Background-Video games designed to promote behavior change are a promising venue to enable children to learn healthier behaviors.

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This article-the Romanell Report-offers an analysis of the current state of medical ethics education in the United States, focusing in particular on its essential role in cultivating professionalism among medical learners. Education in ethics has become an integral part of medical education and training over the past three decades and has received particular attention in recent years because of the increasing emphasis placed on professional formation by accrediting bodies such as the Liaison Committee on Medical Education and the Accreditation Council for Graduate Medical Education. Yet, despite the development of standards, milestones, and competencies related to professionalism, there is no consensus about the specific goals of medical ethics education, the essential knowledge and skills expected of learners, the best pedagogical methods and processes for implementation, and optimal strategies for assessment. Moreover, the quality, extent, and focus of medical ethics instruction vary, particularly at the graduate medical education level. Although variation in methods of instruction and assessment may be appropriate, ultimately medical ethics education must address the overarching articulated expectations of the major accrediting organizations. With the aim of aiding medical ethics educators in meeting these expectations, the Romanell Report describes current practices in ethics education and offers guidance in several areas: educational goals and objectives, teaching methods, assessment strategies, and other challenges and opportunities (including course structure and faculty development). The report concludes by proposing an agenda for future research.

Purpose A Youth Compendium of Physical Activities (Youth Compendium) was developed to estimate the energy costs of physical activities using data on youth only. Methods Based on a literature search and pooled data of energy expenditure measurements in youth, the energy costs of 196 activities were compiled in 16 activity categories to form a Youth Compendium of Physical Activities. To estimate the intensity of each activity, measured oxygen consumption (V̇O2) was divided by basal metabolic rate (Schofield age-, sex- and mass-specific equations) to produce a youth MET (METy). A mixed linear model was developed for each activity category to impute missing values for age ranges with no observations for a specific activity. Results This Youth Compendium consists of METy values for 196 specific activities classified into 16 major categories for four age groups, 6–9, 10–12, 13–15, and 16–18 years. METy values in this Youth Compendium were measured (51%) or imputed (49%) from youth data. Conclusion This Youth Compendium of Physical Activities uses pediatric data exclusively, addresses the age-dependency of METy and imputes missing METy values and thus represents advancement in the physical activity research and practice. This Youth Compendium will be a valuable resource for stakeholders interested in evaluating interventions, programs, and policies designed to assess and encourage physical activity in youth.

The physician-patient encounter may be structured, but it is never scripted; every physician-patient interaction is to some degree improvised. Both physicians and improvisers must prepare for unpredictability, and the surprising and unrecognized overlap between improvisational theater and medical training and medical practice led the author to develop a seminar that tailors improvisational skills to physician needs, teaching communication, professionalism, and other medical skills through an approach she calls "medical improv." The author observes that there is no example of this teaching strategy as a recurring part of a medical school curriculum reported in the literature, and she describes the contributions medical improv can make to physician skills. The author reports on medical students' positive response to the medical improv seminar she has taught at Northwestern University Feinberg School of Medicine since 2002: 95% of students anonymously evaluating the seminar from 2002 to 2010 agreed with the statement, "Studying improv could make me a better doctor," and 100% agreed with the statement, "I would recommend this class to other medical students." The author proposes a medical improv teaching model that other medical schools and hospitals could adapt and adopt.

BackgroundDespite the large number of parenting questionnaires, considerable disagreement exists about how to best assess parenting. Most of the instruments only assess limited aspects of parenting. To overcome this shortcoming, the “Comprehensive General Parenting Questionnaire” (CGPQ) was systematically developed. Such a measure is frequently requested in the area of childhood overweight.MethodsFirst, an item bank of existing parenting measures was created assessing five key parenting constructs that have been identified across multiple theoretical approaches to parenting (Nurturance, Overprotection, Coercive control, Behavioral control, and Structure). Caregivers of 5- to 13-year-olds were asked to complete the online survey in the Netherlands (N = 821), Belgium (N = 435) and the United States (N = 241). In addition, a questionnaire regarding personality characteristics (“Big Five”) of the caregiver was administered and parents were asked to report about their child’s height and weight. Factor analyses and Item-Response Modeling (IRM) techniques were used to assess the underlying parenting constructs and for item reduction. Correlation analyses were performed to assess the relations between general parenting and personality of the caregivers, adjusting for socio-economic status (SES) indicators, to establish criterion validity. Multivariate linear regressions were performed to examine the associations of SES indicators and parenting with child BMI z-scores. Additionally, we assessed whether scores on the parenting constructs and child BMI z-scores differed depending on SES indicators.ResultsThe reduced questionnaire (62 items) revealed acceptable fit of our parenting model and acceptable IRM item fit statistics. Caregiver personality was related as hypothesized with the GCPQ parenting constructs. While correcting for SES, overprotection was positively related to child BMI. The negative relationship between structure and BMI was borderline significant. Parents with a high level of education were less likely to use overly forms of controlling parenting (i.e., coercive control and overprotection) and more likely to have children with lower BMI. Based on several author review meetings and cognitive interviews the questionnaire was further modified to an 85-item questionnaire.ConclusionsThe GCPQ may facilitate research exploring how parenting influences children’s weight-related behaviors. The contextual influence of general parenting is likely to be more profound than its direct relationship with weight status.

The aims of this study were to: (1) determine whether the number of pedometer counts recorded by adolescents differs according to the adiposity of the participant or location on the body; (2) assess the accuracy and reliability of pedometers during field activity; and (3) set adolescent pedometer-based physical activity targets. Seventy-eight 11- to 15-year-old Boy Scouts completed three types of activity: walking, fast walking and running. Each type was performed twice. Participants wore three pedometers and one activity monitor during all activities. Participants were divided into groups of normal weight (BMI < 85th percentile) and at risk of being overweight (BMI > or = 85th percentile). Intra-class correlations across the three activities indicated reliability (r = 0.51 - 0.92, P < 0.001). This conclusion was supported by narrow limits of agreement that were within a pre-set range that was practically meaningful. Multivariate analysis of covariance indicated adiposity group differences, but this difference was a function of the increased stature among the larger participants (P < 0.001). Ordinary least-squares regression models and multi-level regression models showed positive associations between the number of pedometer and activity monitor counts recorded by the three groups of participants during all activities (all P < 0.001). The mean number of counts recorded for all participants during the fast walk was 127 counts per minute. In conclusion, the pedometers provided an accurate assessment of adolescent physical activity, and a conservative estimate of 8000 pedometer counts in 60 min is equivalent to 60 min of moderate to vigorous physical activity.