An Article-Based Format for Medical Specialty and Subspecialty Maintenance of Certification.

Introduction: This article describes an article-based alternative for maintenance of certification that the American Board of Psychiatry and Neurology developed and began pilot testing in 2019. The rationale for and components of the pilot program are presented along with data on participant performance and feedback from the first year of implementation in three primary specialties (neurology, child neurology, and psychiatry) and one subspecialty (child and adolescent psychiatry).

Methods: Evaluation of the pilot program was guided by a widely used validity framework.

Make a Joyful Noise: Integrating Music into Child Psychiatry Evaluation and Treatment.

Music is a significant part of daily life for most youth, affording clinical opportunities to cultivate positive emotions, engagement, relationships, meaning, and accomplishment. Clinical inquiry into what types of music elicit different emotions, how music fits into daily life routines, how music connects one to others, and how music anchors life events can improve the clinician-patient alliance and patient well-being practices. Music may be useful in home and school settings to help youth manage diverse moods.

Navigating the Perfect Storm: Ethical Guidance for Conducting Research Involving Participants with Multiple Vulnerabilities.

The development of ethical guidelines and regulations regarding human subjects research has focused upon protection of vulnerable populations by relying on a categorical approach to vulnerability. This results in several challenges: First, Institutional Review Boards (IRBs) struggle to interpret and apply the regulations because they are often vague and inconsistent. Second, applying the regulations to subjects who fit within multiple categories of vulnerability can lead to contradictions and the rejection of research that would be permissible if only one category were applicable.

Primary Care and Neurology in Psychiatry Residency Training: a Survey of Early Career Psychiatrists.

Objective: A survey of recently certified psychiatrists was conducted to obtain their feedback about the contribution of the primary care and neurology components of residency training to their professional development and to their current needs as practitioners.

Methods: A 22-item survey was developed based on issues discussed at a forum on residency competence requirements and administered electronically to four cohorts of recently certified psychiatrists.

Results: The response rate was 17% (1049/6083).

Does Acute Propranolol Treatment Prevent Posttraumatic Stress Disorder, Anxiety, and Depression in Children with Burns?

Objective: This study examined whether acute propranolol treatment prevented posttraumatic stress disorder (PTSD), anxiety, and depression in children hospitalized in the pediatric intensive care unit for large burns. We hypothesized that the prevalence of PTSD, anxiety, and depression would be significantly less in the propranolol than nonpropranolol groups.

Methods: Children who had previously participated in a randomized controlled clinical trial of acute propranolol and nonpropranolol controls were invited to participate in long-term follow-up interviews.

The Road Ahead in Education: Milestones for Geriatric Psychiatry Subspecialty Training.

Objective: The Accreditation Council of Graduate Medical Education (ACGME) Milestone Project is the next step in a series of changes revamping the system of graduate medical education. In 2013 the ACGME completed the general psychiatry milestones. The ACGME then pursued creation of milestones for accredited psychiatric subspecialty fellowships.

Epigenetics and Child Psychiatry: Ethical and Legal Issues.

Epigenetics has the potential to revolutionize diagnosis and treatment in psychiatry, especially child psychiatry, as it may offer the opportunity for early detection and prevention, as well as development of new treatments. As with the previous introduction of genetic research in psychiatry, there is also the problem of unrealistic expectations and new legal and ethical problems. This article reviews the potential contributions and problems of epigenetic research in child psychiatry.

The milestones for psychosomatic medicine subspecialty training.

Background: The Accreditation Council of Graduate Medical Education Milestones project is a key element in the Next Accreditation System for graduate medical education. On completing the general psychiatry milestones in 2013, the Accreditation Council of Graduate Medical Education began the process of creating milestones for the accredited psychiatric subspecialties.

Methods: With consultation from the Academy of Psychosomatic Medicine, the Accreditation Council of Graduate Medical Education appointed a working group to create the psychosomatic medicine milestones, using the general psychiatry milestones as a starting point.

Introduction and commentary on the psychiatry milestones.

Objective: The Psychiatry Milestones are a major change in the accreditation of residency training and evaluation of residents and programs. This introduction provides an overview of the papers in this issue describing the Psychiatry Milestones and a commentary on the process of their development.

Methods: The author describes the challenges and experiences in creating the Psychiatry Milestones as a member of the Working Group and Advisory Group.

Phase II trial of adjuvant oral thalidomide following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal surface disease from colorectal/appendiceal cancer.

Purpose: This phase II single-institution trial of adjuvant thalidomide after cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for patients with appendiceal and colorectal malignancies sought to detect an improvement in progression-free survival (PFS) from 7 to 12 months.

Methods: Eligible patients received CS, HIPEC, and baseline imaging, followed by pretreatment thalidomide counseling. All participants were then started on a 28-day regimen of thalidomide, 100 mg by mouth at bedtime, followed by 200 mg for 4 weeks, followed by 300 mg as the final maintenance dose, as tolerated.

Self-perceptions of young adults who survived severe childhood burn injury.

The transition of pediatric burn survivors into adulthood is accompanied by a reformulation of their self-concept. To anticipate the need for and guide development of appropriate psychosocial interventions, this study examines how young adults who were burned as children perceive themselves and how this perception might affect their self-esteem. Eighty-two young adult burn survivors (45 male, 37 female) were assessed using the Tennessee Self-Concept Scale, 2nd edition (TSCS2) to determine how the participants perceive themselves and their interaction with society.

Personality disorders in young adult survivors of pediatric burn injury.

Objective: Life experience shapes personality and chronic trauma in childhood has been associated with risk for development of subsequent personality disorder. The purpose of this study is to determine the prevalence and character of personality disorders and traits in young adult survivors of severe pediatric burn injury. METHOD.

Practice parameter for child and adolescent forensic evaluations.

This Parameter addresses the key concepts that differentiate the forensic evaluation of children and adolescents from a clinical assessment. There are ethical issues unique to the forensic evaluation, because the forensic evaluator's duty is to the person, court, or agency requesting the evaluation, rather than to the patient. The forensic evaluator clarifies the legal questions to be answered and structures the evaluation to address those issues.

Sexual attitudes and behavior of young adults who were burned as children.

Objective: Little is known about sexual attitudes and behaviors of adults burned as children. We hypothesized that survivors with large burn scars would have differences in sexual attitudes and behaviors from their unburned counterparts.

Methods: Ninety-two young adults (50 males and 42 females), ages 21.

Shortage of child and adolescent psychiatrists in Texas.

This study was conducted to determine how the current shortage of Texas child and adolescent psychiatrists (CAPs) impacts the delivery of mental health care services to indigent Texas youth. First, Texas Medical Board data detailed how many counties had CAPs and how many did not. Second, statewide Medicaid data revealed the number of prescriptions for psychotropics written for Medicaid youth by CAPs and non-CAPs.