64 research outputs found

    ANÁLISIS DESCRIPTIVO DE LAS PRÁCTICAS LOCALES DE CRÍA Y MANEJO DEL GUAJOLOTE NATIVO (Meleagris gallopavo L.) EN CAMPECHE, MÉXICO

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    A transversal study was carried out in 48 small-scale poultry production units (PUs) located in Maya indigenous communities in center-south Campeche, México, to understand the breeding and management practices for native turkey (Meleagris gallopavo L.) and establishing a group of PUs as a basis of a development program. Descriptive statistics were estimated and a typological grouping based on a principal components (PC) analysis was made, using the SAS statistical program. The results evidenced the prevailing role of women in poultry management (91.6 %), with age of 46 years or more (43.7 %), and basic schooling (41.6 %). Turkey meat is destined mostly to auto-consumption (60.4 %) and egg for natural incubation and consumption. The flocks are made up mostly by juvenile stage birds with 4.93±0.71 males and 4.7±0.7 females per production unit. Of the producers, 62.5 % feeds adult birds with maize produced in their PU and commercial feed for poults (95.6 %). The most common diseases are respiratory (34.2 %) and digestive (34.2 %), consequence of a low frequency of vaccine application (28.2 %). The broad variation of the PUs was related to the size of the flock, age of sexual maturity, annual sale of adult turkeys, egg production, and years of experience with poultry management, which allowed grouping them into four PC that explained 76.6 % of the total variation. This typological grouping of PUs can serve as the basis for regional development programs.Se realizó un estudio transversal en 48 unidades de producción avícola (UP) en pequeña escala ubicadas en comunidades indígenas mayas del centro-sur de Campeche, México, para conocer las prácticas de crianza y manejo del guajolote nativo (Meleagris gallopavo L.) y establecer una agrupación de las UP como base de un programa de desarrollo. Se estimaron los estadísticos descriptivos y realizó una agrupación tipológica basada en un análisis de componentes principales (CP) usando el programa estadístico SAS. Los resultados evidenciaron el papel preponderante de la mujer en el manejo de las aves (91.6%), con edad de 46 años o más (43.7%) y escolaridad básica (41.6%). La carne del guajolote se destina principalmente al autoconsumo (60.4%) y el huevo para incubación natural y consumo. Las parvadas están constituidas mayormente por aves en etapa juvenil con 4.93±0.71 machos y 4.7±0.7 hembras por unidad de producción. El 62.5% de los productores alimenta a las aves adultas con maíz producido en su UP y alimento comercial para pavipollos (95.6%). Las enfermedades más comunes son las respiratorias (34.2%) y digestivas (34.2%), consecuencia de una baja frecuencia de aplicación de vacunas (28.2%). La amplia variación de las UP se relacionó con el tamaño de la parvada, edad a la madurez sexual, venta anual de guajolotes adultos, producción de huevo, y años de experiencia en el manejo de las aves, lo que permitió agruparlas en cuatro CP que explicaron el 76.6% de la variación total. Esta agrupación tipológica de UP puede servir de base para programas de desarrollo regional

    EVALUACIÓN ECONÓMICA DEL SISTEMA DE PRODUCCIÓN LECHERA FAMILIAR

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    In Estado de México there is a lack of productive, economic and social indicators of family dairy livestock production. The objective of the study was to identify these parameters, in the municipality of Texcoco and San Andrés Chiautla in the eastern region of Estado de México. The information was obtained through direct surveys with producers and visits to dairy farms. A random unconditional sampling design and periodical monitoring of the indicators mentioned was used; the size of the sample was made up of 24 family farms, which make up 22 % of the population. The results indicated a small-scale production system, integrated mostly by producers older than 50 years, with experience in livestock production of 28 years, with average herds of 21 Holstein animals, housed in small barns of 904 m2 and average production of 14.65 kg cow-1 day-1.The total cost of annual milk production and fattening calves was 236,871.14Mexicanpesos,corresponding90.7236,871.14 Mexican pesos, corresponding 90.7 % to variable costs and 9.3 % to fixed costs, whose income over the sale of products generated (milk and fattening calves) was 299,121.45. The use per sold product was 1.32kg1formilkand1.32 kg-1 for milk and 8.45 kg-1 for meat, obtaining a profitability of 20.81 %. The production cost per liter of milk was 5.05,coveringthisproductioncostwith10,252.77liters,generatedbythreecows.EnelEstadodeMeˊxicosecarecendeindicadoresproductivos,econoˊmicosysocialesdelaganaderıˊalecherafamiliar.Elobjetivodelestudiofueidentificarestosparaˊmetros,enlosMunicipiosdeTexcocoySanAndreˊsChiautlaenlaregioˊnorientedelEstadodeMeˊxico.Lainformacioˊnseobtuvoporencuestasdirectasconlosproductoresyvisitasalasgranjaslecheras.Seutilizoˊundisen~odemuestreoaleatorioirrestrictoymonitoreoperioˊdicodelosindicadoresmencionados;eltaman~odemuestraseintegroˊcon24granjasfamiliares,queconforman225.05, covering this production cost with 10,252.77 liters, generated by three cows.En el Estado de México se carecen de indicadores productivos, económicos y sociales de la ganadería lechera familiar. El objetivo del estudio fue identificar estos parámetros, en los Municipios de Texcoco y San Andrés Chiautla en la región oriente del Estado de México. La información se obtuvo por encuestas directas con los productores y visitas a las granjas lecheras. Se utilizó un diseño de muestreo aleatorio irrestricto y monitoreo periódico de los indicadores mencionados; el tamaño de muestra se integró con 24 granjas familiares, que conforman 22% de la población. Los resultados indicaron un sistema de producción en pequeña escala, integrado en su mayoría por productores con más de 50 años de edad, con una experiencia en la actividad ganadera de 28 años, con hatos promedio de 21 animales Holstein, alojados en pequeños establos con 904 m2 y con producciones promedio de 14.65 kg vaca-1 día-1. El costo total de la producción anual de leche y becerros de engorda fue de 236,871.14 pesos mexicanos, correspondiendo un 90.7% a los costos variables y 9.3% a los costos fijos; cuyo ingreso por venta de productos generados (leche y becerros de engorda) fue de 299,121.45.Lautilidadporproductovendidofuede299,121.45. La utilidad por producto vendido fue de 1.32 kg-1para leche y 8.45kg1paracarne,obteniendounarentabilidaddel20.818.45 kg-1 para carne, obteniendo una rentabilidad del 20.81%. El costo de producción por cada litro de leche fue de 5.05, cubriendo este costo de producción con 10,252.77 litros, generada por tres vacas

    Assessing Single Upconverting Nanoparticle Luminescence by Optical Tweezers

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    We report on stable, long-term immobilization and localization of a single colloidal Er3+/Yb3+ codoped upconverting fluorescent nanoparticle (UCNP) by optical trapping with a single infrared laser beam. Contrary to expectations, the single UCNP emission differs from that generated by an assembly of UCNPs. The experimental data reveal that the differences can be explained in terms of modulations caused by radiation-trapping, a phenomenon not considered before but that this work reveals to be of great relevanceThis work was supported by the Spanish Ministerio de Educación y Ciencia (MAT2010–16161 and MAT2013–47395-C4–1-R). P.H.G. thanks the Spanish Ministerio de Economía y Competitividad (MINECO) for the Juan de la Cierva program. P.R.S thanks the Spanish Ministerio de Economía y Competitividad (MINECO) for the “Promoción 14 del talento y su Empleabilidad en I+D+i” statal program. Fondazione Cariverona (Verona, Italy) is gratefully acknowledged for financial support in the frame of the project “Verona Nanomedicine Initiative

    Productive performance and carcass characteristics of New Zealand white and California rabbits and their crosses

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    Objective: Evaluate the growth performance and carcass characteristics as well as the individual and maternal heterosis effects of New Zealand White (NZB), California (CA) rabbits and their crosses. Design/methodology/approach: 450 offspring rabbits, from 48 females mated to 6 stud rabbits, were evaluated, recording the weight and litter size at birth (TCN) and at weaning (TCD), and weight (PMS), gain (GMD), consumption (CMS), and feed conversion (CONV) during 8 weeks post-weaning. The carcass live weight at slaughter, warm carcass weight with head, carcass yield and parts of the carcass were evaluated. Results: Showed differences (p <0.05) in TCN and TCD with values of 10.47 and 9.03 kits, respectively. When NZB was used as the paternal breed, obtaining an individual heterosis of 5.91% for litter size and 12.44% for weaning weight. In the productive performance and carcass characteristics, the superiority of California breed as paternal breed was evidenced, with average values of 36.05 g in GMD and 2.95 kg in CONV. The average individual weight at the end of the fattening, at 70 days of age, was 2.09 kg and the weight of the carcass 1.16 kg. Post-weaning heterosis for the characteristics evaluated during fattening were positive and moderate. Limitations on study/implications: It is necessary to carry out genetic improvement studies, with different crossing systems and to evaluate results based on the productive and reproductive behavior. Findings/conclusions: in reproductive characteristics, when using NZB as paternal breed, the offspring are superior to those obtained from CA; while in the productive variables the offspring from CA show superior results.Objective: Evaluate the growth performance and carcass characteristics as well as the individual and maternal heterosis effects of New Zealand White (NZB), California (CA) rabbits and their crosses.Design/methodology/approach: 450 offspring rabbits, from 48 females mated to 6 stud rabbits, were evaluated, recording the weight (PNC) and litter size at birth (TCN) and at weaning (TCD), as well as, and weight (PMS), weight gain (GMD), consumption (CMS), and feed conversion (CONV) for during 8 weeks post-weaning. The carcass live weight at slaughter, warm carcass weight with head, carcass yield, and carcass parts of the carcass were evaluated.Results: Showed differences (p <0.05) in TCN and TCD with values of 10.47 and 9.03 kits, respectively. When NZB was used as the paternal breed, obtaining an individual heterosis of 5.91% for litter size and 12.44% for weaning weight. In the productive performance and carcass characteristics, the superiority of the California breed as a paternal breed was evidenced, with average values of 36.05 g in GMD and 2.95 kg in CONV. The averageindividual weight at the end of the fattening, at 70 days of age, was 2.09 kg and the weight of the carcass 1.16 kg. Post-weaning heterosis for the characteristics evaluated during fattening was were positive and moderate.Limitations on study/implications: It is necessary to carry out genetic improvement studies, with different crossing systems and to evaluate results based on the productive and reproductive behavior.Findings/conclusions: in reproductive characteristics, when using NZB as apaternal breed, the offspring are superior to those obtained from CA; while inthe productive variables, the offspring from CA show superior results

    Localized Intersections of Non-Extremal p-branes and S-branes

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    A class of solutions to Supergravity in 10 or 11 dimensions is presented which extends the non-standard or semi-local intersections of Dp-branes to the case of non-extremal p-branes. The type of non-extremal solutions involved in the intersection is free and we provide two examples involving black-branes and/or D-\bar{D} systems. After a rotation among the time coordinate and a relatively transverse radial direction the solutions admit the interpretation of an intersection among D-branes and S-branes. We speculate on the relevance of these configurations both to study time dependent phenomena in the AdS/CFT correspondence as well as to construct cosmological brane-world scenarios within String Theory admitting accelerating expansion of the Universe.Comment: 31 pages, latex file; v2: typos corrected and references adde

    Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: A systematic analysis for the Global Burden of Disease Study 2015

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    Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods: We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings: Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation: Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding: Bill & Melinda Gates Foundation

    Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980�2015: a systematic analysis for the Global Burden of Disease Study 2015

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    Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14�294 geography�year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61·7 years (95 uncertainty interval 61·4�61·9) in 1980 to 71·8 years (71·5�72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7�17·4), to 62·6 years (56·5�70·2). Total deaths increased by 4·1 (2·6�5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0 (15·8�18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1 (12·6�16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1 (11·9�14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1, 39·1�44·6), malaria (43·1, 34·7�51·8), neonatal preterm birth complications (29·8, 24·8�34·9), and maternal disorders (29·1, 19·3�37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146�000 deaths, 118�000�183�000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393�000 deaths, 228�000�532�000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost YLLs) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Funding Bill & Melinda Gates Foundation. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY licens

    Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

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    BACKGROUND: Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. METHODS: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. FINDINGS: Globally, 18·7% (95% uncertainty interval 18·4–19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2–59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5–49·6) to 70·5 years (70·1–70·8) for men and from 52·9 years (51·7–54·0) to 75·6 years (75·3–75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5–51·7) for men in the Central African Republic to 87·6 years (86·9–88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3–238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6–42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2–5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. INTERPRETATION: This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing

    Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

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    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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