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Am Fam Physician. 2003;68(11):2117-2119

AAFP Releases Recommended Adult Immunization Schedule

The American Academy of Family Physicians (AAFP) recently released an online version of the recommended immunization schedule for adults in the United States for 2003–2004 that was approved by the Centers for Disease Control and Prevention's (CDC's) Advisory Committee on Immunization Practices (ACIP). The schedule, which is available in English and Spanish at, indicates the recommended age groups for routine administration of currently licensed vaccinations for persons who are at least 19 years of age. Representatives from the AAFP Commission on Clinical Policies and Research participated with the ACIP to develop the schedule. An updated recommended childhood immunization schedule will be released in January. The adult immunization schedule also will be published in the December 15, 2003, issue of American Family Physician, and the updated childhood immunization schedule will appear in the January 1, 2004 issue.

NRMP Requires Residency Programs to Reveal Contract Terms

The National Residency Matching Program (NRMP) Board of Directors recently adopted the policy that requires residency programs participating in the main residency match to provide applicants with contract terms before students accept the positions. This new rule is effective for participants in the 2005 match. This action by the NRMP comes 18 months after three physicians filed an antitrust lawsuit against the NRMP, six other medical organizations, and 29 teaching hospitals and related institutions. The NRMP is a not-for-profit organization whose sole function is to run the computerized matching system that links medical students to residency programs. In 2003, more than 21,000 persons were matched to residencies in the “Main Match” and to over 2,000 subspecialty positions. For more information, go online to the NRMP's Web site at The NRMP also has established a Web site to explain and promote the benefits of the match at

CDC Report Shows Decline in U.S. Pregnancy Rate, Births, and Abortions

According to a report by the CDC, the number of pregnancies in the United States in 1999 (6.28 million) dropped 7 percent from the peak in 1990 (6.78 million). The pregnancies in 1999 included 3.96 million live births, 1.31 million induced abortions, and 1 million fetal losses (miscarriages or stillbirths). From 1990 to 1999, there was a 9 percent decline in the birth rate (70.9 to 64.4 births per 1,000 women 15 to 44 years of age) and a 22 percent drop in the abortion rate (27.4 to 21.4). The highest pregnancy rate was in women 20 to 24 years of age. Among teenagers, pregnancy rates reached historic lows from 1990 to 1999, with the birth rate and abortion rate dropping 19 percent and 39 percent, respectively. The report also analyzed the data based on marital status and race/ethnicity. The report, “Revised Pregnancy Rates, 1990–97, and New Rates for 1998–99: United States,” is available online at

HHS Launches Effort to Identify Undiagnosed Cases of Diabetes

The U.S. Department of Health and Human Services (HHS) Secretary Tommy G. Thompson recently announced the creation of a community-based effort to identify persons with undiagnosed type 2 diabetes mellitus and refer them for appropriate blood testing and treatment. The broad-based effort, Diabetes Detection Initiative: Finding the Undiagnosed (DDI), encourages persons to determine their risk for undiagnosed diabetes using a customized paper risk-assessment tool adapted from the American Diabetes Association. Based on the results of this assessment, a finger stick/capillary blood test will be performed and, if necessary, further testing will be done to diagnose diabetes. The DDI will be piloted in 10 communities throughout the United States and then expanded to other locations. This initiative, in conjunction with Steps to a HealthierUS and the President's HealthierUS programs, is designed to create a healthier, prevention-oriented society. For more information about this initiative, go online to

NCI, FDA Partner on Two Initiatives to Develop Better Cancer Treatments

The National Cancer Institute (NCI) and the U.S. Food and Drug Administration (FDA) recently announced two new collaborative initiatives designed to facilitate the development and use of better cancer treatm ents. One of the initiatives will create a system for submitting investigational new drug applications to the FDA electronically that will streamline regulatory interactions and accelerate the overall regulatory review process for new cancer drugs. The FDA currently reviews investigational new drug applications in 30 days or less. More information on this system, the “Cancer Biomedical Informatics Grid (caBIG) project,” is available online at The other initiative creates cancer fellowship training programs aimed at developing a corps of physicians and scientists who are experts in clinical research, the regulatory approval process, and translation of research breakthroughs to clinical practice. Under this program, fellows will work in clinical oncology programs at NCI and in the technical and regulatory review programs at the FDA.

Pisacano Leadership Foundation Names Recipients of Scholarships

The board of directors of the Pisacano Leadership Foundation has announced the recipients of the 2003 Pisacano Scholars. The scholarships are awarded to outstanding fourth-year medical students who demonstrated a strong commitment to family medicine. The scholars for 2003 are Seth Spanos, University of Utah School of Medicine, Salt Lake City; Elizabeth Hutchinson, University of Washington School of Medicine, Seattle; and Sean Lucan, Yale University School of Medicine, New Haven, Conn. Each will receive leadership training and up to $7,000 a year for the next four years. The American Board of Family Practice (ABFP) established the Pisacano Leadership Foundation in 1990 to honor Nicholas J. Pisacano, M.D., founder and first executive director of the ABFP. For more information about the program, visit the foundation's Web site at

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