School engagement,risky peers,and student–teacher relationships as mediators of school violence in Taiwanese vocational versus academically oriented high schools

Educational tracking based on academic ability accounts for different school dynamics between vocational versus academically‐oriented high schools in Taiwan. Many educational practitioners predict that the settings of vocational schools and academic schools mediate school violence in different ways. Alternatively, some researchers argue the actual mediating mechanism may not vary significantly between the different school types in different cultures. The purpose of this study was to examine how within‐school variables (school engagement, risky peers, and student–teacher interaction) mediate external‐school variables (personal traits, parental monitoring, and victimization) and school violence in Taiwanese vocational and academically‐oriented schools. Structural equation modeling analysis, based on a national representative sample (N=7,841), suggested school violence was mediated through school variables. Similar mediational findings were found between academic and vocational schools as well as between males and females. Findings suggest that school violence is mediated by within‐school variables in similar ways across different school types, genders, and cultures. © 2010 Wiley Periodicals, Inc.     

Pulmonary Atresia with Ventricular Septal Defect and Multifocal Pulmonary Blood Supply: Does an Intensive Interventional Approach Improve the Outcome?

Introduction. Pulmonary atresia with ventricular septal defect (VSD) continues to be associated with significant morbidity and mortality, with significant institutional variation in therapeutic strategies. This study reports a single center experience utilizing an intensive transcatheter approach to promote pulmonary vascular growth. Methods. A retrospective analysis of 20 patients undergoing surgical and transcatheter treatment for pulmonary atresia with VSD between 2002 and 2010. Results. The median age at initial surgical palliation was 6.3 months (8 days to 2.5 years). Eleven patients (group 1) underwent initial surgical palliation without VSD closure and nine patients (group 2) underwent an initial complete repair with fenestrated or complete VSD closure. Group 1 had a smaller Nakata index (54 mm²/m² vs. 134 mm²/m², P= .04) and a smaller absolute native pulmonary artery diameter (2.7 mm vs. 4.5 mm, P= .01) than group 2. Intraoperative angiography was performed in 10 cases to evaluate if early transcatheter intervention was warranted. The median follow‐up during the study period was 2.3 years (1.6 months to 8.3 years). Of the 16 patients who survived the initial early postoperative period, 15 patients (94%) went on to receive surgical (n = 11) and/or interventional (n = 25) catheterization procedures. There was improvement in the mean Nakata index from the initial presurgical evaluation to the most recent catheterization data (38.4 mm²/m² vs. 169.7 mm²/m², P≤ .05). To date, two of 11 (18%) patients in group 1 ultimately underwent surgical VSD closure. Overall mortality was six of 20 (30%) with four deaths in group 1 and two deaths in group 2. There were no procedural deaths. Conclusions. Combining surgical unifocalization procedures with subsequent early and intensive catheter‐based pulmonary artery rehabilitation may improve vascular growth, ultimately rendering many patients suitable for fenestrated VSD closure. Risk stratification, including intraoperative exit angiography, is essential to determine the need for early transcatheter interventions.