The authors' 30-year experience with the modified Furlow palatoplasty shows stable speech results, decreasing rates of secondary surgery, and an acceptable rate of postoperative oronasal fistula.

The Goslon Yardstick proved capable of discriminating among the centers' dental arch relationships. Possible explanations for the differences are discussed.

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This is the first paper in a series of five that outlines the overall goals of the study and sets the basis for the clinical outcome studies that are reported in the following four papers. The five centers' samples and treatment protocols as well as the methods used for each study are reported. The challenges encountered and possible mechanisms to resolve them and reduce methodological error with intercenter studies are also reviewed.

There were no significant differences in nasolabial aesthetics among the centers evaluated. Overall good to fair nasolabial aesthetic results were achieved using the different treatment protocols in the four North American centers.

The United States has the highest rates of teenage pregnancy and birth in the Western industrialized world, and research indicates that television and other mass media are important sources of sexual information for young people. The purpose of this study was to determine if a teen-led, media literacy curriculum focused on sexual portrayals in the media would increase adolescents' awareness of media myths concerning sex, decrease the allure of sexualized portrayals, and decrease positive expectancies for sexual activity. A posttest-only quasi-experiment with control groups was conducted at 22 school and community sites in Washington state (N = 532). The intervention, a 5-lesson media literacy curriculum targeted primarily to middle school students, encouraged sexual abstinence because of federal government funding requirements. Adolescents evaluated the program positively, with 85% rating it as better than other sex education programs. Compared to control-group participants, students were less likely to overestimate sexual activity among teens, more likely to think they could delay sexual activity, less likely to expect social benefits from sexual activity, more aware of myths about sex, and less likely to consider sexual media imagery desirable. The results showed that media literacy has promise as part of a sex education program by providing adolescents with a cognitive framework necessary to understand and resist the influence of media on their decision making concerning sex.

Although the optimal technique of cleft-palate repair remains controversial, several small series have suggested that superior speech results may be obtained with the Furlow double-opposing Z-plasty. To examine speech outcome in a large series of Furlow palatoplasties performed at a single center, we retrospectively reviewed the records of 390 cleft-palate patients who underwent Furlow palatoplasty at The Children's Hospital of Philadelphia from 1979 to 1992. Speech outcome at 5 years of age or greater was available for 181 nonsyndromic patients and was scored using the Pittsburgh Weighted Values for Speech Symptoms Associated with Velopharyngeal Incompetence. No or mild hypernasality was noted in 93.4 percent of patients, with 88.4 percent demonstrating no or inaudible nasal escape and 97.2 percent demonstrating no errors in articulation associated with velopharyngeal incompetence. Secondary pharyngeal flap surgery was required in just 7.2 percent of patients. Age at palatoplasty, cleft type, and experience of the operating surgeon had no significant effect on speech results, although there was a trend toward better outcome in those undergoing palatal repair before 6 months of age and toward poorer outcome in those with Veau class I and II clefts. Overall, Furlow palatoplasty yielded outstanding speech results, with rates of velopharyngeal dysfunction that seem to improve upon those reported for other techniques.

Researchers used a quasi-experiment (N = 723) conducted in the field and using both pretests and posttests to carry out a theory-based evaluation of the effectiveness of a media literacy curriculum implemented in Washington state. Results showed that reflective thinking concerning media message about tobacco increased for all media literacy participants, whether or not they had used tobacco previously. Changes in reflective thinking affected a range of decision-making indicators. Lesson participants who had not used tobacco demonstrated greater change at earlier stages of decision making in ways that suggested a greater understanding of the persuasive techniques used by tobacco manufacturers, on indicators such as perceived realism, desirability, and similarity. Lesson participants who had tried tobacco demonstrated greater change at later stages of decision making on indicators such as perceived peer norms for tobacco use, identification with tobacco-related portrayals, and expectancies for tobacco use. All participants also showed increases in their ability and motivations to resist smoking-related influences. Overall, the results suggest that media literacy has important and somewhat different effects on those who have and those who have not experimented with tobacco use. The results also show the importance of measuring cognitive and affective indicators of decision making that may change gradually as participants gain experience putting lessons learned into action.