Futures consciousness (FC) refers to the capacity to understand, anticipate and prepare for the future. As a form of future orientation, it encompasses five interrelated dimensions of time perspective, agency beliefs, openness to alternatives, systems perception and concern for others. We present here cross-sectional evidence that FC is related to greater environmental engagement, above and beyond other future orientation constructs. In two pre-registered studies (one convenience student sample and one representative sample; N = 1041), we found that respondents with higher futures consciousness reported greater proenvironmental behaviour (consumption behaviour, land stewardship, social environmentalism and environmental citizenship). FC proved a better predictor of proenvironmental behaviour than the Zimbardo Inventory\'s Future Time Perspective and the Consideration for Future Consequences Scale (Study 1). FC was also related to stronger biospheric values (Study 2). However, it was not significantly related to personal environmental footprint (derived from a 16-item calculator). Strikingly, the environmental footprint was also unrelated to the Proenvironmental Behaviour Scale, which could point to a lack of correspondence between measures of proenvironmental propensity and impact. We discuss implications for future-thinking research and interventions aiming to improve futures consciousness.

UNASSIGNED: To estimate the economic and environmental impact of single-use instruments (SUIs) to perform standard cataract surgery in six ophthalmology centers located in Europe and in the United States.
UNASSIGNED: Online survey and interview.
UNASSIGNED: Comparative cost analysis based on an online survey with follow-up questionnaire and interview. The carbon footprint calculation was made by ClimatePartner.
UNASSIGNED: Annual costs of reusable instruments (RUIs) were calculated based on data provided by the centers. Annual costs of SUIs were estimated based on the average-selling price of a single-use cataract set of 5 instruments and the reported annual volume of cataract surgery. The calculation carbon footprint of a cataract instrument covered the whole life cycle from production to end-of-life.
UNASSIGNED: Annual costs for SUIs were found inferior or similar to the annual costs for RUIs for 4 out of the 6 centers included in this study. The centers where SUIs were demonstrated to be the most cost-effective were also associated with the highest costs of sterilization per instrument. The carbon footprint of 5-years usage of a cataract instrument was found to be 5478.2 kg CO2 eq for SUIs without recycling, 4639.9 kg CO2 eq for SUIs with recycling and 20.6 kg CO2 eq for RUIs.
UNASSIGNED: The study demonstrated that SUIs can be an alternative solution to using RUIs in multispecialty hospitals associated with high sterilization costs.

OBJECTIVE: To focus on the ecological footprint of radiotherapy (RT), on opportunities for sustainable practices, on future research directions.
METHODS: Different databases were interrogated using the following terms: Carbon Footprint, Sustainab*, Carbon Dioxide, Radiotherapy, and relative synonyms.
RESULTS: 931 records were retrieved; 15 reports were included in the review. Eight main thematic areas have been identified. Nine research works analyzed the environmental impact of photon-based external beam RT. Particle therapy was the subject of one work. Other thematic areas were brachytherapy, intra-operative RT, telemedicine, travel-related issues, and the impact of COVID-19.
CONCLUSIONS: This review demonstrates the strong interest in identifying novel strategies for a more environmentally friendly RT and serves as a clarion call to unveil the environmental impact of carbon footprints entwined with radiation therapy. Future research should address current gaps to guide the transition towards greener practices, reducing the environmental footprint and maintaining high-quality care.

This review assesses the feasibility of reusing treated wastewater for irrigation in agricultural soils as a strategy for nutrients recycling and mitigation of CO2 emissions. Through a literature review, it was examined wastewater sources enriched with carbon and nutrients, including municipal wastewater and associated sludge, vinasse, swine wastewater, as well as wastewater from the food industry and paper and pulp production. The review also explores the dynamics of organic matter within the soil, discussing the aspects related to its potential conversion to CO2 or long-term storage. It was found that industrial wastewaters, owing to their higher organic matter and recalcitrance, exhibit greater potential for carbon storage. However, the presence of pollutants in wastewater necessitates careful consideration, particularly concerning their impact on soil quality. Toxic metals, microplastics, and organic compounds emerged as significant contaminants that could accumulate in the soil, posing risks to ecosystem health. To mitigate the environmental impacts, it was evaluated various wastewater treatment technologies and their associated carbon emissions. While advanced treatments may effectively reduce the contaminant load and mitigate soil impacts, their adoption is often associated with an increase in CO2 emissions. Membrane bioreactors, microfiltration, ultrafiltration, and up-flow anaerobic sludge blanket reactors were identified as promising technologies with lower carbon footprints. Looking ahead, future research should aim to enhance the understanding of carbon dynamics in soil and validate the environmental impacts of treated wastewater disposal. Despite remaining uncertainties, the literature indicates a positive outlook for wastewater recycling in soil, offering a viable strategy for carbon storage and mitigation of greenhouse gas emissions.

Inhalation systems, mostly metered dose inhalers (MDIs) and dry powder inhalers (DPIs), are currently submitted to a critical assessment for their carbon footprint (CF) and environmental impact. They are related to greenhouse gas (GHG) emissions and they produce waste of used devices with withheld drug residues and unused doses. However, with estimated contributions to anthropogenic GHG-emissions of 0.03% for MDIs and 0.0012% for DPIs globally, it may not be expected that mitigating the GHG emissions from inhalers will have a meaningful effect on the current climate change and global warming, notwithstanding that nationally these percentages may be somewhat higher, depending on the ratio of MDIs to DPIs and the total national CF. MDIs are particularly the preferred type of inhalers over DPIs in the USA and UK with ratios of 9: 1 and 7: 3 respectively. In such countries, a partial switch from MDIs to DPIs is to be recommended, providing that such a switch does not jeopardize the therapy. Using renewable energy only for the production and waste management of DPIs will make this type of inhaler almost climate neutral. A greater concern exists about inhaler waste, more particularly about the residual drug and unused doses in discarded devices. Inhalers contribute less than 0.02% to global plastic waste annually and most plastic inhalers end in the domestic waste bin and not as litter polluting the environment with plastic. However, they do contain retained drug and unused doses, whereas even full inhalers are disposed. Because globally most municipal waste (70%) ends up in dumps and landfills, leakage of the drugs into the soil and surface waters is a serious problem. It pollutes drinking water and endangers species and biodiversity. Therefore, a good collection system and an adequate waste management program for used inhalers seems to be the most meaningful measure to take for the environment, as this will stop inhalers and drugs from putting ecosystems at risk.

The increase in the negative effects of global change promotes the search for alternatives to supply the demand for food worldwide aligned with the Sustainable Development Goals (SDGs) to ensure food security. Animal protein, which is a main source of nutrients in the diet of today\'s society, especially beef, which is one of the most demanded products nowadays, has been criticized not only for its high water consumption and land occupation for production but also for the emission of greenhouse gases (GHG) from enteric methane generated in the fermentation process within the bovine rumen and deforestation for the adaptation of pastures. This study is mainly motivated by the lack of quantifiable scientific information in Colombia on the environmental impacts of beef production. Therefore, it is intended to estimate some of the impacts of beef production in extensive systems using the life cycle assessment (LCA) method under a particular scenario considering all the production phases (from raw material to fattening, where the cattle are ready to be slaughtered). The study was conducted with data supplied by a farm in Antioquia, Colombia, and the functional unit (FU) was defined as 1 kg of live weight (LW). The scope of this study was gate-to-gate. \"The 2019 Refinement to the 2006 IPCC Guidelines for National Greenhouse Gas Inventories\" (IPCC  2006; IPCC 2019) was used to calculate methane and nitrous oxide emissions. LCA modeling was developed with Ecoinvent database v3.8 and the Umberto LCA + software. It was found that the most affected category of damage was ecosystem quality, which represents 77% of the total, followed by human health at 17% and resources at 6%. The category impact of agricultural land occupation is the one that represents the most significant contribution to the ecosystem quality endpoint, with a percentage of 87%, due to the soil\'s compaction and the loss of the soil\'s properties. Additionally, the obtained carbon footprint for the system was 28.9 kg of CO2-eq/kg LW.

Healthcare is a major generator of greenhouse gases, so consideration of this contribution to climate change needs to be quantified in ways that can inform models of care. Given the availability of activity-based financial data, environmentally-extended input-output (EEIO) analysis can be employed to calculate systemic carbon footprints for healthcare activities, allowing comparison of different patient care pathways. We thus quantified and compared the carbon footprint of two common care pathways for patients with stable coronary artery disease, with similar clinical outcomes: coronary stenting and coronary artery bypass surgery (CABG). Healthcare cost data for these two pathways were disaggregated and the carbon footprint associated with this expenditure was calculated by connecting the flow of money within the economy to the greenhouse gases emitted to support the full range of associated activities. The systemic carbon footprint associated with an average stable patient CABG pathway, at a large tertiary referral hospital in Sydney, Australia in 2021-22, was 11.5 tonnes CO2-e, 4.9 times greater than the 2.4 tonnes CO2-e footprint of an average comparable stenting pathway. These data suggest that a stenting pathway for stable coronary disease should be preferred on environmental grounds and introduces EEIO analysis as a practical tool to assist in health-care related carbon footprinting.

The COVID-19 pandemic disrupted medical conferences, where restrictions on public gatherings resulted in the postponement or cancellation of in-person meetings. Virtual events emerged as a substitute, providing a mechanism for scientific collaboration and continuing medical education with the additional benefit of low environmental impact. However, digital events may not meet all the needs of delegates, such as professional networking and social connection. In this report, we describe the methods used to minimise the carbon footprint of the 2023 Australian and New Zealand College of Anaesthetists\' Annual Scientific Meeting, a conference with approximately 2000 in-person and 500 virtual delegates. A core group led the initiative, with all conference participants invited to contribute to this goal. A prospective prediction of carbon generation was undertaken, followed by the implementation of strategies to minimise and then measure the total carbon footprint of the event. Post-event calculations assessed the conference as better than carbon-neutral; however, delegate travel was not included in the analysis and therefore this result is tempered. Off-site workshops including virtual offerings were also not included in the analysis. We encourage medical conference organisers to collaborate with all stakeholders to embed low carbon-generation choices for their meetings where education, networking and social needs are also met.

暂无摘要。

This consensus document addresses the reduction of the environmental impact of inhalers in Portugal. It was prepared by the Portuguese Council for Health and the Environment and the societies representing the specialties that account for these drugs\' largest volume of prescriptions, namely the Portuguese Society of Pulmonology, the Portuguese Society of Allergology and Clinical Immunology, the Portuguese Society of Pediatrics, the Portuguese Society of Internal Medicine, the Portuguese Association of General and Family Medicine and also a patient association, the Respira Association. The document acknowledges the significant impact of pressurized metered-dose inhalers on greenhouse gas emissions and highlights the need to transition to more sustainable alternatives. The carbon footprint of pressurized metered-dose inhalers and dry powder inhalers in Portugal was calculated, and the level of awareness among prescribing physicians on this topic was also estimated. Finally, recommendations were developed to accelerate the reduction of the ecological footprint of inhalers.
Este documento de consenso aborda a redução do impacto ambiental dos inaladores em Portugal. Foi elaborado pelo Conselho Português para a Saúde e Ambiente e pelas sociedades que representam as especialidades com maior volume de prescrição destes medicamentos, nomeadamente a Sociedade Portuguesa de Pneumologia, a Sociedade Portuguesa de Alergologia e Imunologia Clínica, a Sociedade Portuguesa de Pediatria, a Sociedade Portuguesa de Medicina Interna e a Associação Portuguesa de Medicina Geral e Familiar em conjunto com uma associação de doentes, a Associação Respira. Reconhece-se o impacto significativo dos inaladores pressurizados doseáveis nas emissões de gases com efeito de estufa e a necessidade de transição para alternativas mais sustentáveis. Calculou-se a pegada de carbono dos inaladores pressurizados doseáveis e dos inaladores de pó seco em Portugal e estimou-se o nível de literacia dos médicos prescritores relativamente a este tema. Finalmente, foram elaboradas recomendações com o objetivo de acelerar a redução da pegada ecológica dos inaladores.