Circular economy

循环经济
  • 文章类型: Journal Article
    循环经济实践通过最大限度地提高效率来促进可持续发展,利用可再生资源,延长产品寿命,并实施减少废物的战略。本研究调查了四种循环经济来源对德国生态足迹的影响,一个在建立全面的循环经济路线图方面处于领先地位的国家。检查的四个来源是可再生能源消费(REC),回收,重用,和修复材料。使用1990年至2021年的时间序列数据,该研究采用了动态自回归分布滞后(ARDL)模拟技术,并应用了基于核的线性回归(KRLS)来测试结果的稳健性。研究结果表明,从短期和长期来看,再利用做法都显着减少了生态足迹。REC和修复也大大减少了生态足迹,如仿真分析所示。相反,虽然回收通常被认为对最小化环境影响至关重要,在这项研究中,它被发现有助于环境退化。这种悖论可能归因于回收行业的新生状态和数据限制。KRLS的结果证实了动态ARDL的发现。建议决策者制定适当的措施,高效,并有针对性地增强循环经济各个来源在减少德国生态足迹中的作用。这项研究的主要局限性在于它依赖于循环经济的间接措施,这归因于无法获得直接措施的数据。
    The circular economy practices contribute to sustainable development by maximising efficiency, utilising renewable resources, extending product lifespans, and implementing waste reduction strategies. This study investigates the individual impacts of four sources of the circular economy on the ecological footprint in Germany, a country that is among the pioneers in establishing a comprehensive roadmap for the circular economy. The four sources examined are renewable energy consumption (REC), recycling, reuse, and repair of materials. Using time series data from 1990 to 2021, the study employed the dynamic autoregressive distributed lag (ARDL) simulation technique and also applied kernel-based linear regression (KRLS) to test the robustness of the results. The findings revealed that reuse practices significantly reduce the ecological footprint in both the short and long run. REC and repair also substantially decrease the ecological footprint, as shown by the simulation analysis. Conversely, while recycling is generally considered crucial for minimising environmental impact, in this study, it was found to contribute to environmental degradation. This paradox may be attributed to the nascent state of the recycling industry and data limitations. The results from KRLS confirm the findings of the dynamic ARDL. It is recommended that policymakers develop measures that are appropriate, efficient, and targeted to enhance the role of each source of the circular economy in reducing the ecological footprint in Germany. The major limitation of the study is its reliance on the indirect measures of circular economy attributed to the non-availability of data on direct measures.
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  • 文章类型: Journal Article
    自然环境经常被长链烃等疏水性污染物污染,石化产品,漏油,杀虫剂,和重金属。具有毒性的疏水性污染物,缓慢的降解率,低溶解度对环境和人类健康构成严重威胁。已经发现基于常规化学表面活性剂的去污是有毒的,从而限制了其在制药和化妆品工业中的应用。相比之下,由各种微生物物种合成的生物表面活性剂由于其无毒和经济的性质而被认为优于化学对应物。一些生物表面活性剂可以承受温度和pH的宽范围波动。最近,生物表面活性剂已经成为创新的生物分子,不仅用于增溶,而且还用于环境污染物如重金属的生物降解,杀虫剂,石油碳氢化合物,和漏油。生物表面活性剂已被充分证明可以作为乳化剂,分散稳定剂,和润湿剂。生物表面活性剂的两亲性质具有通过在两个不混溶表面中分布后降低界面表面张力来增强疏水性污染物如石油烃和溢油的溶解度的潜力。然而,使用生物表面活性剂对污染物的修复受温度的影响很大,pH值,媒体组成,搅拌速率,和选择用于生物表面活性剂生产的微生物。本综述简要讨论了微生物合成生物表面活性剂的最新进展,影响生产的因素,及其在修复疏水性环境污染物中的应用。此外,从废物产生生物表面活性剂和生物表面活性剂生产的全球经济方面讨论了循环生物经济的最新方面。
    The natural environment is often contaminated with hydrophobic pollutants such as long-chain hydrocarbons, petrochemicals, oil spills, pesticides, and heavy metals. Hydrophobic pollutants with a toxic nature, slow degradation rates, and low solubility pose serious threats to the environment and human health. Decontamination based on conventional chemical surfactants has been found to be toxic, thereby limiting its application in pharmaceutical and cosmetic industries. In contrast, biosurfactants synthesized by various microbial species have been considered superior to chemical counterparts due to their non-toxic and economical nature. Some biosurfactants can withstand a wide range of fluctuations in temperature and pH. Recently, biosurfactants have emerged as innovative biomolecules not only for solubilization but also for the biodegradation of environmental pollutants such as heavy metals, pesticides, petroleum hydrocarbons, and oil spills. Biosurfactants have been well documented to function as emulsifiers, dispersion stabilizers, and wetting agents. The amphiphilic nature of biosurfactants has the potential to enhance the solubility of hydrophobic pollutants such as petroleum hydrocarbons and oil spills by reducing interfacial surface tension after distribution in two immiscible surfaces. However, the remediation of contaminants using biosurfactants is affected considerably by temperature, pH, media composition, stirring rate, and microorganisms selected for biosurfactant production. The present review has briefly discussed the current advancements in microbially synthesized biosurfactants, factors affecting production, and their application in the remediation of environmental contaminants of a hydrophobic nature. In addition, the latest aspect of the circular bioeconomy is discussed in terms of generating biosurfactants from waste and the global economic aspects of biosurfactant production.
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  • 文章类型: Journal Article
    世界面临着令人震惊的塑料垃圾问题。塑料垃圾的数量正在迅速持续增加,主要是由于一次性塑料的过度消费,而它的回收和利用还有很多不足之处。尽管塑料对环境和公众健康有负面影响,COVID-19的爆发将公众的注意力从环境问题上转移了出去,可能为利益集团和行业的长期游说提供空间,以推迟甚至阻止打击塑料污染的立法。我们的研究旨在了解媒体对一次性塑料(SUP)的讨论,在大流行过程中演变。欧盟成员国之间的差异如何?为此,我们特别分析了2019年6月至2021年6月在四个欧盟成员国发表的主要著名日报上与塑料相关的文章:德国,法国,意大利,波兰,作为具有不同可持续转型水平的国家,形成了欧洲背景下的代表性模型。此外,在2022年11月至2023年1月之间,我们通过GoogleMeet进行了一系列采访,记者同意被问及他们提出的塑料问题。我们的分析最初涵盖了1076篇文章,其中198篇因不遵守主题或重复而被拒绝,留下878篇文章组成数据库进行最终分析。具体来说,我们概述了COVID-19大流行的关键影响,然后是与塑料相关的文章数量的明显变化,关于相关利益相关者的参与,以及对特定SUP项目的关注。此外,我们解决了一个研究空白-更详细地介绍了不同类型的SUP的媒体肖像,并强调了基于单个超国家(EU)中几个文化和语言上非常不同的国家的重要性。在一次性塑料的循环经济模式中,向知情知识流通的明显趋势逆转对于开发可持续解决方案以拒绝一次性文化至关重要。停止自然资源的浪费,并减少用于塑料生产的石油或天然气的消耗,从而保护气候。
    The world faces an alarming plastic waste problem. The volume of plastic waste is rapidly and continuously increasing, mainly due to the single-use plastics overconsumption, whereas its recycling and utilization leave much to be desired. Despite the negative effects of plastic on the environment and public health, the COVID-19 outbreak shifted the public attention away from the environmental issues, potentially giving space for extended lobbyism by interest groups and industry to delay or even prevent legislation to combat plastic pollution. Our study aims to understand how the media discourse on single-use plastic (SUP) in particular, evolves in the course of the pandemic. How it vary across EU Member States? For this purpose, we specifically analyse plastic-related articles in major prestigious daily newspapers published between June 2019 and June 2021 in four EU Member States: Germany, France, Italy, and Poland, as countries with different levels of sustainable transition to form a representative model of an European context. Additionally, between November 2022 and January 2023, we conducted a series of interviews via Google Meet, with journalists who agreed to be asked on the plastic issues they upraised. Our analysis initially covered 1076 articles, out of which 198 articles were rejected due to non-compliance with the subject or repetition, leaving 878 articles forming the database for eventual analysis. Specifically, we outline a key impact of the COVID-19 pandemic followed by a clear evolution on the number of plastic-related articles, on related stakeholder engagement, and the focus on specific SUP items. Moreover, we address a research gap - presenting a media portrait of different types of SUP in more details and highlighting the significance based on several culturally and linguistically very different countries within a single supranational state (EU). A clear trend reversal towards an informed knowledge circulation across the circular economy model of single-use plastics is ultimately essential to develop sustainable solutions to reject the disposable culture, stop the waste of natural resources, and reduce the consumption of oil or gas for plastic production and thus protect the climate.
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  • 文章类型: Journal Article
    在目前的情况下,塑料制品的广泛生产和利用是不可避免的。然而,使用后产生的废塑料的不可降解性质令人严重关切。我们正在做出全面努力,寻找可行的技术解决方案,以应对不断升级的废塑料挑战。本文重点介绍了废塑料转化为增值纳米材料的研究进展。概述了全球范围内的废塑料问题及其生态影响。审查了目前建立的废塑料管理方法,以及他们的局限性。随后,介绍了将废塑料转化为纳米结构材料的最先进技术,对其独特的优点和缺点进行批判性评估。讨论了有关这些纳米材料在各种应用中的利用的几种演示技术和案例研究,包括环境修复,能源生产和储存,催化过程,传感器,药物输送,生物成像,再生医学和先进的包装材料。此外,强调了废塑料衍生纳米材料的商业水平生产及其在工业和实际应用中的应用的挑战和前景。总的来说,这项工作强调了将废塑料转化为纳米结构材料用于多方面应用的潜力。这里提出的价值化方法提供了废塑料管理和可持续纳米技术的整合。这些技术的发展应该为实现循环经济和实现可持续发展目标铺平道路。
    The extensive production and utilization of plastic products are inevitable in the current scenario. However, the non-degradable nature of waste plastic generated after use poses a grave concern. Comprehensive efforts are being made to find viable technological solutions to manage the escalating challenge of waste plastic. This review focuses on the progress made in transformation of waste plastic into value-added nanomaterials. An overview is provided of the waste plastic issue on a global level and its ecological impacts. Currently established methodologies for waste plastic management are examined, along with their limitations. Subsequently, state-of-the-art techniques for converting waste plastic into nanostructured materials are presented, with a critical evaluation of their distinct merits and demerits. Several demonstrated technologies and case studies are discussed regarding the utilization of these nanomaterials in diverse applications, including environmental remediation, energy production and storage, catalytic processes, sensors, drug delivery, bioimaging, regenerative medicine and advanced packaging materials. Moreover, challenges and prospects in the commercial level production of waste plastic-derived nanomaterials and their adoption for industrial and practical usage are highlighted. Overall, this work underscores the potential of transforming waste plastic into nanostructured materials for multifaceted applications. The valorization approach presented here offers an integration of waste plastic management and sustainable nanotechnology. The development of such technologies should pave the way toward a circular economy and the attainment of sustainable development goals.
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  • 文章类型: Journal Article
    聚羟基链烷酸酯(PHA)是一组众所周知的可生物降解和生物相容的生物塑料,其由微生物作为碳和能量储库合成和储存。细胞外PHA解聚酶(ePhaZs),由有限范围的微生物分泌,是导致其环境退化的主要水解酶。假单胞菌。最初鉴定为荧光假单胞菌GK13的GK13产生PHA和特异性降解mcl-PHA的原型ePhaZ。在这项研究中,对菌株GK13进行了全面表征。GK13的整个基因组序列被合并成一条完整的染色体,导致其被重新归类为P.solaniGK13。我们对细菌基因组序列进行了详细的计算机模拟检查,特异性靶向PHA代谢功能。从探索的不同生长条件来看,PHA积累仅发生在碳/氮(C/N)失衡下,而即使在矿物介质中C/N比平衡时,也能诱导ePhaZ的产生。我们将我们的研究扩展到属于假单胞菌属的其他细菌,揭示ePhaZ生产能力与mcl-PHA合成能力密切相关。正如宏基因组样本所暗示的那样。这一发现表明,这些类型的微生物可能有助于微生物群落的碳经济,通过在富碳时代储存PHA,并在碳稀缺时期通过PHA水解与社区分享。结论指出,由P.solaniGK13进行的碳循环代谢可能在微观尺度上有助于环境循环经济。
    Polyhydroxyalkanoates (PHAs) are a well-known group of biodegradable and biocompatible bioplastics that are synthesised and stored by microorganisms as carbon and energy reservoirs. Extracellular PHA depolymerases (ePhaZs), secreted by a limited range of microorganisms, are the main hydrolytic enzymes responsible for their environmental degradation. Pseudomonas sp. GK13, initially identified as P. fluorescens GK13, produces PHA and a prototypic ePhaZ that specifically degrades mcl-PHA. In this study, a comprehensive characterization of strain GK13 was performed. The whole genomic sequence of GK13 was consolidated into one complete chromosome, leading to its reclassification as P. solani GK13. We conducted a detailed in silico examination of the bacteria genomic sequence, specifically targeting PHA metabolic functions. From the different growth conditions explored, PHA accumulation occurred only under carbon/nitrogen (C/N) imbalance, whereas ePhaZ production was induced even at balanced C/N ratios in mineral media. We extend our study to other bacteria belonging to the Pseudomonas genus revealing that the ePhaZ production capacity is closely associated with mcl-PHA synthesis capacity, as also suggested by metagenomic samples. This finding suggests that these types of microorganisms could contribute to the carbon economy of the microbial community, by storing PHA in carbon-rich times, and sharing it with the rest of the population during times of carbon scarcity through PHA hydrolysis. The conclusion pointed that carbon cycle metabolism performed by P. solani GK13 may contribute to the environmental circular economy at a microscopic scale.
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  • 文章类型: Journal Article
    地质聚合物混凝土是一种可持续的建筑材料,使用工业副产品开发,以消除混凝土生产中水泥的使用。然而,考虑使用寿命影响的摇篮到摇篮生命周期评估(LCA)对于全面评估GPC的环境优势至关重要。在这项研究中,对圆形地质聚合物混凝土(CGPC)进行了对比支架到支架的LCA,地质聚合物混凝土(GPC),和圆形普通混凝土(COC),作为波特兰水泥混凝土(PCC)的替代品。此外,常见LCA的偏差是由于忽略使用寿命和报废情况而导致的。最后,评估了替代方案的可持续性潜力.根据使用所采用的功能单元的摇篮到摇篮的生命周期评价,GPC和CGPC显著缓解了水泥生产对环境的影响,例如全球变暖潜势约为53%。忽略使用寿命和寿命终止情景极大地改变了关键中点(CGPC和GPC的电离辐射)和终点指标(CGPC和GPC的资源)以及替代混凝土的优先级。最后,CGPC和GPC显示,与PCC相比,可持续性潜力大幅增加了213%和276%,分别。
    Geopolymer concrete is a sustainable construction material developed with industrial by-products to eliminate the use of cement in concrete production. However, a cradle-to-cradle life cycle assessment (LCA) that accounts for the impact of service life is essential to comprehensively assess the environmental advantages of GPC. In this study, a comparative cradle-to-cradle LCA was performed for circular geopolymer concrete (CGPC), geopolymer concrete (GPC), and circular ordinary concrete (COC), as alternatives to Portland cement concrete (PCC). Also, the biases of common LCA resulted from ignoring service life and end-of-life scenarios were identified. Finally, the sustainability potentials of the alternative scenarios were evaluated. According to the cradle-to-cradle LCA using the adopted functional unit, GPC and CGPC significantly alleviated the environmental impact of cement production, such as global warming potential by about 53%. Ignoring the service life and end-of-life scenarios considerably changed the critical midpoint (ionizing radiation for CGPC and GPC) and endpoint indicators (resources for CGPC and GPC) and priority of alternative concretes. Finally, the CGPC and GPC showed a substantial increase of 213% and 276% in sustainability potential compared to PCC, respectively.
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  • 文章类型: Journal Article
    农村废弃物管理,特别是农业食品废物,对生态系统健康构成了重大挑战。这项研究调查了黑色士兵苍蝇幼虫(HermetiaillucensL.,BSFL)使用鸡粪和食物垃圾作为模型系统,在独立处理或共同处理策略下对农业食品垃圾进行生物转化。结果表明,共同处理不同来源的农业食品垃圾具有协同作用。协同处理策略提高了生物转化效率,导致1.31倍的废物减少率和1.93倍的生物转化率。此外,提高了BSFL幼虫的生长性能和生物量质量,而月桂酸和油酸在共同治疗策略的幼虫脂肪中富集。16SrRNA扩增子测序显示,联合治疗策略重塑了残留和幼虫肠道微生物群,具有明显的分类生物标志物富集。此外,根据这一战略,残留微生物群的代谢功能被显著激活,尤其是碳水化合物,氨基酸,脂质代谢增强了16.3%,23.5%,和20.2%,分别。早期定植的乳酸菌(Weisella和Aerococcus)在残留物中,再加上幼虫肠道中的肠球菌和宿主之间的共生关系,可能促进有机物降解和幼虫生长性能。将调查结果扩大到中国的国家水平表明,共同处理战略可以每年增加86,329吨废物减少量,并产生更多的幼体蛋白质和脂肪,市场价值约为2.37亿美元。因此,使用BSFL对农业食品废物流进行共同处理为农村废物管理提供了可持续解决方案,可能有助于实现SDG2(零饥饿),SDG3(健康和幸福)SDG12(负责任消费和生产)。
    The management of rural waste, particularly agri-food waste, poses a major challenge to the ecosystem health. This study investigated the efficacy of black soldier fly larvae (Hermetia illucens L., BSFL) bioconversion for agri-food waste under independent treatment or co-treatment strategies using chicken manure and food waste as a model system. The results showed a synergistic effect of co-treating agri-food waste from different sources. The co-treatment strategy enhanced bioconversion efficiency, resulting in a 1.31-fold waste reduction rate and a 1.93-fold bioconversion rate. Additionally, larval growth performance and biomass quality of BSFL were improved, while lauric acid and oleic acid were enriched in the larval fat from the co-treatment strategy. 16S rRNA amplicon sequencing revealed that the co-treatment strategy reshaped both the residue and larval gut microbiota, with distinct enrichment of taxonomical biomarkers. Furthermore, under this strategy, metabolic functions of the residue microbiota were significantly activated, especially carbohydrate, amino acid, and lipid metabolism were enhanced by 16.3%, 23.5%, and 20.2%, respectively. The early colonization of lactic acid bacteria (Weisella and Aerococcus) in the residue, coupled with a symbiotic relationship between Enterococcus in the larval gut and the host, likely promoted organic matter degradation and larval growth performance. Scaling up the findings to a national level in China suggests that the co-treatment strategy can increase waste reduction quantity by 86,329 tonnes annually and produce more larval protein and fat with a market value of approximately US$237 million. Therefore, co-treatment of agri-food waste streams using BSFL presents a sustainable solution for rural waste management that potentially contributes to the achievement of SDG2 (Zero Hunger), SDG3 (Good Health and Well-Being), and SDG12 (Responsible Consumption and Production).
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  • 文章类型: Journal Article
    为了应对与医用塑料废物相关的挑战并表征其异质性,不可回收,和潜在的生物危害风险,本研究探索了二氧化碳(CO2)辅助热解过程作为一种可持续的处置方法。医用塑料废物通常包括聚丙烯,聚苯乙烯,和聚氯乙烯。为了实验评估CO2的功能反应性,我们采用了三种热解设置(一级,两阶段,和催化过程)。通过热解试验证明了使用CO2相对于惰性气体如氮气(N2)的技术优势。结果表明,在CO2条件下,能源生产得到了提高,与N2环境中的热解相比,催化热解产生146%的可燃气体。由于改进的热裂解,CO2的使用还导致有毒化学品形成的减少。当催化剂存在时,CO2辅助热解过程表现出净负CO2排放,因为在该过程中消耗了大量的CO2。总之,二氧化碳辅助热解医用塑料废物提供了一个可持续的管理解决方案,最大限度地利用碳资源。
    To address the challenges associated with medical plastic waste and to characterize its heterogeneity, non-recyclability, and potential biohazard risks, this study explored a carbon dioxide (CO2)-assisted pyrolysis process as a sustainable disposal method. Medical plastic waste typically includes polypropylene, polystyrene, and polyvinyl chloride. To experimentally evaluate the functional reactivity of CO2, we employed three pyrolysis setups (one-stage, two-stage, and catalytic processes). The technical advantages of using CO2 over inert gases such as nitrogen (N2) were demonstrated through pyrolysis tests. The results showed that energy production was enhanced under CO2 conditions, with catalytic pyrolysis generating 146% more flammable gases compared to pyrolysis in an N2 environment. The use of CO2 also led to a reduction in the formation of toxic chemicals due to improved thermal cracking. The CO2-assisted pyrolysis process exhibited net negative CO2 emissions when a catalyst was present, as a substantial amount of CO2 was consumed during the process. In conclusion, CO2-assisted pyrolysis of medical plastic waste offers a sustainable management solution that maximizes the utilization of carbon resources.
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  • 文章类型: Journal Article
    水-能源-食品(WEF)关系方法越来越多地用于支持向可持续发展的过渡,涉及循环经济(CE)概念的举措。特别是在农业部门,评估这种联系对于确保粮食安全至关重要,控制水和能源等关键资源的消耗,以及测量与气候变化相关的大气排放。本手稿旨在通过将WEFnexus与圆形指示器耦合来提出一种新颖的方法,寻求在单一指数(WEF+CEI)中捕捉样本公司的两种表现。这种新颖的方法适用于位于加利西亚(西班牙西北部)的30个奶牛场,以整体方式对其进行基准测试。要做到这一点,每个农场的WEF联系通过以下指标表示:碳足迹,水足迹,能源足迹,和粮食生产力。此外,每个农场的循环性百分比,对于农产工业合作社,由于应用了循环工具,以百分比计算。最后,使用数据包络分析(DEA)的多标准数学工具获得WEFCEi指标。结果表明,在不考虑农业工业合作社的情况下,这个系统是51%的循环。另一方面,考虑到农场和合作社,该系统达到80%的循环性。最后,拟议的方法可以支持决策,并为该领域的生产者和利益相关者提供见解。
    The Water-Energy-Food (WEF) nexus approach is increasingly being used for supporting a transition to sustainable development, with initiatives involving the concept of circular economy (CE). In the agricultural sector in particular, assessing this nexus is crucial to ensure food security, control the consumption of key resources such as water and energy, as well as measure atmospheric emissions linked to climate change. This manuscript aims to propose a novel approach by coupling the WEF nexus with a circularity indicator, seeking to capture in a single index (the WEF+CEi) both performances in a sample of companies. The novel approach is applied to 30 dairy farms located in Galicia (NW Spain) to benchmark them in a holistic manner. To do this, the WEF nexus of each farm was represented through the following indicators: carbon footprint, water footprint, energy footprint, and food productivity. In addition, the percentage of circularity for each farm, and for the agro-industrial cooperative was measured thanks to the application of a circularity tool in percentage terms. Finally, the WEF+CEi indicator was obtained using the multicriteria mathematical tool of Data Envelopment Analysis (DEA). The results show that without considering the agro-industrial cooperative, the system is 51 % circular. On the other hand, considering the farms and the cooperative, the system goes up to 80 % of circularity. Finally, the proposed approach can support decision-making and provide insights for producers and stakeholders in the area.
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  • 文章类型: Journal Article
    气候变化,环境退化,生物多样性的丧失正在对人类健康产生不利影响,加剧现有的不平等,加大对已经紧张的卫生系统的压力。矛盾的是,医疗保健是一个高污染的行业,占全球温室气体排放量的4.6%和类似比例的空气污染物。围手术期服务是资源最密集的医疗保健服务之一,并且是一些独特污染物的原因。在整个围手术期护理的整个过程中,存在减轻污染的机会,包括在患者选择和优化过程中发生在手术室上游的那些,麻醉和手术的交付,以及术后恢复期。在以病人为中心的情况下,整体方法,临床医生可以倡导健康的公共政策,修改手术疾病的决定因素,可以参与共同决策,以确保适当的临床决策,并且可以成为医疗保健资源的管理者。需要创新和协作来重新设计临床护理路径和流程,优化后勤系统,并解决设施排放问题。结果将超出减少从医疗保健污染到提供更高价值的公共卫生损害,更高质量,以病人为中心的护理。
    Climate change, environmental degradation, and biodiversity loss are adversely affecting human health and exacerbating existing inequities, intensifying pressures on already strained health systems. Paradoxically, healthcare is a high-polluting industry, responsible for 4.6% of global greenhouse gas emissions and a similar proportion of air pollutants. Perioperative services are among the most resource-intensive healthcare services and are responsible for some unique pollutants. Opportunities exist to mitigate pollution throughout the entire continuum of perioperative care, including those that occur upstream of the operating room in the process of patient selection and optimisation, delivery of anaesthesia and surgery, and the postoperative recovery period. Within a patient-centred, holistic approach, clinicians can advocate for healthy public policies that modify the determinants of surgical illness, can engage in shared decision-making to ensure appropriate clinical decisions, and can be stewards of healthcare resources. Innovation and collaboration are required to redesign clinical care pathways and processes, optimise logistical systems, and address facility emissions. The results will extend beyond the reduction of public health damages from healthcare pollution to the provision of higher value, higher quality, patient-centred care.
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