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

Helminthic parasites of chickens (Gallus domesticus) in different regions of São Paulo State, Brazil

The Brazilian poultry industry is an outstanding national and international agribusiness sector. Among the Brazilian states, São Paulo is the largest producer of commercial eggs and the fourth largest producer and exporter of chicken meat. Alternatively, semiintensive and/or organic poultry production have also obtained a significant share of the domestic market as a result of consumer demand. Helminths affect the performance of the birds, causing significant direct or indirect losses. The objective of the present study was to identify the main helminth species present in chickens reared in 17 municipalities of the state of São Paulo. In total, 359 adult birds were investigated. The birds were reared in different housing systems and were obtained from 69 farms in the selected regions. The birds were submitted to procedures for the detection and identification of helminth parasites, following international standards. The evaluation of the small intestine employed the Mello-Campos method (Mello & Campos, 1974), which allows better recovery of cestode scolices attached to the intestinal mucosa. Stereomicroscopy was used to evaluate the collected materials, and light microscopy was used to identify the species based on their morphological characteristics. The following helminth species were diagnosed in chickens reared in 17 municipalities of the state of São Paulo: nematodes (Ascaridia galli, Capillaria sp., Cheilospirura hamulosa, Heterakis gallinarum, Oxyspirura mansoni, and Strongyloides sp.), cestodes (Amoebotaenia cuneata, Choanotaenia infundibulum, Hymenolepis sp., Raillietina cesticillus, Raillietina echinobothrida, and Raillietina tetragona), and trematodes (Zygocotyle lunata and Postharmostomum commutatum).Laboratório de Parasitologia Animal Instituto Biológico-IB/APTA/SAAInstituto Agronômico de Campinas-IAC/ APTA/SAADepartamento de Apoio Produção e Saúde Animal Faculdade de Medicina Veterinária UNESPDepartamento de Clínica Cirurgia e Reprodução Animal Faculdade de Medicina Veterinária UNESPDepartamento de Apoio Produção e Saúde Animal Faculdade de Medicina Veterinária UNESPDepartamento de Clínica Cirurgia e Reprodução Animal Faculdade de Medicina Veterinária UNES

The European Pollen Database: past efforts and current activities

Pollen stratigraphies are the most spatially extensive data available for the reconstruction of past land-cover change. Detailed knowledge of past land-cover is becoming increasingly important to evaluate the present trends in, and drivers of, vegetation composition. The European Pollen Database (EPD) was established in the late 1980s and developed in the early 1990s to provide a structure for archiving, exchanging, and analysing Quaternary pollen data from Europe. It provides a forum for scientists to meet and engage in collaborative investigations or data analysis. In May 2007 several EPD support groups were developed to assist in the task of maintaining and updating the database. The mapping and data accuracy work group (MADCAP) aims to produce an atlas of past plant distributions as detected by pollen analyses in Europe, in order to meet the growing need for this data from palaeoecologists and the wider scientific community. Due to data handling problems in the past, a significant number of EPD datasets have errors. The initial task of the work group, therefore, was a systematic review of pollen sequences, in order to identify and correct errors. The EPD currently (January 2009) archives 1,032 pollen sequences, of which 668 have age-depth models that allow chronological comparison. Many errors have been identified and corrected, or flagged for users, most notably errors in the pollen count data. The application of spatial analyses to pollen data is related to the number of data points that are available for analysis. We therefore take this opportunity to encourage the submission of pollen analytical results to the EPD or other relevant pollen databases. Only in this way will the scientific community be able to gain a better understanding of past vegetation dynamics