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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

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Aproximación al análisis de la política fiscal durante la crisis desde la perspectiva de género

Artikulu honetan, genero-ikuspegia kontuan hartuta zerga-politikak duen garrantziaz ohartarazi nahi da. Lehenengo zatian —sarreran, alegia—, azpimarratzen da beharrezkoa dela zerga-arloan aurrez ahalegina egitea, gizarte-eredu jakin bat garatu ahal izateko, non posible izango den eredu horren berezko osagaitzat txertatzea pertsonen zaintza, bizitzan zehar. Bigarren zatian, berriz, aztertzen da zer nolako genero-eragina izan duten krisiaren inpaktuaren ondorioz zergadoikuntzan egindako aldaketa batzuek: Pertsonen Errentaren gaineko Zergan egindakoak —zerga-tasak igota— eta BEZean egindakoak.This paper tries to emphasize the importance of fiscal policy from a gender perspective. The first part, which can be considered as an introduction, focuses on the necessity to maintain fiscal efforts in order to achieve an appropriate social model, capable of incorporating care services throughout the life circle. The second part analyses the impact generated by the fiscal adjustment policy in the wake of the economic crisis with several increases in the rates of the Personal Income Tax (PIT) and in the Value Added Tax (VAT).Este artículo intenta resaltar la importancia de la política fiscal desde una perspectiva de gé- nero. En la primera parte, que puede considerarse como introductoria, se hace hincapié en la necesidad de llevar a cabo un esfuerzo fiscal previo para poder desarrollar un modelo social en el que sea posible incluir el cuidado de las personas a lo largo la vida como parte intrínseca del mismo; el segundo apartado se centra en el análisis del impacto de género de algunas de las modificaciones llevadas a cabo durante el ajuste fiscal, como consecuencia del impacto de la crisis tanto en el Impuesto Personal sobre la Renta con la subida de los tipos impositivos como en el IVA

La hambruna de 1853. Un acontecimiento a resaltar en la obra de Rosalía de Castro

Actas do Congreso Internacional de estudios sobre Rosalía de Castro e o seu tempo: Santiago, 15-20 de xullo de 1985Universidade de Santiago de Compostela-Consello da Cultura Galeg