The study objective was to compare the accuracy of a deterministic record linkage algorithm and two public domain software applications for record linkage (The Link King and Link Plus). The three algorithms were used to unduplicate an administrative database containing personal identifiers for over 500,000 clients. Subsequently, a random sample of linked records was submitted to four research staff for blinded clerical review. Using reviewers' decisions as the 'gold standard', sensitivity and positive predictive values (PPVs) were estimated. Optimally, sensitivity and PPVs in the mid 90s could be obtained from both The Link King and Link Plus. Sensitivity and PPVs using a basic deterministic algorithm were 79 and 98 per cent respectively. Thus the full feature set of The Link King makes it an attractive option for SAS users. Link Plus is a good choice for non-SAS users as long as necessary programming resources are available for processing record pairs identified by Link Plus.

Background High-level MYCN amplification (MNA) is associated with poor outcome and unfavorable clinical and biological features in neuroblastoma. Less is known about these associations in patients with low-level MYCN copy number increases. Methods In this retrospective study, we defined patients as having tumors with MYCN wild-type, MYCN gain (2–4 fold increase in MYCN signal compared to reference probe), or MNA (>4 fold increase). We used tests of trend to investigate ordered associations between MYCN copy number category and features of interest. Log-rank tests and Cox models compared event-free (EFS) and overall survival (OS) by subgroup. Results Among 4,672 patients, 3,694 (79.1%) had MYCN wild-type tumors, 133 (2.8%) had MYCN gain, and 845 (18.1%) had MNA. For each clinical/biological feature, the proportion of patients with an unfavorable feature was lowest in the MYCN wild-type category, intermediate in the MYCN gain category, and highest in the MNA category (p<0.0001), except for 11q aberration where the highest rates were in the MYCN gain category. Patients with MYCN gain had inferior EFS and OS compared to wild-type. Among patients with high-risk disease, MYCN gain was associated with the lowest response rate following chemotherapy. Patients with non-stage 4 disease and patients with non-high risk disease with MYCN gain had significantly increased risk for death, a finding confirmed on multivariable testing. Conclusions Increasing MYCN copy number is associated with an increasingly higher rate of unfavorable clinical/biological features, with 11q aberration an exception. Patients with MYCN gain have inferior outcomes, especially in otherwise more favorable groups.

Although the study participants identified a role for pediatric oncology clinicians in SRH care for AYA patients with cancer, multiple barriers interfere with such discussions taking place on a regular basis. Future efforts must focus on resource development and provider education and training in SRH to optimize the care provided to this unique patient population.

Online sexuality has become a much discussed topic in the 90's however most people continue to have a narrow and uninformed view of what this area truly consists of. This paper provides an overview of the ubiquitous and explosive effect of the Internet on sexuality and summarizes the following key dimensions including: internet relationships and how they influence face to face relationships, alternative communities and sexually disenfranchised people, commercial aspects of internet sexuality, concerns about employee morality and productivity, and, sexual information and education in the 21st century. The internet and associated technological advances will have a tremendous influence on every aspect of sexuality in this new "information age" and thus we encourage professionals involved in this area to get informed and thereby have a say in shaping the future. In addition, those keeping current with these rapid developments will be in a position to both warn people as to the pathological aspects of cybersexual behavior, as well as educate them as to the more adaptive and expansive sex-positive opportunities offered by the internet.

The relationship between engagement in outpatient treatment facilities in the public sector and subsequent arrest is examined for clients in Connecticut, New York, Oklahoma and Washington. Engagement is defined as receiving another treatment service within 14 days of beginning a new episode of specialty treatment and at least two additional services within the next 30 days. Data are from 2008 and survival analysis modeling is used. Survival analyses express the effects of model covariates in terms of “hazard ratios,” which reflect a change in the likelihood of outcome because of the covariate. Engaged clients had a significantly lower hazard of any arrest than non-engaged in all four states. In NY and OK, engaged clients also had a lower hazard of arrest for substance-related crimes. In CT, NY, and OK engaged clients had a lower hazard of arrest for violent crime. Clients in facilities with higher engagement rates had a lower hazard of any arrest in NY and OK. Engaging clients in outpatient treatment is a promising approach to decrease their subsequent criminal justice involvement.

We examined data on elderly Latinos to identify structural barriers that influence the use of a visiting nurse, home health aide, and/or homemaker, and to investigate possible cultural influence on use. Data are from the 1988 Commonwealth Fund Commission's national survey of 2,299 Latinos age 65 and over. Logistic equations are estimated for all elderly Latinos, those with a hospitalization in the past year, and those without a hospitalization. Need factors consistently increase the odds of using services. The significance of Medicaid and poverty income demonstrates income barriers to community-based care. Living arrangements improve our models only for those with a hospitalization in the past year. Acculturation has no independent effect, although some other findings can be interpreted as cultural preferences. We conclude that a universal, public long-term care program would substantially reduce barriers faced by elderly Latinos, but that nonfinancial barriers are likely to continue.

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In 1996, Congress passed sweeping welfare reform, abolishing the Aid to Families with Dependent Children (AFDC) program. Each state now administers its own welfare‐to‐work program under broad federal guidelines, which require eligible adult recipients to work or perform community service. High‐risk welfare recipients, especially those with chemical dependency problems, face significant obstacles in their efforts to achieve greater self‐sufficiency under the new welfare‐to‐work programs. State databases were used to track employment outcomes for AFDC clients admitted to treatment for chemical dependency in Washington State during a two‐year period. Exposure to treatment was associated with a greater likelihood of becoming employed and with increased earnings for those who became employed. Ensuring that welfare recipients with substance abuse problems have access to appropriate treatment and vocational services is critical if welfare‐to‐work programs are to promote greater economic self‐sufficiency.