Towards a low-carbon and beautiful world: assessing the impact of digital technology on the common benefits of pollution reduction and carbon reduction.

When ecology thrives, civilization thrives, and when ecology declines, civilization declines. Based on panel data from 30 provinces in China from 2000 to 2021, this study used marginal abatement costs to estimate the co-benefits of pollution reduction and carbon reduction. Two-way fixed effect and two-stage intermediary effect models were used to evaluate the impact of digital technology on co-benefits and its indirect channels. The results indicated that China's total carbon emissions maintained a steady growth trend, while air pollution showed a fluctuating declining trend. Reaching peak carbon neutrality calls for more innovative solutions. Under joint emission reduction efforts, the study revealed marginal abatement cost savings of 535.8 million yuan/million tons and 6216.5 million yuan/µg/m3 for carbon reduction and pollution reduction, respectively. Most importantly, the study confirmed that joint emission reduction programs can reduce environmental governance costs more than individual emission reductions can, and the co-benefits increased from 37.983 to 44.757. The co-benefits generally showed a trend of fluctuation and increases and had the characteristics of phased transformation. Intragroup differences and cross-overlapping between regions made regional differences in co-benefits obvious. The subversive, permeable, and integrated features of digital technology have resulted in the all-around transformation of the economy and society, and the new technology-economy paradigm has significantly improved co-benefits. The conclusion remains valid after robustness testing and controlling for endogeneity problems. The results of the mechanism analysis suggest that digital technology can indirectly improve synergies through the intermediary channels of fostering green technology innovation, reducing energy consumption intensity and improving the energy structure.

Blockchain governance and trust: A multi-sector thematic systematic review and exploration of future research directions.

This paper aims to critically examine the scholarly work conducted in blockchain (BC) governance. Without venturing into the wide range of governance paradigms, this research considers governance structures based on trust as a foundation for BC governance. A thematic systematic literature review is conducted to understand the literature on this topic, employing the SALSA (Search, Appraisal, Synthesis and Analysis) technique. An examination of 155 papers shows that using BC technology (BCT) replaces the cognitive attribution of trust in the material and human-independent code. It is also found that further research anchored to the 'trust' concept is required in building BC governance structures. To provide the direction in which the literature is travelling, future research questions on trust and governance are documented. In general, the literature review suggests that BC has the potential to revolutionize the way in which businesses operate. By improving transparency, efficiency, and security, BC can help businesses to reduce costs, improve customer satisfaction, and make better decisions. This research can help policymakers, industrialists, and researchers to identify where BC governance is being used and which aspects of governance are to be focused on. This paper is a general review of literature and evidence on contemporary developmental issues.

Effectiveness of public health spending: Investigating the moderating role of governance using partial least squares structural equation modelling (PLS-SEM).

BACKGROUND: The link between public health spending (PHS) and population health outcomes (PHO) has been extensively studied. However, in sub-Saharan Africa (SSA), the moderating effects of governance in this relationship are little known. Furthermore, studies have focused on mortality as the main health outcome. This study contributes to this literature by investigating the moderating role of governance in the relationship by simultaneously assessing three dimensions of governance (corruption control, government effectiveness and voice accountability) using disability-adjusted life years (DALYs) as a measure of outcomes. METHODS: The study applies the two-stage moderation approach using partial least squares structural equation modelling (PLS-SEM) to panel data from 43 SSA nations from 2013 to 2019. The study also uses domestic general government health expenditure (DGGHE) as an independent variable and disability-adjusted life years (DALY) as the dependent variable in this relationship. RESULTS: The analysis reveals that DGGHE affects DALY negatively and that governance improves the effect of DGGHE on DALY, with bigger improvements among countries with worse governance. CONCLUSION: These findings provide evidence that good governance is crucial to the effectiveness of PHS in SSA nations. Sub-Saharan Africa (SSA) countries should improve governance to improve population health.

Effect of the Cluster Nursing through Empowerment Education on Patients Undergoing Radical Prostatectomy: A Retrospective Study.

BACKGROUND: Radical prostatectomy (RP) is a treatment method for prostate cancer (PCa). However, patients usually experience urinary incontinence and a reduction in quality of life after surgery. Seeking a nursing programme is necessary to improve the prognosis of patients undergoing RP. This study aims to explore the effect of the cluster nursing through empowerment education on patients with RP. METHODS: The general data of 203 patients who underwent RP surgery from June 2021 to June 2023 were collected for a retrospective study. After excluding four patients who changed from RP to laparotomy during surgery, four patients with incomplete clinical data and three patients without normal communication ability, the remaining 192 patients were included in the study. The patients were divided into two groups in accordance with different nursing plans. In this study, 98 patients receiving the cluster nursing through empowerment education were set as the observation group (OG), and 94 patients undergoing routine nursing were included in the reference group (RG). The indicators of postoperative recovery, mental health status and life coping ability were compared between the two groups. RESULTS: The times to first exhaustion, to start eating, of first off-bed activity and of hospitalisation in the OG were shorter than those in the RG (p < 0.001). No significant difference was found in the total incidence of complications between the two groups (p > 0.05). Before management, no significant difference in the scores of Hospital Anxiety and Depression Scale (HADS) and Activity of Daily Living Scale (ADL) was observed between the OG and RG (p > 0.05). After management, the HADS and ADL scores of the two groups all decreased, and the OG showed a greater reduction in scores than the RG (p < 0.001). CONCLUSIONS: The cluster nursing through empowerment education can shorten the recovery time of patients after RP surgery and improve their living ability. This effect is beneficial to their mental health and can provide additional directions for the formulation of subsequent clinical nursing programmes.

[Contributions of urban planning for more food security in German cities]. / Beiträge kommunaler Planung für mehr Ernährungssicherheit in deutschen Städten.

Many German municipalities are developing retail concepts for retail management and taking stock of the food supply is one of the standard tools. A distance-based indicator is commonly used, which measures the degree of supply based on linear distances between the place of residence and the nearest place of purchase. Beyond this distance, however, access to food is influenced by other spatiophysical and socioeconomic factors. So far, these have hardly been considered. Inadequate access to food is not only problematic from a health perspective, but also because of the social function of food as an important field of social participation. Difficult access to food especially affects people in precarious circumstances, who are already restricted in their participation in society. This article therefore presents a model that theoretically informed, comprehensively and systematically captures the spatiophysical and socioeconomic embedding of food access. Based on selected results of a study that was carried out in Bremen using this approach, this article shows the access barriers that affect residents of two districts that are considered to be well supplied. The primary goal of this article is to raise awareness of the complex issue of food access. Finally, approaches that retail and other municipal initiatives can use to improve access to food are also named.

Improving health system responses when patients are harmed: a protocol for a multistage mixed-methods study.

INTRODUCTION: At least 10% of hospital admissions in high-income countries, including Australia, are associated with patient safety incidents, which contribute to patient harm ('adverse events'). When a patient is seriously harmed, an investigation or review is undertaken to reduce the risk of further incidents occurring. Despite 20 years of investigations into adverse events in healthcare, few evaluations provide evidence of their quality and effectiveness in reducing preventable harm.This study aims to develop consistent, informed and robust best practice guidance, at state and national levels, that will improve the response, learning and health system improvements arising from adverse events. METHODS AND ANALYSIS: The setting will be healthcare organisations in Australian public health systems in the states of New South Wales, Queensland, Victoria and the Australian Capital Territory. We will apply a multistage mixed-methods research design with evaluation and in-situ feasibility testing. This will include literature reviews (stage 1), an assessment of the quality of 300 adverse event investigation reports from participating hospitals (stage 2), and a policy/procedure document review from participating hospitals (stage 3) as well as focus groups and interviews on perspectives and experiences of investigations with healthcare staff and consumers (stage 4). After triangulating results from stages 1-4, we will then codesign tools and guidance for the conduct of investigations with staff and consumers (stage 5) and conduct feasibility testing on the guidance (stage 6). Participants will include healthcare safety systems policymakers and staff (n=120-255) who commission, undertake or review investigations and consumers (n=20-32) who have been impacted by adverse events. ETHICS AND DISSEMINATION: Ethics approval has been granted by the Northern Sydney Local Health District Human Research Ethics Committee (2023/ETH02007 and 2023/ETH02341).The research findings will be incorporated into best practice guidance, published in international and national journals and disseminated through conferences.

Sensing, knowing, and making water quality along Marikina River in the Philippines.

Water quality is a major concern around the world, but assessments of quality often privilege producers, regulators and experts over consumers. With water supplies and sources constantly in flux, how do ordinary people experience and "sense" quality? How do they define "good" or "good enough" water, and what practices do they engage in to "make" good water? In this article, we attend to these questions by presenting findings from an open-ended qualitative study carried out along the Marikina River, Manila, the Philippines - a waterway that courses from rural and mountainous villages to highly urbanized communities. First, we describe the sensorial and cognitive attributes that people associate with the different water sources in their environment, as well as their decision-making regarding what kind of water to use for which purposes. Second, we present the "making" of water quality: how, in a context of polluted environments and water scarcity, do people try to secure water they consider acceptable for themselves and their families. Our findings reveal water quality as a contested, relational domain-one that reinforces social and health disparities and calls for further scholarship.

Ang kalidad ng tubig ay kinababahala sa buong mundo, ngunit ang pagkilatis ng kalidad na ito ay kadalasang nasa kamay ng mga kompanya ng tubig, mga dalubhasa, at gobyerno, - wala sa mga tao. Sa kabila ng mga pagbabago at pangamba ukol sa tubig, paano nga ba nararanasan at nararamdaman ng mga ordinaryong tao ang kalidad ng tubig? Paano nila nasasabi na maganda, o puwede na, ang isang klase ng tubig, at anong mga pamamaraan o diskarte ang ginagawa nila para maging 'puwede na' ito? Sa artikulong ito, tinatalakay namin ang mga katanungang ito base sa isang qualitative research na isinagawa namin sa mga bayan sa kahabaan ng Ilog Marikina, na dumadaloy mula sa bulubunduking kanayunan ng Sierra Madre hanggang sa mga urbanisadong pamayanan ng Kamaynilaan. Una, inilalarawan namin ang mga katangian na inuugnay ng mga tao sa iba't ibang uri ng tubig sa kanilang kapaligiran, at kung paano sila nagdedesisyon kung alin sa mga ito ang gagamitin sa iba't ibang paggagamitan. Pangalawa, ipinapakita namin kung paano nila ginagawang 'puwede na' ang tubig para sa kanila at kanilang mga pamilya. Sa kabuuan, napag-alaman namin na ang kalidad ng tubig ay isang komplikadong larangan, nakaugat sa iba't ibang relasyon, nakapagpapalala sa mga hindi pagkakapantay-pantay ng lipunan, at nananawagan ng mas malalamin na pag-aaral.

People living along Marikina River rely on everyday experiences to define "good enough" water and decide what kind of water to take. If the water is not clean, they either choose another source or engage in various household practices to make it good enough, from boiling and filtering to simply waiting. Upstream, the water is perceived as cleaner and has more uses; as the river flows to Manila, people rely increasingly on mineral water and water from refilling stations for drinking. But what kind of what people use, for what purpose, is influenced by social and economic factors. We suggest that governments monitor the quality of water in different sources, and evaluate how people try to make water cleaner and safer. Governments need to take into account how people sense, know, and make water quality in crafting better and fairer policies and programs.

What is "good" or "good enough" water for people? The authors explore the knowing, sensing, and making of water quality along Markina River in the Philippines, and how people's embodied experiences of water are shaped by their geographic, economic, and "hydrosocial" contexts.

Impact of C-level positions on hospital performance: a scoping review protocol.

INTRODUCTION: The objective of this scoping review is to identify evidence of the impact of hospital managers in top management (c-suite) on hospital performance. Managers generally have various effects on organisational objectives of their organisations. In recent years, the healthcare sector has experienced alterations in hospital governance structures, together with the emergence of new c-suite positions, aligning more closely with those found in private organisations. Their impact on hospital performance (ie, quality of care) is not well known. This scoping review seeks to identify all the available evidence of their impact on the organisational objectives. This scoping review will include primary studies, reviews and commentaries that describe the impact of top management team members on organisational outcomes in a hospital setting. METHODS AND ANALYSIS: The search strategy aims to locate both published and unpublished documents (ie, grey literature) using a three-step search strategy. An exploratory search of Medline and Google Scholar identified keywords and Medical Subject Headings terms. A second search of Medline (PubMed), Web of Science Core Collection, ScienceDirect, Business Source Premier (EBScoHost), JSTOR, BASE, Lens.org and the Google Search Engine will be performed. The scope of the search will cover 1990-present time using English search terms. Manual searching by two reviewers will be added to the search strategy. The identified documents will be independently screened, selected by two researchers and extracted by one researcher. The data are then presented in tables and graphics coupled with a descriptive summary. ETHICS AND DISSEMINATION: As this study neither involves human participants nor unpublished secondary data, an ethics approval is not required. Findings will be disseminated through professional networks, conference presentations and publication in a scientific journal. TRIAL REGISTRATION NUMBER: The protocol was registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/EBKUP).

Nurses-Led Municipal Leadership and Governance Program: Experiences of Local Chief Executives in Central Visayas, Philippines.

Background: The strategic response of nurses in addressing health inequities in marginal sectors led to the conduct of a health leadership governance training program for local chief executives. Objective: This study aimed to explore and provide a description of the experiences of local chief executives (LCEs) or mayors who participated in the nurse-initiated health training named Municipal Leadership and Governance Program (MLGP). Methods: A qualitative descriptive design was used through key informant interviews of fifteen mayors or local chief executives (LCE) in the provinces of Bohol and Negros Oriental, Philippines. Data were collected from 16 to 20 November 2022 and analyzed using a thematic approach. Results: The findings generated six themes: a) Leadership capacitation promoting transformative experience, b) Pandemic and program-induced limitations in the training implementation, c) Personal leadership motivation, d) Experiential learning promoting learning as applied in real-world situations, e) Celebrating leadership transformation, and f) 3R's of MLGP: revisit, review, recommend. Conclusion: The realizations of the training participants provided valuable implications for the quality of training offered by nurse leaders who advocated the MLGP implementation. It served as a proactive and responsive approach to the health leadership capacitation of mayors. It guided them in their personal realizations that inspired them to apply what they had learned and enabled them to effect experiences of personal to institutional transformation.

Risk mapping for better governance in biobanking: the case of biobank.cy.

Introduction: Risk governance is central for the successful and ethical operation of biobanks and the continued social license for being custodians of samples and data. Risks in biobanking are often framed as risks for participants, whereas the biobank's risks are often considered as technical ones. Risk governance relies on identifying, assessing, mitigating and communicating all risks based on technical and standardized procedures. However, within such processes, biobank staff are often involved tangentially. In this study, the aim has been to conduct a risk mapping exercise bringing biobank staff as key actors into the process, making better sense of emerging structure of biobanks. Methods: Based on the qualitative research method of situational analysis as well as the card-based discussion and stakeholder engagement processes, risk mapping was conducted at the biobank setting as an interactive engagement exercise. The analyzed material comprises mainly of moderated group discussions. Results: The findings from the risk mapping activity are framed through an organismic metaphor: the biobank as a growing, living organism in a changing environment, where trust and sustainability are cross-cutting elements in making sense of the risks. Focusing on the situatedness of the dynamics within biobanking activity highlights the importance of prioritizing relations at the core of risk governance and promoting ethicality in the biobanking process by expanding the repertoire of considered risks. Conclusion: With the organismic metaphor, the research brings the diverse group of biobank staff to the central stage for risk governance, highlighting how accounting for such diversity and interdependencies at the biobank setting is a prerequisite for an adaptive risk governance.

Dataset on the impact of implementing a shared governance model on the level of professional governance among nurses in Saudi Arabia: Insights from experimental data.

Shared governance is a concept that has been gaining popularity in the nursing field. It is a framework that allows nurses to have a greater role in clinical decision-making. This approach recognizes the expertise and knowledge that nurses possess and allows them to be active participants in the decision-making process. It is a way to empower nurses and to ensure that the best possible care is being provided to patients. By promoting shared governance, nurses are able to work collaboratively with other healthcare professionals and provide high-quality care that is evidence-based and patient-centered. This article presents data that was collected in an empirical study to investigate the impact of implementing a shared governance model on the perceptions of professional governance among nurses working in a tertiary hospital in Saudi Arabia by measuring the level of shared governance from the lowest level, the traditional governance level (management and administration only), to the highest level, the self-governance level (staff only), through six dimensions of nursing professional governance, including personnel, information, resources, participation, practice, and goals. The study was conducted over 8 months between July 2022 to February 2023 with the involvement of a random sample of 200 clinical nurses who completed a structured questionnaire before and after the study interventions as part of quasi-research. The interventions included designing and implementing a shared governance model, and providing a shared governance training to clinical to nurse participants. The pretest-posttest experimental group showed that there were improvements in the level of shared governance (shared governance level - primarily management/administration with some staff input), which denotes the effectiveness of nursing professionals governance training among nurses working in a tertiary hospital in Saudi Arabia. The data used in this study can be utilized by future studies for benchmarking purposes.

Australian researchers' perceptions and experiences with stem cell registration.

The recently issued ISSCR standards in stem cell research recommend registration of human pluripotent stem cell lines (hPSCs). Registration is critical to establishing stem cell provenance and connecting cell lines to data derived on those lines. In this study, we sought to understand common barriers to registration by conducting interviews with forty-eight Australian stem cell stakeholders, including researchers, clinicians, and industry professionals. Australian stem cell researchers do not routinely register their lines, and only a third of those Australian lines captured by an international registry have fully completed the registration process. Most registered Australian cell lines lack complete information about their ethical provenance or key pluripotency characteristics. Incomplete registration is poorly aligned with the goals of open science on which registries are founded. Users also expressed concerns about the quality of the incomplete information provided to the resource. Registration was considered negatively, for instance as a hurdle or barrier to publication, which impacted on user perceptions of usefulness of registration and lowered the likelihood that they would engage with registries to find resources. Broader adoption of registration by journals, and continued advocacy by stem cell societies, will be important levers for awareness and engagement with registration. Although the Australian community represents a small fraction of potential registry users, the results of this study suggest ways for journals, registries, funders, and the international stem cell community to improve registration compliance.

Environmental policy stringency, ICT, and technological innovation for achieving sustainable development: Assessing the importance of governance and infrastructure.

Achieving sustainable development goals (SDGs) has garnered significant attention from academia and policymakers worldwide. In this study, we examine the impact of ICT, technological innovation (TI), and environmental policy stringency (EPS) on SDI, considering the moderating role of governance quality (GQI) and transport infrastructure (TIS). A comprehensive dataset of 17 advanced nations is utilized from 1996 to 2021. To capture the dynamic and extreme marginal impacts of these policy instruments on SDG attainment, we employ the advanced technique of Feasible Generalized Least Square (FGLS). The results demonstrate that ICT has a positive and significant effect on SDGs, particularly when combined with high levels of governance quality (GOV) and transport infrastructure (TIS). Likewise, TI has a positive impact on SDGs, especially in the presence of strong governance. Furthermore, EPS exhibits a positive association with SDGs. The findings also reveal that while governance hurts SDGs, this effect diminishes when combined with higher levels of ICT, TI, and EPS, and when TIS positively moderates the relationships. The robustness estimations using DOLS and PCSE methods validate the FGLS findings. These results underscore the importance of ICT, TI, and EPS in advancing sustainable development. Moreover, they highlight the significance of good governance and robust transport infrastructure in maximizing the positive effects of these factors. These findings hold implications for policymakers and stakeholders involved in promoting sustainable development.

A Typology of National Park Co-management Agreements in the Era of Reconciliation in Canada.

Parks Canada, in response to commitments undertaken towards reconciliation, has signaled its readiness to reassess the participation of Indigenous peoples in the co-management of national parks, national park reserves, and national marine conservation areas (NMCAs). However, the effectiveness of co-management, as the established framework underpinning these and other longstanding partnerships between the state and Indigenous groups, has been disputed, based on an uneven track record in meeting the needs, interests, and aspirations of Indigenous communities. This paper explores the potential of co-management to facilitate reconciliation within national parks, reserves and NMCAs by developing a typology of various types of co-management agreements. Addressing a critical knowledge gap in co-management governance, we provide a comprehensive review of 23 negotiated co-management agreements involving the state and Indigenous groups in a national park context. The resulting typology categorizes these agreements according to contextual factors and governance arrangements, offering insights into the feasibility of shared governance approaches with Parks Canada. Moreover, it identifies the strengths and weaknesses of co-management agreements in fulfilling reconciliation commitments. Our findings indicate that, although Parks Canada has implemented innovative approaches to co-management and shown a willingness to support Indigenous-led conservation efforts, true shared governance with Indigenous groups, as defined by international standards, is limited by the Canadian government's evident reluctance to amend the foundational legislation to effectively share authority in national parks.

Urban trees as a lever for citizen engagement in public consultation processes: the case of Paris, France.

In the present context of increasing human population demography, worldwide social crises, and rapid ecological global change, large cities are facing major socio-environmental challenges. This convokes authorities to adapt their governance and urban planning to reconcile urban development, ecological systems, and city dwellers in the most sustainable way. To achieve such goals, local officials have to associate all local actors, including city-dwellers, to the decision-making process through participatory governance and/or participatory systems. Here, we elaborated an original pilot project governance system for a "Participatory System Combining Town Planning and Science" (the 2PS-CiTy), as part of the revision of the Local Urban Plan (LUP) of Paris, France, into a Bioclimatic LUP held from 2020 to 2024. By implementing 2PS-CiTy, we aimed to answer "How to turn trees into a lever for inhabitants' engagement in urban consultation systems?" Trees were chosen because they are emblematic elements of nature with significant roles in ecosystemic services such as urban climate regulation. Parisians were invited to (i) share in the first questionnaire some information on their knowledge about the LUP and their engagement in it, (ii) identify urban trees they consider remarkable, (iii) explain their choice in a second questionnaire, (iv) contribute to the urban consultation as part of the LUP revision, and finally, (v) give their feedback during a dedicated survey. Out of the 41 Parisians who took part in 2PS-City, 83% declared they were motivated to participate because they could contribute to the tree census, which in turn can constructively contribute to the Parisian LUP revision to bring more nature and sustainability in town. This study demonstrates that trees can be used as a lever for inhabitants' engagement in urban consultation systems to make cities more sustainable. Our survey also showed that the 2PS-CiTy governance system could be improved by (1) developing a participatory culture among decision-makers and (2) preventing nowadays silo governance from developing the most promising public governance systems that involve the departments of green space, urban planning, and local democracy.

The role of governance in the digital transformation of healthcare: Results of a survey in the WHO Europe Region.

Optimal governance is among the key facilitators of the digital transformation of health systems intended to improve access to healthcare, quality, safety, and efficiency, and to attain universal health coverage. This paper highlights the findings of a survey assessing the status of governance of digital health in the WHO European Region. The 2022 survey is a continuation of the 2015 WHO Global Survey on eHealth. The survey focused on national digital health governance, monitoring and evaluation of digital health interventions, and funding and investment in digital health and was conducted through April to October 2022. All 53 Member States of the WHO European Region participated in the survey. The results showed that 83% of the Member States reported having a national digital health strategy in place, and 79% of the Member States reported having a health information system strategy. Most of the priorities of the national digital health strategies were devoted to increasing the accessibility, quality, safety, and efficiency of the health systems, strengthening health information systems, and improving information sharing and interoperability of data. Measures to ensure equity in access to digital healthcare services were directed towards improving broadband connectivity, information and communication technology, digital literacy, and digital health promotion. Oversight for the implementation and operation of the national digital health strategies are mostly delegated to government agencies. The prime source of funding for digital health programs was public funding, though a combination of funding sources was also noted. This analysis revealed increasing adoption of national digital health strategies for access to healthcare and creation of digital health agencies and funding programs for digital health.

An Orthopedic Healthcare Facility Governance Assessed with a New Indicator System.

BACKGROUND AND OBJECTIVES: A sustainability-oriented hospital governance has the potential to increase the efficiency of healthcare services and reduce the volume of expenses. The objective of this research is to develop a new complex tool for evaluating healthcare facility governance as a component of social responsibility, integrated into sustainability. MATERIALS AND METHODS: We designed the research to develop the domains of a new reference framework for evaluating healthcare facility governance. The methodology for designing the indicators that make up the new reference framework consists of collecting and processing the most recent and relevant practices regarding the governance of healthcare facilities that have been reported by representative hospitals around the world. RESULTS: We designed eight indicators that are brought together in the healthcare facility governance indicators matrix. They have descriptions and qualitative and quantitative rating scales with values from 0 to 5 that allow the degree of fulfillment to be quantified. The importance of the indicators is evaluated on a specific scale described qualitatively and quantitatively by values from 0 to 5. The values of the degree of achievement-importance couples of the indicators allow the development of improvement measures with priority according to the results revealed by the Eisenhower-type assessment diagram. CONCLUSIONS: Validation in practice of the system of indicators at an emergency hospital in an orthopedic profile highlighted the fact that they can be integrated into other national and international reference frameworks implemented in the hospital. The added value of the implementation consists of the facilitation of sustainable development and the orientation of health personnel, patients, and interested parties toward sustainability.

Animal Lives Affected by Meat Consumption Trends in the G20 Countries.

Trends in dietary habits have far-reaching implications, but their impact on animals remains insufficiently explored, as many people continue to dissociate meat from individual animal lives. This research study quantifies the temporal development of the number of animal lives affected by meat consumption within the G20 countries between 1961 and 2020 and forecasts for 2030. Production (including slaughter) and historical and projected food balance data were analyzed to explore these trends. The results indicate an increase in the number of animal lives affected due to increasing consumption, but discrepancies exist between different countries and animal categories. Increases are stronger in emerging countries, such as China, than in more industrialized countries, such as Germany. Overall, the number of animals affected grows 1.7 times as fast as meat consumption due to a shift towards poultry. Poultry birds are affected by far the most, and their dominance in number only slightly reduces when considering the differentiated moral values of the animals, reflecting their sentience. Until 2030, we can expect further increases in the number of animal lives affected. The findings highlight the need for progressive legislation to address the complex trade-offs and challenges in reversing the increasing trends in the number of animals affected.

Enhancing Clinical Decision Support in Nephrology: Addressing Algorithmic Bias Through Artificial Intelligence Governance.

There has been a steady rise in the use of clinical decision support (CDS) tools to guide Nephrology, as well as general clinical care. Through guidance set by federal agencies and concerns raised by clinical investigators, there has been an equal rise in understanding whether such tools exhibit algorithmic bias leading to unfairness. This has spurred the more fundamental question of whether sensitive variables such as race should be included in CDS tools. In order to properly answer this question, it is necessary to understand how algorithmic bias arises. We break down three sources of bias encountered when using electronic health record data to develop CDS tools: (1) use of proxy variables, (2) observability concerns and (3) underlying heterogeneity. We discuss how answering the question of whether to include sensitive variables like race often hinges more on qualitative considerations than on quantitative analysis, dependent on the function that the sensitive variable serves. Based on our experience with our own institution's CDS governance group, we show how health system-based governance committees play a central role in guiding these difficult and important considerations. Ultimately, our goal is to foster a community practice of model development and governance teams that emphasizes consciousness about sensitive variables and prioritizes equity.