scholarly journals Carbon footprint reduction associated with a surgical outreach clinic

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
David Forner ◽  
Chad Purcell ◽  
Victoria Taylor ◽  
Christopher W. Noel ◽  
Larry Pan ◽  
...  
Keyword(s):  
Carbon Footprint ◽  
Carbon Emissions ◽  
Surgical Care ◽  
Neck Surgery ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Carbon Footprints ◽  
Regional Centre ◽  
Patient Travel ◽  
Outreach Clinic

Abstract Background Healthcare systems generate substantial carbon footprints that may be targeted to decrease greenhouse gas emissions. Outreach clinics may represent tools to assist in this reduction by optimizing patient related travel. Therefore, we sought to estimate the carbon footprint savings associated with a head and neck surgery outreach clinic. Methods This study was a cross-sectional survey of patient travel patterns to a surgical outreach clinic compared to a regional cancer treatment centre from December 2019 to February 2020. Participants completed a self-administered survey of 12 items eliciting travel distance, vehicle details, and ability to combine medical appointments. Canadian datasets of manufacturer provided vehicular efficiency were used to estimate carbon emissions for each participant. Geographic information systems were used for analyses. Results One hundred thirteen patients were included for analysis. The majority of patients (85.8%) used their own personal vehicle to travel to the outreach clinic. The median distance to the clinic and regional centre were 29.0 km (IQR 6.0–51.9) and 327.0 km (IQR 309.0–337.0) respectively. The mean carbon emission reduction per person was therefore 117,495.4 g (SD: 29,040.0) to 143,570.9 g (SD: 40,236.0). This represents up to 2.5% of an average individual’s yearly carbon footprint. Fewer than 10% of patients indicated they were able to carpool or group their appointments. Conclusion Surgical outreach clinics decrease carbon footprints associated with patient travel compared to continued care at a regional centre. Further research is needed to determine possible interventions to further reduce carbon emissions associated with the surgical care of patients. Graphical abstract

Are e-learning Webinars the future of medical education? An exploratory study of a disruptive innovation in the COVID-19 era

2020 ◽  
pp. 1-10
Author(s):  
Colin J. McMahon ◽  
Justin T. Tretter ◽  
Theresa Faulkner ◽  
R. Krishna Kumar ◽  
Andrew N. Redington ◽  
...  
Keyword(s):  
Deep Learning ◽  
Carbon Footprint ◽  
Quantitative Research ◽  
Survey Design ◽  
Hybrid Approach ◽  
Disruptive Innovation ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
E Learning ◽  
The Impact

Abstract Objective: This study investigated the impact of the Webinar on deep human learning of CHD. Materials and methods: This cross-sectional survey design study used an open and closed-ended questionnaire to assess the impact of the Webinar on deep learning of topical areas within the management of the post-operative tetralogy of Fallot patients. This was a quantitative research methodology using descriptive statistical analyses with a sequential explanatory design. Results: One thousand-three-hundred and seventy-four participants from 100 countries on 6 continents joined the Webinar, 557 (40%) of whom completed the questionnaire. Over 70% of participants reported that they “agreed” or “strongly agreed” that the Webinar format promoted deep learning for each of the topics compared to other standard learning methods (textbook and journal learning). Two-thirds expressed a preference for attending a Webinar rather than an international conference. Over 80% of participants highlighted significant barriers to attending conferences including cost (79%), distance to travel (49%), time commitment (51%), and family commitments (35%). Strengths of the Webinar included expertise, concise high-quality presentations often discussing contentious issues, and the platform quality. The main weakness was a limited time for questions. Just over 53% expressed a concern for the carbon footprint involved in attending conferences and preferred to attend a Webinar. Conclusion: E-learning Webinars represent a disruptive innovation, which promotes deep learning, greater multidisciplinary participation, and greater attendee satisfaction with fewer barriers to participation. Although Webinars will never fully replace conferences, a hybrid approach may reduce the need for conferencing, reduce carbon footprint. and promote a “sustainable academia”.

scholarly journals Implementation and Evaluation of a Virtual Elective in Otolaryngology in the Time of COVID-19

2020 ◽  
pp. 019459982095115
Author(s):  
Andrew J. Steehler ◽  
Brian Pettitt-Schieber ◽  
Matthew B. Studer ◽  
Geetha Mahendran ◽  
Barbara J. Pettitt ◽  
...  
Keyword(s):  
Medical Students ◽  
Neck Surgery ◽  
Formative Assessments ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Qualitative Survey ◽  
School Of Medicine ◽  
Case Based Learning ◽  
Fourth Year Medical Students ◽  
Survey Results

Objective To develop and evaluate a virtual otolaryngology medical student elective created during the COVID-19 crisis with the intention of teaching the basic tenets of otolaryngology and increasing exposure to the specialty. Study Design Cross-sectional survey. Setting Emory University School of Medicine. Methods A 1-week virtual otolaryngology curriculum was offered to third- and fourth-year medical students that centered on the American Academy of Otolaryngology–Head and Neck Surgery Foundation’s handbook Primary Care in Otolaryngology (fourth edition). The course covered a variety of topics and was conducted remotely via online video conferencing software. We applied multiple teaching modalities and surveyed students regarding the effectiveness of the course. Mixed methods analysis was employed to analyze the course data. Results Twelve students participated; 67% reported their baseline precourse understanding of otolaryngology in the “poor-fair” range. After the course, 92% of students reported increased understanding, with 42% and 58% reporting “good” and “very good” understanding, respectively. Following completion of the course, posttest scores on summative assessments were significantly higher than pretest scores ( P < .001). Ninety-two percent of students reported either “increased” or “greatly increased” interest in otolaryngology postcourse. Qualitative survey results revealed students’ appreciation of course organization, formative assessments, and case-based learning. Conclusions An otolaryngology elective administered through a virtual format can be effective at providing an educational experience and garnering interest in the field. Positive exposure to otolaryngology can increase medical students’ interest in pursuing the specialty and expand their general knowledge of consultation, diagnosis, and management in otolaryngology.

scholarly journals Carbon Footprint Analysis of Bamboo Scrimber Flooring—Implications for Carbon Sequestration of Bamboo Forests and Its Products

Forests ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 51 ◽  
Author(s):  
Lei Gu ◽  
Yufeng Zhou ◽  
Tingting Mei ◽  
Guomo Zhou ◽  
Lin Xu
Keyword(s):  
Carbon Sequestration ◽  
Carbon Cycling ◽  
Carbon Footprint ◽  
Carbon Emissions ◽  
Carbon Emission ◽  
Carbon Stocks ◽  
Bamboo Forest ◽  
Carbon Footprints ◽  
Production Processes ◽  
Bamboo Scrimber

Bamboo forest is characterized by large carbon sequestration capability and it plays an important role in mitigating climate change and global carbon cycling. Previous studies have mostly focused on carbon cycling and carbon stocks in bamboo forest ecosystems, whereas the carbon footprints of bamboo products have not received attention. China is the largest exporting country of bamboo flooring in the world. Estimating the carbon footprint of bamboo flooring is of essential importance for the involved enterprises and consumers to evaluate their own carbon footprints. In this study, we investigated the production processes of bamboo scrimber flooring for outdoor use, a typical bamboo flooring in China. Based on business-to-business (B2B) evaluation method, we assessed CO2 emission and carbon transfer ratio in each step of the production process, including transporting bamboo culms and producing and packing the products. We found that to produce 1 m3 of bamboo scrimber flooring, direct carbon emissions from fossil fuels during transporting raw materials/semi-finished products, from power consumptions during production, and indirect emissions from applying additives were 30.94 kg CO2 eq, 143.37 kg CO2 eq, and 78.34 kg CO2 eq, respectively. After subtracting the 267.54 kg CO2 eq carbon stocks in the product from the 252.65 kg CO2 eq carbon emissions derived within the defined boundary, we found that the carbon footprint of 1 m3 bamboo scrimber flooring was −14.89 kg CO2 eq. Our results indicated that the bamboo scrimber flooring is a negative carbon-emission product. Finally, we discussed factors that influence the carbon footprint of the bamboo flooring and gave suggestions on carbon emission reduction during production processes. This study provided a scientific basis for estimating carbon stocks and carbon footprints of bamboo products and further expanded knowledge on carbon cycling and lifespan of carbon in the bamboo forest ecosystem.

Barriers to Accessing Surgical Care: A Cross-Sectional Survey Conducted at a Tertiary Care Hospital in Karachi, Pakistan

2013 ◽  
Vol 37 (10) ◽  
pp. 2313-2321 ◽  
Author(s):  
Lubna Samad ◽  
Fayez Jawed ◽  
Sana Zehra Sajun ◽  
Mohammad Hussham Arshad ◽  
Naila Baig-Ansari
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Surgical Care ◽  
Care Hospital ◽  
Cross Sectional Survey ◽  
Cross Sectional

scholarly journals Essential Emergency Surgical Care in Remote Hilly Districts of Karnali - A Cross-Sectional Survey

2020 ◽  
Vol 3 (2) ◽  
pp. 116-121
Author(s):  
Praveen Kumar Giri ◽  
Prem Prasad Panta ◽  
Niresh Thapa
Keyword(s):  
Human Resources ◽  
Electrical Power ◽  
Unmet Need ◽  
Surgical Care ◽  
Situational Analysis ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Running Water ◽  
Surgical Interventions

Background: Remote hilly areas of Karnali Province has one in all the very best burdens of surgically treatable conditions within the world and therefore, the highest unmet need. The first objective of our study was to gauge the capacity of first-referral health facilities in remote districts of Karnali Province to perform basic surgical procedures. The aim is to assess the status of Essential Emergency Surgical Care in remote hilly districts of Karnali region of Nepal. Method: The screening Tool was Situational Analysis to Assess Emergency and Essential Surgical Care, to spot the health facility’s capacity to perform basic surgical (including obstetrics and trauma) and anesthetic procedures by investigating four categories of data: human resources, infrastructure, equipment and interventions available. The tool interrogated the supply of eight sorts of care providers, 35 surgical interventions and 67 items of apparatus. Results: on the average, 72.83% of all admissions required either minor or major surgical interventions. Oxygen supplies, electrical power backup, running water, blood bank, hospital guidelines were inconsistent. Only 1 Hospital have trained Surgeons, Anesthesiologist and Obstetrician/Gynecologist. Only 1 hospital can perform around 97.1% of procedures. Conclusion: The capacity for essential surgery is severely limited in Karnali region of Nepal. Limitations was seen in basic equipment, human resources, infrastructure, and supplies.  

scholarly journals Competency in End-of-Life Care among ENT – HNS Consultants and Residents: A Multi-Center Study

2008 ◽  
Vol 23 (2) ◽  
pp. 5-13
Author(s):  
Arnelle Y. Quiambao ◽  
Flordelina E. Pio-Gulapan
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Neck Surgery ◽  
Life Care ◽  
Cross Sectional Survey ◽  
Knowledge Domain ◽  
Cross Sectional ◽  
Metro Manila ◽  
Tertiary Hospitals ◽  
Multi Center Study

Objectives: To determine the competency in end of life care of Ear, Nose, Throat – Head and Neck Surgery (ENT-HNS) consultants and residents using the domains of knowledge, skills and attitudes as measures of competency and to identify opportunities for improvement in end of life care education   Method: Design:  Cross- sectional survey Setting:  Five tertiary hospitals in Metro Manila Subjects: 52 ENT-HNS consultants and residents   Results: The majority of the respondents scored low across the knowledge, attitude and skills domains. Majority the respondents (67%) were low in the knowledge domain. More than half of the respondents (58%) demonstrated negative attitudes towards end- of-life care while majority of the respondents (56%) had low skills scores. Similarly, more than half (67%) of the respondents showed low over-all competence in end of life care.   Conclusion: The majority of the respondents scored low across all three domains that were used to measure the competency in end of life care. These findings may suggest a need to strengthen the ENT- HNS practitioners’ education in end-of-life care.   Keywords: end of life care, palliative care, terminal care

scholarly journals Global community perception of ‘surgical care’ as a public health issue: a cross sectional survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nurhayati Lubis ◽  
Meena Nathan Cherian ◽  
Chinmayee Venkatraman ◽  
Fiemu E. Nwariaku
Keyword(s):  
Public Health ◽  
Surgical Care ◽  
World Health ◽  
Health Issue ◽  
Public Health Issue ◽  
Community Perception ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
World Health Assembly Resolution ◽  
A Priority

Abstract Background In the last decade surgical care has been propelled into the public health domain with the establishment of a World Health Organisation (WHO) designated programme and key publications. The passing of the historic World Health Assembly Resolution (WHA) acknowledged surgical care as a vital component towards achieving Universal Health Coverage (UHC). We conducted the first worldwide survey to explore the perception of surgical care as a public health issue. Method The anonymous, cross sectional survey targeted worldwide participants across a range of professional backgrounds, including non-medical using virtual snowball sampling method (in English) using Google Forms (Google Inc., Mountain View, CA, USA) from 20th February 2019 to 25th June 2019. The survey questions were designed to gauge awareness on Sustainable Development Goals (SDGs), UHC, WHO programmes and key publications on surgical care as well as perception of surgical care as a priority topic in public health. Results The survey was completed by 1954 respondents from 118 countries. Respondents were least aware of surgical care as a teaching topic in public health courses (27%; n = 526) and as a WHO programme (20%; n = 384). 82% of respondents were aware of UHC (n = 1599) and of this 72% (n = 1152) agreed that surgical care fits within UHC. While 77% (n = 1495) of respondents were aware of SDGs, only 19% (n = 370) agreed that surgery was a priority to meet SDGs. 48% (n = 941) rated surgical care as a cost-effective component of Primary Health Care. 88% (n = 1712) respondents had not read the WHA Resolution on ‘Strengthening emergency and essential surgical care and anaesthesia as a component of UHC’. Conclusion There is still a widespread gap in awareness on the importance of surgical care as a public health issue amongst our respondents. Surgical care was not seen as a priority to reach the SDGs, less visible as a WHO programme and not perceived as an important topic for public health courses.

scholarly journals What is the financial burden to patients of accessing surgical care in Sierra Leone? A cross-sectional survey of catastrophic and impoverishing expenditure

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e039049
Author(s):  
Manraj Phull ◽  
Caris E Grimes ◽  
Thaim B Kamara ◽  
Haja Wurie ◽  
Andy J M Leather ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Financial Burden ◽  
Surgical Care ◽  
Indirect Costs ◽  
Poverty Line ◽  
Household Expenditure ◽  
Tertiary Level ◽  
Catastrophic Expenditure ◽  
Cross Sectional Survey ◽  
Cross Sectional

ObjectivesTo measure the financial burden associated with accessing surgical care in Sierra Leone.DesignA cross-sectional survey conducted with patients at the time of discharge from tertiary-level care. This captured demographics, yearly household expenditure, direct medical, direct non-medical and indirect costs for surgical care, and summary household assets. Missing data were imputed.SettingThe main tertiary-level hospital in Freetown, Sierra Leone.Participants335 surgical patients under the care of the hospital surgical team receiving operative or non-operative surgical care on the surgical wards.Outcome measuresRates of catastrophic expenditure (a cost >10% of annual expenditure), impoverishment (being pushed into, or further into, poverty as a result of surgical care costs), amount of out-of-pocket (OOP) costs and means used to meet these costs were derived.ResultsOf 335 patients interviewed, 39% were female and 80% were urban dwellers. Median yearly household expenditure was US$3569. Mean OOP costs were US$243, of which a mean of US$24 (10%) was spent prehospital. Of costs incurred during the hospital admission, direct medical costs were US$138 (63%) and US$34 (16%) were direct non-medical costs. US$46 (21%) were indirect costs. Catastrophic expenditure affected 18% of those interviewed. Concerning impoverishment, 45% of patients were already below the national poverty line prior to admission, and 9% of those who were not were pushed below the poverty line following payment for surgical care. 84% of patients used household savings to meet OOP costs. Only 2% (six patients) had health insurance.ConclusionObtaining surgical care has substantial economic impacts on households that pushes them into poverty or further into poverty. The much-needed scaling up of surgical care needs to be accompanied by financial risk protection.

scholarly journals Management of obstructive sleep apnea in children: a Canada-wide survey

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
J. Cousineau ◽  
A.-S. Prévost ◽  
M.-C. Battista ◽  
M. Gervais
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Tertiary Care ◽  
Neck Surgery ◽  
Cross Sectional Survey ◽  
Drug Induced ◽  
Cross Sectional ◽  
Adenotonsillar Hypertrophy ◽  
Flexible Scope ◽  
Obstructive Sleep

Abstract Background Obstructive sleep apnea frequently persists in children following adenotonsillectomy, which is the first-line treatment recommended for obstructive sleep apnea with adenotonsillar hypertrophy. Drug-induced sleep endoscopy (DISE) is a diagnostic tool increasingly used to assess pediatric obstructive sleep apnea, but its use has not been standardized. The overarching goal of this study was to document the current practice of Canadian otolaryngologists managing this population. Methods A nation-wide online cross-sectional survey of Canadian otolaryngologist members of the Canadian Society of Otolaryngology – Head and Neck Surgery and the Association d’otorhinolaryngologie et chirurgie cervico-faciale du Québec. The 58-question electronic survey was developed based on a validated survey redaction guide with the aim to assess management and treatment of pediatric obstructive sleep apnea, as well as indications and performance of DISE. Consensus on practice items was defined by a minimum of 75% similar answers. Results One hundred and nine Canadian otolaryngologists completed the survey on management of pediatric obstructive sleep apnea, among which 12 of them completed the questions on DISE. Overall, there was a poor rate of agreement of 55% among the respondents for the 58 questions altogether. There was a consensus to assess pediatric obstructive sleep apnea clinically ± with videos (82.6%), to assess adenotonsillar hypertrophy clinically (93.6%) and with flexible scope in the office (80.7%), as well as for the airway sites examined endoscopically during DISE. However, there was no consensus regarding anesthetic protocol and scoring system. DISE was mostly performed in cases of persistent obstructive sleep apnea after adenotonsillectomy rather than before performing any surgical procedure. There was no difference in the management of obstructive sleep apnea between otolaryngologists who perform DISE and those who do not. The only difference between otolaryngologists who practice in community centers versus in tertiary care centers was the more frequently use of the Brodsky tonsil scale by the latter ones. Conclusion This Canadian-wide survey highlighted a lack of consensus in the management of pediatric obstructive sleep apnea and DISE. Certain aspects regarding DISE remain unclear, including establishment of its ideal timing in order to eventually avoid unnecessary tonsillectomies.

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