COVID‐19 and cardiothoracic surgery: Effects on training and workforce utilization in a global pandemic

Background The COVID-19 pandemic has disrupted all aspects of healthcare, including cardiothoracic surgery (CTS). We sought to determine the pandemic's impact on CTS trainees' educational experiences. Methods A survey was developed and distributed to members of the Thoracic Surgery Residents Association and other international CTS trainees. Trainees were asked to evaluate their cumulative experiences and share their overall perceptions of how CTS training had been impacted during the earliest months of the COVID-19 pandemic (i.e., since March 01, 2020). Surveys were distributed and responses were recorded June 25–August 05, 2020. In total, 748 surveys were distributed and 166 responses were received (overall response rate 22.2%). Of these, 126 of 166 responses (75.9%) met inclusion criteria for final analysis. Results Final responses analyzed included 45 of 126 (35.7%) United States (US) and 81 of 126 (64.3%) international trainees, including 101 of 126 (80.2%) senior and 25 of 126 (19.8%) junior trainees. Most respondents (76/126, 43.2%) lost over 1 week in the hospital due to the pandemic. Juniors (12/25, 48.0%) were more likely than seniors (20/101, 19.8%) to be reassigned to COVID-19-specific units (p < .01). Half of trainees (63/126) reported their case volumes were reduced by over 50%. US trainees (42/45, 93.3%) were more likely than international trainees (58/81, 71.6%) to report reduced operative case volumes (p < .01). Most trainees (104/126, 83%) believed their overall clinical acumen was not adversely impacted by the pandemic. Conclusions CTS trainees in the United States and abroad have been significantly impacted by the COVID-19 pandemic, with time lost in the hospital, decreased operative experiences, less time on CTS services, and frequent reassignment to COVID-19-specific care settings

Advancing Work—Life Integration in Individuals, Organizations, and Communities

The problem and the solution. Working adults report they experience greater challenges today in their ability to be productive employees, experience personal and interpersonal health and well-being, and make meaningful contributions as citizens to their respective communities. By better understanding work—life theory and research, human resource development professionals can contribute to the strategic development of policies, practices, programs, and interventions that appear to alleviate or ameliorate demands fostering greater work—life integration. Integration is a solution representing a holistic strategy including effective and efficient coordination of efforts and energies among all stakeholders sharing interest and benefits from workers being able to fulfill their personal, work, family, and community obligations

Environmental management of confectionery products: Life cycle impacts and improvement strategies

This paper presents the first environmental life cycle analysis for a range of different confectionery products. A proposed Life Cycle Assessment (LCA) approach and multi-criteria decision analysis (MCDA) was developed to characterise and identify the environmental profiles and hotspots for five different confectionery products; milk chocolate, dark chocolate, sugar, milk chocolate biscuit and milk-based products. The environmental impact categories are based on Nestle's EcodEX LCA tool which includes Global Warming Potential (GWP), Abiotic Depletion Potential (ADP), ecosystems quality, and two new indicators previously not considered such as land use and water depletion. Overall, it was found that sugar confectionery had the lowest aggregated environmental impact compared to dark chocolate confectionery which had the highest, primarily due to ingredients. As such, nine key ingredients were identified across the five confectionery products which are recommended for confectionery manufacturers to prioritise e.g. sugar, glucose, starch, milk powder, cocoa butter, cocoa liquor, milk liquid, wheat flour and palm oil. Furthermore, the general environmental hotspots were found to occur at the following life cycle stages: raw materials, factory, and packaging. An analysis of five improvement strategies (e.g. alternative raw materials, packaging materials, renewable energy, product reformulations, and zero waste to landfill) showed both positive and negative environmental impact reduction is possible from cradle-to-grave, especially renewable energy. Surprisingly, the role of product reformulations was found to achieve moderate-to-low environmental reductions with waste reductions having low impacts. The majority of reductions was found to be achieved by focusing on sourcing raw materials with lower environmental impacts, product reformulations, and reducing waste generating an aggregated environmental reduction of 46%. Overall, this research provides many insights of the environmental impacts for a range of different confectionery products, especially how actors across the confectionery supply chain can improve the environmental sustainability performance. It is expected the findings from this research will serve as a base for future improvements, research and policies for confectionery manufacturers, supply chain actors, policy makers, and research institutes towards an environmentally sustainable confectionery industry