Early Otorrhea Rates: A Randomized Trial of Ciprofloxacin versus Saline Drops after Tympanostomy Tubes.

OBJECTIVE: The objectives of this study are to evaluate incidence, duration, and quality of life (QOL) impact of early tympanostomy tube otorrhea and tube patency when comparing topical ciprofloxacin versus normal saline use in the perioperative period. METHODS: Overall, 200 patients undergoing tube placement between November 19, 2015, and September 12, 2016, were randomized to intraoperative plus 5 days of either topical ciprofloxacin or normal saline. Parents or caregivers reported the incidence, duration, and QOL impact of early otorrhea via 4 weekly surveys. In addition, the patient's otorrhea history and tube patency were evaluated at a 4- to 6-week postoperative visit. RESULTS: Survey and in-office follow-ups were completed on 128 patients. The overall otorrhea incidence was 23.9% for normal saline and 16.7% for ciprofloxacin (P = .32). The week-by-week otorrhea incidence was not statistically different. The percentage of days otorrhea was present, likewise, was not statistically different (normal saline 4.5%, ciprofloxacin 2.8%; P = .74). The QOL impact was not statistically different (normal saline 1.2, ciprofloxacin 1.5; P = .71). Tube patency was not statistically different, with only 1 of 280 ears occluded at follow-up. CONCLUSION: We find no difference in the incidence, duration, and QOL impact of early tympanostomy tube otorrhea or tube patency between ciprofloxacin and normal saline. This supports the option to substitute normal saline for ciprofloxacin in ears without an active ear infection at the time of tube placement, which would reduce both cost and unnecessary antibiotic use. LEVEL OF EVIDENCE: 1b.

Impact of political conflict on trajectories of adolescent prosocial behavior: Implications for civic engagement.

Counterbalancing the narrative of youth as either helpless victims or ruthless perpetrators, a new generation of research in conflict settings focuses on their peace-building potential, including constructs such as prosocial behaviors and civic engagement. Previous research on the impact of political violence on prosocial behaviors in mixed, finding both positive and negative links. This study examines this relation using a launch and ambient approach, which helps to disentangle these effects over time. To do so, the article prospectively examines trajectories of adolescent prosocial behaviors (N = 999; Time 1: Mage = 12.18 years, SD = 1.82, range = 10-20) over 6 consecutive years in Belfast, Northern Ireland, a setting of on-going sectarian conflict. A dual change model, which combines the strengths of auto-regressive and latent growth curves approaches, found an initial shallow decrease in prosocial behaviors that dropped more sharply in later adolescence. Exposure to sectarianism related to an accelerated decrease in prosocial behaviors. Trajectories of prosocial behaviors positively related to later social and political engagement. Intervention implications address how to promote youth prosocial behaviors and civic engagement amid protracted political conflict. This type of research is needed because participation in civic life is a good indicator of youth agency and has positive implications for society. (PsycINFO Database Record

Neighborhood Effects of Intergroup Contact on Change in Youth Intergroup Bias.

Intergroup contact plays a critical role in the reduction of prejudice; however, there is limited research examining the multiple ways through which contact can impact trajectories of development for adolescents in divided societies. Thus, the goal of the current study was to examine individual- and context-level effects of intergroup contact on change in intergroup bias through adolescence. Hierarchical linear modeling was used to analyze five waves of data from 933 youth (M age = 15.5, SD = 4.03; range: 10-20 years old; 52% female) living in 38 neighborhoods in Belfast, Northern Ireland. The results suggest that youth increase in bias with age. Adolescents with more frequent intergroup contact increase more quickly, and those who report higher quality of contact increase more slowly. Both frequency and quality of contact at the neighborhood level predicted slower increases in bias across adolescence. The results add to a growing literature that combines social and developmental approaches to understanding how intergroup processes and intergroup divide impact youth development of intergroup attitudes and behaviors. The results are discussed in terms of the importance of both individual experiences and the context of intergroup contact for youth development in divided contexts.

Performance of time-varying predictors in multilevel models under an assumption of fixed or random effects.

Time-varying predictors in multilevel models are a useful tool for longitudinal research, whether they are the research variable of interest or they are controlling for variance to allow greater power for other variables. However, standard recommendations to fix the effect of time-varying predictors may make an assumption that is unlikely to hold in reality and may influence results. A simulation study illustrates that treating the time-varying predictor as fixed may allow analyses to converge, but the analyses have poor coverage of the true fixed effect when the time-varying predictor has a random effect in reality. A second simulation study shows that treating the time-varying predictor as random may have poor convergence, except when allowing negative variance estimates. Although negative variance estimates are uninterpretable, results of the simulation show that estimates of the fixed effect of the time-varying predictor are as accurate for these cases as for cases with positive variance estimates, and that treating the time-varying predictor as random and allowing negative variance estimates performs well whether the time-varying predictor is fixed or random in reality. Because of the difficulty of interpreting negative variance estimates, 2 procedures are suggested for selection between fixed-effect and random-effect models: comparing between fixed-effect and constrained random-effect models with a likelihood ratio test or fitting a fixed-effect model when an unconstrained random-effect model produces negative variance estimates. The performance of these 2 procedures is compared. (PsycINFO Database Record