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Contains fulltext : 174096.pdf (Publisher’s version ) (Open Access) Knowledge of aortic growth in patients with bicuspid aortic valve (BAV) is essential to identify patients at risk for dissection, but data on children remain unclear. We retrospectively evaluated the aortic diameters of all pediatric BAV patients, identified through an echocardiographic database (2005 to 2013). Medical records were reviewed and aortic diameters re-measured on echocardiographic images at diagnosis and if available on variable mid- and endpoints follow-up. Dilatation (z-score >2) was based on 2 different z-score equation methods (Gautier/Campens). In 234 of the total 250 BAV patients, aortic diameters were analyzed; median age was 6.1 years (interquartile range 1.7 to 10), of which 63% were male. Aortic coarctation was present in 81 (36%) patients, 23% had a ventricular septal defect. BAV morphology according to Sievers was as follows: type 0 in 128 patients (55%), type 1 in 96 (41%), and type 2 in 10 (4%). Ascending aortic (AA) dilatation was present in 24% (Gautier) and 36% (Campens) at inclusion. Median follow-up was 4.7 years. The AA was the only location where mean z-scores progressed significantly with age: 0.06 (Gautier) and 0.09 (Campens) units per year between ages 5 and 15 years. Associations for higher AA z-scores at older age were an initial z-score >2 (p

markdownabstractMoral conflicts, where a person is confronted with two or more clashing values, norms or responsibilities, are common in public service delivery. Choosing one is realized at the cost of the other(s). Frontline professionals, such as physicians and police officers, often experience clashes over the right thing to do as new policies, organisational rules, professional obligations and clients’ demands come together. Stress may be a consequence. This chapter aims to increase our understanding of moral conflicts and coping with stress in regard to public service delivery and explore how morality and coping strategies are interconnected in the policy context.