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Tracheostomy is being performed on children with increasing frequency and is usually performed surgically. The indications have changed over the past 100 years and it is now most commonly performed in patients requiring prolonged mechanical ventilation. Multidisciplinary preoperative assessment is valuable. There are some areas of debate regarding the best surgical technique. Care should be taken to minimize early complications related to poor technique. Postoperative management should take place in the intensive care setting. Sedation is frequently necessary for children until the first tube change, which can be performed early if stomal maturation sutures have been used and the condition of the patient is appropriate. Delayed complications may require the input of a specialist airway surgeon. Clinical nurse specialists play an important role in perioperative care. Each center should have a protocol for decannulation. Ex utero intrapartum treatment may necessitate tracheostomy in a high-pressure setting and requires significant planning. Guidelines have been developed regarding tracheostomy management during the COVID-19 pandemic and should be adhered to. © Springer Nature Switzerland AG 2023. All rights reseverd.
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How do citizens in a polarized political system react to an unexpected emergency like the COVID-19 pandemic and how do citizens process conflicting polarized narratives to for-mulate a public policy view of the threat of the pandemic? The emergence of the COVID-19 pandemic is a health emergency unlike anything in the United States since the polio epidemic 70 years ago, but the political climate of the U.S. in the 1950's was far more centrist and consensual than the deep divisions observed today. This paper will utilize data from a 35-year longitudinal study of Generation X young adults (now in their mid-40's) and a three-decade time series of national U.S. surveys to examine information acquisition behaviors to understand the new threat. Our analysis of the last 35 years of Generation X finds that polarized ideological partisanship was the strongest single predictor of individual votes in the 2020 election, but that individuals with a higher level of understanding of the corona-virus were more critical of the Trump Administration's handling of the COVID-19 pandemic and were more likely to vote for Bid-en than Trump. A parallel analysis of a national probability sample of U.S. adults in 2020 found the same pattern of influence from ideological partisanship, coronavirus understanding, and assessment of the Trump Administration's handling of the pan-demic. The results indicate that knowledge and understanding can provide a critical balancing effect in an evenly divided polarized political system. © 2022, CSIC Consejo Superior de Investigaciones Cientificas. All rights reserved.
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Purpose: The purpose of this paper is to work with Aboriginal and Torres Strait Islander people (ATSI), it is expected that non-ATSI health-care professionals become culturally aware;however, participants’ perceptions of the relative merit of cultural awareness training (CAT) formats is uncertain. Design/methodology/approach: The authors compared undergraduate students’ perceptions of an asynchronous online format with onsite delivery formats of CAT using a mixed-method design. Students from five successive cohorts (n = 64) in an undergraduate programme were invited to complete a post-training survey which gathered quantitative and qualitative data. Findings: Whilst feedback was positive regarding both formats, the onsite format was preferred qualitatively with several valuable learning outcome themes emerging from the results. These themes included;“perceived benefits of self-evaluation of students’ own culture whilst learning about Aboriginal culture”;“encouraging to be provided with scenarios, examples and exercises to enhance cultural awareness” and “engagement with the interactive facilitator approach”. There were differing views about the benefits of learning the history of oppression which warrant further research. Research limitations/implications: Results may be applicable to undergraduate allied health students who participate in clinical immersion placements (CIPs) who participate in Aboriginal CAT. Practical implications: Given the changing dynamic in education forced by the COVID-19 pandemic, more resources may need to be directed to improving online training and possibly combining formats in course delivery. Social implications: The strength of the study is that the authors achieved a response rate of 100%, thus the results are highly significant for the sample. This sample represents 41.3% of chiropractic students who attended CAT and CIPs at this university over the course of 9 years, thus the results could be generalized to chiropractic students who participated in these types of placements. Originality/value: To the best of the authors’ knowledge, this is the first study to compare student perceptions of different formats of Aboriginal CAT for final year chiropractic undergraduate students in Australia. © 2021, Emerald Publishing Limited.