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Background: Seven per cent of general waste and 20% of healthcare risk waste produced in acute hospitals in Ireland comes from operating theatres. Surgical wrap comprises 11% of operating theatre waste. Aims: The primary aim of this study was to pilot the implementation of a recycling initiative for surgical instrument set wrap in an operating theatre in Ireland. Secondary aims included quantification of the surgical wrap diverted from general waste to recycling streams over a 5-week period and estimation of the annual carbon emissions associated with gynaecology surgical wrap use in Cork. Methods: The amount of polypropylene surgical wrap generated by a single gynaecology theatre at Cork University Maternity Hospital was prospectively quantified from 24/1/22 to 1/3/22. At the end of the study period, individual sheets of polypropylene wrap were counted and dimensions were measured to calculate the total surface area of surgical wrap saved for recycling. Results: A total of 66 surgeries were performed over the 5-week study period. Two hundred twenty-one individual sheets of surgical wrap were collected, equating to 282.1 m2 of polypropylene wrap. An estimated 11,564 m2 of surgical wrap could be recycled annually from the gynaecology theatre service in Cork with an associated annual carbon emissions equivalent of at least 2.2 tonnes of CO2. Conclusion: Diversion of surgical wrap from general waste and clinical waste streams to the recycling stream is achievable in every operating theatre. Small changes to operating theatre waste disposal practices have the potential to yield significant reductions to theatre waste outputs and to hospital carbon emissions. [ABSTRACT FROM AUTHOR]

NIMH requires intervention research to utilize an experimental therapeutic approach, identifying mediators to examine causal mechanisms of change. The authors propose utilizing self-determination theory (SDT) to guide research design for self-management interventions, using Wellness Recovery Action Plan (WRAP) as an exemplar. To delineate the theory's relevance to self-management interventions and recovery outcomes, the authors describe the main constructs of SDT and demonstrate its applicability to WRAP and recovery. Suggestions for research design and measurement strategies are provided. [ABSTRACT FROM AUTHOR]

Abstract—Experiments on extension of polyethylene film have been performed: the results have been analyzed in order to select wrapping material with optimal properties. [ABSTRACT FROM AUTHOR]

Introduction Gastroesophageal reflux disease is a common condition in pediatric age group. Many surgeons believe that complete fundoplication provides better reflux control, yet it results in more dysphagia and gas-bloat symptoms. On the other hand, a partial wrap is reported to have fewer adverse effects but a higher failure rate in controlling reflux. Until now, there is no agreement and little evidence as to whether complete or partial fundoplication is the optimal procedure in this age group. Patients and methods This is a prospective singleblinded randomized comparative study that included 30 patients who were admitted in the time period from May 2013 to May 2015 and were treated laparoscopically by either Nissen or Thal fundoplication. Results Operative time (minutes) was significantly longer in the Thal group (186 ± 52) when compared with the Nissen group (150 ±48) (P =0.031). Intraoperative complications showed no significant difference when comparing the two groups. Although the incidence of postoperative dysphagia was statistically insignificant, the duration of dysphagia did show significantly shorter duration in the Thal group (median: 6 days), when compared with the Nissen group (median: 17 days). There was no recurrence in the Thal group, whereas there was one recurrence in the Nissen group. Conclusion This study suggests that Thal fundoplication offers an effective alternative to Nissen fundoplication with apparently shorter duration of dysphagia and thus earlier return to the normal eating pattern. Level of evidence: 1b. [ABSTRACT FROM AUTHOR]

In this paper, two modelling systems used for the simulation of water resources management are compared. These modelling systems can be used in the implementation of the European Water Framework Directive or to perform any other kind of integrated assessment with regard to water resources management. In such investigations the use of models is inevitable, as integrated water resources management demands the survey of large areas as well as the inclusion of the different functions of the water cycle and water utilisation processes. Water quantity data provides important input for hydro-chemical, hydro-ecological or hydro-economic models. If no significant water resources management activities are realised in the basin under study, these data can be provided by simple rainfall-runoff models. If significant water resources management activities are realised or planned, the effects of these water resources management activities must be taken into consideration. Then, however, the use of water resources management models becomes necessary. Two such modelling systems, WRAP and WBalMo, are compared. Both have been designed for the development and revision of water resources management plans. Due to different approaches regarding the modelling routines the models lead to different results in the calculation of water quantities. By tracking the simulation algorithms, an understanding of the detected differences becomes possible. By adapting the spatial configuration of the modelled system, equivalent results can be obtained. [ABSTRACT FROM AUTHOR]

This article examines four leading multi-stakeholder labour monitoring organizations. All operating in the maquiladora industry, these organizations are viewed in light of the growing global trend toward industry self-regulation, or what has been referred to as the ‘global out-sourcing of regulation’. Their Board compositions, codes of conduct and monitoring and enforcement strategies are all examined as a means of tentatively positioning these organizations along an ‘egoist-instrumentalist-moralist’ ethical culture continuum. Such a framing provides insights into the perceived salience of these organizations’ broader stakeholders, the effectiveness of codes of conduct on workplace practices more generally, and the role that ethics plays in the governance and accountability of these increasingly important types of organizations. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the clinical outcome for patients treated with walking cast immobilization and wrap early mobilization after surgical repair of acute Achilles tendon ruptures. A total of 39 consecutive patients with complete ruptures of the Achilles tendon were identified, treated, and functionally rehabilitated with either a walking cast or a wrap. Because the randomization was quasi-random, chi-square and t-tests were performed to compare the baseline characteristics. A statistically significant difference was present only for the injured side (p<0.05). Therefore, groups were considered comparable for analysis of outcome. All patients were evaluated at an average follow-up of 6.7 years (range 5–8 years). Functional postoperative treatment with a wrap allowed a significantly shorter hospital stay (p<0.05) as well as a shorter period to return to pre-injury sports level (p<0.01) compared with treatment with a walking cast. According to the modified Rupp score, 91.3% of patients in the walking cast group had a good or excellent result, as did 93.8% in the wrap group (p=0.9). Slight atrophy of the calf muscles was reported in 3 patients in the walking cast group (13.0%) and in 4 in the wrap group (25.0%). One re-rupture was reported in the walking cast group (4.3%). Functional treatment after surgical Achilles tendon repair is safe, and there is no increased risk of re-rupture or wound healing problems. Functional treatment with a wrap is preferable to treatment with a walking cast with respect to hospitalization time and return to sports. [ABSTRACT FROM AUTHOR]

The aim of the present study was to describe and assess a new method of fixation using a self-adhesive prosthesis (Adhesix™) in laparoscopic ventral rectopexy (LVR). The technical principles are based on a very low dissection and the adhesive properties of the prosthesis which can be applied to the rectum without stitches or staples. The prosthesis is made from polypropylene coated with a synthetic hydrogel. The binding of the prosthesis to rectum and vagina takes place in a wet environment after a few minutes and enables the shaping of the mesh on the surface of the rectum (wrap effect). Between March 2010 and March 2013, 41 patients were operated on using LVR with a self-adhesive prosthesis. The effectiveness of prosthesis fixation was evaluated in a subset of 27 patients suffering from complete rectal prolapse. With a median follow-up of 30 months, there were no major complications and no recurrence. In this initial experience, LVR with a self-adhesive prosthesis does not increase the risk of recurrence. No undesirable effects were associated with the prosthesis. [ABSTRACT FROM AUTHOR]

Vein grafts have been used to cope with several problems in peripheral nerve surgery, including vein wrapping of scarred nerves involved in chronic pain syndromes, vein caps for recurrent end-stump neuromas, vein conduits for nerve gaps after resection of neuromas-in-continuity, and following trauma. From 1993–1997, 30 vein grafts were performed in 28 patients. Five chronic peripheral nerve pain syndromes were treated by vein wrapping for two ulnar, two median and one radial sensory nerve, with significant pain resolution in all cases. Two recurrent digital neuromas were treated with vein caps, with pain resolution in each case. Nine patients with neuromas-in-continuity underwent neuroma resection and nerve repair with vein conduits. Twelve patients (14 nerves) underwent primary or delayed repair with vein conduits for nerve gaps following trauma. Sensory return measured by two point discrimination after repair of nerve gaps, following either neuroma-in-continuity resections or trauma, was 5–10 mm in 17 digital or common digital nerve injuries, and greater than 10 mm in three radial sensory nerve injuries. [ABSTRACT FROM AUTHOR]

The evaluations of water quantity and quality and then modeling of its phenomenon are required for water quality protection in Brady Creek watershed. This study is to predict the monthly flow, reservoir storage volume, and salinity; estimate the benefit of brush and aging flood-retardation dam control; and evaluate the impact of evaporation and discharge from Waste Water Treatment Plans (WWTP). The Soil and Water Assessment Tool (SWAT) model is verified with the monthly flow developed for pre-dam construction condition and shows the difference of − 9% and 10% than measured average flow for calibration and validation periods, respectively. The SWAT monthly flows are adjusted by 1963–2010 yearly conversion factors and are used as the input in the Water Rights Analysis Package (WRAP) model. The WRAP model verified with measured reservoir storage volume and total dissolved solid shows the average differences of simulated reservoir storage volume and salinity by − 13% lower and 11% higher for calibration period and 0% and 3% higher for validation period than measured average value, respectively. The impacts from brush and dams controls increase the runoff but also increase the water quality parameters. The impact of evaporation and WWTP discharge provide the information of relative impact for watershed phenomenon. [ABSTRACT FROM AUTHOR]

An application of the rectus abdominis muscle flap to salvage an infected prosthetic graft of the ascending thoracic aorta is presented. The length of this flap along with its width and thickness allows it to be wrapped around prosthetic grafts of the ascending aorta in a spiral fashion. This rectus muscle wrap around flap method is straightforward involving the use of one muscle rather than multiple muscles. The abdominal cavity is not opened as with the use of omentum. The procedure can be accomplished in a short time which is important in the critically ill patient. [ABSTRACT FROM AUTHOR]