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Dağlı E, Reyhan FA, Kırca AŞ. Midwives' views about the effects of climate change on maternal and child health: A qualitative study. Women Birth 2024; 37:451-457. [PMID: 38355342 DOI: 10.1016/j.wombi.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 01/28/2024] [Accepted: 02/02/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Midwives have important responsibilities to protect the health of mothers and children from the negative effects of climate change. AIM This research was conducted to determine how midwives perceived climate change, the effects of climate change on maternal and child health, and what midwives could do to combat these effects. METHODS The research was designed as a case study, one of the qualitative research designs. The research sample consisted of 11 midwives selected by snowball sampling, which is one of the non-random sampling methods. FINDINGS The data obtained were collected under five main themes. The themes were determined as "(I) the causes of climate change, (II) concerns about the consequences of climate change, (III) the effects of climate change on mother-child health, (IV) measures to mitigate the effects of climate change, and (V) midwives' role in protecting mother-child health against the effects of climate change." CONCLUSION Midwives are knowledgeable about climate change. They are aware of the effects of climate change on maternal and child health and they are doing some practices in this regard (breastfeeding, promoting the regulation of fertility and adequate/balanced nutrition, etc.). Midwives are aware of the importance of the midwifery profession in raising awareness of the individual and society, in addressing the effects of climate change on human health and in reducing the negative effects of climate change on health, and they want to take action at the national level (with the support of the midwifery organization and the state) for the sustainability of health.
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Affiliation(s)
- Elif Dağlı
- Çukurova University, Abdi Sütcü Vocational School of Health Services, Department of Health Care Services, Adana, Turkey.
| | - Feyza Aktaş Reyhan
- Kütahya University of Health Sciences, Faculty of Health Sciences, Midwifery Department, Kütahya, Turkey
| | - Ayça Şolt Kırca
- Kırklareli University of Faculty of Health Sciences, Midwifery Department, Kırklareli, Turkey
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Mosadeghrad AM, Isfahani P, Eslambolchi L, Zahmatkesh M, Afshari M. Strategies to strengthen a climate-resilient health system: a scoping review. Global Health 2023; 19:62. [PMID: 37641052 PMCID: PMC10463427 DOI: 10.1186/s12992-023-00965-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Climate change is a major global threat to human health and puts tremendous pressure on health systems. Therefore, a resilient health system is crucial to enhance, maintain, and restore the population's health. This study aimed to identify interventions and actions to strengthen a climate-resilient health system to deal with the adverse health effects of climate change. METHOD This study was a scoping review. Five databases and Google Scholar search engine were searched using relevant keywords. Initially, 4945 documents were identified, and 105 were included in the review. Content thematic analysis method was applied using MAXQDA 10 software. RESULTS Overall, 87 actions were identified for building a climate-resilient health system and were classified into six themes (i.e., governance and leadership; financing; health workforce; essential medical products and technologies; health information systems; and service delivery). The most commonly reported actions were formulating a national health and climate change adaptation plan, developing plans for essential services (electricity, heating, cooling, ventilation, and water supply), assessing the vulnerabilities and capacities of the health system, and enhancing surveillance systems targeting climate-sensitive diseases and their risk sources. CONCLUSIONS A holistic and systemic approach is needed to build a climate-resilient health system owing to its complex adaptive nature. Strong governance and leadership, raising public awareness, strategic resource allocation, climate change mitigation, emergency preparedness, robust health services delivery, and supporting research, are essential to building a climate-resilient health system.
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Affiliation(s)
- Ali Mohammad Mosadeghrad
- Professor of Health policy and management, Health Economics and Management Department, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Parvaneh Isfahani
- School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Leila Eslambolchi
- PhD in Health management, Health Economics and Management Department, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Maryam Zahmatkesh
- School of Business and Management, Royal Holloway University of London, Egham, England
| | - Mahnaz Afshari
- School of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran.
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Wicklum SC, Nuique K, Kelly MA, Nesbitt CC, Zhang JJ, Svrcek CP. Greening Family Medicine clinic operations and clinical care, where do we start? A scoping review of toolkits and aids. Fam Pract 2023; 40:473-485. [PMID: 36730055 DOI: 10.1093/fampra/cmad006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND There is a pressing need for healthcare to respond to the climate crisis. Family physicians, given their central role in community healthcare provision, are strategically placed to lead, support, and promote sustainable healthcare, yet guidance on how to do this is fragmented. OBJECTIVE To identify and evaluate toolkits and aids on sustainable healthcare to act as a curated resource for family physicians and their care teams interested in delivering evidence-based sustainable healthcare in their clinical practices. METHODS A scoping review was completed of the published and grey literature across 4 databases and 2 search engines to identify articles and aids/toolkits from 1990 to present. Toolkits were subsequently evaluated for purpose, evidence-base, implementation process, adaptability to family medicine, and outcome measures. RESULTS The search identified 17,751 articles. Screening resulted in 20 published articles and 11 toolkits. Most articles presented simple checklists to support greening clinic initiatives, 3 studies focussed on partial carbon footprint analyses, and 4 on educational initiatives. Toolkits ranged in sustainability topics and degree of depth covered, and adaptability and outcome measures. None of the resources identified have been formally evaluated for effectiveness. CONCLUSIONS A range of aids exist to support greening of clinic operations; however, there is a significant gap in the literature for greening clinical care. Two toolkits were found to be comprehensive, one requiring tracking and reporting of sustainability initiatives. This scoping review provides a starting point for motivated family doctors and community clinics to initiate change and support more sustainable healthcare.
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Affiliation(s)
- Sonja C Wicklum
- Department of Family Medicine, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada
| | - Kate Nuique
- Department of Family Medicine, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada
| | - Martina A Kelly
- Department of Family Medicine, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada
| | - Colleen C Nesbitt
- Department of Family Medicine, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada
| | - Jessica J Zhang
- Department of Family Medicine, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada
| | - Clark P Svrcek
- Department of Family Medicine, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada
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Cheung R, Ito E, Lopez M, Rubinstein E, Keller H, Cheung F, Liu ZA, Liu FF, Wong P. Evaluating the Short-term Environmental and Clinical Effects of a Radiation Oncology Department's Response to the COVID-19 Pandemic. Int J Radiat Oncol Biol Phys 2023; 115:39-47. [PMID: 36309074 PMCID: PMC9598491 DOI: 10.1016/j.ijrobp.2022.04.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE During the COVID-19 pandemic, many radiation oncology departments worldwide adopted the use of shorter and more intense hypofractionated regimens. Hospital foot traffic was reduced through virtual care. This study's primary objective was to assess the collective environmental effect of these strategic changes by identifying sources of carbon dioxide equivalents (CO2e). The rate of radiation-related adverse events from the increased use of hypofractionated treatments was assessed. METHODS AND MATERIALS All patients treated with external beam radiation therapy from April 1, 2019, to March 31, 2021, at our single institution were identified (n = 10,175) along with their radiation therapy visits (176,423 fractions) and unplanned visits to the radiation nursing clinic or emergency department. Out-patient hospital and virtual visits (n = 75,853) during this same period were also analyzed. Environmental effect measures, including linear accelerator power usage, patient travel distances, and personal protection equipment consumption were all converted into CO2e. RESULTS The use of curative hypofractionated regimens increased from 17% to 27% during the pandemic year. Carbon footprint was reduced by 39% during the pandemic year (1,332,388 kg CO2e) compared with the prepandemic year (2,024,823 kg CO2e). Comparing patients in the prepandemic versus pandemic year, there was a significant reduction in the proportion of hypofractionated patients who needed a visit to either the radiation nursing clinic (39% vs 25%; P < .001) or emergency department (6% vs 2%; P < .001) during and within 90 days of radiation therapy. CONCLUSIONS This is the first study to demonstrate the environmental benefits of increased use of hypofractionated regimens and virtual care, while assuring that there was no added acute radiation-related adverse event. Our findings support their continued use as one of many long-term strategies to reduce the environmental footprint of health care delivery.
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Affiliation(s)
- Ronald Cheung
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada,Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Emma Ito
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Marianela Lopez
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Ed Rubinstein
- Energy & Environment Department, University Health Network, Toronto, Ontario, Canada
| | - Harald Keller
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Fred Cheung
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Zhihui Amy Liu
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Fei-Fei Liu
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Philip Wong
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
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ÖZTÜRK DÖNMEZ R, KURT Ş. İklim Değişikliğinin Anne ve Yenidoğan Sağlığı Üzerine Etkisi. DOKUZ EYLÜL ÜNIVERSITESI HEMŞIRELIK FAKÜLTESI ELEKTRONIK DERGISI 2022. [DOI: 10.46483/deuhfed.1008043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Özellikle son yıllarda üzerinde durulan iklim değişikliği; on yıllardır süren sıcaklık, yağış, rüzgâr gibi hava olaylarındaki değişiklik olarak tanımlanmaktadır. İklim değişikliği ile birlikte, temiz suya erişim, hava kalitesi, hava sıcaklıklarında değişim, güvenli barınma ve gıda güvenliği gibi sağlığın belirleyicileri olumsuz etkilenerek insan sağlığı etkilenmektedir. Bu durumdan etkilenen risk grubunda bulunan bireyler, özellikle gebeler ve yenidoğanlar, savunmasız ve duyarlı alt grupları oluşturmaktadırlar. İklim değişikliği ve sağlığa etkilerini konu alan çalışmaların özellikle son yıllarda yürütülmüş olduğu dikkati çekmektedir. Bu derlemede iklim değişikliğinin anne ve yenidoğan sağlığı üzerine etkilerinin neler olduğuna dikkat çekilmek istenmiştir. İncelenen araştırmalardan yüksek derece sıcaklığa maruz kalma ve hava kirliliği ile gestasyonel diyabet, hipertansiyon, erken doğum, erken membran rüptürü, düşük doğum ağırlığı, ölü doğum, yenidoğan cinsiyeti ve konjenital anomaliler arasında ilişki olduğu saptanmıştır. İklim değişikliğinin sağlık üzerine olumsuz etkilerini azaltmada hemşirelere önemli sorumluluklar düşmektedir. Toplumun ve bireyin dayanıklılık kapasitesini arttırma, başa çıkma stratejilerini ve ileriye dönük davranışlarını geliştirme, sosyal destek ve yeşil çevre için politikalar geliştirmeye yönelik eğitici, savunucu, değişim ajanı, liderlik, bakım verici ve denetleyici gibi var olan rollerini hemşireler etkili bir biçimde kullanmalıdır.
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Affiliation(s)
| | - Şeyma KURT
- EGE ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ ENSTİTÜSÜ
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