Alien Registration- Budd, Flora M. (Portland, Cumberland County)

https://digitalmaine.com/alien_docs/24096/thumbnail.jp

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

Into the void: a realist evaluation of the eGovernment for You (EGOV4U) project

e-government for You’ (EGOV4U) was a European Commission (EC) funded project developed to pilot models of multi-channel, public and community e-services designed to tackle social exclusion and disadvantage through a range of initiatives delivered by five project partners from a variety of European countries. The project evaluation employed a theory-driven approach and the use of mixed methods for data capture and analysis. In this article we combine this with a form of mechanistic explanation that has been specifically developed for realist evaluation: namely the context + mechanism = outcome (CMO) approach. Our contention is that by so doing we further enhance the analytical focus and granularity of the evaluation process and thus the material we present here. This article aims to make use of previously unused material from the EGOV4U evaluation, and provide a realist insight into what works, for whom, in what circumstances and why