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

Chalepin: Isolated from Ruta angustifolia L. Pers induces mitochondrial mediated apoptosis in lung carcinoma cells

10.1186/s12906-016-1368-6BMC Complementary and Alternative Medicine16138

Cause-Related Marketing in the Retail and Finance Sectors: An Exploratory Study of the Determinants of Cause Selection and Nonprofit Alliances

Firms devote increasing funds and resources to cause-related marketing (CRM). This report seeks to uncover some of the factors that explain how firms choose between competing social causes in the development of their CRM strategy. The behavior of firms traded on the London Stock Exchange is analyzed, by highlighting regularities and patterns in CRM activities. The rationales for the observed patterns are investigated through semistructured interviews with managers employed by UK-based nonprofit organizations, financial services, and retail firms. The authors identify, among other things, differences in the nature of the “selected” social causes, the length and geographical scope of the social campaigns, and the (CRM) strategies used to implement them. It is argued that these variations may reflect differences in the organizational legitimacy pressures experienced by firms in the retail and financial services sectors

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