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

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Not AvailableTraditionally, the farmers of arid regionare growing sole crops of moth bean and clusterbean under rainfed conditions. Sole cropping under traditional cropping system (TCS) is successful once in three years. Even in good cropping season, the land utilization does not exceed four months.Not Availabl

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Not AvailableForty two genotypes were tested together during rabi season 2015-16 under three water regimes 1. Well watered -irrigated throughout the crop season, 2. Water stressed ie irrigation till 45 days after sowing and 3. Water stressed ie. irrigation till 30 DAS along with four checks viz., M35-1, Phule Anuradha, CSV 22, and CSV 26. The design of experiment was split plot design with three replications. Drought tolerance and susceptible genotypes were categorised on the basis of stress susceptible index (SSI), Weighted Mean Index (WMI) and regression line. Based on these criteria genotypes Phule Anuradha x Sangola Hondi, Sangola hondi x BRJ 62, SLR 24 x BRJ 62, IC 392155, CRS 7, CRS 20, CRS 48, Selection 3 and IC - 343586 were categorised as drought tolerant. Correlations between peduncle length (cm) and days to flowering were negative and significant under all environments (-0.36* *,-0.44* * and -0.39* *) indicating higher peduncle length earlier the flowering. Under less soil moisture condition early flowering and maturity traits is important as it helps in completing life cycle with available soil moisture, thereby imparting drought tolerance. Correlations between grain yield and per cent panicle emergence were positive and significant (0.67* *, 0.44* * and 0.37* *) under all environments. Correlation between per cent reduction in grain yield and per cent reduction in leaf area at the time of flowering under one irrigation was (r=0.53*) significant and positive. Traits like early flowering, long peduncle length and less reduction in leaf area at the time of flowering were found to be associated with drought.Not Availabl

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Not AvailableForty two genotypes were tested together during rabi season 2015-16 under three water regimes 1. Well watered -irrigated throughout the crop season, 2. Water stressed ie irrigation till 45 days after sowing and 3. Water stressed ie. irrigation till 30 DAS along with four checks viz., M35-1, Phule Anuradha, CSV 22, and CSV 26. The design of experiment was split plot design with three replications. Drought tolerance and susceptible genotypes were categorised on the basis of stress susceptible index (SSI), Weighted Mean Index (WMI) and regression line. Based on these criteria genotypes Phule Anuradha x Sangola Hondi, Sangola hondi x BRJ 62, SLR 24 x BRJ 62, IC 392155, CRS 7, CRS 20, CRS 48, Selection 3 and IC - 343586 were categorised as drought tolerant. Correlations between peduncle length (cm) and days to flowering were negative and significant under all environments (-0.36* *,-0.44* * and -0.39* *) indicating higher peduncle length earlier the flowering. Under less soil moisture condition early flowering and maturity traits is important as it helps in completing life cycle with available soil moisture, thereby imparting drought tolerance. Correlations between grain yield and per cent panicle emergence were positive and significant (0.67* *, 0.44* * and 0.37* *) under all environments. Correlation between per cent reduction in grain yield and per cent reduction in leaf area at the time of flowering under one irrigation was (r=0.53*) significant and positive. Traits like early flowering, long peduncle length and less reduction in leaf area at the time of flowering were found to be associated with drought.Not Availabl

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Not AvailableTwenty five genotypes were evaluated along with four checks viz., M35-1, Phule Anuradha, CSV 22, and CSV 26during post-rainy season 2016-17 under three water regimes at Centre on Rabi Sorghum farm, Solapur (1.) Well watered -irrigated throughout the crop season, 2. Limited water stressed i.e irrigated till GS2 growth stage and 3. Severe water stressed i.e. irrigated till GS1 growth stage. The experiment was conducted in split plot design with three replications. Plot size was 3 rows of 3m length for each genotypes and spacing 45x15cm. Drought tolerant and susceptible genotypes were categorised on the basis of Weighted Geometric Mean Index (WGMI). To calculate WGMI, different weights were assigned to the treatments according to experimental mean yield difference between severe drought (yield under GS1 environment ) and well watered (non-drought) environment. The experimental mean grain yield under GS1, GS2 and well watered conditions were 230.60, 802.23, and 1160.39 g/plot, respectively hence weights 5.03, 3.47, and 1 were assigned to these treatments accordingly. Genotypes having higher WGMI than summation of mean WGMI and standard deviation of WGMI were categorized as tolerant, higher than mean WGMI as moderately tolerant and lower than mean WGMI as susceptible. Based on these criteria genotypes under GS1 environment CRSDT 10, CRSDT 3, CRSDT 4, and CRS 58 were categorized as drought tolerant and CRS 57, CRS 52, CRS 7, CRSDT 7, Phule Anuradha, and M35-1as moderately tolerant. Under GS2 environment genotypes CRSDT 4, CRS 60, Selection 3, Phule Suchitra and CRS 58 as tolerant and IC 343586, CRSDT 5, CRS 52, CRSDT 12, IC 392137, M35-1, CRSDT 3, and CRSDT 8 as moderately tolerant. For GS 1 as well as GS 2 environments CRSDT 4, CRSDT 3, CRS 58, CRSDT 10 and CRS 52 as tolerant and CRS 57, CRS 7, Phule Anuradha, Phule Suchitra, M35-1, Selection 3, CRSDT 12, CRSDT 7, and IC 343586 moderately tolerant. The experimental mean fodder yield under GS1, GS2 and well watered conditions were 1969.33, 2292.00, and 2525.33 g/plot, respectively hence weights 1.28, 1.16, and 1 were assigned to these treatments. Under GS1 environment for fodder yield CRS 48, IC 392156, IC 392137 and CRS 60 as drought tolerant and CRS 20, IC 343586, IC 392155, CRS 59, CRS 7, CSV 26, CRSDT 6, Selection 3, CRSDT 4 and Phule Suchitra as moderately tolerant. Under GS 2 environment CRS 20, CRS 60, IC 392156, CRS 48 as tolerant and IC 343586, IC 392137, Phule Suchitra, CRS 59, CRSDT 4, CRSDT 12, Selection 3, CRSDT6, CRS 57 and phule Anuradha categorized as moderately drought tolerant. For GS 1 as well as GS 2 environments CRS 48, IC 392156, CRS 60, and IC 392137 tolerant and CRS 20, IC 343586, IC 392155, CRS 59, CSV 26, CRS 7, CRS DT6, Phule Suchitra CRSDT 4 and Selection 3 moderately tolerant.Not Availabl