共查询到20条相似文献，搜索用时 31 毫秒
1.
Carol Wheeler Karen-Jill Browner-Elhanan Yolanda Evans Nathalie Fleming Patricia S. Huguelet Nicole W. Karjane Meredith Loveless Hina J. Talib Paritosh Kaul 《Journal of pediatric and adolescent gynecology》2018,31(1):3-6
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. The curricula used print as well as interactive electronic resources.Results
After publication of the short and long curricula, a dissemination strategy was developed to present the information at national meetings. A curricular study was performed after introduction of the curriculum to evaluate its efficacy. Long-term plans for further curricular components and expansion of educational tools are ongoing.Conclusion
We gathered a diverse multispecialty group of doctors to collaborate on a unified educational goal. This committee developed and disseminated resident PAG curricula using a variety of learning tools. This curricular development and implementation can occur with a minimal financial burden. 相似文献2.
Anna Torres Magdalena Horodeńska Grzegorz Witkowski Tomasz Bielecki Kamil Torres 《Journal of pediatric and adolescent gynecology》2019,32(2):110-116
Study Objective
To describe a hybrid simulation model for pediatric and adolescent gynecology (PAG) examination teaching, to evaluate if it would be feasible to be conducted as a part of the PAG training, and to find out how it would be perceived by the trainees.Design
The development process and a 2-day workshop is presented.Setting
An academic 2-day PAG simulation training at the Medical University of Lublin Centre of Medical Simulation.Participants
Twenty-two obstetrics and gynecology and pediatric residents from various hospitals of the Lublin county region.Interventions
Participants took part in a 2-day simulation-based workshop consisting of a theoretical part and 3 high-fidelity PAG simulation scenarios, followed by an anonymous feedback survey on their opinions about the hybrid model teaching strategy.Main Outcome Measures
To describe and evaluate feasibility of a hybrid simulation model for PAG examination teaching and to report students’ satisfaction and acceptance of this teaching modality; to share faculty experience and lessons learned during the development process.Results
Of 22 initially enrolled residents, 16 of them completed the simulation-based session. All but 1 participant preferred a hybrid model to a task trainer as a teaching modality. The same number of surveyed residents stated that they learned more using the hybrid model. Qualitative feedback from the participants was overall positive.Conclusion
A hybrid model for teaching PAG examination is feasible and greatly accepted by the trainees. We are convinced that such a model of training can improve trainees' skills and translate to PAG patients’ comfort and safety. It could be potentially used in teaching more difficult procedures (eg, intrauterine device insertion or examination after sexual assault). 相似文献3.
《Journal of pediatric and adolescent gynecology》2016,29(6):623-627
Study ObjectiveTo determine if the North American Society for Pediatric and Adolescent Gynecology (NASPAG) Short Curriculum improves self-reported knowledge in pediatric and adolescent gynecology (PAG) among obstetrics and gynecology (Ob/Gyn) residents, at programs without PAG-trained faculty.DesignProspective, cross-sectional exposure to the NASPAG short curriculum with a follow-up questionnaire.SettingOb/Gyn residency training programs without PAG faculty.ParticipantsOb/Gyn residents in training from February 2015 to June 2015.InterventionsExposure to the NASPAG Short Curriculum.Main Outcome MeasuresImprovement in self-perceived knowledge after completion of curriculum.ResultsTwo hundred twenty-seven residents met inclusion criteria; 34 completed the study (15% response). Less than 50% of residents reported adequate knowledge in the areas of prepubertal vaginal bleeding, vulvovaginitis, precocious and delayed puberty, Home environment, Education and Employment, Eating, peer-related Activities, Drugs, Sexuality, Suicide/depression, Safety from injury and violence (HEEADSSS) interview, pelvic pain, and bleeding management in teens with developmental delay. After completion of the curriculum, self-reported knowledge improved in 8 of 10 learning objectives, with no significant improvement in bleeding disorders or Müllerian anomalies. There was no association between pretest knowledge and level of residency training, type of residency program, previous exposure to PAG lectures, and previous exposure to patients with PAG complaints.ConclusionSignificant deficiencies exist regarding self-reported knowledge of core PAG topics among Ob/Gyn residents at programs without PAG-trained faculty. Use of the NASPAG Short Curriculum by residents without access to PAG-trained faculty resulted in improved self-reported knowledge in PAG. 相似文献
4.
5.
6.
Lauren M. Bergeron Katherine C. Bishop Holly R. Hoefgen Margaret S. Abraham Nhial T. Tutlam Diane F. Merritt Jeffrey F. Peipert 《Journal of pediatric and adolescent gynecology》2017,30(1):123-127
Study Objective
The purpose of this study was to compare ovarian conservation rates and surgical approach in benign adnexal surgeries performed by surgeons vs gynecologists at a tertiary care institution.Design
A retrospective cohort review.Setting
Children's and adult tertiary care university-based hospital.Participants
Patients 21 years of age and younger who underwent surgery for an adnexal mass from January 2003 through December 2013.Interventions
Patient age, demographic characteristics, menarchal status, clinical symptoms, radiologic imaging, timing of surgery, surgeon specialty, mode of surgery, rate of ovarian conservation, and pathology were recorded. Patients were excluded if they had a uterine anomaly or pathology-proven malignancy.Main Outcome Measures
The primary outcome was the rate of ovarian conservation relative to surgical specialty; secondary outcome was surgical approach relative to surgical specialty.Results
Of 310 potential cases, 194 met inclusion criteria. Gynecologists were more likely than surgeons to conserve the ovary (80% vs 63%; odds ratio, 2.28; 95% confidence interval, 1.16-4.48). After adjusting for age, body mass index, mass size, and urgency of surgery, the difference was attenuated (adjusted odds ratio, 1.84; 95% confidence interval, 0.88-3.84). Surgeons and gynecologists performed minimally invasive surgery at similar rates (62% vs 50%; P = .11). A patient was more likely to receive surgery by a gynecologist if she was older (P < .001) and postmenarchal (P = .005).Conclusion
Results of our study suggest that gynecologists are more likely to perform ovarian-conserving surgery. However, our sample size precluded precise estimates in our multivariable model. Educational efforts among all pediatric and gynecologic surgeons should emphasize ovarian conservation and fertility preservation whenever possible. 相似文献7.
《Journal of pediatric and adolescent gynecology》2021,34(6):793-798.e1
A previous study determined that Obstetrics and Gynecology (ObGyn) residency Program Directors (PD) endorse mandatory Pediatric and Adolescent Gynecology (PAG) training to achieve national PAG objectives. Although barriers exist that limit the achievement of PAG objectives, this paper presents existing PAG tools and curricula. These include the North American Society for Pediatric and Adolescent Gynecology (NASPAG) short and long curricula, a wide variety of PAG electives available across Canada, more than 25 online clinical cases, and a simulation curriculum. This paper details these resources and provides a 4-week PAG schedule to accommodate ObGyn residency training programs. 相似文献
8.
Hina J. Talib Nicole Karjane Karen Teelin Margaret Abraham Stephanie Holt Gayaythri Chelvakumar Tania Dumont Patricia S. Huguelet Lindsay Conner Carol Wheeler Nathalie Fleming 《Journal of pediatric and adolescent gynecology》2018,31(2):71-76
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. This curriculum outlines specific learning objectives that are central to PAG education and lists essential resources for learners' reference. This updated curriculum replaces the previous 2014 publication with added content, resources, and updated references. Additionally, attention to the needs of learners in pediatrics and adolescent medicine is given greater emphasis in this revised North American Society for Pediatric and Adolescent Gynecology Short Curriculum 2.0. 相似文献
9.
Mirko Bertozzi Ciro Esposito Claudio Vella Vito Briganti Nicola Zampieri Daniela Codrich Michele Ubertazzi Alessandro Trucchi Elisa Magrini Sonia Battaglia Vittorio Bini Maria Luisa Conighi Caterina Gulia Alessandra Farina Francesco Saverio Camoglio Waifro Rigamonti Piergiorgio Gamba Giovanna Riccipetitoni Antonino Appignani 《Journal of pediatric and adolescent gynecology》2017,30(3):413-417
Study Objective
To report results of a retrospective multicentric Italian survey concerning the management of pediatric ovarian torsion (OT) and its recurrence.Design
Multicenter retrospective cohort study.Setting
Italian Units of Pediatric Surgery.Participants
Participants were female aged 1-14 years of age with surgically diagnosed OT between 2004 and 2014.Interventions
Adnexal detorsion, adnexectomy, mass excision using laparoscopy or laparotomy. Different kinds of oophoropexy (OPY) for OT or recurrence, respectively.Main Outcome Measures
A total of 124 questionnaires were returned and analyzed to understand the current management of pediatric OT and its recurrence. The questionnaires concerned patient age, presence of menarche, OT site, presence and type of mass, performed procedure, OPY technique adopted, intra- and postoperative complications, recurrence and site, procedure performed for recurrence, OPY technique for recurrence, and 1 year follow-up of detorsed ovaries.Results
Mean age at surgery was 9.79 ± 3.54 years. Performed procedures were open adnexectomy (52 of 125; 41.6%), laparoscopic adnexectomy (25 of 125; 20%), open detorsion (10 of 125; 8%), and laparoscopic detorsion (38 of 125; 30.4%). Recurrence occurred in 15 of 125 cases (12%) and resulted as significant (P = .012) if associated with a normal ovary at the first episode of torsion. Recurrence occurred only in 1 of 19 cases after OPY (5.2%). Ultrasonographic results of detorsed ovaries were not significant whether an OPY was performed or not (P = 1.00).Conclusion
Unfortunately, oophorectomy and open technique are still widely adopted even if not advised. Recurrence is not rare and the risk is greater in patients without ovarian masses. OPY does not adversely affect ultrasonographic results at 1 year. When possible OPY should be performed at the first episode of OT. 相似文献10.
Ji Son Willa M. Miller Krystel Tossone Fredrick Butcher Kelly Kuo 《Journal of pediatric and adolescent gynecology》2017,30(3):370-375
Study Objective
To assess the effects of an interprofessional student-led comprehensive sexual education curriculum in improving the reproductive health literacy among at-risk youths in detention.Design, Setting, and Participants
We performed a prospective cohort study involving 134 incarcerated youth and an interprofessional team of 23 medical, nursing, and social work students, who participated in a comprehensive reproductive health curriculum over the course of 3 days.Interventions, and Main Outcome Measures
Basic reproductive health knowledge, confidence in condom use with a new partner, and self-efficacy with regard to contraception use and sexual autonomy were assessed before and after completion of the curriculum. We also assessed the student teachers' level of comfort with teaching reproductive health to adolescents and their perception of interprofessionalism.Results
Incarcerated youth showed a statistically significant increase in knowledge regarding sexually transmitted infections as well as self-reported confidence in condom use (P = .002). Self-efficacy in contraception use and sexual autonomy did not show significant improvement. Qualitative analysis of student teachers' surveys revealed theme categories regarding perception of youth, perception of self in teaching youth, perception of interacting with youth, and perception of working in interprofessional teams.Conclusions
Our program might represent a mutually beneficial community relationship to improve reproductive health literacy in this high-risk youth population. 相似文献11.
Kristl Tomlin Lucia Mirea Amy Williamson 《Journal of pediatric and adolescent gynecology》2018,31(4):346-349
Study Objective
The American Academy of Pediatrics and American College of Obstetricians and Gynecologists have identified the menstrual cycle as essential in assessing overall health of adolescent girls. Menses should be considered a “vital sign” and documentation of last menstrual period (LMP) is recommended at every patient encounter. The aim of this study was to estimate and compare LMP documentation among adolescent and pediatric health care providers.Design, Setting, and Participants
A retrospective cohort study identified a random sample of 50 female patients seen in the general pediatrics (PEDS), adolescent medicine (AM), and pediatric and adolescent gynecology (PAG) ambulatory clinics at Phoenix Children's Hospital between January 1, 2016 and March 31, 2016.Interventions and Main Outcome Measures
Rates of LMP documentation were compared between clinics using the Pearson χ2 test. Multivariable logistic regression analyses quantified the association of clinic and LMP documentation, with adjustments for visit reason, provider gender, and age at presentation.Results
Rates of LMP documentation were 100% for adolescent gynecologists, but significantly lower for general pediatricians (14%) and AM (60%) providers (P < .0001). These findings were confirmed in multivariable analyses (PAG vs PEDS: odds ratio [OR], 280; 95% confidence interval [CI], 32-2331; PAG vs AM: OR, 34; 95% CI, 4.4-270; AM vs PEDS: OR, 3.8; 95% CI, 1.3-11.0).Conclusion
Adolescent gynecologists document LMP routinely. In contrast, LMP documentation rates in AM, and especially in PEDS, were significantly lower. Quality improvement methods such as incorporation of an LMP section into the vitals portion of an electronic medical record could help improve rates of compliance. 相似文献12.
Peili Liang Xin Zhang Zhenfeng Zhang Guocai Xu Xingsu Yu Sijin Li Yuanyuan Zhang Lijuan Bian Bingzhong Zhang 《Journal of pediatric and adolescent gynecology》2018,31(3):304-310
Study Objective
Nonepithelial malignant ovarian tumors are rare in the pediatric and adolescent population. The aim of this study was to observe the spectrum of pathology, presentation, outcome, and risk factors for survival of pediatric nonepithelial malignant ovarian tumors in a Chinese pediatric population.Design, Setting, Participants, Interventions, and Main Outcome Measures
This was a retrospective study of 171 girls (median age at presentation of 14 years) diagnosed with primary malignant ovarian tumors between 1990 and 2014 at the Yat-Sen Memorial Hospital and Cancer Center of Sun Yat-sen University. Symptoms, pathological data, treatments, and outcomes were obtained retrospectively from the medical records.Results
Most (85.96%, 147/171) tumors occurred in patients aged 10-18 years and most cases were International Federation of Gynecology and Obstetrics stage I (68.42%, 117/171). The predominant pathological type was germ cell tumors (87.13%, 149/171). All patients underwent surgery, and 87 (50.88%, 87/171) underwent conservative incomplete staging surgery (unilateral salpingo-oophorectomy or tumor excision). The 5-year progression-free survival (PFS) was 59.2%. The 5-year overall survival (OS) was 88.7%. Surgical hospital (hazard ratio, 0.388; 95% confidence interval, 0.213-0.706; P = .002) was independently associated with PFS. Recurrence state (hazard ratio, 163.26; 95% confidence interval, 1.321-20,181.875; P = .038) was independently associated with OS.Conclusion
Ovarian cancers in children and adolescents have features of good prognosis. Girls who received their first surgery in a tertiary hospital had better PFS. Patients who did not suffer recurrence had better OS. 相似文献13.
Beryl L. Manning-Geist Antonio R. Perez-Atayde Marc R. Laufer 《Journal of pediatric and adolescent gynecology》2018,31(3):311-314
Background
Granular cell tumors (GCTs) are rare soft tissue lesions that can involve the female genital tract, including the vulva. Although malignant tumors are aggressive and uncommon, benign and atypical lesions still have associated risks, including recurrence and multisite development.Cases
Four cases of pediatric vulvar GCT are presented, including 1 atypical and 3 benign tumors. The atypical lesion occurred in a 3-year-old girl, to our knowledge, the youngest reported patient with GCT of the vulva. Follow-up information is available for 3 patients, ranging 0-12 years.Summary and Conclusion
GCTs are an important differential diagnosis in patients with vulvar lesions. In the pediatric population, the tumors' risk of recurrence and multisite development require gynecologists to advocate for complete resection, careful follow-up, and thorough examination for additional tumor sites. 相似文献14.
Brittany L. Murphy Amy E. Glasgow Dan S. Ubl Elizabeth B. Habermann Valerie Lemaine 《Journal of pediatric and adolescent gynecology》2018,31(3):299-303
Study Objective
Adolescent breast disorders are rare and typically benign in nature; however, surgical treatments might require multiple surgeries. Because of the limited existing data, we sought to evaluate national trends and describe our institutional experience to help guide patient conversations.Design
Retrospective review.Setting
National database and academic institution.Participants
Patients 20 years old or younger who underwent a breast procedure in the Kids' Inpatient Database from January 2000 to December 2012 and at Mayo Clinic-Rochester from January 2000 to July 2016. Conditions were categorized into common and complex breast disorders.Interventions
None.Main Outcome Measures
To assess any trend of adolescent breast procedures across the United States as a whole, weighted Kids' Inpatient Database data were assessed using a Rao-Scott χ2 test. Within the institutional data, the average number of procedures needed to correct common vs complex breast disorders were compared using an unequal variance t test.Results
In recent years, the estimated number of hospitalizations for breast procedures decreased in the United States from 1661 in 2000 to 1078 in 2012 (P < .001). At our institution, 241 patients underwent a breast procedure (75.1% [181/241] female) over 16 years. Common breast disorders were corrected with fewer procedures than complex breast disorders (mean 1.09 vs 2.22 procedures; P = .0003).Conclusion
Inpatient treatment of adolescent breast disorders has been decreasing in recent years, likely reflecting a trend to outpatient procedures. Common adolescent breast disorders might be surgically corrected with 1 procedure, whereas complex disorders often require multiple surgeries to correct. It is important to discuss this with patients and their families to adequately set up expectations. 相似文献15.
Gylynthia E. Trotman Eleanor Mackey Eshetu Tefera Veronica Gomez-Lobo 《Journal of pediatric and adolescent gynecology》2018,31(5):516-521
Study Objective
To explore parental and adolescent views on the confidential interview in the gynecologic setting and compare adolescent reported risk-taking behaviors with parental perception.Design
Anonymous surveys were administered separately to parents/guardians and adolescents between the ages of 11 and 17 years. Information pertaining to the patient's Tanner stage and reason for visit was obtained from the provider. This first phase served as the usual care group. In the second phase of the study, surveys were again distributed after a brief educational intervention. Linear regression analysis, Wilcoxon rank sum test, and Fisher exact test were used where appropriate.Setting and Participants
Pediatric and adolescent gynecology clinics in 2 tertiary hospitals.Interventions
Brief educational handout on key concepts of the confidential interview.Main Outcome Measures
Parental perception of the confidential interview and adolescent risk-taking behaviors.Results
A total of 248 surveys were included in the final analysis, which accounts for 62 adolescent and parent/guardian pairs in each group. Most parents and adolescents reported perceived benefit to the confidential interview. However, parents were less likely to rate benefits of private time specifically for their own adolescent and less than half of the parents believed that adolescents should have access to private time in the gynecologic setting. Parents/guardians as well as adolescents feared that the confidential interview would limit the parent's ability to take part in decision-making. The low support for confidential time for their adolescent was not different in the usual care group compared with the intervention group, although there was a trend toward parental acceptance with increased adolescent age. Adolescents were consistently more likely to report more risk-taking behaviors than their parents perceived.Conclusion
There is a discord between parental perception and adolescent reports of risk-taking behaviors. This is coupled with a lack of understanding or comfort regarding the benefits of the confidential interview among parents and adolescents who present for gynecologic care. A short educational intervention had only a modest effect on parental perceptions regarding the confidential interview. 相似文献16.
17.
Patrick Campbell Michael Krychman Thomas Gray Holly Vickers John Money-Taylor Weiguang Li Stephen Radley 《The journal of sexual medicine》2018,15(11):1515-1517
Introduction
Vaginal laxity is increasingly recognized as an important condition, although little is known regarding its prevalence and associated symptoms.Aim
To report the prevalence of self-reported vaginal laxity in women attending a urogynecology clinic and investigate its association with pelvic floor symptoms and female sexual dysfunction.Method
Data were analyzed from 2,621 women who completed the electronic Personal Assessment Questionnaire-Pelvic Floor (ePAQ-PF).Main Outcome Measure
Response data from ePAQ-PF questionairre.Results
Vaginal laxity was self-reported by 38% of women and significantly associated with parity, symptoms of prolapse, stress urinary incontinence, overactive bladder, reduced vaginal sensation during intercourse, and worse general sex life (P < .0005).Clinical Implications
Clinicians should be aware that vaginal laxity is prevalent and has an associated influence and impact on sexual function.Strength & Limitations
The main strength of this study is the analysis of prospectively collected data from a large cohort of women using a validated questionnaire. The main limitation is lack of objective data to measure pelvic organ prolapse.Conclusion
Vaginal laxity is a highly prevalent condition that impacts significantly on a woman’s sexual health and quality of life.Campbell P, Krychman M, Gray T, et al. Self-reported vaginal laxity—Prevalence, impact, and associated symptoms in women attending a urogynecology clinic. J Sex Med 2018;15:1515–1517. 相似文献18.
Marzieh Araban Zahra Karimian Zohre Karimian Kakolaki Karen A. McQueen Cindy-Lee Dennis 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(2):173-183
Objective
To determine the effects of a prenatal breastfeeding self-efficacy intervention on breastfeeding self-efficacy and breastfeeding outcomes.Design
Randomized controlled trial.Setting
Four health centers in Ahvaz, Iran.Participants
A total of 120 low-risk, nulliparous women between 35 and 37 weeks gestation who intended to breastfeed their singleton infants.Methods
Women were randomly assigned to receive the breastfeeding self-efficacy intervention (n = 60) or standard care (n = 60). The intervention was multifaceted and included two prenatal group sessions, an information package with breastfeeding images, and text messages until 8 weeks postpartum to promote exclusive breastfeeding. The primary outcome was breastfeeding self-efficacy measured with the Breastfeeding Self-Efficacy Scale–Short Form, translated into Persian, at 8 weeks postpartum. Additional outcomes included rates of breastfeeding exclusivity, duration, practices, satisfaction, and problems.Results
At 8 weeks postpartum, participants in the intervention group had significantly higher mean Breastfeeding Self-Efficacy Scale–Short Form scores and rates of exclusive breastfeeding than those in the control group. No significant group differences were found with regard to breastfeeding duration.Conclusion
Emerging evidence supports the use of breastfeeding self-efficacy interventions to improve breastfeeding self-efficacy and rates of exclusive breastfeeding. Further evaluation of this prenatal intervention is warranted. 相似文献19.
Alexa Kaskowitz Elisabeth Quint Melissa Zochowski Amy Caldwell Kavita Vinekar Vanessa K. Dalton 《Journal of pediatric and adolescent gynecology》2017,30(2):184-187