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

Desenvolvimento de modelo auto-regressivo para previsão em pronto-atendimento

The 1988 constitution makes an life is a supreme good when increased health as the fundamental condition requiring that all ill patient has the right to be treated in a public hospital (CF, art. 196). In this sense, the goal of this work is to generate a weekly forecast of hospital care by means of an advanced prediction model. It is expected that the model of self-regressivas seasonal moving averages SARIMA generate reliable and adherent to issue forecasts analyzed, thus enabling better resource allocation and more efficient hospital managementA constituição de 1988, deixa bem claro que a vida é um bem supremo quando elevou a saúde como à condição fundamental solicitando que, todo paciente enfermo tem direito a ser tratado em um hospital público (CF, art. 196). Neste sentido, o objetivo deste trabalho é gerar uma previsão semanal de atendimentos hospitalares por meio de um modelo avançado de previsão. Espera-se, que o modelo de médias móveis integradas sazonais auto-regressivas- SARIMA gere previsões confiáveis e aderentes ao problema analisado, possibilitando assim, uma melhor alocação dos recursos e uma gestão hospitalar mais eficient

Biodiversity conservation gaps in the Brazilian protected areas

Although Brazil is a megadiverse country and thus a conservation priority, no study has yet quantified conservation gaps in the Brazilian protected areas (PAs) using extensive empirical data. Here, we evaluate the degree of biodiversity protection and knowledge within all the Brazilian PAs through a gap analysis of vertebrate, arthropod and angiosperm occurrences and phylogenetic data. Our results show that the knowledge on biodiversity in most Brazilian PAs remain scant as 71% of PAs have less than 0.01 species records per km2. Almost 55% of Brazilian species and about 40% of evolutionary lineages are not found in PAs, while most species have less than 30% of their geographic distribution within PAs. Moreover, the current PA network fails to protect the majority of endemic species. Most importantly, these results are similar for all taxonomic groups analysed here. The methods and results of our countrywide assessment are suggested to help design further inventories in order to map and secure the key biodiversity of the Brazilian PAs. In addition, our study illustrates the most common biodiversity knowledge shortfalls in the tropics.Fil: Oliveira, Ubirajara. Universidade Federal de Minas Gerais; BrasilFil: Soares-Filho, Britaldo Silveira. Universidade Federal de Minas Gerais; BrasilFil: Paglia, Adriano Pereira. Universidade Federal de Minas Gerais; BrasilFil: Brescovit, Antonio Domingos. Governo do Estado de Sao Paulo. Secretaria da Saude. Instituto Butantan; BrasilFil: De Carvalho, Claudio J. B.. Universidade Federal do Paraná; BrasilFil: Silva, Dasniel Paiva. Instituto Federal Goiano; BrasilFil: Teixeira de Rezende, Daniella. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales “Bernardino Rivadavia”; ArgentinaFil: Leite, Felipe Sá Fortes. Universidade Federal de Vicosa; BrasilFil: Batista, João Aguiar Nogueira. Universidade Federal de Minas Gerais; BrasilFil: Barbosa, João Paulo Peixoto Pena. Governo do Estado de Sao Paulo. Secretaria da Saude. Instituto Butantan; BrasilFil: Stehmann, João Renato. Universidade Federal de Minas Gerais; BrasilFil: Ascher, John S.. National University Of Singapore; SingapurFil: De Vasconcelos, Marcelo Ferreira. Instituto Prístino; BrasilFil: De Marco, Paulo. Universidade Federal de Goiás; BrasilFil: Löwenberg-Neto, Peter. Universidade Federal da Integração Latino-Americana; BrasilFil: Ferro, Viviane Gianluppi. Universidade Federal de Goiás; BrasilFil: Santos, Adalberto J.. Universidade Federal de Minas Gerais; Brasi

Reply to Biodiversity conservation gaps in Brazil: A role for systematic conservation planning

Previous article in issueNext article in issue Fonseca and Venticinque (2018) (hereafter FV) present a critical assessment of a paper in which we attempt to estimate the biodiversity coverage of the Brazilian conservation units (Oliveira et al., 2017). We appreciate their contribution to this important debate. We have no doubts that conservation planning should be based on a variety of information sources, including not only the coverage of species? ranges but also the contribution of each area to the preservation of ecosystem services, landscape features and socioeconomic and cultural aspects. This systematic and integrative conservation planning is certainly a complex process, which requires the contribution of experts from different fields. However, we have shown, in this reply, that our paper (Oliveira et al., 2017) aims to quantify the knowledge and protection gaps of biodiversity in protected areas, not to propose priority areas or to test whether the current proposal of priority areas is efficient. Objectives and the conclusions of our paper. We hope this short response can clarify this debate.Fil: Oliveira, Ubirajara. Universidade Federal de Minas Gerais; BrasilFil: Soares Filho, Britaldo Silveira. Universidade Federal de Minas Gerais; BrasilFil: Paglia, Adriano Pereira. Universidade Federal de Minas Gerais; BrasilFil: Brescovit, Antonio Domingos. Governo do Estado de Sao Paulo. Secretaria da Saude. Instituto Butantan; BrasilFil: de Carvalho, Claudio J. B.. Universidade Federal do Paraná; BrasilFil: Silva, Daniel Paiva. Instituto Federal Goiano; BrasilFil: Teixeira de Rezende, Daniella. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales “Bernardino Rivadavia”; ArgentinaFil: Leite, Felipe Sá Fortes. Universidade Federal de Viçosa; BrasilFil: Batista, João Aguiar Nogueira. Universidade Federal de Minas Gerais; BrasilFil: Barbosa, João Paulo Peixoto Pena. Governo do Estado de Sao Paulo. Secretaria da Saude. Instituto Butantan; BrasilFil: Stehmann, João Renato. Universidade Federal de Minas Gerais; BrasilFil: Ascher, John S.. National University Of Singapore; SingapurFil: Vasconcelos, Marcelo Ferreira de. Instituto Prístino; BrasilFil: De Marco, Paulo. Universidade Federal de Goiás; BrasilFil: Löwenberg-Neto, Peter. Universidade Federal Da Integração Latino-americana; BrasilFil: Ferro, Viviane Gianluppi. Universidade Federal de Goiás; BrasilFil: Santos, Adalberto J.. Universidade Federal de Minas Gerais; Brasi

Núcleos de Ensino da Unesp: artigos 2008

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