What Pediatric Subspecialists Need to Know About Sexual and Reproductive Health: A Review of the American Board of Pediatrics Content Outlines for Subspecialty Certifying Examinations

ABSTRACT

Many adolescents with complex medical conditions regard their subspecialty providers as an important source of clinical information including sexual and reproductive health information related to their medical condition. Thus, training for pediatric subspecialty providers should include clinically relevant sexual and reproductive content. The purpose of this study is to understand what disease-relevant sexual and reproductive health information is currently included in content outlines for each of the available pediatric subspecialty certifying examinations. The American Board of Pediatrics (ABP) offers 17 subspecialty certifying examinations; 13 content outlines are available on the ABP website which defines the body of knowledge to be tested. Each available outline underwent content analysis for sexual and reproductive health information. A team of adolescent medicine physicians identified seven thematic areas including: 1) puberty; 2) sexual behavior and identity; 3) fertility; 4) contraception; 5) sexually transmitted infections; 6) other genital pathology; 7) pregnancy. Across disciplines, learning objectives related to sexual behavior, sexual identity, fertility, contraception and pregnancy were the most limited. However, content related to puberty, sexually transmitted infections and other genital pathology was better represented. Overall, disease-and treatment-specific sexual and reproductive health information was sparse. Most subspecialty content outlines contain very little disease-specific sexual and reproductive health information despite the growing adolescent and young adult population with complex medical conditions in the care of pediatric subspecialists. Further studies are needed to explore if lack of sexual and reproductive information on board exams relates to the knowledge base and skill set of pediatric subspecialists.     

Children's Perceptions of Their Relationships with Coresiding and Non-Coresiding Fathers

In this study the perceptions of children who reside with their fathers and children who live apart from their fathers are compared on a number of relationship qualities. Residential status significantly affected the likelihood of a father being named as some- one who was important in thc life of the child, as well as the likeli- hood of the father being named as someone the child went to for help with a reccnt srressful event. However, for those fathers who were named by their children, the child's perception of the general quality of the relationship and the amount of social support it provided did not differ by residential status. In addition, noncoresiding fathers were seen as filling the functional roles of teacher, supporter, and challeng- er at a higher level than co-residing faUiers. It appears that residential status may reduce the child's access to his or her father, but that those fathers who maintain contact remain important, functional people in their children's lives and important sources of support in times of stress. The need to change the common rception that noncoresid- ing fathers are unimportant in the lives o P" their children is discussed.     

A Challenge to Teachers of the Social Studies

When teachers in elementary and middle school classrooms portray history as an immutable sequence of certain facts, dates, and events, young learners tend to view the past, and by extension the future, as something fixed and inevitable. Learning about the past through investigating biographies can help counter this tendency by teaching students to recognize that individuals and groups have the agency to make history and shape the future. In this article, the author presents three instructional strategies in which learners make use of graphic organizers to investigate the historical contexts and chronologies of individuals' lives. Students learn how people have effected historical change and worked together to preserve continuity with the past. They also learn that the values and attitudes that motivated individuals and groups to act as they did were in large measure the result of historically specific social structures and institutional arrangements.     

Effectiveness of smoking cessation program for male adolescents in South Korea

The objective of this study was to implement and verify the effectiveness of a smoking cessation program based on a cognitive behavioral model, composed of six sessions. Participants included 80 male middle school students who smoked. They were divided into experimental (n = 35 students) and comparison (n = 45 students) groups, and the smoking cessation program was conducted in the experimental group. Results of self-report scales for smoking behaviors and urinary cotinine and CO levels before and after the program were statistically analyzed with mixed regression including factors for group, time, and a group-by-time interaction. The results indicated that the group effect, time effect, and group-by-time interaction effect were significant for the nicotine dependency. The variation patterns in the two groups became significantly different over time as nicotine dependency drastically decreased in the experimental group, whereas those in the comparison group showed little change from pre-program examination to post-program examination. Significant time effects were observed for smoking cessation efficacy and urinary cotinine levels, reflecting increased smoking cessation efficacy and decreased cotinine levels in both groups across time. The results suggest that this six-week smoking cessation program in male adolescents in South Korea was valid to implement.     

Implications of no recent sexual activity,casual sex,or exclusive sex for college women's sexual well-being depend on sexual attitudes

Objective: We examine how sexual activity relates to sexual well-being within the context of sexual attitudes, sexual agency, and sexual desire. Participants/Methods: We surveyed 471 college women in 2012–2014 who had ever had sex. Results: Sexual agency and sexual desire consistently predicted well-being, regardless of recent sexual activity. There was a significant interaction between recent sexual activity (none, casual, or exclusive relationship) and sexual attitudes. Exclusive sex was associated with higher than average sexual well-being, especially for women with permissive attitudes. Women who had casual sex and held permissive to average attitudes had the next highest levels of well-being, but those with non-permissive attitudes fell substantially below the overall mean. Women who had no recent sex were consistently below the mean, especially for women with more permissive attitudes. Conclusions: A disconnect between sexual attitudes and recent sexual activity may lower women's sexual well-being.     

An evaluation case: The implementation and evaluation of a problem-solving training program for adolescents

This study recounts the implementation and evaluation of a problem-solving skills training program for adolescents. Sixty-six students from the seventh, eighth, and ninth grades of a local junior high school were identified by guidance counselors as needing problem-solving training—48 male and 18 female students between the ages of 11 and 16. The hypothesis that students included in the training sessions would demonstrate better problem-solving skills, a more internal locus of control, and a higher level of self-esteem than control group students was tested via a pretest-posttest Control Group Design. The results of a stepwise discriminant analysis of the data supported the hypothesis. An analysis of grade level differences indicated that the program had less effect on the seventh-grade training group. Implications for program modification and the limitations of the evaluation findings are discussed.     

Loneliness,social support,and preference for online social interaction: the mediating effects of identity experimentation online among children and adolescents

This study explores the practices of online social activities among children and adolescents in order to uncover the connections between preferences for online social interaction and loneliness, social support, and the mediating effect of identity experimentation online. Data were gathered from a random sample of 718 youngsters aged 9 to 19. Analyses revealed that individuals who are lonely and have a lower level of offline social support find opportunities for identity experimentation online more gratifying than those who are less lonely or not lonely. Both loneliness and social support offline were found significantly related to preference for online social interaction, but the relationships were mediated by identity experimentation online. Finally, it was found that age differences exist. In particular, individuals aged 9 to 14 who are lonely and those aged 15 to 19 with little social support show a significant preference for online social interaction. Implications for future research into identity experimentation online and social relationship are discussed.     

Social work students dealing with moral dilemmas in the care for children and young people: an evaluation of moral case deliberation as an educational tool

Social work professionals face moral dilemmas. Evidence-based guidelines only partly help them to deal with these dilemmas. Recently, moral case deliberation (MCD) as a bottom-up aid has been successfully introduced into Dutch health care to help strengthen professional moral competence. This research investigates whether MCD can help future professionals caring for children and young people to deal with their dilemmas. Research questions are: (1) How do students evaluate two series of four MCD sessions related to moral dilemmas in cases they experienced in practice? and (2) Does MCD contribute to students’ ability to justify their decisions? Applying a mixed-method evaluation study, we found that students consider MCD highly important. They feel supported in their ability to justify decisions ethically. Most students value the challenge of thinking critically in MCD. However, some do not appreciate the uncertainties which come with this. One-third of the students prove able to justify their decisions ethically after attending MCD sessions. Robust conclusions about MCD as the cause of these results cannot be drawn on the basis of the study design. Suggestions are made for future research regarding the contribution of MCD to the development of competence in dealing better with moral dilemmas.