Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

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

Detecting dangerous maritime refugee migration paths through cell phone activities

In the 21st century, the world has experienced devastating wars that have caused people to migrate, creating problems in host countries. Among these migration routes, maritime migration routes are more desirable compared to other routes because coasts cannot be controlled as strictly as the alternative passages. However, maritime migration poses life-threatening risks due to unsafe boats, transportation between undesignated areas, lack of life-saving equipment, and dangerous weather conditions chosen for covert operations. Refugees and migrants may die or go missing at sea during these migrations. Most refugees are unaware of high risks they are facing as they hopelessly set out in search of better living conditions. In this study, we propose that such suicide-like maritime migration activities can be detected to some extent through cell phone activities and there may be a way to track early signs of migrants coming together from other regions and migrating through sea routes. By collecting media reports of failed attempts by immigrants and linking them to the D4R cell phone data, we were able to gain some indications of the possibility of early warning systems through analysis of cell phone calls

Effect of Interviews Done by Intensive Care Physicians on Organ Donation

PubMed ID: 28340798In this study, we examined the correspondence between intensive care unit physicians and the relatives of potential brain-dead donors regarding the decision to donate or the reasons for refusing organ donation. A total of 12 consecutive cases of potential brain-dead patients treated in intensive care units of Marmara University Pendik Education and Research Hospital in 2013 were evaluated. For each of the cases, the Potential Donor Questionnaire, and Family Notification, Brain Death Criteria Fulfilment and Organ Donation Conversation Questionnaires were used to collect the required data. Statistically, descriptive analyses were performed. We concluded that honestly, regularly, and sufficiently informed relatives of the potential brain-dead donor more readily donate organs, with a positive contribution from the intensive care physician. © 2017 Elsevier Inc