Search Results for: Scoperto come far morire di fame le cellule tumorali

To the Editor I write regarding Dr Grover’s Viewpoint on the importance of health policy education for physicians in training. The article offers tangible action items for medical trainees and educational institutions to promote health systems education. There is growing recognition that learning about payment models, insurance systems, and drug pricing is a more valuable use of time than memorizing biochemical minutiae. However, eliminating foundational medical knowledge can undermine the clinical training of physicians. The key is finding the right balance; currently, the scale tips too far away from health systems education. This imbalance reflects incentives that must be understood before proposing solutions.

Aisf Odv, il 12 maggio la Giornata mondiale

Background
Given the imperative to combat climate change, reducing the healthcare sector’s implications on the environment is crucial.

Objective
This study aims to offer a comprehensive assessment of the environmental impact of gastrointestinal endoscopy (GIE) procedures, specifically focusing on greenhouse gas (GHG) emissions and waste generation.

Design
A prospective study was conducted at the Asian Institute of Gastroenterology (AIG Hospitals), Hyderabad, India, from 29 May to 10 June 2023, including all consecutive GIE procedures. Carbon emissions for various variables involved were calculated with specific emission factors using ‘The GHG Protocol’.

Results
Based on data from 3244 consecutive patients undergoing 3873 procedures, the study revealed a total carbon footprint of 148 947.32 kg CO2e or 38.45 kg CO2e per procedure. Excluding patient travel, the emissions were 6.50 kg CO2e per procedure. The total waste generated was 1952.50 kg, averaging 0.504 kg per procedure, far less than 2–3 kg per procedure in the West. The waste disposal breakdown was 9.5% direct landfilling, 64.8% incineration, then landfilling and 25.7% recycling, which saved 380 kg CO2e. India effectively recycles 25.7% of hospital-related waste, which undergoes landfilling in the West. The primary contributors to GHG emissions were patient travel (83.09%), electricity consumption (10.42%), medical gas transport and usage (3.63%) and water consumption (1.86%). Diagnostic procedures generate less waste and lower carbon footprint than therapeutic procedures.

Conclusion
This study highlights the significant environmental footprint of GIE procedures, emphasising the importance of optimising practices to reduce patient travel and repeat procedures, alongside improving electricity and water management for sustainable healthcare.

We walk past the old, slump block house, & I can’t help but glance at the blinds, drawn down like surrendering eyelids. The front yard has a small, white statue of Mary Magdalene with her palms turned up in what could either be a gesture of welcome or a sign of dismay. Once, as part of a home health care company, I was inside, speaking with a woman who thought I was her grandson. I corrected her the first time, but afterwards, I went along with the story. It was easier. My job was to get her up & walk with her around the home, where residents gazed with peach-pit eyes at the television & waited for a savior to come. We walked on a thin, cement path that lined the backyard, between geraniums arranging their lipstick toward the light. We came to know each other. I learned that she grew up in a small farming town not far from my real grandmother, which explained her familiar tenderness & prolonged drawl. After several days of this, she asked if I would go to her house & check on the roses, like her husband & son had done before they died, tragically, in the same 12 months. I don’t know why, but I did. It was summer, & roses are not a hardy plant. The raised bed held nothing but a crisp, brown carcass. Rather than lie, I bought a 3-gallon rose plant at the nursery & returned with a shovel. That way, I could say Don’t worry, as she breathed more heavily, as the day came she could not leave her bed, they are doing alright. It was true— I’d managed to fix her irrigation, & I shouldn’t have expected, I guess, more than one miracle. So when she died two weeks later, her room a blank slate, all I could think about— & all I can see for a block after passing that house— was that she’d never said goodbye to her grandson & the deep, deep red of those roses.

So far, studies suggest modest benefits for acute postoperative pain, but many questions remain.

This Viewpoint discusses scientific, medical, and public health actions, including withdrawing from the World Health Organization, taken so far during the first week of the Trump administration.

Introduction
Diabetic retinopathy is one of the leading causes of vision impairment globally. Alongside the systemic control of diabetes and timely detection of diabetic retinopathy, the prompt initiation and completion of treatment is essential to prevent vision loss. Routine monitoring of access to retinal screening services for the detection of diabetic retinopathy is common, while monitoring of coverage of subsequent treatment services is far less common. When diabetic retinopathy treatment coverage is assessed, there is great variability in how it is defined and reported. If a definition of treatment coverage could be standardised, the monitoring of the quality of diabetes eye care could more readily be compared between settings and over time. The aim of this review is to summarise how diabetic retinopathy treatment coverage has been measured in published studies and the extent to which these have been disaggregated by population groups.

Methods and analysis
A search will be conducted on Medline and Embase without any language restrictions, for cohort and cross-sectional studies published from 1 January 2015 that report diabetic retinopathy treatment coverage for adults with diabetic retinopathy and/or macular oedema. We will include studies from any world region reporting diabetic retinopathy treatment coverage for one or more of: (1) laser photocoagulation; (2) intravitreal injections of antivascular endothelial growth factor agents; (3) intravitreal injections of corticosteroids; (4) vitrectomy. The PROGRESS framework (place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status and social capital) will be used to assess disaggregation by population groups. Two investigators will independently screen studies and extract relevant data. Data will be synthesised descriptively to outline the full range of definitions of diabetic retinopathy treatment coverage in the literature and identify the common sources of data used.

Ethics and dissemination
This review will only include published data; thus, no ethical approval will be sought. The findings of this review will be published in a peer-reviewed journal and presented at relevant conferences. The findings will also be considered in conjunction with an ongoing review on retinal screening for diabetic retinopathy to develop indicators for monitoring of services along the diabetes eye care pathway, which may include an indicator of effective service coverage.

Registration
Open Science Framework registration 6/08/2024: https://osf.io/5b93m

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