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

Cross-cultural differences in supportive responses to positive event disclosure

Perceived reactions to sharing of good news (capitalization), can have important implications for romantic relationships. Typically, when European Americans perceive that their partners respond in an active constructive (versus passive and/or destructive,) manner, they tend to perceive their partners as more responsive and report higher relationship quality. RHowever, cross-cultural differences in norms can influence peoples’ preference for different capitalization responses and whether different capitalization responses convey partner responsiveness. In a combined sample of European Americans, East, and South Asians (N = 915), we investigated whether links among capitalization responses, perceived partner responsiveness, and relationship quality differed by culture. People who perceived active constructive and passive destructive responses reported higher and lower levels of partner responsiveness and relationship satisfaction, respectively. Further, European Americans who perceived active destructive, and European Americans and East Asians who perceived passive constructive, responses, reported less partners responsiveness and relationship satisfaction. South Asians who perceived passive constructive responses reported greater partner responsiveness and relationship satisfaction. East and South Asians who perceived active destructive responses did not differ in relationship satisfaction. Our findings provide a cross-cultural perspective on the study of romantic couples’ positive event disclosure and expand capitalization research to an understudied sample of South Asians

Cross-cultural differences in supportive responses to positive event disclosure

Perceived reactions to sharing of good news (capitalization), can have important implications for romantic relationships. Typically, when European Americans perceive that their partners respond in an active constructive (versus passive and/or destructive,) manner, they tend to perceive their partners as more responsive and report higher relationship quality. RHowever, cross-cultural differences in norms can influence peoples’ preference for different capitalization responses and whether different capitalization responses convey partner responsiveness. In a combined sample of European Americans, East, and South Asians (N = 915), we investigated whether links among capitalization responses, perceived partner responsiveness, and relationship quality differed by culture. People who perceived active constructive and passive destructive responses reported higher and lower levels of partner responsiveness and relationship satisfaction, respectively. Further, European Americans who perceived active destructive, and European Americans and East Asians who perceived passive constructive, responses, reported less partners responsiveness and relationship satisfaction. South Asians who perceived passive constructive responses reported greater partner responsiveness and relationship satisfaction. East and South Asians who perceived active destructive responses did not differ in relationship satisfaction. Our findings provide a cross-cultural perspective on the study of romantic couples’ positive event disclosure and expand capitalization research to an understudied sample of South Asians

International Workshop on Globalization, Education and Social Futures cum postgraduate student sharing session

With particular reference to the changing expectations of education and the growing concerns of mismatch of skills being found in the labour market, the International Workshop critically examines how the growing influence of globalization has affected educational development and governance, as well as reflecting upon social futures in Europe and East Asia. Specific attention is given to examine skill formation, changing labour needs and how educational institutions have responded to prepare students and graduates to become more adaptive and competitive in the intensified global market place. A special session is organized for postgraduate students to share their research with special focus on reflections on research methodology with leading speakers at the workshop

Delayed Neuropathy Due to Organophosphate Insecticide Injection in an Attempt to Commit Suicide

Organophosphates (OPs) are commonly used as pesticides throughout the world. Exposures to OPs cause a significant number of poisonings and deaths every year. Organophosphate-induced delayed polyneuropathy is a sensory-motor distal axonopathy which usually occurs after exposure of certain OP insecticides. Neuropathies due to ingestion of OPs have rarely been reported in the literature. Moreover, until now, there is no report of a patient developing organophosphorus injection-induced delayed neuropathy in the literature. We report a patient with serious organophosphorus-induced delayed neuropathy due to malathion injection. The patient was a 32-year-old female who self-injected undetermined amounts of malathion over the median nerve trace on the forearm crease in a suicide attempt which resulted in peripheral neuropathy

Effects of Erythropoietin on Hyperoxic Lung Injury in Neonatal Rats

Pulmonary oxygen toxicity is believed to play a prominent role in the lung injury that leads to the development of bronchopulmonary dysplasia (BPD). To determine whether human recombinant erythropoietin (rhEPO) treatment reduces the risk of developing BPD, we investigated the effect of rhEPO treatment on the histopathologic changes seen in hyperoxia-induced lung injury of BPD. Twenty-five rat pups were divided into four groups: air-exposed control group (n = 5), hyperoxia-exposed placebo group (n = 7), hyperoxia-exposed rhEPO-treated group (n = 6), and air-exposed rhEPO-treated group (n = 7). Measurement of alveolar surface area, quantification of secondary crest formation, microvessel count, evaluation of alveolar septal fibrosis, and smooth muscle actin immunostaining were performed to assess hyperoxia-induced changes in lung morphology. Treatment of hyperoxia-exposed animals with rhEPO resulted in a significant increase in the mean alveolar area, number of secondary crests formed, and the microvessel count in comparison with hyperoxia-exposed placebo-treated animals, There was significantly less fibrosis in rhEPO-treated animals. However. treatment of hyperoxia-exposed animals with rhEPO did not result in a significant change in smooth muscle content compared with hyperoxia-exposed placebo treated animals. Our results suggest treatment with rhFPO during hyperoxia exposure is associated with improved alveolar structure. enhanced vascularity. and decreased fibrosis. Therefore. we conclude that treatment of preterm infants with EPO might reduce the risk of developing BPD

Osseointegration in arthroplasty: can simvastatin promote bone response to implants?

Cementless fixation depends on bone ingrowth for long-term success. Simvastatin as a lipid lowering agent has been demonstrated to have osteoanabolic effects. This study was designed to measure the possible effect of simvastatin on implant osseointegration. Bilateral femoral implantation of titanium cylinders was performed in 20 rabbits. Blood lipid levels were measured pre- and postoperatively. Scanning electron microscopy (SEM) was used to measure the percentage of the surface of each implant in contact with bone and mechanical pull-out testing was performed. The blood lipid levels were significantly reduced in the simvastatin group. Histomorphometric examination revealed increased bone ingrowth and mechanical examination showed increased interface strength in the simvastatin group. Mechanical and histological data showed superior stability and osseous adaptation at the bone/implant interface for the simvastatin group. We conclude that simvastatin has potential as a means of enhancing bone ingrowth, which is a key factor in the longevity of cementless implants