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OBJECTIVE To quantify vitamin D 3 (VitD 3 ) concentrations in commercial dog foods and compare those concentrations with Association of American Feed Control Officials (AAFCO) recommendations and manufacturer-reported concentrations. DESIGN Cross-sectional study. SAMPLE 82 commercial dog foods. PROCEDURES Samples of commercially available dog foods were obtained from owners of healthy dogs in the Guelph, ON, Canada, area and owners of dogs that were patients at the Ontario Veterinary College Health Sciences Centre's Mona Campbell Centre for Animal Cancer. For each food, the VitD 3 concentration was determined by high-performance liquid chromatography-tandem mass spectrometry, and adherence to AAFCO and National Research Council recommendations was assessed. Analyzed VitD 3 concentrations were compared with manufacturer-reported VitD 3 concentrations and between wet and dry foods, among AAFCO nutritional adequacy statements (nutrient profiles vs feeding trials and adult maintenance vs all life stages), between foods sold only by veterinarians and those sold over the counter, and between small and large manufacturers. RESULTS The analyzed VitD 3 concentration was below both AAFCO and National Research Council recommendations for one sample and below the assay detection limit for another. Analyzed VitD 3 concentrations did not differ significantly from manufacturer-reported VitD 3 concentrations or between wet and dry foods, among foods with different AAFCO nutritional adequacy statements, between foods sold only by veterinarians and those sold over the counter, or between foods produced by small and large manufacturers. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that manufacturer-reported VitD 3 concentrations were accurate and that dog owners can be confident that VitD 3 intake is adequate for AAFCO-compliant commercial dog foods.

In 2006, hospice and palliative medicine (HPM) became an officially recognized subspecialty. This designation helped initiate the Accreditation Council of Graduate Medical Education Outcomes Project in HPM. As part of this process, a group of expert clinician-educators in HPM defined the initial competency-based outcomes for HPM fellows (General HPM Competencies). Concurrently, these experts recognized and acknowledged that additional expertise in pediatric HPM would ensure that the competencies for pediatric HPM were optimally represented. To fill this gap, a group of pediatric HPM experts used a product development method to define specific Pediatric HPM Competencies. This article describes the development process. With the ongoing evolution of HPM, these competencies will evolve. As part of the Next Accreditation System, the Accreditation Council of Graduate Medical Education uses milestones as a framework to better define competency-based, measurable outcomes for trainees. Currently, there are no milestones specific to HPM, although the field is designing curricular milestones with multispecialty involvement, including pediatrics. These competencies are the conceptual framework for the pediatric content in the HPM milestones. They are specific to the pediatric HPM subspecialist and should be integrated into the training of pediatric HPM subspecialists. They will serve a foundational role in HPM and should inform a wide range of emerging innovations, including the next evolution of HPM Competencies, development of HPM curricular milestones, and training of adult HPM and other pediatric subspecialists. They may also inform pediatric HPM outcome measures, as well as standards of practice and performance for pediatric HPM interdisciplinary teams., (Copyright © 2014 by the American Academy of Pediatrics.)