Does cardiopulmonary resuscitation cause rib fractures in children? A systematic review

BACKGROUND: There is a diagnostic dilemma when a child presents with rib fractures after cardiopulmonary resuscitation (CPR) where child abuse is suspected as the cause of collapse. We have performed a systematic review to establish the evidence base for the following questions: (i) Does cardiopulmonary resuscitation cause rib fractures in children? (ii) If so, what are the frequency and characteristics of these fractures that may help to distinguish them from rib fractures caused by physical abuse? METHODS: We performed a literature search of original articles, references, textbooks, and conference abstracts, published in any language from 1950 to 1 October 2005. Articles were identified from ASSIA, Caredata, Medline, Ovid Medline in Process, ChildData, CINAHL, Embase, ISI Proceedings, SIGLE, Science Citation Index, Social Science Citation Index, and TRIP databases. We included all studies that addressed rib fractures and CPR in children less than 18 years, and excluded review articles, expert opinion, consensus guidelines, and studies that were significantly methodologically flawed on critical appraisal. Each study underwent two independent reviews (with a third review if there was disagreement). Each reviewer used standardized criteria for study definition, data extraction, and critical appraisal, to determine the quality of the study and to establish if it met the inclusion criteria of this systematic review. FINDINGS: Of the 427 studies reviewed, 6 were included: 1 case control, 4 cross-sectional, and 1 case series. These represent data on 923 children who underwent CPR. Three children sustained rib fractures as a result of resuscitation; all three of these had fractures that were anterior (two mid-clavicular and one costo-chondral). We did not find any child in the literature who had a posterior rib fracture due to CPR. Resuscitation was performed variably by both medical and non-medical personnel. CONCLUSION: Rib fractures after cardiopulmonary resuscitation are rare. When they do occur, they are anterior and may be multiple. As the studies performed to date did not use the most sensitive techniques for detecting rib fractures, further prospective studies of children would be valuable to provide additional clarification on this question.     

Ethnography in Action: Active Learning in Academic Library Outreach to Middle School Students

This article describes an outreach activity developed and coordinated by academic librarians as part of a state program for low-income middle school students. Rather than offering a traditional library tour, the library organizers wanted to provide the middle school students with a meaningful experience that would encourage active participation, critical thinking, and alleviate library anxiety. As a spin on the traditional tour, students applied an ethnographic approach to learning about the library. The authors describe the development and implementation of the activity and provide recommendations for other librarians involved in outreach to K–12 students.     

Network-related teaching and changes in classroom seating

The extent to which teachers make changes in classroom seating reflects, in part, the degree to which they value promoting positive peer relationships in the classroom. We assessed the frequency with which teachers made both minor (i.e., involving only 2–3 students) and major (involving half or more students in the class) changes in classroom seating. We tested whether the frequency of seating changes was linked to teachers' beliefs about promoting positive peer relationships, their attunement to child- or peer-reports of peer victimization, and their concern about bullying at the school. Participants were 37 fourth-grade teachers and their students (N = 677). The frequency of major seating changes was negatively associated with teachers' peer-focused classroom seating (PFCS) beliefs and to their attunement to student peer victimization. Minor seating changes were positively associated with PFCS beliefs for teachers with low or average attunement to peer victimization; however, teachers highly attuned to peer victimization made fewer minor seating changes regardless of their PFCS beliefs. Implications for research and practice are discussed.     

Does First Sex Really “Just Happen?” A Retrospective Exploratory Study of Sexual Debut Among American Adolescents

First sex marks a significant transition for most adolescents, yet teens often report that it was unplanned. Seventy-four college students participated in exploratory focus groups about their first sex. Although initially asked whether their first sex was spontaneous or planned, many participants revealed evidence of forethought or anticipation, signifying a third option, anticipation. This study suggests that the development and timing of sexual health messages should build on the apparent, albeit often unacknowledged, planning and thought that accompany the transition to first sex. Specifically, during the time immediately preceding first sex, young people might be particularly open to such messages.     

教育成就代际传递的机制:资本和沟通的视角

父母传递给子女的不仅是生理特征,各种社会特征如教育成就、社会地位等也存在代际传递的现象。从资本视角看,这种传递不仅是父母通过人力资本、文化资本实现的文化再生产过程,它已经成为一个将经济资本和社会资本转化为升学、教育机会的过程;从沟通视角看,各种资本对教育成就的影响都离不开亲子沟通和家校沟通等具体过程。资本和沟通的视角为帮助弱势群体降低教育成就的代际传递性,促进教育公平带来重要启示。     

Correlates of Sustained Volunteering: Advocacy for Students with Disabilities

Parents of students with disabilities often receive support from special education advocates, who may be trained through a variety of programs. Using a web-based survey, this study examined the postgraduation advocacy activities of 83 graduates of one such volunteer advocacy training program. In the one to four years after program graduation, 63.8% (53 of 83) of the graduates advocated for one or more families; these sustained advocates reported stable rates of advocacy over time, and advocates performed activities that were either family-focused or school-focused. For graduates who advocated post-training, amounts of advocacy were positively related to satisfaction with advocating and with higher levels of involvement with other advocates and with the broader disability community. Compared to those not advocating after graduating, sustained advocates reported greater advocacy-role identities, increased involvement in disability groups, and higher likelihood to advocate in the upcoming year. Future research and practice implications are discussed.     

Children Persist Less When Adults Take Over

Children need to learn to persist through challenges, yet adults sometimes step in to solve problems for them. Here, we looked at how adult taking over related to children’s persistence. In an observational study (N = 34, ages 4–8), we found that parents who took over more often during a challenging puzzle task rated their children as dispositionally less persistent. To establish whether taking over can cause reduced persistence, we ran two preregistered experiments (N = 150, ages 4–5). Children assigned to a taking over condition persisted less on a subsequent task compared to those in a teaching or a baseline condition. Reframing the context did not ameliorate the negative impact of taking over. The results suggest that taking over impairs children’s persistence.