Treatment integrity refers to implementing interventions as intended. Treatment integrity is critically important for experimental validity and for drawing valid inferences regarding the relationship between treatment and outcome. Yet, it is rarely adequately addressed in psychotherapy research. The authors examined barriers to treatment integrity implementation by surveying psychotherapy researchers. Results indicate that lack of theory and guidelines on treatment integrity procedures, as well as time, cost, and labor constraints, were regarded as strong barriers. The lack of general knowledge about treatment integrity and the lack of editorial requirement for reporting integrity procedures were also perceived as barriers to its implementation. However, psychotherapy researchers indicated awareness of the importance of treatment integrity for the experimental validity of a study and did not regard lack of its appreciation as a barrier for implementing integrity procedures. Further, a higher number of endorsed barriers predicted lower adequacy of treatment integrity procedures in the authors' own research. Recommendations for improving how integrity is addressed include journal and editorial enforcement of treatment integrity implementation, funding for integrity procedures, and provision of specific guidelines.

Background Substance use, housing instability, and transactional sex all contribute to HIV risk engagement among homeless women. Because of the increased risk of HIV among homeless women, this study sought to understand the context of sexual behaviors and condom use among homeless women and elucidate modifiable factors that can be targeted by interventions. Methods Homeless women (n = 45) participated in focus groups (n = 6) at shelters throughout Los Angeles County. Thematic analyses revealed that similar to other high-risk women, homeless women engage in sex with multiple types of partners (steady, casual, and transactional). Findings Our findings indicate that, similar to use among other high-risk women, condom use by homeless women varied by type of partner. Substance use also contributed to condom non-use. In a departure from previous research, homeless women reported overarching feelings of hopelessness. Participants spoke of hopelessness contributing to risk engagement, specifically the number of ongoing stressors experienced because of homelessness contributing to despair. Without acknowledgement of this unique quality of homelessness, women felt their risk reduction needs would never truly be understood. Conclusions Interventions involving homeless women should include self-esteem building, acknowledgment and use of inherent resilience qualities gained during homelessness, respect for current knowledge and skills, and an exploration of when women choose to trust their partners and how they make safer sex choices.

The disposable soma theory proposes a trade-off between fertility and longevity but existing findings on this association have been mixed. This study used data from 15,622 twins born between 1901 and 1925 ascertained from the population-based Swedish Twin Registry to test the child-longevity association and whether it is accounted for by individual-level factors or by genetic and environmental factors shared by family members. Based on survival analysis, both women and men with children had significantly longer survival relative to the childless, with a slightly higher relative advantage in men. Adjustments for demographic factors and cotwin fertility did not mediate the parenting-survival association, indicating that this association is attributable to individual-level factors associated with fertility rather than family-level environmental or genetic factors shared by cotwins. These results, derived from a large, population-based sample, are inconsistent with the disposable soma theory as applied to modern human populations.

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People 13 595 female twins and 10 524 male twins aged 20-47 years, born in Sweden between 1959 and 1985. The study included monozygotic and same-and opposite-sex dizygotic twins, who were taking part in the Study of Twin Adults: Genes and Environment (STAGE). Participants were identified using the Swedish Twin Registry. Setting Sweden; 2005. Risk factors Genetic and environmental factors; gender; and childhood trauma (measured using the selfcompleted Life Stressor Checklist, LSC-R). A basic twin model was used to quantify genetic and environmental effects. Heritability (genetic effects) was compared in male and females. Childhood trauma was assessed in both sexes, but were analyzed and reported on in women. Outcomes Lifetime diagnosis of alcohol dependence, established using a standardised, computerassisted Structured Clinical Interview for DSM-IV. Alcohol dependence was classified as late onset (type I) or early onset (type II) alcohol dependence, based on the revised Cloninger-Bohman criteria. (early onset is defined as onset of alcohol problems before age 25, and/or seeking treatment before age 30; plus two or more social complications of alcohol misuse, such as drunk driving or job loss).