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

IHS Mittelfristprognose 2020-2024

Am 23. Juli 2020 präsentierte das Institut für Höhere Studien seine diesjährige mittelfristige Konjunkturprognose. Erstmalig fand der Pressetermin als Videokonferenz via MS Teams statt. Im Fokus der mittelfristigen Prognose 2020 bis 2024 steht die explizite Analyse unterschiedlicher Szenarien der wirtschaftlichen Entwicklung. Es liegt auf der Hand, dass die Anstrengungen, das Coronavirus weiterhin und immer besser einzudämmen, auch ausschlaggebend dafür sind, wie schnell es mit der Konjunktur wieder bergauf geht

More Opportunity, More Cooperation? The Behavioral Effects of Birthright Citizenship on Immigrant Youth

Inequality of opportunity, particularly when overlaid with racial, ethnic, or cultural differences, increases the social distance between individuals, which is widely believed to limit the scope of cooperation. A central question, then, is how to bridge such divides. We study the effects of a major citizenship reform in Germany — the introduction of birthright citizenship on January 1, 2000 — in terms of inter-group cooperation and social segregation between immigrant and native youth. We hypothesize that endowing immigrant children with citizenship rights levels the playing field between them and their native peers, with possible spill-overs into the domain of social interactions. Our unique setup connects a large-scale lab-in-the-field experiment based on the investment game with the citizenship reform by exploiting the quasi-random assignment of citizenship rights around its cut-off date. Immigrant youth born prior to the reform display high levels of cooperation toward other immigrants, but low levels of cooperation toward natives. The introduction of birthright citizenship caused male, but not female, immigrants to significantly increase their cooperativeness toward natives. This effect is accompanied by a near-closure of the educational achievement gap between young immigrant men and their native peers