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

Stratificering 1974-1988

Contains fulltext : 140699.pdf (publisher's version ) (Open Access)93 p

Why does unemployment come in couples? An analysis of (un)employment and (non)employment homogamy tables for Canada, the Netherlands and the United States in the 1980s

Contains fulltext : 140709.pdf (publisher's version ) (Open Access)12 p

From unemployment to unemployment - from employment to employment?

Contains fulltext : 140704.pdf (publisher's version ) (Open Access

Losers in market transition: the unemployed, the retired, and the disabled

The market transition debate is almost primarily focused on the ‘winners’ and on what happens to the formerly privileged during the market transformation process in post- Communist societies. This study emphasizes the impact of the market transformation process on the income of those who have few resources and are eligible for social benefits. Are these people the ‘real’ losers of the market transformation process in post-Communist societies? OLS regression models are estimated based on 50 standardized cross-sectional surveys on the Czech Republic, Hungary, Poland, Russia, and Slovakia covering a period from 1991 to 2002. The analyses show that the unemployed have the lowest income and that the income of retirement and disability pensioners is relatively protected, especially during the early transformation years. Education seems to be a helpful resource for the unemployed and pensioners, but not specifically during the turbulent early transformation years. Results on the income effect of urban residence are inconclusive.