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

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

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

Deterioration Control Decision Support System for the Retailer during Availability of Trade Credit and Shortages

The deterioration rate is a significant aspect of perishable goods. Since perishable items will always deteriorate, there are effective methods for reducing the rate of deterioration. Furthermore, in the existing inventory control literature, the deterioration rate is often viewed as an exogenous component. Keeping this problem in mind, this article develops the perishable inventory control system from the retailer’s perspective in which: (i) the deterioration rate is a controllable factor and suggests a new fresh quality technology (FQT) indicator, (ii) demand is determined by the perishable product’s quality, that is controlled by its rate of deterioration, (iii) the credit duration is predefined, and (iv) shortages are expected. The key goal is to demonstrate that there is an ideal quantity of the order that minimizes the retailer’s overall cost in terms of cycle time and deterioration rate. Finally, theoretical results are validated by solving two numerical illustrations and conducting a sensitivity analysis of the main factors resulting from the following managerial implications: (i) if the range of deterioration is between zero and one then the retailer should invest in the preservation factor to preserve the perishable product and if greater than one the retailer should not invest in the preservation factor, (ii) credit period significantly reduces the total cost. Hence, this trade credit strategy is more beneficial to the model

Deterioration Control Decision Support System for the Retailer during Availability of Trade Credit and Shortages

The deterioration rate is a significant aspect of perishable goods. Since perishable items will always deteriorate, there are effective methods for reducing the rate of deterioration. Furthermore, in the existing inventory control literature, the deterioration rate is often viewed as an exogenous component. Keeping this problem in mind, this article develops the perishable inventory control system from the retailer’s perspective in which: (i) the deterioration rate is a controllable factor and suggests a new fresh quality technology (FQT) indicator, (ii) demand is determined by the perishable product’s quality, that is controlled by its rate of deterioration, (iii) the credit duration is predefined, and (iv) shortages are expected. The key goal is to demonstrate that there is an ideal quantity of the order that minimizes the retailer’s overall cost in terms of cycle time and deterioration rate. Finally, theoretical results are validated by solving two numerical illustrations and conducting a sensitivity analysis of the main factors resulting from the following managerial implications: (i) if the range of deterioration is between zero and one then the retailer should invest in the preservation factor to preserve the perishable product and if greater than one the retailer should not invest in the preservation factor, (ii) credit period significantly reduces the total cost. Hence, this trade credit strategy is more beneficial to the model

Senses of hauora and wellbeing in early childhood initial teacher education: Report of phase one data

Auckland University of Technology, Unitec Institute of Technology, The University of Auckland, and Open Polytechnic have joined together to research early childhood student teacher hauora and wellbeing. The project is underpinned by a dedication to treasure and nurture early childhood student teachers during their studies and throughout their journey as teachers and leaders. This research aims to contribute provocations for the design of early childhood teacher education programmes. We are collectively concerned with better understanding the ways in which student teachers navigate their studies, how the navigated journey contributes to professional learning, identity and experience, and how these factors impact on the hauora and wellbeing of student teachers. We recognise that the study of teaching contributes to each student teacher’s personal and professional understanding of hauora and wellbeing through a complex whole of direct and indirect experiences. This understanding is similarly holistic, including cognitive, affective, and embodied learning. The study involves multiple phases, beginning with a first phase gathering student teacher views on hauora and wellbeing in their study. This first phase began in October 2020, at which time the nation was in Level One of its pandemic response. In phase one, student teachers were invited to respond to an online anonymous questionnaire. The survey was completed by 101 participants. A link was provided for participants to share contact details if they were interested in being involved in subsequent phases. The primary purpose of phase one was to provide themes for the development of later phases. The data was analysed through the development of student teacher cases, analysis of themes, and poetic inquiry – the latter of which introduces this Executive Summary as A student teacher’s promise