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

An empirical analysis of Okun\u27s law in the Philippines using a production function model

Arthur Okun\u27s [1962] initial study uncovered the underlying negative relationship between the United States\u27 output and unemployment. Okun\u27s study paved the way for the establishment of one of the most stable macroeconomic relationships known as Okun\u27s Law, which states that a for every one percentage point increase of the unemployment rate above its natural rate, there is a corresponding 3 point percentage decrease in real GNP. Presently, the stability of Okun\u27s coefficient is questioned and several studies have uncovered that the coefficient may vary across time. This study offers an initial insight of the Okun\u27s coefficient in the Philippines. Using quarterly data of unemployment, real GDP, labor hours, labor force and capacity utilization from 1988 - 2000, and employing the Prachowny\u27s [1993] production function model, this study revealed that the negative relationship between output and employment in the Philippines holds true and the Okun\u27s coefficient is 0.28. In particular, for every 1-percentage point increase in the employment rate above its natural rate, there is a corresponding 0.28 percentage point decrease in the Philippines\u27 real GDP. The study also uncovered that factors like the average weekly labor hours, labor force and capacity utilization rates significantly affect the measurement of output. Future researchers may want to verify the coefficient generated in this study by employing other production function models and including other variables that may affect output through unemployment