Diverted from Landfill: Reuse of Single-Use Plastic Packaging Waste.

Low-density polyethylene (LDPE) based packaging films mostly end up in landfill after single-use as they are not commonly recycled due to their flexible nature, low strength and low cost. Additionally, the necessity to separate and sort different plastic waste streams is the most costly step in plastics recycling, and is a major barrier to increasing recycling rates. This cost can be reduced through using waste mixed plastics (wMP) as a raw material. This research investigates the properties of PE-based wMP coming from film packaging wastes that constitutes different grades of PE with traces of polypropylene (PP). Their properties are compared with segregated individual recycled polyolefins and virgin LDPE. The plastic plaques are produced directly from the wMP shreds as well as after extruding the wMP shreds into a more uniform material. The effect of different material forms and processing conditions on the mechanical properties are investigated. The results of the investigation show that measured properties of the wMP fall well within the range of properties of various grades of virgin polyethylene, indicating the maximum possible variations between different batches. Addition of an intermediate processing step of extrusion before compression moulding is found to have no effect on the tensile properties but results in a noticeably different failure behaviour. The wMP does not show any thermal degradation during processing that was confirmed by thermogravimetric analysis. The results give a scientific insight into the adoption of wMP in real world products that can divert them from landfill creating a more circular economy.

Second opinion programmes in Germany: a mixed-methods study protocol.

INTRODUCTION: Second opinion programmes aim to support the patients' decision-making process and to avoid treatments that are unnecessary from a medical perspective. The German second opinion directive, introduced in December 2018, constitutes a new legal framework in statutory health insurance for seeking second opinions for elective procedures and so far includes tonsillectomy, tonsillotomy, hysterectomy and shoulder arthroscopy. The directive mandates physicians who recommend one of the above-mentioned surgeries to inform their patients of their legal right to visit a certified second opinion provider. Since second opinion programmes are a fairly recent phenomenon in Germany, no comprehensive data are yet available on the degree of implementation, users, potential barriers and their effectiveness. We aim to examine the characteristics and the use of second opinion programmes as well as the needs and wishes from the perspective of (potential) users in Germany, with focus on the decision-making process, the patient-physician relationship and the motivation to seek a second opinion, as well as the role of health literacy. METHODS AND ANALYSIS: Six substudies will include the following stakeholders: (1 and 2) patients with one of the four surgery-indications covered by the directive, (3) patients who electively sought an online-based second opinion, (4) patients with oncological diseases, (5) the general population and (6) medical specialists. A mixed-methods approach will be used, including questionnaires, interviews and focus groups. The data will be evaluated using quantitative descriptive analysis and qualitative content analysis. The integration of the results will take place in the form of a triangulation protocol. ETHICS AND DISSEMINATION: The study protocol was approved by the Ethics Committee of the Brandenburg Medical School. The findings will be published in peer-reviewed journals and presented at scientific conferences.

Dienogest and the breast.

In a clinical pilot study, 21 women with endometriosis have been primarely treated with dienogest 2 x 10 mg daily p.o. for 24 weeks. Besides the effect on endometriosis the action of such high-dose progestogen treatment on the breast was evaluated by breast ultrasound prior to medication and at 24 weeks of medical treatment. In all women, a significant size reduction of the mammary gland (p < 0.023) and regression of mastopathic changes were observed. There was a non-significant reduction (p = 0.089) of the maximum diameter of the ducts. The portion of the fatty tissue increased slightly, but not significantly (p = 0.348).