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

Prévalence, morbidité et stratégies de dépistage de la bilharziose chez les migrants originaires de zone d'endémie (revue de littérature et étude descriptive des patients dépistés au Comede entre 2006 et 2009)

PARIS6-Bibl. St Antoine CHU (751122104) / SudocSudocFranceF

Addressing sexuality and sexual health with migrants. Practice guidelines

Sexual health is an integral part of overall health and should be discussed with all people who seek help. The Vaccination and Prevention working group of the French Infectious Diseases Society (SPILF) and the Migrant Commission of the French AIDS Society (SFLS) developed recommendations to address this issue with migrants presenting vulnerability factors. After defining sexual health and target migrants, practical recommendations were issued. Sexual health can be discussed simply with migrants or people with an immigrant background. Some migrants are exposed to sexual vulnerability due to their migration route, social isolation, administrative and housing insecurity, gender inequalities, and discrimination. Situations of sexual vulnerability, sexual violence, and female genital mutilation should be systematically identified and followed by appropriate care that respects the migrant's needs. Extended screening for HIV and sexually transmitted infections (STI) should be systematically offered as part of a "migrant health checkup" and completed, if necessary, with information on preventing tools for HIV, STIs, unwanted pregnancies, and sexual violence. In this population, it is important to check if vaccinations are up to date. Sexology and addiction counselling is sometimes useful. The specific needs of LGBTQIA+ people with an immigrant background should be taken into account