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

Collaborative Learning through Podcast Creation by University Faculty and Students

En esta propuesta se exploró el uso de los podcasts con una finalidad docente. El uso educativo de los podcasts no sólo mejora las competencias digitales de PDI, PAS y alumnado y suponen una innovación en el uso de recursos educativos en abierto, sino que va son un excelente recurso frente a los desafíos que sentimos desde la comunidad educativa. Este proyecto se creó un grupo de trabajo formado por docentes, PAS y estudiantes en el cual se cumplieron los objetivos de tener acceso al material necesario para poder realizar podcasts educativos; formarnos para conocer su funcionamiento y posibilidades; utilizarlos durante el curso 2022-2023; contrastar colectivamente los retos y oportunidades que supone su uso; para, finalmente, evaluar la experiencia y transferirla al resto de la comunidad educativa. Así, entre quienes decidieron finalmente utilizar este recurso, un 60% lo hizo sólo en una asignatura y el 40% en dos asignaturas, en las que están matriculados un conjunto de 400 estudiantes. En dos de estas asignaturas, ha sido el o la docente quienes han realizado los podcasts y en el resto se ofreció al alumnado hacer un podcast de forma obligatoria o voluntaria. Como resultado final, en el marco de este proyecto se realizaron un total de 28 podcasts: 11 podcasts por parte del profesorado y 17 por parte del alumnado.Universidad Complutense de MadridDepto. de Antropología Social y Psicología SocialDepto. de Álgebra, Geometría y TopologíaDepto. de Didáctica de las Lenguas, Artes y Educación FísicaDepto. de Física de la Tierra y AstrofísicaDepto. de Periodismo y Nuevos MediosFac. de Ciencias Políticas y SociologíaFac. de Ciencias MatemáticasFac. de Ciencias de la InformaciónFac. de Trabajo SocialFac. de Ciencias FísicasFac. de EducaciónFALSEsubmitte

Global impact of the COVID-19 pandemic on subarachnoid haemorrhage hospitalisations, aneurysm treatment and in-hospital mortality: 1-year follow-up

Background: Prior studies indicated a decrease in the incidences of aneurysmal subarachnoid haemorrhage (aSAH) during the early stages of the COVID-19 pandemic. We evaluated differences in the incidence, severity of aSAH presentation, and ruptured aneurysm treatment modality during the first year of the COVID-19 pandemic compared with the preceding year. Methods: We conducted a cross-sectional study including 49 countries and 187 centres. We recorded volumes for COVID-19 hospitalisations, aSAH hospitalisations, Hunt-Hess grade, coiling, clipping and aSAH in-hospital mortality. Diagnoses were identified by International Classification of Diseases, 10th Revision, codes or stroke databases from January 2019 to May 2021. Results: Over the study period, there were 16 247 aSAH admissions, 344 491 COVID-19 admissions, 8300 ruptured aneurysm coiling and 4240 ruptured aneurysm clipping procedures. Declines were observed in aSAH admissions (-6.4% (95% CI -7.0% to -5.8%), p=0.0001) during the first year of the pandemic compared with the prior year, most pronounced in high-volume SAH and high-volume COVID-19 hospitals. There was a trend towards a decline in mild and moderate presentations of subarachnoid haemorrhage (SAH) (mild: -5% (95% CI -5.9% to -4.3%), p=0.06; moderate: -8.3% (95% CI -10.2% to -6.7%), p=0.06) but no difference in higher SAH severity. The ruptured aneurysm clipping rate remained unchanged (30.7% vs 31.2%, p=0.58), whereas ruptured aneurysm coiling increased (53.97% vs 56.5%, p=0.009). There was no difference in aSAH in-hospital mortality rate (19.1% vs 20.1%, p=0.12). Conclusion: During the first year of the pandemic, there was a decrease in aSAH admissions volume, driven by a decrease in mild to moderate presentation of aSAH. There was an increase in the ruptured aneurysm coiling rate but neither change in the ruptured aneurysm clipping rate nor change in aSAH in-hospital mortality