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

The Software Design Board: a Tool supporting Workstyle Transitions in Collaborative Software Design

Abstract. Software design is a team activity, and designing effective tools to support collaborative software design is a challenging task. Designers work together in a variety of different styles, and move frequently between these styles throughout the course of their work. As a result, software design tools need to support a variety of collaborative styles, and support fluid movement between these styles. This paper presents the Software Design Board, a prototype collaborative design tool supporting a variety of styles of collaboration, and facilitating transitions between them. The design of Software Design Board was motivated by empirical research demonstrating the importance of such support in collaborative software design, as well as activity analysis identifying the lack of support in existing tools for different styles of collaboration and transitions between them.

Price-Setting Combinatorial Auctions for Coordination and Control of Manufacturing Multiagent Systems: Updating Prices Methods

International audienceCombinatorial auctions are used as a distributed coordination mechanism in Multiagent Systems. The use of combinatorial auctions as negotiation and coordination mechanism is especially appropriate in systems with interdependencies and complementarities such as manufacturing scheduling systems. In this work we review some updating price mechanisms for combinatorial auctions based on the Lagrangian Relaxation Method. We focus our research to solve the optimization scheduling problem in the shop floor, taking into account the objectives of resource allocation in dynamic environments, i.e. -robustness, stability, adaptability, and efficiency-