bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurses’ challenges, concerns and unfair requirements during the COVID-19 outbreak
Authors: Sperling Daniel
Published: May 2021

Background

During disease outbreaks, nurses express concerns regarding the organizational and social support required to manage role conflicts.

Objectives

The study examined concerns, threats, and attitudes relating to care provision during the COVID-19 outbreak among nurses in Israel.

Design

A 53-item questionnaire was designed for this research, including four open-ended questions. The article used a qualitative research to analyze the responses to the open-ended questions and their association with responses to the close-ended ones.

Participants and research context

In all, 231 registered nurses and fourth-year nursing students throughout the whole country. The questionnaire was delivered in nursing Facebook and WhatsApp groups and through snowball sampling.

Ethical considerations

The research was pre-approved by the Ethics Committee at the researchers’ university.

Results

Nurses mostly referred to personal risk, followed by dilemmas regarding care provision. On average, 38.6% of quotations stated that during the pandemic, nurses are not asked to perform unfair duties. Nurses discussed activities and requirements that impact their personal and familial safety, their relationship with employer, organization or the state, and their duty to providing care. Other than fear of contraction, respondents’ most frequent themes of concerns were related to work condition and patients’ interests, inter-collegiate relationships, and uncertainty and worries about the future. Respondents’ ethical dilemmas mostly referred to clinical questions, providing care without adequate equipment or managerial support, and in conditions of uncertainty and increased risk.

Discussion

Nurses raise important issues concerning their relationships with employers and family members, and significant insights regarding the pandemic and their revised responsibilities and definition of work. They raise serious concerns regarding their rights at work and their standing for them.

Conclusions

Health managers should find ways to enhance the ethical climate and institutional support to enable a better work-life balance in times of pandemic and support nurses’ working needs and labor rights.
Upcoming damage size quantification in aeronautic composite structures based on imaging results post-processing
Authors: Briand William , Rébillat Marc , Guskov Mikhail , Mechbal Nazih
Published: May 2021

In this paper, a damage quantification strategy relying on post-processing of Lamb wave based damage localization results is presented. This method is able to predict the upcoming sizes of a delamination after a training step. Inputs of the proposed method are localization index maps produced by damage localization algorithms and representing the presence likelihood of a damage over the structure under study. The area covered by a high localization index around the estimated damage location are then extracted from these spatial probability maps. A data-driven model representing the mathematical relationship between this quantification feature and the actual size of the damage is finally inferred and used to predict future damage size. The proposed method is successfully validated on experimental data coming from CFRP plate samples equipped with piezoelectric transducers. Delaminations induced by fatigue testing and laser shock are studied. The sensitivity of the method to input frequency and damage localization algorithms parameters is assessed and a method to automatically select its own parameters is proposed. Furthermore, it is demonstrated that a model can be confidently learned on a given CFRP plate sample and transferred to predict damage size on another similar CFRP plate sample.
Safety and Efficacy of Single-Dose Ketorolac for Postoperative Pain Management After Primary Palatoplasty: A Prospective Cohort Study With Historical Controls
Authors: Stein Jason R. , Mantilla-Rivas Esperanza , Aivaz Marudeen , Rana Md Sohel , Mamidi Ishwarya Shradha , Ichiuji Brynne A. , Manrique Monica , Rogers Gary F. , Finkel Julia C. , Oh Albert K.
Published: May 2021

Objective:

To analyze safety and efficacy of single-dose ketorolac after primary palatoplasty (PP).

Design:

Consecutive cohort of patients undergoing PP, comparing to historical controls. Setting: A large academic children’s hospital.

Patients, Participants:

A consecutive cohort of 111 patients undergoing PP (study n = 47) compared to historical controls (n = 64).

Interventions:

All patients received intraoperative acetaminophen, dexmedetomidine, and opioids while the study group received an additional single dose of ketorolac (0.5 mg/kg) at the conclusion of PP.

Main Outcome Measures:

Safety of ketorolac was measured by significant bleeding complications and need for supplementary oxygen. Efficacy was assessed through bleeding, Face Legs Activity Cry Consolability (FLACC) scale, and opioid dose.

Results:

Length of stay was similar for both groups (control group 38.5 hours [95% CI: 3.6-43.3] versus study group 37.6 hours [95% CI: 31.3-44.0], P = .84). There were no significant differences in all postoperative FLACC scales. The mean dose of opioid rescue medication measured as morphine milligram equivalents did not differ between groups ( P = .56). Significant postoperative hemorrhage was not observed.

Conclusions:

This is the first prospective study to evaluate the safety and efficacy of single-dose ketorolac after PP. Although lack of standardization between study and historical control groups may have precluded observation of an analgesic benefit, analysis demonstrated a single dose of ketorolac after PP is safe. Further investigations with more patients and different postoperative regimens may clarify the role of ketorolac in improving pain after PP.
Family of Origin as Cultural Messengers in the Training Context
Authors: Haber Russell , Braga Cristina , Benda John , Fitch Jenelle , Mitran Carrie Leigh , Nelson Kimberly A.
Published: May 2021

A novel Family of Origin as Supervisory Resource Model that harnesses the family of origin of the therapist-in-training as a cultural supervisory resource in the training paradigm is presented. The format of the model comprises three phases: supervisor’s exploration of the trainee’s professional dilemmas, supervisor’s exploration of the same dilemma through stories narrated by the supervisee’s family of origin members, and supervisee’s presentation of a case that is an example of the dilemma. The application of this training model during supervision strengthens the trainee’s flexibility in divergent family systems and enhances the ability to handle dilemmas and to form a healthy therapeutic alliance.
The Association of Syndecan-1, Hypercoagulable State and Thrombosis and in Patients With Nephrotic Syndrome
Authors: Chen Xin , Geng Xuemei , Jin Shi , Xu Jiarui , Guo Man , Shen Daoqi , Ding Xiaoqiang , Liu Hong , Xu Xialian
Published: May 2021

The aim of this study is to investigate whether Syndecan-1 (SDC-1), an indicator of endothelial glycocalyx injury, would increase the risk of hypercoagulable state and thrombosis in patients with nephrotic syndrome (NS). The prospective study was conducted among patients undergoing renal biopsy in the Department of Nephrology in our hospital from May to September 2018. We enrolled in patients with NS as the experimental group and patients with normal serum creatinine and proteinuria less than 1 g as the control group. Patients’ characteristics including age, sex, laboratory test results and blood samples were collected for each patient. The blood samples were taken before the renal biopsy. The samples were immediately processed and frozen at −80°C for later measurement of Syndecan-1. One hundred and thirty-six patients were enrolled in the study. Patients with NS and hypercoagulability had a higher level of SDC-1 compared with control group. Patients with membranous nephropathy occupied the highest SDC-1 level ( P = 0.012). Logistic regression showed that highly increased level of SDC-1 (>53.18 ng/ml) was an independent predicator for predicting hypercoagulable state. The elevated level of SDC-1 indicated that endothelial injury, combined with its role of accelerating hypercoagulable state, might be considered of vital importance in the pathophysiological progress of thrombosis formation in patients with NS.
A method for degradation features extraction of diesel engine valve clearance based on modified complete ensemble empirical mode decomposition with adaptive noise and discriminant correlation analysis feature fusion
Authors: Ke Yun , Hu Yihuai , Song Enzhe , Yao Chong , Dong Quan
Published: May 2021

The health assessment of the valve clearance is a key link to realize the failure prediction and health management of the valve mechanism. To accurately evaluate the state of valve clearance, this article proposes a diesel engine valve clearance degradation feature extraction method based on modified complete ensemble empirical mode decomposition with adaptive noise and discriminant correlation analysis feature fusion algorithm. First, we use modified complete ensemble empirical mode decomposition with adaptive noise to adaptively filter the cylinder head vibration signal. Then, power spectrum entropy and improved hierarchical dispersion entropy are proposed as degenerate feature entropy. To improve the sensitivity of the degraded feature entropy to the degraded state, the discriminant correlation analysis algorithm is used to fuse the two types of feature entropy to obtain fused degraded feature entropy. Finally, the degenerate fusion features are input into the least squares support vector machine to realize the health status assessment of the valve mechanism. Through the verification of test data, the results show that the proposed method can effectively evaluate the health state of the valve clearance of diesel engines.
Economic impact of implementation of an automated drug supplying and management system in a Central Chemotherapy Preparation Unit in a Moroccan hospital
Authors: Baraka Soumaya El , Ouedraogo Jean-Marie , Sessouma Abou , Arbai Soumaya , Belahcen Mohammed-Jaouad , Rahali Younes
Published: May 2021

Objective

Automated Drug Supplying and management System (ADS) are effective devices that secure drug’s circuit and reduce hospital’s expenses. The purposes of this study are to estimate the earnings made from ADS through a cost-benefit medical economic study, to highlight its impact on Central Chemotherapy Preparation Unit’s (CCPU) global organization, its ergonomy and staff’s satisfaction.

Method

Measurement of cytotoxic drug’s consumption, expiration losses, pharmacy staff’s working time, drugs stock-out before and after the implementation of ADS on the one hand, and assess its ergonomy and acceptability by users on the other hand.

Results

After the implementation of ADS, cytotoxic drug’s consumption decreased by 9 (%), expiration losses by 98.3 (%), and we could see a gain in working time among CCPU’S technicians of 1.32 (h/day) and pharmacist of 0.67 (h/day), in contrast to the stock manager who increased his working time by 0.95 (h/day). Stock-out have decreased by 41.1 (%). The cost-benefit analysis has shown a net benefit of 67,437 between the two six-month phases, which corresponds to an economy of 134,874 (USD) over one year. The ADS was generally appreciated by the CCPU and pharmaceutical staff and 93(%) don’t want to return to the old system.

Conclusion

ADS implementation within CCPU led to financial savings in the hospital, an optimization of expenses and better pharmaceutical management.
Global solutions to a phase-field model with logarithmic potential for lithium-ion batteries
Authors: Cheng Fang , Hu Ye , Zhao Lixian , Sarwar Shahzad
Published: May 2021

We study the phase-field model with the elasticity energy arising from the coherency stress across the two-phase interface for lithium-ion batteries by using olivine LiFePO4 as a model system. The existence of global solutions about this model which is a coupled system of elliptic and parabolic equations with the singular points in the case of a logarithmic nonlinear term [Formula: see text] is proved. We demonstrate the model satisfies the second law of thermodynamics, and numerical simulations are given to show that the evolution of lithium concentration and the motion of interfaces are consistent with the experiments results of Laffont et al.
DEM modeling and simulation of post-impact shotgun pellet ricochet for safety analysis
Authors: Zohdi Tarek I.
Published: May 2021

Shotguns have increasingly used case-hardened steel pellets, as opposed to “classical” lead, owing to food safety and environmental concerns. Correspondingly, there is increasing concern about unintended ricochet of pellets and subsequent bodily harm, such as eye damage. Correspondingly, this paper focuses on the impact of pellets with a surface and the post-impact ricochet range. Equations for general three-dimensional inelastic impact with unilateral stick–slip conditions are derived for pellets and a post-impact trajectory analysis is performed. Qualitatively, with increasing friction, ranges of ricochet decrease because most of the pre-impact translational energy of the pellets is converted upon impact into rotational energy, which reduces the post-impact ricochet range. For slippery surfaces, wide ranging trajectory distributions occur owing to the mix of stick and slip conditions among the pellets. In the case of slip, the pellets retain much of their translational energy and the post-impact linear velocities are greater than high-friction cases, which leads to much larger post-impact trajectory ranges. The model enables analysts to make more quantitative decisions on the choices of parameters associated with shotgun use and can reduce trial-and-error procedures in testing.
Fat Talk in College Women: A Response Styles Perspective
Authors: Dalley Simon E. , Toffanin Paolo , Libert Jacqueline , Vidal Jose
Published: May 2021

This study placed the phenomenon of college women’s fat talk within response styles theory. We predicted that with increasing trait body dissatisfaction there would be an increase in rumination leading to a greater frequency of fat talk. We also predicted that neuroticism would moderate this mediation pathway, and that these effects would occur over and above body size. A survey was conducted on a convenience sample of 212 college women with a mean age of 22.04 years ( SDage = 2.61). A bootstrap analysis utilizing PROCESS software supported the predicted moderated-mediation model. Thus, those college women higher in both trait body dissatisfaction and neuroticism would experience greater rumination and engage more frequently in fat talk. Implications of applying a response styles perspective for future research and fat talk interventions are discussed.
Self-affirmation and responses to cigarette warning labels: The moderating role of message strength
Authors: Kaynak Malatyalı Meryem , Van Koningsbruggen Guido M , Büyükşahin Sunal Ayda
Published: May 2021

The present research investigated whether message strength moderates the effect of self-affirmation on reactions given to cigarette warning labels. Three hundred eighty-four female (Study 1) and 383 male (Study 2) smokers completed a self-affirmation manipulation and then evaluated either strong or weak warning labels in terms of message derogation. Next, they reported their intentions to quit smoking. Only for the male sample, message strength moderated the effect of self-affirmation on message derogation. However, message strength did not have a moderating role on both message derogation and quit intentions for the female sample and on quit intentions for the male sample.
Paediatric post-discharge pain and parent perceptions of support from an Australian nurse practitioner led acute pain service
Authors: Forster Elizabeth M. , Kotzur Catherine , Richards Julianne , Gilmour John
Published: May 2021

Poorly managed post-operative pain remains an issue for paediatric patients. Post-discharge telephone follow-up is used by an Australian Nurse Practitioner Acute Pain Service (NpAPS) to provide access to effective pain management post-discharge from hospital. This cross-sectional survey design study aimed to determine the pain levels of children following discharge and parent views on participation in their child’s pain management and perceptions of support from the NpAPS. Parents completed the Parents’ Postoperative Pain Measure–Short Form (PPPM-SF) and factors affecting parents’ participation in children’s pain management questionnaire (FPMQ). Results indicated that pain score was high, especially on the day of discharge and 24 hours post-discharge. Parents, despite feeling supported by the NpAPS, experienced uncertainty, emotional responses and expressed concerns about communication and coordination of care. The clinically significant pain levels of the majority of children on the day of discharge and day post-discharge from hospital are a concern. Worry and uncertainty among parents, particularly on the day and first night of discharge, suggest this transition period where responsibility of clinical management of pain is handed over to parents may require greater focus for parental support.
Polynomial Chaos-Kriging metamodel for quantification of the debonding area in large wind turbine blades
Authors: Pavlack Bruna , Paixão Jessé , da Silva Samuel , Cunha Americo , García Cava David
Published: May 2021

This study aims to investigate the performance of a data-driven methodology for quantifying damage based on the use of a metamodel obtained from the Polynomial Chaos-Kriging method. The investigation seeks to quantify the severity of the damage, described by a specific type of debonding in a wind turbine blade as a function of a damage index. The damage indexes used are computed using a data-driven vibration-based structural health monitoring methodology. The blade’s debonding damage is introduced artificially, and the blade is excited with an electromechanical actuator that introduces a mechanical impulse causing the impact on the blade. The acceleration responses’ vibrations are measured by accelerometers distributed along the trailing and the wind turbine blade. A metamodel is formerly obtained through the Polynomial Chaos-Kriging method based on the damage indexes, trained with the blade’s healthy condition and four damage conditions, and validated with the other two damage conditions. The Polynomial Chaos-Kriging manifests promising results for capturing the proper trend for the severity of the damage as a function of the damage index. This research complements the damage detection analyses previously performed on the same blade.
Incorporating gender issues into the classroom: Study on the teaching of gender-related courses in the general curriculum of Taiwan’s universities
Authors: Shih Yi-Huang , Wang Ru-Jer
Published: May 2021

Gender equality is a universal and local issue. National policies have been initiated to ensure gender equality and to safeguard human rights on campus. Gender-related courses have been developed in the general education centers of various universities to allow the concept of gender equality to take root and flourish in these universities and to establish just and safe university campuses in Taiwan. This study examines the introduction of gender issues into the general curriculum of universities and discusses its implications for teaching practice and the establishment of gender-equal university campuses. After reviewing related literature, the following recommendations are made for the teaching of gender issues in universities’ general curricula: (a) teaching must be devoid of gender discrimination, (b) gender awareness for teachers, (c) consideration of gender differences in the teaching field, (d) implementation of reverence for justice in the teaching field, (e) increasing students’ awareness of gender equality, and (f) fostering a teaching atmosphere of mutual respect.
Perspectives on Racism: Reflections on Our Collective Moral Responsibility When Leveraging Arts and Culture for Health Promotion
Authors: Burch Shanaé R.
Published: May 2021

In this commentary essay, I examine the collective moral responsibility of leveraging arts and culture for health promotion, and the role ethical storytelling can play in reframing how health educators promote “good health” with specific regard to the next generation of the workforce. I reflect on the impact of racism, White supremacy, and anti-Blackness when merging the arts and culture sector with public health disciplines, and close with a call to action as our niche field expands. I argue that no matter our role as artists, cultural workers, heritage holders, and/or focus within public health education and health promotion, our work is both an art and a science. Just as the language we use forms a story, the collection of scholars we choose to cite exposes a narrative. I hope this commentary encourages readers to reflect on opportunities in their work to close the health equity gap with recognition of the knowledge, skills, abilities, and capital within and across Black culture while also lifting up the community cultural wealth that exists in Indigenous, Latinx, and Asian and Pacific Islander communities.
Exploring Community Art and Its Role in Promoting Health, Social Cohesion, and Community Resilience in the Aftermath of the 2015 Nepal Earthquake
Authors: Baumann Sara E. , Merante Monica M. , Sylvain-Holmgren Marie-Ange , Burke Jessica G.
Published: May 2021

A magnitude 7.8 earthquake struck Nepal in 2015, followed by hundreds of aftershocks that led to physical destruction, loss, and negative mental health outcomes. Yet, in the days, months, and years following the disaster, numerous forms of community art rose from the rubble, such as urban murals, spoken word poetry, public dance performances, and sacred art. This study explored the relationship between community art and health, social cohesion, and community resilience in postearthquake Nepal. We utilized photography and audio recorders to capture 19 unique artworks/projects created in the aftermath of the earthquake and conducted in-depth interviews with 19 artists and/or experts about the relationship between art and health in postdisaster contexts. The 19 postearthquake artworks/projects ranged from contemporary paintings to Buddhist ritual dance and reflected the unique combination of the traditional and contemporary necessary for salvaging and restoring Nepali heritage. Findings revealed three key themes regarding linkages between art and mental health in the context of postearthquake Nepal. First, community art offers relief and is a mechanism for coping, through the creation or observation of art. Second, community art can be used as a means of communication, both as a tool for promoting connections and conversations in the community and by communicating messages of hope. Third, community art can promote community cohesion and ultimately serve as a tool to create physical and emotional safe spaces. Overall, there is promise for initiatives that engage artists and communities in arts-based initiatives following traumatic events, such as natural disasters, which can positively affect health. Funding support and development of partnerships with grassroots artists and creators should be promoted in health and development programming, especially for risk reduction and recovery after disasters.
Poetry as Praxis + “Illumination”: Toward an Epistemically Just Health Promotion for Resistance, Healing, and (Re)Imagination
Authors: Petteway Ryan J.
Published: May 2021

Health promotion is facing a most challenging future in the intersections of structural racism, COVID-19 (coronavirus disease 2019), racialized police violence, and climate change. Now is a critical moment to ask how health promotion might become more responsive to and representative of people’s daily realities. Also how it can become a more inclusive partner in, and collaborative conduit of, knowledge—one capable of both informing intellects and transforming hearts. It needs to feel the pulse of the “fierce urgency of now,” and perhaps nothing can reveal this pulse more than the creative power of art—especially poetry. Drawing from critical and Black feminist theory, I use commentary in prose to conceptualize and call for an epistemically just health promotion guided by poetry as praxis—not just as method. I posit that, as praxis rooted in lived realities, poetry becomes experiential excavation and illumination; a practice of community, communion, and solidarity; a site and source of healing; and a space to create new narratives of health to forge new paths toward its promotion. I accordingly suggest a need to view and value poetry as a critical scholarship format to advance health promotion knowledge, discourse, and action toward a more humanized pursuit—and narrative—of health equity.
Percutaneous endovascular abdominal aortic aneurysm repair with monitored anesthesia care decreases operative time but not pulmonary complications
Authors: Kronenfeld Joshua P , Ryon Emily L , Lall Alex , Kang Naixin , Kenel-Pierre Stefan , DeAmorim Hilene , Rey Jorge , Karwowski John , Bornak Arash
Published: May 2021

Objectives

To report our experience and compare the results of percutaneous endovascular aortic aneurysm repair (PEVAR) performed under monitored anesthesia care (MAC) to PEVAR under general anesthesia (GA).

Methods

A retrospective review of patients who underwent non-emergency endovascular abdominal aortic aneurysm repair (EVAR) was completed. Patients were excluded if they had a complex repair, including fenestrated, branched, or parallel endografting. Demographics, operative data, 30-day mortality/morbidity and postoperative outcomes were analyzed.

Results

A total of 159 patients were identified with a median age of 69. 115 patients had PEVAR, 45 (39.1%) PEVAR MAC and 70 (60.9%) PEVAR GA. PEVAR MAC compared to PEVAR GA had decreased operative time (106 vs. 134 min, P < 0.001), time in the operating room (163 vs. 245 min, P = 0.016), and estimated blood loss (EBL) (115 vs. 176 mL P = 0.012). There was no statistically significant difference in the hospital length of stay (LOS) (1.9 vs. 2.7 days, P = 0.133), and post-operative complications including pulmonary (2.2 vs. 2.9%, P = 0.835). Forty-four patients had EVAR with a femoral cutdown (FC), including 14 PEVAR conversions. PEVAR conversion was associated with higher EBL (543 vs. 323 mL, P = 0.03), operative time (230 vs. 178 min, P = 0.01), and operating room time (307 vs. 275 min, P = 0.01) compared to planned EVAR with FC.

Conclusions

PEVAR under MAC is associated with shorter time in the operating room compared to PEVAR under GA. PEVAR under MAC does however not decrease overall morbidities, including postoperative pulmonary complications.
‘Nigeria is fighting Covid-419’: A multimodal critical discourse analysis of political protest in Nigerian coronavirus-related internet memes
Authors: Unuabonah Foluke O , Oyebode Oluwabunmi O
Published: May 2021

This paper examines political protest in 40 purposively sampled internet memes circulated among Nigerian WhatsApp users during the Covid-19 pandemic, with a view to exploring the thematic preoccupation, ideology, and the representation of participants and processes in the memes. The data, which were subjected to qualitative analysis, are examined from a multimodal critical discourse analytic approach. The analysis reveals that the memes are used to protest corruption, perceived government deceit, insecurity, hunger, and inadequate health facilities and other social amenities. These are done in order to project and resist an anti-welfarist ideology and emphasise the negative representation of the government.
Identification of Heat Shock Protein 90 as a Recurrence Related Marker in Juvenile Nasopharyngeal Angiofibroma
Authors: Wang Jingjing , Hu Li , Liu Zhuofu , Wang Huan , Zhang Huankang , Song Xiaole , Sun XiCai , Wang DeHui
Published: May 2021

Background

Juvenile nasopharyngeal angiofibroma (JNA) is a highly recurrent tumor after curative surgery.

Objective

The purpose of this study was to evaluate heat shock protein 90 (HSP90) expression in JNA and its association with tumor recurrence.

Methods

Immunohistochemistry was performed to assess HSP90 expression using tissue microarrays containing 70 JNA patients and 10 control subjects. The associations of HSP90 expression with clinicopathological features and tumor recurrence were analyzed.

Results

Immunohistochemistry revealed high HSP90 expression in JNA compared with normal middle turbinate samples. High expression of HSP90, which correlated with MVD ( P = .001), ER-α ( P = .001), VEGF ( P < .001) and JNA recurrence ( P = .009), was an independent prognostic factor of time to recurrence ( P = .017). The combination of HSP90 and ER-α had a better power to predict disease recurrence than other clinicopathological features ( P = .008).

Conclusions

HSP90 may be an independent prognostic marker in JNA patients administered surgical treatment. Combination of HSP90 and ER-α expression may be the best predictor of tumor recurrence among all clinicopathological factors.
The challenges and opportunities of conducting PhD participatory action research on sensitive issues: Young people and sexting
Authors: York Leanne , MacKenzie Alison , Purdy Noel
Published: May 2021

This paper presents the challenges and opportunities of using a participatory action research (PAR) methodology in a social science PhD exploring young people’s attitudes to sexting in Northern Ireland. Based upon a children’s rights approach, a Young People’s Advisory Group (YPAG) was created to seek advice on data collection activities and resources to be used with the participants of the research. Single-sex and mixed-sex focus group interviews were conducted in one youth club with 17 young people. PAR provides opportunities for young people to voice their views on matters affecting their lives, and supports the development of interpersonal, teamworking and research skills. Challenges of PAR included recruiting young people, gaining consent from young people and parents. This study highlights the importance of including young people as co-researchers. As a result of the method used, young people confirmed that Relationships and Sexuality Education (RSE) is inadequate.
SOGI statements and LGBT+ student care in Christian schools
Authors: Smith Julia
Published: May 2021

This article discusses a sexual orientation and gender identity (SOGI) statement widely used in Christian schools in light of its expressed commitment to treating all persons with compassion, love, kindness, respect, and dignity. I argue that this commitment is undermined by other parts of the statement which fail to address, and even exacerbate, the harms LGBT+ students experience in schools. I suggest revisions to the SOGI statement and a range of practices that would improve LGBT+ student safety and support in Christian schools that hold a traditional view of marriage.
How Cooperative Learning Is Conceptualized and Implemented in Chinese Physical Education: A Systematic Review of Literature
Authors: Dyson Ben , Shen Yanhua , Xiong Wen , Dang Linxiu
Published: May 2021

Purpose:

The purpose of this literature review was to investigate how cooperative learning (CL) has been conceptualized and implemented in Chinese physical education (PE). CL is one of the most influential and widespread areas of theory, research, and practice in western education. With the promotion of Chinese government policies, CL has become a popular field of research and was widely used as a pedagogical practice in Chinese.

Design/Approach/Methods:

Shulruf’s five methodological steps were utilized as the process of screening and selecting relevant studies. Inductive analysis and constant comparison were conducted for analyzing the chosen literature.

Findings:

The analytic induction revealed four key themes: (a) historical development, (b) policy influence, (c) conceptualization of CL, and (d) implementation of CL. We found that the conceptualization of CL in Chinese PE was ambiguous, and the implementation of CL was predominantly documented by quantitative research methods. In addition, few studies were conducted at the elementary school level.

Originality/Value:

This is a comprehensive literature review on CL in Chinese PE. Findings and recommendations in this article will be beneficial for policymakers, scholars, and PE teachers to better understand and promote CL in China.
Surveillance Cultures and Infection in 230 Pacemaker and Defibrillator Generator Changes in Pediatric and Adult Congenital Patients
Authors: Webster Gregory , Balmert Lauren C. , Patel Ami B. , Kociolek Larry K. , Gevitz Melanie , Olson Rachael , Chaouki Ahmed S. , El-Tayeb Osama , Monge Michael C. , Backer Carl
Published: May 2021

Background:

Postoperative infections can occur during surgical replacement of pulse generators for pacemakers and implantable cardioverter-defibrillators. The incidence of infection is poorly documented in children and patients with adult congenital heart disease. The utility of surveillance cultures obtained from device pocket swabs is unknown in this group.

Methods:

We reviewed surgical replacements of cardiovascular implantable pulse generators from 2010 to 2017. Two cohorts were defined. In a surveillance cohort (123 patients), aerobic and anaerobic culture swabs of the device pocket were obtained at the time of generator change. In a nonsurveillance cohort (107 patients), generator change occurred without obtaining cultures.

Results:

During 230 generator changes (mean patient age 19 years; 77% with structural congenital heart disease), two clinical infections occurred at the surgical site (0.9% incidence). Neither infection occurred in the surveillance cohort. Cultures were positive in 12 (9.8%) of 123 patients in the surveillance cohort, but 11 of 12 were likely contaminants and none were subsequently associated with clinical disease. There was no association between clinical infection or positive surveillance cultures and the location of pulse generator, the presence of other concurrent surgeries, or a history of prior pocket infection.

Conclusions:

Clinical infection was rare after pulse generator change in children and young adults. No cases required reintervention on the pocket. Surveillance cultures did not improve clinical care. These data extend current recommendations that surveillance cultures are not required during generator change to the pediatric and young adult population.
Pediatric Cardiac Surgical Patterns of Practice and Outcomes in Japan and Europe
Authors: Hörer Jürgen , Hirata Yasutaka , Tachimori Hisateru , Ono Masamichi , Vida Vladimiro , Herbst Claudia , Kansy Andrzej , Jacobs Jeffrey P. , Tobota Zdzislaw , Sakamoto Kisaburo , Ebels Tjark , Maruszewski Bohdan
Published: May 2021

Objectives:

The Japan Cardiovascular Surgery Database–Congenital section (JCVSD-Congenital) and the European Congenital Heart Surgeons Association (ECHSA) Congenital Heart Surgery Database (CHSD) share the same nomenclature. We aimed at comparing congenital cardiac surgical patterns of practice and outcomes in Japan and Europe using the JCVSD-Congenital and ECHSA-CHSD.

Methods and Results:

We examined Japanese (120 units, 63,365 operations) and European (96 units, 90,098 operations) data in JCVSD-Congenital and ECHSA-CHSD from 2011 to 2017. Patients’ age and weight, periprocedural times, mortality at hospital discharge, and postoperative length of stay were calculated for ten benchmark operations. There was a significantly higher proportion of ventricular septal defect closures and Glenn operations and a significantly lower proportion of coarctation repairs, tetralogy of Fallot repairs, atrioventricular septal defect repairs, arterial switch operations, truncus repairs, Norwood operations, and Fontan operations in JCVSD-Congenital compared to ECHSA-CHSD. Postoperative length of stay was significantly longer following all benchmark operations in JCVSD-Congenital compared to ECHSA-CHSD. Mean STAT mortality score (Society of Thoracic Surgeons European Association for Cardio-Thoracic Surgery mortality score) was significantly higher in JCVSD-Congenital (0.78) compared to ECHSA-CHSD (0.71). Mortality at hospital discharge was significantly lower in JCVSD-Congenital (4.2%) compared to ECHSA-CHSD (6.0%, P < .001).

Conclusions:

The distribution of the benchmark procedures and age at the time of surgery differ between Japan and Europe. Postoperative length of stay is longer, and the mean complexity is higher in Japan compared to European data. These comparisons of patterns of practice and outcomes demonstrate opportunities for continuing bidirectional transcontinental collaboration and quality improvement.
Current Status of Training and Certification for Congenital Heart Surgery Around the World: Proceedings of the Meetings of the Global Council on Education for Congenital Heart Surgery of the World Society for Pediatric and Congenital Heart Surgery
Authors: Tchervenkov Christo I. , Herbst Claudia , Jacobs Jeffrey P. , Al-Halees Zohair , Edwin Frank , Dearani Joseph A. , Finucane Kirsten , Sandoval Nestor , Sarris George E. , Fragata Jose , Abdulgani Hafil B. , Arboleda Miguel , Bacha Emile A. , Barron David J. , Becker Pedro , Boumzebra Drissi , Cervantes Jorge , Elgamal Adel , Helvind Morten H. , Iyer Krishna S. , Jatene Marcelo B. , Jun Tae-Gook , Kirklin James K. , Kreutzer Christian , Lee Cheul , Lotto Attilio A. , Manuel Valdano , Maruszewski Bohdan , Najm Hani , Overman David , Rahmat Budi , Reddy Darshan , Sakamoto Kisaburo , Samankatiwat Piya , Sivalingam Sivakumar , St. Louis James D. , Stellin Giovanni , Stephens Elizabeth H. , Tretter Justin T. , Truong Nguyen Ly Thinh , Tweddell James S. , Vida Vladimiro , Vosloo Susan , Zhang Hao , Zheleva Bistra , Jonas Richard A.
Published: May 2021

The optimal training of the highly specialized congenital heart surgeon is a long and complex process, which is a significant challenge in most parts of the world. The World Society for Pediatric and Congenital Heart Surgery (WSPCHS) has established the Global Council on Education for Congenital Heart Surgery as a nonprofit organization with the goal of assessing current training and certification and ultimately establishing standardized criteria for the training, evaluation, and certification of congenital heart surgeons around the world. The Global Council and the WSPCHS have reviewed the present status of training and certification for congenital cardiac surgery around the world. There is currently lack of consensus and standardized criteria for training in congenital heart surgery, with significant disparity between continents and countries. This represents significant obstacles to international job mobility of competent congenital heart surgeons and to the efforts to improve the quality of care for patients with Congenital Heart Disease worldwide. The purpose of this article is to summarize and document the present state of training and certification in congenital heart surgery around the world.
Transaxillary Approach for Surgical Repair of Simple Congenital Cardiac Lesions: Pitfalls, and Complications
Authors: Bayya Praveen Reddy , Kottayil Brijesh Parayaru , Srimurugan Balaji , Balachandran Rakhi , Jayashankar Jessin Puliparambil , Baquero Luis , Kumar Raman Krishna
Published: May 2021

Background:

In the treatment of simple congenital cardiac lesions, percutaneous and cosmetic surgical approaches have steadily gained prominence. Surgically, right vertical axillary approach is sparsely used despite superior cosmesis and less pain and blood product usage. Knowledge of potential pitfalls could lead to its more widespread acceptance.

Methods:

We retrospectively analyzed perioperative outcomes of 104 consecutive patients who underwent surgery by this technique between mid-2016 and December 2019, including ostium secundum (67), sinus venosus (34), coronary sinus (1), and ostium primum (1) atrial septal defects and hemianomalous pulmonary venous connection (1). Perioperative variables, surgical times, complications, and follow-up data were analyzed.

Results:

Patient weight ranged from 6.8 to 41 kg. Incision length ranged from 4 to 6 cm. There was no mortality. All cannulation was central. Difficulty in cannulation (inferior vena cava) was seen in two patients. Morbidity included pneumothorax in 2 (1.9%) patients and subcutaneous emphysema necessitating prolonged intercostal drain retention in 20 (19.2%) patients. Surgical time increased linearly (r = 0.567; P < .001) with increasing patient weight but cardiopulmonary bypass (CPB) time remained unaffected. No chest deformities or paresthesia were noted on follow-up. Scar size decreased in some patients.

Conclusions:

Right vertical axillary approach can be safely employed to treat simple congenital cardiac lesions with adequate awareness of potential pitfalls. Increasing patient weight increases the surgical time but does not affect CPB times. Incidence of pneumothorax and subcutaneous emphysema is similar to other thoracotomy approaches. It is cosmetically superior.
Outcomes Following Surgery to Address Shone Syndrome in Children
Authors: Dalton Tyler J. , Johnson William K. , Kuhn Evelyn M. , Goot Benjamin H. , Woods Ronald K. , Mitchell Michael E. , Hraska Viktor
Published: May 2021

Background:

Shone syndrome is characterized by coincident mitral valve stenosis and left ventricular outflow tract obstruction. Although first described in 1963, little research has expounded surgical outcomes. We sought to evaluate our experience with this cohort, emphasizing outcomes including mortality, morbidity, and cardiac function.

Methods:

A retrospective chart review of 46 patients who underwent operation for Shone syndrome between 1990 and May 2018 was conducted. Index operations included 32 repairs of the left ventricular outflow tract, four mitral valve repair/replacements, nine combined repairs, and one non-Shone’s repair. Median age at index procedure was 22 days (2 days-10 years). Mean follow-up was 9.1 years (2 months-21 years), and 70 additional operations (51 reoperations) were required. Three patients were lost to follow-up.

Results:

Overall survival was 95.7% with two late deaths. Freedom from death or transplant was 93.5%. Thirteen (28.3%) patients remained free from reoperation. Thirty-three patients required 51 reoperations of the left ventricle outflow tract (n = 12), mitral valve (n = 16), combined repairs (n = 21), and transplant (n = 1). At most recent follow-up, patients exhibited mitral stenosis (n = 21), aortic stenosis (n = 7), and diminished LV function (n = 2).

Conclusion:

Surgical correction of Shone’s offers excellent survival benefit, but reoperation burden is high, with >70% of patients requiring reintervention in the follow-up period. A total of 65% of patients developed recurrent obstruction of left ventricular inflow or outflow, however, ventricular function is preserved in the majority of patients. All but one patient had no functional deficits, classified as New York Heart Association I with > 60% requiring no medication.
What Factors Should Be Considered to Improve Outcome of Mechanical Mitral Valve Replacement in Children?
Authors: Elsisy Mohamed F. , Dearani Joseph A. , Ashikhmina Elena , Krishnan Prasad , Anderson Jason H. , Taggart Nathaniel W. , Van Dorn Charlotte S. , Stephens Elizabeth H.
Published: May 2021

Objective:

To identify risk factors for pediatric mechanical mitral valve replacement (mMVR) to improve management in this challenging population.

Methods:

From 1993 to 2019, 93 children underwent 119 mMVR operations (median age, 8.8 years [interquartile range [IQR]: 2.1-13.3], 54.6% females) at our institution. Twenty-six (21.8%) patients underwent mMVR at ≤2 years and 93 (78.2%) patients underwent mMVR at >2 years. Median follow-up duration was 7.6 years [IQR: 3.2-12.4].

Results:

Early mortality was 9.7%, but decreased with time and was 0% in the most recent era (13.9% from 1993 to 2000, 7.3% from 2001 to 2010, 0% from 2011 to 2019, P = .04). It was higher in patients ≤2 years compared to patients >2 years (26.9% vs 2.2%, P < .01). On multivariable analysis for mitral valve reoperation, valve size <23 mm was significant with a hazard ratio of 5.38 (4.87-19.47, P = .01);. Perioperative stroke occurred in 1% and permanent pacemaker was necessary in 12%. Freedom from mitral valve reoperation was higher in patients >2 years and those with a prosthesis ≥23 mm. Median time to reoperation was 7 years (IQR: 4.5-9.1) in patients >2 years and 3.5 years (IQR: 0.6-7.1) in patients ≤2 years ( P = .0511), but was similar between prosthesis sizes ( P = .6). During follow-up period (median 7.6 years [IQR: 3.2-12.4], stroke occurred in 10%, prosthetic valve thrombosis requiring reoperation in 4%, endocarditis in 3%, and bleeding in 1%.

Conclusion:

Early and late outcomes of mMVR in children are improved when performed at age >2 years and with prosthesis size ≥23 mm. These factors should be considered in the timing of mMVR.
First Harvest of Pediatric and Congenital Heart Surgery Multicenter Database in Turkey: Novel Application of Real-Time Online Reporting
Authors: Erek Ersin , Yalçınbaş Yusuf Kenan , Sarıosmanoğlu Nejat , Özkan Murat , Yıldız Okan , Şenkaya Işık , Özdemir Fatih , Biçer Mehmet , Sarıtaş A. Bülent , Atay Yüksel , Seçici Serkan , Kutsal Ali , Haydin Sertac , Bilen Cagatay , Onan Ismihan Selen , Tuncer Osman Nuri , Citoglu Gorkem , Doğan Abdullah , Turkoz Riza , Temur Bahar , Koc Murat , Sarıoğlu C. Tayyar
Published: May 2021

Objectives:

A new congenital heart surgery database (CKCV) with real-time online reporting function was recently developed in Turkey. All standard international parameters were used, but Aristotle Comprehensive Complexity score was modified. In this study, the first analysis of the CKCV Database is reported.

Methods:

The CKCV Database included 2307 procedures from 12 centers between January 2018 and March 2020. All parameters, including 10 real-time online reports, which represent the number of centers, number and mortality rates of all procedures, number of extracorporeal membrane oxygenation (ECMO) and results, details of postoperative complications, age-group statistics, analysis for priority status, mean intensive care and hospital stay durations of the procedures, results of Aristotle Basic, Modified Aristotle Comprehensive (MACC) and Society of Thoracic Surgeons-European Association (STAT) Score Categories, comparison of centers were analyzed.

Results:

Most common 10 procedures were ventricular septal defect (VSD) repair (n = 273), tetralogy of Fallot (TOF) repair (n = 243), atrial septal defect (ASD) repair (n = 181), complete AVSD repair (n = 95), cavopulmonary anastomosis (n = 81), systemic to pulmonary shunt (n = 79), modified Fontan (n = 71), subaortic resection, (n = 66) PA banding (n = 66), and arterial switch operation (n = 66). Cardiopulmonary bypass was used in 84.6% of the procedures. Overall mortality rate was 6.0%. A total of 618 major and 570 minor complications were observed in 333 and 412 patients, respectively. According to six MACC categories, number of the patients and mortality rates were I (293; 0.3%); II (713; 1.4%); III (601; 3.3%); IV (607; 12%); V (84; 35.7%); and VI (9; 55.6%), respectively. Analysis of five STAT Categories showed 0.7, 3.8, 5.4, 14.9, and 54.7% mortality rates.

Conclusions:

CKCV Database has a great potential for nationwide quality improvement studies. Users could instantly analyze and compare their results to national and international aggregate data using a real-time online reporting function. This is the first multicenter congenital database study in Turkey.