Principles of environmentally-sustainable anaesthesia: a global consensus statement from the World Federation of Societies of Anaesthesiologists

The Earth’s mean surface temperature is already approximately 1.1°C higher than pre-industrial levels. Exceeding a mean 1.5°C rise by 2050 will make global adaptation to the consequences of climate change less possible. To protect public health, anaesthesia providers need to reduce the contribution their practice makes to global warming. We convened a Working Group of 45 anaesthesia providers with a recognised interest in sustainability, and used a three-stage modified Delphi consensus process to agree on principles of environmentally sustainable anaesthesia that are achievable worldwide. The Working Group agreed on the following three important underlying statements: patient safety should not be compromised by sustainable anaesthetic practices; high-, middle- and low-income countries should support each other appropriately in delivering sustainable healthcare (including anaesthesia); and healthcare systems should be mandated to reduce their contribution to global warming. We set out seven fundamental principles to guide anaesthesia providers in the move to environmentally sustainable practice, including: choice of medications and equipment; minimising waste and overuse of resources; and addressing environmental sustainability in anaesthetists’ education, research, quality improvement and local healthcare leadership activities. These changes are achievable with minimal material resource and financial investment, and should undergo re-evaluation and updates as better evidence is published. This paper discusses each principle individually, and directs readers towards further important references.     

An Interdisciplinary Collaboration for Environmental Education

Climate change education in advanced practice registered nursing curricula prepares nurse practitioners to respond to the health effects of climate change. Knowledge of the relationship between human and environmental health is essential for nurse practitioners to identify, teach, and respond to the health effects of climate change in clinical and community settings. This article describes a webinar hosted by the Sarah P. Duke Gardens in partnership with the Duke University School of Nursing. Our webinar provided an opportunity for attendees to understand how gardening can mitigate climate change, the important relationship between human and environmental health, and nurses’ role in climate crisis.     

The Nurse Practitioners’ Role in Engaging Health Care Systems in Addressing Climate Change

A recent United Nations (UN) report concluded that the inability to curb fossil fuel emissions from burning coal, oil, and gas has resulted in a short window of time to prevent an abysmal future. The health care industry remains one of the largest contributors to climate change. NPs must not only recognize the clinical presentations resulting from climate change but must also contribute to the efforts presented by the UN report to create a health system that does not contribute to climate change. This article reviews potential ways to decrease the health care sector’s contribution to climate change.     

Race to Beat the Heat: Climate Change Impacts Physical Activity

Climate change has led to increased frequency, intensity, and duration of extreme heat events with dire consequences for health. These are the deadliest of climate change impacts with preventable mortality from heat-related illnesses and increased threat to safe participation in physical activity and sports. Nurse practitioners can collaborate with community and professional sports health organizations to ensure evidence-based health and safety policies to reduce health-related risks. Adverse consequences on engagement in key health-promoting physical activity and sports may catalyze urgent action to address climate change.     

Climate Change: Effects on the Older Adult

The effects of climate change include floods, hurricanes, heat waves, and fires; these natural disasters can result in respiratory, cardiovascular, and psychological harm in older adults, who experience the highest morbidity and mortality during heat waves. Advanced practice registered nurses (APRNs) need education on preparing, assessing, and treating older adults for climate-change disasters, especially heat waves. This article will help APRNs understand the effects of climate-change events on the vulnerable older adults and advocates for the need to integrate health effects of climate change into curricula, practicums, policy, and research agendas.     

Physical violence and vulnerable adolescents: the roles of school climate and presence of similar peers

ABSTRACT

Using nationally representative data from the National Longitudinal Study of Adolescent Health (a.k.a., Add Health), this study examines the impact of school climate and share of vulnerable groups of students on self-perceived discrimination and violence involvement in high school. Violence involvement is operationalized as victimization and perpetration of physical violence. Five categories of vulnerability status are analyzed: the emotionally disabled, learning disabled, physically disabled, obese and LGB. Results suggest that relatively higher odds of violence involvement for individuals who were members of vulnerable groups as adolescents are fully explained by school climate and an extensive set of individual-level controls. While the share of vulnerable groups in school is not consistently correlated with violence involvement, school climate is found to be highly predictive of self-perceived discrimination and violence involvement. Consequently, we believe that improving school climate is the most effective strategy for reducing violence involvement of vulnerable youth in school.     

School climate for the internally displaced children (IDPs) in Manila,Philippines

ABSTRACT

The article aims to examine the spheres which help create positive school climate suitable for the integration of internally displaced children (IDPs). The paper looks at how the experience of IDP children affects their overall school life as perceived by their own teachers. Data from this study were taken from nine (9) elementary school teachers who participated in the focus group discussion (FGD). The participants, all from a particular school in Manila, handled the IDP students as they continued their studies after displacement. Results suggest that the spheres of safety, supportive and inclusive environment have created a positive school climate for the IDP students. The paper argues that school integration of IDP children requires the positive fulfillment of these spheres. Feeling secured, being surrounded with supportive social network, and learning in inclusive environment are all non-negotiable features of a school climate that facilitates successful school integration. Results of this study provide insights as to what components have to be improved and focused on by host schools when receiving IDP school children.     

Commentary: Climate change worry among adolescents—on the importance of going beyond the constructive–unconstructive dichotomy to explore coping efforts—a commentary on Sciberras and Fernando (2021)

This opinion piece comments on Sciberras and Fernando’s (2021) article in which an 8-year longitudinal study is presented. The authors investigate trajectories of climate change worry through adolescence and associations with measures of depression and engagement with news and politics in late adolescence. Their objective is to explore whether climate change worry is a constructive or unconstructive psychological phenomenon. Their conclusion is that it is mainly an adaptive response but, for some groups, such as young people with pre-existing mental health problems, climate change worry could exacerbate their difficulties. In this commentary, it is argued that since research has found diverse results regarding whether climate worry is adaptive or not, one should perhaps not focus so much on the emotion itself, but rather on how people cope with their worry. Some examples of how young people cope with climate change are presented, and it is argued that taking account of these coping strategies in future longitudinal studies would be beneficial.