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.
Data for this phenomenological study of preschoolers' prejudices were collected through an interview protocol developed by the researchers. The participants, selected using purposeful sampling, were 100 four-to six-year-old children from Van, Turkey. For data analysis, coders looked firstly at word or phrase repetition, and then at the connectors the children used. This revealed that the children had several distinct prejudices related to each of seven main themes drawn from the existing literature: (1) race, (2) age, (3) physical abilities, (4) physical characteristics, (5) economic class, (6) gender and (7) family composition. However, some of the children's prejudices were nested and interrelated. For instance, when expressing prejudices related to age, they tended to exhibit their prejudices related to gender or physical characteristics.
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