Rising global temperatures will have a radical impact on the environment where global warming is associated with weather extremes such as thunderstorms and droughts which can affect the regional ecosystems. The healthcare sector is a major emitter of greenhouse gasses. Within healthcare, the outpatient clinic is responsible for a considerable sum of emissions. These can be organized under scopes 1, 2 and 3 as described in the Greenhouse Gas Protocol where scope 1 accounts for direct emissions from healthcare facilities, scope 2 is emissions from purchased electricity and scope 3 is indirect emissions including procurement and waste. Emissions and mitigation strategies from the surgical outpatient clinic are outlined under each scope of the Greenhouse Gas Protocol. These include using insulation materials, renovating or building new facilities, incorporating renewable energy sources and utilizing more efficient appliances. Telehealth and virtual clinics have been shown to be an effective method of delivering care while avoiding the combustion of fossil fuels to facilitate patient transport. In addition, virtual set-ups are cost effective and have not been proven to compromise patient safety when implemented correctly.
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http://dx.doi.org/10.1016/j.surge.2024.06.005 | DOI Listing |
J Binocul Vis Ocul Motil
January 2025
Department of Ophthalmology, Vanderbilt Eye Institute, Nashville, Tennessee.
Parinaud syndrome, also known as dorsal midbrain syndrome, is a condition affecting the dorsal midbrain region of the brainstem that presents with a triad of ophthalmic clinical findings, including upgaze paresis, convergence retraction nystagmus, and light-near dissociation. This case report will discuss the clinical presentation of Parinaud syndrome in a four-year-old patient who was seen in an out-patient clinic for intermittent exotropia 5 months after a suboccipital craniotomy resection of a pineal mass and ventriculoperitoneal (VP) shunt placement for associated hydrocephalus. Current literature is relatively sparse regarding the presentation of Parinaud syndrome in the pediatric population, with little known about prognosis and potential for recovery.
View Article and Find Full Text PDFSovrem Tekhnologii Med
January 2025
MD, DSc, Professor, Head of the Laboratory of Optical Coherence Tomography Research Institute of Experimental Oncology and Biomedical Technologies; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia.
Unlabelled: is to demonstrate the effect of fractional CO laser treatment on vulvar skin in lichen sclerosus using multimodal optical coherence tomography (MM OCT).
Materials And Methods: The study included 3 clinical cases of vulvar lichen sclerosus (VLS) (histologically classified as early, early with dermal edema, late) and 2 control cases without vulvar pathology. Patients with VLS underwent 3 procedures of fractional CO laser treatment with an interval of 30-40 days.
Psychiatr Serv
January 2025
School of Social Work, Boise State University, Boise, Idaho (Williams, Esp); Department of Psychiatry, University of California, San Diego School of Medicine, La Jolla (Aarons, Sklar, Carandang, Brookman-Frazee); Department of Psychology, University of Central Florida, Orlando (Ehrhart); Ballmer Institute for Children's Behavioral Health, University of Oregon, Portland (Vega); School of Social Policy and Practice, University of Pennsylvania, Philadelphia (Marcus).
Objective: Little is known about how to sustain evidence-based interventions with fidelity in community mental health settings. Phase 1 of the Working to Implement and Sustain Digital Outcome Measures (WISDOM) trial showed that an organizational strategy improved the implementation of measurement-based care (MBC) in mental health services for youths 1-12 months after clinician MBC training. The authors report results from phase 2 of the trial, in which the strategy's effects on MBC sustainment 13-26 months after clinician MBC training were examined.
View Article and Find Full Text PDFRadiat Oncol
January 2025
Department of Radiotherapy and Radiooncology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany.
Background: Medulloblastoma is the most common malignant pediatric brain tumor, typically treated with normofractionated craniospinal irradiation (CSI) with an additional boost over about 6 weeks in children older than 3 years. This study investigates the sensitivity of pediatric medulloblastoma cell lines to different radiation fractionation schedules. While extensively studied in adult tumors, these ratios remain unknown in pediatric cases due to the rarity of the disease.
View Article and Find Full Text PDFArch Dis Child
January 2025
Tics and Neurodevelopmental Movements Service (TANDeM), Evelina London Children's Hospital Neurosciences Department, London, UK
Objective: To investigate the prognosis and co-occurring disorders, including functional neurological symptoms, in adolescents diagnosed with functional tic-like behaviour (FTLB).
Design: This was a single-centre tertiary study in the UK. A structured clinical interview was administered to 43 parents or carers of adolescents assessed with FTLB at their previous outpatient clinic appointment.
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