Fertility Desires of Adolescent Females: Decreased Desire for Children in Those Identifying as Transgender/Gender Diverse and in Depressed Adolescents.

Study Objective: We aimed to describe fertility desires in healthy adolescent females and to explore associations of fertility desire with conditions and therapies potentially compromising fertility.

Design: This was a cross-sectional, anonymous survey.

Setting And Participants: A total of 323 female adolescents aged 13-19 years were recruited from clinic waiting areas at a children's hospital.

Pediatricians as Child Health Advocates: The Role of Advocacy Education.

In this article, we discuss the role of formal advocacy education with high-effort advocacy activities among pediatricians. We discuss the historical role of advocacy in the field of pediatrics and the changing role of advocacy education in pediatric training programs. We describe our survey of pediatricians in New York, in which we asked about a history of formal child health advocacy education, current high- and low-effort advocacy activities, perceived barriers to advocacy work, and child health advocacy issues of interest.

Painful Periods in the Adolescent Girl.

Up to two-thirds of adolescent girls report painful periods but few seek medical care for their dysmenorrhea. Dysmenorrhea is associated with multiple physical and psychological symptoms, and the delayed evaluation and treatment of dysmenorrhea contributes to a poor quality of life and can result in lifelong health problems, including chronic pelvic pain and infertility. It is recommended that an assessment of patients' menstrual cycles be performed regularly, as identification of abnormally painful menstrual cycles may reveal potential health problems, including pelvic diseases such as endometriosis and adenomyosis.

Prepubertal and Adolescent Vulvovaginitis: What to Do When a Girl Reports Vaginal Discharge.

Vaginitis presents with vaginal discharge, odor, pruritis, and/or discomfort and affects up to 75% of girls and women over the course of their lifetimes, with most women experiencing their first episode during adolescence. Given the prevalence of this disorder, this article aims to provide an overview of vaginitis for the general pediatrician. We start with prepubertal etiologies of vaginitis, then discuss pubertal and normal physiologic discharge, and then focus on the most common etiologies of adolescent vulvovaginitis.

Fertility Counseling for Adolescents.

Fertility awareness, or general knowledge about one's fertility, is low in adolescents and in adult women as well. Misconceptions about reproduction contribute to high rates of unplanned pregnancy in the United States, as well as delayed childbearing and infertility. Alhough primary care providers caring for adolescents have historically focused on contraception and reduction of sexually transmitted infections during their sexual and reproductive health conversations with adolescents and young adult women, fertility awareness counseling would help these women optimize their future fertility and make informed reproductive choices throughout their life.

The Impact of a Clinical Asthma Pathway on Resident Education.

Clinical pathways for asthma management decrease hospital cost and length of stay; however little is known about the educational impact of pathways on residents. Pediatric residents at a children's hospital ( = 114) were invited to complete a 22-item computerized, anonymous survey 6 months before and 6 months after asthma pathway implementation. The survey assessed pathway use and residents (1) pathway knowledge, (2) attitudes and experiences with managing asthma, and (3) perceived educational benefits.

Acceptance of Routine HIV Testing by Hospitalized Adolescents and Young Adults.

Background And Objectives: Youth carry a disproportionate burden of new HIV infections. With our study, we aimed to characterize HIV testing experiences among adolescents and young adults admitted to a children's hospital that is located in a high HIV-prevalent community and implemented routine HIV testing for all patients ≥13 years of age.

Methods: A total of 120 patients aged 13 to 24 years old who were admitted to our hospital and had a documented offer of routine HIV testing on admission were invited to complete a self-administered survey that asked about sex, race and/or ethnicity, HIV risk behaviors, and attitudes toward routine HIV testing in the hospital.

Resident Education Curriculum in Pediatric and Adolescent Gynecology: The Short Curriculum 2.0.

The degree of exposure to pediatric and adolescent gynecology (PAG) varies across residency programs in obstetrics and gynecology and pediatrics. Nevertheless, these programs are responsible for training residents and providing opportunities within their programs to fulfill PAG learning objectives. To that end, the North American Society for Pediatric and Adolescent Gynecology has taken a leadership role in PAG resident education by creating and systematically updating the Short Curriculum.

Improving Resident Knowledge in Pediatric and Adolescent Gynecology: An Evaluation of the North American Society for Pediatric and Adolescent Gynecology Short Curriculum.

Study Objective: Resident education in pediatric and adolescent gynecology (PAG) is challenging. It encompasses patients from neonates to young adults with different disorders involving multiple subspecialties. Residents have inadequate exposure to PAG topics and report lack of knowledge in this area.

Creation and Dissemination of a Multispecialty Graduate Medical Education Curriculum in Pediatric and Adolescent Gynecology: The North American Society for Pediatric and Adolescent Gynecology Resident Education Committee Experiences.

Study Objective: The goal was to develop a multispecialty committee to address deficiencies in pediatric and adolescent gynecology (PAG) resident education through curricular development under the auspices of the North American Society for Pediatric and Adolescent Gynecology. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A multispecialty North American committee was organized to develop short as well as long curricula in PAG through a combination of conference calls and face-to-face meetings. Content was guided by objectives of national accrediting organizations.

Reproductive Coercion in High School-Aged Girls: Associations with Reproductive Health Risk and Intimate Partner Violence.

Study Objective: To determine the prevalence of reproductive coercion, a form of intimate partner violence (IPV) including contraceptive sabotage and pregnancy pressure, among urban high school-aged girls and to examine its associations with reproductive health risks.

Design And Setting: A self-administered survey completed by high school-aged girls living in high-poverty neighborhoods while awaiting medical care in a pediatric emergency room, inpatient service, school-based, and hospital-based clinic.

Participants: One hundred forty-nine sexually active girls aged 14-17 years.

Polycystic Ovary Syndrome: An Under-recognized Cause of Abnormal Uterine Bleeding in Adolescents Admitted to a Children's Hospital.

Study Objective: To evaluate whether ovulatory dysfunction due to polycystic ovary syndrome (PCOS) is a common underlying etiology of abnormal uterine bleeding (AUB) in adolescents who require hospitalization and to explore etiology, treatment, and complications of AUB with severe anemia in adolescents. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We identified female patients aged 8-20 years admitted to a children's hospital for treatment of AUB from January 2000 to December 2014. Our hospital protocol advises hormonal testing for PCOS and other disorders before treatment for AUB.

Fertility Awareness Counseling for Adolescent Girls; Guiding Conception: The Right Time, Right Weight, and Right Way.

Study Objective: To provide a detailed summary of fertility awareness counseling pearls for healthy teens and those with fertility-relevant comorbidities, and to assist providers in offering such counseling to adolescents and young adult women. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Comprehensive literature review of English-language studies relating to fertility in pediatric and adolescent female patients (ages 13-21 years), and evidence-based dialogue guide.

Results: The literature indicates that although adolescents are interested in discussing sexuality and reproduction, this is commonly overlooked during the standard office medical visit.

Challenges to Adolescent Confidentiality in a Children's Hospital.

Objectives: Protecting confidentiality for hospitalized adolescents can be challenging and may interfere with optimal adolescent-friendly care. The goal of this study was to explore physician trainees' experience with adolescent confidentiality at an academic children's hospital.

Methods: A total of 175 trainees were invited to complete an online survey about knowledge, attitudes, and experiences with confidential adolescent concerns in the inpatient setting.

Treatment of Vitamin D Deficiency in Predominantly Hispanic and Black Adolescents: A Randomized Clinical Trial.

Objectives: To compare 3 different treatment regimens for vitamin D deficiency in minority adolescents and to explore factors that impact treatment efficacy.

Study Design: We conducted an 8-week, prospective, open-label, randomized clinical trial in an urban, academic, children's hospital. A total of 183 vitamin D-deficient adolescents, mean 25-hydroxyvitamin D or 25(OH)D 13.

Resident education curriculum in pediatric and adolescent gynecology: the short curriculum.

The degree of exposure to Pediatric and Adolescent Gynecology (PAG) varies across academic programs in Obstetrics and Gynecology, Pediatrics, and Adolescent Medicine. Nevertheless, these programs are responsible to train residents and provide opportunities within their training programs to fulfill PAG learning objectives. To that end, North American Society for Pediatric and Adolescent Gynecology has taken a leadership role in PAG resident education by disseminating the Short Curriculum with specific learning objectives and list of essential resources where key concepts in PAG can be covered.

The influence of individual, partner, and relationship factors on HIV testing in adolescents.

Early identification of HIV by increasing testing is a national priority; however, little is known about HIV testing behaviors in high school age adolescents. We examined the association of individual, partner, and relationship factors with HIV testing using a computer-assisted survey administered from 2003 to 2006 in a community sample of 980 sexually active 14- to 17-year-olds (56% female, 55% Latino, 25% African American) living in a jurisdiction with a high AIDS burden. Twenty percent reported their first sexual encounter as having occurred when they were <13 years of age, 33% had had four or more lifetime sexual partners, 21% reported high partner HIV-risk behavior, and 428 (44%) had been tested for HIV.

Gynecologic and reproductive health concerns of adolescents using selected psychotropic medications.

Psychiatric disorders are common in adolescent girls and may require chronic therapies with psychotropic medications. Antipsychotic medications and mood stabilizers have been increasingly prescribed to and widely used by adolescents for a variety of both "on" an "off" label indications. Studies on the safety and monitoring of these medications in adolescent girls have shown important potential for gynecologic and reproductive adverse effects.

Excessive uterine bleeding.

Menstrual bleeding that falls outside the range of normal in adolescents is often a cause of great concern for both girls and their families. Often, much of this anxiety can be alleviated with proper anticipatory guidance about menarche and early menstrual bleeding patterns. Eliciting a menstrual history from an adolescent girl is challenging, and the use of concrete methods to chart their patterns and flow, such as menstrual calendars and pictorial bleeding assessment calendar (PBAC) tools, may be helpful.