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

CEO Compensation In Poorly Performing Firms

This paper studies the association between CEO compensation and firm performance in solvent but poorly performing firms.  By focusing on solvent firms, this study insulates the bankruptcy effects (and the complex creditor-shareholder-manager effects) on pay-performance relationship.  Furthermore, there is a widespread belief that CEO pay in such firms does not reflect firms’ poor performance.   I find that on average, the level of CEOs cash compensation is positively related to the firms’ level of operating cash flows. I interpret this finding as suggesting that stockholders of poorly performing firms reward CEOs in the short-run, for the effect of the managerial decisions on cash flows.  However, change in CEOs compensation is unrelated to any measure of the changes in firms’ performance.  This is consistent with the cautious approach of stockholders to wait and see, if change in performance is more permanent

The Relevance Of Firms Accounting And Market Performance For CEO Compensation

This paper investigates the relationship between several different CEO compensation components and several firm performance metrics using canonical correlation analysis (CCA).  The principal findings presented in this paper offer evidence supporting the pay-performance relationship in corporate America. CEOs bonuses   are closely associated with accounting measures of performance whereas CEO’s long-term compensation is directly linked to firm’s market performance.  Furthermore, a substantial portion of the variance in CEOs bonus is explained by firm performance variables.  Firm performance measures have some predictive power for CEO bonus but very little predictive power for other compensation measures

Terminal solid solubilities at 900-1000°C in the magnesium oxide-zinc oxide system measured using a magnesium fluoride solid-electrolyte galvanic cell

The terminal solid solubilities of the periclase (MgO-rich) and zincite (ZnO-rich) solid solutions in the MgO-ZnO system have been determined by measuring the activity of MgO using a solid-state galvanic cell of the type 02(g), Pt/MgO, MgF2//MgF2//{χMgO+(1-χ)ZnO}(s, sln), MgF2/Pt, O2(g) in the temperature range 900-1050° C. The ZnO activity was calculated by graphical Gibbs-Duhem integration. The activity-composition plots of both components exhibit a strong positive deviation from ideality and are characterised by a miscibility gap. The terminal solid solubilities of the periclase and zincite solid solutions obtained from the activity-composition plots are found to be in reasonable agreement with those reported in the literature