Impact of an American board of pediatrics maintenance of certification (MOC) on weight-related counseling at well-child check-ups

Objective

The Healthy Weight Counseling Maintenance of Certification (MOC) program integrates pediatrician training and clinic changes to promote use of evidence-based, diet and physical activity (PA) health messages and counseling strategies. This interrupted time series study assessed the impact of this MOC program on provision of weight-related counseling.

Family Functioning and Social Support in the Adaptation of Caregivers of Children With Sickle Cell Syndromes

Objective: To examine moderating effects of family functioningand social support on the relationship of child-related stressorsto caregivers' psychological adaptation in a sample of caregiversof children with a chronic illness. Method: Participants were 67 caregivers of children and adolescentswith sickle cell syndromes. We conducted MANOVAs and subsequenteffect size calculations to determine if family functioningwould buffer the effects of caring for difficult-to-manage childrenwith this illness. Results: Findings supported a moderator effect of family functioningon the association of children's externalizing behavioral problemsto caregivers symptoms of hostility. Greater levels of cohesiveand adaptive family functioning buffered the potential detrimentaleffects of caring for children perceived as hard to manage.No significant associations were obtained between measures ofcaregivers' psychological adaptation and the severity of theirchildren's disease. Conclusions: We make recommendations for family systems interventions,particularly for caregivers of children with behavior problems.     

Standardized BACTEC Method To Measure Clarithromycin Susceptibility of Mycobacterium genavense

A standardized clarithromycin susceptibility test for Mycobacterium genavense is reported. The BACTEC radiometric broth dilution test method recommended for Mycobacterium avium complex was modified to develop a reliable and reproducible procedure. Test development involved optimization of medium pH and inoculum densities for antibiotic vials as well as growth control vials. MIC control organisms included Mycobacterium simiae, Mycobacterium avium, and Mycobacterium xenopi. Growth control vials required two to three inoculum dilutions, which varied for each species. Clarithromycin MICs and MBCs for 12 isolates and 1 colonial variant of M. genavense ranged from ≤0.06 to 0.25 μg/ml.     

Sexual activity among adolescents in romantic relationships with friends, acquaintances, or strangers

OBJECTIVE: To explore the influence of preexisting social ties between romantic partners (ie, knowing the partner as a friend or acquaintance before a relationship was considered "romantic" by the adolescent) on sexual risk behaviors among adolescents.Design, Setting, and PARTICIPANTS: By using data from 6658 adolescents from Wave II of the National Longitudinal Study of Adolescent Health, we examined associations between preromantic social ties between partners and several sexual risk behaviors using logistic regression analyses. MAIN OUTCOME MEASURES: Whether the couple had intercourse, and if they did have intercourse, whether the couple talked about contraception or sexually transmitted infections and whether one of them used some method of birth control every time they had sexual intercourse. RESULTS: Knowing one's partner as a friend (vs being acquaintances) before a romantic relationship was protective against engaging in sexual intercourse for male and female adolescents (odds ratios and 95% confidence intervals, 0.66 [0.51-0.86] and 0.76 [0.62-0.94], respectively). For female adolescents, sexually active relationships with partners they had not known before the romantic relationship began were less likely to include discussions of sexually transmitted infections or contraception, and were less likely to include consistent use of birth control (odds ratios and 95% confidence intervals, 0.37 [0.22-0.62] and 0.62 [0.39-0.99], respectively). Preromantic social ties did not play a statistically significant role for these outcomes among male adolescents (odds ratios and 95% confidence intervals of friends and of those who had not met, respectively, are 0.85 [0.60-1.18] and 0.90 [0.50-1.63] for talking about sexually transmitted infections or contraception and 0.93 [0.66-1.30] and 1.17 [0.71-1.96] for always using birth control). CONCLUSION: The existence and nature of an adolescent's prior relationship with a future romantic partner have significant implications for an adolescent couple's later sexual decisions, but patterns differ for male and female adolescents.     

The costs of constraint and prospects for health care reform in Canada

The sharp decline and equally sharp recovery in public health care spending in the 1990s in Canada set the stage for a broad consideration of reform options but also established hurdles to be overcome in taking action. By moving health care to the center of the federal-provincial agenda, reconfiguring the internal politics of medical and hospital groups, and heightening a public sense of the need for improvement, the legacy of the 1990s prepared the ground for reforms that would "modernize" the Canadian model. But it also yielded a degree of federal-provincial rancor and provider demands for "catch-up," which complicated the process of achieving major change.     

Women's reflections on divorce-- 10 years later

Ten years after divorce 95 women who participated in an earlier study of divorce were asked to reflect on their lives since their divorce. They were mailed a questionnaire to describe demographic data, self-esteem, control, life assessment, and their lives since divorce. Fewer than half remarried and of those who did, 10 divorced a second time. Slightly more women partnered than married. Their overall assessment of their lives was reported positively. However, 25% felt the same or worse than they had 10 years earlier. Income was the only demographic variable correlated with self-esteem, control, and life assessment. Women used a variety of self-care actions to improve their lives and only six women went to professional therapy. Their lives and some of the actions taken are described.