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HIV Testing Among Adolescents With Acute Sexually Transmitted Infections

BACKGROUND AND OBJECTIVES:

Rates of sexually transmitted infections (STIs) have increased over the decade. Guidelines recommend HIV testing with incident STIs. Prevalence and factors associated with HIV testing in acute STIs are unknown in adolescents. Our objective was to determine the prevalence of completed HIV testing among adolescents with incident STIs and identify patient and health care factors associated with HIV testing.

METHODS:

Retrospective study of STI episodes (gonorrhea, Chlamydia, trichomoniasis, or syphilis) of adolescents between 13 and 24 years old from July 2014 to December 2017 in 2 urban primary care clinics. We performed mixed effects logistic regression modeling to identify patient and health care factors associated with HIV testing within 90 days of STI diagnosis.

RESULTS:

The 1313 participants contributed 1816 acute STI episodes. Mean age at STI diagnosis was 17.2 years (SD = 1.7), 75% of episodes occurred in females, and 97% occurred in African Americans. Only half (55%) of acute STI episodes had a completed HIV test. In the adjusted model, female sex, previous STIs, uninsured status, and confidential sexual health encounters were associated with decreased odds of HIV testing. Patients enrolled in primary care at the clinics, compared with those receiving sexual health care alone, and those with multipathogen STI diagnoses were more likely to have HIV testing.

CONCLUSIONS:

HIV testing rates among adolescents with acute STIs are suboptimal. Patient and health care factors were found to be associated with receipt of testing and should be considered in clinical practice.




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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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Predicting School-Aged Cognitive Impairment in Children Born Very Preterm

BACKGROUND AND OBJECTIVES:

Children born very preterm (VPT) are at high risk of cognitive impairment that impacts their educational and social opportunities. This study examined the predictive accuracy of assessments at 2, 4, 6, and 9 years in identifying preterm children with cognitive impairment by 12 years.

METHODS:

We prospectively studied a regional cohort of 103 children born VPT (≤32 weeks’ gestation) and 109 children born term from birth to corrected age 12 years. Cognitive functioning was assessed by using age-appropriate, standardized measures: Bayley Scales of Infant Development, Second Edition (age 2); Wechsler Preschool and Primary Scale of Intelligence (ages 4 and 6); and Wechsler Intelligence Scale for Children, Fourth Edition (ages 9 and 12).

RESULTS:

By 12 years, children born VPT were more likely to have severe (odds ratio 3.9; 95% confidence interval 1.1–13.5) or any (odds ratio 3.2; 95% confidence interval 1.8–5.6) cognitive impairment compared with children born term. Adopting a severe cognitive impairment criterion at age 2 under-identified 44% of children born VPT with later severe impairment, whereas a more inclusive earlier criterion identified all severely affected children at 12 years. Prediction improved with age, with any delay at age 6 having the highest sensitivity (85%) and positive predictive value (66%) relative to earlier age assessments. Inclusion of family-social circumstances further improved diagnostic accuracy.

CONCLUSIONS:

Cognitive risk prediction improves with age, with assessments at 6 years offering optimal diagnostic accuracy. Intervention for children with early mild delay may be beneficial, especially for those raised in socially disadvantaged family contexts.




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The Infantile Hemangioma Referral Score: A Validated Tool for Physicians

OBJECTIVES:

Infantile hemangiomas (IHs) are common; some cases require timely referral and treatment to prevent complications. We developed and validated a reliable instrument for timely and adequate referral of patients with IH to experts by nonexpert primary physicians.

METHODS:

In this multicenter, cross-sectional, observational study, we used a 3-stage process: (1) development of the Infantile Hemangioma Referral Score (IHReS) tool by IH experts who selected a representative set of 42 IH cases comprising images and a short clinical history, (2) definition of the gold standard for the 42 cases by a second independent committee of IH experts, and (3) IHReS validation by nonexpert primary physicians using the 42 gold standard cases.

RESULTS:

A total of 60 primary physicians from 7 different countries evaluated the 42 gold standard cases (without reference to the IHReS tool); 45 primary physicians evaluated these cases using the IHReS questionnaire, and 44 completed retesting using the instrument. IHReS had a sensitivity of 96.9% (95% confidence interval 96.1%–97.8%) and a specificity of 55.0% (95% confidence interval 51.0%–59.0%). The positive predictive value and negative predictive value were 40.5% and 98.3%, respectively. Validation by experts and primary physicians revealed substantial agreement for interrater reliability and intrarater repeatability.

CONCLUSIONS:

IHReS, a 2-part algorithm with a total of 12 questions, is an easy-to-use tool for primary physicians for the purpose of facilitating correct and timely referral of patients with IH. IHReS may help practitioners in their decision to refer patients to expert centers.




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Trends in Pediatric Malpractice Claims 1987-2015: Results From the Periodic Survey of Fellows

BACKGROUND:

Pediatricians are less frequently sued than other physicians. When suits are successful, however, the average payout is higher. Little is known about changes in the risk of litigation over time. We sought to characterize malpractice lawsuit trends for pediatricians over time.

METHODS:

The Periodic Survey is a national random sample survey of American Academy of Pediatrics members. Seven surveys between 1987 and 2015 asked questions regarding malpractice (n = 5731). Bivariate and multivariable analyses examined trends and factors associated with risk and outcome of malpractice claims and lawsuits. Descriptive analyses examined potential change in indemnity amount over time.

RESULTS:

In 2015, 21% of pediatricians reported ever having been the subject of any claim or lawsuit, down from a peak of 33% in 1990. Report of successful outcomes in the most-recent suit trended upward between 1987 and 2015, greatest in 2015 at 58%. Median indemnity was unchanged, averaging $128 000 in 2018 dollars. In multivariate analysis, male sex, hospital-based subspecialty (neonatology, pediatric critical care, pediatric emergency medicine, and hospital medicine), longer career, and more work hours were associated with a greater risk of malpractice claim.

CONCLUSIONS:

From 1987 to 2015, the proportion of pediatricians sued has decreased and median indemnity has remained unchanged. Male pediatricians and hospital-based subspecialists were more likely to have been sued. Greater knowledge of the epidemiology of malpractice claims against pediatricians is valuable because it can impact practice arrangements, advise risk-management decisions, influence quality and safety projects, and provide data to guide advocacy for appropriate tort reform and future research.




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Home Chef Meal Delivery Service

True to its name, Home Chef is the homiest of meal services we've tried. The recipes are simple and not too adventurous, but for some home chefs, that's a good thing.




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GoDaddy GoCentral Online Store

Given that GoDaddy's GoCentral Online Store is an add-on service to its web hosting product, you'll find its features a little more limited than much of the competition. But if you're a GoDaddy customer, then it's a great way to start quickly.




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Samsung Galaxy Note 10+

The Samsung Galaxy Note 10+ is a big, powerful phone that's good for artists and note-takers.




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Infusionsoft by Keap

Infusionsoft by Keap combines robust analytics with an intuitive interface and easily customizable dashboards to help you track your customers and email marketing campaigns.




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Champions League Fantasy: Inside info

Who takes the penalties? Who can't you afford to ignore? And who are the bargain signings that could make all the difference?




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Champions League Fantasy: Who's in form?

With the UEFA Champions League resuming next week, UEFA.com looks at which players have been hitting the heights on the domestic front.




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Champions League Fantasy: Bargain signings

Players who provide excellent value for money are a key component of successful Fantasy sides; check out our suggestions.




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Champions League Fantasy: Big-money assets

UEFA.com runs the rule over some of the most expensive players in the game to assess who's worth splashing out for.




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Champions League Fantasy Matchday 7: What the numbers say

UEFA.com studies the statistics to find out which players are predicted for big Matchday 7 totals.




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Champions League Fantasy: Captain marvel

The UEFA Champions League is back and UEFA.com are here to guide #UCLfantasy managers through the first legs of the round of 16.




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Champions League Fantasy popular picks and potential differentials

Ahead of Matchday 7, UEFA.com looks at some obvious selections and some lesser-owned options.




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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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Juventus v Lyon facts

Lucas Tousart's first-leg goal gave Lyon a first win against Juventus, who once against face a round of 16 deficit on home soil.




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Fantasy Football Matchday 7 lessons: Goalkeepers

UEFA.com delves into the numbers and finds clean sheets were at a premium in the first legs.




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Bayern v Chelsea facts

Led by Serge Gnabry's first-leg double, Bayern München have one foot in the quarter-finals as Chelsea come to Germany.




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Fantasy Football Matchday 7 lessons: Defenders

The start of the knockout rounds provided a reminder there is still plenty of value to be found at the defensive end of the field.




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Manchester City v Real Madrid facts

A first-leg comeback has put Manchester City in the driving seat as Real Madrid travel to north-west England facing a 2-1 deficit.




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Fantasy Football Matchday 7 lessons: Midfielders

Key differentials were once again to the fore in the round of 16 first legs, although Serge Gnabry took the headlines again.




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Fantasy Football Matchday 7 lessons: Forwards

Erling Braut Haaland and Robert Lewandowski continued to hit the net, although injury means the latter is likely to miss the second leg.




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Saskia's Albanian journey

Saskia perseveres through language learning and connects with a young Albanian girl who becomes a follower of Jesus.




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Serving God through coffee shops and carpentry

Jose, an Argentinian worker serving in Southeast Asia, tells of how he entered overseas service and what he has seen God do through his not-so-typical ministry.




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God of unity

Rosario, Argentina :: Crewmembers with experience working with least-reached people share a message of unity between churches.




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Not your stereotypical missionary

From age 17, Ana Maria prayed to serve God in Switzerland. While she waited, she became a dance instructor with no idea dance would become her ministry.




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God called you, and God has a plan for you

An OM worker in Cambodia shares about how a new training she is attending is transforming the way she does ministry.




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Seizing every opportunity

Buenos Aires, Argentina :: Maintenance crew share Christ's love with local welders helping repair Logos Hope.




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'They don’t understand what love is'

Noy shares her journey of experiencing God's love for herself and forgiving the community that persecuted her family.




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Ordinary woman, extraordinary journey

God uses Janet to reach people through one-on-one encounters at a bookshop in a closed country.




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Educational Technology Has Limitations

Deep and lasting learning can best come from the relationship between teachers and their students.




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Getting Youth Technology Use Right




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Tech Company Wins Ed. Dept Award to Create Accessible Books

Benetech, a Palo Alto, Calif. based software company, is embarking on is third 5-year award with the U.S. Department of Education to create books for students with print disabilities.




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Technology

The U.S. education system isn't adequately preparing students to use technology for problem-solving, according to a newly released analysis.




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Is Technology the "Elephant in the Room"?

The "elephant in the room" has everything to do with technology but is not really about technology at all.




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Response: 'Embracing Technology' as a Tool for Differentiation

Elizabeth Stringer Keefe, Becky Shiring, Katie Robinson, Dr. Sonny Magana and Dr. Monica Burns contribute their suggestions on using tech to differentiate instruction.




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4 Reasons for Technology Integration

Second year teacher, Christine Pinto, shares some reasons she integrates technology in her classroom.




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Digital Technology Is Gambling With Children's Minds

Writing, reading, focusing, and remembering have all been transformed in ways we don't yet fully understand, writes psychologist Elias Aboujaoude.




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Education Technology

Although educational apps for preschoolers abound, many don't include sound teaching strategies, says a new study in the journal Learning, Media and Technology.




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Education Technology

The lack of access to technology and internet connectivity at home is especially severe among poor, rural, and minority students, according to a new survey from ACT's nonprofit Center for Equity in Learning.




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Education Technology

One-to-one technology programs may boostmath scores over time, finds a new study in the Educational Evaluation and Policy Analysis journal.




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Technology Has No Impact on Teaching and Learning

If we truly want educational technology to take root in schools and finally live up to the promise we've been expecting for more than a decade, schools need to develop a cadre of well-trained tech instructional coaches.




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Education Technology

More than two-thirds of districts are very confident in their networks' ability to support a digital device for every student, and nearly a quarter of districts now average two devices for each student, finds the latest annual report of the Consortium for School Networking.




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Education Technology

A massive international analysis finds more screen time is associated with a lower sense of well-being among teenagers, but the effects are too small to require policy changes, according to a study in the journal Nature Human Behavior.




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Education Technology

When it comes to a key international test, there's little evidence that technology use benefits student scores and some evidence that it could drag them down, according to a new report by the nonprofit Reboot Foundation.




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Technology 'Doesn't Replace Good Teaching'

Anne Jenks, Michelle Shory, Ed.S, Irina V. McGrath, Ph.D, Kim Jaxon, Dr. Beth Gotcher, Elizabeth Stringer Keefe, Ph.D., and Keisha Rembert share their suggestions for using tech effectively in class.




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Technology in Education: An Overview

From blended learning to computerized testing, digital and online technologies are reshaping the classroom experience for millions of students.




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Technology