Recent Evolution of Logistic Spatial Patterns in Metropolitan Contexts: The Case of Madrilenian Urban Region

La actividad logística se ha estudiado bajo distintas ópticas, pero con escasa atención a sus impactos en la reorganización urbana y territorial. Este trabajo investiga su expansión en la Región Urbana de Madrid, considerando la localización preferente en los espacios suburbanos y rurales del área metropolitana y su polarización geográfica. El método analiza cuantitativamente tres variables que ilustran su difusión espaciotemporal: trabajadores y empresas por municipios, superficie logística por provincias y usos del suelo con aprovechamiento logístico. Los resultados confirman la propagación de la logística en los espacios metropolitanos mediante procesos de suburbanización y dispersión, al tiempo que la aparición de nuevas centralidades urbanas, consecuencia de la mayor integración de las economías capitalistas a distintas escalas.The logistic activity has been analysed by different approaches, but with a lack of attention to its impacts in the urban and spatial configuration. This work studies the logistic expansion in the Urban Region of Madrid, considering the geographical polarization and its preferential location in suburban and rural zones in the metropolitan area. The methodology considers three variables enlightening the spatial and temporal diffusion: workers and companies by municipality, logistic land use by province and different types of logistic land use. The results confirm the dissemination of logistics in metropolitan areas according to suburbanization and spread processes, at the same time appears new urban centralities as a consequence of the capitalist integration of the economy at different scales.Universidad de Castilla-La Mancha CGT18001

Recent Evolution of Logistic Spatial Patterns in Metropolitan Contexts: The Case of Madrilenian Urban Region

The logistic activity has been analysed by different approaches, but with a lack of attention to its impacts in the urban and spatial configuration. This work studies the logistic expansion in the Urban Region of Madrid, considering the geographical polarization and its preferential location in suburban and rural zones in the metropolitan area. The methodology considers three variables enlightening the spatial and temporal diffusion: workers and companies by municipality, logistic land use by province and different types of logistic land use. The results confirm the dissemination of logistics in metropolitan areas according to suburbanization and spread processes, at the same time appears new urban centralities as a consequence of the capitalist integration of the economy at different scales

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