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Certain characteristics can be used to predict contacts most likely to have a positive tuberculin skin test result. Use of such models can significantly reduce the number of contacts that public health officials need to investigate while still maintaining excellent disease control.

This paper describes an asthma screening procedure developed to identify children with asthma for an intervention study. Students were classified into three categories based on questionnaire responses (previous asthma, suspected asthma, and no evidence of asthma). Those classified as suspected asthma by questionnaire underwent further testing including spirometry and exercise challenge. Using the questionnaire alone, the measured asthma prevalence was 32%; the addition of spirometry and step testing reduced this estimate to 9.89%. The diagnosis of asthma was confirmed in 96% of children who saw the study physician. This screening procedure can identify school children with suspected undiagnosed asthma.

Characteristics of subjective symptomatology of asthma were examined within a group of 132 adult asthma patients receiving medical care in a university-based, ambulatory clinic setting. Patients responded to 36 symptom descriptions or adjectives associated with asthma which were included in a modified version of the Asthma Symptoms Checklist (ASC). A principal components exploratory factor analysis was conducted and five factors were identified. The five factors measured 1) panic-fear, 2) airways obstruction, 3) hyperventilation, 4) fatigue, and 5) irritability. Psychometric properties of the factor scores were satisfactory. The reliabilities were high, standard deviations were large, and differences in factor mean scores conformed to clinical experience. Correlational analyses support the construct validity of the ASC, especially the panic-fear factor. An important outcome of this study was to verify the ASC factor structure in an outpatient setting. The ASC was confirmed as a valuable instrument for use in self-management programs for adults with asthma. The five ASC factors represent highly stable components of subjective symptomatology of asthma among diverse adult patient populations and geographical settings.

Many studies have examined the relationships between students' performances on the National Board of Medical Examiners (NBME) Part I and Part II examinations and their postgraduate clinical performances. Most studies have found a positive relationship between students' NBME examination scores and the ratings of residents' clinical performances and/or scores on specialty board certification examinations. Surveys of residency directors have also shown that NBME scores are used as part of the process for selecting residents, although other data and other selection criteria are considered more useful than the NBME scores. One area of continued concern is that a large body of data on the United States Medical Licensing Examination (USMLE) is not yet available. However, the predictive validity of the NBME scores supports the use of USMLE scores as part of the review process to screen potential residents. Residency directors should continue to use a variety of criteria in their final selection decisions and are encouraged to use their own program-specific data to establish and monitor particular cutoff scores for screening applicants.

The ASCN Committee on Medical/Dental School and Residency Nutrition Education conducted a series of activities to establish guidelines for nutrition core content in a medical school curriculum. These activities included mail surveys of medical-nutrition educators and a representative group of medical school curriculum administrators and a national consensus workshop of nutrition educators. Results indicated close agreement between the nutrition educators and curriculum administrators (r = 0.89, p less than 0.0001) on the importance ratings of 41 nutrition topics and on the number of hours of nutrition course work that medical schools should provide (44 vs 37 h, respectively, p = 0.14). There was consensus among the nutrition educators that 26 topics should be given priority ratings as essential for inclusion in medical course work. Further prioritization of these topics resulted in a listing of core content topics and subtopics to serve as a guide to administrators and educators for planning nutrition course work in a medical school curriculum.

The development and analysis of an instrument to evaluate the use of metered dose inhalers by patients in the University of Alabama at Birmingham (UAB) Asthma Program is presented. A total of 238 adult asthma patients demonstrated use of the metered dose inhaler for this analysis. Patient skill in using the inhaler was recorded using the instrument, Inhaler-Use Checklist, developed at UAB. The study found that most patients use metered dose inhalers incorrectly, despite training received from their physicians on proper use of inhalers.