Improving transition from pediatric to adult cystic fibrosis care: lessons from a national survey of current practices.

Objectives: More than 500,000 adolescents with special health care needs age into adulthood each year in the United States, and there is growing recognition of the need for support of their transition to adult-oriented health care. Because of improved survival, cystic fibrosis has experienced this increasing transition need, and cystic fibrosis policy leaders responded by mandating the transition of adults with cystic fibrosis to adult-focused cystic fibrosis care programs by 2000. The primary objective of this study was to characterize in detail recent transition practices at US cystic fibrosis programs, to identify areas for improvement and to serve as a model for other diseases.

Correlates of readiness to receive Chlamydia screening among 2 populations of youths.

Objectives: To assess young people's preferences for Chlamydia testing venues and methods, attitudes about testing, sex differences among these variables, and their predictive associations with young people's readiness for screening.

Design: Survey.

Setting: National Job Training site and Department of Youth Services site.

Behavioral problems and the effects of early intervention on eight-year-old children with learning disabilities.

Objectives: 1) To investigate the comorbidity of verbal and nonverbal learning disability subtypes with several domains of behavior problems among 8-year-old children. 2) To determine whether receipt of an early intervention modified the association between childhood behavior problems and learning disabilities (LD).

Methods: This is a secondary data analysis of the Infant Health and Development Program (IHDP), a randomized clinical trial of an early intervention provided between ages 0 and 3 involving 985 children born low birthweight and premature.

Using propensity scores to estimate the cost-effectiveness of medical therapies.

The cost-effectiveness ratio is a popular statistic that is used by policy makers to decide which programs are cost-effective in the public health sector. Recently, the net monetary benefit has been proposed as an alternative statistical summary measure to overcome the limitations associated with the cost-effectiveness ratio. Research on using the net monetary benefit to assess the cost-effectiveness of therapies in non-randomized studies has yet to be done.

A propensity score approach to estimating the cost-effectiveness of medical therapies from observational data.

Health summary measures are commonly used by policy makers to help make decisions on the allocation of societal resources for competing medical treatments. The net monetary benefit is a health summary measure that overcomes the statistical limitations of a popular measure namely, the cost-effectiveness ratio. We introduce a linear model framework to estimate propensity score adjusted net monetary benefit.

Changes in pathology instruction and student performance on the United States Medical Licensing Examination Step 1, 1995-2000: a nationwide 6-year longitudinal study.

A multi-institutional collaborative longitudinal study was conducted to assess the effect of curricular change (overall curricular format and detailed pathology instruction) and school policy regarding the Step 1 requirement on the United States Medical Licensure Examination (USMLE) Step 1 Total and Step 1 Pathology scores over a period of 6 years (1995 to 2000). Detailed descriptions of instruction (overall curricular format and the format and number of hours of instruction in various areas of pathology) and the school policy of USMLE Step 1 requirement for classes entering in 1993 to 1998 were matched with Step 1 Total scores and Step 1 Pathology scores for 48,166 students from 73 schools who took the corresponding June 1995 to 2000 examination. Hierarchical linear modeling was used for analysis while controlling for students' MCAT-bpv (Medical College Admission Test, composite of biological and physical sciences and verbal reasoning) scores and undergraduate grade point average (GPA).

Prevalence, stability, and predictors of clinically significant behavior problems in low birth weight children at 3, 5, and 8 years of age.

Objectives: To examine the prevalence, stability, and predictors of clinically significant behavior problems in 869 preterm low birth weight (LBW) infants at 3, 5, and 8 years of age.

Methods: A prospective cohort study was conducted. Clinically significant behavior problems were assessed using dichotomized total problem Child Behavior Checklist scores in LBW children at ages 3, 5, and 8 years.

Relationship between pathology curricular approaches and performance in the United States medical licensing examination (USMLE), step 1: a national cross-sectional study.

A collaborative multi-institutional study was conducted to study the relationship between characteristics of pathology instruction and student performance in the United States Medical Licensing Examination (USMLE), Step 1. Detailed descriptions of pathology instruction, such as curriculum format, style of instruction, and design of instruction of various areas of pathology for the 1996-1997 academic year were matched with Step 1 total scores and pathology subscores for 10,159 students from 88 schools who took the June 1997 examination. Hierarchical linear modeling was used for analysis while controlling for students' MCAT-bpv scores (Medical College Admission Test scores, average of biological and physical sciences and verbal reasoning).

Childhood growth and exposure to dichlorodiphenyl dichloroethene and polychlorinated biphenyls.

Objectives: Dichlorodiphenyl dichloroethene (DDE) and polychlorinated biphenyls (PCB), toxic contaminants known to be persistent in the environment, may affect growth. We investigated whether growth from birth to 10 years of age is associated with blood concentrations of DDE and PCB taken at 8 years of age.

Study Design: We ambispectively followed up a cohort of 343 German children.