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Whereas recent reports from national studies have presented extremely high rates for many personality disorders in American Indian communities, persistent concerns about the meaning of these symptoms have left many troubled by these reports. American Indians as a group are known to suffer disproportionately from a number of violent experiences, but the dynamics of this violence have received little attention. This paper examines perspectives on violence in the lives of 15 northern plains tribal members who met criteria for antisocial personality disorder and comorbid alcohol use disorder. It explores how study participants constructed and understood their own violent encounters, as well as the motivations they described (characterized here as reputation, leveling, retaliation, catharsis, and self-defense). Violence was gendered in this study, with men generally presenting as perpetrators and women as victims. Men often described themselves as ready participants in a violent world, while women were quite clear that aggression for them was often simply required as they tried to defend themselves from male violence. While this analysis does not replace clinical analyses of violence in antisocial personality disorder, it does reveal an underlying cultural logic that may play a role in shaping the recourse to violence for that minority of individuals for whom it appears to be the obvious choice. [ABSTRACT FROM AUTHOR]

The aim of this study is to test a multifaceted model across gender, consisting of bonding systems in relation to violent behaviors of youth and explaining the relationships among them. The National Survey on Drug Use and Health in 2006 was the source of data. This paper reports findings of a study examining gender-sensitive models with adolescent violent behavior, by testing multiple bonding systems in the adolescents’ environment simultaneously with use of (1) bi-variate statistical test, (2) t test, and (3) estimation of the structural equation modeling among all the concepts of violent behavior and bonding systems for the whole juvenile sample and separated sample of male and female juveniles. Both peer bonding and school bonding have an effect in decreasing violent behavior of both male and female youth. However, some different bonding systems were found to be effective only for a certain gender, community bonding for male youths and parental bonding for female youths. The satisfactory model fit was confirmed with whole, male-only, and female-only samples, along with new findings of several male-only and one female-only significant causal linkage among bonding systems. [ABSTRACT FROM AUTHOR]

Since Michelle Fine's writing on the missing discourse of desire in sex education, there has been considerable prompting among sexuality educators and feminist scholars to incorporate talk of pleasure into sex education curricula. While the calls for inclusion continue, few have actually examined the curricula for a pleasure discourse or explored how it is contextualised within sex education curricula. In this paper, we analysed curricula used in the USA in the past decade. A qualitative thematic analysis revealed that the discourse around pleasurable sex was often linked to a range of dangerous or negative outcomes including not using condoms, rushing into sex without thinking, regretted sex, and pregnancy or STDs. When the discourse around pleasure was included in sections on ‘knowing one's body’, this discourse took a medicalised, scientific tone. Pleasurable sex was also presented in more positive ways, either linked to marriage in Abstinence Only Until Marriage curricula, or within a more feminist discourse about female pleasure in comprehensive sex education curricula. Our research indicates that a discourse of desire is not missing, but that this discourse was often situated as part of a discourse on safe practice and there, continues to equate pleasure with danger. [ABSTRACT FROM PUBLISHER]

People of Latin American descent make up the largest and fastest-growing minority group in the USA. Rates of pregnancy, childbirth, and sexually transmitted infections among people of Latin American descent are higher than among other ethnic groups. This paper builds on research that suggests that among families of Latin American descent, mothers have a particularly strong influence on the sexual attitudes and behaviours of their children, yet that parents of Latin American descent communicate less with their children about sex than parents of other ethnic groups. It examines the messages about sex women received as children in their countries of origin, and how these messages and their views of the USA influence the sexual education women provide for their children. On the basis of data from focus groups, we suggest that, in spite of the persistence of sexual silence, some women's self-reflective analyses of their own sexual education as well as their views of the USA as a sexually more open society contribute to their views of silence as dangerous and trigger more open communication with sons and daughters. Mothers hope to break the cycle of unwanted pregnancy by speaking with daughters about the consequences of menstruation and with sons about contraception. [ABSTRACT FROM AUTHOR]

Background This paper examines the prevalence, the symptom profile, and the drinking and sociodemographic predictors of current (past 12 months) DSM- IV alcohol abuse and dependence among Mexican Americans living along the U. S.- Mexico border and those living in metropolitan areas away from the border. Methods Respondents in the non-border areas (primarily Houston and Los Angeles) constitute a multistage probability sample ( N = 1,288) of these areas, interviewed as part of the 2006 Hispanic Americans Baseline Alcohol Survey ( HABLAS). Respondents in the border area ( N = 1,307) constitute a household probability sample of Mexican Americans living on the border. In both surveys, data were collected during computer-assisted interviews conducted in respondents' homes. The HABLAS and the border sample response rates were 76 and 67%, respectively. Results Although bivariate analyses revealed no overall differences between border and non-border locations, (negative) age trends were more pronounced on the border for male abuse and for dependence among both genders. Among females aged 18 to 29, border residence was linked to significantly higher rates of dependence. In multivariable analyses, the prevalence of male abuse declined more rapidly with age on the border than off the border. Other unique predictors of male abuse were Jewish/other religion and weekly volume of alcohol consumption. Being married or out of the workforce, attaining a higher education, having no religious preference, and weekly volume uniquely predicted female dependence. Age and weekly volume uniquely predicted male dependence. Conclusions The prevalence of alcohol use disorders among Mexican Americans on and off the U. S.- Mexico border largely mirrors previously documented patterns of alcohol consumption in these areas. For young Mexican American women in particular, border residence is linked to heightened vulnerability to alcohol dependence. [ABSTRACT FROM AUTHOR]

The article discusses a survey on smokers that assessed if the relationship between beliefs and smoking behaviors was in consistent with Cognitive Dissonance Theory. It included adult smokers from Canada, U.S., Great Britain and Australia. The findings revealed that smokers with no intetion of quitting across the three waves, were inclined towards the highest levels of rationalizations for smoking. It suggests studies to determine if the change in beliefs has any effect on intentions to quit.

Although the U.S Supreme Court Roe v. Wade decision legalized abortion in 1973, intense controversy over access, legality, and morality has persisted ever since that landmark decision. National opinion data collected from 1975 to 2007 show that a majority of Americans support a woman's right to an abortion, but this right is increasingly under attack, and recent proposed changes to abortion access are not in line with how most Americans feel. This paper considers public opinion trends in the sharply divided arenas of abortion, partial-birth abortion, and adolescents' rights to access abortion with a critical eye to social work practice. We explore several opportunities for social workers to advocate for clients, including legislative advocacy, reform through litigation, social action, and social policy analysis. [ABSTRACT FROM AUTHOR]

Natural disasters and other emergencies can cause an increased risk of foodborne illness. We conducted a nationally representative survey to understand consumers’ knowledge and use of recommended practices during/after extended power outages and other emergencies. Because older adults are at an increased risk for foodborne illness, this paper presents findings from a sample of older adults (n = 290). Only 17% of respondents reported they are fully prepared to keep food safe during an extended power outage. Respondents identified lack of cogitation (42%), storage space (19%), and concern (27%) as barriers to not being fully prepared. Of those who had experienced a recent power outage, less than 40% followed the recommended practices of discarding frozen foods that had thawed and discarding refrigerated, perishable foods. Additionally, 21% to 36% of respondents reported they tasted food to determine whether it was safe to eat. Awareness and likelihood of following recommended practices were higher among women than men. Many older adults are not following recommended practices to ensure food safety during/after extended power outages and other emergencies. Educational materials need to address barriers and be tailored to specific locations and subpopulations of older adults. Educators and public health officials can use the survey findings to address gaps in older adults’ knowledge and practices and to help reduce the risk of foodborne illness among older adults. [ABSTRACT FROM PUBLISHER]

The purpose of this study is to shed light on the effects of the CEO pay ratio and say‐on‐pay votes on directors' concerns about CEO pay equity. Investigation of the pay ratio disclosure rule offers opportunities to gain insights into whether equity perceptions associated with mandated pay ratio disclosure have significant effects on remuneration decisions in organizations. We conduct an online experiment with practicing corporate directors to examine the effects of CEO pay ratio disclosures and say‐on‐pay (SOP) votes on director decisions. Results indicate that CEO pay ratio disclosures significantly influence directors' decisions regarding executive compensation, leading directors to be less willing to increase CEO pay when the pay ratio is above the industry average pay ratio. Results also demonstrate that say‐on‐pay votes only influence directors' compensation decisions when the CEO pay ratio is above the industry average. Directors in firms with pay ratios that are above the industry average are less willing to increase CEO pay when they anticipate shareholder votes against a CEO pay increase than when they anticipate positive SOP voting outcomes. Directors in firms with CEO pay ratios that are below the industry average, however, are willing to increase CEO pay regardless of SOP voting outcomes. [ABSTRACT FROM AUTHOR]

This paper investigates how firms responded to standardized nutrition labels on food products required by the Nutrition Labeling and Education Act (NLEA). Using a longitudinal quasi-experimental design, we test our predictions using two large-scale samples that span 30 product categories. Results indicate that the NLEA reduced brand nutritional quality relative to a control group of products not regulated by the NLEA. At the same time, among regulated products, brand taste increased. Although this reduction in nutrition represents an unintended consequence of regulation, there were a set of category, firm, and brand conditions under which the NLEA produced a positive effect on brand nutritional quality. We find that firms were more likely to improve brand nutrition when firm risk or firm power is low. Lower risk occurs when the firm is introducing a new brand rather than changing an existing brand, and weaker power in a category is reflected by lower market share in a category. Furthermore, firms competing in low-health categories (e.g., potato chips) or small-portion categories (e.g., peanut butter) improved nutrition more than firms competing in high-health categories (e.g., bread) or large-portion categories (e.g., frozen dinners). Recommendations for firm strategy and the design of consumer information policy are examined in light of these surprising firm responses. [ABSTRACT FROM AUTHOR]

This paper estimates the sampling error variances of gridded monthly U.S. Historical Climatology Network, version 2 (USHCN V2), time-of-observation-biases (TOB)-adjusted data. The analysis of mean surface air temperature (SAT) assesses uncertainties, trends, and the rankings of the hottest and coldest years for the contiguous United States in the period of 1895-2008. Data from the USHCN stations are aggregated onto a 2.5° × 3.5° latitude-longitude grid by an arithmetic mean of the stations inside a grid box. The sampling error variances of the gridded monthly data are estimated for every month and every grid box with data. The gridded data and their sampling error variances are used to calculate the contiguous U.S. averages and their trends and associated uncertainties. The sampling error variances are smaller (mostly less than 0.2°C2) over the eastern United States, where the station density is greater and larger (with values of 1.3°C2 for some grid boxes in the earlier period) over mountain and coastal areas. In the period of 1895-2008, every month from January to December has a positive linear trend. February has the largest trend of 0.162°C (10 yr)−1, and September has the smallest trend at 0.020°C (10 yr)−1. The three hottest (coldest) years measured by the mean SAT over the United States were ranked as 1998, 2006, and 1934 (1917, 1895, and 1912). [ABSTRACT FROM AUTHOR]

Among Asian Americans, particularly within immigrant communities, religious leaders are respected and sought out for support and guidance. There is a need to examine how religious leaders, especially within non-Christian faiths, identify persons and ascribe meaning and attributions to mental health concerns. The aim of this paper was to address this knowledge gap by exploring the perceptions of five Vietnamese American Buddhist leaders in regards to mental illness. Using qualitative analytic techniques we identified appearance, behaviours, and cognitive impairments that leaders interpreted as indicators of a mental health condition. Religious leaders cited messy and overly adorned outer appearance, aggressive and violent behaviours, and abnormal cognitive functioning as indicative of mental health problems. They attributed mental illness to a variety of causes: daily stressors, mind-body imbalance, karma, virtuous deeds, and spiritual possession. Findings inform strategies for faith-based initiatives and mental health service delivery to religiously affiliated Asian Americans. [ABSTRACT FROM PUBLISHER]

Purpose: The purpose of this study was to survey 1,800 current licensed dental hygienists in the U.S. and identify broad and basic interest patterns within Holland's 6 General Occupational Themes. Methods: A national stratified random sample of 1,800 members of the American Dental Hygienists' Association was surveyed. Paper and online surveys included the Strong Interest Inventory and the Skills Confidence Inventory. Descriptive statistics and independent t-tests were used to analyze the data. Results: A total of 928 participants (51.9%) completed and returned the paper survey, while 436 participants (24.4%) also completed the online surveys. Results support coding the dental hygiene profession as Investigative - Social - Realistic using the General Occupational Themes. Dental hygienists had the most significant mean differences in the Healthcare Services, Medical Science and Science Basic Interest Scales as compared to the General Representative Sample. Conclusion: Holland's 6 General Occupational Themes have the potential to help guide student choice regarding dental hygiene as a career. [ABSTRACT FROM AUTHOR]

This paper studies the effect of the division of labor within households on husbands’ and wives’ depressive symptoms. Economic theory argues that specialization enhances mental health and wellbeing, whereas other, more psychological theories argue that equity matters most. We analyze data on husbands and wives from two waves of the National Survey of Families and Households. By combining information on the time spent on household and paid labor, we are able to construct separate and partly independent measures of equity and specialization. We find clear evidence for the equity hypothesis. When hours spent on paid and household labor are more equally distributed between husband and wife, both report fewer depressive symptoms. Only weak and inconsistent support was found for a positive effect of specialization. [ABSTRACT FROM PUBLISHER]

brewer c.s., kovner c.t., greene w., tukov-shuser m. & djukic m. (2012) Predictors of actual turnover in a national sample of newly licensed registered nurses employed in hospitals. Journal of Advanced Nursing 68(3), 521-538. Abstract Aim. This paper is a report of a study of factors that affect turnover of newly licensed registered nurses in United States hospitals. Background. There is a large body of research related to nursing retention; however, there is little information specific to newly licensed registered nurse turnover. Incidence rates of turnover among new nurses are unknown because most turnover data are not from nationally representative samples of nurses. Method. This study used a longitudinal panel design to obtain data from 1653 registered nurses who were recently licensed by examination for the first time. We mailed surveys to a nationally representative sample of hospital registered nurses 1 year apart. The analytic sample consisted of 1653 nurses who responded to both survey mailings in January of 2006 and 2007. Results. Full-time employment and more sprains and strains (including back injuries) result in more turnover. Higher intent to stay and hours of voluntary overtime and more than one job for pay reduces turnover. When we omitted intent to stay from the probit model, less job satisfaction and organizational commitment led to more turnover, confirming their importance to turnover. Magnet Recognition Award® hospitals and several other work attributes had no effect on turnover. Conclusion. Turnover problems are complex, which means that there is no one solution to decreasing turnover. Multiple points of intervention exist. One specific approach that may improve turnover rates is hospital policies that reduce strains and sprains. [ABSTRACT FROM AUTHOR]

Background: Confusion about how to assess for intolerance to feedings often results in unnecessary feeding interruptions. Objectives: To report findings from a national survey of methods used by critical care nurses to assess tolerance to gastric tube feedings and to discuss the findings in light of current enteral nutrition guidelines. Methods: A paper-and-pencil survey was mailed to 1909 members of the American Association of Critical-Care Nurses. In addition, the same survey was posted online in a newsletter circulated to association members. Results from both surveys were pooled for data analysis. Results: A total of 2298 responses were obtained; most respondents reported using a combination of methods to assess tolerance to gastric tube feedings (listening for bowel sounds, measuring gastric residual volumes, observing for abdominal distention/discomfort and for nausea and vomiting). More than 97% of the nurses reported measuring gastric residual volumes; the most frequently cited threshold levels for interrupting feedings were 200 mL and 250 mL. About 25% of the nurses reported interrupting feedings for gastric residual volumes of 150 mL or less; only 12.6% of the respondents reported allowing gastric residual volumes of up to 500 mL before interrupting feedings. Conclusions: Practice among the 2298 critical care nurses varied widely. Many of the survey respondents are practicing in ways that can unnecessarily diminish the delivery of calories to patients. Protocols based on current enteral nutrition guidelines must be developed and implemented in practice settings. [ABSTRACT FROM AUTHOR]

This paper describes a flexible, multi-stage, nonprobability sampling process used in a study of persons recently diagnosed as HIV-positive (PRDH). From July 2007 to June 2008, we used venue and chain-referral sampling strategies to recruit PRDH in the US. We sought equal distributions (n = 20) of eligible PRDH from four self-identified subgroups: gay or bisexual men (GBM), heterosexual men (HM), heterosexual women (HW), and male-tofemale transgender women (TGW). We categorized 30 sampling venues as websites, health clinics, or other networks. For 359 volunteer respondents, website venues proved more productive compared to health clinics and other sources. Website venues were most efficient for sampling recently diagnosed GBM and HW. Passive sampling methods were less effective in recruiting HM and TGW. Sampling approaches should be flexible and tailored to reach sub-categories within hidden populations. The sampling process itself produced valuable knowledge about social networks of hidden HIV populations. [ABSTRACT FROM PUBLISHER]

Background Present day service systems evolved from the traditional model of disability intervention where the child with the disability and the family were viewed as pathological entities that needed to be fixed rather than supported. Scholars have increasingly called for a greater focus on the family in service delivery, but few studies have empirically examined the practical reality of such a shift. The present paper examines the disability-related formal service supports within the family quality of life (FQOL) framework in a sample of predominantly low-income, minority families in the USA. Methods Cross-sectional data collected from a convenience sample of 149 families using the Family Quality of Life Survey (FQOLS-2006) was analysed at the univariate, bivariate and multivariate levels. Results Over half of the families indicated that they needed more help from the service system, and the largest barrier to accessing services was a lack of information. Almost all families viewed service support as very important to their overall FQOL; however, only half of them were satisfied with the formal support that they were receiving. Less than half of the families reported having many service support opportunities and high attainment of service support, although most took high initiative in pursuing formal supports. The path model illustrated the complex inter-relationships between the six dimensions of service support. Conclusions Findings underscore the need for resources to empower families and the value of using the FQOLS-2006 to ascertain the service support needs and strengths of families. [ABSTRACT FROM AUTHOR]

Context--Despite increased rates of solid organ transplantation and frequent use of advanced practice nurses (APNs) to manage patients, no established staffing model including APNs and their roles exists. Objective--To characterize the role and integration of APNs in the staffing models of existing transplant centers. Design--Descriptive research using a researcher-designed survey of transplant APN professionals. Participants--53 attendees of a national APN transplant clinical management symposium. Main Outcome Measure-Investigator-designed survey tool consisting of 21 questions delivered in a paper format with 1 open-ended question about adequacy of current staffing and ideas for improvement. Results--53 responses from staff members of 21 different transplant centers were collected. In addition to APNs, members of existing transplant staffing models were identified as licensed practical nurses, registered nurses, social workers, administrative assistants, and data managers. The primary responsibilities of APNs were both inpatient and outpatient, before and after transplant, and consisted primarily of collecting patients' medical histories, doing physical examinations, handling clinic visits, and education. Licensed practical and registered nurses handled pretransplant referral management and phone triage duties. Social workers, administrative assistants, and data managers were responsible for social support, medical record management, and regulatory documentation, respectively. Most respondents (57%) found current staffing to be inadequate in their centers and suggested areas for improvement. Conclusion--APNs play a vital role in management of transplant patients. Transplant centers use APNs in different capacities, depending on the individual needs of the institution. Across institutions, support staff is crucial in the perception of adequate staffing. Additional research is needed to determine the most efficient use of APNs in transplant centers. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: A descriptive, nonexperimental study of community/public health nurses' (C/PHN) perceptions of their work and their workplace was conducted for the purpose of identifying factors that may affect tenure intention and, by extension, health care delivery, at a time when nursing workforce capacity is in crisis, a subject not studied well among the C/PHN workforce. It was thought that findings would potentially contribute to decisions about curriculum development, hiring practices, and work design by nurse educators, leaders, and administrators. Spreitzer's Theory of Structural and Psychological Empowerment and Meyer and Allen's Commitment theory were utilized together as a framework. Design and Sample: A paper-pen survey was mailed to 688 C/PHNs in 10 states seeking national accreditation serving in community-oriented and population-focused roles and selected randomly in local health departments with a census of 10 or more eligible nurses. The return of 478 completed surveys yielded a response rate of 76%. Measures: Data were examined with descriptive statistics, correlation, and multiple logistic regression methods. Results: Results revealed 1/3 of C/PHNs were in some way considering leaving the job in spite of significant relationships among empowerment factors and between empowerment and commitment factors. Conclusions: These data beg for a clearer understanding of C/PHNs' perceptions of empowerment and the reasons for intent to leave. [ABSTRACT FROM AUTHOR]

This paper discusses characteristics that are associated with enhanced maternal and child health (MCH) epidemiology functioning in state health agencies. The concept of the 'MCH Epidemiology Effort' is introduced as 'the epidemiologic work carried out by multiple units and agencies aimed at informing program planning and policy development on behalf of women, children and families.' This concept focuses attention on MCH epidemiology functioning at the organizational level rather than on individual MCH epidemiologists. The analysis used data from all 50 states and the District of Columbia. Each state participated in a telephone interview and submitted material that demonstrated the breadth, depth, and capacity of its MCH Epidemiology Effort. Several organizations, including the Council for State and Territorial Epidemiologists, the Health Resources and Services Administration/Maternal and Child Health Bureau, and the Centers for Disease Control and Prevention provided additional secondary data. The outcome for analysis was a three-category measure of MCH epidemiology functioning. The findings are consistent with, and add specificity to, those from prior assessments. In a multivariable model, agenda-setting by consensus, involvement of external stakeholders, the total of doctorally trained staff, and accessing CDC assignees or other staff were all significantly related to higher level MCH epidemiology functioning (ORs of 6.1, 6.6, 2.5, and 6.4, respectively; P < 0.05). Organizational visibility of the MCH Epidemiology Effort and a data environment marked by routine data-sharing and data integration were marginally related. We provide recommendations for action at the state and federal level for advancing evidence-based decision-making in maternal and child health. [ABSTRACT FROM AUTHOR]

ABSTRACT As the number of Latino children in public child welfare continues to grow, it is necessary to understand how their mental health is faring. The paper examines emotional and behavioural needs among Latino children who had contact with the public child welfare system. The purpose of this longitudinal study was twofold: to examine the severity of emotional and behavioural problems, and to assess the predictive role of generation status and Latino origin. Latent growth models were completed using the National Survey on Children and Adolescent Well-Being. The predictive model for the externalizing CBCL scale revealed that generation status and Latino origin were significant predictors. At baseline, Puerto Rican children exhibited higher rates of externalizing problems compared with Mexican children. Over time children who were first/second generation tended to have lower scores compared with the third-plus generation children. Implications for practise are discussed. [ABSTRACT FROM AUTHOR]

suhonen r., papastavrou e., efstathiou g., lemonidou c., kalafati m., da luz m.d.a., idvall e., berg a., acaroglu r., sendir m., kanan n., sousa v.d., katajisto j., välimäki m. & leino-kilpi h. (2011) Nurses' perceptions of individualized care: an international comparison. Journal of Advanced Nursing 67(9), 1895-1907. Abstract Aim. This paper is a report of a study of internationally-based differences in nurses' perceptions of individualized care in orthopaedic surgical in-patient wards. Background. Individualized care is valued in healthcare policy, practice and ethical statements as an indicator of care quality. However, nurses' assessments of individualized care are limited and comparative cross-cultural studies on individualized nursing care are lacking. Methods. A descriptive comparative survey was used to sample orthopaedic surgical nurses ( n = 1163) working in 91 inpatient wards in 34 acute hospitals in Finland, Cyprus, Greece, Portugal, Sweden, Turkey and the United States of America. Data were collected between March and November 2009 using the Individualized Care Scale-Nurse and analysed using descriptive and inferential statistics. Results. Nurses in different countries perceived that they supported patients' individuality generally and provided individualized care during nursing activities. Although the highest scores were in support of patients' individuality in the clinical situation both through nursing provision and nurses' perceptions of individuality, there were between-country differences within these scores. Generally, the Greek and American nurses gave the highest scores and the Turkish, Cypriot and Portuguese nurses the lowest. Conclusions. Between-country differences found may be attributed to differing roles of nurses, care processes, healthcare systems and/or the ways nursing care is defined and organized. As this was the first time the Individualized Care Scale-Nurse was used in an international context, the results are formative and indicate the need to continue studies in this area. [ABSTRACT FROM AUTHOR]

We apply the Communication Theory of Identity to investigate how patients display their ethnic identities during intercultural patient—provider interactions. Ethnic identity displays play a large part in reflecting patients’ and providers’ assumptions about the other, as well as their communicative needs. We collected paper-and-pencil responses from a convenience sample of providers and their patients, and conducted a constant comparative analysis of their open-ended reports of a recent intercultural medical interview. The results revealed how both parties viewed their roles in intercultural medical encounters and how they looked for accommodative behaviors from the other party. We draw implications for new applications and future developments of the Communication Theory of Identity and Communication Accommodation Theory. [ABSTRACT FROM PUBLISHER]

Background: The objective of this paper is to examine 10-year trends (1992 to 2002) in the number and type of indicators of DSM-IV abuse and dependence among whites, blacks, and Hispanics in the United States. Methods: Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population. Results: Increases in the prevalence of alcohol abuse between 1992 and 2002 seem associated with a rise in the prevalence of the indicator for 'hazardous use.' which usually means reports of driving after drinking. The decrease in dependence was not associated with changes in a particular indicator. In addition, both in 1992 and 2002, 12.3 to 15.4% of the men and 5.2 to 7.9% of the women were diagnostic 'orphans.' These respondents reported 1 or 2 indicators of alcohol dependence as present. Conclusions: The observed trends in number and types of indicators of DSM-IV alcohol abuse and dependence were probably triggered by a complex interplay between individuals' volume and pattern of drinking and reactions from the drinkers' social environment. The close association between hazardous use of alcohol and the prevalence of abuse deserves further discussion. A medical diagnostic category should not be so dependent on a criterion that may be influenced by social situations. It is necessary to understand more about diagnostic 'orphans' to better design interventions to address their problems. [ABSTRACT FROM AUTHOR]

The 'prevention paradox,' a notion that most alcohol-related problems are generated by nonheavy drinkers, has significant relevance to public health policy and prevention efforts. The extent of the paradox has driven debate over the type of balance that should be struck between alcohol policies targeting a select group of high-risk drinkers versus more global approaches that target the population at-large. This paper examines the notion that most alcohol problems among 4 Hispanic national groups in the United States are attributable to moderate drinkers. A general population survey employing a multistage cluster sample design, with face-to-face interviews in respondents' homes was conducted in 5 metropolitan areas of the United States. Study participants included a total of 2,773 current drinkers 18 years and older. Alcohol consumed in the past year (bottom 90% vs. top 10%), binge drinking (binge vs. no binge), and a 4-way grouping defined by volume and binge criteria were used. Alcohol-related harms included 14 social and dependence problems. Drinkers at the bottom 90% of the distribution are responsible for 56 to 73% of all social problems, and for 55 to 73% of all dependence-related problems reported, depending on Hispanic national group. Binge drinkers are responsible for the majority of the social problems (53 to 75%) and dependence-related problems (59 to 73%), also depending on Hispanic national group. Binge drinkers at the bottom 90% of the distribution are responsible for a larger proportion of all social and dependence-related problems reported than those at the top 10% of the volume distribution. Cuban Americans are an exception. The prevention paradox holds when using volume-based risk groupings and disappears when using a binge-drinking risk grouping. Binge drinkers who drink moderately on an average account for more harms than those who drink heavily across all groups, with exception of Cuban Americans. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a study of perceived levels of mental, physical and total fatigue, and also acute and chronic fatigue states, among registered nurses. Relationships between dimensions of fatigue and performance were investigated, as were differences in fatigue across levels of several demographic and work environment variables. Background. Fatigue is a factor that has been linked to performance decrements in healthcare workers. As a result of the nature of their work, nurses may be particularly susceptible to multiple dimensions of fatigue, and their performance is closely linked to patient safety. Methods. An online survey was used to measure mental, physical, and total fatigue dimensions, acute and chronic fatigue states, and performance. Participants were recruited via convenience sampling in cooperation with professional nursing organizations; 745 registered nurses completed the survey between February 2008 and April 2009. Results. Reported mental fatigue levels were higher than physical fatigue levels, and acute fatigue levels were higher than chronic fatigue levels. All fatigue dimensions and states were negatively correlated with perceived performance. Longer shift lengths and hours worked per week were associated with increases in physical and total fatigue levels. Mental, physical and total fatigue levels also differed with shift schedule. Conclusions. Fatigue levels were negatively correlated with performance, further supporting the role of fatigue in nurse performance. Work environment variables were strongly associated with differences in perceived levels of fatigue. By altering the work environment, it may thus be possible to reduce fatigue levels and the rates of medical errors. [ABSTRACT FROM AUTHOR]

This paper investigates whether private information from lending activities improves the forecast accuracy of bank-affiliated analysts. Using a matched sample design, matching by affiliated bank or borrower, we demonstrate that the forecast accuracy of bank-affiliated analysts increases after the followed firm borrows from the affiliated bank. We also find that the increase in forecast accuracy is more pronounced for borrowers with greater information asymmetry and bad news, and for deals with financial covenants. Last, we find that the informational advantage of bank-affiliated analysts exists only when the affiliated banks serve as lead arrangers, not merely as participating lenders. Overall, our evidence suggests that information flows from commercial banking to equity research divisions within financial conglomerates. [ABSTRACT FROM AUTHOR]

Objective To determine what the tobacco industry knew about the potential effects of menthol on smoking topographydhow a person smokes a cigarette. Methods A snowball strategy was used to systematically search the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) between 1 June 2010 and 9 August 2010. We qualitatively analysed a final collection of 252 documents related to menthol and smoking topography. Results The tobacco industry knew that menthol has cooling, anaesthetic and analgesic properties that moderate the harshness and irritation of tobacco. Owing to its physiological effects, menthol contributes to the sensory qualities of the smoke and affects smoking topography and cigarette preference. Conclusion Our review of industry studies suggests that the amount of menthol in a cigarette is associated with how the cigarette is smoked and how satisfying it is to the smoker. If menthol in cigarettes was banned, as the US Food and Drug Administration (FDA) is currently considering, new/experimental smokers might choose not to smoke rather than experience the harshness of tobacco smoke and the irritating qualities of nicotine. Similarly, established menthol smokers might choose to quit if faced with an unpleasant smoking alternative. [ABSTRACT FROM AUTHOR]

Billions of dollars are lost each year to Medicare and Medicaid fraud. Using three real payment populations, we consider the operating characteristics of commonly used sampling-and-extrapolation strategies for these audits: simple random sampling using (1) the simple expansion estimator or (2) the ratio estimator; and (3) stratified sampling where the basis of stratification is the payment amount. The achieved confidence level (=rate of under-recoupment) of the lower confidence bound based on the ratio estimator fell far below the government-prescribed 90% level for all three populations in commonly encountered high denial-rate scenarios. For the expansion estimator in simple random sampling, the achieved confidence level depends on the skew of the overpayment population: if it is left skewed, the level will fall below 90%, sometimes far below; if it is right-skewed, it will exceed 90%. In the latter case, careless stratification by payment amount can destroy this conservatism. When there is strong right skew, limited stratification can sometimes preserve the 90% confidence while yielding improvements in overpayment recovery. In any population where 90% under-recoupment is not achieved by extrapolation methods based on the central limit theorem, methods based on sample counts and the hypergeometric distribution (Edwards et al., Health Serv Outcomes Res Methodol 4:241-263, ; Gilliland and Feng, Health Serv Outcomes Res Methodol 10:154-164, 2010; Edwards et al., Pennysampling. Technical Report No. 232, Dept. of Statistics, University of South Carolina, Columbia, SC, ) should be considered; these mathematically guarantee the 90% confidence level. Regardless of the sampling and extrapolation plan being considered, operating characteristics (under-recoupment rate, overpayment recovery, etc.) should be thoroughly checked in the planning stages with Monte Carlo simulation testing, which we use throughout this paper. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a comparison of advice on lifestyle given by healthcare providers and subsequent action by recipients between Korean Americans and native Koreans with hypertension. Background. High blood pressure is controllable by having a healthy lifestyle, such as weight control, dietary change, exercise, low-sodium diet, alcohol restriction and ' smoking cessation, and by taking medication. Healthcare providers play an important role in teaching individuals with hypertension on healthy lifestyles. Method. This descriptive comparative study was conducted with a convenience sample of 100 Korean Americans and 100 native Koreans with hypertension. They were interviewed between May 2003 and June 2004 on the advice they received from healthcare providers on lifestyle and their subsequent action in terms of taking medication, weight control, dietary change, exercise, low-sodium diet, smoking cessation, alcohol restriction and tension reduction. Nutrient profiles were examined using the 24-hour dietary recall method. Findings. Korean Americans received advice on lifestyle less than did native Koreans, but more Korean Americans followed healthy lifestyle advice on dietary change and exercise than did native Koreans (P < 0.001). Weight control was the least adhered to behaviour among the Korean Americans, although almost two-thirds of them were overweight or obese. Both groups exceeded the Dietary Reference Intakes of sodium, but perceived their sodium consumption as low. Conclusion. Native Korean participants need to pay closer attention to carrying out the advice, whereas healthcare providers to Korean Americans need to give more advice on culturally acceptable healthy lifestyles, particularly on dietary changes and weight control. Both groups need to monitor their sodium intake more realistically. It is not only advice from healthcare providers that is integral to control of hypertension, but also that patients should follow that advice. [ABSTRACT FROM AUTHOR]

Complex sample designs, involving stratified and/or multistage sampling with sample weighting, along with frequency matching, are used to select controls or cases for case-control studies. Examples that motivated this paper are the Kaposi sarcoma case-control study that was conducted in Sicily and the US kidney cancer case-control study. Survey design-based approaches can be inefficient for the analysis of case-control studies with frequency matching. We propose a weighting method that post-stratifies control sample weights to the estimated population distribution of the matching variables among cases. This weighting maintains the efficiency of frequency matching. The method proposed is evaluated by using simulation studies and is applied to the two case-control studies. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to gain information from parents in the United States about their children with albinism. The article focuses on information and services related to medical care and low vision care. Methods: An online questionnaire was used to collect data, and parents had opportunities to submit additional information. One hundred ninetytwo families, representing 223 children with albinism from 40 U.S. states, completed surveys. Results: A snapshot of the data indicates that for 8.6 out of 10 families, there were no known relatives with the condition; 55.8% of the children had visual acuities that met the criteria for legal blindness in the United States; and 48% of the children using optical devices had received clinical low vision evaluations by optometrists or ophthalmologists who specialized in low vision. Implications for practitioners: The data gathered suggest recommendations for medical service providers, including clinical low vision specialists who perform evaluations for improving the functional use of vision. [ABSTRACT FROM AUTHOR]

Summary: Results obtained in randomized trials may not easily generalize to target populations. Whereas in randomized trials the treatment assignment mechanism is known, the sampling mechanism by which individuals are selected to participate in the trial is typically not known and assuming random sampling from the target population is often dubious. We consider an inverse probability of sampling weighted (IPSW) estimator for generalizing trial results to a target population. The IPSW estimator is shown to be consistent and asymptotically normal. A consistent sandwich‐type variance estimator is derived and simulation results are presented comparing the IPSW estimator with a previously proposed stratified estimator. The methods are then utilized to generalize results from two randomized trials of human immunodeficiency virus treatment to all people living with the disease in the USA. [ABSTRACT FROM AUTHOR]

The author comments on the article "Market Reactions to Mandated Interest Capitalization," by J. S. Hughes and W. E. Ricks (HR), concerning the security market reaction to SFAS No. 34. He states that HR's paper was a descriptive analysis of the reaction the capital market had to mandate on accounting changes. He suggests that when HR confined their sample to calendar-year businesses, their sample was considerably reduced and introduced problems with event date clustering. He states that in HR's estimating the net income of over half of the companies, a measurement error was introduced into HR's primary independent variable.

li w.-w., wallhagen m.i. & froelicher e.s. (2010) Factors predicting blood pressure control in older Chinese immigrants to the United States of America. Journal of Advanced Nursing 66(10), 2202–2212. Aim. This paper is a report of a study of the extent to which demographic characteristics, medication-related factors, hypertension-related knowledge and medication adherence predict systolic and diastolic blood pressure. Background. Little is known about predictors of hypertension control in Chinese elders. Methods. A longitudinal study with a 3-month follow-up was conducted with 90 Chinese immigrants to the United States of America aged ≥65 years and recruited from 2006 to 2007. The independent variables were measured at baseline. Blood pressure was measured at 3 months. Multiple linear regression analysis was used to evaluate the independent effects of seven variables on change in blood pressure at 3 months. Results. Participants ranged in age from 66 to 92 years (Mean 76·7,sd 6·6). The overall regression model for systolic blood pressure was statistically significant ( R2 = 0·32, F = 4·37, P < 0·01). A higher number of prescribed oral medications (sr2 = 0·06, t = 2·42, P = 0·02) and lower medication adherence (sr2 = 0·07, t = −2·60, P = 0·01) were statistically significant determinants of an increased systolic blood pressure. The overall regression model for diastolic blood pressure was statistically significant ( R2 = 0·21, F = 2·39, P = 0·03). Male gender (sr2 = 0·06, t = 2·26, P = 0·03) and lower medication adherence (sr2 = 0·11, t = −3·03, P < 0·01) were statistically significant determinants of an increased diastolic blood pressure. Conclusion. A greater number of prescribed medications and lower adherence predicted higher level of systolic blood pressure. Male gender and lower adherence were significantly associated with higher level of diastolic blood pressure. These predictors should be considered when designing interventions to help Chinese elders achieve better hypertension management. [ABSTRACT FROM AUTHOR]

This paper reports baseline behavioral and biological data collected from a cohort of 535 African American HIV serodiscordant couples enrolled in the Eban study across four urban metro areas. Data were collected on (1) the prevalence of risky sexual behaviors that occur within a couple and with concurrent sexual partners, (2) the STD prevalence for each member of the couple and (3) the correlates of STDs in the male partner as well as in the female partner. Presentation of the sociodemographic characterization and HIV risk behavior profiles of African American HIV serodiscordant couples represents an important initial description of a hidden, vulnerable population. Future research should be conducted with diverse samples of African American couples (i.e., younger couples, non-stable couples) to explore other potential correlates of STD prevalence. [ABSTRACT FROM AUTHOR]

Objective: In 2006, the Food and Drug Administration (FDA) approved the human papillomavirus (HPV) vaccine Gardasil® (Merck) for girls and women aged 9-26 years. Although the vaccine is ideally administered to 11 and 12 year olds, college-aged women may be uniquely at risk for HPV due to high rates of sexual activity and, thus, serve as an important catch-up population for the HPV vaccine. The purpose of this study is to examine factors associated with HPV vaccination status among college women. Methods: In fall 2008, a convenience sample of 256 undergraduate women enrolled in an introductory social science course at a large, public, urban university in the southeastern United States was surveyed. The 30-item paper-and-pencil questionnaire asked for demographic information, HPV knowledge, HPV vaccine beliefs, and HPV vaccination status. The overall survey response rate was 89.6%. Results: Most women were unmarried/single (91.7%), with a mean age of 18.9 years (range 17-42). Race/ethnicity status included 73.0% white, 17.5% Hispanic, and 7.7% black/African American. One hundred eleven (40.5%) women reported receiving the vaccine. Nonvaccinated women were less likely to have heard of the vaccine through a healthcare provider (odds ratio [OR] 0.12, 95% confidence interval [CI] 0.04-0.35) or from a family member (OR 0.33, 95% CI 0.16-0.68) and more likely to consider a healthcare provider recommendation as being only somewhat important (OR 2.91, 95% CI 1.32-6.41) or not important at all (OR 5.61, 95% CI 0.44-71.87) vs. very important. Conclusions: Findings suggest that healthcare providers have an important role in encouraging HPV vaccination. Continuing education for providers who see preadolescent girls in conjunction with a parent or who treat women of college age may be a worthwhile endeavor. [ABSTRACT FROM AUTHOR]

Background: There have been limited trend studies examining variations on the patterns of alcohol consumption among Whites, Blacks, and Hispanics in the United States. The current paper reports national trends in drinking patterns, volume of drinking (number of drinks per month), binge drinking, and drinking to intoxication among Blacks, Whites, and Hispanics over a period of 10 years and identifies sociodemographic predictors of these behaviors across the 3 ethnic groups. Methods: Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population. Results: Trends varied across different dimensions of drinking and ethnic groups. There were no statistically significant differences in the mean number of drinks consumed per month among men and women in any of the 3 ethnic groups between 1992 and 2002, but there was a significant rise in the proportion of current drinkers in both genders and in all 3 ethnic groups. Multivariate analysis indicated that, compared to Whites in 1992, Blacks and Hispanics did not increase their volume of drinking, but Whites did. Drinking 5 or more drinks in day at all did not increase between 1992 and 2002, but drinking 5 or more drinks at least once a month was more likely for all groups in 2002 compared to Whites in 1992. Drinking to intoxication at all was more likely among Whites in 2002 than 1992, but drinking to intoxication at least once a month was more likely among Whites and Blacks in 2002 than 1992. Conclusion: The only common trend between 1992 and 2002 across both genders and 3 ethnic groups was a rise in the proportion of drinkers. There was also a rise in drinking 5 or more drinks in a day (Whites, Blacks, and Hispanics) and drinking to intoxication (Whites and Blacks), but this was limited to those reporting such drinking at least once a month. The reasons for these changes are many and may involve complex sociodemographic changes in the population. It is important for the field to closely monitor these cross-ethnic trends in alcohol consumption. [ABSTRACT FROM AUTHOR]

Testing for deviations from Hardy-Weinberg equilibrium is a widely recommended practice for population-based genetic association studies. However, current methods for this test assume a simple random sample and may not be appropriate for sample surveys with complex survey designs. In this paper, the authors present a test for Hardy-Weinberg equilibrium that adjusts for the sample weights and correlation of data collected in complex surveys. The authors perform this test by using a simple adjustment to procedures developed to analyze data from complex survey designs available within the SAS statistical software package (SAS Institute, Inc., Cary, North Carolina). Using 90 genetic markers from the Third National Health and Nutrition Examination Survey, the authors found that survey-adjusted and -unadjusted estimates of the disequilibrium coefficient were generally similar within self-reported races/ethnicities. However, estimates of the variance of the disequilibrium coefficient were significantly different between the 2 methods. Because the results of the survey-adjusted tests account for correlation among participants sampled within the same cluster, and the possibility of having related individuals sampled from the same household, the authors recommend use of this test when analyzing genetic data originating from sample surveys with complex survey designs to assess deviations from Hardy-Weinberg equilibrium. [ABSTRACT FROM PUBLISHER]

The article discusses a paper that summarized the history of the subspecies concept as well as the major debates and issues surrounding its use. The significance of subspecies under the U.S. Endangered Species Act was examined. Ten issues were covered by the authors that have already been resolved, such as sampling theory, evolutionary biology and the heterogeneity of named subspecies. It is noted that the subspecies concept comprises two important issues namely trinomial nomenclature and the question of what constitutes a subspecies.

This paper demonstrates the importance of correcting for trip frequency bias in on-site samples of visitors when estimating regional economic effects associated with outdoor recreation. Because visitors taking more trips are more likely to be intercepted during on-site exit interviews than those taking fewer trips, it is important to correct for this bias when estimating total trips, calculating average expenditures and when calculating total local income and employment using input-output models. The paper presents methods for correcting for trip frequency bias in estimates of the number of trips, length of stay bias in visitor day estimates, as well as the resulting bias in visitor expenditures. In the empirical example of rafting trips on the Snake River in Wyoming, correcting for trip frequency and length of stay reduced by half total jobs and total income associated with recreation. Correcting average expenditures for trip frequency bias further reduced jobs and income by an additional 14%. [ABSTRACT FROM AUTHOR]

The article presents information on the American Time Use Survey (ATUS). In January 2003, the U.S. Bureau of Labor Statistics began a major initiative in gathering data on how Americans spend their time. The ATUS is the culmination of a design and development effort that lasted nearly ten years, including a pilot study in 1997 and full-scale field testing in 2002. The ATUS uses a random sample drawn from households that have recently completed their participation in the Current Population Survey. The American Time Use Survey is administered using computer-assisted telephone interviewing, rather than paper diaries as in many other countries. For labor and demographic economists, the ATUS will provide a wealth of useful information. Household bargaining and its outcomes have preoccupied students of family behavior. The absence of time-budget information on both spouses in ATUS households obviates the analysis of idiosyncratic family behavior; but the samples are large enough to allow the construction of large numbers of small cells containing information on matched pairs of observationally identical representative husbands/wives.

A large body of research suggests that US cropland soils can also sequester significant amounts of C and are a promising source of C credits. This paper presents a framework for assessing the transactions costs associated with per-hectare and per-credit contract types and addresses the potential magnitude of transactions costs associated with measuring soil C credits under a per-credit contract within the dry-land crop region of Montana, USA. In the empirical analysis, we estimate the total measurement costs for soil C credits and investigate how changes in contract (and region) size as well as increases in C credit variability affect total measurement costs. The empirical analyses suggest that increasing the size of the contract and aggregating credits over a larger number of producers can lower measurement costs associated with the per-credit contract, even in the face of increasing C variability. Thus contracts for large quantities of soil credits increase the likelihood that the per-credit contract remains more efficient than the per-hectare contract. However, these empirical results reflect the specific data and conditions present within the case study region. The theoretical expectation is that sample size and measurement costs can either increase or decrease as the population to be sampled increases. Thus the measurement costs associated with a per-credit contract could respond differently from this analysis across the spatial extent of the US. [ABSTRACT FROM AUTHOR]

This paper applies the hedonic technique to investigate the effectiveness of benefit transfer methodologies in a statistically controlled, repeated sampling scheme. Benefit transfers are carried out on several sets of 1,000 pairs of random, non-overlapping sub-samples drawn from a Chicago housing sample. The study finds that even under extremely favorable transfer conditions, quality of transferred benefits is poor, and there is no gain in precision in adopting function transfer over unit value transfer. In the presence of dissimilarities between two sites, however, quality of transferred benefits deteriorates further and function transfer appears more appropriate than unit value transfer. [ABSTRACT FROM AUTHOR]

LGBTQIAþpeople, particularly those aging into end-of-life care decisions, need safety cues to identify safe spaces to access equitable death care. We conducted a website content analysis of 90 randomly selected funeral homes across the United States to evaluate the presence of LGBTQIAþsafety cues, such as inclusive language, symbols, imagery, and LGBTQIAþ-friendly collaborations. Results showed that none of the selected funeral homes displayed any kind of safety cues. A significant change in funeral home marketing strategies is warranted so sexual and gender minorities can easily locate inclusive and affirming death care services. [ABSTRACT FROM AUTHOR]

Purpose: This study examined current auditory processing disorder (APD) protocols and audiologists' perspectives on the active debate seen in the literature regarding the status of APD as a unique disorder. Method: This study used a cross-sectional, nonexperimental survey design. The participants were 134 U.S. audiologists, representing diversity across experience level and work setting. Results: Popular APD tests from prior surveys remain popular, and a few new tests have emerged. Most audiologists use diverse strategies to identify potential comorbid disorders as part of their APD protocol, including multidisciplinary assessment and referral to other specialists. Most participants disagreed with the assertion that APD is not a unique disorder; however, many also pointed out that patients' struggles with listening need to be the primary focus of APD assessment and management, regardless of the label of the disorder. Qualitative analysis of participant comments on the controversy yielded six themes: Clinical Experience, Comorbidity, Listening Skills, Literature Support, Overdiagnosis, and More Information Needed. Conclusion: Most participants consider APD to be a unique disorder, citing clinical experience and the literature for support; however, many also indicated APD is complicated by comorbidity and APD may be overdiagnosed. [ABSTRACT FROM AUTHOR]

Background and Aims: Treatment of depression‐related psychological factors related to smoking behavior may improve rates of cessation among adults with major depressive disorder (MDD). This study measured the efficacy and safety of 12 weeks of behavioral activation for smoking cessation (BASC), varenicline and their combination. Design, Setting, Participants: This study used a randomized, placebo‐controlled, 2 × 2 factorial design comparing BASC versus standard behavioral treatment (ST) and varenicline versus placebo, taking place in research clinics at two urban universities in the United States. Participants comprised 300 hundred adult smokers with current or past MDD. Interventions: BASC integrated behavioral activation therapy and ST to increase engagement in rewarding activities by reducing avoidance, withdrawal and inactivity associated with depression. ST was based on the 2008 PHS Clinical Practice Guideline. Both treatments consisted of eight 45‐min sessions delivered between weeks 1 and 12. Varenicline and placebo were administered for 12 weeks between weeks 2 and 14. Measurements: Primary outcomes were bioverified intent‐to‐treat (ITT) 7‐day point‐prevalence abstinence at 27 weeks and adverse events (AEs). Findings No significant interaction was detected between behavioral treatment and pharmacotherapy at 27 weeks (χ2(1) = 0.19, P = 0.67). BASC and ST did not differ (χ2(1) = 0.43, P = 0.51). Significant differences in ITT abstinence rates (χ2(1) = 4.84, P = 0.03) emerged among pharmacotherapy arms (16.2% for varenicline, 7.5% for placebo), with results favoring varenicline over placebo (rate ratio = 2.16, 95% confidence interval = 1.08, 4.30). All significant differences in AE rates after start of medication were higher for placebo than varenicline. Conclusion: A randomized trial in smokers with major depressive disorder found that varenicline improved smoking abstinence versus placebo at 27 weeks without elevating rates of adverse events. Behavioral activation for smoking cessation did not outperform standard behavioral treatment, with or without adjunctive varenicline therapy. [ABSTRACT FROM AUTHOR]

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