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.

Background: Arts-based Interventions involve the use of aesthetic engagements, sensory activation, evocation of emotion and cognitive stimulation and involvement of the imagination, to promote wellbeing. This include a wide range of practices, from prehistoric traditions to the modern day evidence based usage of different forms of arts for therapeutic purposes. Despite the early recognition and proven efficacy of art-based interventions, an organized structure for integration of art into healthcare is lacking in Nigeria. Aim: This review aims to explore and describe the existing literature on the use of various art forms in the care of patients in health care institutions in Nigeria. Materials and Methods: A scoping review was done. MEDLINE, Embase, African Index Medicus and PsycINFO were searched using the following key words; art in medicine in Nigeria, art therapy in Nigeria and art in health in Nigeria. The search results were screened for articles using predefined criteria. A hand search for articles and communication with Arts in Medicine Project Nigeria were also done. The articles included in the review were read and summarized using a proforma. Result: Overall there is a sparseness of academic articles on the use and effectiveness of arts-based interventions in the management of patients in health care institutions in Nigeria. The most commonly applied art forms are music and visual arts.

Reflective practice has evolved over the years from being an informal subconscious process to a deliberate and formal one. Residency training programs are avenues for preparing residents for a lifetime of specialist practice, and reflective practice is being incorporated into the curriculum of the program in many parts of the world. There is no universal template for carrying out reflective practice; however, there appear to be accruable benefits to residents who can surmount the barriers and undergo some form of reflection using any of the available models. This article seeks to appraise reflective practice and the inherent benefits to the resident doctor and his practice. Thus, it makes a case for incorporating reflection into the curriculum of residency training programs in Sub-Saharan Africa. It also demonstrates the need to ensure standardized, reproducible methods of reflection globally.

The utilization of art for therapeutic purposes in the formal healthcare setting is gradually gaining prominence in Nigeria. However, there is a paucity of evidence on the effectiveness of these interventions. Therefore, we explored the pooled effect of the various arts-based interventions in managing clinical disorders in hospitalized and out-patients in Nigeria. An electronic search of PubMed, African Journal Online, Web of Science, Google Scholar, Cochrane Library, and Scopus databases was carried out from the inception of the databases to October 31, 2021. Three researchers using Rayyan QCRI software independently screened and de-duplicated the identified studies. Eight eligible studies were selected for this review, with a total of 541 participants. The earliest study was published in 2012. Seven of the eight studies were conducted in the Southern part of Nigeria. There were four quasi-experimental studies, two randomized controlled trials, and two comparative cross-sectional studies. The predominant art forms were music (three) and dance/movement (three), followed by visual art (two). The groups of patients in the identified studies were managed for mental health problems (two), hypertension (two), Parkinson’s disease (one), spinal cord injury (one), autistic spectrum disorder (one), and chronic back pain (one). In all the studies, the art-based intervention significantly improved the overall outcome of the patients. The findings of the available studies have proven to yield a significant positive outcome in managing different health conditions. However, there is a need to conduct more high-quality research in this field in Nigeria.

BACKGROUND: The relevance of closing the platysma muscle layer after open thyroidectomy has received little interest in terms of research. The objective was to determine whether non-closure of the platysma muscle layer after open thyroidectomy impacts significantly on the cosmetic outcome of the resulting collar scar. METHODS: In this prospective randomised controlled clinical trial, patients were assigned randomly to have the platysma muscle layer closed or not closed. The primary endpoint was the cosmesis of the collar scar six weeks after surgery assessed using the patient and observer scar assessment scale (POSAS). Additional endpoints included operation time and early postoperative wound complications. RESULTS: Ninety-two patients were recruited, with 46 randomised to each group. The patient scar assessment subscale (PSAS) of the POSAS showed no significant difference in the scar cosmesis between the two groups six weeks after surgery (median PSAS: 16.5 vs 17.5; p = 0.514). The observer scar assessment subscale (OSAS) showed that the platysma muscle layer closure group had marginally better scars (median OSAS: 15 vs 17; p = 0.045). The size of the goitre did not make any significant difference in the scar cosmesis. There was no significant difference in the incidence of early postoperative wound complications as well as the median operation time. CONCLUSION: Not closing the platysma muscle layer had no significant impact on the scar cosmesis six weeks after open thyroidectomy, with no significant difference in the incidence of early postoperative wound complications and the operation time.