The Human Cost of Anthropogenic Global Warming: Semi-Quantitative Prediction and the 1,000-Tonne Rule

Establishing and Defining an Approach to Climate Conscious Clinical Medical Ethics

An anthropocentric scope for clinical medical ethics (CME) has largely separated this area of bioethics from environmental concerns. In this article, we first identify and reconcile the ethical issues imposed on CME by climate change including the dispersion of related causes and effects, the transdisciplinary and transhuman nature of climate change, and the historic divorce of CME from the environment. We then establish how several moral theories undergirding modern CME, such as virtue ethics, feminist ethics, and several theories of justice, promote both a flourishing of human medical practice and the environment. We conclude by defining an expanded the scope of CME as inclusive of not only patients, families, physicians, and other health professionals but other humans, non-humans, and their shared environment. We then apply this scope and theory to a widely used framework for applying CME, the Four Topics model, to construct a climate conscious approach to CME.

Colistin- and amikacin-loaded lipid-based drug delivery systems for resistant gram-negative lung and wound bacterial infections

Antimicrobial resistance (AMR) is a global health issue, which needs to be tackled without further delay. The World Health Organization(WHO) has classified three gram-negative bacteria, Pseudomonas aeruginosa, Klebsiella pneumonia and Acinetobacter baumannii, as the principal responsible for AMR, mainly causing difficult to treat nosocomial lung and wound infections. In this regard, the need for colistin and amikacin, the re-emerged antibiotics of choice for resistant gram-negative infections, will be examined as well as their associated toxicity. Thus, current but ineffective clinical strategies designed to prevent toxicity related to colistin and amikacin will be reported, highlighting the importance of lipid-based drug delivery systems (LBDDSs), such as liposomes, solid lipid nanoparticles (SLNs) and nanostructured lipid carriers (NLCs), as efficient delivery strategies for reducing antibiotic toxicity. This review reveals that colistin- and amikacin-NLCs are promising carriers with greater potential than liposomes and SLNs to safely tackle AMR, especially for lung and wound infections.

Estimating the environmental impact of disposable endoscopic equipment and endoscopes

OBJECTIVE

Procedure-intense specialties, such as surgery or endoscopy, are a major contributor to the impact of the healthcare sector on the environment. We aimed to measure the amount of waste generated during endoscopic procedures and to understand the impact on waste of changing from reusable to single use endoscopes in the USA.

DESIGN

We conducted a 5-day audit (cross-sectional study) of all endoscopies performed at two US academic medical centres with low and a high endoscopy volume (2000 and 13 000 procedures annually, respectively). We calculated the average disposable waste (excluding waste from reprocessing) generated during one endoscopic procedure to estimate waste of all endoscopic procedures generated in the USA annually (18 million). We further estimated the impact of changing from reusable to single-use endoscopes taking reprocessing waste into account.

RESULTS

278 endoscopies were performed for 243 patients. Each endoscopy generated 2.1 kg of disposable waste (46 L volume). 64% of waste was going to the landfill, 28% represented biohazard waste and 9% was recycled. The estimated total waste generated during all endoscopic procedures performed in the USA annually would weigh 38 000 metric tons (equivalent of 25 000 passenger cars) and cover 117 soccer fields to 1 m depth. If all endoscopic procedures were performed with single-use endoscopes and accounting for reprocessing, the net waste mass would increase by 40%. Excluding waste from ancillary supplies, net waste generated from reprocessing and endoscope disposal would quadruple with only using single-use endoscopes.

CONCLUSION

This quantitative assessment of the environmental impact of endoscopic procedures highlights that a large amount of waste is generated from disposable instruments. Transitioning to single-use endoscopes may reduce reprocessing waste but would increase net waste.

Assessing Socioeconomic Risks of Climate Change on Tenant Farmers in Pakistan

The study uses a transformative worldview to give voice to an economically marginalized group of tenant farmers vulnerable to climate changes due to their calamity prone geographical location. Drawing on anthropogenic global warming (AGW) theory lens, we examine the impact of manmade actions on climate change in District “Swat” and “Malakand” of Khyber Pakhtunkhwa (KPK) province, Pakistan using a sequential mixed methods research design. Through this research design, the results of quantitative survey were complemented with a qualitative analysis of in-depth interviews. In first phase, we conducted a survey of 200 tenant farmers, followed by second wave of data collection involving 12 open-ended in-depth interviews (IDIs). The both qualitative and quantitative results suggest that farmers in both districts are affected by climate change although their crop yield had progressively increased signaling better coping and survival skills than other parts of country. Majority of respondents believed that climate change is something beyond their control in disagreement with AGW theory. Major economic losses were specifically, due to sudden alterations in weather patterns, such as floods, and hailstorms that reduce productivity as well as results in food waste with no avenues available to reclaim the energy laden in organic food waste. Besides, a productivity loss was attributed to outdated farming, lack of awareness regarding sharecropping and crop loan insurance practices. The study concludes that farmers are most vulnerable to climate change in socioeconomic terms as such changes impact their income sources; This inwardly compels cash strapped tenant farmers to delve in practice of informal credit with substantive risks attached which further deteriorates their livelihoods. The study offers understanding of how low-literate and economically marginalized indigenous tenant farmers cope to climate change and offers policy recommendations to advocate for the rights to earn sustainable livelihoods in the face of grand climate challenge.

Life Cycle Assessment of Solid Recovered Fuel Gasification in the State of Qatar

Gas products from gasified solid recovered fuel (SRF) have been proposed as a replacement for natural gas to produce electricity in future power generation systems. In this work, the life cycle assessment (LCA) of SRF air gasification to energy was conducted using the Recipe2016 model considering five environmental impact categories and four scenarios in Qatar. The current situation of municipal solid waste (MSW) handling in Qatar is landfill with composting. The results show that using SRF gasification can reduce the environmental impact of MSW landfills and reliance on natural gas in electricity generation. Using SRF gasification on the selected five environmental impact categories—climate change, terrestrial acidification, marine ecotoxicity, water depletion and fossil resource depletion—returned significant reductions in environmental degradation. The LCA of the SRF gasification for the main four categories in the four scenarios gave varying results. The introduction of the SRF gasification reduced climate change-causing emissions by 41.3% because of production of renewable electricity. A reduction in water depletion and fossil resource depletion of 100 times were achieved. However, the use of solar technology and SRF gasification to generate electricity reduced the impact of climate change to almost zero emissions. Terrestrial acidification showed little to no change in all three scenarios investigated. This study was compared with the previous work from the literature and showed that on a nominal 10 kg MSW processing basis, 5 kg CO2 equivalent emissions were produced for the landfilling scenarios. While the previous studies reported that 8 kg CO2 produced per 10 kg MSW is processed for the same scenario. The findings indicate that introducing SRF gasification in solid waste management and electricity generation in Qatar has the potential to reduce greenhouse gas (GHG) emission load and related social, economic, political and environmental costs. In addition, the adoption of the SRF gasification in the country will contribute to Qatar’s national vision 2030 by reducing landfills and produce sustainable energy.

Towards Climate Neutrality in Poland by 2050: Assessment of Policy Implications in the Farm Sector

Climate neutrality achievement in the European Union assumes the necessity of efforts and transformations in most economic sectors of its member-states. The farm sector in Poland, being the second largest contributor to the country’s greenhouse gas (GHG) emissions and in the top fifth of farm sectors in the EU-27 countries, needs to undergo structural and technological transformations to contribute to the climate action goals. The article assesses the potential impacts of Poland’s climate neutrality achievement path on the domestic farm sector in terms of its structure, output, income, and prices of agricultural products. The approach is based on complex economic modelling combining computable general equilibrium (CGE) and optimisation modelling, with the farm sector model consisting of farm, structural, and market modules. While the modelling results cover three GHG emission-reduction scenarios up to 2050, to understand the transformation impact within varying policy approaches, the study for each scenario of farm sector development also outlines three policy options: carbon pricing, forced emission limit, and carbon subsidies. Results in all scenarios and policy options indicate a strong foreseeable impact on agricultural output and prices (mainly livestock production), shifts in the production structure toward crops, as well as changes in farm income along the analysed timeframe.

The Multi-hub Academic Conference: Global, Inclusive, Culturally Diverse, Creative, Sustainable

New conference formats are emerging in response to COVID-19 and climate change. Virtual conferences are sustainable and inclusive regardless of participant mobility (financial means, caring commitments, disability), but lack face-to-face contact. Hybrid conferences (physical meetings with additional virtual presentations) tend to discriminate against non-fliers and encourage unsustainable flying. Multi-hub conferences mix real and virtual interactions during talks and social breaks and are distributed across nominally equal hubs. We propose a global multi-hub solution in which all hubs interact daily in real time with all other hubs in parallel sessions by internet videoconferencing. Conference sessions are confined to three equally-spaced 4-h UTC timeslots. Local programs comprise morning and afternoon/evening sessions (recordings from night sessions can be watched later). Three reference hubs are located exactly 8 h apart; additional hubs are within 2 h and their programs are aligned with the closest reference hub. The conference experience at each hub depends on the number of local participants and the time difference to the nearest reference. Participants are motivated to travel to the nearest hub. Mobility-based discrimination is minimized. Lower costs facilitate diversity, equity, and inclusion. Academic quality, creativity, enjoyment, and low-carbon sustainability are simultaneously promoted.

Science-Driven Societal Transformation, Part III: Design

Climate change, biodiversity loss, and other major social and environmental problems pose severe risks. Progress has been inadequate and scientists, global policy experts, and the general public increasingly conclude that transformational change is needed across all sectors of society in order to improve and maintain social and ecological wellbeing. At least two paths to transformation are conceivable: (1) reform of and innovation within existing societal systems (e.g., economic, legal, and governance systems); and (2) the de novo development of and migration to new and improved societal systems. This paper is the final in a three-part series of concept papers that together outline a novel science-driven research and development program aimed at the second path. It summarizes literature to build a narrative on the topic of de novo design of societal systems. The purpose is to raise issues, suggest design possibilities, and highlight directions and questions that could be explored in the context of this or any R&D program aimed at new system design. This paper does not present original research, but rather provides a synthesis of selected ideas from the literature. Following other papers in the series, a society is viewed as a superorganism and its societal systems as a cognitive architecture. Accordingly, a central goal of design is to improve the collective cognitive capacity of a society, rendering it more capable of achieving and sustainably maintaining vitality. Topics of attention, communication, self-identity, power, and influence are discussed in relation to societal cognition and system design. A prototypical societal system is described, and some design considerations are highlighted.

Catastrophic Health Impacts of Spiraling Climate Change: How Certain Can We Be About Their Magnitudes?

Recently, there has been a strong interest in the climate emergency and the human health impacts of climate change. Although estimates have been quoted, the modeling methods used have either been simplistic or opaque, making it difficult for policy makers to have confidence in these estimates. Providing central estimates of health impacts, without any quantification of their uncertainty, is deficient because such an approach does not acknowledge the inherent uncertainty in extreme environmental exposures associated with spiraling climate change and related health impacts. Furthermore, presenting only the uncertainty bounds around central estimates, without information on how the uncertainty in each of the model parameters and assumptions contribute to the total uncertainty, is insufficient because this approach hides those parameters and assumptions which contribute most to the total uncertainty. We propose a framework for calculating the catastrophic human health impacts of spiraling climate change and the associated uncertainties. Our framework comprises three building blocks: (A) a climate model to simulate the environmental exposure extremes of spiraling climate change; (B) a health impact model which estimates the health burdens of the extremes of environmental exposures; and (C) an analytical mathematical method which characterizes the uncertainty in (A) and (B), propagates the uncertainty in-between and through these models, and attributes the proportion of uncertainty in the health outcomes to model assumptions and parameter values. Once applied, our framework can be of significant value to policy makers because it handles uncertainty transparently while taking into account the complex interactions between climate and human health.

Science-Driven Societal Transformation, Part I: Worldview

Humanity faces serious social and environmental problems, including climate change and biodiversity loss. Increasingly, scientists, global policy experts, and the general public conclude that incremental approaches to reduce risk are insufficient and transformative change is needed across all sectors of society. However, the meaning of transformation is still unsettled in the literature, as is the proper role of science in fostering it. This paper is the first in a three-part series that adds to the discussion by proposing a novel science-driven research-and-development program aimed at societal transformation. More than a proposal, it offers a perspective and conceptual framework from which societal transformation might be approached. As part of this, it advances a formal mechanics with which to model and understand self-organizing societies of individuals. While acknowledging the necessity of reform to existing societal systems (e.g., governance, economic, and financial systems), the focus of the series is on transformation understood as systems change or systems migration—the de novo development of and migration to new societal systems. The series provides definitions, aims, reasoning, worldview, and a theory of change, and discusses fitness metrics and design principles for new systems. This first paper proposes a worldview, built using ideas from evolutionary biology, complex systems science, cognitive sciences, and information theory, which is intended to serve as the foundation for the R&D program. Subsequent papers in the series build on the worldview to address fitness metrics, system design, and other topics.

SARS-Cov-2 and environmental protection: A collective psychology agenda for environmental psychology research

While the virus SARS-CoV-2 spreads all over the world, most countries have taken severe measures to protect their citizens and slow down the further spread of the disease COVID-19. These measures affect individuals, communities, cities, countries, and the entire planet. In this paper, we propose that the tremendous consequences of the corona crisis invite environmental psychology to focus more strongly on research questions that address major societal challenges from a collective psychology perspective. In particular, we stress that the corona crisis may affect how people appraise - and potentially respond to - the looming climate crisis. By consistently pointing out systemic links and their human factor, environmental psychology can become central to a scientific agenda of a sustainable 'post-corona society'. In order to provide a framework for future research towards a sustainable societal transformation, we build on the Social Identity Model of Pro-Environmental Action (SIMPEA) and extend its scope to understand people's responses following the corona crisis. The model allows predictions of previously not explicitly included concepts of place attachment, nature connectedness, basic psychological needs, and systems thinking. It may serve as a guiding framework for a better understanding of the transformation towards a sustainable future.