Well-Child Visits for Early Detection and Management of Maternal Postpartum Hypertensive Disorders.

Importance: Innovative approaches are needed to address the increasing rate of postpartum morbidity and mortality associated with hypertensive disorders.

Objective: To determine whether assessing maternal blood pressure (BP) and associated symptoms at time of well-child visits is associated with increased detection of postpartum preeclampsia and need for hospitalization for medical management.

Design, Setting, And Participants: This is a pre-post quality improvement (QI) study.

Trichomonas Vaginalis Infections Among Youth in Detention in the Southeastern United States.

Most juvenile detention facilities do not screen for Trichomonas Vaginalis (TV) despite being the most common parasitic STI. We aimed to assess TV prevalence and risk factors among young women in a large urban juvenile detention center. We evaluated a retrospective cohort from April to December 2016.

Can incoming United States pediatric interns be entrusted with the essential communication skills of informed consent?

Purpose: According to the entrustable professional activities (EPA) for entering residency by the Association of American Medical Colleges, incoming residents are expected to independently obtain informed consent for procedures they are likely to perform. This requires residents to not only inform their patients but to ensure comprehension of that information. We assessed the communication skills demonstrated by 372 incoming pediatric interns between 2007 and 2018 at the University of Texas Health Science Center at Houston, obtaining informed consent for a lumbar puncture.

Are Incoming Pediatric Interns Ready to Obtain the Essential Components of an Informed Consent for Lumbar Puncture?

Objective: In 2013, the Association of American Medical Colleges created the "Core Entrustable Professional Activities (EPAs) for Entering Residency" to more clearly define the set of activities that entering residents should be able to perform on day 1 of residency without direct supervision. EPA #11 is obtaining informed consent for tests and/or procedures. This EPA acknowledges that an entrustable learner should be able to document a complete consent among other components.

Influence of Ethnicity on Parental Preference for Pediatric Dental Behavioral Management Techniques.

The purpose of this study was to determine how ethnicity influences parental acceptability of behavior management techniques (BMTs) used during dental treatment of children. This is the first known study to compare ethnic differences in acceptance levels of the BMTs. Parental acceptance of 10 BMTs (tell-show-do, voice control, non-verbal communication, positive reinforcement, distraction, parental presence/absence, nitrous oxide, protective stabilization, sedation, and general anesthesia) was rated using a visual analogue scale (VAS) after watching vignettes of each technique.

Fluoride Intake of Infants from Formula.

Objective: This study aimed to assess fluoride intake in infants from formula reconstituted with water, with fluorosis risk in mind.

Study Design: Data on water source, formula brand/type, volume of formula consumption and infant weight were collected for infants at two-, four-, six-, nine- and twelve-month pediatrician well child visits. Identified formula brands and water types were reconstituted and analyzed for fluoride concentration.

Epidemiology of Childhood Onset Essential Hypertension.

The knowledge of epidemiology of a disease is paramount in identifying preventive measures. Currently there is a paucity of literature on the epidemiologic determinants of childhood onset essential hypertension (EH). We evaluated children with EH, ascertained in a rigorous manner, in a large multiethnic population in a tertiary pediatric hypertension clinic.

Familial aggregation of first degree relatives of children with essential hypertension.

Purpose: Determining familial aggregation is an important first step in narrowing the search for disease-causing genes and hence we determined the familial aggregation of EH among first degree relatives of children with EH.

Materials And Methods: We prospectively enrolled children with EH along with their first degree relatives from a tertiary pediatric hypertension clinic in a large ambulatory care center. We utilized rigorous methodology for blood pressure (BP) measurements and diagnoses of EH to reduce the heterogeneity in the phenotype.

Cross Talk: Evaluation of a Curriculum to Teach Medical Students How to Use Telephone Interpreter Services.

Purpose: Telephone interpretation and recent technology advances assist patients with more timely access to rare languages, but no one has examined the role of this technology in the medical setting and how medical students can be prepared for their use. We sought to determine if structured curriculum on interpretation would promote learners self-reported competency in these encounters and if proficiency would be demonstrated in actual patient encounters.

Methods: Training on the principles of interpreter use with a focus on communication technology was added to medical student education.

Impact of individualized learning plans on United States senior medical students advanced clinical rotations.

The individualized learning plan (ILP) is a tool that promotes self-directed learning. The aim of this pilot study was to look at the perception of the ILPs in United States senior medical school students as a way to improve their learning experience during their advanced practice clerkship. We conducted a survey of graduating medical students that contained both quantitative and open-ended questions regarding the students' experiences with the ILP during their advanced practice clerkship from July 2014 to March 2016.

Biobehavioral Factors in Child Health Outcomes: The Roles of Maternal Stress, Maternal-Child Engagement, Salivary Cortisol, and Salivary Testosterone.

Background: Exposure to high levels of maternal stress and ineffective maternal-child engagement (MC-E) may adversely affect child health-related outcomes.

Objective: The aim of this study was to examine the impact of maternal stress and MC-E on maternal and child biological responses (salivary cortisol and testosterone) and child health outcome in mother-child dyads of preschool children (3-5.9 years) in a low socioeconomic setting.

Childhood-Onset Essential Hypertension and the Family Structure.

The prevalence and effect of single-parent families in childhood-onset essential hypertension (EH) is unknown. Children with EH and age-, sex-, and ethnicity-matched controls were enrolled. Family structure data were obtained by in-person interview.

Essential hypertension vs. secondary hypertension among children.

Background: The aim was to determine the proportions and correlates of essential hypertension among children in a tertiary pediatric hypertension clinic.

Methods: We evaluated 423 consecutive children and collected demographic and clinical history by retrospective chart review.

Results: We identified 275 (65%) hypertensive children (blood pressure >95th percentile per the "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents") from 423 children referred to the clinic for history of elevated blood pressure.

Variability of the institutional review board process within a national research network.

Objective: To determine the variability of the institutional review board (IRB) process for a minimal risk multicenter study.

Methods: Participants included 24 Continuity Research Network (CORNET) sites of the Academic Pediatric Association that participated in a cross-sectional study. Each site obtained individual institutional IRB approval.

Junk food seen at pediatric clinic visits: is it a problem?

Objective: To document the prevalence of junk foods seen at clinic visits.

Design: A cross-sectional 23-item survey of observed food items were completed by medical staff using a convenience sample of families from June 2, 2011 to March 2, 2012.

Setting: The study was conducted in pediatric clinics affiliated with the University of Texas Medical School at Houston.

Neurocognitive training for children with and without AD/HD.

There is accumulating evidence that computerised cognitive training of inhibitory control and/or working memory can lead to behavioural improvement in children with AD/HD. Using a randomised waitlist control design, the present study examined the effects of combined working memory and inhibitory control training, with and without passive attention monitoring via EEG, for children with and without AD/HD. One hundred and twenty-eight children (60 children with AD/HD, 68 without AD/HD) were randomly allocated to one of three training conditions (waitlist; working memory and inhibitory control with attention monitoring; working memory and inhibitory control without attention monitoring) and completed with pre- and post-training assessments of overt behaviour (from 2 sources), trained and untrained cognitive task performance, and resting EEG activity.

Comparing patients seen in pediatric resident continuity clinics and national ambulatory medical care survey practices: a study from the continuity research network.

Objectives: The goal was to compare visit data from Continuity Research Network practices with data for a nationally representative sample of pediatric visits in practice settings from the National Ambulatory Medical Care Survey.

Methods: A cross-sectional study comparing data for Continuity Research Network practice visits during a 1-week period in 2002 with data from the 2000 National Ambulatory Medical Care Survey was performed. Continuity Research Network and National Ambulatory Medical Care Survey data were derived from 30 patient visits per practice site for patients < 22 years of age, with the primary care providers being residents and practicing pediatricians, respectively.

The epidemiology of sexually transmitted infections in adolescents.

This article addresses the epidemiology of several common sexually transmitted infections (STIs) in adolescents. Chlamydia is a common occurrence in adolescents, more so than is gonorrhea, but both are of particular concern because they may cause pelvic inflammatory disease. Many experts recommend screening for chlamydia in sexually active adolescents, particularly females.

Seasonality and immediate antecedents of sexual intercourse in adolescents.

Objective: To assess immediate antecedents of and seasonal variations in sexual intercourse among a focused population of medically indigent adolescent females in Houston, Texas.

Study Design: From June 2001 to March 2002 we solicited a convenience sample of adolescent females during their visit to a school-based clinic. The survey consisted of 34 multiple choice questions targeting immediate antecedents of sexual behavior.

Self-assessment of circumcision status by adolescents.

In epidemiologic studies of the relation between circumcision and sexually transmitted infections, it is necessary to rely on self-report of circumcision status. The purpose of this 2002 study in Houston, Texas, was to determine whether adolescent males could make correct self-reports. During physical examinations, adolescents were asked whether they were circumcised.

Effect of a teaching skills program on faculty skills and confidence.

Background: Although education is a central mission of medical schools, effectiveness of faculty as teachers is variable, with many faculty lacking formal training. Therefore, a series of sessions around teaching skills was developed.

Objective: To improve the skill, confidence, and comfort levels of faculty who teach general pediatrics.