The Integrated Assessment as the main goal for achieving an Ecosystem Approach to Management in the Western European Shelf Seas

Providing regional integrated ecosystem assessments (IEA) is a key challenge identified in the ICES Strategic Plan (2014-2018). IEAs are seen as a fundamental link between advice and ecosystem science inachieving Ecosystem Based Management (EBM).While EBM is not a new concept, difficulties in achieving such an ambitious goal have been highlighted by the extensive work conducted in this area. The implementation of new regulation policies, such as the Marine Strategy Framework Directive (MSFD) and the reformed Common Fisheries Policy (CFP) in Europe,have challenged the scientific community to rapidly react despite these difficulties and provide scientific advice to support management decisions concerning these policies. RegionalICES groups have been tasked with developing methods and tools for IEA in their corresponding ecoregions; this is the case of the Working Group on Ecosystem Assessment of Western European Shelf Seas (WGEAWESS). The role of this group is to implement, and test tools and methods for the advisory process, focusing on the North Atlantic European continental shelf, including Celtic Seas, Bay of Biscay and Iberian Waters. In this presentation we show the progress made within this WG during its initial three years of activity, in relation to some of the terms of reference already addressed. An adaptation of the ODEMM framework has been selected as a tool for identifying a) links between components, processes, pressures and states, and b) gaps in data availability and indicator implementation. Some preliminary results of a first IEA exercise will also been shownwith emphasis onthe MSFD descriptors D1 (biological diversity) and D4 (food webs)

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

Groundfish surveys in the Atlantic Iberian waters (ICES Divisions VIIIc and IXa): history and perspectives

Spanish Oceanogrnphic Institute (IEO) and Portuguese Research Inistitute (IPIMAR, ex-INIP) using their research vessels "Comide de Saavedra" and "Noruega" have conducted groundfish surveys in Spanish and Portuguese waters. The results of these surveys have been reported to the relevant ICES Working Groups, communicated to ICES Annual Conferences and/or published in journals of bioiogy and flsheries. Data collected from groundfish surveys were also the basis to carry out assemblage studies and to several advices to the Spanish, Porttuguese and European fishery administrations concerning the implementation of technical measures for fish stock management. This communication intends to give information about the past, the present and the future of these surveys, concerning objectives, methodology and publications. Critical aspects and solutions to improve some aspects are presented

Impact of COVID-19 on Cardiovascular Testing in the United States Versus the Rest of the World

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-U.S. institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection