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

《專業樓宇檢查指引》第一冊: 1980年前落成住宅及商住大廈 Professional guide to building inspections: volume 1: pre-1980 residential & composite buildings in Hong Kong

本指引 - 並非單為強制驗樓計劃而設; • 屋宇署就該計劃已出版作業備考2012 - 而是涵蓋一般專業驗樓須知 - 第一冊配合該計劃，提供以下4+1項的檢查指引: • 外牆 • 結構 • 走火與防火結構 • 排水系統 及 • 僭建物 This Guide –Is not just for MBIS; •MBIS CoP 2012 is provided by BD (2012) –But for general building inspections; –Volume 1 is particularly drafted for the following 4+1 aspects： •External Elements & Others Physical Elements •Structural Elements •Fire Safety Elements •Drainage System and •UB

A guide to prepare a building maintenance manual

The main purpose of this book is to provide a practical guidance on the preparation of a BMM, which is comply with the requirements stipulated in the Revised Guidelines for Deeds of Mutual Covenant (DMC) published by the Legal Advisory and Conveyancing Office (LACO) of the Lands Department in 2006. This Guide is tailor made for Hong Kong practice and is applicable for various types of buildings like residential, commercial, industrial buildings and composite buildings no matter they are multi-owned or not. The Guide is divided into three volumes, namely, the General Building Records Manual (GBRM), the Works and Installations Manual (WIM) and the Supplementary Information Manual (SIM) with two appendices and two annexes. Appendix I provided recommended maintenance cycle to various Works and Installations. Appendix II provided sample templates for the BMM. Annexes 1 and 2 provided handy references of related regulations, international standards and codes of practices on various Works and Installations... (preface

Criteria and weighting of a value age index for residential use

Most theoretical and empirical studies regard building age as the most important criterion in property value determination. In this chapter, we have constructed a more general framework to identify the multiple criteria of value determination. The objective is to evaluate the effects of different residential building quality attributes on building values, including presentation, management, structural and system defects, building services, access and circulation, and the provision of amenities. Our findings indicate that building age is just one of the less important criteria that people consider in the evaluation of building value, while the structural and system defects of a building are found to be more important

A new statistical model for the Day Reconstruction Method

The Day Reconstruction Method (DRM) is a method to measure one's subjective affective status by soliciting information in a questionnaire about the previous day's activities. We developed a new model to examine the association of daily activities, the friendliness of interacting partners, and time-of-day on net affect scores among 10,377 adults participating in the World Health Organization's Study on global ageing and adult health (SAGE). A multilevel regression was fitted and the time-of-day effect was modeled by restricted cubic spline. The net affect score was a serpentine curve; stable from 4 a.m. to 6 a.m., increased from 7 a.m. to 12 noon, and became stable onwards. Participants had the highest net affect scores during religious activities (0.48, 95% confidence interval [CI]: 0.44, 0.53), and they enjoyed leisure activities, exercising, and household responsibilities more than work. Compared with events that lacked interacting partners, activities with very friendly interacting partners were associated with higher net affect scores (0.21, 95% CI: 0.19, 0.22), but events with slightly friendly interacting partners, slightly irritating or very irritating partners had lower net affect scores. To conclude, researchers using DRM for assessing well-being status across time should include the type of activities and the friendliness of the interacting partners