Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Implementation Reality of Mathematics Teachers of Higher-Order Problems Thinking Skills at Primary School

This study aimed to identify the reality of mathematics teacher’s use of higher-order thinking skills at primary school. To investigate this, the researchers recruited a random sample of 197 teachers and used an observation card on a random sample of 92 primary school mathematics. The credibility of the investigator and the observation card was checked. Results of the study showed that the implementation of mathematics teachers in primary school to issues of higher-order thinking skills varied in responses between medium and high, from their point of view. While it became clear by observing their teaching in the classroom that the implementation of the issues of higher-order thinking skills actually ranged between weak and high. This indicates a disparity between the standpoint of mathematics teachers and what was observed, and that there are significant differences between the average score of their point of view and what has been seen from the practices. These differences indicated that the reality of the implementation of mathematics teachers in primary school to issues of higher-order thinking from the teachers ’perspective is higher than their implementation it

Overview of Whole-building Energy Engines for Investigating Energy-related Systems

With the rapid importance of high-performance energy modeling of buildings, whole-building energy simulation engines are rapidly used in the decision-making process. However, there are tens of engines in the market, which makes the choice of design engine very challenging. This article provides a comparison of the applications of whole-building energy simulation to predict a significant number of systems. As a result, the selected engines will be compared to establish their characteristics and abilities. Nevertheless, the focus will be placed on: generic criteria; envelope; lighting; service hot water; Heating-ventilation; and renewable systems. However, the authors found that an engine could be used extensively in one system and has limited capabilities in another system

Future orientation and adverse outcomes of peer victimization among African American adolescents

Contains fulltext : 219571.pdf (Publisher’s version ) (Closed access)The present study examines whether positive future orientation might buffer the association between peer victimization and adverse outcomes from a sample of urban African American adolescents. More specifically, it was hypothesized that peer victimization would be significantly associated with internalizing problems, a decline in school grade, substance use, peer aggression, and suicidal thoughts. It was also hypothesized that positive future orientation would moderate the link between peer victimization and these outcomes. Cross-sectional research was conducted in Chicago's Southside, and the study comprised a sample of 638 African American adolescents, ages 13 to 24. Analyses for the study consisted of descriptive statistics, bivariate correlation, and ordinary least squares regression. Peer victimization was found to be directly associated with internalizing problems, peer aggression, and suicidal thoughts. Positive future orientation was also found to buffer the association between peer victimization and peer aggression and suicidal thoughts. It is important for researchers to identify protective psychological resources in the various high-risk neighborhood that can buffer the association between victimization and psychosocial problems. It is also imperative that victims of bullying are involved in programs that foster positive development and reduces the likelihood of psychosocial problems and problematic behaviors.19 p

PREVALENCE OF THROMBOPHILIC GENETIC FACTORS AMONG PATIENTS WITH RETINITIS PIGMENTOSA

Purpose:To determine the prevalence of thrombophilic factors in patients with retinitis pigmentosa (RP).Methods:Fifty consecutive patients with RP and 50 controls matched by age and gender were tested for the presence of the following mutations: factor II (GA20210), factor V Leiden (GA1691), methylenetetrahydrofolate reductase (CT677), factor XIIIa (Val(34)Leu), -fibrinogen (GA455), tumor necrosis factor receptor (TNFRII) (M196R), plasminogen activator inhibitor-1 (PAI-1) (4 G/5 G), and plasminogen activator inhibitor-1 (PAI-1) (GA844).Results:The following heterozygous mutations were found in patients/controls: factor V Leiden (12/14), factor XIIIa (20/30), methylenetetrahydrofolate reductase 677 TT (48/52), -fibrinogen GA455 (36/36), TNFRII (M196R) (40/42), PAI-1 4 G/5 G (40/48), and PAI-1 GA844 (50/52). The difference between patients with RP and the control group was not statistically significant for the prevalence of any of the studied factors (P > 0.05).Conclusion:In this study, thrombophilic mutations were not increased in patients with RP. Thrombophilic mutations do not seem to be risk factors for RP. Routine investigation of hereditary thrombophilia in these patients is not justified