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

Flexibility in ad hoc networks

THESIS 8067This thesis represents a step forward in our understanding of what flexibility, adaptability and reconfigurability means at the network-layer of mobile, wireless, ad hoc networks. Mobile, wireless, ad hoc networks are collections of autonomous routers that have the ability to dynamically and rapidly form networks without the use of any centralised network infrastructure using wireless communication technologies. Ad hoc routing protocols are at the core of enabling ad hoc networks as they allow remote nodes to communicate without resorting to primitive flooding techniques. Ad hoc networks, by their nature, will experience divergent user scenarios and networking conditions that demand routing protocols which are tailored to their requirements. However, to date, the static configuration of one routing protocol across the entire network has been the norm. This thesis argues that such a rigid approach constrains the temporally and spatially divergent nature of the system. This thesis shows that a more flexible approach to the design of the network-layer for mobile wireless ad hoc networks is both necessary and feasible. The thesis explores the need for such flexibility in ad hoc networks and presents an enabling system in the form of a novel network-layer which incorporates multiple routing protocols

Workshop on Stochastic Processes for Wireless Networks

Abstract?This paper considers the use of a recently developed Bayesian statistical approximation technique that leads to very fast determination of highly accurate estimates for latent radio signal power. Following suitable data analysis, a first order non-stationary auto-regressive process is considered for latent radio signal and the fast approximation technique is then used to provide accurate estimates of the hidden model parameters. These estimates are based on having received several noisy, but spatially correlated, observations of the true latent signal. The implication of this technique for real time decision analysis and the problem of finding, and making use of, so-called radio spectrum holes is also discussed