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Human actions have led to a range of global environmental changes. Health professionals must be prepared to deliver systemic changes to mitigate and adapt to the ecological crisis. This rapid review aimed to describe exemplar frameworks that inform planetary health education across health professions. The rapid review methodology was informed by a scoping review process. A targeted search strategy was conducted using one representative database and additional strategies such as expert consultation and citation searching were used. Results are described narratively. Of the 11 637 articles, 17 were eligible for inclusion. The frameworks differed, with many recently developed for health professions broadly using a range of methodologies, including qualitative research, opinion/consensus data, literature reviews, and adaptation of previous models. Models such as metric‐based scoring indicators and Sustainable Quality Improvement were featured in the frameworks, as were the application of First Nations Natural Laws. This rapid review identifies and showcases accessible, interdisciplinary frameworks to inform the integration of planetary health in curricula, highlighting a rapidly evolving field through which interdisciplinary collaborations in healthcare are important to inform its pedagogy and application. Health education is an important component of health promotion; and thus this rapid review offers a range of approaches that health professionals, health promotion practitioners, and educators can use to inform the integration of planetary health, including sustainable healthcare, into curricula. Educational frameworks are informed by research and practice and provide key guidance to practitioners and educators; summarising key available planetary health education frameworks consolidates and guides effective education and builds on the existing body of knowledge to support urgent pro‐environmental change.

(Int J Obstet Anesth.2023;55:103893/https://doi.org/10.1016/j.ijoa.2023.103893/)Postpartum hemorrhage (PPH) is a significant contributor to preventable maternal morbidity and mortality, necessitating a comprehensive, interdisciplinary approach. Recognizing the urgency, the American College of Obstetricians and Gynecologists advocates adopting PPH bundles to ensure prompt identification and intervention. Obstetric anesthesiologists, possessing expertise in critical care and transfusion, are integral to the resuscitation efforts in PPH. Nevertheless, their involvement in implementing PPH bundles is inconsistent, prompting the need for a more dedicated focus on predelivery risk assessment, early recognition, and institutional protocol development.

Elderly cardiac patients are often excluded from exercise programmes following acute myocardial infarction (AMI) despite proven benefits in younger patients. To evaluate potential benefits that elderly patients might gain from exercise programmes, 20 consecutive patients over 65 years of age, who were entered into our rehabilitation programme within 6 weeks of AMI, were studied. All patients performed symptom or ischaemialimited exercise tests before and after completion of the exercise programme. Patients were aged 65-77 years (mean 69.5 years). Six patients were tested using a Bruce protocol and 14 with a modified Bruce protocol. In 9 patients, tests were limited by ischaemia, determined by ST depression of at least 2 mm in three leads. Between tests, resting (75 to 76 beats/min) and maximal (129 to 126 beats/min) heart rates were unchanged. Using the same protocol in both tests, exercise time on the treadmill increased in 14 patients from 9 minutes, 17 seconds to 11 minutes, 24 seconds (P<0.05) and workload increased in the same 14 patients from 7 to 8.5 METS (P<0.05). Of the 9 patients whose initial tests were limited by ischaemia, 6 showed a longer time to onset of ischaemia and 3 were unchanged (P=0.05). All patients felt they had benefited from participation in the programme. Results suggest that benefits of exercise programmes seen following AMI in young patients may be expected in elderly patients and that elderly patients should therefore be encouraged to participate in exercise programmes following AMI.

Following acute myocardial infarction (AMI), anxiety and depression usually occur early after discharge at a time of transition from highly supervised care to little support at home. In 1993 we initiated a 'fast-track' programme, starting full cardiac rehabilitation within 14 days of AMI. Retrospectively, we analysed and compared records of the first 100 patients to enter the fast-track programme with the last 100 patients to enter the standard programme (rehabilitation starting 4-6 weeks following AMI) with follow-up of 42 months. Satisfactory records for 90 standard and 93 fast-track patients aged 27-64 years were obtained. Over 90% of patients completed rehabilitation with high satisfaction levels. Ages of both groups were the same (median 51 vs 52 years). Standard rehabilitation commenced 26-176 (median 54) days after AMI and fast-track rehabilitation commenced at 6-38 (median 12) days. No deaths from ischaemic heart disease occurred in either group. Coronary angiography was undertaken in 29 standard and in 30 fast-track patients. Revascularization was undertaken in 19 standard and in 17 fast-track patients. Hospital activity analysis showed that 25 standard and 21 fast-track patients were readmitted under a cardiologist (excluding intervention admissions). Some patients had multiple cardiology readmissions, making 48 episodes in the standard group and 28 in the fast-track group. This observation concurs with our impression that more fast-track patients rehabilitate satisfactorily. This experience shows that patients appreciate and attend early rehabilitation, which appears safe. A randomized controlled trial is planned to assess whether early rehabilitation improves outcomes following AMI and reduces costs of unnecessary admissions.

Abstract: Beetles (Coleoptera) harbor many species ofAcholeplasma andSpiroplasma (division Tenericutes, class Mollicutes). Mollicutes were isolated from guts and/or hemocoels of firefly beetles (Lampyridae) from the United States (Maryland and West Virginia), Ecuador, and Tobago. Firefly beetles were frequent hosts for the group XIV spiroplasma, isolated from Ellychnia corrusca, and the group XIX spiroplasma, isolated fromPhoturis spp. The most unusual feature of the firefly-mollicute association is the carriage of four Mycoplasma species. Recent phylogenetic studies indicate that these species are members of a clade that includes a vertebrate pathogen,Mycoplasma mycoides. The high rate of occurrence ofMycoplasma species (which are, otherwise, infrequent in insects) in lampyrid beetles suggests that the association is significant. The unusual light-producing physiology of lampyrids (which is dependent on large pools of energy) and the production of large amounts of cardenolides from cholesterol (a critical growth factor for many mollicutes) may favor colonization by mollicutes.

Essential facts Oxygen is one of the most commonly used drugs in emergency medicine and before publication of the first British Thoracic Society (BTS) 2008 guideline, emergency departments and ambulance services gave oxygen to almost all breathless or seriously ill patients.