7 research outputs found
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
State of nature
For the first time ever, the UK’s
wildlife organisations have
joined forces to undertake a
health check of nature in the
UK and its Overseas Territories. 60% of the 3,148 UK species we assessed
have declined over the last 50 years and
31% have declined strongly.
Half of the species assessed have shown
strong changes in their numbers or range,
indicating that recent environmental
changes are having a dramatic impact
on nature in the UK. Species with specific
habitat requirements seem to be faring
worse than generalist species.
A new Watchlist Indicator, developed
to measure how conservation priority
species are faring, shows that their
overall numbers have declined by 77%
in the last 40 years, with little sign
of recovery.
Of more than 6,000 species that have
been assessed using modern Red List
criteria, more than one in 10 are thought
to be under threat of extinction in the UK.
Our assessment looks back over 50 years
at most, yet there were large declines in
the UK’s wildlife prior to this, linked to
habitat loss.
The UK’s Overseas Territories hold a
wealth of wildlife of huge international
importance and over 90 of these species
are at high risk of global extinction.
There is a lack of knowledge on the
trends of most of the UK’s species.
As a result, we can report quantitative
trends for only 5% of the 59,000 or so
terrestrial and freshwater species in
the UK, and for very few of the 8,500
marine species. Much needs to be done
to improve our knowledge.
What we do know about the state of
the UK’s nature is often based upon
the efforts of thousands of dedicated
volunteer enthusiasts who contribute
their time and expertise to monitoring
schemes and species recording.
The threats to the UK’s wildlife are
many and varied, the most severe
acting either to destroy valuable habitat
or degrade the quality and value of
what remains.
Climate change is having an increasing
impact on nature in the UK. Rising
average temperatures are known to be
driving range expansion in some species,
but evidence for harmful impacts is
also mounting.
The full report is online:
www.rspb.org.uk/stateofnature
We should act to save nature both for
its intrinsic value and for the benefits
it brings to us that are essential to our
wellbeing and prosperity.
Targeted conservation has produced
inspiring success stories and, with
sufficient determination, resources
and public support, we can turn the
fortunes of our wildlife around.
The State of Nature report serves
to illustrate that with shared resolve
and commitment we can save nature
Identification of environmental factors that promote intestinal inflammation
Genome-wide association studies have identified risk loci linked to inflammatory bowel disease (IBD)1-a complex chronic inflammatory disorder of the gastrointestinal tract. The increasing prevalence of IBD in industrialized countries and the augmented disease risk observed in migrants who move into areas of higher disease prevalence suggest that environmental factors are also important determinants of IBD susceptibility and severity. However, the identification of environmental factors relevant to IBD and the mechanisms by which they influence disease has been hampered by the lack of platforms for their systematic investigation. Here we describe an integrated systems approach, combining publicly available databases, zebrafish chemical screens, machine learning and mouse preclinical models to identify environmental factors that control intestinal inflammation. This approach established that the herbicide propyzamide increases inflammation in the small and large intestine. Moreover, we show that an AHR-NF-κB-C/EBPβ signalling axis operates in T cells and dendritic cells to promote intestinal inflammation, and is targeted by propyzamide. In conclusion, we developed a pipeline for the identification of environmental factors and mechanisms of pathogenesis in IBD and, potentially, other inflammatory diseases