Colonial Origins of Inequality in Hispanic America? Some reflections based on new empirical evidence

This paper attempts at contributing to the ongoing debate on the historical roots of the high economic inequality of contemporary Iberian America. Basically empirical, our approach departs from mainstream scholarship. We show new data on wages and heights in several viceroyalties that: 1) suggest relatively medium to high levels of material welfare among the commoners in Bourbon Hispanic America; 2) allow us to build indexes of economic inequality. An international comparison of those indexes casts some doubts on the widely accepted view that Viceroyal America’s economy was exclusively based on extremely unequal or extractive institutions, as it has been popularized by the influential works by Engerman and Sokoloff (1994, 2002, 2005), Acemoglu et al. (2002).economic inequality, Iberian America, Viceroyal America’s economy

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