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

Uranium Mining on the Colorado Plateau I.C. 7726

Uranium Mining on the Colorado Plateau I.C. 7726 (Sept. 1955)Documents in the AZGS Document Repository collection are made available by the Arizona Geological Survey (AZGS) and the University Libraries at the University of Arizona. For more information about items in this collection, please contact [email protected]

Inclined lidar observations of boundary layer aerosol particles above the Kongsfjord, Svalbard

An inclined lidar with vertical resolution of 0.4 m was used for detailed boundary layer studies and to link observations at Zeppelin Mountain (474 m) and Ny-Ålesund, Svalbard. We report on the observation of aerosol layers directly above the Kongsfjord. On 29 April 2007, a layer of enhanced backscatter was observed in the lowest 25 m above the open water surface. The low depolarization ratio indicated spherical particles. In the afternoon, this layer disappeared. The ultrafine particle concentration at Zeppelin and Corbel station (close to the Kongsfjord) was low. On 1 May 2007, a drying process in the boundary layer was observed. In the morning, the atmosphere up to Zeppelin Mountain showed enhanced values of the backscatter coefficient. Around noon, the top of the highly reflecting boundary layer decreased from 350 to 250 m. The top of the boundary layer observed by lidar was confirmed by radiosonde data