Search

Background: There are no large studies reporting oncological or survival outcomes for patients diagnosed with perineural spread (PNS) of cutaneous squamous cell carcinoma (cSCC) via the ophthalmic nerve (V1). Where orbital exenteration may be necessary for curative treatment, it is critical to have survival data with which the morbidity associated with surgical treatment can be justified. Furthermore, with the emerging treatment option of immunotherapy, current standard of care outcomes are needed to help guide future trial design and eventually changed management guidelines. Objective: To determine the oncological and survival outcomes observed in patients with PNS of cSCC via V1. Materials and methods: Retrospective analysis of prospectively maintained cohort of patients with PNS of cSCC via V1 treated in a tertiary Australian head and neck oncology/skull base referral center. Consecutive sample of 53 patients managed between March 1, 1999 and April 30, 2020. Follow‐up closure date was September 1, 2021. Curative‐intent surgery, curative‐intent radiotherapy, or palliative care was undertaken. Endpoints included five‐year overall, disease‐specific, and disease‐free survival from the date of treatment. Results: Five‐year Kaplan–Meier overall survival was 61.9% (95% CI 46.2%–74.3%), with disease‐specific survival of 74.6% (95% CI 58.8%–85.3%), and disease‐free survival 62.1% (95% CI 46.5%–74.3%). Survival was superior in patients treated via surgery and adjuvant radiotherapy than in those receiving surgery alone or definitive radiotherapy. Survival was superior among patients with less advanced disease as assessed by the Williams zonal staging system; patients with Zone 1 disease had disease‐specific survival of 94.1% at 5 years with 82.5% disease‐free survival. Discussion: Five‐year oncological and survival outcomes in this cohort were favorable. Superior survival was observed in patients treated with curative‐intent surgery and adjuvant radiotherapy. Less extensive disease as delineated by the Williams zonal staging system was associated with improved survival. Conclusion: Surgical resection with adjuvant radiotherapy confers favourable oncological and survival outcome in patients with V1 PNS, particularly with early disease limited to Zone 1. [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]

Background: Medical students face a unique collection of stressors, both intrinsic and external with consequences to health and well-being, ultimately impacting patient care. Health education institutions play a role in perpetuating or mitigating this experience of stress. Objective: This pilot project aimed to identify the impact of an extra-curricular wellness program on well-being among naturopathic medical students. Methods: Participants engaged in a 2-day facilitated wellness retreat followed by three monthly workshops, which coincided with the onset of the COVID-19 pandemic. Frequencies of pre-defined behaviours, and validated measures of stress, resilience, and mental health were assessed prior to the start of the program, immediately upon completion, and 6 months after the program concluded and were compared with wait-listed controls. Results: There was a clear trend toward reduced stress perception and anxiety, along with improved resilience among program participants through the duration of the study and compared with controls. The positive trends over the course of the study, especially during a global pandemic, suggests that the intervention was beneficial to participants. Conclusion: The results suggest that supporting students in cultivating the skills of resilient coping may reduce perceived stress and improve mental health for medical students, even during times of uncontrollable external stress. [ABSTRACT FROM AUTHOR]

Describes requirements for ISO 9000 certification in industry, using a factory example. Shows how requirements might be applied in higher education, with "product" being the actual learning outcome and "customer" anyone who purchases educational services. Addresses issues of continuous improvement in higher education. (SK)

Describes how multipoint desktop video conferencing (MDVC) is used in preservice teacher education programs in Singapore to enhance the professional development of student teachers by allowing them to share ideas, experiences, and teaching resources in real time with an audience wider than the schools in which they teach. Summative evaluations support earlier findings that real-time conferencing tends to promote more frank discussion and equal opportunity among participants. (Contains 14 references.) (AEF)

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.