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This study examined relationships among parental monitoring, family conflict, and subgroups of adolescent alcohol use identified through longitudinal latent class analyses (LLCA). Differences in these subgroups across sex and race/ethnicity were also examined. The present study used data (

A ubiquitous research finding in regional and national studies is that at least 40% of persons with mental disorders cannot access mental health services, and pharmacotherapy in particular. The American Psychological Association's (APA) designated programs for the provision of education and training in clinical psychopharmacology can be of great help in alleviating this national need. We address key developments relevant to the foundation of a predoctoral model of clinical psychopharmacology education and training. To this end, an overview of the Master of Science in Clinical Psychopharmacology (MSCP) program at The Chicago School of Professional Psychology (TCSPP) is presented. TCSPP is now enrolling its eleventh consecutive cohort of MSCP students, many of whom are doctoral students who are concurrently attending various APA accredited Health Service Psychology (HSP) programs. We provide two predoctoral routes for completing MSCP training: (a) a route allowing for the creation of concentrations in clinical psychopharmacology in Health Service Psychology (HSP) doctoral programs, providing up to half of MSCP coursework; and (b) a joint doctoral PsyD or PhD/MSCP program meeting APA accreditation and designation standards integrated into a 5-year curriculum to impart HSP graduates with the competencies to provide both psychotherapy and pharmacotherapy. We conclude with a discussion about the future direction of predoctoral clinical psychopharmacology education and training. Given its emphasis on neuroscience and interdisciplinary health care, such curricular models may help to address the nation's immediate mental health care needs, while serving to enhance the sustainability of HSP education and professional practice in the 21st Century. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Objective Background Method Results Conclusion Implications The goal of this study was to understand how intergenerational intimacy and individuation associate with COVID‐19 pandemic‐related stresses and changes to relationship qualities, and consequentially, with substance use indicators, happiness, and life satisfaction.Intergenerational family systems theory suggests that dysfunctional relationship patterns in one's family of origin contribute to greater stress, and consequentially, to poorer health outcomes. We examined how these patterns emerge for young adults during a pandemic.A sample (N = 501) of young adults at a large university in Texas completed an online questionnaire about health and happiness.More intergenerational intimacy was associated with more positive COVID‐19 pandemic‐related changes in relationship quality with family and friends, and with more happiness and life satisfaction. More intergenerational individuation was associated with less COVID‐19 pandemic‐related stress, fewer coping motives for alcohol use, and with more happiness and life satisfaction. Less COVID‐19 pandemic‐related stress and more positive COVID‐19 pandemic‐related changes in relationship qualities with family and friends were associated with more positive outcomes.More positive intergenerational relationships are associated with more positive outcomes in regards to COVID‐19 pandemic‐related stress and relationship changes.Promoting positive intergenerational relational qualities between young adults and their parents can buffer against pandemic‐related consequences in health and happiness. Family health practitioners should promote these intergenerational qualities in families, which in turn should increase positive psychosocial and health outcomes in the context of a pandemic. [ABSTRACT FROM AUTHOR] Copyright of Family Relations is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aims of this study were to estimate the walking cadence required to elicit a VO2reserve (VO2R) of 40% and determine if fitness status moderates the relationship between walking cadence and %VO2R. Twenty participants (10 male, mean(s) age 32(10) years; VO2max 45(10) mL·kg-1·min-1) completed resting and maximal oxygen consumption tests prior to 7 x 5-min bouts of treadmill walking at increasing speed while wearing an Apple Watch and measuring oxygen consumption continuously. The 7 x 5-min exercise bouts were performed at speeds between 3 and 6 km·h-1 with 5-min seated rest following each bout. Walking cadence measured at each treadmill speed was recorded using the Apple Watch "Activity" app. Using Bayesian regression, we predict that participants need a walking cadence of 138 to 140 steps·min-1 to achieve a VO2R of 40%. However, these values are moderated by fitness status such that those with lower fitness can achieve 40% VO2R at a slower walking cadence. The results suggest that those with moderate fitness need to walk at ~40% higher than the currently recommended walking cadence (100 steps·min-1) to elicit moderate-intensity physical activity. However, walking cadence required to achieve moderate-intensity physical activity is moderated by fitness status.

This study examined the dose-response effects of ingesting different sodium concentrations on markers of hydration and tennis skill. Twelve British nationally-ranked tennis players (age: 21.5 ± 3.1 years; VO2peak: 45.5 ± 4.4 ml.kg.min−1) completed four identical in-door tennis training sessions in a cluster randomized, single-blind, placebo-controlled, crossover design. Twenty-minutes prior to each training session, participants consumed a 250 ml sodium-containing beverage (10, 20, 50 mmol/L) or a placebo (0 mmol/L), and continued to consume 1,000 ml of the same beverage at set periods during the 1-h training session. Tennis groundstroke and serve performance, agility, urine osmolality, fluid loss, sodium sweat loss and perceptual responses (rating of perceived exertion (RPE), thirst, and gastrointestinal (GI) discomfort) were assessed. Results showed that ingesting 50 mmol/L sodium reduced urine osmolality (−119 mOsmol/kg; p = 0.037) and improved groundstroke performance (5.4; p < 0.001) compared with placebo. This was associated with a reduction in RPE (−0.42; p = 0.029), perception of thirst (−0.58; p = 0.012), and GI discomfort (−0.55; p = 0.019) during the 50 mmol/L trial compared with placebo. Linear trend analysis showed that ingesting greater concentrations of sodium proportionately reduced urine osmolality (β = −147 mOsmol/kg; p = 0.007) and improved groundstroke performance (β = 5.6; p < 0.001) in a dose response manner. Perceived thirst also decreased linearly as sodium concentration increased (β = −0.51; p = 0.044). There was no evidence for an effect of sodium consumption on fluid loss, sweat sodium loss, serve or agility performance (p > 0.05). In conclusion, consuming 50 mmol/L of sodium before and during a 1-h tennis training session reduced urine osmolality and improved groundstroke performance in nationally-ranked tennis players. There was also evidence of dose response effects, showing that ingesting greater sodium concentrations resulted in greater improvements in groundstroke performance. The enhancement in tennis skill may have resulted from an attenuation of symptomologic distracters associated with hypohydration, such as RPE, thirst and GI discomfort.

Background Prior research using psychosocial developmental models have identified emotional detachment from family and susceptibility to peer pressure as predictors of adolescent substance use. Despite mixed support for the gateway hypothesis, less is known about how these psychosocial developmental factors facilitate adolescent substance use. The purpose of this study was to examine how age of first substance use, emotional detachment from parents, and susceptibility to peer pressure influence the progression from alcohol, marijuana, and tobacco use to other illicit substance use (e.g., cocaine, hallucinogens). Method Data (N = 5792) were collected from high school students across seven semesters. Latent growth curve modeling was used to examine how age of first use of alcohol, marijuana, and tobacco predicted initial levels and changes in emotional detachment, peer pressure, and other illicit substance use. Results Earlier age of first use of alcohol, marijuana, and tobacco predicted detachment, peer pressure, and a greater likelihood of initial use of other illicit substances. More initial emotional detachment was associated with increases in other illicit substance use. Earlier ages of first use of alcohol, marijuana, and tobacco had indirect effects on initial use of other illicit substances through initial emotional detachment. Conclusion Emotional detachment from parents and peer pressure impact the likelihood of other illicit substance use across the high school years. Prevention programs may benefit by focusing on delaying the onset of first use of substance use and by preventing emotional detachment from parents and peer pressure.

Maximal heart rate (HRmax) is a fundamental measure used in exercise prescription. The Apple Watch™ measures heart rate yet the validity and inter-device variability of the device for measuring HRmax are unknown. Fifteen participants completed a maximal oxygen uptake test while wearing an Apple Watch™ on each wrist. Criterion HRmax was measured using a Polar T31™ chest strap. There were good to very good correlations between the watches and criterion (left: r = 0.87 [90%CI: 0.67 to 0.95]; right: r = 0.98 [90%CI: 0.94 to 0.99]). Standardised mean bias for the left and right watches compared to the criterion were 0.14 (90%CI: −0.12 to 0.39; trivial) and 0.04 (90%CI: −0.07 to 0.15; trivial). Standardised typical error of the estimate for the left and right watches compared to the criterion were 0.51 (90%CI: 0.38 to 0.80; moderate) and 0.22 (90%CI: 0.16 to 0.34; small). Inter-device standardised typical error was 0.46 (90%CI: 0.36 to 0.68; moderate), ICC = 0.84 (90%CI: 0.65 to 0.93). The Apple Watch™ ...

Homelessness in the U.S. remains a pernicious social problem despite national coordinated efforts to end it. Psychologists are well positioned to address homelessness through direct service, advocacy, research, and policy work. Results of a survey of psychologist members (n = 197) and student members (n = 209) of the American Psychological Association highlighted activities they engaged in related to helping people who experience housing instability and showed psychologists are more compassionate toward those who experience homelessness than is the general public. Respondents suggested a number of factors that would encourage their greater involvement with homelessness issues including receiving more focused training, increased funding for services, and simply being asked by someone to help. Given the continued problem of homelessness, psychologists can play an important role in supporting those who are in this situation. Suggestions for increasing training and engagement of psychologists are disc...

Introduction Investigate the effectiveness of short-term heat acclimation (STHA), over 5-days (permissive dehydration), on an intermittent sprint exercise protocol (HST) with females. Controlling for menstrual cycle phase. Materials and Methods Ten, moderately trained, females (Mean [SD]; age 22.6 [2.7] y; stature 165.3 [6.2] cm; body mass 61.5 [8.7] kg; V.⁢O2⁢peak 43.9 [8.6] mL⋅kg–1⋅min–1) participated. The HST (31.0°C; 50%RH) was 9 × 5 min (45-min) of intermittent exercise, based on exercise intensities of female soccer players, using a motorized treadmill and Wattbike. Participants completed HST1 vs. HST2 as a control (C) trial. Followed by 90 min, STHA (no fluid intake), for five consecutive days in 39.5°C; 60%RH, using controlled-hyperthermia (∼rectal temperature [Tre] 38.5°C). The HST3 occurred within 1 week after STHA. The HST2 vs HST3 trials were in the luteal phase, using self-reported menstrual questionnaire and plasma 17β-estradiol. Results Pre (HST2) vs post (HST3) STHA there was a reduction at 45-min in Tre by 0.20°C (95%CI −0.30 to −0.10°C; d = 0.77); T¯s⁢k (−0.50; −0.90 to −0.10°C; d = 0.80); and T¯b (−0.25; −0.35 to −0.15°C; d = 0.92). Cardiac frequency reduced at 45-min (−8; −16 to −1 b⋅min–1; d = 1.11) and %PV increased (7.0; −0.4 to 14.5%: d = 1.27). Mean power output increased across all nine maximal sprints by 56W (−26 to 139W; d = 0.69; n = 9). There was limited difference (P > 0.05) for these measures in HST1 vs HST2 C trial. Discussion Short-term heat acclimation (5-days) using controlled-hyperthermia, leads to physiological adaptation during intermittent exercise in the heat, in moderately trained females when controlling for menstrual cycle phase.

Background: Moderate fitness levels and habitual exercise have a protective effect for cardiovascular disease, stroke, type 2 diabetes, and all-cause mortality. The Apple Watch displays exercise completed at an intensity of a brisk walk or above using a green “exercise” ring. However, it is unknown if the exercise ring accurately represents an exercise intensity comparable to that defined as moderate-intensity. In order for health professionals to prescribe exercise intensity with confidence, consumer wearable devices need to be accurate and precise if they are to be used as part of a personalized medicine approach to disease management. Objective: The aim of this study was to examine the validity and reliability of the Apple Watch for measuring moderate-intensity exercise, as defined as 40-59% oxygen consumption reserve (VO2R). Methods: Twenty recreationally active participants completed resting oxygen consumption (VO2rest) and maximal oxygen consumption (VO2 max) tests prior to a series of 5-minute bouts of treadmill walking at increasing speed while wearing an Apple Watch on both wrists, and with oxygen consumption measured continuously. Five-minute exercise bouts were added until the Apple Watch advanced the green “exercise” ring by 5 minutes (defined as the treadmill inflection speed). Validity was examined using a one-sample t-test, with interdevice and intradevice reliability reported as the standardized typical error and intraclass correlation. Results: The mean %VO2R at the treadmill inflection speed was 30% (SD 7) for both Apple Watches. There was a large underestimation of moderate-intensity exercise (left hand: mean difference = -10% [95% CI -14 to -7], d=-1.4; right hand: mean difference = -10% [95% CI -13 to -7], d=-1.5) when compared to the criterion of 40% VO2R. Standardized typical errors for %VO2R at the treadmill inflection speed were small to moderate, with intraclass correlations higher within trials compared to between trials. Conclusions: The Apple Watch threshold for moderate-intensity exercise was lower than the criterion, which would lead to an overestimation of moderate-intensity exercise minutes completed throughout the day.

Dear Editor-in-ChiefWe thank Moore and colleagues for their interest in our recently published paper “Walking cadence required to elicit criterion moderate-intensity physical activity is moderated ...

Powerful forces have shaped professional psychology over the past 25 years, including significant changes in health policy and health care delivery systems. Examples include managed care cost containment, rapid growth of nondoctoral mental health providers, federal mental health parity legislation, and passage of the Affordable Care Act of 2010, with its emphasis on primary care-behavioral health integration and alternatives to fee-for-service reimbursement. This article considers these factors for psychology as a mental health profession and as a health profession more broadly defined, and describes the American Psychological Association's advocacy about the value of psychology in each domain. While challenging to psychology's traditional models of care, these changes offer significant promise for the future of psychology in health care. (PsycINFO Database Record

Neuroscience and Attachment in Helping Maltreated Children and Adolescents James Bray; PsycCRITIQUES

Regular physical activity is recommended for patients diagnosed with impaired glucose tolerance (IGT) and Type 2 Diabetes. However, "lack of time" is a common cited barrier in achieving the recommended weekly physical activity guidelines. High-intensity interval training (HIT) has been proposed as a time efficient exercise modality able to elicit similar adaptations in aerobic fitness as traditional moderate-intensity endurance exercise.

High-intensity interval training (HIT) has been proposed as an effective, time efficient strategy to elicit similar cardiometabolic health benefits as traditional moderate-intensity endurance training. This is an important consideration as "lack of time" is a common cited barrier to regular physical activity.

Background The Baylor College of Medicine SBIRT Medical Residency Training Program is a multilevel project that trains residents and faculty in evidenced-based screening, brief intervention, and referral to treatment methods for alcohol and substance use problems. Methods This paper describes the training program created for pediatric residents and provides an evaluation of the program. Ninety-five first-year pediatric residents participated in the training program. They were assessed on satisfaction with the program, self-rated skills, observed competency, and implementation into clinical practice. Results The program was successfully incorporated into the residency curricula in two pediatric residencies. Evaluations indicate a high degree of satisfaction with the program, self-reported improvement in SBIRT skills, observed proficiency in SBIRT skills, and utilization of SBIRT skills in clinical practice. Conclusions SBIRT skills training can be incorporated into pediatric residency training, and residents are able to learn and implement the skills in clinical practice.

This study compared the intensity distribution of time-motion analysis data, when speed zones were categorized by different methods. 12 U18 players undertook a routine battery of laboratory- and field-based assessments to determine their running speed corresponding to the respiratory compensation threshold (RCT), maximal aerobic speed (MAS), maximal oxygen consumption (vV˙O2max) and maximal sprint speed (MSS). Players match-demands were tracked using 5 Hz GPS units in 22 fixtures (50 eligible match observations). The percentage of total distance covered running at high-speed (%HSR), very-high speed (%VHSR) and sprinting were determined using the following speed thresholds: (1) arbitrary; (2) individualised (IND) using RCT, vV˙O2max and MSS; (3) individualised via MAS per se; (4) individualised via MSS per se; and (5) individualised using MAS and MSS as measures of locomotor capacities (LOCO). Using MSS in isolation resulted in 61% and 39% of player's % HSR and % VHSR, respectively, being incorrectly interpreted, when compared to the IND technique. Estimating the RCT from fractional values of MAS resulted in erroneous interpretations of % HSR in 50% of cases. The present results suggest that practitioners and researchers should avoid using singular fitness characteristics to individualise the intensity distribution of time-motion analysis data. A combination of players' anaerobic threshold, MAS, and MSS characteristics are recommended to individualise player-tracking data.

Dehydration has been shown to augment cellular stress. Glycerol hyperhydration can delay dehydration, which may decrease the level of pre- and post-exercise oxidative stress. This study aimed to compare the effects of glycerol (G) or water (W) hyperhydration with no hyperhydration (C) on oxidative stress, thermoregulation, and cycle performance. Seven trained males consumed 1.2 g of glycerol·kg⁻¹ body mass (BM) in 26 ml·kg⁻¹ BM water or equal volume water to achieve hyperhydration followed by a 90 min time trial. Total glutathione increased post exercise (PE) in all trials (p < 0.01), while oxidized glutathione (p < 0.05) and protein carbonyl concentrations (p < 0.001) were increased PE for the C trial only. Mean body temperature and heart rate increased with exercise but were not different between interventions. Total distance covered and power outputs were not different between interventions. Fluid intake attenuated oxidative stress but did not enhance thermoregulation or performance.

Review Question/ Objective The objective of this review is to identify the effectiveness of parent-centred interventions implemented in the community setting, in modifying eating and physical activity behaviours or weight-related outcomes of children. Criteria for inclusion Types of Participants This review will consider studies that include children of pre-school, primary and secondary school age and/or their parents aged >18 years. Types of interventions Interventions of interest are implemented in a community setting including, but not limited to; pre-schools (outside of curriculum), schools (non-curricular, before- and after-school), home based community centres and community camps, with an aim of improving eating and physical activity behaviours and/ or overweight/obesity outcome measures. Interventions conducted at pre-schools and schools must be conducted outside of those school curriculums and must be resourced separately. Types of Outcomes This review will consider studies that include the following outcome measures for children and / or their parents: i) Overweight/obesity related outcomes: weight (kg), % body weight lost, BMI, waist circumference (cm) ii) Eating behaviour outcomes: fruit and vegetable intake, macronutrient composition (eg fat intake per day), core food groups, diet quality iii) Physical activity behaviour outcomes: steps per day, time spent in activity, energy expenditure iv) Sedentary behaviour outcomes and constructs: Time spent in non-educational, small screen recreation (eg TV, computer, hand held electronic games.)

Aim The objective of the present study was to assess the feasibility and acceptability of an after-school obesity prevention strategy for families. Methods Ten children aged 5–12 years and their parents/guardians from an economically disadvantaged area participated in an after-school healthy lifestyle program, which was run over a school term. It consisted of five face-to-face sessions that were run fortnightly with an additional social barbeque session at program completion. Results Feasibility was demonstrated by successful recruitment, retention (80%) and collection of a high percentage of usable data (96% at baseline, 80% at follow up). Acceptability was demonstrated by a session attendance of 83%, 100% positive enjoyment response. There was no significant change in anthropometrics, child or adult fruit and vegetable intake with no or little effect on all other dietary variables. Conclusions The present study illustrated an approach to the translation of a program used in an evidence-based efficacious clinical trial into a sustainable community setting.

Background: Screening, brief intervention, and referral to treatment (SBIRT) is shown to be effective in identifying, intervening with, and making appropriate referrals for patients with unhealthy alcohol use. SBIRT training consists of knowledge-based and skill-based components and has increased the use of screening and intervention skills in clinical settings. This article reports on the development and evaluation of 2 SBIRT proficiency checklists for use across institutions to assess SBIRT skills in both simulated and clinical encounters. Methods: A national panel of 16 experts identified 137 discrete SBIRT skills items for the checklists. From this final list, 2 proficiency checklists were derived: the SBIRT Proficiency Checklist (SPC), composed of 22 questions for videotaped interviews, and the Clinical SBIRT Proficiency Checklist (CSPC), composed of 13 questions for direct clinical observation. An evaluation was conducted to test the reliability of the SPC and to assess the utility of the CSPC. Results: Two checklists for assessing SBIRT proficiency were developed by a collaborative workgroup. Fleiss’ kappa analyses indicated moderate agreement. In addition, faculty recorded satisfaction with the CSPC for assessing residents on their SBIRT performance during clinical encounters. Conclusions: The SPC and the CSPC are practical tools for assessing competence with SBIRT and are easily integrated as standard instruments in a wide range of training settings. Future advancements to the checklists and their evaluation include modification of the SPC rating scale to be consistent with the CSPC, developing a training program for using the checklists, and further testing to improve interrater reliability.

El propósito este estudio fue el obtener un instrumento estandarizado de autoridad personal para la población mexicana. Se utilizó el Cuestionario de Autoridad Personal en el Sistema Familiar y se examinó su estructura factorial. Los participantes fueron 600 personas voluntarias, mayores de edad, casadas o en unión libre residentes del Distrito Federal y área metropolitana con número de hijos y ocupaciones variables. Las dimensiones propuestas en el cuestionario original fueron distintas para la población mexicana. Los resultados sugieren una solución de 16 factores para explicar el fenómeno y uno adicional correspondiente a un estudio exploratorio preliminar. Entre las diferencias, se encontraron factores por separado para el padre y la madre relacionados con la intimidad e intimidación intergeneracional en lugar de dimensiones unificadas. También se observaron factores exclusivos para describir la importancia de las expectativas de la madre hacia los hijos resaltando el impacto de la estructura de la familia mexicana en la obtención de los resultados. El análisis factorial de segundo orden muestra la conformación de cinco dimensiones que subyacen a la autoridad personal.

The Baylor College of Medicine SBIRT Medical Residency Training Program is a multilevel project that trains residents and faculty in evidenced-based screening, brief intervention, and referral to treatment (SBIRT) methods for alcohol and substance use problems. This paper describes the training program and provides initial evaluation after the first year of the project. The program was successfully incorporated into the residency curricula in family medicine, internal medicine, and psychiatry. Initial evaluations indicate a high degree of satisfaction with the program and, despite a slight decrease in satisfaction scores, participants remained satisfied with the program after 30 days. Implementation barriers, solutions, and future directions of the program are discussed.

While tremendous progress has been made in the prevention and treatment of HIV, individuals continue to be at risk of acquiring HIV. There is increased recognition that interventions need to target couples and families in at-risk populations. This article provides an introduction to this special issue on couples, families, and HIV and a review of research on couple and family interventions for prevention of HIV. The section on couples focuses on prevention programs for heterosexual couples while the section on families focuses on family based prevention programs for adolescents. This review demonstrates the efficacy of couple and family interventions to reduce HIV risk behavior and to increase other HIV-related behaviors in couples and to prevent HIV risk behaviors in families. Implementation of these evidenced-based interventions in couple and family practice are discussed.

This paper describes challenges of studying complex and changing families and provides suggestions for methods of analyses to study these family systems. Five common problems that NIMH-funded investigators have encountered in analyzing family based studies are addressed and analytic solutions for addressing these problems are illustrated using data from Family HIV/AIDS projects. The problems discussed in the paper are (1) differences in subgroup responses to interventions; (2) longitudinal changes in family relationships and covariates that vary by group in nested designs; (3) dealing with missing data over time from attrition and planned missing data due to death; (4) dealing with multiple reports from different family members; and (5) developing concordance measures among family members. The use of multi-level and growth curve modeling techniques to address these problems is illustrated with some of the studies.

This article reviews the 2009 APA President's initiatives and recommendations for the future of psychology practice and science. The future of psychology practice requires that we expand the focus of traditional practice; become health care providers, not just mental health providers; use evidence-based practice, assessment, and outcome measures; incorporate technology into our practices, including electronic health records; and change training and focus to meet the needs of our diverse society. The future of psychological science requires that we train and work in multidisciplinary teams, employ different methods and approaches, and shift our focus to translational science. The future of our profession requires substantial changes in graduate education to prepare our students for science and practice in the 21st century. In light of advances in science and practice that reveal the critical importance of psychosocial and behavioral factors in health and disease, I call for the creation of a department of behavioral health within the federal government.

Purpose: Few efficacious child obesity interventions have been converted into ongoing community programs in the after-school setting. The aim of this study was to evaluate the impact of phase 2 of the Back to Basics cooking club on dietary behaviours and fruit and vegetable variety in a population at risk of obesity at a low income school with > 10% indigenous population. Methods: Baseline and 3-month dietary intake and social cognitive theory (SCT) constructs were collected in 51 children, mean age 9 years, 61% female. McNemar tests were used for comparison of proportions between categorical variables. Cohen's d was used to compare effect sizes across different measures. Results: Consumption of one or more fruit servings per day significantly increased from 41% to 67% (P = 0.02, d = 0.13) and there was a trend for increasing the weekly variety of fruit and vegetables. The SCT constructs assessed within the current study improved significantly (P < 0.05), with moderate to large effect sizes (d = 0.33–0.78). Conclusion: This study documents that a previous efficacious healthy lifestyle program can be adapted for use as an obesity prevention program addressing improvements in vegetable and fruit intakes in a low income community with a relatively high indigenous population.

This article describes an innovative program to meet the needs of homeless women, children, and families residing at a transitional living center in an urban setting. The program involves collaboration between medical and mental health professionals to address the multiple problems and unmet needs of this population. Recommendations for future work in expanding collaborative practice are discussed. ((c) 2004 APA, all rights reserved)

A prospective, school-based study of increasing alcohol use in a multi-ethnic sample of 7,540 adolescents showed that the effects of stress, family conflict, and parental monitoring were differentially moderated by two modes of individuation. The effects of stress were moderated by ethnic status and individuation. Implications for prevention and intervention are discussed.

The influence of the developmental process of individuation, family conflict and cohesion, and ethnicity on adolescent alcohol use was examined in a 3-year longitudinal study. Participants included non-Hispanic White, Mexican American, and African American adolescents (n = 6,522) from 6th, 7th, and 8th grades. They were surveyed annually for 3 years. Depending on which aspect of individuation was measured, hierarchical linear modeling indicated that changes in adolescent individuation were related to either increases or decreases in alcohol use over the 3-year period. Separation and family conflict were related to increases in alcohol use, and intergenerational individuation and family cohesion were related to decreases in alcohol use. White and Mexican American adolescents had a faster rate of increase in alcohol use than did African American youth. Separation and family process similarly influenced adolescent alcohol use from different ethnic groups. Implications for prevention and intervention programs are discussed.

This study evaluates a developmental psychosocial model of adolescent drinking. Specifically, the role of two aspects of adolescent individuation-separation and intergenerational individuation-is examined within the context of family dynamics, stress and peer associations. These measures parallel an ongoing debate regarding the nature of individuation. The separation measure captures aspects of individuation related to detachment or rebelliousness. Intergenerational individuation measures increasing self-reliance and control with maintenance of supportive family bonds.A structural equation model describing adolescent alcohol use as a function of two measures of individuation, family conflict, communication with mother, stress and peer use of alcohol was tested in two independent samples. The first included 6th- through 12th-grade adolescents and the second was composed of 6th- through 8th-grade students.In both studies, significant direct and indirect paths were found from individuation measures and family, peer use and stress constructs to adolescent alcohol use. Separation had a stronger relationship to alcohol use than did intergenerational individuation and was associated with higher levels of stress and alcohol use by peers.The findings support the role of individuation as a contributing factor in adolescent alcohol use. They indicate the importance of family and parent-adolescent relationships in adolescent alcohol use and suggest directions for both family-based and school-based preventive interventions.

Many psychologists are finding new opportunities for practice in primary care settings. These settings challenge many aspects of traditional practice and require adaptation and innovation. Psychologists must consider changes in their site of practice, treatment duration, type of intervention, and role as part of a health care team. This article describes the culture of primary care medicine and offers 10 practical tips for the adaptation of psychological practice to primary care. Primary care is now the linchpin of the new health care delivery system. This focus on primary care creates both threats to the conventional independent practice of psychology and new opportunities for collaboration and direct participation in the delivery of primary care services. In terms of threat, a psychologist whose solo or small-group practice has focused predominately on private, office-based psychological assessment and psychotherapy faces increasing economic pressures created by market-driven reforms, managed care, and other limits to traditional fee-for-service psychological services (Frank & VandenBos, 1994). Managed care systems increasingly rely on primary care providers (including physicians in family n'~edicine, general internal medicine, pediatrics, and sometimes obstetricsgynecology) to screen and triage patients with a wide range of medical and psychological problems. These physicians are the gatekeepers for referral to all specialists, including psychologists. In terms of opportunity, psychologists who shift their practices to work closely with these providers as part of an integrated delivery system are most likely to continue to deliver services to a wide variety of patients (Shortell, Gillies, & Anderson, 1994).

Coordinated intervention from multiple service agencies is a necessity because of the complex set of issues facing families without homes. Barriers to interagency collaboration exist, but are not insurmountable. This chapter presents ten evidence-based principles that can guide successful collaborations that are based on the Federal Strategic Plan to End Homelessness. These principles are illustrated using real-life examples taken from several programs that help people without homes.

This paper provides a review of previous literature reviews on the effectiveness of marital therapy and evaluates the long-term efficacy of couples therapy in preventing marital separation and divorce. There is general agreement that marital therapy can be effective in reducing marital conflict and promoting marital satisfaction, at least in the short term. Research examining the long-term efficacy of couples therapy for the prevention of marital separation and divorce is sparse but promising with respect to its effectiveness in promoting marital stability. Predictors of successful marital therapy outcomes, the clinical significance of marital therapy outcomes, and the cost effectiveness of marital therapy are also discussed.

The application of selected multivariate statistics is illustrated for use in family psychology research. The use of multivariate analysis of variance (MANOVA) and discriminant analysis in factorial designs and profile analysis is discussed. Profile analysis provides a method for dealing with unit of analysis issues in family psychology research. Applications of confirmatory factor analysis are also discussed as useful methods for researchers examining multiple components of families and handling multiple perspectives of various family members. Limitations and applications of these methods in family psychology research are reviewed.

Fathers have not been exclusively targeted in family-based lifestyle programmes. The aim was to determine whether dietary intakes of fathers and children can be improved, following an intervention targeting fathers. Overweight and obese fathers (n=50, 21-65 years, body mass index [mean ± standard deviation] 33.3 ± 4.1) and their children (5-12 years) were recruited. Dietary intake was assessed at baseline and 6 months (n=35) by food frequency questionnaire. Linear mixed models determined differences by time. Fathers significantly reduced portion size (P=0.03) but not energy intakes, whereas children reduced energy intakes (kJ) (P=0.02). There is an opportunity to target fathers as to improve child intakes.

Background As most sport drinks contain some form of non-nutritive sweetener (e.g. aspartame), and with the variation in blood glucose regulation and insulin secretion reportedly associated with aspartame, a further understanding of the effects on insulin and blood glucose regulation during exercise is warranted. Therefore, the aim of this preliminary study was to profile the insulin and blood glucose responses in healthy individuals after aspartame and carbohydrate ingestion during rest and exercise. Findings Each participant completed four trials under the same conditions (45 min rest + 60 min self-paced intense exercise) differing only in their fluid intake: 1) carbohydrate (2% maltodextrin and 5% sucrose (C)); 2) 0.04% aspartame with 2% maltodextrin and 5% sucrose (CA)); 3) water (W); and 4) aspartame (0.04% aspartame with 2% maltodextrin (A)). Insulin levels dropped significantly for CA versus C alone (43%) between pre-exercise and 30 min, while W and A insulin levels did not differ between these time points. Conclusions Aspartame with carbohydrate significantly lowered insulin levels during exercise versus carbohydrate alone.

This column presents issues that affect families undergoing separation, divorce, and remariage, including single parenting and stepfamilies. If you have specific areas or questions that you would like discussed in this column, please write to: James H. Bray, Department of Family Medicine, Baylor College of Medicine, 5510 Greenbnar, Houston TX 77005, or call (713) 798-7751.

This column presents issues that affect families undergoing separation, divorce, and remari7age, includingsingleparent and stepfamilies. If you have specific areas or questions that you would like discussed in this column, please write to: James H. Bray, Department of Family Medicine, Baylor College of Medicine, 5510 Greenbriar, Houston, TX 77005, or call (713) 798-7751.

Although a considerable amount of literature exists on the ergogenic potential of ingesting sodium bicarbonate (NaHCO3) before short-term, high-intensity exercise, very little exists on optimal loading times before exercise. The purpose of this study was to determine the influence of NaHCO3 supplementation timing on repeated sprint ability (RSA). Eight men completed 3 (randomized and counterbalanced) trials of ten 10-second sprints separated by 50 seconds of active recovery (1:5 work-to-rest) on a nonmotorized treadmill. Before each trial, the subjects ingested 0.3 g·kg(-1) body weight of NaHCO3 at 60 (H1), 120 (H2), or 180 (H3) minutes before exercise. Additionally, the subjects were assessed for any side effects (gastrointestinal [GI] discomfort) from the NaHCO3 ingestion via a visual analog scale (VAS). Blood buffering was assessed using a 2-way analysis of variance (ANOVA) with repeated measures, whereas repeated sprint performance and GI discomfort were assessed via a 1-way ANOVA with repeated measures. Blood-buffering capacity was not different at preexercise times (HCO3(-) [millimoles per liter] H1: 30.2 ± 0.4, H2: 30.9 ± 0.6, H3: 31.2 ± 0.6; p > 0.74). Average speed, average power, and total distance covered progressively declined over the 10 sprints; however, there was no difference between conditions (p > 0.22). The incidence of GI discomfort was significantly higher (p < 0.05) from preingestion at all time points with the exception of 180 minutes, whereas severity was only different between 90 and 180 minutes. Ingestion times (between 60 and 180 minutes) did not influence the blood buffering or the ergogenic potential of NaHCO3 as assessed by RSA. However, VAS scores indicated that at 180 minutes postingestion, an individual is less prone to experiencing significant GI discomfort.