Search

BACKGROUND AND OBJECTIVE The optimal duration of intravenous (IV) antibiotic therapy for children with nontyphoidal Salmonella bacteremia (NTSB) is unknown. The objective of the authors of this study is to evaluate differences in outcomes among children with NTSB who received a short (≤3 days; short-duration group [SDG]) versus long (>3 days; long-duration group [LDG]) course of IV antibiotics. METHODS This is a retrospective study of children 3 months to 18 years old with NTSB admitted to a tertiary pediatric health care system in the southeastern United States between 2008 and 2018. RESULTS Among 57 patients with NTSB without focal infection, 24 (42%) were in the SDG and received IV antibiotics for a median of 3.0 days and 33 (58%) were in the LDG and received IV antibiotics for a median of 5.0 days. Demographic and clinical characteristics were similar between the SDG and LDG. The median total duration of antibiotics was 11.5 days in the SDG and 13.0 in the LDG (P = .068). The median length of stay was 3.0 days in the SDG and 4.0 in the LDG (P ≤ .001). Two children in the SDG (8%) and 1 child in the LDG (3%) returned to the emergency department for care unrelated to the duration of their IV antibiotic therapy (P = .567). None of the children were readmitted for sequelae related to salmonellosis. CONCLUSIONS The duration of IV antibiotics varied for NTSB, but the outcomes were excellent regardless of the initial IV antibiotic duration. Earlier transitions to oral antibiotics can be considered for NTSB.

BACKGROUND AND OBJECTIVES Molecular diagnostics provide a rapid and sensitive diagnosis of gastroenteritis compared with a stool culture. In this study, we seek to describe the changes in medical management and outcomes of children with Salmonella gastroenteritis as our hospital system adopted molecular diagnostics. METHODS This study is a retrospective chart review of children RESULTS Of 965 eligible patients with Salmonella gastroenteritis, 264 (27%) had a stool molecular test and 701 (73%) only had a stool culture performed. Groups were similar in age and presentation. Those diagnosed by molecular methods had higher hospitalization rates (69% vs 50%, P CONCLUSIONS The rapid diagnosis of Salmonella gastroenteritis by molecular methods was associated with increased hospital admission rates, blood culture obtainment, and antibiotic use. This suggests possible overmedicalization of uncomplicated Salmonella gastroenteritis, and clinicians should remain cognizant of the possibility of providing low-value care for uncomplicated disease.

As popular music education programs become more common, it is essential to determine what kinds of professional development experiences that are designed to help teachers include popular music into their music education classrooms are effective—keeping in mind that the inclusion of popular music in K–12 classrooms requires a change not only in instrumentation and repertoire but also pedagogical approaches. This study examined the effects of a popular music professional development initiative on more than 600 New York City urban music teachers’ musicianship, their pedagogy, and their leadership skills throughout one school year. Results revealed increases in all three areas, most notably in teachers’ musicianship. The study also showed an increase in teachers’ positive perceptions about their music programs, specifically, their level of excitement about the state of their music program and that their music program was more effective at meeting their students’ needs than it had been previously.

Changes in the world economy and U.S. educational policy present music educators with the challenge of reassessing traditional pedagogy to ensure they are instructing and assessing in ways that contribute to students’ development of 21st-century knowledge and skill sets. Educators are responding by incorporating pedagogical approaches that challenge students to think critically, problem solve collaboratively, and use technology and media efficiently. Popular Music Pedagogies (PMPs) invite students, music teachers, and music teacher educators to take risks, learn alongside one another, and address 21st-century knowledge and skills through engaging with the music that students choose and create. In this article, we define PMPs and discuss how music teacher educators can incorporate PMPs into music teacher education programs to better prepare preservice and inservice music teachers to function within a Partnership for 21st Century Learning framework.

Background. Pediatric obesity has become a significant public health concern. Pediatricians are the ideal group to help identify and treat this epidemic, but unfortunately, many pediatricians are not trained to discuss obesity with patients and their families. Standardized training initiatives for pediatric residents on prevention and/or management of obesity are needed to equip emerging pediatricians to combat the obesity epidemic. Objectives. This systematic literature review aims to examine the effectiveness of childhood obesity prevention/counseling resident training interventions. Methods. A comprehensive literature search was performed using preidentified search terms and limited to articles published prior to November 6, 2019. Articles were analyzed by 2 reviewers with a standardized evaluation tool. Results. A total of 698 articles were identified by the search. These were reduced to 111 articles after title review and 11 articles following abstract/full paper review. The 11 articles described 10 different obesity training interventions for residents. The articles varied in their size, length of training session, and study design. Despite these variations, all articles outlined positive outcomes, including an increase in physician confidence, positive changes in behavior, and/or improved electronic medical record documentation. Conclusions. With the continued increase in pediatric obesity, there is a need for practical, easy-to-implement, standardized trainings for pediatric residents on obesity prevention and treatment. More investigation needs to be done to look at long-term results of current interventions as well as other outcomes such as whether physicians are correctly identifying patients who are overweight or obese and whether there is improvement in patient follow-up.

Supplemental Digital Content is available in the text., Introduction: Communication between pediatric hospitalists and primary care physicians (PCPs) at discharge is an essential part of a successful transition to home. While many hospitals require communicating with PCPs for all admitted patients, it is unknown if PCPs find such communication valuable or if it improves outcomes. Our global aim was to improve discharge communication for patients that pediatric hospitalists and PCPs deemed appropriate. Methods: We sent surveys to 422 outpatient pediatricians in our care network to understand their communication preferences. Survey results informed local guidelines for when hospitalists should directly contact PCPs. We determined the proportion of inpatient discharges meeting those guidelines and set a target for our primary process metric: the proportion of discharges with attempted direct PCP contact. We engaged in Plan-Do-Study-Act cycles, including a discharge documentation tool in the electronic health record, education of inpatient teams, email reminders including group performance data, asynchronous Health Insurance Portability and Accountability Act-compliant messaging application, and competitions that shared blinded individual data. Results: We increased the percentage of documented direct communication with the PCPs from 2% to 33% and from 4% to 65% for those who met guidelines for direct communication. Conclusions: PCPs only want direct communication on a subset of discharges. Interventions focused on high-yield populations improved discharge communication in our institution.

Introduction: To combat resident physician burnout, wellness programming should include approaches that foster joy to work as a physician. Photograph trading cards have been used to improve patient satisfaction but have not been explored as a way to improve physician work satisfaction. We aimed to use trading cards to improve resident physician identification by patients’ families, as well as measure their effect on the hospital experience for patients and residents. Methods: For a one-month period in 2019, trading cards were piloted with the nine residents assigned to the inpatient pediatrics service. Employing five-point Likert scales, surveys were administered to residents and convenience samples of 100 patients’ families before and after card distribution. Results: Compared to families prior, those given trading cards reported increased perceived importance of physician identification and a greater association with care satisfaction. Families’ ability to identify treating physicians increased from 5% to 66% with card distribution (p

Human rights and cultural heritage emerge within different contexts of national, cosmopolitan, and local practice. The Liberation Heritage Route in South Africa is proposed at the cosmopolitan level, enacted at the national level, and contested at the informal, urban level. The concept of liberation bridges these different contexts for human rights in cultural heritage, illustrating different concepts of freedom and rights at play within heritage. Development and new social movements in particular demonstrate diverging contexts for imaging heritage as a site of socio-economic capacitation or recognition. The example of the Liberation Heritage Route underscores the importance of specifying what the concept of cultural rights actually capacitates in terms of concrete delivery. Because the discourse of human rights tends to exceed the mechanisms of its implementation, a heritage of human rights should start from a critical awareness of how the recognition of rights practices resonates with local communities.

Informal urban settlements and trade zones represent an increasingly pressing issue for urban heritage developers. In light of the recent revisitation of the UNESCO Recommendation on the Historic Urban Landscape, this article explores the current challenges faced at the intersection of heritage practice, urban planning, and informal communities. Heritage recommendations operate within the domain of soft law and their implementation relies on the voluntarism of public parties and the private sector. Such heritage recommendations are thus rarely taken up outside of city improvement districts with recognizable property-owning stakeholders, commercial infrastructures for security, maintenance, and investor marketing. In South Africa, the particular circumstances of the post-apartheid landscape render urban planning frameworks prone to reinforcing the marginalization of informal stakeholder engagement, ultimately perpetuating a socio-spatial inequality such programs set out to mitigate. The civic practices of new social movements and historical knowledge that emerges from the context of informal and neglected urban environments illustrate emergent answers to the exclusionary dynamics of urban heritage planning.

Objective. To evaluate the impact of an obesity didactic session for pediatric physicians on confidence in counseling and identified overweight/obesity and follow-up recommendations. Methods. Pediatric residents underwent training and completed pre/post online surveys evaluating confidence in obesity prevention and identification. A booster training occurred 1 year later. Pre-/post-training scores were compared using χ2 or Fisher’s exact tests. Electronic medical records data for patients ≥3 years with BMI-for-age percentile ≥85 during 3 months prior/following the training/booster compared frequency of overweight/obesity identification and follow-up recommendations (≤3 months recommended vs longer) using logistic regression adjusting for age and overweight/obese status. Results. Post trainings, improvements in confidence to define/screen for obesity were observed, with a decline between trainings. Overweight/obese identification and follow-up time recommendations improved post-training (identification: 14.2% to 27.4%, adjusted odds ratio [aOR] = 3.16, 95% confidence interval [CI] = 1.54-6.51; follow-up: 48.9% to 58.9%, aOR = 1.63, 95% CI = 1.01-2.64), aOR = 1.77, 95% CI = 1.10-2.85, and identification remained stable/above pre-training rates both pre-/post-booster (25.8%, aOR = 3.14, 95% CI = 1.53-6.45; and 22.1%, aOR = 2.57, 95% CI = 1.25-5.30, respectively). Recommended follow-up time rates continued to rise when measured pre-booster (60.6%, aOR = 1.77, 95% CI = 1.10-2.85), then declined (46.0%, aOR = 0.95, 95% CI = 0.60-1.52). Conclusion. This didactic session improved resident confidence in defining/screening, identification of overweight/obesity and follow-up recommendations; however, rates of identification remained low. The successes of this intervention support similar didactic sessions in residency programs and identifies opportunities for improved resident/attending education.

This article explores the history of claims to intellectual cultural property as they relate to claims to sovereignty in settler societies by Indigenous groups. The recent Southern African legal vi...

In this essay, I argue that the concept of heritage today, as we have come to understand it through the lens of the politics of recognition and through various tourism-oriented national and global programs of public recognition, contains within itself a number of inherent structural logics — logics which suggest that projects labeled heritage will be pulled in directions which might run counter to the hopes and expectations of those invoking the term. We must, therefore, be cognizant of the fact that at the same moment that heritage discourse enables one mode of conceiving of — and potentially celebrating — historical persons and events, it also disables other forms and modes. We must take seriously what these modes are and what are the implications of their being bracketed. This essay, then, is a call for scholars to consider carefully the fundamental political rationalities at the hearts of our central concepts if we are to understand more fully what is at stake in choosing them.

This chapter examines the material dynamics of the emergent nineteenth-century culture of speculation and finance capital on the Diamond Fields of South Africa. I am interested in understanding how the relationship between the speculative spirit of rush camps, and the physical routes of traded diamonds conspired to transform the Diamond Fields into what later would become one of the first projects of urban segregation in South Africa. To understand these changes, it is important to explore the discursive spaces that were forming in the wake of the diamond rush, as the fields were essentially transformed by the work of illicitly that traded thousands of tiny diamonds. In many ways, the socially repressive turn that life on the Diamond Fields took in the late nineteenth century, participates in broader dynamics in the culture of finance capital, in which shareholder anxiety and the security of the commodity became determinative of the political form.

As an intellectual figure in South Africa, J. M. Coetzee has consistently engaged with the politics of the past, particularly the contemporary ethical ramifications of the colonial past, alongside the more recent and bitter history of oppression under apartheid. As archaeologists, we aim to excavate these engagements through his novels and essays, particularly his long-standing concerns with the Khoekhoe communities of the Cape. In South Africa today, the tensions between remembering and forgetting are palpable and, in the aftermath of the Truth and Reconciliation Commission (TRC), we suggest that not all forgetting can be cast as therapeutic. Throughout his complex relationships with the nation's history, Coetzee foregrounds the colonial past and reiterates the ethical responsibilities of remembering so that the patterns of the past are not repeated.

This chapter is an examination of the late nineteenth-century diamond rush in South Africa, with particular attention to the effects of its speculative culture. The complex relationship between material culture and a speculative community is examined through a discussion of the excavated remains of a tavern on the outskirts of the fields called the Half-Way House Hotel. By positioning questions of speculative markets on the late nineteenth-century South African landscape, this chapter illustrates how some characteristics of our contemporary speculative economy were forged in the colonial context.

In introducing Capitalism in Colonial Contexts, we raise the question whether there is currently an epistemological crisis in historical archaeology, as those writing from the “margins” of the field increasingly critique taken-for-granted arguments about the development of capitalism and the way in which colonized and indigenous populations are largely viewed as peripheral to this process. We draw upon postcolonial theory, particularly Subaltern Studies histories, to suggest new engagements with capitalism and colonialism in historical archaeology, which are able to recognize the importance of these two “universals” of our discipline, and yet are able to do so without privileging Eurocentric narratives. Case-study chapters in the volume are also introduced and discussed in relation to our overall theoretical arguments.

This chapter explores and compares the causes and effects of colonial labor camps and concentration camps in nineteenth-century southern Africa. This comparison is an attempt to understand the relationship between the lethality of wartime camps and labor camps in the modern era. While concentration camps and worker labor camps were established according to ostensibly different power regimes and causal factors, British wartime concentration camps established dif- ferent camps for Boers and Africans—the latter being structurally identical to preceding labor camps established on the South African Diamond Fields.

Fictive Capital and Economies of Desire: A Case Study of Illegal Diamond Buying and Apartheid Landscapes in Nineteenth-Century Southern Africa. Columbia University, 2009. http://dx.doi.org/10.1080/...

Heritage of Value, Archaeology of Renown: Reshaping Archaeological Assessment and Significance. Clay Mathers, Timothy Darvill, and Barbara J. Little, eds. Gainesville: University Press of Florida, 2005. 339 pp.