Parents' Perspectives of Family Engagement with Early Childhood Education and Care During the COVID-19 Pandemic.

The COVID-19 pandemic has created significant challenges for Early Childhood Education and Care (ECEC) services and families, impacting family access to services and their communication and engagement with educators. This study aimed to examine parents' perspectives of family engagement with ECEC services during the pandemic. Primary caregivers in Victoria at the time of recruitment (September-November 2020) were invited to participate. Of the 66 participants who completed an online survey, 25 also took part in semi-structured video call or phone interviews; qualitative findings from these interviews are reported in this paper. Four key themes were conceptualised using a reflexive thematic approach: (1) disruptions to ECEC access and attendance impacting on family routines and relationships, and child development; (2) barriers to family engagement; (3) ECEC educators' support of families and children during the pandemic; and (4) increased parental appreciation of the ECEC profession. Findings revealed that disruptions to ECEC access and routines during the pandemic adversely impacted family engagement, and child learning and social-emotional wellbeing for some families. These were aggravated by other stressors, including increased parental responsibilities in the home, financial and health concerns, and changed work conditions. Findings also demonstrated successful methods used by educators to maintain communication and connections with families. Importantly, parents expressed increasing appreciation of the profession and an increased awareness of the value of family involvement in children's learning. Learnings regarding strategies for effective and alternative ways of engaging families are discussed.

Diagnosis of bone cement implantation syndrome using point of care ultrasound examination.

Once regarded as a rare complication, the potentially fatal bone cement implantation syndrome (BCIS) has been increasingly reported. BCIS can present as transient desaturation, hypotension, cardiac dysrhythmias, and cardiovascular collapse. Diagnosis of BCIS is often clinical and confirmed with computed tomography (CT) imaging postoperatively. However, point of care ultrasound (POCUS) examination could be a helpful and timely tool to clinch the diagnosis in a sudden cardiovascular collapse. We present a case of Grade 3 BCIS where POCUS examination revealed a massive clot in the right atrium, which supports the diagnosis.

An Observational Study on Early Empiric versus Culture-Directed Antifungal Therapy in Critically Ill with Intra-Abdominal Sepsis.

Objective. To compare early empiric antifungal treatment with culture-directed treatment in critically ill patients with intra-abdominal sepsis. Methods. A prospective observational cohort study was conducted between August 2010 and July 2011, on SICU patients admitted after surgery for gastrointestinal perforation, bowel obstruction or ischemia, malignancy and anastomotic leakages. Patients who received antifungal treatment within two days of sepsis onset were compared to patients who received culture-directed antifungal treatment in terms of mortality rate and clinical improvement. Patients' demographics, comorbidities, severity-of-illness scores, and laboratory results were systematically collected and analysed. Results. Thirty-three patients received early empiric and 19 received culture-directed therapy. Of these, 30 from the early empiric group and 18 from culture-directed group were evaluable and analysed. Both groups had similar baseline characteristics and illness severity. Patients on empiric antifungal use had significantly lower 30-day mortality (P = 0.03) as well as shorter median time to clinical improvement (P = 0.025). Early empiric antifungal therapy was independently associated with survival beyond 30 days (OR 0.131, 95% CI: 0.018 to 0.966; P = 0.046). Conclusion. Early empiric antifungal therapy in surgical patients with intra-abdominal sepsis was associated with reduced mortality and warrants further evaluation in randomised controlled trials.