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Smokers with elevated anxiety sensitivity (AS) have poorer smoking cessation outcomes. Smokers with elevated anxiety/depression report worse smoking cessation outcomes and greater AS. Thus, it is important to examine the utility of intervention strategies that target AS in the context of smoking cessation. Hatha yoga encourages the implementation of present-centered awareness in the face of discomfort, which may be a potential therapeutic strategy to reduce AS. The current study examines the impact of hatha yoga on AS among 51 smokers. Participants were randomly assigned to hatha yoga or wellness control on their quit/reduce smoking day. Compared to the control, the yoga condition reported significantly less AS at one-week follow-up. This relationship was moderated by baseline anxiety/depression, such that among individuals with elevated anxiety/depression, yoga was related to less AS than the control. Hatha yoga may serve as an additional strategy for successful smoking cessation in individuals with high AS.

The current paper presents a biopsychosocial model of cannabis use and anxiety that focuses explicitly on aspects of anxiety that may contribute to cannabis use and use-related problems among individuals with elevated anxiety. Elevated anxiety and anxiety disorders are common among individuals who use cannabis and those with cannabis use disorder (CUD). One possible explanation for this co-occurrence may be that symptoms associated with anxiety disorders (i.e., physiological arousal, subjective anxiety, and avoidance) may place anxious individuals at risk of using cannabis to cope with these symptoms. A review of the literature on the relationships between facets of anxiety and cannabis use and related problems partially supports the utility of this model and informs future directions for research and treatment in this area.

To review data published in the past 5 years to evaluate the utility of our biopsychosocial model of social anxiety’s relation to substance misuse to evaluate the model’s utility and update it. Data support the utility of our revised model—e.g., socially anxious persons report using substances to manage subjective anxiety, despite evidence that some substances may not have a direct effect on physiological responding. Other factors with promise include social influence, cognitive processes (e.g., post-event processing), and avoidance. Data highlight the importance of context as socially anxious persons use some substances more in some high-risk situations, despite lack of relation between social anxiety and use generally. Sociocultural factors remain understudied. This updated model is a theory- and data-driven model of the relations between social anxiety and substance misuse that can inform future work to improve substance-related outcomes among this especially vulnerable group.

Objectives United States Postal Service letter carriers are exposed to long bouts of UVR and thus are vulnerable to skin cancer. While previous studies have shown that occupational sun protection is often deficient, few studies have examined outdoor workers’ behavior during leisure time. Methods Subjects (n = 2,660) self-reported widebrim hat and sunscreen use over the past five workdays and past two non-working days using Likert-type scales. Generalized linear mixed models and generalized estimating equations were used to compare hat and sunscreen rates and predictors during occupational and leisure time. Results On average, carriers spent 3.9 h outside during workdays and 3.3 h during non-working days. Sunscreen and widebrim hat use during the workday is low and rates of use are significantly lower during non-working days. Conclusions Sun safety interventions for carriers should encourage sun protection at all times when outdoors.

The growth of child and adolescent psychiatric services based on the wraparound philosophy raises new questions for medical directors, investigators, and clinicians interested in improving quality of care and outcomes. Typically, quality improvement studies have focused on standardizing care and decreasing variation while community based services following a wraparound model are by definition individualized. To date, little information on how to evaluate such services in a managed care environment has been available. We present one option for evaluating the distribution of medical services and the extent to which providers individualize services for children with severe emotional disorders. Specifically, we (a) review the philosophy and goals of wraparound services, (b) introduce the Lorenz curve as a tool for determining the degree of inequality in service distribution at a given institution, and (c) present a case study on the use of Lorenz curves by a Medicaid Behavioral Health Organization in profiling behavioral providers.

Skin cancer incidence in the United States has increased. Exposure to ultraviolet radiation (UVR) is a major risk factor for skin cancer. Every year, millions of children with their families visit outdoor leisure facilities such as zoos where overexposure to UVR may occur. This study was conducted to assess the proportion of U.S. zoos that provided sun safety activities during the summer of 1998 and their willingness to incorporate skin cancer prevention strategies at their facility in the future. A 56 item self-administered questionnaire was mailed to 140 zoos accredited by the American Zoo and Aquarium Association. A follow-up telephone survey was also conducted with 33 mail non-respondents. The response rate was 97% (N = 136). Results revealed that in the summer of 1998, only 5% of zoos provided sun safety recommendations to visitors and 25% of zoos provided recommendations to their employees. The recommendations made most often to visitors and employees were to use sunscreen and wear protective clothing. Eighty-five percent of zoos indicated interest in providing sun safety activities at their facilities in the future. The next step will be to design environmentally appropriate sun safety programs for zoos and to encourage zoos to implement these programs.