Subtypes of Alcohol Expectancies Are Differentially Associated With Alcohol Use for Bisexual and Heterosexual Women.

Background: Bisexual women, compared to heterosexual women, report greater amounts of alcohol use and heavy drinking. Alcohol expectancies (i.e., beliefs about alcohol outcomes) are a strong predictor of alcohol use, but few studies have examined the importance of alcohol expectancies in relation to alcohol use among bisexual women specifically or in comparison to heterosexual women. Objectives: The current study examined 262 heterosexual and 225 bisexual women using an online survey about alcohol use, sexual risk-taking, and alcohol expectancy subtypes (sexuality, tension reduction, and aggression). Results: Compared to heterosexual women, bisexual women reported greater sexuality and tension reduction expectancies after accounting for their level of drinking, but groups did not differ on aggression expectancies. Moreover, sexual identity status moderated the associations between sexuality and tension reduction expectancies and alcohol use, respectively. Specifically, our study findings suggested that sexuality and tension reduction alcohol expectancies were more strongly tied to alcohol use among bisexual women than heterosexual women. Conclusions: Taken together, in our study, bisexual women held stronger sexuality and tension reduction expectancies, as compared to heterosexual women. Interventions targeting alcohol expectancies may be considered when tailoring intervention content for this population.

Understanding the distinct experience of rural interprofessional collaboration in developing palliative care programs.

INTRODUCTION: Palliative care is one component of rural generalist practice that requires interprofessional collaboration (IPC) amongst practitioners. Previous research on developing rural palliative care has created a four-phase capacity development model that included interprofessional rural palliative care teams; however, the details of rural team dynamics had not been previously explored and defined. A growing body of literature has produced models for interprofessional collaborative practice and identified core competencies required by professionals to work within these contexts. An Ontario College of Family Physicians discussion paper identifies seven essential elements for successful IPC: responsibility and accountability, coordination, communication, cooperation, assertiveness, autonomy, and mutual trust and respect. Despite the fact that IPC may be well conceptualized in the literature, evidence to support the transferability of these elements into rural health care practice or rural palliative care practice is lacking. The purpose of this research is to bridge the knowledge gap that exists with respect to rural IPC, particularly in the context of developing rural palliative care. It examines the working operations of these teams and highlights the elements that are important to rural collaborative processes. METHODS: For the purpose of this qualitative study, naturalistic and ethnographic research strategies were employed to understand the experience of rural IPC in the context of rural palliative care team development. Purposive sampling was used to recruit key informants as participants who were members of rural palliative care teams. The seven elements of interprofessional collaboration, as outline above, provided a preliminary analytic framework to begin exploring the data. Analysis progressed using a process of interpretive description to embrace new ideas and conceptualizations that emerged from the patterns and themes of the rural health providers' narratives. The questions of particular interest that guided this work were: What are the collaborative processes of a rural palliative care team? To what extent are the seven elements of IPC representative of rural teams' experiences? Are there any additional elements present when examining the experiences of rural teams? RESULTS: The analysis showed that the seven identified elements of IPC were very much integrated in rural teams' collaborative practice, and thus validated the applicability of these elements in a rural context. However, all seven elements were implemented with a rural twist: the distinctiveness of the rural environment was observed in each element. In addition, another element, specific to rural context, was observed, that being the 'automatic teams' of rural practitioners - the collaboration has been established informally and almost automatically between rural practitioners. CONCLUSIONS: This research contributes new knowledge about rural palliative care team work that can assist in implementing models for rural palliative care that apply accepted elements of collaborative practice in the rural context. Understanding the process of how rural teams form and continue to function will help further the current understanding of IPC in the context in which these professionals work.

Latent profiles of impulsivity facets and associations with drinking behaviors.

BACKGROUND: Impulsivity is positively associated with alcohol use. However, scant research has used person-centered approaches to examine how patterns of impulsivity facets may be associated with alcohol-related outcomes. Consequently, the present study sought to (1) identify latent groups of individuals who share similarities based on the five facets of impulsivity assessed using the UPPS-P scale (positive urgency, negative urgency, premeditation, perseverance, and sensation seeking) and (2) examine differences between latent profiles on alcohol use (i.e., typical alcohol quantity, typical alcohol frequency, binge frequency), alcohol consequences, and drinking motivations. METHODS: Participants were 360 (M age = 21.83; 78.9 % female; 49.4 % racial/ethnic minority) college students who reported weekly drinking over the prior 30 days. They completed questionnaires of impulsivity, alcohol use behaviors, alcohol consequences, and drinking motivations. Latent profile analysis was used to identify classes based on the five UPPS-P facets as indicators. RESULTS: Results revealed that three classes best fit the data: Highest UPPS-P (14.4 %); Moderate UPPS-P (56.9 %); and Lowest UPPS-P (28.6 %). Profiles did not vary on drinking behaviors (quantity, frequency, or binge frequency), but significant differences were observed on alcohol consequences and drinking motivations, specifically coping and conformity motives. CONCLUSIONS: Our data demonstrated that UPPS-P facets tend to cluster together, and patterns may pose risk for consequences and negative motives for drinking. The current study contributed to the conceptualization of impulsivity by identifying specific impulsivity typologies that may be used to target individuals at elevated risk for alcohol consequences.

Expression of homologues for p53 and p73 in the softshell clam (Mya arenaria), a naturally-occurring model for human cancer.

Homologues for human p53 (Hsp53) and p73 (Hsp73) genes were cloned and expression patterns for their corresponding proteins analysed in tissues from normal and leukemic softshell clams (Mya arenaria). These are the first structural and functional data for p53 and p73 cDNAs and gene products in a naturally occurring, non-mammalian disease model. Core sequence of the predicted clam p53 (Map53) and p73 (Map73) proteins is virtually identical and includes the following highly conserved regions: the transcriptional activation domain (TAD), MDM2 binding site, ATM phosphorylation site, proline rich domain, DNA binding domains (DBDs) II-V, nuclear import and export signals and the tetramerization domain. The core sequence is a structural mosaic of the corresponding human proteins, with the TAD and DBDs resembling Hsp53 and Hsp73, respectively. This suggests that Map53 and Map73 proteins may function similarly to human proteins. Clam proteins have either a short (Map53) or long (Map73) C-terminal extension. These features suggest that Map53 and Map73 may be alternate splice variants of a p63/p73-like ancestral gene. Map73 is significantly upregulated in hemocytes and adductor muscle from leukemic clams. In leukemic hemocytes, both proteins are absent from the nucleus and sequestered in the cytoplasm. This observation suggests that a non-mutational p53/p73-dependent mechanism may be involved in the clam disease. Further studies of these gene products in clams may reveal p53/p73-related molecular mechanisms that are held in common with Burkitt's lymphoma or other human cancers.

An aryl hydrocarbon receptor (AHR) homologue from the soft-shell clam, Mya arenaria: evidence that invertebrate AHR homologues lack 2,3,7,8-tetrachlorodibenzo-p-dioxin and beta-naphthoflavone binding.

The aryl hydrocarbon receptor (AHR) mediates numerous toxic effects following exposure of vertebrate animals to certain aromatic environmental contaminants, including 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). To investigate possible effects of TCDD on invertebrates, a cDNA encoding an AHR homologue was cloned from the soft-shell clam, Mya arenaria. The predicted amino acid sequence contains regions characteristic of vertebrate AHRs: basic helix-loop-helix (bHLH) and PER-ARNT-SIM (PAS) domains and a glutamine-rich region. Phylogenetic analysis shows that the clam AHR sequence groups within the AHR subfamily of the bHLH-PAS family, in a clade containing AHR homologues from Drosophila melanogaster and Caenorhabditis elegans. AHR mRNA expression was detected in all tissue types tested: adductor muscle, digestive gland, foot, gill, gonad, mantle, and siphon. The in vitro-expressed clam AHR exhibited sequence-specific interactions with a mammalian xenobiotic response element (XRE). Velocity sedimentation analysis using either in vitro-expressed clam AHR or clam cytosolic proteins showed that this AHR homologue binds neither [(3)H]TCDD nor [(3)H]beta-naphthoflavone (BNF). Similarly, in vitro-expressed D. melanogaster and C. elegans AHR homologues lacked specific binding of these compounds. Thus, the absence of specific, high-affinity binding of the prototypical AHR ligands TCDD and BNF, is a property shared by known invertebrate AHR homologues, distinguishing them from vertebrate AHRs. Comparative studies of phylogenetically diverse organisms may help identify an endogenous ligand(s) and the physiological role(s) for this protein.

Internalizing and externalizing behavior of children with enlisted Navy mothers experiencing military-induced separation.

OBJECTIVES: To examine whether children with Navy mothers exhibit higher levels of internalizing and externalizing behavior than children in civilian families and whether deployment affects children's internalizing and externalizing behavior. METHOD: Navy mothers who experienced deployment completed a measure assessing children's internalizing and externalizing behavior before and after a deployment (and at similar intervals for the Navy and civilian comparison groups). Data collection took place between 1996 and 1998. RESULTS: Navy children with deployed mothers exhibited higher levels of internalizing behavior than children with nondeployed Navy mothers. Navy children whose mothers experienced deployment were more likely to exhibit clinical levels of internalizing behavior than Navy children with nondeployed mothers or civilian children. Group differences, however, were modest and overall mean scores were in the normal range. CONCLUSIONS: Findings do not suggest greater pathology in children of Navy mothers; however, findings do indicate we should be particularly attentive of deployed mothers and their children.

Development and validation of the Screen for Adolescent Violence Exposure (SAVE).

Empirical evidence was provided on the utility of the Screen for Adolescent Violence Exposure (SAVE) in assessing adolescent exposure to school, home, and community violence. The SAVE was empirically developed on 1,250 inner-city adolescents, and obtained excellent reliability and validity. Both exploratory and confirmatory factor analyses identified three factors: Traumatic Violence, Indirect Violence, and Physical/Verbal Abuse. The SAVE demonstrated utility in classifying high- and low-violence participants, and correlated significantly with both objective crime data and theoretically relevant constructs (anger, posttraumatic stress symptoms, and internalizing/externalizing problems). Thus, the SAVE provides measurement of the stressor criterion associated with posttraumatic stress disorder, and allows quantification of severity of violence exposure by setting.

Psychometric properties of the Social Problem Solving Inventory (SPSI) with normal and emotionally disturbed adolescents.

The factor structure of the Social Problem Solving Inventory (SPSI; D'Zurilla & Nezu, 1990) was evaluated with a sample of 708 normal adolescents. Confirmatory factor analysis supported the empirically derived five-factor model reported by D'Zurilla and Maydeu-Olivares (1994) using an adult sample, but not the theoretically derived seven-factor structure of the original SPSI. The psychometric properties of the original and revised inventories are reported for normal adolescents and psychiatrically hospitalized adolescents (n = 63). Internal consistency and reliability estimates were adequate. Support for the validity of the revised SPSI was demonstrated by examining the relationship between social skills, depression, and social problem solving; in addition, differences between normal and inpatient adolescent samples were examined. The findings are discussed in terms of the utility of the inventories with adolescents.

The adolescent activities checklist: reliability, standardization data, and factorial validity.

This study was conducted to provide standardization data and information on the reliability and factorial validity of the recently developed Adolescent Activities Checklist (AAC). A total of 563 adolescents in grades 7 through 12 served as subjects. Significant main effects for gender, race, and grade were obtained in a multivariate analysis of variance. On the basis of this information, standardization data were established for these three variables. Further investigation indicated that the internal consistency of the AAC was high. In addition, results of a principal components analysis conducted on the frequencies of the Unpleasant and Pleasant Activities subscales revealed four and three factors, respectively. For unpleasant activities, the major dimensions were found to occur in three situations--namely, social interactions, family situations, and school situations. Stressful events also occurred as one of the four unpleasant activities dimensions. For pleasant activities, three dimensions appeared: heterosocial behavior, reinforcing interpersonal situations, and social reinforcement.

Attribution processes in mother-adolescent conflict.

Attributions reported by 115 mothers and 122 adolescents were examined as they related to family conflict. Subjects completed measures of parent-adolescent conflict (Issues Checklist, Conflict Behavior Questionnaire) and the Mother-Adolescent Attribution Questionnaire. The results revealed that parent-adolescent conflict correlated with mothers' and teenagers' negative attributions. Specifically, self-reported conflict was positively correlated with mothers' and teenagers' beliefs that one another's negative behavior was intentional, selfishly motivated, and blameworthy.

The development of the Toddler Behavior Screening Inventory.

The purpose of the present study was to develop the Toddler Behavior Screening Inventory (TBSI) for rapidly assessing maternal reports of toddler behavior problems. The TBSI is a 40-item measure intended for use by pediatricians, psychologists, and other child-care professionals. A group of mothers (n = 312) rated the initial 93-item TBSI in terms of behavior frequency and parental perception of the behavior as problematic. Following item elimination, 40 items were retained due to being both frequent and problematic at all toddler age levels. Data were obtained with a new sample of mothers (n = 581) and showed the TBSI to possess good reliability and validity.

Development of adaptive behavior in adolescents and young adults with autism and Down syndrome.

Vineland Adaptive Behavior Scales were used to assess adolescents and young adults with Down syndrome or autism. Matched for verbal mental age (MA), the groups did not differ in adaptive behavior; however, older individuals with Down syndrome had more skills than did younger ones in all areas measured. Skills did not change for the autistic group. For persons with Down syndrome, adaptive skills kept pace with verbal and nonverbal MA, whereas those with autism were delayed in communication and socialization relative to their nonverbal MA.

Development of adaptive behavior in preschoolers with autism or Down syndrome.

The Vineland Adaptive Behavior Scales were used to assess adaptive behavior of MA-matched preschool children with autism or Down syndrome. Preschoolers with Down syndrome attained higher age equivalents and standard scores in the Socialization domain than did children with autism. Adaptive standard scores were unrelated to chronological age (CA) in both groups. However, adaptive age equivalent was positively related to CA for children with Down syndrome in all domains, but only in Communication for children with autism. All children with higher mental ages (MAs) also had higher levels of adaptive skills in all domains. Vineland standard scores recalculated by MA were higher in the Down syndrome than the autism group for Socialization. Results suggest that differing patterns of adaptive development are present very early in children with autism or Down syndrome.

Identification of an E3 ubiquitin-protein ligase in the softshell clam (Mya arenaria).

Softshell clams (Mya arenaria) were exposed to dioxin in controlled laboratory experiments in order to study their molecular response to dioxin exposure. A complementary DNA (cDNA) fragment with sequence similarity to E3 ubiquitin-protein ligase appeared to be upregulated in dioxin-exposed clams compared to controls. E3 covalently ligates ubiquitin onto a protein, targeting it for degradation. Our findings suggest that the ubiquitin-mediated proteolytic pathway in the softshell clam may be activated by dioxin exposure. Because the clam E3-predicted amino acid sequence is most similar to a specific vertebrate E3 protein (E6-AP), we hypothesize that dioxin may stimulate ubiquitin-mediated degradation of cell-cycle regulatory proteins, such as the tumor suppressor p53, which promotes cell proliferation. This pathway has been observed in human cervical cancer. Partial cDNA sequence of the clam E3 has been identified using the differential display polymerase chain reaction (ddPCR) and RACE (Rapid Amplification of cDNA Ends) PCR; the full-length sequence is currently being determined. Discovering the molecular mechanism(s) stimulated by dioxin exposure in this invertebrate model may contribute to a better understanding of the effects of dioxin on marine organisms.

Acceptability of positive and punitive discipline methods: comparisons among abusive, potentially abusive, and nonabusive parents.

The present study compared abusive, potentially abusive, and control group parents' perceptions of commonly used discipline procedures. The clinical samples were obtained from Parents Anonymous (PA) and consisted of both court-referred (abusive) and self-referred (potentially abusive) members. The subjects were presented with case vignettes that described a child with either mild or severe behavior problems and asked to rate four methods of disciplining the child. The discipline methods involved positive reinforcement, timeout, timeout with spanking, and spanking. The findings indicated that (1) overall, the parents generally evaluated positive reinforcement as significantly more acceptable than timeout, timeout with spanking, and spanking; (2) self-referred PA members viewed timeout, timeout with spanking, and spanking as relatively more acceptable than did their demographically similar comparison group; and (3) court-referred PA parents' ratings did not significantly differ from their comparison group, since both groups rated the reinforcement method as significantly more acceptable than the other three discipline methods.

Palliative care providers' perspectives on service and education needs.

To obtain the information necessary for coordinated regional program development, we examined (a) the multidisciplinary viewpoint of palliative care service provision and (b) the continuing education needs reported by non-physician service providers. Of 146 surveys distributed to care providers from multiple settings, 135 were returned. Respondents cited these problems: fragmented services, poor pain and symptom control, lack of education for providers, lack of public awareness, problems with the continuity and coordination of care, lack of respite, and lack of hospice beds. Stress management for caregivers, pain management, communication skills, and symptom assessment were rated as priorities in continuing education. Lectures, small group discussions, practicum, and regular medical centre rounds were the preferred learning formats, while costs and staff shortages were cited as educational barriers.

The efficacy of a response cost-based treatment package for managing aggressive behavior in preschoolers.

The present study examined the effectiveness of a response cost treatment package for improving the classroom behavior of four aggressive preschoolers. Using a multiple baseline design, teachers implemented the response cost system during the treatment phases of the study. The system required teachers to remove smiley faces contingent on aggressive behavior. Each face loss was accompanied by a reprimand. If the child retained at least one smiley face at the end of the observation period, he was allowed to choose from a list of rewards. Rewards were easily administered at school. The results indicated that the response cost treatment package substantially decreased aggressive behavior and was a highly acceptable classroom treatment to teachers and parents.

Promoting academic performance in inattentive children. The relative efficacy of school-home notes with and without response cost.

The present study examined the effectiveness of two different school-home notes for increasing academic productivity and appropriate classroom behavior in five inattentive children. Using an alternating treatments design, students received a school-home note with or without response cost. Both notes required teachers to evaluate students and required parents to provide consequences on a daily basis. The notes differed as to whether reprimands and response cost were included. The results indicated that on-task behavior and academic work completion improved in all five elementary school-aged children. The majority of subjects achieved greater improvements in on-task behavior with the response-cost component added to the school-home note.

Nonorganic failure to thrive: developmental outcomes and psychosocial assessment and intervention issues.

Serious growth problems, such as Nonorganic Failure to Thrive (NFTT), place an infant/toddler at significant risk for poor developmental outcomes. Evidently, an NFTT child's malnutrition and subsequent poor growth and development are accentuated by a family context of impoverishment, dysfunctional relationships, inadequate education, and a dearth of developmentally enriching experiences. The purpose of this review is to describe NFTT, to present development outcomes, and to discuss psychosocial assessment and intervention issues relevant to this developmental disability of early childhood. An ideographic approach to case conceptualization, evaluation, and treatment is suggested to achieve successful developmental outcomes and to guide research endeavors.

The effects of military-induced separation on family factors and child behavior.

Data from 61 mothers of school-age children were examined before, during, and after military deployment of their husbands. Separations resulted in temporary disruptions in families' reported ability to maintain supportive relationships. Wives of servicemen sent to the Persian Gulf War reported less nurturance and family cohesiveness, and more internalizing and externalizing in children than did those whose husbands' deployment was routine.