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

O universo da cura na Capitania de Minas Gerais (1750-1808)

This article studies the everyday of medicine in Minas Gerais, Brasil, in the eighteen century, considering the questions was suggest by that reality, how the analyses of the presence of magic belief about cure and of the new techniques of medicine.Este artigo estuda o cotidiano da medicina nas Minas Gerais, Brasil, no século XVIII, tendo em vista as questões sugeridas por aquela realidade, como a análise da presença de crenças mágicas acerca da cura e do surgimento e difusão de novas técnicas médicas

Doenças de feitiço: as Minas setecentistas e o imaginário das doenças Diseases from witchcraft: eighteenth century Minas Gerais captaincy/Brazil and the imaginary of the diseases

O presente artigo objetiva discutir a crença e o consenso em torno da ideia partilhada, entre aqueles que viveram nas Minas no curso do século XVIII, de que determinados indivíduos poderiam, por meio de feitiços, provocar uma série de males. Assim, as doenças de feitiço, conforme aparecem na documentação compulsada, pareciam bastante assíduas. Procurei igualmente analisar como eram descritos tais achaques provocados pelos feitiços: tolhimentos, dores, ligamentos, dentre outros. Estes se faziam presentes tanto nas denúncias levadas ao conhecimento de membros do clero no curso das devassas eclesiásticas (documentação sob a guarda do Arquivo Eclesiástico da Arquidiocese de Mariana) como em tratados médicos publicados, sobretudo, nas primeiras décadas do setecentos.<br>This article aims to discuss the belief and the consensus around the idea shared among those who lived in Minas in the course of the eighteenth century that certain individuals could, by spells, cause a variety of ailments. Thus, the spell of illness, as it appears in the documentation compelling seemed very assiduous. I also tried to analyze how they were described such ailments caused by spells: stunting, pain, ligaments, among others. These were present both in the complaints brought to the attention of members of the clergy during the wanton ecclesiastical (documentation in the custody of the ecclesiastical archives of the Archdiocese of Mariana) as published in medical treatises, especially in the first decades of the 18th century

De jure sacro: a inquisição nas vilas d'El Rei De jure sacro: the inquisition in the villages of the king

Esse artigo tem por objetivo divulgar as denúncias registradas nos Cadernos do Promotor relativos a Minas Gerais, pertencentes ao fundo da Inquisição de Lisboa, depositados no Arquivo Nacional da Torre de Tombo/Portugal, com ênfase nos estudos de caso relativos a São João del-Rei e Tiradentes<br>The purpose of this article is to make known the accusations registered in the Lisbon Inquisition's Cadernos do Promotor (Prosecutor'S Notebooks) and the prosecuted cases pertaining to Minas Gerais, especially the villages of São João del-Rei and Tiradentes. These sources are deposited in Portugal's Arquivo Nacional da Torre de Tombo/Lisbo

Stress neuropeptide levels in adults with chest pain due to coronary artery disease: potential implications for clinical assessment

: Substance P (SP) and neuropeptide Y (NPY) are neuropeptides involved in nociception. The study of biochemical markers of pain in communicating critically ill coronary patients may provide insight for pain assessment and management in critical care. Purpose of the study was to to explore potential associations between plasma neuropeptide levels and reported pain intensity in coronary critical care adults, in order to test the reliability of SP measurements for objective pain assessment in critical care