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The authors used recursive partitioning methods to identify combinations of baseline characteristics that predict 2-year physical activity success in each of 3 physical activity interventions delivered in the multisite Activity Counseling Trial. The sample consisted of 874 initially sedentary primary care patients, ages 35-75 years, who were at risk for cardiovascular disease. Predictors of 2-year success were specific to each intervention and represented a range of domains, including physiological, demographic, psychosocial, health-related, and environmental variables. The results indicate how specific patient subgroups (e.g., obese, unfit individuals; high-income individuals in stable health) may respond differently to varying levels and amounts of professional assistance and support. The methods used provide a practical first step toward identifying clinically meaningful patient subgroups for further systematic investigation.  相似文献   
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This study evaluated cardiovascular responses (CVR) to an active speech task with blatantly discriminatory (BRC) versus neutral (NRC) stimuli and an anger recall task in a sample of Black men (N = 73; age 18 to 47). Diastolic blood pressure scores were higher for NRC versus BRC stimuli during anger recall (p = .05). Moreover, persons in the NRC group who perceived high levels of racism (vs. no racism or BRC group) during active speech showed larger increases in blood pressure across postspeech rest, anger recall, and subsequent rest (p = .03). The notable elevation in CVR in response to an ambiguous event extends current models of racism suggesting that subtle racism is a psychosocial stressor that erodes health through chronically elevated CVR.  相似文献   
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OBJECTIVE: This report reviews the evidence that informs the role of health and mental health care providers in addressing youth smoking cessation. DESIGN: Qualitative literature review. RESULTS: Physicians do not consistently screen adolescents for tobacco use and fail to provide recommended cessation advice. Challenges to addressing smoking cessation include the need for procedures to ensure confidentiality and the existence of competing demands to provide other services. Few published studies have specifically addressed the effectiveness of clinical interventions. Interventions that require return visits or follow-up phone contacts are technically difficult to implement in this population. Successful interventions may require resources not available in nonresearch settings. Most studies have used brief clinical intervention as a control condition, making it impossible to evaluate its effectiveness. CONCLUSION: There is little evidence that supports current clinical smoking cessation guidelines for adolescents. More research is needed to develop inexpensive, efficient clinical interventions that can provide youths access to smoking cessation help. Future challenges include reorganizing clinical systems to offer greater counseling by support staff or in electronic formats and to provide effective booster messages and follow-up care in a population that is difficult to track.  相似文献   
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Previous work on children's intuitive knowledge about the natural world has documented their difficulty in acquiring an overarching concept of biological life that includes plants as well as humans and non‐human animals. It has also suggested that the acquisition of fundamental biological concepts like alive and die may be influenced by the language used to describe them, as evidenced by differences between English‐ and Indonesian‐speaking children's performance in tasks involving these concepts. Here, we examine one particularly important source of linguistic information available to children during this acquisition process: everyday conversations with their parents. We take a cross‐linguistic approach in analysing the evidence available to English‐ and Indonesian‐speaking children as they acquire meanings for words corresponding to the concepts alive and die . Our analysis illustrates that young children acquiring English and Indonesian are faced with distinct problems, but that parental input in both languages does little to support the acquisition of broad, inclusive biological concepts.  相似文献   
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The current study was designed to gain a better understanding of the nature of the relationship between substance use and sexual risk taking within a community sample of women (N = 1,004). Using confirmatory factor analysis, the authors examined the factor structure of sexual risk behaviors and substance use to determine whether they are best conceptualized as domains underlying a single, higher order, risk-taking propensity. A 2 higher order factor model (sexual risk behavior and substance use) provided the best fit to the data, suggesting that these 2 general risk domains are correlated but independent factors. Sensation seeking had large general direct effects on the 2 risk domains and large indirect effects on the 4 first-order factors and the individual indicators. Negative affect had smaller, yet still significant, effects. Impulsivity and anxiety were unrelated to sexual health risk domains.  相似文献   
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