‘The core’: the centre as a concept in twentieth-century British planning and architecture. Part one: the emergence of the idea

This is the first of a pair of articles in which we argue that what we term the ‘centre-idea’ was fundamental to British modernist architecture and planning thought from the mid-1940s onwards. We locate this idea’s roots in the pre-1939 British voluntary sector, specifically the activities of the Peckham Experiment and the Pioneer Health Centre which housed it. We evidence its long-term influence on post-1945 architecture and planning in the invitation to the Experiment’s co-creator George Scott Williamson to speak at CIAM’s eighth Congress in 1951. The paper begins with a discussion of the Experiment, an architectural and urban setting which was understood to effect new forms of human relationships and subjectivity suited to a democratic, post-imperial modernity. We then consider other environments to show how this ‘centre-idea’ was widespread in progressive circles by the late 1930s. The paper concludes by discussing the community centre as an emerging building type increasingly supported by the state. This coming together of the British state, modernist architecture and progressive voluntarist thinking by the outbreak of war in 1939, would mean that the ‘centre-idea’ had a significant impact on reconstruction debates and post-war planning; the subject of our forthcoming companion article

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