This study examined how parenting factors were associated with adolescent problem behaviors among urban minority youth and to what extent these relationships were moderated by family structure and gender. Sixth-grade students (N = 228) reported how often they use alcohol, smoke cigarettes, or engage in aggressive or delinquent behaviors; a parent or guardian reported their monitoring and other parenting practices. Findings indicated that boys and those from singleparent families engaged in the highest rates of problem behavior. More parental monitoring was associated with less delinquency overall, as well as less drinking in boys only. Eating family dinners together was associated with less aggression overall, as well as less delinquency in youth from single-parent families and in girls. Unsupervised time at home alone was associated with more smoking for girls only. Implications for prevention interventions are discussed. Research and theory on the etiology of problem behavior in childhood and adolescence often focus on the role of the family in the development of antisocial behavior (

Synopsis Substantial progress has been made in developing prevention programs for adolescent drug abuse. The most effective interventions target salient risk and protective factors at the individual, family, and/or community levels and are guided by relevant psychosocial theories regarding the etiology of substance use and abuse. This article reviews the epidemiology, etiologic risk and protective factors, and evidence-based approaches that have been found to be most effective in preventing adolescent substance use and abuse. Exemplary school and family-based prevention programs for universal (everyone in population), selected (members of at-risk groups), and indicated (at-risk individuals) target populations are reviewed, along with model community-based prevention approaches. Challenges remain in widely disseminating evidence-based prevention programs into schools, families, and communities.

In response to the estimated potential impact of coronavirus disease (COVID-19) on New York City hospitals, our institution prepared for an influx of critically ill patients. Multiple areas of surge planning progressed, simultaneously focused on infection control, clinical operational challenges, ICU surge capacity, staffing, ethics, and maintenance of staff wellness. The protocols developed focused on clinical decisions regarding intubation, the use of high-flow oxygen, engagement with infectious disease consultants, and cardiac arrest. Mechanisms to increase bed capacity and increase efficiency in ICUs by outsourcing procedures were implemented. Novel uses of technology to minimize staff exposure to COVID-19 as well as to facilitate family engagement and end-of-life discussions were encouraged. Education and communication remained key in our attempts to standardize care, stay apprised on emerging data, and review seminal literature on respiratory failure. Challenges were encountered and overcome through interdisciplinary collaboration and iterative surge planning as ICU admissions rose. Support was provided for both clinical and nonclinical staff affected by the profound impact COVID-19 had on our city. We describe in granular detail the procedures and processes that were developed during a 1-month period while surge planning was ongoing and the need for ICU capacity rose exponentially. The approaches described here provide a potential roadmap for centers that must rapidly adapt to the tremendous challenge posed by this and potential future pandemics.

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Substance use and abuse are important public health problems in the USA and throughout the world. In many developed countries, the initial stages of substance use typically include experimentation with alcohol, tobacco, or marijuana with one's peer group during adolescence. While there have been gradual decreases in the use of these substances in recent years among youth in the USA and other countries, increases have been observed in the use and misuse of other substances, such as the misuse of prescription drugs and over-the-counter cough medications in the USA. From a developmental perspective, data shows that rates of alcohol, tobacco, marijuana, and other illicit drug use typically escalate during adolescence and peak during young adulthood, corresponding with the increased freedom and independence of this time of life. Substance use decreases for most young people as they take on adult responsibilities, although a proportion will continue or increase their use and develop substance use problems. Given what we know about the onset and progression of substance use, implementing preventive interventions during early adolescence is critical. Most drug prevention or education programmes take place in school settings. A variety of theory-based school-based drug prevention programmes have been developed and tested. The most effective programmes are delivered interactively and teach skills to help young people refuse drug offers, resist pro-drug influences, correct misperceptions that drug use is normative, and enhance social and personal competence skills. A key challenge is to identify mechanisms for the wide dissemination of evidence-based drug preventive interventions and ways to train providers to implement programmes effectively and thoroughly.