4 research outputs found

    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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    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

    Dietary Effects of Garlic (Allium sativum) Powder on Growth Performance of Commercial Broiler

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    The study was conducted during summer (April-May) to investigate the growth performance of 120-day-old mixed-sex commercial broiler chicks (Cobb-400) by examining the dietary effects of different levels of garlic (Allium sativum) powder supplementation. In a 28-day experiment, four distinct diets (T1, T2, T3, and T4) were utilized, each containing varying amounts of dried garlic powder (0%, 0.5%, 1%, and 2%). The effectiveness of garlic powder on feeding was evaluated by measuring weight gain, feed consumption, feed efficiency, dressing yield, and survivability. The results showed that there were no significant differences in body weight gain among the treatment groups in the first seven days. However, significant differences were observed in broiler diets containing 0.5%, 1%, and 2% garlic powder during the 8-14, 15-21, and 22-28 day periods, with the highest body weight gain observed in birds fed a diet containing 1% garlic powder. Furthermore, significant enhancements (P<0.05) in the feed conversion ratio (FCR) were observed by increasing the inclusion of garlic powder compared to the control group during specific age periods (1-7, 15-21, and 22-28 days), with the treatment group fed with 1% garlic powder exhibiting the most favorable FCR at the trial’s conclusion. Regarding feed intake and survivability, the study showed no significant differences (P>0.05) in broilers with different dietary treatments. The inclusion of garlic powder in broiler feed led to a notable decrease in fat content and an increase in dressing yield, with the highest yield achieved at a 1% supplementation level. Therefore, the study suggests that 1% garlic powder could be a potential feed additive to enhance the overall performance of the broiler

    SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

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    Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.The aim of this study was to inform vaccination prioritization by modelling the impact of vaccination on elective inpatient surgery. The study found that patients aged at least 70 years needing elective surgery should be prioritized alongside other high-risk groups during early vaccination programmes. Once vaccines are rolled out to younger populations, prioritizing surgical patients is advantageous
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