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

Destination Image and Intention to Visit the Tokyo 2020 Olympics among Hong Kong Generation Y

Although a great deal of previous research has been done to evaluate the impact of international mega sports events on a destination image, there is a lack of empirical evidence on images that people hold of a destination before the event. The purpose of this study is to examine the relationship between destination image and the intention to travel to Japan to attend the 2020 Tokyo Olympic Games. A total of 315 surveys were collected online through the social media Facebook during the time of the 2014 Winter Olympics in Sochi, Russia. Hong Kong Generation Y's interest in attending the 2020 Tokyo Olympics is driven by destination image factors such as being a safe and clean destination and being perceived to be able to competently hold such a mega-event as well as by an interest in sports. Interest in attending the Games is negatively related to Japan being perceived as having many historical, cultural and environmental attractions. The implications of these findings are valuable to the Japan National Tourism Organization and Tokyo Olympic Organizing Committee for marketing the event

Do corporate governance mechanisms create shareholder value : a comparison between Singapore and US companies.

This document study integrates organisational monitoring and incentive alignment mechanisms and examines the issues based on agency theory framework. To facilitate an international comparison, Singapore and US companies were studied