A Model of Evangelism for a Bilingual Worship Community

The purpose of this DMIN action research project is to develop a model of evangelism for the Lahu-English bilingual worship community at Calvary Evangelical Free Church in Rochester, Minnesota. This study claims that the Lahu-English bilingual worship community has not emphasized evangelism—to share the gospel beyond this group—due to the decline of Christian influence in general and the cultural and language barriers that first and second- generation Lahu Christians encounter. Most ethnic worship communities tend to congregate and remain in their sphere of social and worship gatherings as a haven and belonging. While this is not intrinsically wrong, it ignores the command to reach more people for Christ. There are three objectives for this project. The first objective is to train this worship community on the content of the gospel. Namely, the participants are trained to articulate and summarize the main points of the gospel. The second objective is to provide a strategy for implementing evangelism. This strategy should be incorporated into their everyday lives. The final objective of this project is regarding the sustainability of this model. Sharing the gospel with others is not a project but rather an ongoing, lifelong process. This action research project will employ the qualitative and quantitative research philosophy and acquire data through pre- and post-questionnaire, discussions, interviews, and follow-ups. This project aims to call all Christians, including immigrants and ethnic churches, to engage and share the gospel wherever God has placed them in His sovereignty

Experience of Bakri balloon tamponade at a single tertiary centre: a retrospective case series

Intrauterine balloon tamponade (IUBT) is an established fertility-sparing and life-saving treatment for postpartum haemorrhage. However, high-level evidence is lacking for specific aspects of its use. Our aim was to evaluate a large case series of IUBT to inform evidence-based clinical practice. 296 cases of IUBT over a three-year period at a tertiary obstetric referral centre were identified and reviewed. Demographic, clinical, and procedural outcome measures were collected; including rates of success and failure of IUBT, duration of tamponade, and complications. IUBT was successful in 265 (90%) of women and failed in 18 (6%). All failures occurred within six hours of balloon insertion. Once deemed stable and successful at six hours, no women required return to theatre or further intervention. The mean duration of intrauterine balloon tamponade was 18.5 hours. A large variance in clinical practice exists including duration of intrauterine balloon tamponade, and method and timing of removal. A number of changes informed by the results will be introduced and prospectively audited to improve IUBT use.Impact statement What is already known on this subject? Intrauterine balloon tamponade (IUBT) is an important second-line treatment option in severe postpartum haemorrhage (PPH). IUBT is easy to use, is effective especially in the setting of uterine atony, and is associated with minimal complications. What the results of this study add? This study confirms the high rate of success for IUBT in controlling PPH. We found that after six hours, if deemed successful, it is rare that further intervention is required. In addition, tamponade beyond 12 hours, gradual or incremental deflation of the balloon, and antibiotic cover beyond the duration of tamponade are unlikely to yield any further safety benefit. What the implications are of these findings for clinical practice and/or further research? Our findings suggest that women should not be required to fast for balloon removal; removal of the balloon should occur by 12 hours if deemed stable and adequately resuscitated; deflation and removal of the balloon can occur at once; and antibiotics should be ceased after balloon removal. These will allow women to mobilise and recover sooner, and improve flow and throughput in our high-acuity care areas

Parental Psychosocial Factors Moderate Opioid Administration Following Children’s Surgery

BackgroundThis investigation aimed to examine the impact of parental psychosocial variables on the administration of opioids to young children experiencing postoperative pain.MethodsParticipants in this longitudinal analysis were children ages 2-12 undergoing tonsillectomy with or without adenoidectomy and their parents. Parents completed validated instruments assessing trait anxiety, perceived stress, and coping style before surgery, and children and parents completed instruments assessing pain and administration of opioids and acetaminophen on days 1, 2, 3, and 7 at home after surgery. The structure of the data was such that parents and children completed multiple data assessments making the data multilevel (ie, days of data within dyads). To address this issue of data structure, multilevel modeling was used to analyze the dataset.ResultsParticipants included 173 parent-child dyads (mean child age = 5.99 ± 2.51) recruited between 2012 and 2017. We found that parent-related psychosocial variables, such as trait anxiety, stress, and coping style, moderated the relationship between the child's pain and postoperative medication administration. Specifically, when predicting hydrocodone, the interactions between anxiety and pain and stress and pain were significant; when child pain was high, high-anxiety and high-stressed parents gave their children 19% and 12% more hydrocodone, respectively, compared to low-anxiety and low-stressed parents. When predicting acetaminophen, the interactions between anxiety and pain, a blunting coping style and pain, and a monitoring coping style and pain were significant.ConclusionsThese results suggest the need to identify parents who experience high levels of perceived stress and trait anxiety and use appropriate interventions to manage stress and anxiety. This may ensure children receive optimal amounts of pain medication following surgery