This study strongly confirms the benefit of chest reopening after cardiac arrest in the cardiac surgical ICU. Patients who arrest within 24 h of surgery and in whom reopening is instituted within 10 min are particularly likely to benefit. The value of chest reopening in arrests outside the ICU remains unresolved. All patients reopened on the ward died, suggesting that this practice should be discontinued. Early 'scoop and run' resulted in one solitary survivor though it should probably be restricted to patients who arrest within 72 h of surgery as surgically remediable problems are unlikely after this time.

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Background-Early outcomes after tricuspid valve replacement in young children are ill defined. The experience of the Pediatric Cardiac Care Consortium (45 centers, 1984 to 2002) was reviewed to evaluate the results of tricuspid valve replacement in children Ͻ6 years of age. Methods and Results-Ninety-seven patients who underwent initial tricuspid valve replacement are included in the present analysis. The most frequent cardiac diagnoses were Ebstein's anomaly (40%), pulmonary atresia (11%), and tetralogy of Fallot (8%). Age at tricuspid valve replacement was 2.9Ϯ1.7 years (meanϮSD). Mean patient weight was 12.7Ϯ6.1 kg. The major outcome was survival to discharge. Associations among age, diagnosis, valve type/size, and outcome were evaluated through the use of 2 analysis and logistic regression model fitting approaches. Hospital mortality was 26% and was very high (64%) in patients Ͻ1 year of age. A large size-to-weight ratio was the strongest predictor of mortality based on multivariable analysis (PϽ0.001). Mortality was 54% for patients with a size-to-weight ratio Ͼ2.5.Other complications included heart block requiring a pacemaker (13%) and thrombosis (5%

For children born in the 21st century, the enmeshing of natural and human forces in the survival of the planet requires conceptual and practical innovation. This paper comes from a project funded by the Australian Research Council investigating the integration of literacy and sustainability in early years learning. The methodology employed was ‘deep hanging out’, the purpose of which is to observe without bias or assumption. This paper focuses on a video from a preschool depicting children playing drums and percussion instruments outside, in the playground. We consider the nature of literacy differently, conceptualizing literacy+sustainability within the context of the more-than-human, intra-active world. In our example, the drumming ebbs and flows in intensity, children come and go, rhythms merge then diverge; a chaos of sound and vibration, a refrain of rhythm, movement and bodies, driven by the excess of the earth’s energy and musical force. We see children communicate a sense of the world – with drums, each other, earth – sustained by the vitality of place, the materiality of drums and sound, the energy of earth and the movement of bodies. In this example, we extend the conversation around what literacy and sustainability might look like, offering possibilities for producing new knowledge about literacy and new understandings of sustainability.