Greening procurement: Exploring evolving practices in an Irish university

Including green criteria in the public procurement of goods and services requires increased expertise, new methodologies, more significant monitoring efforts and more support towards innovation. These added complexities influence procurement professionals and their everyday practices. This article explores the under-researched issue of practitioner-led beliefs, attitudes, and their accounts of Green Public Procurement (GPP). We delve into a qualitative case study of University College Cork (UCC) in Ireland to explore the journey of procurement professionals in introducing GPP across the various sectors and departments of the university. We draw from interviews, a horizon scanning workshop, and secondary materials to capture and build on the expertise of a broad range of staff in UCC with experience in this area. We use this collective viewpoint to make sense of GPP and to position such views relative to ongoing policy priorities, looking at past, present, and future outlooks. The research shows that efforts have been made to introduce green criteria in new tenders. These gradually became wider opportunities to develop competencies, skills, and stimuli to implement more impactful strategies. The research also shows underdeveloped practices around supporting innovation, monitoring, and post-award evaluation. Overall, the paper offers a unique perspective based on the day-to-day practice of public procurement practitioners. While the case study is geographically bound and therefore presents difficulties in replicating findings, it provides a new lens for researching GPP adoption through interaction with practitioners.

Safety and efficacy of an outpatient 12-step desensitization protocol for antineoplastic agents

OBJECTIVE

Antineoplastic agents can cause hypersensitivity reactions that may preclude further treatment, possibly compromising patient outcome if the tumor remains sensitive to such agent. Although desensitization protocols can be used to re-introduce agents after the development of a hypersensitivity reaction, these protocols vary across institutions. Our study evaluated the safety and efficacy of our desensitization protocol.

METHODS

All patients who underwent desensitization to platinum, taxane, liposomal doxorubicin, or trastuzumab between November 2016 and May 2021 after a prior hypersensitivity reaction to the specific agent were included in a retrospective review. The 12-step, outpatient desensitization protocol included pretreatment with a leukotriene receptor antagonist, antihistamines, and corticosteroids, as well as extended infusion times. Successful desensitization was defined as the completion of ≥3 cycles without discontinuation of the agent due to a hypersensitivity reaction.

RESULTS

A total of 186 eligible patients were included. Median age was 59.5 years (range 26-87). 155 (83%) patients were treated with platinum. 55 (30%) patients were treated for colorectal cancer and 52 (28%) for ovarian cancer. 104 (56%) patients completed ≥3 cycles of therapy during desensitization. The median infusion time was 380 min (range 325-360 min). The median number of desensitization cycles was 3, with 694 cycles completed among all patients. A total of 79 (42%) patients had a breakthrough hypersensitivity reaction during desensitization, 4 of whom required epinephrine, and 84 (45%) patients discontinued the agent undergoing desensitization due to progression of disease.

CONCLUSIONS

Our outpatient 12-step, institutional desensitization protocol for antineoplastic therapy proved safe and efficacious, with 56% of patients successfully completing ≥3 cycles and not requiring an inpatient admission.