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

Effects of dynamic stretches on Isokinetic hamstring and Quadriceps femoris muscle strength in elite female soccer players

This study investigated the effects of dynamic stretches on isokinetic hamstring (H) strength, quadriceps femoris (Q) strength, and the H/Q ratio in elite female soccer players. Fifteen elite female soccer players (age: 22.13±2.69; height: 164.53±7.57; weight: 57.8±7.86) participated in the study. The length of the lower extremity and the circumference of the thigh were measured for each subject. On different days, isokinetic muscle strength of the participants was measured twice using a Biodex dynamometer and concentric/concentric 60˚/s, 180˚/s and 300˚/s test protocols. Knee flexion-extension range of motion (ROM) was measured using goniometry at two different times. After a non-stretching warm-up, the peak torque (PT) of the H and Q muscles at 60˚/s, 180˚/s and 300˚/s were measured. The H/Q ratios were calculated for 60˚/s, 180˚/s and 300˚/s. In addition, the PT values for the latter were calculated after dynamic stretches for H and for Q. Comparisons between the H and Q measurements showed a significant difference between peak torques, H/Q ratios, and ROM (p<0.01). In conclusion, dynamic stretches have positive effects on muscle strength, H/Q ratios and ROM. Therefore, dynamic stretches may increase performance and reduce the risk of injury to athletes.Keywords: Quadriceps; Hamstrings; Muscles Isokinetic; Dynamic stretchesSouth African Journal for Research in Sport, Physical Education and Recreation, 2012, 34(2): 15-25

The postgraduate students’ (masters, PhD) metaphors about education of statistic

Statistics is an important part of our life when it comes to economy, education, sport, politics and research. Research is a primary job for the ones pursuing academic career and statistics is one of the basic components of a research. Metaphor is used as an equivalent to figurative expression (‘mecaz’ in Turkish language). Study group is composed of 19 females (age 27.7) and 40 males (age 30.85) - 59 students in total. Demographic information of participants was collected. Participants were provided with questionnaire in order to assess their metaphorical creation whereby they were asked to fill in the sentence - “statistics is like/ similar to …, because…” - with metaphor. The study has collected total of 59 metaphors in 6 categories. The most created metaphor is in ‘discovering/ revealing’ category. 42.5% of Master’s students and 25% of PhD students are in this category. Metaphors created by graduate students are representing their views about statistics course and hence their view about importance of research. The category ‘discovering/ revealing’, the one with the most created metaphor of this study, is the main concept of science. Consequently, good knowledge of statistics is needed for graduate students to conduct research

The postgraduate students’ (masters, PhD) metaphors about education of statistic

Statistics is an important part of our life when it comes to economy, education, sport, politics and research. Research is a primary job for the ones pursuing academic career and statistics is one of the basic components of a research. Metaphor is used as an equivalent to figurative expression (‘mecaz’ in Turkish language). Study group is composed of 19 females (age 27.7) and 40 males (age 30.85) - 59 students in total. Demographic information of participants was collected. Participants were provided with questionnaire in order to assess their metaphorical creation whereby they were asked to fill in the sentence - “statistics is like/ similar to …, because…” - with metaphor. The study has collected total of 59 metaphors in 6 categories. The most created metaphor is in ‘discovering/ revealing’ category. 42.5% of Master’s students and 25% of PhD students are in this category. Metaphors created by graduate students are representing their views about statistics course and hence their view about importance of research. The category ‘discovering/ revealing’, the one with the most created metaphor of this study, is the main concept of science. Consequently, good knowledge of statistics is needed for graduate students to conduct research

Solid phase extractive preconcentration of trace metals using p-tert-butylcalix[4]arene-1,2-crown-4-anchored chloromethylated polymeric resin beads

5,11,17,23-Tetrakis(1,1-dimethylethyl)-25,26-dihydroxy-27,28-crown-4-calix[4]arene in the cone conformation was synthesized. This p-tertbutylcalix[4]arene-1,2-crown-4 compound was then anchored with Merrifield chloromethylated resin beads. The modified polymeric resin was characterized by H-1 NMR, FT-IR and elemental analysis and used successfully for the separation and preconcentration of Cu(II), Cd(II), Co(II), Ni(II) and Zn(II) prior to their determination by FAAS. Effective extraction conditions were optimized in both batch and column methods. The resin exhibits good separating ability with maximum between pH 6.0-7.0 for Cu(II), pH 6.0 for Cd(II), pH 5.0 for Co(II), pH 4.0-4.5 for Ni(II), and pH 4.5 for Zn(H). The elution studies were carried out with 0.5 mol L-1 HCL for Cu(II), Co(II) and Co(II), 1.0 mol L-1 HCl for Cd(II) and Zn(II). The sorption capacity, preconcentration factor and distribution coefficient of each metal ion were determined. The detection limits were 1.10, 1.25, 1.83, 1.68 and 2.01 mu g L-1 for Cu(II), Cd(II), Co(II), Ni(II) and Zn(II). The influence of several ions on the resin performance was also investigated. The validity of the proposed method was checked for these metal ions in NIST standard reference material 2709 (San Joaquin Soil) and 2711 (Montana Soil). (c) 2006 Elsevier B.V. All rights reserved

The Palu-Uluova Strike-Slip Basin in the East Anatolian Fault System, Turkey: Its Transition from the Palaeotectonic to Neotectonic Stage

The East Anatolian fault system (EAFS) is the 80-km-wide, 700-km-long, NE-trending sinistral strike-slip fault system forming a seismically very active intracontinental transfom fault boundary. It is located between Karhova County in the northeast and Karatas-Samandag counties in the southwest, and forms the southeastern boundary of the Anatolian platelet. The Palu-Uluova basin is one of several strike-slip basins located along the EAFS. It is surrounded by several push-ups such as the Karaomerdagi, Mastardagi and Askerdagi push-ups caused by the complexities peculiar to strike-slip faulting. The Palu-Uluova basin consists of three sub-sections: two are NE-trending strike-slip sub-basins, the Uluova and the Palu-Kumyazi sub-basins, while the third is a ramp basin, the E-W-trending Yolustu basin which links the earlier two sub-basins. The Palu-Uluova basin is characterized and shaped by a 130-m-thick neotectonic basin infill (Palu Formation) and a series of bounding strike-slip fault zones such as the Sivrice, Adiyaman, Uluova, Elazig, Pertek and Yolustu fault zones. The Palu Formation is an undeformed fluvio-lacustrine sedimentary sequence. The youngest palaeotectonic rock-stratigraphic unit is the Upper Miocene-Lower Pliocene caybagi Formation, deposited in a ramp type of intermontane basin bounded and controlled by the reverse faults. The caybagi Formation is intensely deformed (steeply tilted, folded and thrust to reverse-faulted) on a regional (mappable) scale. The compressional deformation pattern of the Caybagi Formation is truncated, sealed and overlain with angular unconformity by the nearly horizontal undeformed Plio-Quaternary Palu Formation. This regional angular unconformity reflects: (a) a series of pre-Late Pliocene regional tectonic inversions (e.g., type of the tectonic regime, style of deformation and nature of magmatic activity), and (b) the timing of the major transition from the folding and thrust to reverse faulting-dominated palaeotectonic period into the strike-slip faulting-dominated neotectonic period is Late Pliocene

Influence of the long term use of a computer on median, ulnar and radial sensory nerves in the wrist region

Objectives: Repetitive microtrauma or overuse injuries may often affect upper extremities of the long term computer users. The aim of this study was to compare sensory nerve conduction velocities (SNCV) for median, radial and ulnar nerves in the wrist of computer users with the same parameters in controls who do not use computers regularly. Material and Methods: Twenty one male computer users (age: mean (M) = 28.3 years ± standard deviation (SD) = 7.5 years) and 21 male control subjects (age: M±SD = 24.1±4.6 years) were recruited for the study. Limb length and the perimeters of the dominant arm and forearm were measured for each subject. The neurophysiological study consisted of measuring sensory nerve conduction of the median, ulnar and radial nerves. Results: The sensory conduction velocities of both median and ulnar nerves were significantly delayed in the dominant arm of the computer users compared to the controls. In addition, sensory conduction velocity of the median nerve was significantly delayed in the dominant extremity of the computer users compared to their non-dominant extremity. Conclusions: This study shows that computer users have a tendency toward developing median and ulnar sensory nerve damage in the wrist region. Mechanism of delayed SNCV in the median and ulnar nerves may be due to sustained extension and ulnar deviation of the wrist during computer mouse use and typing. Reduced SNCV changes were more apparent on the dominant side of the median nerve. This may indicate the increased neural deficits related to an increased use of the dominant side. Further investigation is needed to determine how to reduce potential risk factors at this stage in order to prevent development of median or ulnar neuropathy in the long term computer users

Determination of nursing students’ self-efficacy belief levels in anatomy lectures

The Anatomy is the most basic lecture of the departments that give health education. The human anatomy is need to be comprehended to success in nursing field. Anatomy subjects are taught independently in each committee in Nursing Department that is in School of Health in Kocaeli University. The aim of our study is assessment of the impact of the Anatomy lectures on Anatomy Self-Efficacy Beliefs of nursing students. Totally 95 students (mean of ages 19,13 ± 1,595) who are 25 boys (%26,3) and 70 girls (%73,7) attended to our research. Anatomy Self-Efficacy Belief (ASEB) scale and personal information survey(age, gender, the geographical region that he/she came from, the place that he/she resides) are applied to these students. Statistically, when the relation between ASEB levels of the students and their residences was assessed, it is found that there is a significant difference on between the ASEB levels of the students who reside in dormitory and that of the students who reside at home (p<0.05). This outcome makes think that the residences of students can be effective on their success levels on the lectures. Due to the fact that dormitories that are in campus are close to the university, the attendances of lectures of students who reside in dormitory are more than the others and it shows that these students are able to study better than the others

Determination of nursing students’ self-efficacy belief levels in anatomy lectures

The Anatomy is the most basic lecture of the departments that give health education. The human anatomy is need to be comprehended to success in nursing field. Anatomy subjects are taught independently in each committee in Nursing Department that is in School of Health in Kocaeli University. The aim of our study is assessment of the impact of the Anatomy lectures on Anatomy Self-Efficacy Beliefs of nursing students. Totally 95 students (mean of ages 19,13 ± 1,595) who are 25 boys (%26,3) and 70 girls (%73,7) attended to our research. Anatomy Self-Efficacy Belief (ASEB) scale and personal information survey(age, gender, the geographical region that he/she came from, the place that he/she resides) are applied to these students. Statistically, when the relation between ASEB levels of the students and their residences was assessed, it is found that there is a significant difference on between the ASEB levels of the students who reside in dormitory and that of the students who reside at home (p<0.05). This outcome makes think that the residences of students can be effective on their success levels on the lectures. Due to the fact that dormitories that are in campus are close to the university, the attendances of lectures of students who reside in dormitory are more than the others and it shows that these students are able to study better than the others