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

Instructional materials as determinants of students’ academic performance at the secondary school level In Ikorodu local government, Lagos State, Nigeria

This study was carried out to find out the effects of instructional resources on the academic achievement of secondary school students. The study is descriptive in nature and it adopted a survey design. Stratified random sampling technique was used for the selection. This therefore gives 29.8 respondents from teachers and 251.2 students making a total of 281 respondents. Teachers and students in the sampled schools were administered, an investigator – constructed questionnaire. Two research questions were raised for the study. Data collected were analyzed using simple percentages. The findings showed that instructional resources play a significant role in enhancing performance of students in schools. Furthermore, the results revealed that schools with adequate quality of teachers and enough instructional material resources showed superiority in academic achievements test than schools without adequate teacher quality and instructional material resources. As seen in the findings from this research, it could be easily concluded that the main reason for lack of proper use of instructional materials in the secondary schools is the lack of users’ education. The study therefore concludes that if authorities and staff should take this up as an urgent responsibility to build the expected capacity by orientating the users of the available instructional materials properly, improper use of available instructional materials will be curbed in Nigerian especially in the secondary schools setting.Keywords: Education, instructional resources, instructional materials, academic qualit

Diptheria in Nigeria: is there resurgence?

Reported cases of diphtheria from Nigeria have been reducing since the beginning of the millennium even though coverage with diphtheria, pertussis, tetanus (DPT) vaccine has only been low to moderate. Accordingly only sporadic cases of diphtheria have been managed in the past in our hospital. However the occurrence of five cases in the period of one year raises questions on the status of diphtheria control in Nigeria. We present the clinical and sociodemographic features of the cases and discuss the implications of a rising incidence of diphtheria. We conclude by noting the need for health care workers to have a high index of suspicion in children with no, incomplete or uncertain immunization status who present with symptoms of pharyngo-tonsillar disease and by a call for the strengthening of routine immunization services in Nigeria

An assessment of the willingness of patients in hospitals in Benin city to give consent to clinical research

Background: Clinical research directly involves the use of materials of human origin, such as tissue samples, obtained through direct contact with a particular living person that volunteers and agrees to participate in a research study. An ethical background where informed consent is sought from patients before engaging them is necessary in any research for credibility.Objective: The study ascertained the willingness of patients in hospitals in Benin City to consent to research and the factors associated with it.Materials/method: A descriptive cross-sectional study was done, and information was obtained through interviewer administered questionnaires. Stratified sampling method was used to recruit respondents and data was analyzed using SPSS 16.0. P value was set at <0.05.Results: About 62.5% of the respondents would consent to clinical research. Among those willing to consent to research, 92% were influenced by improved health outcome, 62.7% minimal harm, 40.7% cordial relationship with the researcher and 26.7% wanted payment for participation. Factors affecting willingness to consent were information on the possible side effects (72.9%), benefits of participation (68.8%), Permanent cure (73.8%), insurance in place for health risks (65.0%), reduction in the cost of management (58.8%).Conclusion: There was willingness among patients in hospitals in Benin City to give consent to research.Key words: Consent, Medical research, Willingness, Patients

Diphtheria in Nigeria: is there resurgence?

Reported cases of diphtheria from Nigeria have been reducing since the beginning of the millennium even though coverage with diphtheria, pertussis, tetanus (DPT) vaccine has only been low to moderate. Accordingly only sporadic cases of diphtheria have been managed in the past in our hospital. However the occurrence of five cases in the period of one year raises questions on the status of diphtheria control in Nigeria. We present the clinical and sociodemographic features of the cases and discuss the implications of a rising incidence of diphtheria. We conclude by noting the need for health care workers to have a high index of suspicion in children with no, incomplete or uncertain immunization status who present with symptoms of pharyngo-tonsillar disease and by a call for the strengthening of routine immunization services in Nigeria

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 coprioritized 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