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

Neoinstitutionalism and the appropriation of bourdieu's work: a critical assessment

Despite the still present hegemony of the structural-functionalist orthodoxy, the mid 1980's witnesses the insurgence of new philosophical approaches. This body of work had become a vital intellectual and ideological resource for those who wanted to confront the functionalist dominance in organization studies, such as structuration theory, labour process theory and neoinstitutionalist theory. The purpose of this paper is to review the incorporation of Bourdieu's work into neoinstitutionalism. I argue that this appropriation has resulted in a significant loss of theoretical strength. By giving place to the cognitivist metaphors of mental models, "scripts" and "schemas", instead of adopting the notion of habitus, neoinstitutionalism reinforces some of the ever-present dichotomies in social sciences, especially those of agency/structure and individual/society. While neoinstitutionalism was refining the cognitive approach in the 1990's, Bourdieu was moving towards psychoanalysis. Some indications for future research are provided in the concluding notes

As "confrarias" como um fenômeno organizacional brasileiro: uma reflexão sobre significados

Apesar da grande quantidade de artigos acadêmicos sobre a importância dos grupos informais, produzidos nas últimas duas décadas, a maior parte dos estudos limitou-se à análise da influência das redes interorganizacionais na competitividade e na capacidade de mudança das empresas. Neste artigo, argumenta-se que os grupos informais são reproduções sociais do contexto onde estão inseridos, e que seu poder de influência precisa ser investigado numa perspectiva ampliada, interdisciplinar, onde o objeto possa ser analisado, simultaneamente, dos pontos de vista inter e intra-organizacional. Para isso, pretende-se realizar uma reflexão crítica sobre o fenômeno das "confrarias", as quais são vistas como grupos informais que emergem nas organizações a partir de valores socialmente construídos e compartilhados. O principal questionamento teórico é quanto à natureza dos valores e lógicas de ação compartilhados pelos seus participantes, dos recursos de poder de que dispõem e de como esses participantes utilizam tais recursos para atingir seus objetivos. É proposto um modelo analítico para explicar a dinâmica do processo de surgimento e legitimação das "confrarias", desenvolvido a partir dos mais recentes conceitos elaborados segundo a teoria institucional