Search

Background: Ultraviolet (UV)-exposure behaviors can directly impact an individual's skin cancer risk, with many habits formed during childhood and adolescence. We explored the utility of a photoaging smartphone application to motivate youth to improve sun safety practices., Methods: Participants completed a preintervention survey to gather baseline sun safety perceptions and behaviors. Participants then used a photoaging mobile application to view the projected effects of chronic UV exposure on participants' self-face image over time, followed by a postintervention survey to assess motivation to engage in future sun safety practices., Results: The study sample included 87 participants (median [interquartile (IQR)] age, 14 [11-16] years). Most participants were White (50.6%) and reported skin type that burns a little and tans easily (42.5%). Preintervention sun exposure behaviors among participants revealed that 33 (37.9%) mostly or always used sunscreen on a sunny day, 48 (55.2%) experienced at least one sunburn over the past year, 26 (30.6%) engaged in outdoor sunbathing at least once during the past year, and zero (0%) used indoor tanning beds. Non-skin of color (18 [41.9%], p = .02) and older (24 [41.4%], p = .007) participants more often agreed they felt better with a tan. Most participants agreed the intervention increased their motivation to practice sun-protective behaviors (wear sunscreen, 74 [85.1%]; wear hats, 64 [74.4%]; avoid indoor tanning, 73 [83.9%]; avoid outdoor tanning, 68 [79%])., Conclusion: The findings of this cross-sectional study suggest that a photoaging smartphone application may serve as a useful tool to promote sun safety behaviors from a young age., (© 2024 Wiley Periodicals LLC.)

Background: Addressing suboptimal breastfeeding initiation and duration rates is a priority in the United States. To address challenges to improving these rates, the voices of the providers who work with breastfeeding mothers should be heard. Research aim: The purpose of this study was to explore lactation consultants' perceived barriers to managing early breastfeeding problems., Methods: This qualitative study was conducted with a grounded theory methodological approach. In-depth interviews were conducted with 30 International Board Certified Lactation Consultants across Florida. Lactation consultants were from a range of practice settings, including hospitals, Special Supplemental Nutrition Program for Women, Infants, and Children clinics, private practice, and pediatric offices. Data were digitally recorded, transcribed, and analyzed in Atlas.ti., Results: A range of barriers was identified and grouped into the following categories/themes: indirect barriers (social norms, knowledge, attitudes); direct occupational barriers (institutional constraints, lack of coordination, poor service delivery); and direct individual barriers (social support, mother's self-efficacy). A model was developed illustrating the factors that influence the role enactment of lactation consultants in managing breastfeeding problems., Conclusion: Inadequate support for addressing early breastfeeding challenges is compounded by a lack of collaboration among various healthcare providers and the family. Findings provide insight into the professional management issues of early breastfeeding problems faced by lactation consultants. Team-based, interprofessional approaches to breastfeeding support for mothers and their families are needed; improving interdisciplinary collaboration could lead to better integration of lactation consultants who are educated and experienced in providing lactation support and management of breastfeeding problems.

Training pediatric residents in Bright Futures and oral health concepts is critical to improving oral health. This study's objective was to determine the skill level of pediatric residents in integrating oral health promotion during health supervision visits of 12- to 35-month-old children. One hundred forty-three pediatric residents participated in an evaluation of the effectiveness of a Bright Futures oral health curriculum. Competencies assessed preintervention included partnership building, communication, and integration of oral health concepts. Pediatric residents' abilities to integrate oral health promotion into health supervision visits varied considerably. Residents demonstrated greater skill in communication and partnership building compared with oral health promotion behaviors and performance of an oral examination. Further education is needed at a national level if we are to meet Healthy People 2020 goals.

Although copper deficiency is a rare occurrence in the developed world, attention should be given to the proper supplementation of minerals to at-risk pediatric patients. This study presents 3 distinct cases of copper deficiency in hospitalized patients aged 14 months, 6 years, and 12 years. Two patients had short bowel syndrome, requiring prolonged parenteral nutrition or complex intravenous fluid supplementation. The third patient was severely malnourished. Copper deficiency manifested in all of our patients as either microcytic anemia or pancytopenia with myelodysplastic syndrome. Copper deficiency is an important diagnosis to be considered in patients with prematurity, parenteral nutrition dependency, malabsorption, and/or those with malnutrition. More studies are needed to establish appropriate amounts of copper supplementation to replenish copper stores in deficient patients.

Introduction. Mentoring relationships have been shown to support academicians in areas of research, work/life balance, and promotion. Methods. General pediatric division chiefs accessed an electronic survey asking about mentorship relationships, their ability to create a mentorship program, and resources needed. Results. Dyadic mentorship programs were available at 53% of divisions. Peer mentorship programs were available at 27% of divisions. Overall, 84% of chiefs believed that dyadic mentorship would benefit their faculty. 91% of chiefs believed that peer mentorship would benefit their faculty. Chiefs were interested in starting peer (57%) or dyadic (55%) mentorship programs. Few divisions had a peer mentorship program available, whereas 24% already had a dyadic program. 43% of chiefs felt that they had the tools to start a program. Many tools are needed to create a program. Discussion. General pediatric division chiefs acknowledge the benefits of mentoring relationships, and some have programs in place. Many need tools to create them. Pediatric societies could facilitate this critical area of professional development.

Residency is a time of stress and turmoil for many residents. The stresses are varied and great, often involving both personal and professional issues. One institutional mechanism that has been shown to help residents cope with stress is the use of residents' wellness, or assistance, programs. The University of South Florida (USF) College of Medicine developed the USF Residency Assistance Program (RAP) in 1997, modeled after business employee assistance programs but tailored to enhance the well-being of residents. The program was developed in an organized, thoughtful manner starting with a Request for Proposals to all local employee assistance programs and the selection of one of these to run the program. The RAP is broad-based, readily available, easily accessible, totally voluntary and confidential, and not reportable to the state board of medicine. It is well integrated into all residency programs and has had excellent acceptance from the administration; information about access to the RAP is available to all residents through multiple venues. The cost is minimal, at only seven cents a day per resident. The authors present data from the eight years the RAP has been operating, including information on program use, referral rates, acceptance, and types of problems encountered. One suicide occurred during this time period, and the RAP provided a significant role in grief counseling. Assistance programs are critical to the well-being of residents. The USF program presents a model that can be used by other programs around the country.

Pediatric residents on block community rotations completed journals and exit interviews regarding their perceptions of the rotation. Three common themes present in residents' responses were identified via qualitative analysis: enlightenment and attitude change, impact of direct participation, and rotation challenges. Advantages and disadvantages to block rotations in community pediatrics, and their relationship to learning child advocacy skills, are discussed. Finally, the use of journals as a tool to document systems-based practice competency is explored.

Objective: Prominent pediatric organizations agree that young physicians need to be trained for the role of patient advocate in the community. However, information on the community site administrators' perspective on such training is limited. Therefore, the objective of this study was to explore community site administrators' perceptions of the advantages and disadvantages to pediatric resident training at their centers. Understanding these perspectives may lead to better partnerships and experiences for both the residents and the community sites., Methods: Twenty-eight community site administrators participating in 2 residency community rotations located in Ohio and Florida were surveyed with a semistructured questionnaire. A qualitative data analysis methodology was used to explore the entire set of responses. Research team members reviewed the responses, coded them for emerging themes, and generated three themes: 1) awareness, 2) knowledge exchange, and 3) organizational issues., Results: Fifty-seven percent of site administrators responded. These administrators consistently indicated that they valued the opportunity to increase residents' awareness of the services their sites provided to the community. The administrators and families served by the agencies appeared to benefit from the medical knowledge exchange, and this was a significant advantage from the community site administrators' perspective. Finally, community sites identified organizational issues of complex scheduling as an area for improvement., Conclusions: These findings demonstrate the value community sites place on active, early involvement of pediatric residents with community agencies. We have also identified key points to improve the experiences for both community sites and residents during a community pediatric rotation.

Autoimmune neutropenia of infancy is a primary, usually self-limiting, antineutrophil autoimmune phenomenon seen in infancy and early childhood. These infants are at a higher risk of infection, and early detection, particularly with the availability of newer therapeutic options such as hematopoietic growth factors, can allow close follow-up and, if needed, treatment. We report two infants with autoimmune neutropenia who presented with a persistent perianal abscess, which has not been documented previously in this population.

The purpose of this study was to define the barriers to breastfeeding in the inner city African American adolescent mother. The study was conducted at Johnnie Ruth Clarke Health Center in St. Petersburg, Florida from October 1999 to February 2000. The study population included 25 African American adolescent mothers between the ages of 15 and 21 years. The results indicate that these mothers possess adequate knowledge about the benefits of breast milk. The greatest barriers to breastfeeding included pain, embarrassment, and lack of interest. These concerns are appropriate given their developmental stage; however, interventions are necessary to address these issues.

Questionnaires were mailed to 116 female physicians who completed their pediatric training within the last 5 years. The questionnaire contained items focusing on (1) maternal complications, (2) health of the infant, and (3) attitudes toward the pregnancy experience. Thirty-five (38%) of the 93 respondents were pregnant during their residency. Seventeen complications occurred in 14 (36%) of the 39 pregnancies. Of the 17 complications, 6 (35%) were serious enough to require hospitalization. Complications resulted in time lost from work in 40% (15/39) of the pregnancies. When asked to describe the experience of being pregnant during residency, only 24% felt that it was "pleasant," while 52% said the experience was "tolerable" and 24% found it "miserable"! Thirty-seven percent (13/35) stated that they would not get pregnant during residency if they had it to do over again.