120 research outputs found
Emissions from Animal Agriculture—16.5% Is the New Minimum Figure
Knowledge production within the climate sciences is quickly taken up by multiple stakeholders, reproduced in scientific citation and the broader culture, even when it is no longer accurate. This article accomplishes two goals: firstly, it contributes to the clarification of the quantification of emissions from animal agriculture, and secondly, it considers why the dominant framing of the United Nations Food and Agricultural Organization (FAO) on this subject focuses on maximizing production efficiency. Specifically, analysing the FAO’s own work on this topic shows that the often-used FAO estimate that emissions from animal agriculture amount to 14.5% of all greenhouse gas (GHG) emissions is now out of date. In returning to the FAO’s own explanation of its data sources and its more recent analysis of emissions from animal agriculture, this article finds that the figure of minimum estimate should be updated to 16.5%. The tendency of the FAO to prioritize a technological approach focused on making animal production more “eco-efficient” is critically examined in light of many other evidence-based calls for reductions in animal consumption. An explanation for this FAO approach is offered in terms of a type of epistemological bias
Pathways to Veganism: Exploring Effective Messages in Vegan Transition Report on additional focus group phase of project – November 2019:Pathways to Veganism follow on
Rhetorics of Species Revivalism and Biotechnology – A Roundtable Dialogue
This informal dialogue contextualises and explores contemporary practices of nonhuman animal gene-modification in de-extinction projects. Looking at recent developments in biotechnology’s role in de-extinction sciences and industries, these interdisciplinary scholars scrutinise the neoliberal impetus driving ‘species revivalism’ in the wake of the Capitalocene. Critical examinations of species integrity, cryo-preservation, techno-optimism, rewilding initiatives and projects aimed at restoring extinct animals such as the woolly mammoth and bucardo are used to map some of the necessary restructuring of conservation policies and enterprises that could secure viably sustainable – and just – futures for nonhuman animals at risk of extinction. The authors question what alternatives are being ignored in the wake of technoscientific responses to the climate emergency, and interpret the motivations, tactics and tools responsible for commodifying nonhuman animals down to the cellular level. Our conversation on the messy relations within endangered ecologies offers alternative approaches to environmental governance and strategies for addressing the climate and biodiversity crises today
Rhetorics of Species Revivalism and Biotechnology:A Roundtable Dialogue
This informal dialogue contextualises and explores contemporary practices of nonhuman animal gene-modification in de-extinction projects. Looking at recent developments in biotechnology’s role in de-extinction sciences and industries, these interdisciplinary scholars scrutinise the neoliberal impetus driving ‘species revivalism’ in the wake of the Capitalocene. Critical examinations of species integrity, cryo-preservation, techno-optimism, rewilding initiatives and projects aimed at restoring extinct animals such as the woolly mammoth and bucardo are used to map some of the necessary restructuring of conservation policies and enterprises that could secure viably sustainable —and just—futures for nonhuman animals at risk of extinction. Authors question what alternatives are being ignored in the wake of technoscientific responses to the climate emergency and interpret the motivations, tactics and tools responsible for commodifying nonhuman animals down to the cellular level. Our conversation on the messy relations within endangered ecologies offers alternative strategies and approaches to how environmental governance addresses the climate and biodiversity crises today
Exploring the Representation of Cows on Dairy Product Packaging in Brazil and the United Kingdom
Food packages must communicate mandatory information, but they can also be used for marketing practices such as promotion and are a communication pathway from industry to consumer. Considering that cows are the main beings affected by the dairy industry, it is essential to scrutinise what dairy product packages convey about them. The aims of this study are to analyse the occurrence of reference to cows on the packaging of dairy products in popular supermarket retail stores in Brazil and the United Kingdom and to discuss ethical implications of promotional practices of dairy producers. We found that in both countries most packaging does not refer to cows at all. In the UK, an average of 31% of the packaging used some visual reference to cows, and in Brazil an average of 15% of packaging used some visual reference to cows. We identified four modalities of cow signifiers with a strong common appeal to nature that reflect and reaffirm an idyllic narrative of milk production. Our findings reflect the concept of absent referent, coined by Carol Adams, both on the packages containing some type of cow representation and on the packages not containing any. Considering that it might influence the consumer’s understanding and attitude towards cows, we highlight that the lack of adequate information about cows’ conditions and the obscuring of problematic issues in cows’ exploitation through the globalization of the happy cow narrative are two important issues to be placed on the Marketing Ethics concerns
Systematic review and narrative synthesis of surgeons’ perception of postoperative outcomes and risk
Background
The accuracy with which surgeons can predict outcomes following surgery has not been explored in a systematic way. The aim of this review was to determine how accurately a surgeon's ‘gut feeling’ or perception of risk correlates with patient outcomes and available risk scoring systems.
Methods
A systematic review was undertaken in accordance with PRISMA guidelines. A narrative synthesis was performed in accordance with the Guidance on the Conduct of Narrative Synthesis In Systematic Reviews. Studies comparing surgeons' preoperative or postoperative assessment of patient outcomes were included. Studies that made comparisons with risk scoring tools were also included. Outcomes evaluated were postoperative mortality, general and operation‐specific morbidity and long‐term outcomes.
Results
Twenty‐seven studies comprising 20 898 patients undergoing general, gastrointestinal, cardiothoracic, orthopaedic, vascular, urology, endocrine and neurosurgical operations were included. Surgeons consistently overpredicted mortality rates and were outperformed by existing risk scoring tools in six of seven studies comparing area under receiver operating characteristic (ROC) curves (AUC). Surgeons' prediction of general morbidity was good, and was equivalent to, or better than, pre‐existing risk prediction models. Long‐term outcomes were poorly predicted by surgeons, with AUC values ranging from 0·51 to 0·75. Four of five studies found postoperative risk estimates to be more accurate than those made before surgery.
Conclusion
Surgeons consistently overestimate mortality risk and are outperformed by pre‐existing tools; prediction of longer‐term outcomes is also poor. Surgeons should consider the use of risk prediction tools when available to inform clinical decision‐making.
Introduction
Surgical procedures all carry associated risks. It is therefore important that surgeons are able to make accurate predictions of potential benefit and risk, including immediate mortality and morbidity, as well as long‐term outcomes, to enable balanced decision‐making and fully informed consent. Risks can also be estimated after surgery, based on additional perioperative and intraoperative data, which allows contemporary prediction of outcome. There are numerous risk prediction models that enable the surgeon to quantify risk based on measurable parameters1-5. However, there are inherent limitations in using a generalized risk prediction model, which may not include clinical data pertinent to the individual case in question, leading to variability in model accuracy6-10.
As a result, risk prediction tools are generally used in tandem with the surgeon's ‘gut feeling’ of overall risk and anticipated outcome (‘clinical gestalt’). Several disparate factors influence surgeons' perception of outcome: patient factors, such as their perceived fitness, their pathology and planned procedure; setting factors, such as the experience of other members of staff; and surgeon factors, such as clinical knowledge, operative skill, previous significant surgical complications, and inclinations and attitudes11-13.
Anticipating surgical risk is subject to multiple biases, which make it challenging. These include the natural tendency toward anecdotal recall and the availability heuristic (the likelihood of making a decision based on how easily the topic or examples come to mind)14, 15. Some studies16-18 support the accuracy and reproducibility of surgeons' predictions, whereas others19-22 demonstrate less favourable results. The complexity of synthesizing risk perceptions is significant and incompletely understood23, 24. The accuracy of surgeons' prediction has not been explored previously in a systematic manner.
The aim of this review was thus to determine, from the available evidence, whether a surgeon's gut feeling or perception of risk correlates with postoperative outcomes, and to compare this prediction with currently available risk scoring systems, where available.
Methods
This systematic review was undertaken in accordance with the PRISMA guidelines25, 26. MEDLINE (via PubMed), Embase, the Cochrane Library Database, and the Cochrane Collaboration Central Register of Controlled Clinical Trials were searched with no date or language restrictions, with the last search date on 9 July 2018. The search term used was (‘Surgeons’[Mesh] OR ‘General Surgery/manpower*’ [MeSH]) AND (‘perception’ OR ‘intuition’ OR ‘predict*’ OR ‘decision making’ [mesh]). There was no restriction on publication type. This search was complemented by an exhaustive review of the bibliography of key articles, and also by using the Related Articles function in PubMed of included papers. Results were restricted to human research published in English.
Inclusion and exclusion criteria
All studies of patients undergoing surgery in which a preoperative or postoperative surgeon assessment (or proxy assessment) of a postoperative outcome was performed were included. This included articles that reported general risk (such as mortality) or a surgery‐specific risk (for example anastomotic leakage). Studies that made comparisons with established risk scoring tools were also included. Papers or abstracts in English, or non‐English papers with an English abstract, were included.
Papers describing the risk assessment of ‘theoretical’ cases, or patient vignettes in a situation distant from clinical practice (such as a conference), were excluded, as were studies in which surgeons' assessment of risk was compared with an established risk scoring tool, without data on actual patient outcome.
Data extraction and assessment of study quality
Three authors independently extracted data and assessed the methodological quality of the studies, with all data extraction independently checked by the senior author.
The following baseline data were extracted from each study: first author, year of publication, data collection period, geographical location, study design and type (single or multiple centres, number of surgeons involved in risk estimation, whether consecutive patients were enrolled), surgical specialty, whether other risk scoring systems were used for comparison and, if so, whether the assessor was blinded to this result. Data extracted regarding the assessment of risk included: risk outcome assessed; timing of risk estimation (preoperative or postoperative); type of risk assessment by surgeons (qualitative, quantitative, continuous scale such as a visual analogue scale (VAS), or composite score); absolute value of risk event predicted by surgeon and by scoring system; absolute value of risk occurrence rate; summary data on outcome reported, including area under the curve (AUC) of receiver operating characteristic (ROC) curves, observed : expected (O : E) or predicted : observed (P : O) ratios, or any other summary data.
When data were available, AUCs were extracted with their 95 per cent confidence intervals. AUCs greater than 0·9 were considered as indicating high performance, 0·7–0·9 as moderate performance, 0·5–0·7 as low performance, and less than 0·5 as indicating risk assessment no better than chance alone27, 28.
Risk predictions made by pre‐existing tools, such as the Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (POSSUM)1, Portsmouth‐POSSUM (P‐POSSUM)4 or Continuous Improvement in Cardiac Surgery Program (CICSP)5, were compared with outcome when given. Internal prediction models, where authors would derive significant predictive co‐variables from their data set and assess the accuracy of these co‐variables within the same data set, were not evaluated as they lacked validity.
Study quality was assessed using the Newcastle–Ottawa (NO) score29, 30. The NO score assigns points based on: the quality of patient selection (maximum 4 points); comparability of the cohort (maximum 2 points); and outcome assessment (maximum 3 points). Studies that scored 6 points or more were considered to be of higher quality.
Outcome measures
The following outcome measures were defined a priori and refined during data extraction: postoperative mortality (usually defined as 30 days after surgery); postoperative general morbidity (usually defined as 30 days after surgery); postoperative procedure‐specific morbidity; and long‐term outcome (typically operation‐specific).
Further comparative analyses of outcomes included comparison of preoperative and postoperative predictions, and of predictions made by consultants and surgical trainees.
Narrative synthesis
Given the marked heterogeneity in study design, patient population included, method of assessing risk and outcomes assessed, meta‐analysis was deemed not appropriate. A narrative synthesis was therefore performed according to the Guidance on the Conduct of Narrative Synthesis In Systematic Reviews31. Three authors systematically summarized each article using bullet points to document key aspects of each study, focusing particularly on methods used and results obtained. The validity and certainty of the results were noted (whether appropriate statistical comparisons were used and, if so, their effect size and significance). The senior author identified and grouped common themes, divided larger themes into subthemes, tabulated a combined summary of the paper, and synthesized a common rubric for each theme. Consolidated reviewers' comments can be found in Table S1 (supporting information).
Results
A total of 584 articles were identified from the literature search, of which 48 were retrieved for evaluation. Papers were excluded on the basis of being duplicates (1) and being irrelevant based on the title (497) and abstract (38) (Fig. 1). Twenty‐seven studies16-24, 32-49 comprising 20 898 patients met the inclusion criteria and were included in the narrative synthesis (Appendix S1, supporting information)
A Sustainable Campus: The Sydney Declaration on Interspecies Sustainability
Under the remit of an expanded definition of sustainability – one that acknowledges animal agriculture as a key carbon intensive industry, and one that includes interspecies ethics as an integral part of social justice – institutions such as Universities can and should play a role in supporting a wider agenda for sustainable food practices on campus. By drawing out clear connections between sustainability objectives on campus and the shift away from animal based products, the objective of this article is to advocate for a more consistent understanding and implementation of sustainability measures as championed by university campuses at large. We will draw out clear connections between sustainability objectives on campus and the shift away from animal based products. Overall, our arguments are contextualised within broader debates on the relationship between sustainability, social justice and interspecies ethics. We envisage that such discussion will contribute to an enriched, more robust sense of sustainability—one in which food justice refers not only to justice for human consumers and producers of food and the land used by them, but also to justice for the nonhuman animals considered as potential sources of food themselves
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