Fast-track recovery program after cardiac surgery in a teaching hospital: a quality improvement initiative.

OBJECTIVE: Fast-track cardiac anesthesia (FTCA) is a technique that may improve patient access to surgery and maximize workforce utilization. However, feasibility and factors impacting FTCA implementation remain poorly explored both locally and internationally. We describe the specific intraoperative and postoperative protocols for our FTCA program, assess protocol compliance and identify reasons for FTCA failure. RESULTS: We tested the program in 16 patients undergoing elective cardiac surgery requiring cardiopulmonary bypass. There was 100% compliance with the FTCA protocols. Four (25%) patients successfully completed the FTCA protocol (extubated < 4 h postoperatively and discharged from the intensive care unit on the same operative day).

Reconnaissance and latent learning in ants.

We show that ants can reconnoitre their surroundings and in effect plan for the future. Temnothorax albipennis colonies use a sophisticated strategy to select a new nest when the need arises. Initially, we presented colonies with a new nest of lower quality than their current one that they could explore for one week without a need to emigrate. We then introduced a second identical low quality new nest and destroyed their old nest so that they had to emigrate. Colonies showed a highly significant preference for the (low quality) novel new nest over the identical but familiar one. In otherwise identical experiments, colonies showed no such discrimination when the choice was between a familiar and an unfamiliar high-quality nest. When, however, either all possible pheromone marks were removed, or landmarks were re-orientated, just before the emigration, the ants chose between identical low-quality new nests at random. These results demonstrate for the first time that ants are capable of assessing and retaining information about the quality of potential new nest sites, probably by using both pheromones and landmark cues, even though this information may only be of strategic value to the colony in the future. They seem capable, therefore, of latent learning and, more explicitly, learning what not to do.