Key Strategies for Optimizing Pediatric Perioperative Nutrition-Insight from a Multidisciplinary Expert Panel.

Adequate nutrition is an essential factor in healing and immune support in pediatric patients undergoing surgery, but its importance in this setting is not consistently recognized. Standardized institutional nutrition protocols are rarely available, and some clinicians may be unaware of the importance of assessing and optimizing nutritional status. Moreover, some clinicians may be unaware of updated recommendations that call for limited perioperative fasting. Enhanced recovery protocols have been used in adult patients undergoing surgery to ensure consistent attention to nutrition and other support strategies in adult patients before and after surgery, and these are now under evaluation for use in pediatric patients as well. To support better adoption of ideal nutrition delivery, a multidisciplinary panel of experts in the fields of pediatric anesthesiology, surgery, gastroenterology, cardiology, nutrition, and research have gathered and reviewed current evidence and best practices to support nutrition goals in this setting.

Young Child Nutrition: Knowledge and Surveillance Gaps across the Spectrum of Feeding.

The first 1000 days is a critical window to optimize nutrition. Young children, particularly 12-24 month-olds, are an understudied population. Young children have unique nutrient needs and reach important developmental milestones when those needs are met. Intriguingly, there are differences in the dietary patterns and recommendations for young children in the US vs. globally, notably for breastfeeding practices, nutrient and food guidelines, and young child formulas (YCFs)/toddler drinks. This perspective paper compares these differences in young child nutrition and identifies both knowledge gaps and surveillance gaps to be filled. Parental perceptions, feeding challenges, and nutrition challenges are also discussed. Ultimately, collaboration among academia and clinicians, the private sector, and the government will help close young child nutrition gaps in both the US and globally.

The CARE Inventory: A Self-Reflective, Behavior-Based Instrument to Guide Professional Development and Mentorship of Academic Faculty.

Introduction: Traditional needs assessments often rely on self-reported skill levels. To gather more objective and growth-focused data, we developed a behavior-based inventory to measure perceived faculty competence and desired areas for growth in four common domains of academic medicine: clinical, administrative/leadership, research, and education (CARE). Methods: Competencies in teaching, research, and professional development and leadership noted in the literature were used as the foundation of our instrument. Clinical service topics were added, and questions were vetted with the executive committee of our faculty development center. A behavior-based inventory was developed to enhance self-reporting of competency. The instrument was piloted with faculty at an external institution and revisions made prior to data collection. Results: In May 2016, the CARE Inventory was sent to all full-time faculty members in the Ohio State University College of Medicine (n = ∼1,800). We received 350 responses (20% response rate). Individual reports were generated and sent to the faculty member and his/her identified mentor for individual professional development. Summary data were used in aggregate for professional development program planning. Discussion: Anchoring measurement to current and desired future behavior allows for more self-reflective and growth-oriented assessment for individuals, and results can inform tactical faculty development by both individual and program. We believe this is a scalable and generalizable instrument other academic medical and health sciences programs could use both as a needs assessment tool for program planning and for individualized development plans with faculty and their mentors.