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Antibiotic Use and Outcomes in Children in the Emergency Department With Suspected Pneumonia

BACKGROUND AND OBJECTIVES:

Antibiotic therapy is often prescribed for suspected community-acquired pneumonia (CAP) in children despite a lack of knowledge of causative pathogen. Our objective in this study was to investigate the association between antibiotic prescription and treatment failure in children with suspected CAP who are discharged from the hospital emergency department (ED).

METHODS:

We performed a prospective cohort study of children (ages 3 months–18 years) who were discharged from the ED with suspected CAP. The primary exposure was antibiotic receipt or prescription. The primary outcome was treatment failure (ie, hospitalization after being discharged from the ED, return visit with antibiotic initiation or change, or antibiotic change within 7–15 days from the ED visit). The secondary outcomes included parent-reported quality-of-life measures. Propensity score matching was used to limit potential bias attributable to treatment selection between children who did and did not receive an antibiotic prescription.

RESULTS:

Of 337 eligible children, 294 were matched on the basis of propensity score. There was no statistical difference in treatment failure between children who received antibiotics and those who did not (odds ratio 1.0; 95% confidence interval 0.45–2.2). There was no difference in the proportion of children with return visits with hospitalization (3.4% with antibiotics versus 3.4% without), initiation and/or change of antibiotics (4.8% vs 6.1%), or parent-reported quality-of-life measures.

CONCLUSIONS:

Among children with suspected CAP, the outcomes were not statistically different between those who did and did not receive an antibiotic prescription.




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Body Dissatisfaction and Mental Health Outcomes of Youth on Gender-Affirming Hormone Therapy

OBJECTIVES:

Our first aim was to examine baseline differences in body dissatisfaction, depression, and anxiety symptoms by gender, age, and Tanner (ie, pubertal) stage. Our second aim was to test for changes in youth symptoms over the first year of receiving gender-affirming hormone therapy. Our third aim was to examine potential differences in change over time by demographic and treatment characteristics. Youth experiences of suicidal ideation, suicide attempt, and nonsuicidal self-injury (NSSI) are also reported.

METHODS:

Participants (n = 148; ages 9–18 years; mean age 14.9 years) were receiving gender-affirming hormone therapy at a multidisciplinary program in Dallas, Texas (n = 25 puberty suppression only; n = 123 feminizing or masculinizing hormone therapy). Participants completed surveys assessing body dissatisfaction (Body Image Scale), depression (Quick Inventory of Depressive Symptoms), and anxiety (Screen for Child Anxiety Related Emotional Disorders) at initial presentation to the clinic and at follow-up. Clinicians completed the Quick Inventory of Depressive Symptoms and collected information on youth experiences of suicidal ideation, suicide attempt, and NSSI.

RESULTS:

Affirmed males reported greater depression and anxiety at baseline, but these differences were small (P < .01). Youth reported large improvements in body dissatisfaction (P < .001), small to moderate improvements in self-report of depressive symptoms (P < .001), and small improvements in total anxiety symptoms (P < .01). No demographic or treatment-related characteristics were associated with change over time. Lifetime and follow-up rates were 81% and 39% for suicidal ideation, 16% and 4% for suicide attempt, and 52% and 18% for NSSI, respectively.

CONCLUSIONS:

Results provide further evidence of the critical role of gender-affirming hormone therapy in reducing body dissatisfaction. Modest initial improvements in mental health were also evident.




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Mental Health Outcomes Among Homeless, Runaway, and Stably Housed Youth

BACKGROUND AND OBJECTIVES:

Runaway youth and homeless youth are at risk for adverse mental health outcomes. These 2 populations are frequently pooled together in both research and interventions yet may have unique health needs. We sought to assess differences in mental health outcomes among these populations.

METHODS:

We conducted a secondary data analysis of ninth- and 11th-graders in the 2016 minnesota Student Survey (n = 68 785). We categorized youth into 4 subgroups based on housing status in the previous year: (1) unaccompanied homeless youth (0.5%), (2) runaway youth (4%), (3) youth who had both run away and been homeless (0.6%), and (4) stably housed youth (95%). We performed multivariable logistic regression to compare 4 mental health outcomes (self-injury, suicidal ideation, suicide attempts, and depressive symptoms) across groups, controlling for demographics and abuse history.

RESULTS:

Unstably housed youth had poorer mental health outcomes when compared with their stably housed peers (P < .05). For example, 11% of homeless youth, 20% of runaways, and 33% of youth who had experienced both had attempted suicide in the previous year compared with 2% of stably housed youth (adjusted odds ratios 2.4, 4.9, and 7.1, respectively). Other outcomes showed a similar pattern.

CONCLUSIONS:

Our findings suggest that runaway and homeless youth represent unique populations with high levels of mental health needs who would benefit from targeted clinical and community interventions. Pediatric clinicians represent one potential point of screening and intervention.




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Transgender Youth Experiences and Perspectives Related to HIV Preventive Services

BACKGROUND:

In the United States, transgender youth are at especially high risk for HIV infection. Literature regarding HIV prevention strategies for this vulnerable, often-hidden population is scant. Before effective, population-based HIV prevention strategies may be adequately developed, it is necessary to first enhance the contextual understanding of transgender youth HIV risk and experiences with HIV preventive services.

METHODS:

Two 3-day, online, asynchronous focus groups were conducted with transgender youth from across the United States to better understand participant HIV risk and experiences with HIV preventive services. Participants were recruited by using online advertisements posted via youth organizations. Qualitative data were analyzed by using content analysis.

RESULTS:

A total of 30 transgender youth participated. The average age was 18.6 years, and youth reported a wide range of gender identities (eg, 27% were transgender male, 17% were transgender female, and 27% used ≥1 term) and sexual orientations. Four themes emerged: (1) barriers to self-efficacy in sexual decision-making; (2) safety concerns, fear, and other challenges in forming romantic and/or sexual relationships; (3) need for support and education; and (4) desire for affirmative and culturally competent experiences and interactions (eg, home, school, and health care).

CONCLUSIONS:

Youth discussed experiences and perspectives related to their gender identities, sexual health education, and HIV preventive services. Findings should inform intervention development to improve support and/or services, including the following: (1) increasing provider knowledge and skills to provide gender-affirming care, (2) addressing barriers to services (eg, accessibility and affordability as well as stigma and discrimination), and (3) expanding sexual health education to be inclusive of all gender identities, sexual orientations, and definitions of sex and sexual activity.




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Champions League Fantasy Matchday 7: The Scout squad

As the knockout stage kicks off this week, The Scout has put together a squad drawing on players from nine teams.




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Getting Youth Technology Use Right




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Penn State Health resumes construction to convert space to outpatient care

Penn State Health today resumed construction of Penn State Health Cocoa Outpatient Center, an expansion of medical services at the former CocoaPlex Center location.




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Fin24.com | Watch out for loan scam, warns Sanlam

Unsuspected consumers are being targeted by fraudsters using the name of Sanlam to swindle cash out of them, the financial service provider has warned.




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Fin24.com | South Africans are big borrowers and poor savers - expert

Reducing indebtedness and improving savings in South Africa is a major socio-economic challenge, warns an industry expert.




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Antibiotic Use and Outcomes in Children in the Emergency Department With Suspected Pneumonia

Matthew J. Lipshaw
Apr 1, 2020; 145:e20193138-e20193138
ARTICLES




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Fin24.com | What to know about shift from equities to 'safety' of bonds

Geopolitical factors and economic uncertainty make some investors shift away from equities into what they perceive to be the safety of higher-quality bonds.




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Fin24.com | As South African investors eye 2020, the Budget looms large

Finance Minister Tito Mboweni’s February Budget speech will be scrutinised for evidence the country is doing enough to preserve its last remaining investment grade rating from Moody’s.




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Fin24.com | Taxpayers invested about R1.6 billion in Section 12J projects

Interest in Section 12J has grown each year, with the current financial year being no different, says Jonty Sacks, a partner at Jaltech.




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Fin24.com | Coronavirus and retirement savings: 5 things experts want you to think about

Instability in local and international stock markets – mainly due to concerns over the impact of the coronavirus – might have you concerned about preserving your retirement savings.




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Youth Olympics futsal qualifying report

The future of European futsal – male and female – was displayed over the last week in qualifying for the 2018 Youth Olympic games with Russia and Portugal coming out on top.




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Neurodevelopmental Outcomes of Preterm Infants With Retinopathy of Prematurity by Treatment




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How to View Files in Windows 10 Without Opening Them

Don’t like to wait for programs to boot up when you’re looking for a specific document? With the right tools, you can preview a variety of files in Windows 10 without opening their applications.




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Check Out These BJ's Wholesale Club Super Bowl 2020 TV Deals

The 65-inch LG 65SM8600AUA 4K HDR smart LED TV is marked down to just $769.99, a 48 percent discount off its $1,469 list price.




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How We Test Wireless Routers

Your router is the at the heart of your home network, so it's important to get the right one. Here's how we test every Wi-Fi router we review.




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Veteran's Day Deals: Netgear Router, Apple AirPods, Dell Monitor

The popular Netgear Nighthawk R6700 wireless router is just $68 right now. Plus, you can save on a 32-inch Dell monitor and Apple AirPods with the wireless charging case.




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Netgear Nighthawk AX12 12-Stream Wi-Fi 6 Router (RAX120)

The Netgear Nighthawk AX12 12-Stream Wi-Fi 6 Router (RAX120) is a powerful, if expensive, router that uses the latest 802.11ax technology to deliver fast throughput and file-transfer speeds.




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The Best Gaming Routers for 2020

Have a household of digital devices—and an online gamer or three? You need a router that's ready-made to give gaming traffic the right of way. Here's how to buy the right gaming router, along with our top-rated favorites.




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US Law Stops ISPs Charging Customers for Their Own Routers

Until now, providing your own router didn't stop ISPs charging you a router rental fee.




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Save 35 Percent on TP-Link AC1750 Smart Wi-Fi Router

Usually priced at $79.99, it's available now for just $51.99.




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D-Link EXO AC3000 Smart Mesh Tri-Band Router (DIR-3060)

The D-Link EXO AC3000 is a tri-band router that delivered speedy throughput in our tests and offers solid parental controls, malware protection, and mesh technology.




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The Best Wireless Routers for 2020

In the days of surfing, streaming, gaming, and more, your Wi-Fi router is the single most important piece of technology in your home. Make sure you pick the right one. Here's what you need to know to optimize your network, along with the best wireless routers for all budgets.




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In full: Partick Thistle criticise SPFL in scathing letter and hit out at 'agenda' accusations

Partick Thistle have released, in full, a letter sent by the club to SPFL chiefs following the news that league reconstruction has been scrapped - confirming the Jags' relegation.




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Ian Blackford hits out at family's 800-mile holiday to Motherwell as Scots poke fun at bizarre trip

A family who was fined for travelling more than 400 miles for the bank holiday weekend have been slammed online by politicians and Scots.




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Variations in Practice and Outcomes in the Canadian NICU Network: 1996-1997

Shoo K. Lee
Nov 1, 2000; 106:1070-1079
ARTICLES




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The Burden of Diabetes Mellitus Among US Youth: Prevalence Estimates From the SEARCH for Diabetes in Youth Study

SEARCH for Diabetes in Youth Study Group
Oct 1, 2006; 118:1510-1518
ARTICLES




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Randomized Placebo-controlled Trial of a 42-Day Tapering Course of Dexamethasone to Reduce the Duration of Ventilator Dependency in Very Low Birth Weight Infants: Outcome of Study Participants at 1-Year Adjusted Age

T. Michael O'Shea
Jul 1, 1999; 104:15-21
ARTICLES




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Supplemental Therapeutic Oxygen for Prethreshold Retinopathy of Prematurity (STOP-ROP), A Randomized, Controlled Trial. I: Primary Outcomes

The STOP-ROP Multicenter Study Group
Feb 1, 2000; 105:295-310
ARTICLES




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Growth in the Neonatal Intensive Care Unit Influences Neurodevelopmental and Growth Outcomes of Extremely Low Birth Weight Infants

Richard A. Ehrenkranz
Apr 1, 2006; 117:1253-1261
ARTICLES




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Abnormal Pulmonary Outcomes in Premature Infants: Prediction From Oxygen Requirement in the Neonatal Period

Andrew T. Shennan
Oct 1, 1988; 82:527-532
ARTICLES




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The EPICure Study: Outcomes to Discharge From Hospital for Infants Born at the Threshold of Viability

Kate Costeloe
Oct 1, 2000; 106:659-671
ARTICLES




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Neurodevelopmental and Functional Outcomes of Extremely Low Birth Weight Infants in the National Institute of Child Health and Human Development Neonatal Research Network, 1993-1994

Betty R. Vohr
Jun 1, 2000; 105:1216-1226
ARTICLES




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Neonatal Outcomes of Extremely Preterm Infants From the NICHD Neonatal Research Network

Barbara J. Stoll
Sep 1, 2010; 126:443-456
ARTICLES




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Quiz Yourself: How Much Do You Know About Teacher Recruitment?

Quiz Yourself: What are today's biggest challenges to teacher recruitment?




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Science Teachers, Be Honest About What Science Still Can't Explain

The universe is full of questions waiting to be solved. So why teach science like all the discoveries have already been made? asks Alexander Bell.




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LG Pulls Out From Mobile World Congress Over Coronavirus Fears

LG is skipping the event, citing the travel restrictions from the ongoing coronavirus outbreak. However, the GSMA still plans on holding the annual tech show, saying the outbreak has caused 'minimal impact' so far.




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mezon PHP Router Library

Package:
Summary:
Route HTTP requests mapping URLs into classes
Groups:
Author:
Description:
This package can route HTTP requests mapping URLs into classes...

Read more at https://www.phpclasses.org/package/11631-PHP-Route-HTTP-requests-mapping-URLs-into-classes.html#2020-04-29-03:57:19




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Penn State Brandywine recognizes outstanding student leaders

Penn State Brandywine students who have impacted the campus through their leadership and service have been honored with student leadership awards. The annual awards program highlights the achievements of students involved with clubs, student government and campus programs




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Student submits entry for 'Get Out the Count' video challenge

A rising Penn State senior has submitted a video to a national contest promoting the 2020 Census, which includes several other Penn State students and University President Eric Barron.




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Anxious about public speaking? Your smart speaker could help

A team of Penn State researchers has developed a public-speaking tutor on the Amazon Alexa platform that could help users reduce their public speaking anxiety.




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Materials science graduate student earns award for outreach efforts

Tom Nigl, doctoral candidate in materials science and engineering (MatSE), was awarded the Intercollege Graduate Student Outreach Achievement Award from the Graduate School for outreach efforts that promote science within society.




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Should I Use a VPN on My Router?

Configuring your router to run a VPN lets it protect all the devices on your network, but senior security analyst Max Eddy explains why it might not be practical for the average user.




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Man hit, killed by Southwest plane after security breach at airport

The man hopped the airport perimeter fence, an airport spokesperson confirmed.




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How Digital Games Take the Stress Out of Formative Tests

Elementary school teachers in the Peach State are using "game-based" formative assessments to take a pulse on their students' learning.




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Students With Disabilities Fear Fallout From College Admissions Scandal

Allegations that some students lied about having disabilities so they could get special accommodations on college entrance exams have the disabilities community worried about a backlash.




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How to Assess Group Projects: It's About Content and Teamwork

Group projects founder when students don't work well together. Here's the latest thinking on evaluating students on both content mastery and collaboration skills.