Fossweaver6284

Pediatric anxiety disorders have high rates of prevalence and confer risk for later disorders if they go undetected. In primary care, they are underdiagnosed, partly because pediatricians often lack relevant training. We developed a brief, video-based training program for pediatric residents aimed at improving early identification of anxiety disorders in primary care.

Video content was consistent with the American Academy of Pediatrics Behavioral Health Competencies, as applied to the evaluation of anxiety disorders and guidance for discussing treatment options. This training can be delivered in two formats videos (43 minutes) can be shown in a live, group-based format, or accessed via an online, asynchronous training. We tested this training program using both formats and developed surveys to evaluate knowledge about child anxiety, perceived evaluation skills, and satisfaction with the training. We also developed a video-based vignette to measure sensitivity to detecting disorders (how much the conditionucation. This cost-effective and minimally burdensome training program can be used to enhance resident education in a much-needed area.

A majority of residents provide care for critically ill patients, yet only a minority of medical schools require ICU rotations. Therefore, many medical students enter residency without prior ICU experience. The third-year internal medicine (IM) clerkship at our institution's Veterans Affairs Medical Center (VAMC) provided an opportunity for medical students to rotate through an open ICU as part of their inpatient ward rotation. Prior to March 2019, no structured critical care curriculum existed within the IM clerkship to prepare students for this experience.

We created a seven-session ICU curriculum integrated within the VAMC IM clerkship addressing core critical care topics and skills including bedside presentations, shock, and respiratory failure. IM residents facilitated the curriculum's case-based, small-group discussions. Ivosidenib mouse We assessed curricular efficacy and impact with a pre- and posttest and end-of-curriculum survey.

Forty-one students participated in the curriculum from March to November 2019. As a result, students agreed that their overall clerkship experience improved (73%

, 24%

). Students also reported increased comfort in their ability to participate in the management of critically ill patients (44%

, 51%

). Objectively, student performance on a 15-question pre- and posttest improved from a precurricular average of 7.5 (50%) questions correct to a postcurricular average of 10.7 (71%) questions correct (

<.0001; CI 2.2-4.4).

Following implementation of our ICU curriculum, medical student attitudes regarding overall IM clerkship experience, self-perceived confidence in critically ill patient management, and medical knowledge all improved.

Following implementation of our ICU curriculum, medical student attitudes regarding overall IM clerkship experience, self-perceived confidence in critically ill patient management, and medical knowledge all improved.

Firearm-related fatalities are a public health crisis. Despite recognizing the vital nature of counseling parents/caregivers regarding firearm safety, residents remain uncomfortable asking patients about the presence of firearms in homes and discussing American Academy of Pediatrics recommendations regarding safe firearm storage.

We designed an interactive curriculum to improve pediatric resident knowledge, skills, attitudes, and behavior regarding counseling families about safe firearm storage. Components of the curriculum included a didactic session, a hands-on experience to better understand the parts of a firearm and its relevant storage/safety devices, and role-playing scenarios.

The curriculum was delivered to 53 pediatric residents in two different residency programs. A statistically significant improvement in knowledge and skills related to safe firearm storage counseling was demonstrated in both settings. Furthermore, a statistically significant change in counseling behavior was noted among one resident group. Curriculum evaluation revealed overwhelmingly positive learner responses.

An adaptable interactive safe firearm storage counseling curriculum was well received by pediatric residents and improved resident knowledge and skills, resulting in an increase in safe firearm storage counseling discussions with families.

An adaptable interactive safe firearm storage counseling curriculum was well received by pediatric residents and improved resident knowledge and skills, resulting in an increase in safe firearm storage counseling discussions with families.Recurrence of hepatocellular carcinoma (HCC) is an important predictor of survival after liver transplantation (LT). Recent studies show that early diagnosis, aggressive treatment, and surveillance may improve outcomes after HCC recurrence. We sought to determine the current practices and policies regarding surveillance for HCC recurrence after LT.

We conducted a web-based national survey of adult liver transplant centers in the United States to capture center-specific details of HCC surveillance post-LT. Responses were analyzed to generate numerical and graphical summaries.

Of 101 eligible adult liver transplant centers, 48 (48%) centers across the United States responded to the survey. Among the participating centers, 79% stratified transplant recipients for HCC recurrence risk, while 19% did not have any risk stratification protocol. Explant microvascular invasion (mVI) was the most common factor used in risk stratification. Use of pretransplant serum biomarkers such as alpha-fetoprotein (AFP) was variable, with only 48% of the participating centers reporting specific "cutoff" values. While a majority of centers (88%) reported having a routine imaging protocol for HCC recurrence surveillance, there was considerable heterogeneity in terms of frequency and duration of such surveillance. Of the centers that did risk stratify patients to identify those at higher risk of HCC recurrence, about 50% did not change their surveillance protocol.

Our study affirms significant variability in center practices, and our results reflect the need for high-quality studies to guide risk stratification and surveillance for HCC recurrence.

Our study affirms significant variability in center practices, and our results reflect the need for high-quality studies to guide risk stratification and surveillance for HCC recurrence.