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Background: Opioid analgesia remains a cornerstone of the management of perioperative pain in cardiac surgical patients. Emerging evidence suggests that intermediate and long-term postoperative opioid dependence is underappreciated and associated with adverse patient outcomes. Methadone has emerged in the cardiothoracic and non-cardiothoracic anesthesia literature as an option that may provide lasting analgesic benefit and may be associated with a reduction in overall perioperative opioid requirements. Main body: This study was a systematic literature review and meta-analysis that aimed to provide evidence supporting the use of perioperative or intraoperative methadone in adult cardiac surgical patients, particularly with respect to objective measures of postoperative pain and opioid requirements prior to and at discharge from the hospital. Electronic searches of three research databases were performed: PubMed (1972 to October 2023), Ovid MEDLINE (1946 to October 2023), and EMBASE (1978 to October 2023). This search yielded a total of 190 articles, 7 of which met the relevant inclusion and exclusion criteria. This included five randomized controlled trials and two large retrospective cohort studies. Conclusion: Preoperative or intraoperative methadone led to reduced pain scores at 24 h postoperatively and reduced opioid requirements at discharge. Methadone may be effective at reducing perioperative pain scores and opioid requirements postoperatively, including at discharge. The literature on this subject has important limitations, and further research in larger randomized controlled trials is needed. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES The aim of this study was to assess the early outcomes and risk factors of paediatric patients requiring extracorporeal membrane oxygenation after cardiac surgery (post-cardiotomy). METHODS Retrospective binational cohort study from the Australia and New Zealand Congenital Outcomes Registry for Surgery database. All patients younger than 18 years of age who underwent a paediatric cardiac surgical procedure from 1 January 2013 to 31 December 2021 and required post-cardiotomy extracorporeal membrane oxygenation (PC-ECMO) in the same hospital admission were included in the study. RESULTS Of the 12 290 patients included in the study, 376 patients required post-cardiotomy ECMO (3%). Amongst these patients, hospital mortality was 35.6% and two-thirds of patients experienced a major complication. Hypoplastic left heart syndrome was the most common diagnosis (17%). The Norwood procedure and modified Blalock–Taussig shunts had the highest incidence of requiring PC-ECMO (odds ratio of 10 and 6.8 respectively). Predictors of hospital mortality after PC-ECMO included single-ventricle physiology, intracranial haemorrhage and chylothorax. CONCLUSIONS In the current era, one-third of patients who required PC-ECMO after paediatric cardiac surgery in Australia and New Zealand did not survive to hospital discharge. The Norwood procedure and isolated modified Blalock–Taussig shunt had the highest incidence of requiring PC-ECMO. Patients undergoing the Norwood procedure had the highest mortality (48%). Two-thirds of patients on PC-ECMO developed a major complication. [ABSTRACT FROM AUTHOR]

as soil and clay. Common among pregnant women in rural, tropical areas, it is culturally accepted within some societies and stigmatized within others. There is no scientific consensus on the effects of geophagy on human health. This study was developed as a comprehensive diagnostic to assess the causes, social aspects and potential health impacts of geophagy among pregnant women in rural Panama. Methods: Private, structured interviews (n=41) were carried out with women in ten subsistence community farms in the province of Veraguas and the Ngöbe-Bugle Comarca. Additional interviews with healthcare workers were conducted at nearby healthcare facilities. Five soil samples were collected in locations indicated by confirmed geophagists, subjected to simulated human digestion and analyzed for mineral composition and parasite eggs. Results: There is no cultural or religious element to the practice; rather it seems to be driven by physiological desires tied to the smell of the material. Prevalence is higher among women with lower education levels and poorer nutritional status suggesting that the practice is associated with low socioeconomic status. Soil analysis did not indicate presence of parasites, but there are potential nutritional benefits of the practice by providing essential minerals missing in the diet. Discussion: We find that geophagy in Panama may offer nutritional benefits. However, without a clearer understanding of specific effects of soil in the gastrointestinal tract, it is difficult to determine direct biophysical impacts of geophagy [ABSTRACT FROM AUTHOR]

Members of this research team are investigating the use of multipoint desktop video conferencing (MDVC) technology in Singapore to enhance the National Institute of Education's schools practicum partnership model. The project builds on the Singapore ONE ATM island-wide network and the high-speed ADSL line access provided by Singtel Magix. This infrastructure provides state-of-the-art support for the White Pine CU-SeeMe Meeting Point server and client software that enables students on teaching practice to conference with each other and their university-based supervisors. A typical conference involves four of five students at different schools and one staff member at the National Institute of Education in Singapore. These conferences provide opportunities for professional sharing between staff and students without the limits of time and space which are traditional constraints on conventional teaching practice. [ABSTRACT FROM AUTHOR]

Traces the Hong Kong government's attempts to develop secondary education in Hong Kong during the period 1945-1971. Effects of the Second World War; Strategies for reconstruction; Operation of grant-aided schools; Anglo-Chinese schools.

Focuses on initiatives in Western Australia concerning the transition from school to work. Launch of vocational pilot programs in secondary schools; Introduction of compulsory senior English course in Years 11 and 12; Promotion of study programs that balance skill training and personal and social development of students.

Deals with a study which examined and developed an appropriate environment for post-compulsory education among young adults. Appropriate facilities for the promotion of post-compulsory schooling; Supporting organizational structure; Conclusions.

Rapid technological development in computer video conferencing and digital video photography over the last decade makes it easier than ever for teacher educators to use the technology in facilitating reflective practice. This paper reports recent developments in the use of multipoint desktop videoconferencing (MDVC) in preservice teaching practice in Singapore. In addition to regular video conferencing, preservice teachers now have opportunities to view their own teaching video clips and receive feedback from their peers and university supervisors. The experience helped enhance professional development of preservice teachers by allowing them to share ideas, experiences and teaching resources in real time with an audience wider than the schools where they taught. [Copyright &y& Elsevier]

With ongoing progress of components of extracorporeal membrane oxygenation including improvements of oxygenators, pumps, and coating materials, extracorporeal membrane oxygenation became increasingly accepted in the clinical practice. A suitable testing in an adequate setup is essential for the development of new technical aspects. Relevant tests can be conducted in ex vivo models specifically designed to test certain aspects. Different setups have been used in the past for specific research questions. We conducted a systematic literature review of ex vivo models of extracorporeal membrane oxygenation components. MEDLINE and Embase were searched between January 1996 and October 2017. The inclusion criteria were ex vivo models including features of extracorporeal membrane oxygenation technology. The exclusion criteria were clinical studies, abstracts, studies in which the model of extracorporeal membrane oxygenation has been reported previously, and studies not reporting on extracorporeal membrane oxygenation components. A total of 50 studies reporting on different ex vivo extracorporeal membrane oxygenation models have been identified from the literature search. Models have been grouped according to the specific research question they were designed to test for. The groups are focused on oxygenator performance, pump performance, hemostasis, and pharmacokinetics. Pre-clinical testing including use of ex vivo models is an important step in the development and improvement of extracorporeal membrane oxygenation components and materials. Furthermore, ex vivo models offer valuable insights for clinicians to better understand the consequences of choice of components, setup, and management of an extracorporeal membrane oxygenation circuit in any given condition. There is a need to standardize the reporting of pre-clinical studies in this area and to develop best practice in their design. [ABSTRACT FROM AUTHOR]