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Leadership development is a core value of Maternal Child Health Bureau training programs. Mentorship, an MCH Leadership Competency, has been shown to positively affect career advancement and research productivity. Improving mentorship opportunities for junior faculty and trainees may increase pursuit of careers in areas such as adolescent health research and facilitate the development of new leaders in the field. Using a framework of Developmental Networks, a group of MCH Leadership Education in Adolescent Health training program faculty developed a pilot mentoring program offered at the Society for Adolescent Health and Medicine Annual Meeting (2011-2013). The program matched ten interdisciplinary adolescent health fellows and junior faculty with senior mentors at other institutions with expertise in the mentee's content area of study in 2011. Participants were surveyed over 2 years. Respondents indicated they were "very satisfied" with their mentor match, and all agreed or strongly agreed that the mentoring process in the session was helpful, and that the mentoring relationships resulted in several ongoing collaborations and expanded their Developmental Networks. These results demonstrate that MCH programs can apply innovative strategies to disseminate the MCH Leadership Competencies to groups beyond MCH-funded training programs through programs at scientific meetings. Such innovations may enhance the structure of mentoring, further the development of new leaders in the field, and expand developmental networks to provide support for MCH professionals transitioning to leadership roles.

The Life Course Perspective (LCP), or Model, is now a guiding framework in Maternal and Child Health (MCH) activities, including training, supported by the Health Resources and Services Administration's Maternal and Child Health Bureau. As generally applied, the LCP tends to focus on pre- through post-natal stages, infancy and early childhood, with less attention paid to adolescents as either the 'maternal' or 'child' elements of MCH discourse. Adolescence is a distinct developmental period with unique opportunities for the development of health, competence and capacity and not merely a transitional phase between childhood and adulthood. Adequately addressing adolescents' emergent and ongoing health needs requires well-trained and specialized professionals who recognize the unique role of this developmental period in the LCP. Keywords Life course * Adolescent health * Adolescent development * Maternal and child health training programs, Background In 2010, as part of the 75th Anniversary celebration of the Maternal and Child Health Bureau (MCHB), a concept paper Rethinking MCH: The Life Course Model as an Organizing [...]

Little research has been undertaken on the mediating neuroanatomy of human appetitive function, although studies have been carried out on primates and rodents. A new study uses a state induction paradigm and positron emission topography to test the theory that limbic/paralimbic regions respond to the desirability of food stimuli. It is shown that significant increases in desire to eat, together with decreases in left temporo-insular cortical blood flow, occur during high-calorific versus control conditions. It is suggested that desirability to eat is associated with activity in the temporo-insular cortex.

Most pediatric residencies provide training in adolescent medicine but there is considerable variation in the subjects taught. A survey of 155 directors of pediatric residencies found that 90% required their residents to complete a one-month rotation in adolescent medicine. However, only 39% believed they had enough faculty to teach adolescent medicine. Topics most likely to be covered included sexually transmitted diseases, puberty, contraception and menstrual problems. Substance abuse, violence, and weapon use were least likely to be covered., Objectives. To determine how pediatric residency programs are responding to the new challenges of teaching adolescent medicine (AM) to residents by assessing whether manpower is adequate for training, whether AM curricula and skills are adequately covered by training programs, what types of teaching methodologies are used to train residents in AM, and the needs for new curricular materials to teach AM. Design. A 3-part 92-item survey mailed to all US pediatric residency training programs. Setting. Pediatric residency programs. Participants. Residency program directors and directors of AM training. Main Outcome Measures. AM divisional structure, clinical sites of training, presence of a block rotation, and faculty of pediatric training programs; training materials used and desired in AM; perceived adequacy of coverage of various AM topics; competency of residents in performing pelvic examinations in sexually active teens; and manpower needs. Results. A total of 155/211 (73.5%) of programs completed the program director and the AM parts of the survey. Ninety-six percent of programs (size range, 5-120 residents) had an AM block rotation and 90% required the AM block; those without a block rotation were more likely to be larger programs. Only 39% of programs felt that the number of AM faculty was adequate for teaching residents. Almost half of the programs reported lack of time, faculty, and curricula to teach content in substance abuse. Besides physicians, AM teachers included nurse practitioners (28%), psychologists (25%), and social workers (19%). Topics most often cited as adequately covered included sexually transmitted diseases (81.9%), confidentiality (79.4%), puberty (77.0%), contraception (76.1%), and menstrual problems (73.5%). Topics least often cited as adequately covered included psychological testing (16.1%), violence in relationships (20.0%), violence and weapon-carrying (29.7%), and sports medicine (29.7%). Fifty-eight percent of 137 respondents thought that all or nearly all of their residents were competent in performing pelvic examinations by the end of training; there was no difference between perceived competence and the residents' use of procedure books. Seventy-four percent used a specific curriculum for teaching AM; materials included chapters/articles (85%), lecture outlines (76.1%), slides (41.9%), videos (35.5%), written case studies (24.5%), computerized cases (6.5%), and CD-ROMs (3.2%). Fifty-two percent used Bright Futures, 48% used the Guidelines for Adolescent Preventive Services, and 14% used the Guide to Clinical Preventive Services for teaching clinical preventive services. Programs that used Bright Futures were more likely to feel that preventive services were adequately covered in their programs than those who did not (78% vs 57%). A majority of programs desired more learner-centered materials. Conclusions. Although almost all pediatric programs are now providing AM rotations, there is significant variability in adequacy of training across multiple topics important for resident education. Programs desire more learner-centered materials and more faculty to provide comprehensive resident education in AM. Pediatrics 1998;102:588-595; pediatric residency training, adolescent medicine, medical education, clinical preventive services, pelvic examinations., ABBREVIATIONS. STD, sexually transmitted diseases; GAPS, Guidelines for Adolescent Preventive Services; AAP, American Academy of Pediatrics; RRC, Residency Review Committee; AM, adolescent medicine; Med/Peds, Medicine/Pediatrics. Adolescents in the United States [...]

Objectives. Music videos from five genres of music were analyzed for portrayals of tobacco and alcohol use and for portrayals of such behaviours in conjunction with sexuality. Methods. Music videos (n = 518) were recorded during randomly selected days and times from four television networks. Four female and four male observers aged 17 to 24 years were trained to use a standardized content analysis instrument. All videos were observed by rotating two-person, male-female teams who were required to reach agreement on each behavior that was scored. Music genre and network differences in behaviors were analyzed with chi-squared tests. Results. A higher percentage (25.7%) of MTV videos than other network videos portrayed tobacco use. The percentage of videos showing alcohol use was similar on all four networks. In videos that portrayed tobacco and alcohol use. the lead performer was most often the one smoking or drinking and the use of alcohol was associated with a high degree of sexuality on all the videos. Conclusions. These data indicate that even modest levels of viewing may result in substantial exposure to glamorized depictions of alcohol and tobacco use and alcohol use coupled with sexuality. (Am J Public Health. 1997:87:1131-1135)

Teenagers who use anabolic steroids may also engage in other risky behavior. Anabolic steroids are chemical hormones that promote body growth and masculine characteristics. The 1993 Massachusetts Youth Risk Behavior Survey contained 89 multiple-choice questions about anabolic steroid use, risky sexual activities, and problem behaviors. A total of 3,054 high school students completed the questionnaire on a voluntary basis. The average student was 16 years old. The rate of anabolic steroid use was 5.7 percent among boys and 1.7% among girls. A cluster syndrome of general risk-taking linked anabolic steroid use to all other health risks in this population. These health risks included drinking and driving, unprotected sex, physical fighting, possession of a gun, and suicidal behavior. Teenagers who strive to act like adults and use hormones to achieve these goals are more likely to take a variety of risks. It remains unclear how steroids are related to aggression and other behaviors., Objective. To assess the association between the frequency of anabolic steroid use and the frequency of other health risk and problem behaviors among high school students in Massachusetts. Methods. The 1993 Massachusetts Youth Risk Behavior Survey was conducted on a random sample of 3054 high school students (49% male; mean age, 16 [+ or -] 1.2 years). The frequency of lifetime anabolic steroid use was measured on an ordinal scale from 1 to 6, representing "0" to "40 or more times." Other health risk and problem behaviors measured were sexual behaviors, suicidal behaviors, frequency of not wearing a passenger seat belt, riding a motorcycle, not wearing a helmet while riding a motorcycle, driving after drinking alcohol, riding with a driver who had been drinking alcohol, fighting, and carrying a weapon. The associations between the frequency of anabolic steroid use and other high-risk behaviors were determined using the Spearman correlation coefficient for ordinal data and the Kruskall-Wallis analysis of variance for categorical data. Representative indicators of each risk behavior significantly associated with anabolic steroid use were then analyzed using a stepwise multiple-regression analysis. Results. The frequency of anabolic steroid use was associated with all of the other high-risk behaviors analyzed. Using multiple-regression analysis, driving after drinking alcohol accounted for 12.5% of the variance of the model. Carrying a gun, the number of sexual partners within the past 3 months, not using a condom during last intercourse, injury in a physical fight requiring medical attention, history of a sexually transmitted disease, not wearing a helmet on a motorcycle, not wearing a passenger seatbelt, and a suicide attempt requiring medical attention accounted for an additional 9.0% of the variance. The full model accounted for greater than 21% of the variation. Conclusions. The frequency of anabolic steroid use among adolescents is associated with other high-risk behaviors, thus supporting the hypothesis that anabolic steroid use is part of a "risk behavior syndrome" rather than an isolated behavior. This finding emphasizes the need for comprehensive high-risk behavior screening and counseling among teens who use anabolic steroids. Pediatrics 1995; 96:268-272; anabolic steroids, health risk behaviors, risk behavior syndrome., ABBREVIATION. YRBS, Youth Risk Behavior Survey. The lifetime prevalence of anabolic steroid use among adolescents in the United States has been reported to be between 4% and 12% for male [...]

The recent increase in request for genital examinations in girls who may have been sexually abused has necessitated detailed information not previously available on normal anatomy of the prepubertal girl. This study was undertaken to document the genital anatomy of 211 girls between the ages of 1 month and 7 years who presented for well child care or nongynecologic complaints and who had no history of sexual abuse. Each child's genitalia was examined and photographed, with findings reported reflecting those observed photographically The study population consisted of 36% blacks, 33.6% white non-Hipanics, 29% Hispanics, and 0.5% Asians. Subjects had a mean age of 21 [+ or -] 20.6(SD) months. Extensive labial agglutination sufficient to obscure the hymen was noted in 5% (10/11) and partial agglutination in an additional 17% (35/211). A significant difference was noted in hymenal configuration by age, with a fimbriated hymen the most common type (46%) in infants aged 12 months or younger and a crescentic hymen the most common (51%) in girls older than 24 months (P [less than or equal to].001. No significant difference was noted in hymen configuration by race. Hymenal bumps (mounds) were observed in 7%, hymenal tags in 3%, vestibular bands in 89%, longitudinal intravaginal ridges in 25%, and external ridges in15% of subjects in whom the anatomy under study could be visualized. Hymenal notches (clefts) occurred superiorly and laterally on the hymenal rim but none were found inferiorly on the lower half of the hymen. A narrow rounded hymenal ring with a transection was observed in only 1 (0.5%) of 201 subjects and was not considered a normal finding. Transverse hymenal openings measured only in annular and crescentic hymens had a mean which ranged from 2.5 [+ or -] 0.8 tp 3.6 [+ or -] 1.2 mm and varied significantly with age (P = .003). normal hymenal findings must be recognized by medical professionals so that posttraumatic findings can be diagnosed appropriately. Pediatirics 1992;89:387-394; hymen, hymenal configuration, sexual abuse.