CICE Consortium

PURPOSE OF REVIEW: Enhanced recovery protocols (ERPs) have been adopted for a variety of adult surgical conditions and resulted in markedly improved outcomes, including decreased length of stays, complications, costs, and narcotic utilization. In this review, we describe the development and implementation of an ERP for children undergoing gastrointestinal surgery. RECENT FINDINGS: Existing ERP components from adult and pediatric surgical populations were reviewed and modified through an iterative process that included literature review, a national survey of practicing pediatric surgeons, and appropriateness assessment by a multidisciplinary expert panel. A single-center pilot implementing a gastrointestinal ERP demonstrated a steady increase in the number of ERP elements being employed over time with a simultaneous decrease in length of stays, decrease in median time to regular diet, decrease in median dose of intraoperative and postoperative narcotics, and decrease in median volume of intraoperative fluids. Balancing measures such as complication rates and 30-day readmission rates were stable or trended toward improved outcomes. SUMMARY: ERPs for children undergoing gastrointestinal surgery appear feasible, safe, and associated with improved outcomes. Further validation of these results and expansion to a wider breadth of children's surgical care will help to establish ERPs as a new standard of surgical care.

Nanotechnology is intensively developing and is mostly introduced in renewable energy, cosmetics, nanomedicine, electricity and electronics thereby increasing amount of nanowaste has been challenging issue in the world. However waste management policy in Mongolia has incomplete, nanowaste regulation has to be embedded in order to protect environment and human health. Because environmental and health impact of nanomaterial is still open field for researchers. The main objectives of this study are to introduce test results of some nanomaterials, and to evaluate waste including nanowaste management policy in Mongolia. 21 nanomaterials were tested by X-Ray Diffraction analysis, Cross Correlation Analysis and the Ames test. As a result, physical sizes of 5 nanomaterials were measured at less than 100 nm, and all samples were non-mutagenic. In conclusion, the registration of imported goods in Mongolia needs to be improved in high technology products and safety data sheet for nanomaterial is necessary due to sound disposal of hazardous waste.

is a strategic consulting and research service provided by ITHAKA, a not-for-profit organization dedicated to

The author is looking for the origins of crime in the conflict between those who legally possess power and have access to resources and others, who have no power and are deprived of most of the important resources. He brings up evidence suggesting that the societies with the highest rates of crime are also those with the highest levels of inequality. The author tries to answer two questions: how can crime be prevented(primary prevention) and how can the likelihood of its happening again be reduced (preventing re-offending), in both an effective and ethical way. The author states that the ideal method of preventing the crime is not the threat of potential punishment, but social crime prevention, such as more equitable distribution of material goods, which would encourage people to live a rewarding life without harming others. Further, the author discusses the advantages of the restorative system over the conventional one in terms of ‘preventing re-offending’: focussing on the harm that is caused rather than on the laws that are broken, giving victims a chance to express their fear and needs as well as giving perpetrators the possibility to explain their reasons and express their needs, which enables reflection on how to put everything right and how to engage the community.