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

Timed picture naming in seven languages

Timed picture naming was compared in seven languages that vary along dimensions known to affect lexical access. Analyses over items focused on factors that determine cross-language universals and cross-language disparities. With regard to universals, number of alternative names had large effects on reaction time within and across languages after target-name agreement was controlled, suggesting inhibitory effects from lexical competitors. For all the languages, word frequency and goodness of depiction had large effects, but objective picture complexity did not. Effects of word structure variables (length, syllable structure, compounding, and initial frication) varied markedly over languages. Strong cross-language correlations were found in naming latencies, frequency, and length. Other-language frequency effects were observed (e.g., Chinese frequencies predicting Spanish reaction times) even after within-language effects were controlled (e.g., Spanish frequencies predicting Spanish reaction times). These surprising cross-language correlations challenge widely held assumptions about the lexical locus of length and frequency effects, suggesting instead that they may (at least in part) reflect familiarity and accessibility at a conceptual level that is shared over languages

Success and Risk Factors in the Pre-Startup Phase

Why does one person actually succeed in starting a business, while a second person gives up? In order to answer this question, a sample of 517 nascent entrepreneurs (people in the process of setting up a business) was followed over a 3-year period. After this period, it was established that 195 efforts were successful and that 115 start up efforts were abandoned. Our research focuses on estimating the relative importance of a variety of approaches and variables in explaining pre-start-up success. These influences are organized in terms of Gartner’s (1985) framework of new venture creation. This framework suggests that start-up efforts differ in terms of the characteristics of the individual(s) who start the venture, the organization that they create, the environment surrounding the new venture, and the process by which the new venture is started. Logistic regression analyses are run for the sample as a whole as well as for subgroups within the sample, namely for those with high ambition versus low ambition and for those with substantial versus limited experience. The results point to the importance of perceived risk of the market as a predictor of getting started versus abandoning the start up effort. Copyright Springer 2006performance, survival, nascent entrepreneurs, start-ups, M13,