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van Schie V. Governance related factors influencing the implementation of sustainability in hospitals: A systematic literature review. Health Policy 2024; 146:105115. [PMID: 38924862 DOI: 10.1016/j.healthpol.2024.105115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 05/24/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
Climate change is a pressing issue that has a negative impact on the planet but also on public health. The healthcare sector contributes to environmental pollution, while it aims to improve health. Therefore, its environmental sustainability should be improved. This study focuses on the governance of sustainability in hospitals, since hospitals are the largest operational units in the healthcare system and can therefore make a large impact. To successfully implement and embed sustainable development through the hospital, the right governance approach is needed. This systematic literature review aims to give an overview of governance related factors that influence the implementation of sustainable development in hospitals in Europe. Following PRISMA guidelines, 2426 papers were identified and screened of which 30 were included in the analysis. In these papers, four governance related factors were identified to be important for the implementation of sustainable development in the hospital: knowledge, involvement from management, commitment from healthcare professionals, and technology use. These factors currently mostly form barriers in the implementation process. Future research is recommended on how to practically deploy these factors as facilitators for implementation. Since both involvement from management and commitment from healthcare professionals are crucial factors, further research should look into combining the input of these stakeholders in policy development.
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Affiliation(s)
- Vera van Schie
- School of Business and Economics, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV, Amsterdam, the Netherlands.
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Pratt B. Defending and Defining Environmental Responsibilities for the Health Research Sector. SCIENCE AND ENGINEERING ETHICS 2024; 30:25. [PMID: 38842627 PMCID: PMC11156718 DOI: 10.1007/s11948-024-00487-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 04/30/2024] [Indexed: 06/07/2024]
Abstract
Six planetary boundaries have already been exceeded, including climate change, loss of biodiversity, chemical pollution, and land-system change. The health research sector contributes to the environmental crisis we are facing, though to a lesser extent than healthcare or agriculture sectors. It could take steps to reduce its environmental impact but generally has not done so, even as the planetary emergency worsens. So far, the normative case for why the health research sector should rectify that failure has not been made. This paper argues strong philosophical grounds, derived from theories of health and social justice, exist to support the claim that the sector has a duty to avoid or minimise causing or contributing to ecological harms that threaten human health or worsen health inequity. The paper next develops ideas about the duty's content, explaining why it should entail more than reducing carbon emissions, and considers what limits might be placed on the duty.
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Affiliation(s)
- Bridget Pratt
- Queensland Bioethics Centre, Australian Catholic University, Brisbane, Australia.
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3
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Guihenneuc J, Cambien G, Blanc-Petitjean P, Papin E, Bernard N, Jourdain B, Barcos I, Saez C, Dupuis A, Ayraud-Thevenot S, Migeot V. Knowledge, behaviours, practices, and expectations regarding climate change and environmental sustainability among health workers in France: a multicentre, cross-sectional study. Lancet Planet Health 2024; 8:e353-e364. [PMID: 38849178 DOI: 10.1016/s2542-5196(24)00099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/25/2024] [Accepted: 04/26/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Faced with climate change, hospitals are confronted with a dual challenge. On one hand, they need to embark on a far-reaching ecological transformation to reduce their contribution to greenhouse gas emissions and other environmental impacts; on the other hand, they need to limit the effects of climate change on their activities. We aimed to evaluate the knowledge, behaviours, practices, and expectations of health workers in French hospitals regarding climate change and environmental sustainability. METHODS This multicentre, cross-sectional study was carried out in six French hospitals from June 1, 2021 to Dec 31, 2022. All health workers at the hospitals were eligible to participate and were recruited through internal publicity. We designed a structured questionnaire consisting of five parts: participant characteristics, knowledge and perceptions of climate change, pro-environmental behaviours, practices concerning environmental sustainability actions, and expectations. A multilevel logistic regression model was used to evaluate associations between the knowledge, behaviours, and practices of health workers and the characteristics of the health workers and hospitals. FINDINGS Of 57 034 health workers across the six hospitals, 4552 (8·0%) participated in the study. Of those for whom gender data were available, 3518 (78·2%) participants were women and 979 (21·8%) were men. Participants considered energy consumption (71·0%) and waste and discharges related to medical activities (55·6%) and non-medical activities (50·2%) to be the three activities with the greatest environmental impact. On a scale of 1 (not a priority) to 10 (high priority), the median rating attributed by the participants to the commitment of their hospitals to ecological transformation was 5·0 (IQR 3·0-6·0). 1079 (23·7%) of 4552 participants had already initiated at least one environmental sustainability action in their hospital. Barriers reported by participants to the implementation of environmental sustainability-related projects were the lack of dedicated time (40·4%), hierarchical support (32·5%), methodological support (28·9%), and access to training (23·7%). The presence of a sustainable development steering committee, especially one with more than 5 years of activity, was positively associated with health workers feeling better informed about the ecological transformation of their hospital (adjusted odds ratio 1·78 [95% CI 1·29-2·45]), having better knowledge of the environmental impacts of their hospital (1·83 [1·32-2·53]), and initiating a larger number of environmental sustainability actions (1·74 [1·33-2·29]). INTERPRETATION We showed that health workers in French hospitals seem to be committed to the ecological transformation of their workplaces, and identified some drivers and barriers to further support these essential transformations. There is an urgent need to bolster training for all health workers, enhance structural frameworks within hospitals, and encourage future interdisciplinary research on the vulnerability of health-care facilities to climate change. FUNDING The University Hospital of Poitiers.
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Affiliation(s)
- Jérémy Guihenneuc
- Université de Poitiers, CNRS, EBI, Poitiers, France; Université de Poitiers, CHU de Poitiers, INSERM, Centre d'Investigation Clinique CIC1402, Axe Santé Environnementale, Poitiers, France; Pôle BIOSPHARM, CHU de Poitiers, Poitiers, France.
| | - Guillaume Cambien
- Université de Poitiers, CNRS, EBI, Poitiers, France; Université de Poitiers, CHU de Poitiers, INSERM, Centre d'Investigation Clinique CIC1402, Axe Santé Environnementale, Poitiers, France; Pôle BIOSPHARM, CHU de Poitiers, Poitiers, France
| | - Pauline Blanc-Petitjean
- Epidemiology and Public Health Department, CHU Rennes, Rennes, France; CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, Rennes, France
| | - Emeline Papin
- Université de Poitiers, CHU de Poitiers, INSERM, Centre d'Investigation Clinique CIC1402, Axe Santé Environnementale, Poitiers, France
| | - Noëlle Bernard
- Department of Internal Medicine and Infectious Diseases, University Hospital of Bordeaux, Hôpital Saint André, Bordeaux, France
| | - Bernard Jourdain
- Sustainable Development Department, Hospital of Niort, Niort, France
| | - Isabelle Barcos
- Methodological Support and Innovation in Prevention Department, University Hospital of Bordeaux, Hôpital Pellegrin, Bordeaux, France
| | - Cécile Saez
- Sustainable Development Department, University Hospital of Bordeaux, Talence, France
| | - Antoine Dupuis
- Université de Poitiers, CNRS, EBI, Poitiers, France; Université de Poitiers, CHU de Poitiers, INSERM, Centre d'Investigation Clinique CIC1402, Axe Santé Environnementale, Poitiers, France; Pôle BIOSPHARM, CHU de Poitiers, Poitiers, France
| | - Sarah Ayraud-Thevenot
- Université de Poitiers, CNRS, EBI, Poitiers, France; Université de Poitiers, CHU de Poitiers, INSERM, Centre d'Investigation Clinique CIC1402, Axe Santé Environnementale, Poitiers, France; Pôle BIOSPHARM, CHU de Poitiers, Poitiers, France
| | - Virginie Migeot
- Epidemiology and Public Health Department, CHU Rennes, Rennes, France; CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, Rennes, France
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van Gils-Schmidt HJ, Salloch S. Physicians' duty to climate protection as an expression of their professional identity: a defence from Korsgaard's neo-Kantian moral framework. JOURNAL OF MEDICAL ETHICS 2024; 50:368-374. [PMID: 37879902 DOI: 10.1136/jme-2023-109203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 10/10/2023] [Indexed: 10/27/2023]
Abstract
The medical profession is observing a rising number of calls to action considering the threat that climate change poses to global human health. Theory-led bioethical analyses of the scope and weight of physicians' normative duty towards climate protection and its conflict with individual patient care are currently scarce. This article offers an analysis of the normative issues at stake by using Korsgaard's neo-Kantian moral account of practical identities. We begin by showing the case of physicians' duty to climate protection, before we succinctly introduce Korsgaard's account. We subsequently show how the duty to climate protection can follow from physicians' identity of being a healthcare professional. We structure conflicts between individual patient care and climate protection, and show how a transformation in physicians' professional ethos is possible and what mechanisms could be used for doing so. An important limit of our analysis is that we mainly address the level of individual physicians and their practical identities, leaving out important measures to respond to climate change at the mesolevels and macrolevels of healthcare institutions and systems, respectively.
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Affiliation(s)
| | - Sabine Salloch
- Institute for Ethics, History and Philosophy of Medicine, Medizinische Hochschule Hannover, Hannover, Niedersachsen, Germany
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Garcia Borrega J, Hermes C, König V, Kitz V, Möller S, Stark D, Janssens U, Mager D, Kochanek M. [Sustainability in intensive and emergency care : A nationwide survey by the German Society of Medical Intensive Care and Emergency Medicine]. Med Klin Intensivmed Notfmed 2024; 119:108-115. [PMID: 37341751 PMCID: PMC10901941 DOI: 10.1007/s00063-023-01039-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/31/2023] [Accepted: 06/06/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND The impact of climate change on humans is well known. However, the health care system is also a relevant contributor, accounting for up to 5-7% of global greenhouse gas emissions, and work should be adapted to be more sustainable. AIM The survey investigated whether sustainability plays a role in hospitals and specifically in the field of emergency and intensive care. Concrete measures and which hurdles are already recognized were also inquired. MATERIALS AND METHODS The "AG Nachhaltigkeit" (working group on sustainability) of the "Deutschen Gesellschaft für Internistische Intensivmedizin und Notfallmedizin" (DGIIN) conducted an electronic survey among the staff of intensive care units, emergency rooms, and ambulance services in Germany. RESULTS In all, 218 survey results were included in the analysis: 108 (50%) participants were from the nursing sector and 98 (45%) belonged to the medical staff. The majority of participants work in an intensive care unit (181 [83%]) followed by intermediate care unit (52 [24%]). A total of 104 (47%) participants indicated that their workplace had already implemented sustainability measures. However, when asked whether decision-makers in the workplaces incorporate sustainability into their decisions, management scored highest with only 20%. Potential for improvement is seen in energy and waste management, among others. CONCLUSION The survey results show that (1) employees are highly motivated to address the issue of sustainability and to implement measures, (2) the potential to establish a resource-saving and environmentally friendly hospital is far from being exhausted, and (3) it must become a priority that decision-makers in the hospital propagate sustainability, make processes transparent, and support the motivation of employees on the subject of sustainability. In addition, this process must be supported by politicians and health insurance companies.
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Affiliation(s)
- Jorge Garcia Borrega
- Klinik I für Innere Medizin, Zentrum für Integrierte Onkologie Aachen Bonn Köln Düsseldorf, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - Carsten Hermes
- Hochschule für angewandte Wissenschaften (HAW), Hamburg, Deutschland
- Akkon Hochschule für Humanwissenschaften, Berlin, Deutschland
| | | | - Valery Kitz
- Interdisziplinäre Intensivstation, Pflegeentwicklung, Agaplesion Diakonieklinikum Hamburg, Hohe Weide 17, 20259, Hamburg, Deutschland
| | - Sverrir Möller
- Interdisziplinäre konservative Intensivstation, Universitätsklinikum Schleswig-Holstein (UKSH), Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - Dominik Stark
- Klinik I für Innere Medizin, Zentrum für Integrierte Onkologie Aachen Bonn Köln Düsseldorf, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - Uwe Janssens
- Innere Medizin und Internistische Intensivmedizin, St-Antonius-Hospital gGmbH, Eschweiler, Deutschland
| | - David Mager
- Krankenhaus der Barmherzigen Brüder Trier, Trier, Deutschland
| | - Matthias Kochanek
- Klinik I für Innere Medizin, Zentrum für Integrierte Onkologie Aachen Bonn Köln Düsseldorf, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
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Shah IH, Manzoor MA, Jinhui W, Li X, Hameed MK, Rehaman A, Li P, Zhang Y, Niu Q, Chang L. Comprehensive review: Effects of climate change and greenhouse gases emission relevance to environmental stress on horticultural crops and management. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2024; 351:119978. [PMID: 38169258 DOI: 10.1016/j.jenvman.2023.119978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/30/2023] [Accepted: 12/26/2023] [Indexed: 01/05/2024]
Abstract
Global climate change exerts a significant impact on sustainable horticultural crop production and quality. Rising Global temperatures have compelled the agricultural community to adjust planting and harvesting schedules, often necessitating earlier crop cultivation. Notably, climate change introduces a suite of ominous factors, such as greenhouse gas emissions (CGHs), including elevated temperature, increased carbon dioxide (CO2) concentrations, nitrous oxide (N2O) and methane (CH4) ozone depletion (O3), and deforestation, all of which intensify environmental stresses on crops. Consequently, climate change stands poised to adversely affect crop yields and livestock production. Therefore, the primary objective of the review article is to furnish a comprehensive overview of the multifaceted factors influencing horticulture production, encompassing fruits, vegetables, and plantation crops with a particular emphasis on greenhouse gas emissions and environmental stressors such as high temperature, drought, salinity, and emission of CO2. Additionally, this review will explore the implementation of novel horticultural crop varieties and greenhouse technology that can contribute to mitigating the adverse impact of climate change on agricultural crops.
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Affiliation(s)
- Iftikhar Hussain Shah
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai 200240, PR China
| | - Muhammad Aamir Manzoor
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai 200240, PR China
| | - Wu Jinhui
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai 200240, PR China
| | - Xuyang Li
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai 200240, PR China
| | - Muhammad Khalid Hameed
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai 200240, PR China
| | - Asad Rehaman
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai 200240, PR China
| | - Pengli Li
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai 200240, PR China
| | - Yidong Zhang
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai 200240, PR China
| | - Qingliang Niu
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai 200240, PR China
| | - Liying Chang
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai 200240, PR China.
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Sullivan GA, Reiter AJ, Smith C, Glick RD, Skarda DE, Le HD, Gow KW, Rich BS, Raval MV. Pediatric Surgeon Perceptions on Operating Room Environmental Stewardship and Current Institutional Climate-Smart Actions. J Pediatr Surg 2023; 58:2278-2285. [PMID: 37468347 DOI: 10.1016/j.jpedsurg.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Operating rooms generate significant greenhouse gas emissions. Our objective was to assess current institutional climate-smart actions and pediatric surgeon perceptions regarding environmental stewardship efforts in the operating room. METHODS A survey was distributed to members of the American Pediatric Surgical Association in June 2022. The survey was piloted among ten general surgery residents and two professional society cohorts of pediatric surgeons. Comparisons were made by demographic and practice characteristics. RESULTS Survey response rate was 15.9% (n = 160/1009) and included surgeons predominantly from urban (n = 93/122, 76.2%) and academic (n = 84/122, 68.9%) institutions. Only 9.8% (n = 12/122) of pediatric surgeons were currently involved in operating room environmental initiatives. The most common climate-smart actions were reusable materials and equipment (n = 120/159, 75.5%) and reprocessing of medical devices (n = 111/160, 69.4%). Most surgeons either strongly agreed (n = 48/121, 39.7%) or agreed (n = 62/121, 51.2%) that incorporation of environmental stewardship practices at work was important. Surgeons identified reusable materials/equipment (extremely important: n = 61/129, 47.3%, important: n = 38/129, 29.5%) and recycling (extremely important: n = 68/129, 52.7%, important: n = 29/129, 22.5%) as the most important climate-smart actions. Commonly perceived barriers were financial (extremely likely: n = 47/123, 38.2%, likely: n = 50/123, 40.7%) and staff resistance to change (extremely likely: n = 29/123, 23.6%, likely: n = 60/123, 48.8%). Regional differences included low adoption of energy efficiency strategies among respondents from southern states (n = 0/26, p = 0.01) despite high perceived importance relative to other regions (median: 5, IQR: 4-5 vs median: 4, IQR 4-5, p = 0.04). CONCLUSIONS While most pediatric surgeons agreed that environmental stewardship was important, less than 10% are currently involved in initiatives at their institutions. Opportunities exist for surgical leadership surrounding implementation of climate-smart actions. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Gwyneth A Sullivan
- Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Audra J Reiter
- Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Charesa Smith
- Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Richard D Glick
- Division of Pediatric Surgery, Department of Surgery, Cohen Children's Medical Center, New Hyde Park, NY, USA
| | - David E Skarda
- University of Utah, Department of Surgery, Division of Pediatric Surgery, Salt Lake City, UT, USA; Primary Children's Hospital, Intermountain Health Care, Salt Lake City, UT, USA
| | - Hau D Le
- Division of Pediatric Surgery, Department of Surgery, American Family Children's Hospital, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Kenneth W Gow
- Seattle Children's Hospital and the University of Washington, Seattle, WA, USA
| | - Barrie S Rich
- Division of Pediatric Surgery, Department of Surgery, Cohen Children's Medical Center, New Hyde Park, NY, USA
| | - Mehul V Raval
- Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
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Chen X, Abdallah MF, Landschoot S, Audenaert K, De Saeger S, Chen X, Rajkovic A. Aspergillus flavus and Fusarium verticillioides and Their Main Mycotoxins: Global Distribution and Scenarios of Interactions in Maize. Toxins (Basel) 2023; 15:577. [PMID: 37756003 PMCID: PMC10534665 DOI: 10.3390/toxins15090577] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/25/2023] [Accepted: 09/04/2023] [Indexed: 09/28/2023] Open
Abstract
Maize is frequently contaminated with multiple mycotoxins, especially those produced by Aspergillus flavus and Fusarium verticillioides. As mycotoxin contamination is a critical factor that destabilizes global food safety, the current review provides an updated overview of the (co-)occurrence of A. flavus and F. verticillioides and (co-)contamination of aflatoxin B1 (AFB1) and fumonisin B1 (FB1) in maize. Furthermore, it summarizes their interactions in maize. The gathered data predict the (co-)occurrence and virulence of A. flavus and F. verticillioides would increase worldwide, especially in European cold climate countries. Studies on the interaction of both fungi regarding their growth mainly showed antagonistic interactions in vitro or in planta conditions. However, the (co-)contamination of AFB1 and FB1 has risen worldwide in the last decade. Primarily, this co-contamination increased by 32% in Europe (2010-2020 vs. 1992-2009). This implies that fungi and mycotoxins would severely threaten European-grown maize.
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Affiliation(s)
- Xiangrong Chen
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, 9000 Ghent, Belgium; (M.F.A.); (A.R.)
- Department of Plants and Crops, Faculty of Bioscience Engineering, Ghent University, 9000 Ghent, Belgium; (S.L.); (K.A.)
| | - Mohamed F. Abdallah
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, 9000 Ghent, Belgium; (M.F.A.); (A.R.)
- Department of Forensic Medicine and Toxicology, Faculty of Veterinary Medicine, Assiut University, Assiut 71515, Egypt
| | - Sofie Landschoot
- Department of Plants and Crops, Faculty of Bioscience Engineering, Ghent University, 9000 Ghent, Belgium; (S.L.); (K.A.)
| | - Kris Audenaert
- Department of Plants and Crops, Faculty of Bioscience Engineering, Ghent University, 9000 Ghent, Belgium; (S.L.); (K.A.)
| | - Sarah De Saeger
- Centre of Excellence in Mycotoxicology and Public Health, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium;
- Department of Biotechnology and Food Technology, Faculty of Science, University of Johannesburg, Doornfontein Campus, P.O. Box 17011, Gauteng 2028, South Africa
| | - Xiangfeng Chen
- Shandong Analysis and Test Centre, Qilu University of Technology (Shandong Academy of Science), Jinan 250014, China;
| | - Andreja Rajkovic
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, 9000 Ghent, Belgium; (M.F.A.); (A.R.)
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Hoffmann JM, Bauer A, Grossmann R. The carbon footprint of clinical trials: a global survey on the status quo and current regulatory guidance. BMJ Glob Health 2023; 8:e012754. [PMID: 37730244 PMCID: PMC10510862 DOI: 10.1136/bmjgh-2023-012754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/04/2023] [Indexed: 09/22/2023] Open
Abstract
INTRODUCTION All economic sectors including the service sector, along with healthcare, education and research, need to reduce their greenhouse gas emissions to limit global temperature increases. In this study, we aim to globally assess the awareness and current actions taken by Academic Research Institutions (ARIs) or governments regarding the reduction of carbon dioxide equivalent (CO2e) emissions for clinical research. METHODS We designed a cross-sectional survey-based study, which was distributed within the International Clinical Trials Center Network (ICN). The survey population comprised representatives of the ICN who had extensive experience in academic clinical research and profound knowledge and understanding of the local context. RESULTS The response rate was 80%. Responding ARIs were from 15 different countries and 4 continents. Around half of the ARIs reported that almost none of their research projects considered reducing their carbon footprint. The other half of the ARIs were not familiar with this subject at all. According to 60% of the respondents, greenhouse gas emissions are not assessed by Institutional Review Boards (IRBs)/Ethics Committees (ECs) or competent authorities, while 40% did not know. Neither IRBs/ECs nor competent authorities currently advise sponsors and investigators on reducing the carbon footprint of their clinical research projects. As for reducing greenhouse gas emissions in clinical research, virtual conferences and meetings were the most commonly implemented measures by ARIs across all regions. Finally, we have put together an action plan/checklist advising researchers on carbon footprint reduction for clinical trials. CONCLUSION Currently, greenhouse gas emissions are neglected during the planning phase of a research project, and they are not yet addressed or assessed by default during the approval procedures by IRBs/ECs or competent authorities. Thus, all involved stakeholders within clinical research need to be made aware of it through advice from ARIs and IRBs/ECs, among others.
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Affiliation(s)
- Jean-Marc Hoffmann
- Clinical Trials Center, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Annina Bauer
- Clinical Trials Center, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Regina Grossmann
- Clinical Trials Center, University of Zurich and University Hospital Zurich, Zurich, Switzerland
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10
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Abstract
OBJECTIVE To examine the quality and strength of evidence for an association between temperature increases caused by climate change and suicide used in policy documents to advocate for radical changes to healthcare systems in pursuit of decarbonisation. METHOD The designs of articles collected in a systematic review which concluded that there was an association between climate change and increased rates of suicide were analysed for their capacity to support this conclusion. Complete US data covering temperatures and suicide rates between 1968 and 2004 was aggregated and analysed using linear regression to evaluate evidence for an association between temperature and suicide. RESULTS None of the articles collected in the review has a design capable of investigating whether there is an association between temperature increases caused by climate change and rates of suicide. At the national level increased annual US temperatures were associated with a decrease in the rate of suicide, and at the state level it was common for high average temperature states to have low rates of suicide and vice versa. CONCLUSIONS Policy recommendations for radical changes in healthcare services have been based on misrepresented evidence. Policy makers should beware of recommendations that ignore scientific evidence to pursue faith-based goals.
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Affiliation(s)
- Andrew James Amos
- Division of Tropical Health and Medicine, College of Medicine and Dentistry, James Cook University, Townsville, Australia
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Gebhardt N, Saur C, Litke N, Nikendei C. [Motives, goals and anticipated barriers as experienced by employees engaged in an initiative promoting sustainability at a general hospital - A qualitative analysis]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2023; 176:90-96. [PMID: 36658015 DOI: 10.1016/j.zefq.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/14/2022] [Accepted: 11/29/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND As a consequence of the climate crisis, a drastic reduction of greenhouse gas emissions and a transformation towards a sustainable economy are indispensable for the health care sector. METHODS For the present study, barriers and facilitators in implementing a transformation towards more sustainability were evaluated in qualitative interviews with members of an initiative attempting to establish more sustainability at a general hospital. RESULTS In 12 interviews, the interviewees were asked about the necessary personal characteristics for their commitment, short- and long-term ideas about how to reduce green house gas emissions, as well as barriers and facilitators of the organization's structure and of the societal context. CONCLUSION The methods for implementing more sustainability at a general hospital are mostly known. However, more knowledge is needed about the capacity to withstand both organizational barriers and feelings of hopelessness and impotence in order to preserve one's ability to act.
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Affiliation(s)
- Nadja Gebhardt
- Klinik für Allgemeine Innere Medizin und Psychosomatik, Universitätsklinikum Heidelberg, Deutschland.
| | - Clara Saur
- Klinik für Allgemeine Innere Medizin und Psychosomatik, Universitätsklinikum Heidelberg, Deutschland
| | - Nicola Litke
- Abteilung Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg, Deutschland
| | - Christoph Nikendei
- Klinik für Allgemeine Innere Medizin und Psychosomatik, Universitätsklinikum Heidelberg, Deutschland
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12
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Moving From Rhetoric to Real Climate Action: Making a Difference for a Sustainable Planet. Heart Lung Circ 2023; 32:4-7. [PMID: 36739117 DOI: 10.1016/j.hlc.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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13
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Mohtady Ali H, Ranse J, Roiko A, Desha C. Healthcare Workers' Resilience Toolkit for Disaster Management and Climate Change Adaptation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12440. [PMID: 36231739 PMCID: PMC9564616 DOI: 10.3390/ijerph191912440] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/23/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
Climate change has been recognised as a multiplier of risk factors affecting public health. Disruptions caused by natural disasters and other climate-driven impacts are placing increasing demands on healthcare systems. These, in turn, impact the wellness and performance of healthcare workers (HCWs) and hinder the accessibility, functionality and safety of healthcare systems. This study explored factors influencing HCWs' disaster management capabilities with the aim of improving their resilience and adaptive capacity in the face of climate change. In-depth, semi-structured interviews were conducted with thirteen HCWs who dealt with disasters within two hospitals in Queensland, Australia. Analysis of the results identified two significant themes, HCWs' disaster education and HCWs' wellness and needs. The latter comprised five subthemes: HCWs' fear and vulnerability, doubts and uncertainty, competing priorities, resilience and adaptation, and needs assessment. This study developed an 'HCWs Resilience Toolkit', which encourages mindfulness amongst leaders, managers and policymakers about supporting four priority HCWs' needs: 'Wellness', 'Education', 'Resources' and 'Communication'. The authors focused on the 'Education' component to detail recommended training for each of the pre-disaster, mid-disaster and post-disaster phases. The authors conclude the significance of the toolkit, which provides a timely contribution to the healthcare sector amidst ongoing adversity.
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Affiliation(s)
- Heba Mohtady Ali
- Cities Research Institute, Griffith University, Gold Coast, QLD 4215, Australia
- School of Engineering and Built Environment, Griffith University, Gold Coast, QLD 4215, Australia
| | - Jamie Ranse
- Department of Emergency Medicine, Griffith University, Gold Coast, QLD 4215, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4215, Australia
| | - Anne Roiko
- Cities Research Institute, Griffith University, Gold Coast, QLD 4215, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4215, Australia
| | - Cheryl Desha
- Cities Research Institute, Griffith University, Gold Coast, QLD 4215, Australia
- School of Engineering and Built Environment, Griffith University, Gold Coast, QLD 4215, Australia
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