomes in those who birthed multiples (n = 127, 57.47%) vs. singletons (n = 94, 42.53%). When recruited, participants were either 6-12 (n = 129, 58.37%) or 18-24 (n = 83, 37.56%) weeks postpartum. All 221 participants completed baseline measures of self-reported depression, anxiety, stress, sleep, relationship satisfaction, and maternal-infant bonding. One hundred thirty participants (58.82%) engaged in 7 days of EMA assessing self-reported momentary mood, stress, fatigue, bonding, and sleep. Data were analyzed using two-by-two ANOVAs and hierarchical linear modeling. Mothers of multiples reported more baseline parenting stress and less maternal-infant bonding than mothers of singletons (ps < .05). Mothers of multiples who were 6-12 weeks postpartum reported the lowest bonding (p = .03). Mothers of multiples also reported more momentary stress, overwhelm, nighttime awakenings, and wake time after sleep onset (ps < .05). The latter two variables positively correlated with momentary fatigue, stress, and worse mood (ps < .05). Mothers of multiples experienced worse postpartum bonding, more stress, and more interrupted sleep than mothers of singletons. This population may benefit from tailored postpartum interventions to decrease stress, increase bonding, and improve sleep.

Randomized Double-Blind Controlled Trial of Freeze-Dried Strawberry Powder Supplementation in Adults with Overweight or Obesity and Elevated Cholesterol.

OBJECTIVE: Recommended dietary patterns improve cardiovascular disease (CVD) risk factors such as blood pressure and LDL-C, as well as emerging markers that confer residual risk. Strawberry consumption has been shown to improve CVD risk factors, but further research is needed to better understand these effects using a dose-response model that evaluates a standard serving and a higher (but still achievable) dose. METHODS: A randomized, placebo-controlled, double-blinded crossover trial was conducted in middle-aged adults with overweight or obesity (n = 40; mean BMI = 29.4 ± 0.2 kg/m2; mean age = 50 ± 1.0 years) and moderately elevated LDL-C (mean LDL-C: 140 ± 3 mg/dL) to investigate the effect of two doses of strawberry supplementation on LDL-C and other CVD risk factors. Study interventions were: 0 g/d (control), 13 g/d (low-dose), and 40 g/d (high-dose) of freeze-dried strawberry powder (4-week supplementation periods separated by a 2-week compliance break). RESULTS: There was a significant main effect of treatment for the primary outcome of LDL-C, with a 4.9% reduction following the low-dose strawberry supplement compared to the high-dose (P = 0.01), but not compared to the control. There was also a significant effect on total cholesterol (TC), with a 2.8% and 2.4% reduction following the low-dose compared to the control and high-dose, respectively (P ≤ 0.05 in post-hoc analyses). There was a near significant effect for direct LDL-C (P = 0.07). There were no significant treatment effects for other atherogenic lipoprotein characteristics, indices of vascular function, measures of inflammation, or HDL efflux. CONCLUSION: Low-dose supplementation with freeze-dried strawberry powder, equivalent to ∼1 serving/day of fresh strawberries, improved cholesterol in adults with overweight or obesity, compared to both the high-dose (∼3 servings/day of fresh strawberries) and control, but did not alter other markers of CVD.Supplemental data for this article is available online at.

Effects of Cranberry Juice Supplementation on Cardiovascular Disease Risk Factors in Adults with Elevated Blood Pressure: A Randomized Controlled Trial.

Emerging cardiovascular disease (CVD) risk factors, including central vascular function and HDL efflux, may be modifiable with food-based interventions such as cranberry juice. A randomized, placebo-controlled, crossover trial was conducted in middle-aged adults with overweight/obesity (n = 40; mean BMI: 28.7 ± 0.8 kg/m2; mean age: 47 ± 2 years) and elevated brachial blood pressure (mean systolic/diastolic BP: 124 ± 2/81 ± 1 mm Hg). Study participants consumed 500 mL/d of cranberry juice (~16 fl oz; 27% cranberry juice) or a matched placebo juice in a randomized order (8-week supplementation periods; 8-week compliance break), with blood samples and vascular measurements obtained at study entry and following each supplementation period. There was no significant treatment effect of cranberry juice supplementation on the primary endpoint of central systolic blood pressure or central or brachial diastolic pressure. Cranberry juice significantly reduced 24-h diastolic ambulatory BP by ~2 mm Hg compared to the placebo (p = 0.05) during daytime hours. Cranberry juice supplementation did not alter LDL-C but significantly changed the composition of the lipoprotein profile compared to the placebo, increasing the concentration of large LDL-C particles (+29.5 vs. -6.7 nmol/L; p = 0.02) and LDL size (+0.073 vs. -0.068 nm; p = 0.001). There was no effect of treatment on ex vivo HDL efflux in the total population, but exploratory subgroup analyses identified an interaction between BMI and global HDL efflux (p = 0.02), with greater effect of cranberry juice in participants who were overweight. Exploratory analyses indicate that baseline C-reactive protein (CRP) values may moderate treatment effects. In this population of adults with elevated blood pressure, cranberry juice supplementation had no significant effect on central systolic blood pressure but did have modest effects on 24-h diastolic ambulatory BP and the lipoprotein profile. Future studies are needed to verify these findings and the results of our exploratory analyses related to baseline health moderators.

A 6-Year Experience of Laser Treatments for Burn Scars in a Regional Burn Center-Safety, Efficacy, and Quality Improvement.

Laser treatments have long been used as a treatment method for burn scars. Since 2012, more than 1800 laser treatments were performed at Lehigh Valley Health Network Burn Center, far exceeding any previous cohort in studies exploring laser treatments for burn scars. Although previous research has looked at improving scar appearance and physiology with laser treatments, very few have focused on safety. The purpose of the study was to determine whether laser treatments are a safe treatment option for burn scars. Four hundred and fourteen patients who had undergone at least one laser treatment in the outpatient burn center since 2012 were analyzed. Electronic medical records (EPIC) were reviewed. The data were entered in REDCap and later exported to Microsoft Excel and R Studio for statistical analysis. Most of the complications found were related to the moderate sedation during the procedures and were mild, ie, nausea. The most common adverse effect was prolonged recovery time, which can affect practice flow. The overall postoperative complication rate for laser treatments with and without moderate sedation was minimal at 2.2% and 1.4%, respectively. Pain during and after the procedure averaged 3.9 and 1.7, respectively, on a 1 to 10 scale. The Vancouver Scar Scale showed modest improvement in scar appearance over time with an average improvement of 1.4. The high variability of the Vancouver Scar Scale observed in this series underlines its lack of sensitivity. The study results show that laser treatments for burn scars in the outpatient setting generally are safe for patients in need of burn scar intervention. Some practice flow adjustments need to be taken into consideration when offering these procedures in an outpatient setting.

Relationship quality and 5-year mortality risk.

OBJECTIVE: The present study examined positive and negative aspects of relationship quality with one's spouse or partner as predictors of mortality and the role of gender in moderating this link. METHOD: Data were drawn from 2 waves, 5 years apart, of the National Social Life, Health, and Aging Project (N = 1,734). Positive aspects of relationship quality (frequency of opening up to the partner to talk about worries and relying on the partner) and negative aspects (frequency of the partner making too many demands and criticism by the partner) were assessed. Survival/mortality status was recorded at the time of Wave 2 data collection 5 years later (1,567 alive; 167 deceased). Covariates included sociodemographic variables, relationship type, health status, and the network size of close family relationships and friendships. RESULTS: Logistic regression analyses showed that negative relationship quality with one's spouse or partner was associated with significantly higher odds for mortality after 5 years (odds ratio [OR] = 1.20, 95% CI [1.03, 1.38], p < .001), after including the statistical covariates. Also, age, gender, education, self-rated health, and medication use were significantly related to mortality. Propensity score matching replicated these findings. Follow-up analyses revealed that criticism from one's spouse or partner, in particular, was linked to a higher mortality risk (OR = 1.44, 95% CI [1.10, 1.88]). Gender did not moderate the relationship-quality-mortality link. CONCLUSIONS: Negative relationship quality, notably, criticism received from one's spouse or partner, heightens older adults' risk of mortality. These results suggest the value of developing interventions that target reducing expressed criticism in couple relationships. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Bridging information domains to improve ecological understanding of biological invasions in a marine ecosystem.

We devised a practical method for integrating information on 2 marine invasive species using 3 different approaches: standardized ecological monitoring, online-reporting databases, and surveys of anglers and crabbers. Focusing on 2 recently introduced species with different characteristics, the Asian shore crab (Hemigrapsus sanguineus) and Chinese mitten crab (Eriocheir sinensis), in the Hudson-Raritan watershed of New York and New Jersey, we used sensitivity analyses to explore the relative contribution of each information source to knowledge of species abundance and distribution. All 3 information sources contributed something unique to understanding abundance and distribution of the introduced crabs. Online and survey data on Asian shore crabs significantly affected predictions of abundance, whereas monitoring data did not. When survey data were omitted, abundance estimates were unchanged over time, but when they were included, the model predicted an increased abundance in 2012. All 3 data sets for the Asian shore crab significantly affected estimates of species coverage; surveys had the biggest influence, increasing range size by 4097.25 km2 . For the catadromous Chinese mitten crab, ecological monitoring data collected in freshwater shortly after the original sighting significantly shaped model estimates for abundance and documented the establishment phase of the mitten crab in an area outside the spatial scope of the surveyed resource users. However, the survey data significantly enlarged mitten crab range-size estimates by 6498.01 km2 . By demonstrating that data integration produced an image of the invasion process that would not have emerged had we used any 1 method individually, model results provide evidence for the advantages of an interdisciplinary approach.

Acoplamiento entre los Dominios de Información para Mejorar el Entendimiento Ecológico de las Invasiones Biológicas en un Ecosistema Marino Resumen Diseñamos un método práctico para integrar la información sobre dos especies marinas invasoras usando tres estrategias diferentes: el monitoreo ecológico estandarizado, las bases de datos de reporte en línea y las encuestas realizadas a pescadores y recolectores de cangrejos. Con un enfoque sobre dos especies con características diferentes, Hemigraspus sanguineus y Eriocheir sinensis, introducidas recientemente en la vertiente Hudson-Raritan de Nueva York y Nueva Jersey, usamos varios análisis de sensibilidad para explorar la contribución relativa de cada fuente de información para el conocimiento sobre la abundancia y distribución de las especies. Las tres fuentes de información contribuyeron algo único al entendimiento de la abundancia y distribución de los cangrejos introducidos. Los datos obtenidos en línea y de las encuestas sobre la especie H. sanguineus afectaron significativamente las predicciones de su abundancia, mientras que los datos de monitoreo no lo hicieron. Cuando se omitieron los datos de las encuestas, las estimaciones de abundancia no sufrieron modificaciones con el tiempo, pero cuando incluimos esos datos, el modelo pronosticó un incremento en la abundancia en 2012. Los tres conjuntos de datos de la especie H. sanguineus afectaron significativamente las estimaciones de la cobertura de la especie; las encuestas tuvieron la mayor influencia incrementando el tamaño de la distribución por 4097.25 km2 . Para la especie catádroma E. sinensis, los datos del monitoreo ecológico recolectados en agua dulce poco tiempo después del avistamiento original moldearon significativamente las estimaciones del modelo para la abundancia y documentaron la fase de establecimiento de esta especie en un área fuera del alcance espacial de los usuarios del recurso encuestados. Sin embargo, los datos de las encuestas agrandaron considerablemente las estimaciones de la distribución de E. sinensis por 6498.01 km2 . Con la demostración de que la integración de datos produjo una imagen del proceso de invasión que no habría surgido de haber usado un método individualmente, los resultados del modelo proporcionan evidencias para las ventajas de una estrategia interdisciplinaria.

Are mnemonic failures and benefits two sides of the same coin?: Investigating the real-world consequences of individual differences in memory integration.

Theories of reconstructive memory have long been influenced by investigations of false recognition errors, in which old/new judgements are compromised by spontaneous activation of associated but nonpresented concepts. Recent evidence similarly suggests that reconstructive memory processes (so-called memory integration) also support positive learning behaviors, such as inferential reasoning. Despite prevailing hypotheses, the question of whether a common integration process underlies these seemingly disparate mnemonic outcomes is not well understood. To address this question, young adults, recruited from two institutions, completed the Deese-Roediger-McDermott (Deese, Journal of Experimental Psychology, 58, 17-22, 1959; Roediger & McDermott, Journal of Experimental Psychology: Learning, Memory, and Cognition, 21(4), 803-814, 1995) and Bransford and Franks (Cognitive Psychology, 2, 331-350, 1971) false recognition paradigms, as well as an inferential paradigm (Varga & Bauer, Memory & Cognition, 45, 1014-1027, 2017b), all of which depend on integration of related information in memory. Across two experiments, the well-established tasks were adapted such that successful memory integration resulted in the same negative outcome (i.e., false recognition; Experiment 1) or positive outcome (i.e., inferential reasoning; Experiment 2). By capturing variability in item-to-item responding within and among tasks for each person, a common memory integration process was found to elicit positive and negative consequences in paradigms that required the combination of individual units to construct a composite understanding, but only when memory for directly learned and novel, integrated items were modeled together. Furthermore, linking task-related behavior to academic performance revealed that a greater propensity to integrate factual information (but not arbitrary materials) was related to higher SAT scores. Together, these results provide evidence for domain-general and domain-specific reconstructive mechanisms and their role in supporting educational success beyond the laboratory.

Momentary experiential avoidance: Within-person correlates, antecedents, and consequences and between-person moderators.

We used ecological momentary assessment to investigate momentary correlates, antecedents, and consequences of experiential avoidance (EA), and to explore whether depression and anxiety moderate these within-person relationships. Participants recorded their mood, thoughts, stress, and EA four times daily for one week. Baseline depression and anxiety were associated with EA. EA was lower when participants reported more positive mood and thoughts, and higher when participants reported more negative mood, negative thoughts, and stress. The EA-stress relationship was stronger for participants with higher depression. Lag analyses showed that negative mood, negative thoughts, and stress predicted subsequent EA. In turn, EA predicted subsequent negative mood, negative thoughts, and stress. The relationship between EA and subsequent negative thoughts was stronger for participants with higher anxiety. Participants with higher depression and anxiety had a less negative association between positive thoughts and subsequent EA. This study adds to a growing body of literature on the process of EA as it unfolds in vivo, in real-time. Findings highlight links between momentary negative internal experiences and EA (which may be especially strong for people with depression or anxiety) and suggest that certain positive subjective experiences may buffer against EA. Clinical implications and future research directions are discussed.

Incorporating freeze-dried strawberry powder into a high-fat meal does not alter postprandial vascular function or blood markers of cardiovascular disease risk: a randomized controlled trial.

BACKGROUND: Postprandial dysmetabolism-an exaggerated spike in triglycerides, glucose, and insulin-increases cardiovascular disease risk by inducing oxidative stress, inflammation, and endothelial dysfunction. Polyphenol-rich foods may blunt these effects when they are incorporated into a high-fat, calorie-dense meal. Strawberries are a rich source of polyphenols, but there is little research on their postprandial effects. OBJECTIVE: This study was designed to investigate the effect of adding 40 g freeze-dried strawberry powder (∼1 lb. or 0.45 kg fresh strawberries) to a high-fat (50 g total fat) meal on postprandial vascular function, as well as triglyceride, glucose, and insulin responses. DESIGN: Healthy, overweight or obese [mean ± SEM body mass index (in kg/m2): 31 ± 0.5] adults (mean ± SEM age: 28 ± 2 y; 17 men and 13 women) consumed a control meal and a strawberry meal in a randomized crossover design. Testing sessions were separated by ≥1 wk for men and ∼1 mo for women to control for hormonal variations. Blood samples were obtained before the meal and 0.5, 1, 2, and 4 h after the meal. Central blood pressure and arterial stiffness indexes were measured at baseline and 2 and 4 h postmeal with the use of pulse waveform analysis. RESULTS: There were no significant differences between the strawberry and control meals for any outcomes. Consumption of either meal significantly decreased the augmentation index at 2 and 4 h (P < 0.002) and significantly increased triglycerides, insulin, and glucose at all time points (P < 0.001) relative to baseline. CONCLUSIONS: The strawberry intervention did not alter vascular function or attenuate postprandial metabolic derangements in triglycerides, glucose, or insulin relative to the control meal. Additional research is needed to clarify whether strawberries or other polyphenol-rich interventions improve postprandial responses, and future studies should take into account the acute meal-induced improvements in measures of vascular function. This trial was registered at clinicaltrials.gov as NCT01989637.

Effects of culinary spices and psychological stress on postprandial lipemia and lipase activity: results of a randomized crossover study and in vitro experiments.

BACKGROUND: Data suggest that culinary spices are a potent, low-calorie modality for improving physiological responses to high fat meals. In a pilot study (N = 6 healthy adults), we showed that a meal containing a high antioxidant spice blend attenuated postprandial lipemia by 30% compared to a low spice meal. Our goal was to confirm this effect in a larger sample and to consider the influence of acute psychological stress on fat metabolism. Further, we used in vitro methods to evaluate the inhibitory effect of spices on digestive enzymes. METHODS: In a 2 x 2, randomized, 4-period crossover design, we compared the effects of 14.5 g spices (black pepper, cinnamon, cloves, garlic, ginger, oregano, paprika, rosemary, and turmeric) vs. placebo incorporated into a high fat meal (1000 kcal, 45 g fat), followed by psychological stress (Trier Social Stress Test) vs. rest on postprandial metabolism in 20 healthy but overweight adults. Blood was sampled at baseline and at 105, 140, 180, and 210 minutes for analysis of triglycerides, glucose, and insulin. Additional in vitro analyses examined the effect of the spice blend and constituent spices on the activity of pancreatic lipase (PL) and secreted phospholipase A2 (PLA2). Mixed models were used to model the effects of spices and stress (SAS v9.3). RESULTS: Serum triglycerides, glucose and insulin were elevated following the meal (p < 0.01). Spices reduced post-meal triglycerides by 31% when the meal was followed by the rest condition (p = 0.048), but this effect was not present during stress. There was no effect of the spice blend on glucose or insulin; however, acute stress significantly increased both of these measures (p < 0.01; mean increase of 47% and 19%, respectively). The spice blend and several of the individual spices dose-dependently inhibited PL and PLA2 activity in vitro. CONCLUSIONS: Inclusion of spices may attenuate postprandial lipemia via inhibition of PL and PLA2. However, the impact of psychological stress negates any influence of the spice blend on triglycerides, and further, increases blood glucose and insulin. TRIAL REGISTRATION: ClinicalTrials.gov as NCT00954902 .

Effects of supplemental long-chain omega-3 fatty acids and erythrocyte membrane fatty acid content on circulating inflammatory markers in a randomized controlled trial of healthy adults.

The long-chain omega-3 polyunsaturated (n-3 PUFA), eicosapentaenoic (EPA) and docosahexaenoic acid (DHA), may have anti-inflammatory effects. We evaluated the dose-response effect of EPA+DHA supplementation on circulating TNF-α, IL-6, and CRP and explored associations between red blood cell (RBC) membrane PUFA content and TNF-α, IL-6, and CRP. Young adults with low fish intake (n=116) received one of five doses (0, 300, 600, 900, or 1,800 mg/d EPA+DHA) for 5 months. There were no significant effects of supplemental EPA+DHA on IL-6 or CRP; however, there was a marginal treatment effect for TNF-α (p<0.08). At baseline, higher quartiles of RBC DHA were associated with lower TNF-α (p=0.001); higher quartiles of arachidonic acid were associated with higher TNF-α (p=0.005). EPA+DHA supplementation had no dose-response effect on TNF-α, IL-6, or CRP in healthy young adults; however, associations between inflammatory markers and RBC PUFA warrant further investigation.

Most genetic risk for autism resides with common variation.

A key component of genetic architecture is the allelic spectrum influencing trait variability. For autism spectrum disorder (herein termed autism), the nature of the allelic spectrum is uncertain. Individual risk-associated genes have been identified from rare variation, especially de novo mutations. From this evidence, one might conclude that rare variation dominates the allelic spectrum in autism, yet recent studies show that common variation, individually of small effect, has substantial impact en masse. At issue is how much of an impact relative to rare variation this common variation has. Using a unique epidemiological sample from Sweden, new methods that distinguish total narrow-sense heritability from that due to common variation and synthesis of results from other studies, we reach several conclusions about autism's genetic architecture: its narrow-sense heritability is ∼52.4%, with most due to common variation, and rare de novo mutations contribute substantially to individual liability, yet their contribution to variance in liability, 2.6%, is modest compared to that for heritable variation.

On the relationship between blast noise complaints and community annoyance.

Military installations typically rely on noise complaints to indicate adverse noise environments and often restrict the firing of certain weapons to reduce the number of noise complaints. Using complaints in this manner may also imply that the absence of complaints is an indicator of low community annoyance. The relationship between individual complaints and general community annoyance, however, is currently not established, and it is unknown whether implementing restrictions in reaction to individual complaints is an appropriate or necessary way to reduce community annoyance. This paper looks at whether there are significant differences in reported annoyance to complaint-referenced blast events and general military noise annoyance between those who complain and their non-complaining neighbors. Those who complained were significantly more annoyed to both complaint-referenced blast events and general military noise in comparison to their non-complaining neighbors. The implications of these findings are discussed in terms of range management.

Beef in an Optimal Lean Diet study: effects on lipids, lipoproteins, and apolipoproteins.

BACKGROUND: A Step I diet with lean beef compared with lean white meat both decrease LDL cholesterol. To our knowledge, no studies have evaluated a low-saturated fatty acid (SFA) (<7% calories) diet that contains lean beef. OBJECTIVE: We studied the effect on LDL cholesterol of cholesterol-lowering diets with varying amounts of lean beef [ie, Dietary Approaches to Stop Hypertension (DASH): 28 g beef/d; Beef in an Optimal Lean Diet (BOLD): 113 g beef/d; and Beef in an Optimal Lean Diet plus additional protein (BOLD+): 153 g beef/d] compared with that of a healthy American diet (HAD). DESIGN: Thirty-six hypercholesterolemic participants (with LDL-cholesterol concentrations >2.8 mmol/L) were randomly assigned to consume each of the 4 diets (HAD: 33% total fat, 12% SFA, 17% protein, and 20 g beef/d), DASH (27% total fat, 6% SFA, 18% protein, and 28 g beef/d), BOLD (28% total fat, 6% SFA, 19% protein, and 113 g beef/d), and BOLD+ (28% total fat, 6% SFA, 27% protein, and 153 g beef/d) for 5 wk. RESULTS: There was a decrease in total cholesterol (TC) and LDL-cholesterol concentrations (P < 0.05) after consumption of the DASH (-0.49 ± 0.11 and -0.37 ± 0.09 mmol/L, respectively), BOLD (-0.48 ± 0.10 and -0.35 ± 0.9 mmol/L, respectively), and BOLD+ (-0.50 ± 0.10 and -0.345 ± 0.09 mmol/L, respectively) diets compared with after consumption of the HAD (-0.22 ± 0.10 and -0.14 ± 0.10 mmol/L, respectively). Apolipoprotein A-I, C-III, and C-III bound to apolipoprotein A1 particles decreased after BOLD and BOLD+ diets compared with after the HAD, and there was a greater decrease in apolipoprotein B after consumption of the BOLD+ diet than after consumption of the HAD (P < 0.05 for both). LDL cholesterol and TC decreased after consumption of the DASH, BOLD, and BOLD+ diets when the baseline C-reactive protein (CRP) concentration was <1 mg/L; LDL cholesterol and TC decreased when baseline CRP concentration was >1 mg/L with the BOLD and BOLD+ diets. CONCLUSIONS: Low-SFA, heart-healthy dietary patterns that contain lean beef elicit favorable effects on cardiovascular disease (CVD) lipid and lipoprotein risk factors that are comparable to those elicited by a DASH dietary pattern. These results, in conjunction with the beneficial effects on apolipoprotein CVD risk factors after consumption of the BOLD and BOLD+ diets, which were greater with the BOLD+ diet, provide support for including lean beef in a heart-healthy dietary pattern. This trial was registered at clinicaltrials.gov as NCT00937898.

Testing for interaction in two-way random and mixed effects models: the fully nonparametric approach.

In a recent paper, Gaugler and Akritas (unpublished manuscript) considered testing for no main effect in a two-factor mixed effects design when the traditional assumptions do not hold. Here we extend the nonparametric modeling to the random effects design and consider the problem of testing for no interaction effect. The new models for these designs allow for dependence among the random effects, heteroscedasticity in the error and interaction terms, and do not require normality. At a more systemic level, these models differ from the classical ones in that they do not consider the random interaction term as an additional, extraneous source of variability. The proposed test procedure applies to settings where the random factor in the case of the mixed model or at least one of the random factors in the case of the random effects model has many levels. The number of replications can be small and possibly unbalanced. Moreover, the model and test procedure are general enough to accommodate data missing at random (MAR), provided the missingness mechanism is the same for each level of the random effect. The limiting distribution of the test statistic is normal. Extensive simulations indicate that our test procedure, with or without missing data, maintains the nominal Type I error rate in all simulation settings. On the contrary, the standard procedures (the F-test of PROC GLM in SAS, and the ML and REML methods of PROC MIXED in SAS), as well as the exact F-test of Khuri, Mathew, and Sinha (1998 in Statistical Tests for Mixed Linear Models), are extremely liberal in heteroscedastic settings, while under homoscedasticity and normality, the proposed test procedure is comparable to them. An analysis of a dataset from the Mussel Watch Project is presented.