Vaping Behavior and Intention to Quit among Undergraduate Students in a Hispanic-Serving University

The surge in electronic nicotine delivery systems (ENDS) usage, particularly among young adults, poses significant public health concerns. This study aimed to identify predictors of e-cigarette use, quit attempts, and frequency among undergraduate students in a Hispanic-serving university in Texas. A cross-sectional study was conducted between August 1 and October 26, 2023, recruiting undergraduate students through the Sona system, an online experiment management platform. Participants completed an online survey that covered demographics, educational status, vaping status, initiation age, reasons for first and current e-cigarette use, frequency of past usage, intentions to quit, and quit attempt frequency. Statistical analysis included descriptive statistics, multinomial logistic regression, and multivariable linear regression. Among 316 participants, 33.9% reported current e-cigarette use. Junior and senior students, as well as prior tobacco users, were more likely to be current vapers. Prior vaping experience was more prevalent among Hispanic individuals and those with a history of tobacco use. Notably, 74.3% of current users attempted to quit in the past year, with a higher frequency of quit attempts among females, Hispanic students, and those with vaping acquaintances. However, the vaping behavior and quit attempt patterns were similar across other categories. This study highlights how various factors influence e-cigarette use among college students. It suggests that prevention and quitting programs should consider the specific needs of different groups. Future studies will continue to look at different student groups to find the most effective ways to help them quit vaping.

Using a counterfactual-based intervention to change eating intentions: Results from Hispanic and non-Hispanic undergraduate and community samples

Finding ways to improve eating behavior has become a major focus of interventions designed to improve health outcomes. Counterfactual thinking (i.e., mental simulations of how a past outcome could have been different) is a cognitive strategy that has been shown to improve behavior regulation and could be a promising intervention to improve eating behavior. The purpose of the current research was to examine the effect of a counterfactual-based intervention to shift contemplation to change eating behavior, motivation towards eating healthier, and intentions to engage in healthier eating behaviors. Participants in both studies were randomly assigned to either a counterfactual-based intervention or a control condition. In Study 1, those in the counterfactual-based intervention condition reported an increase in readiness to change their eating behavior, higher extrinsic motivation towards eating healthy, and higher intentions to eat healthy compared to those in the control condition. Within the counterfactual condition, individuals who self-identified as Hispanic had higher intentions to use their counterfactual strategies than those who identified as non-Hispanic. Study 2 found similar results using a more diverse community sample. Those in the counterfactual-based intervention condition reported an increase in readiness to change, intentions to eat healthy, and intentions to use their counterfactual strategies, with this effect being stronger for self-identified Hispanic participants. These studies provide initial evidence for the use of a counterfactual-based intervention to improve eating behavior in diverse populations.

Iron Deficiency in Attention-Deficit Hyperactivity Disorder, Autism Spectrum Disorder, Internalizing and Externalizing Disorders, and Movement Disorders

This article reviews the role of iron in brain development and function, with a focus on the association between iron deficiency (ID) and neuropsychiatric conditions. First, we describe how ID is defined and diagnosed. Second, the role of iron in brain development and function is summarized. Third, we review current findings implicating ID in a number of neuropsychiatric conditions in children and adolescents, including attention deficit hyperactivity disorder and other disruptive behavior disorders, depressive and anxiety disorders, autism spectrum disorder, movement disorders, and other situations relevant to mental health providers. Last, we discuss the impact of psychotropic medication on iron homeostasis.

Positive Urgency, Drinking Preoccupation, and Alcohol Problems in College Students

OBJECTIVE

Individuals high in positive urgency (i.e., impulsiveness stemming from high positive mood) may be more preoccupied with alcohol-related cognitions. Our aim was to examine how positive urgency, drinking preoccupation, and consumption patterns concurrently influence the endorsement of alcohol-related problems.

METHOD

We sampled 756 students enrolled in a large, public U.S. university, who completed a cross-sectional survey online. Their mean age was 19.6 (SD = 1.72), 71.3% identified as female, and participants largely identified as Caucasian (65.5%) and Hispanic/Latinx (22.1%). Self-report measurements of trait positive urgency and drinking preoccupation and retrospective data of alcohol use and alcohol-related problems were collected. A series of linear regressions tested for a hypothesized indirect effect between variables.

RESULTS

We discovered an indirect effect in the relationship between positive urgency and alcohol-related problems via drinking preoccupation. A significant conditional effect showed that this relationship was influenced by past 30-day alcohol consumption, with the effect gaining strength as consumption days increased.

CONCLUSIONS

Students with high positive urgency may be more engrossed with alcohol-related drinking cognitions, leading to negative consequences as their alcohol consumption increases. This potential association can inform tailored intervention plans for college student alcohol control, such as successfully managing intense positive moods and alcohol-related cognitions and triggers.

A Systematic Review of Patient-Perceived Barriers and Facilitators to the Adoption and Use of Remote Health Technology to Manage Diabetes and Cardiovascular Disease among Disproportionately Affected Populations

As noncontact health interventions have become critical during the Covid-19 pandemic, our study aimed to systematically review the published literature for barriers and facilitators influencing the adoption and use of remote health intervention and technology, as perceived by adult patients with diabetes or cardiovascular diseases (CVD) belonging to groups that are socially/economically marginalized and/or medically under-resourced. We searched Medline, Embase, CINAHL, and PsychINFO for peer-reviewed articles published from 2010 to 2018. We employed content analysis to analyze qualitative patient feedback from the included studies. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A total of 42 studies met the inclusion criteria. The design of the remote health technology used was the most frequently mentioned facilitator and barrier to remote health technology adoption and use. Our results should draw the attention of technology developers to the usability and feasibility of remote technology among populations that are socially/economically marginalized and/or medically under-resourced.

Advancing equity, diversity, and inclusion in the American College of Neuropsychopharmacology (ACNP): advances, challenges, and opportunities to accelerate progress

It is increasingly accepted that higher levels of excellence and innovation in research can be achieved by organizations that promote equity, diversity, and inclusion across several domains including ethnicity and gender. The purpose of this commentary is to provide an overview of the methods used to increase diversity within ACNP, as well as recommendations for accelerating progress. Annual membership surveys confirm increases in female membership and leadership positions, slower but encouraging signals for “Asian” and “Hispanic” members, and less progress for African American and other ethnic populations. Meetings have become visibly more diverse, due in part to ethnic minority travel awards and apparently increasing diversity among guest attendees. Evidence of increasing inclusion includes well-attended networking events and minority-relevant programming, active communications about diversity-related events and resources, and strong statements by ACNP leadership that embrace diversity as a core value and support collaboration among key committees and task forces to identify and implement pro-inclusion and diversity-enhancing efforts. We believe ACNP can accelerate progress with more scientifically valid approaches to assessing diversity and inclusion. The current membership survey includes five outmoded ethnic options and postmeeting surveys that are not designed to assess inclusion efforts and consequences. Measures should be developed that better characterize diversity and assess efforts to reduce the barriers that exist for potential non-White populations (e.g., annual membership and meeting attendance costs). Increased collaboration with NIH and other organizations that are committed to these same goals may also contribute to acceleration of progress by ACNP and other scientific organizations.

The Use of Telehealth Technology to Support Health Coaching for Older Adults: Literature Review

BACKGROUND

Health coaching is an intervention process for driving behavior change through goal-setting, education, encouragement, and feedback on health-related behaviors. Telehealth systems that include health coaching and remote monitoring are making inroads in managing chronic conditions and may be especially suited for older populations.

OBJECTIVE

This literature review aimed to investigate the current status of health coaching interventions incorporating telehealth technology and the associated effectiveness of this intervention to deliver health care with an emphasis on older adults (aged 65 and older).

METHODS

A literature review was conducted to identify the research conducted on health coaching combined with remote monitoring for delivering health care to older adults. The Ovid MEDLINE and CINAHL databases were queried using a combination of relevant search terms (including middle aged, aged, older adult, elderly, health coaching, and wellness coaching). The search retrieved 196 papers published from January 2010 to September 2019 in English. Following a systematic review process, the titles and abstracts of the papers retrieved were screened for applicability to health coaching for older adults to define a subset for further review. Papers were excluded if the studied population did not include older adults. The full text of the 42 papers in this subset was then reviewed, and 13 papers related to health coaching combined with remote monitoring for older adults were included in this review.

RESULTS

Of the 13 studies reviewed, 10 found coaching supported by telehealth technology to provide effective outcomes. Effectiveness outcomes assessed in the studies included hospital admissions/re-admissions, mortality, hemoglobin A_1c (HbA_1c) level, body weight, blood pressure, physical activity level, fatigue, quality of life, and user acceptance of the coaching program and technology.

CONCLUSIONS

Telehealth systems that include health coaching have been implemented in older populations as a viable intervention method for managing chronic conditions with mixed results. Health coaching combined with telehealth may be an effective solution for providing health care to older adults. However, health coaching is predominantly performed by human coaches with limited use of technology to augment or replace the human coach. The opportunity exists to expand health coaching to include automated coaching.

Web-Based Contingency Management for Adolescent Tobacco Smokers: A Clinical Trial

INTRODUCTION

Adolescence is a critical time when the majority of tobacco users initiate smoking. Contingency management for adolescent smoking cessation has shown promise in previous studies, but efficacy following removal of contingencies is not well understood. This study examined a remote form of contingency management among non-treatment-seeking adolescent smokers.

METHODS

Participants (N = 127) submitted breath carbon monoxide (CO) three times daily throughout a 42-day program. For this randomized trial, participants in the active condition (n = 63) were reinforced for providing CO measurements on schedule and below a set criterion, whereas those in the control condition (n = 64) were reinforced for providing CO measurements on schedule. Self-reported smoking and urinary cotinine levels were collected at several timepoints.

RESULTS

Active condition showed greater within-group reductions in CO levels relative to control condition, but not at 3- or 6-month follow-up. Active condition reported significantly less smoking during treatment compared to control condition, but not at follow-up. There were no significant differences for urinary cotinine. Overall treatment adherence was low, with only 37% and 51% of possible CO samples being submitted among active and control, respectively. Poor treatment adherence may explain the disparity between CO and cotinine results, and poor follow-up treatment efficacy.

CONCLUSIONS

This study replicates feasibility of a remote form of contingency management for adolescent smoking. CO results suggest active condition reduced smoking within group, but treatment adherence and posttreatment efficacy was poor. Future research should focus on increasing adherence for this type of program among adolescent smokers.

IMPLICATIONS

This study demonstrates feasibility of a remote form of contingency management therapy for smoking cessation among adolescents, while providing posttreatment efficacy data. Within-group efficacy of this form of treatment is suggested, but treatment adherence and follow-up efficacy were poor. This study underscores the need for further development of contingency management therapy for adolescent smoking cessation, which emphasizes better treatment adherence and posttreatment efficacy.

Drug Use Status in Youth: The Role of Gender and Delay Discounting

BACKGROUND

Evidence from gender and delay discounting studies suggests these variables may influence drug use in youth. However, no studies to date have examined sexual discounting with regard to drug use in youth.

OBJECTIVES

The present study examined gender and delay discounting, both monetary and sexual, with regard to the drug use status of alcohol, tobacco, and marijuana.

METHODS

Youth aged 14-21 years (n = 155) provided demographic and drug use information and completed behavioral tasks assessing monetary and sexual discounting in a single laboratory session. Chi-square and analysis of variance were used to assess group differences.

RESULTS

Across drug use status, differences in gender and sexual discounting but not monetary discounting were found. Moderate drinkers and smokers were more likely to be male and displayed steeper sexual discounting rates. However, no interaction effect between gender and discounting differences on drug use status was observed.

CONCLUSIONS

Findings suggest that drug use may manifest differently by gender and highlight the domain specificity of sexual discounting. These findings further highlight the need to incorporate gender and domain-specific discounting measures when investigating drug use pathology and interventions in youth.

Depressive symptoms, hostility, and hopelessness in inner-city adolescent health clinic patients: factor structure and demographic correlates

BACKGROUND

Depression, hostility, and hopelessness are risk factors for adult cardiovascular disease (CVD). People living in inner-city environments are particularly vulnerable. These associations may begin in adolescence, but research in this area is hampered by inadequate knowledge about how these negative psychological factors are related in teens and how they are affected by demographic characteristics. We hypothesized that depression, hostility, and hopelessness are one construct, and that this construct would be associated with race and gender in attendees at an inner-city adolescent health clinic.

METHODS

Two hundred and forty-six 15-18-year-old patients filled out instruments measuring depressive symptoms, hostility, and hopelessness. Confirmatory factor analysis was used to determine whether the negative psychological factors comprised a single construct or three separate ones. General linear modeling (GLM) was used to test the associations between demographic characteristics and the results of the factor analysis.

RESULTS

Depressive symptoms, hostility, and hopelessness were best characterized as three separate constructs, not one (root mean square error of approximation (RMSEA)=0.041, 90% confidence interval (CI)=(0.035, 0.047), comparative fit index (CFI)=0.98). There were no significant relationships between demographic variables and depressive symptoms or hostility. Six percent of the variance in hopelessness scores was accounted for by gender, race, and the interaction between the two (F=3.76; p=0.006), with White males, reporting the highest levels of hopelessness.

CONCLUSION

In an urban adolescent health clinic population, depressive symptoms, hostility, and hopelessness were best understood as three separate constructs. Hopelessness was significantly higher in White males. Implications for future clinical research on negative psychological factors in teens are discussed.

Examining weight concern and delay discounting in adolescent females

OBJECTIVE

Pediatric obesity is a growing public health concern that contributes to high rates of negative long-term physical and mental health outcomes. Research focused on identifying risk for pediatric obesity has linked delay discounting, or an inclination for immediate rewards, as well as weight concern to individuals with greater Body Mass Index (BMI). The current study seeks to fill a void in the literature by examining how these two variables interact to promote higher BMI in female adolescents.

METHOD

Adolescent (n=60) females between the ages of 13-19years (mage=17.45, SD=1.74) of age completed the Eating Disorder Examination Questionnaire (EDE-Q) and the Delay Discounting Questionnaire.

RESULTS

A mediation model examined whether delay discounting accounted for the relationship between weight concern and BMI. Results indicate that in the current study weight concern was negatively related to delay discounting and delay discounting was negatively related to BMI. The overall model revealed that a partial mediation occurred [b=1.28, t(60)=4.92, p<0.01].

DISCUSSION

These results suggest that while impulsivity is an important factor to consider, other constructs may also be influential in how weight concerns contribute to greater BMI. Nevertheless, the results indicate that prevention and interventions should identify females with high levels of both weight concern and impulsivity as an increased risk for experiencing pediatric obesity and long-term negative health outcomes.

The Role of Counterfactual Thinking on Attitudes Toward ADHD Medication Use

OBJECTIVE

Despite serious health risks, attitudes toward Attention-Deficit Hyperactivity Disorder (ADHD) medication use in college students remain favorable. Given the robust link between attitudes and behavior (e.g., the Theory of Planned Behavior), it is important to understand how these attitudes are developed and maintained. The current study examined the role of counterfactual, or "what if'" thinking as a mechanism for the development of attitudes toward ADHD medications.

METHOD

All participants (n = 190) were asked to read either a positive or negative scenario regarding ADHD medication misuse and rate their attitudes toward the behavior; half of the participants were also asked to generate counterfactuals prior to rating their attitudes.

RESULTS

Results suggest that scenario valence influenced the direction of counterfactual statements. Further, through the generation of upward counterfactuals, the negative scenario elicited more positive attitudes toward ADHD medication misuse.

CONCLUSIONS

Based on limited prior research, it is suggested that upward counterfactuals may allow individuals to explain away the misuse of ADHD medication and avoid negative emotions such as guilt and shame related to current or prior ADHD medication misuse. In sum, additional research is needed to confirm preliminary findings that suggest counterfactual thinking could be a precursor to ADHD medication misuse.

Delay discounting, but not disinhibition or inattention, partially mediates the effects of neuroticism on disordered eating in adolescents

Adolescence represents an integral developmental period for the prevention and intervention of disordered eating. Individuals with high levels of neuroticism have been shown to respond with greater impulsivity and use of disordered eating as a coping mechanism. However, the exact mechanism through which neuroticism and impulsivity affect disordered eating remains unknown. To understand the effects of personality and impulsivity on disordered eating in adolescence, the present study aimed to investigate whether impulsivity mediated the relationship between neuroticism and disordered eating. Adolescents (N=40) between the ages of 13 and 19 (Mage=18.25years; S.D.=1.30) were queried on eating attitudes and personality, as well as completed behavioral tasks assessing impulsivity (delay discounting, disinhibition and inattention). Mediation analyses revealed that neuroticism was significantly associated with patterns of disordered eating, but delay discounting, and not disinhibition and inattention, appeared to mediate the relationship between neuroticism and disordered eating. These results should guide prospective research exploring the relations between neurotic and impulsive behavior, particularly delay discounting on disordered eating, which will assist in future treatment efforts targeting the development of maladaptive eating behaviors.

Examining the psychometric properties of the Barratt Impulsiveness Scale-Brief Form in justice-involved samples

Impulsivity is an important component of many forms of psychopathology. Though widely used as an index of this construct, the 30-item Barratt Impulsiveness Scale-11 (BIS-11) has demonstrated questionable psychometric properties in several research reports. An 8-item shortened version has recently been proposed, the Barratt Impulsiveness Scale-Brief (BIS-Brief) form, which was designed to overcome some of the limitations of the longer scale. In this report, we examine the internal structure and theoretically relevant external correlates of this new short form in large archival samples of individuals involved in the criminal justice system (prison inmates, substance abusers in mandatory treatment, and forensic inpatients). Confirmatory factor analysis of the BIS-Brief indicates adequate fit following a relatively minor modification. Correlations between the BIS-Brief and an array of criterion measures-other self-report scales, interview-based measures, and behavioral outcomes-are consistent with predictions and show relatively little or no decrement in predictive validity when compared with the 30-item BIS-11. Our results suggest that the BIS-Brief is a promising brief measure of impulsivity that evinces good psychometric properties across a range of offender samples.

Effects of emotion on prospection during decision-making

In two experiments we examined the role of emotion, specifically worry, anxiety, and mood, on prospection during decision-making. Worry is a particularly relevant emotion to study in the context of prospection because high levels of worry may make individuals more aversive toward the uncertainty associated with the prospect of obtaining future improvements in rewards or states. Thus, high levels of worry might lead to reduced prospection during decision-making and enhance preference for immediate over delayed rewards. In Experiment 1 participants performed a two-choice dynamic decision-making task where they were required to choose between one option (the decreasing option) which provided larger immediate rewards but declines in future states, and another option (the increasing option) which provided smaller immediate rewards but improvements in future states, making it the optimal choice. High levels of worry were associated with poorer performance in the task. Additionally, fits of a sophisticated reinforcement-learning model that incorporated both reward-based and state-based information suggested that individuals reporting high levels of worry gave greater weight to the immediate rewards they would receive on each trial than to the degree to which each action would lead to improvements in their future state. In Experiment 2 we found that high levels of worry were associated with greater delay discounting using a standard delay discounting task. Combined, the results suggest that high levels of worry are associated with reduced prospection during decision-making. We attribute these results to high worriers' aversion toward the greater uncertainty associated with attempting to improve future rewards than to maximize immediate reward. These results have implications for researchers interested in the effects of emotion on cognition, and suggest that emotion strongly affects the focus on temporal outcomes during decision-making.

The relationship between weight and smoking in a national sample of adolescents: Role of gender

This study sought to investigate the role of weight status and body mass index percentile in risky smoking behaviors in male and female adolescents. Analyses of the data obtained in the 2011 Youth Risk Behavior Surveillance System were conducted. The national sample size included 15,425 adolescents. Questions addressing weight status and smoking behaviors were used in analyses. Significant effects of perceived weight status, weight change status, and body mass index percentile on smoking behaviors were found for both genders. The current findings indicate the importance of accounting for both gender and weight status when developing prevention and cessation programs targeting smoking behaviors.

Delay discounting by adolescents experimenting with cigarette smoking

AIMS

To evaluate delay discounting and self-reported impulsive behavior in a sample of adolescents experimenting with cigarette smoking compared with adolescents who had never smoked or were daily smokers.

DESIGN

A cross-sectional design was used to compare smoking-status groups.

SETTING

Columbus, Ohio, a city of approximately 780,000 people.

PARTICIPANTS

A sample of 141 male and female adolescents with a mean age of 15.37 (standard deviation = 1.09) years.

MEASUREMENTS

Primary measures included a computerized assessment of delay discounting, a self-report assessment of impulsivity [Barratt Impulsiveness Scale-adolescent (BIS-11-A)] and verifications of cigarette smoking status (breath carbon monoxide and urinary cotinine level).

FINDINGS

Smokers discounted more by delay and had higher impulsivity scores than non-smokers. Experimenters had scores intermediate to those of smokers and non-smokers on both measures. In some analyses the difference between experimenters and non-smokers was significant, with experimenters showing greater delay discounting, but in no case did experimenters differ significantly from the smokers.

CONCLUSIONS

Young people who experiment with cigarettes appear to be similar to those who smoke regularly in terms of tendency to discount future gains and report impulsive tendencies, and generally higher in these traits than non-smokers.

Flux and energy analysis of species in hollow cathode magnetron ionized physical vapor deposition of copper

To meet the stringent requirements of interconnect metallization for sub-32 nm technologies, an unprecedented level of flux and energy control of film forming species has become necessary to further advance ionized physical vapor deposition technology. Such technology development mandates improvements in methods to quantify the metal ion fraction, the gas∕metal ion ratio, and the associated ion energies in the total ion flux to the substrate. In this work, a novel method combining planar Langmuir probes, quartz crystal microbalance (QCM), and gridded energy analyzer (GEA) custom instrumentation is developed to estimate the plasma density and temperature as well as to measure the metal ion fraction and ion energy. The measurements were conducted in a Novellus Systems, Inc. Hollow Cathode Magnetron (HCM(TM)) physical vapor deposition source used for deposition of Cu seed layer for 65-130 nm technology nodes. The gridded energy analyzer was employed to measure ion flux and ion energy, which was compared to the collocated planar Langmuir probe data. The total ion-to-metal neutral ratio was determined by the QCM combined with GEA. The data collection technique and the corresponding analysis are discussed. The effect of concurrent resputtering during the deposition process on film thickness profile is also discussed.

Dimensions of impulsive behavior in adolescent smokers and nonsmokers

Robust associations have been identified between impulsive personality characteristics and cigarette smoking during adolescents, indicating that impulsive behavior may play an important role in the initiation of cigarette smoking. The present study extended this research by using laboratory behavioral assessments to explore relationships between three specific dimensions of impulsive behavior (impulsive decision-making, inattention, and disinhibition) and adolescent cigarette smoking. Participants were male and female adolescent smokers (n = 50) and nonsmokers (n = 50). Adolescent smokers were more impulsive on a measure of decision-making; however, there were significant smoking status by gender interaction effects for impulsive inattention and disinhibition. Male smokers were most impulsive on the measure of inattention, but male smokers were least impulsive on the measure of disinhibition. Correlations between biomarkers of smoking and impulsive inattention and disinhibition were found for females but not males. The current findings, coupled with previous findings (Reynolds et al., 2007), indicate there may be robust gender difference in associations between certain types of impulsive behavior and cigarette smoking during adolescence.

Characteristics of psychopathy in adolescent nonsmokers and smokers: Relations to delay discounting and self reported impulsivity

This research compared impulsive behavior in adolescent nonsmokers with low ratings of psychopathy (n = 25) and daily smokers with low (n = 25) and high (n = 25) ratings of psychopathy. Assessments of impulsive behavior included question-based and real-time measures of delay discounting and a self report assessment of impulsivity (Barratt Impulsiveness Scale-Adolescent). Smokers with low psychopathy ratings discounted more by delay (i.e., more impulsively) than nonsmokers on both assessments of discounting; however, smokers with high psychopathy ratings did not differ from nonsmokers on either measure. Inversely, from the self report assessment of impulsivity, smokers with low psychopathy ratings did not differ from nonsmokers, but smokers with high psychopathy ratings were more impulsive than nonsmokers. These findings indicate that delay discounting and self reported impulsivity relate differently to characteristics of psychopathy in adolescent nonsmokers and smokers. Also, these findings demonstrate that there are definable subgroups of smokers for whom the frequently observed relationship between cigarette smoking and delay discounting does not apply.

Meta-analysis of therapeutic relationship variables in youth and family therapy: The evidence for different relationship variables in the child and adolescent treatment outcome literature

This meta-analysis examines associations between therapeutic relationship variables, and the extent to which they account for variability in treatment outcomes, in 49 youth treatment studies. Correlations between therapeutic relationship variables ranged from modest to strong. Among the best predictors of youth outcomes were counselor interpersonal skills, therapist direct influence skills, youth willingness to participate in treatment, parent willingness to participate in treatment, youth participation in treatment, and parent participation in treatment. Adequacy of current approaches to conceptualizing and measuring therapeutic relationship variables, such as the therapeutic alliance, in youth and family therapy is discussed. This paper represents the most comprehensive analysis of therapeutic relationship constructs in the youth treatment literature.

Torsion of an accessory spleen

Torsion of an accessory spleen is extremely rare. We report a case of an acute torsion of an accessory spleen in a young patient who presented with acute left abdominal pain and discuss the computed tomographic findings of this exceptional condition. Awareness of this entity and familiarity with typical imaging findings are mandatory for preoperative diagnosis.

Still looking for Poppa

In 1992, V. Phares published an article titled "Where's Poppa?: The Relative Lack of Attention to the Role of Fathers in Child and Adolescent Psychopathology". Since that time, there have been modest gains in the research literature on clinical child issues, but there remains a wide gap between the inclusion of mothers and fathers in clinical child and family research. To provide an update of this issue for the field of developmental psychopathology, the authors of this comment conducted an updated review and analysis of the research on fathers and developmental psychopathology. These current data were compared with the data from the Phares and Compas (1992) study. It was found that there continues to be a dearth of research on fathers and developmental psychopathology.

A theoretical model of common process factors in youth and family therapy

Recently there has been an increasing emphasis in the youth and family mental health treatment literature on the use of empirically supported treatments (ESTs). In contrast there has been scant attention paid to more universal aspects of the therapy process that may have even greater impact upon therapy outcomes. It is likely that the success of the techniques proposed by ESTs may depend on the presence of common process factors. In this article, the authors explore the status of common process factors research in the youth and family therapy literature, and propose a theoretical model linking specific therapeutic relationship variables and treatment outcomes for children and adolescents. This model is intended to guide synthesis of the empirical evidence for common process factors in youth and family treatment and to stimulate future research on common process factors.

Are fathers involved in pediatric psychology research and treatment?

BACKGROUND

Recently, there has been a growing awareness of the importance of the roles of fathers in understanding normative developmental processes. Increased attention has been given to the roles of fathers in the area of clinical child research and therapy. However, the presence of fathers in research and treatment in pediatric psychology has not been fully examined.

OBJECTIVE

To explore the status of including fathers in both research and treatment in the area of pediatric psychology.

METHOD

An extensive review of published research.

RESULTS

The findings suggest that pediatric psychology research lags even farther behind clinical child research in including fathers in research designs and analyzing for maternal and paternal effects separately. There is also a concomitant lack of inclusion of fathers in family-based interventions in pediatric psychology.

CONCLUSION

These patterns are discussed, with an emphasis on strategies to increase the inclusion of fathers in research and treatment of pediatric psychology issues. Future directions for researchers and clinicians are also included.

Still looking for Poppa

In 1992, V. Phares published an article titled "Where's Poppa?: The Relative Lack of Attention to the Role of Fathers in Child and Adolescent Psychopathology". Since that time, there have been modest gains in the research literature on clinical child issues, but there remains a wide gap between the inclusion of mothers and fathers in clinical child and family research. To provide an update of this issue for the field of developmental psychopathology, the authors of this comment conducted an updated review and analysis of the research on fathers and developmental psychopathology. These current data were compared with the data from the Phares and Compas (1992) study. It was found that there continues to be a dearth of research on fathers and developmental psychopathology.

Computerized Evaluation of Mammographic Lesions:What Diagnostic Role Does the Shape of the Individual Microcalcifications Play Compared with the Geometry of the Cluster?

OBJECTIVE

The objective of this study was to compare the diagnostic role of features reflecting the geometry of clusters with features reflecting the shape of the individual microcalcification in a mammographic computer-aided diagnosis system.

MATERIALS AND METHODS

Three hundred twenty-four cases of clustered microcalcifications with biopsy-proven results were digitized at 42-microm resolution and analyzed on a computerized system. The shape factor and number of neighbors were computed for each microcalcification, and the eccentricity of the cluster was computed as well. The shape factor is related to the individual microcalcification; the average number of neighbors and the cluster eccentricity reflect the cluster geometry. Stepwise discriminant analysis was used to evaluate the contribution of the extracted features in predicting malignancy. The performance of a classifier based on the features selected by stepwise discriminant analysis was evaluated by receiver operating characteristic (ROC) analysis.

RESULTS

To obtain the best discrimination model, we used stepwise discriminant analysis to select the average number of neighbors and the shape of the individual microcalcification, but excluded cluster eccentricity. A classification scheme assigned the average number of neighbors a weighting factor, which was 1.49 times greater than that assigned to the shape factor of the individual microcalcification. A scheme based only on these two features yielded an ROC curve with an area under the curve (A(z)) of 0.87, indicating a positive predictive value of 61% for 98% sensitivity.

CONCLUSION

Computerized analysis permitted calculations reflecting the shape of individual microcalcification and the geometry of clusters of microcalcifications. For the computerized classification scheme studied, the cluster geometry was more effective in differentiating benign from malignant clusters than was the shape of individual microcalcification.

Altered transcription in yeast expressing expanded polyglutamine

Expanded polyglutamine tracts are responsible for at least eight fatal neurodegenerative diseases. In mouse models, proteins with expanded polyglutamine cause transcriptional dysregulation before onset of symptoms, suggesting that this dysregulation may be an early event in polyglutamine pathogenesis. Transcriptional dysregulation and cellular toxicity may be due to interaction between expanded polyglutamine and the histone acetyltransferase CREB-binding protein. To determine whether polyglutamine-mediated transcriptional dysregulation occurs in yeast, we expressed polyglutamine tracts in Saccharomyces cerevisiae. Gene expression profiles were determined for strains expressing either a cytoplasmic or nuclear protein with 23 or 75 glutamines, and these profiles were compared to existing profiles of mutant yeast strains. Transcriptional induction of genes encoding chaperones and heat-shock factors was caused by expression of expanded polyglutamine in either the nucleus or cytoplasm. Transcriptional repression was most prominent in yeast expressing nuclear expanded polyglutamine and was similar to profiles of yeast strains deleted for components of the histone acetyltransferase complex Spt/Ada/Gcn5 acetyltransferase (SAGA). The promoter from one affected gene (PHO84) was repressed by expanded polyglutamine in a reporter gene assay, and this effect was mitigated by the histone deacetylase inhibitor, Trichostatin A. Consistent with an effect on SAGA, nuclear expanded polyglutamine enhanced the toxicity of a deletion in the SAGA component SPT3. Thus, an early component of polyglutamine toxicity, transcriptional dysregulation, is conserved in yeast and is pharmacologically antagonized by a histone deacetylase inhibitor. These results suggest a therapeutic approach for treatment of polyglutamine diseases and provide the potential for yeast-based screens for agents that reverse polyglutamine toxicity.

A yeast sensor of ligand binding

We describe a biosensor that reports the binding of small-molecule ligands to proteins as changes in growth of temperature-sensitive yeast. The yeast strains lack dihydrofolate reductase (DHFR) and are complemented by mouse DHFR containing a ligand-binding domain inserted in a flexible loop. Yeast strains expressing two ligand-binding domain fusions, FKBP12-DHFR and estrogen receptor-alpha (ERalpha)-DHFR, show increased growth in the presence of their corresponding ligands. We used this sensor to identify mutations in residues of ERalpha important for ligand binding, as well as mutations generally affecting protein activity or expression. We also tested the sensor against a chemical array to identify ligands that bind to FKBP12 or ERalpha. The ERalpha sensor was able to discriminate among estrogen analogs, showing different degrees of growth for the analogs that correlated with their relative binding affinities (RBAs). This growth assay provides a simple and inexpensive method to select novel ligands and ligand-binding domains.

Two-hybrid analysis of the Saccharomyces cerevisiae 26S proteasome

A two-hybrid screen against an activation domain array of Saccharomyces cerevisiae proteins was carried out for 31 yeast proteasome proteins. Fifty-five putative interactions were identified: 21 between components of the proteasome complex and 34 between proteasome proteins and other proteins. Many of these latter interactions involved either proteins of the ubiquitin pathway, cell cycle proteins, protein kinases or a translation initiation factor subunit. The role of eleven proteins associated with proteasome function by these screens was analyzed by examining the corresponding deletion strains for temperature sensitivity and canavanine sensitivity and for the stability of a ubiquitin-beta-galactosidase fusion protein. These assays additionally implicated three proteins, Bim1, Ump1, and YKL171W, in proteasome function. This study demonstrates the utility of genome-wide two-hybrid assays as an entry point for the further analysis of a large protein complex.

The interplay of biology and technology

Technologies for biological research arise in multiple ways-through serendipity, through inspired insights, and through incremental advances-and they are tightly coupled to progress in engineering. Underlying the complex dynamics of technology and biology are the different motivations of those who work in the two realms. Consideration of how methodologies emerge has implications for the planning of interdisciplinary centers and the training of the next generation of scientists.

A protein interaction map for cell polarity development

Many genes required for cell polarity development in budding yeast have been identified and arranged into a functional hierarchy. Core elements of the hierarchy are widely conserved, underlying cell polarity development in diverse eukaryotes. To enumerate more fully the protein-protein interactions that mediate cell polarity development, and to uncover novel mechanisms that coordinate the numerous events involved, we carried out a large-scale two-hybrid experiment. 68 Gal4 DNA binding domain fusions of yeast proteins associated with the actin cytoskeleton, septins, the secretory apparatus, and Rho-type GTPases were used to screen an array of yeast transformants that express approximately 90% of the predicted Saccharomyces cerevisiae open reading frames as Gal4 activation domain fusions. 191 protein-protein interactions were detected, of which 128 had not been described previously. 44 interactions implicated 20 previously uncharacterized proteins in cell polarity development. Further insights into possible roles of 13 of these proteins were revealed by their multiple two-hybrid interactions and by subcellular localization. Included in the interaction network were associations of Cdc42 and Rho1 pathways with proteins involved in exocytosis, septin organization, actin assembly, microtubule organization, autophagy, cytokinesis, and cell wall synthesis. Other interactions suggested direct connections between Rho1- and Cdc42-regulated pathways; the secretory apparatus and regulators of polarity establishment; actin assembly and the morphogenesis checkpoint; and the exocytic and endocytic machinery. In total, a network of interactions that provide an integrated response of signaling proteins, the cytoskeleton, and organelles to the spatial cues that direct polarity development was revealed.

Oral clearance and pathogenic oropharyngeal colonization in the elderly

The elderly have an increased incidence of oropharyngeal colonization with respiratory pathogens, a well-known risk factor for the development of pneumonia. Changes in the oral milieu may occur secondary to decreased salivary production and abnormalities in swallowing. These abnormalities, common in the elderly, may result in impaired clearance of organisms, allowing pathogenic colonization. To test this hypothesis, we performed a prospective cross-sectional analysis of 75 elderly institutionalized patients and measured oral clearance using (99m)Tc-human serum albumin (HSA) administered to the oropharynx. Oropharyngeal cultures, salivary cell populations, elastase activity, and clinical parameters were measured simultaneously. Retention of radiolabel ranged from 100% to 2.3% over 120 min of observation. Clearance in the oropharynx was significantly decreased in those patients who had oropharyngeal colonization with gram-negative bacilli (GNB), Staphylococcus aureus (SA), or yeast compared with those demonstrating normal flora by 95% confidence intervals. Decreased clearance was also seen in patients on antidepressants by 95% confidence levels. The absolute number of salivary lymphocytes/ml and buccal cells/ml was increased in colonized patients versus noncolonized persons (mean +/- SEM, 128 x 10(3) +/- 49 x 10(3), 25.4 +/- 11.6 x 10(3)). Elastase activity was elevated in patients who had GNB compared with patients without GNB (mean +/- SEM, 10.6 nM +/- 5.7, versus 2.2 nM +/- 1.2, p = 0.036). We conclude that a decrease in salivary clearance of potentially pathogenic organisms may be a major risk factor for the development of colonization in the elderly.