This study examined the specificity of relations between parent / caregiver behaviors and childhood internalizing and externalizing problems in a sample of 70 fourth grade children (64% male, mean age = 9.7 years). Specificity was assessed via (a) unique effects, (b) differential effects, and (c) interactive effects. When measured as unique and differential effects, specificity was not found for warmth or psychological control but was found for caregiver's use of behavior control. Higher levels of behavior control were uniquely related to lower levels of externalizing problems and higher levels of internalizing problems; differential effects analyses indicated that higher levels of behavior control were related to decreases in the within-child difference in relative levels of level of internalizing vs. externalizing problems. Interactive relations among the three parenting behavior dimensions also were identified. Although caregivers emphasized different parenting behavior dimensions across two separate caregiver-child interaction tasks, relations between parenting behavior dimensions and child psychopathology did not vary as a function of task. These findings indicate the importance of assessing and simultaneously analyzing multiple parenting behavior dimensions and multiple child psychopathology domains.Forty years of parenting research have produced consensus regarding the importance of several dimensions of parenting behavior, including behavior control, psychological control, and warmth/support (e.g., Gray & Steinberg, 1999). Yet the precise nature of the relation of these parenting dimensions to child psychopathology remains unclear. For example, there is not yet consensus as to whether parenting behavior dimensions are best considered as categorical parenting styles (e.g., authoritative parenting, authoritarian parenting; Baumrind, 1991) based on simultaneous consideration of multiple dimensions, or as independent, continuous dimensions (e.g., psychological control; behavior control; Barber, 1996).Underlying the use of parenting style typologies (as opposed to separate dimensions of parenting) are several assumptions about the nature of parenting behaviors, including the belief that (a) parenting behaviors are themselves correlated (e.g., parents who are warm tend to use positive behavior control strategies), and thus parenting behaviors should be NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript considered in clusters rather than separately; and (b) the effects of one type of parenting behavior on children are dependent on the presence or absence of other parenting behaviors (i.e., parenting behaviors have interactive effects on child outcomes), and thus typologies should simultaneously consider multiple parenting behaviors. Although many studies have failed to find interactions among parenting behaviors in the prediction of child psychopathology (e.g., Barber, Olsen, & Shagle, 1994;Garber, Robinson, & Valentiner, 1997), others have found some evidence for interactive rel...

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There was apparent evidence in adult patients to suggest heterogeneity in provider risk for a patient complaint. However, once patient, procedural, and provider factors were acknowledged in analyses, such evidence for heterogeneity is diminished substantially. Further study into how and why these factors are associated with greater complaint risk may reveal potential interventions to decrease complaints.

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Purpose: Atelectasis (AT), or collapsed lung, is frequently associated with central lung tumors. We investigated the variation of atelectasis volumes during radiation therapy and analyzed the effect of AT volume changes on the reproducibility of the primary tumor (PT) position. Methods and materials: Twelve patients with lung cancer who had AT and 10 patients without AT underwent repeated 4-dimensional fan beam computed tomography (CT) scans during radiation therapy per protocols that were approved by the institutional review board. Interfraction volume changes of AT and PT were correlated with PT displacements relative to bony anatomy using both a bounding box (BB) method and change in center of mass (COM). Linear regression modeling was used to determine whether PT and AT volume changes were independently associated with PT displacement. PT displacement was compared between patients with and without AT. Results: The mean initial AT volume on the planning CT was 189 cm 3 (37-513 cm 3 ), and the mean PT volume was 93 cm 3 (12-176 cm 3 ). During radiation therapy, AT and PT volumes decreased on average 136.7 cm 3 (20-369 cm 3 ) for AT and 40 cm 3 (À7 to 131 cm 3 ) for PT. Eighty-three percent of patients with AT had at least one unidirectional PT shift that was greater than 0.5 cm outside of the initial BB during treatment. In patients with AT, the maximum PT COM shift was !0.5 cm in all patients and >1 cm in 58% of patients (0.5-2.4 cm). Changes in PT and AT volumes were independently associated with PT displacement (P < .01), and the correlation was smaller with COM (R 2 Z 0.58) compared with the BB method (R 2 Z 0.80). The median root mean squared PT displacement with the BB method was significantly less for patients without AT (0.45 cm) compared with those with AT (0.8cm, P Z .002).