13 research outputs found

    Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

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    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

    Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

    Get PDF
    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

    Συγκριτική Ανάλυση Ένταξης Μεταναστών και Προσφύγων στην Ελλάδα

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    Η κρίση του 2015-16 και η απότομη αύξηση των ροών από τη Μέση Ανατολή και τη Βόρειο Αφρική δημιούργησαν ένα πιεστικό και πολύπλοκο πολιτικό, οικονομικό και κοινωνικό πλαίσιο στην Ελλάδα και την Ευρώπη. Το πλαίσιο αυτό χαρακτηρίστηκε από το κλείσιμο των συνόρων, τη συμφωνία ΕΕ-Τουρκίας, τη δημιουργία προσωρινών δομών φιλοξενίας, συχνά ανεπαρκών, αλλά και από έντονη κοινωνική δυσαρέσκεια. Σύμφωνα με την Ύπατη Αρμοστεία του ΟΗΕ για τους Πρόσφυγες, από τις αρχές του 2014 και μέχρι τον Οκτώβριο του 2019, περίπου 2.050. 000 άτομα διέσχισαν τη Μεσόγειο αναζητώντας ένα καλύτερο μέλλον. 3 Οι χώρες της Νότιας Ευρώπης αποτέλεσαν και αποτελούν τα κύρια σημεία εισόδου στην Ευρώπη. Η δε Ελλάδα, λόγω της γεωγραφικής της θέσης, βρίσκεται στο επίκεντρο αυτού του φαινομένου.Institutions, Decisions and Collective Behaviou
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