Validating circular performance indicators: The interface between circular economy and stakeholders

Copyright: © 2021 by the authors. The development and application of appropriate Circular Economy indicators is an issue that concerns both the scientific and the business community, as well as decision makers. The existing gap between research, policy and practice could be bridged by using a dynamic indicators selection approach that combines both expert and participatory practices. This study aims to develop such a novel approach for the selection of indicators based on views and needs of practitioners, whilst considering the complex interdependencies of the indicators and determining their importance. Twenty circularity indicators for the Water-Energy-Food-Ecosystems nexus are selected and ranked by different stakeholders. The interrelationships of the indicators are identified using the Interpretive Structural Model, resulting in six levels of importance. Cross-impact matrix multiplication applied to classification (MICMAC) analysis further enabled the classification of the twenty indicators into four categories based on their driving and dependence power. The results indicate that seven indicators— one related to regeneration of natural environment principle, four related to keep resources in use, and two related to design out negative externalities—are the driving indicators to Circular Economy. The approach can be applied to other sets of indicators as well, enabling their prioritization and implementation with other systems.COST Action CA17133 Circular City; Horizon 2020 innovation projects HYDROUSA (grant agreement no. 776643) and HOUSEFUL (grantagreement no. 776708)

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

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

Resuspension and Lateral Movement of Sediment by Tow Traffic on the Upper Mississippi and Illinois Rivers

published or submitted for publicationis peer reviewedOpe