Supporting hospital renewal through strategic environmental sustainability programs.

Although the impact the environment can have on human health is well understood, the healthcare system's impact on the environment is a topic that's only been explored since the mid-1990s. More recent has been a realization of the risks that climate change poses to health and healthcare. Although there are numerous direct benefits for hospitals adapting environmental sustainability programs, this article examines how the systemic approach taken by the University Health Network's (UHN) Energy & Environment program not only improves the hospital's environmental performance and provides significant cost savings but also supports several areas of focus that are part of UHN's current journey of renewal.

Potential Scenarios and Hazards in the Work of the Future: A Systematic Review of the Peer-Reviewed and Gray Literatures.

It would be useful for researchers, practitioners, and decision-makers to anticipate the hazards that workers will face in the future. The focus of this study is a systematic review of published information to identify and characterize scenarios and hazards in the future of work. Eleven bibliographic databases were systematically searched for papers and reports published from 1999 to 2019 that described future of work scenarios or identified future work-related hazards. To compile a comprehensive collection of views of the future, supplemental and ad hoc searches were also performed. After screening all search records against a set of predetermined criteria, the review yielded 36 references (17 peer-reviewed, 4 gray, and 15 supplemental) containing scenarios. In these, the future of work was described along multiple conceptual axes (e.g. labor market changes, societal values, and manual versus cognitive work). Technology was identified as the primary driver of the future of work in most scenarios, and there were divergent views in the literature as to whether technology will create more or fewer jobs than it displaces. Workforce demographics, globalization, climate change, economic conditions, and urbanization were also mentioned as influential factors. Other important themes included human enhancement, social isolation, loneliness, worker monitoring, advanced manufacturing, hazardous exposures, sustainability, biotechnology, and synthetic biology. Pandemics have not been widely considered in the future of work literature, but the recent COVID-19 pandemic illustrates that was short-sighted. Pandemics may accelerate future of work trends and merit critical consideration in scenario development. Many scenarios described 'new' or 'exacerbated' psychosocial hazards of work, whereas comparatively fewer discussed physical, chemical, or biological hazards. Various preventive recommendations were identified. In particular, reducing stress associated with precarious work and its requirements of continual skill preparation and training was acknowledged as critical for protecting and promoting the health and well-being of the future workforce. In conclusion, the future of work will be comprised of diverse complex scenarios and a mosaic of old and new hazards. These findings may serve as the basis for considering how to shape the future of work.

Maternal hypertension and hypospadias in offspring: A systematic review and meta-analysis.

BACKGROUND: Several studies have reported an association between maternal hypertensive disorders and hypospadias in offspring; however there is still debate on the role of maternal hypertension and preeclampsia on this relatively common congenital malformation. Therefore, we conducted a systematic review and meta-analysis to comprehensively evaluate the relationship between these frequent maternal conditions and hypospadias in offspring. METHODS: Fifteen articles meeting the eligibility criteria were identified in our search and included in the analysis. A meta-analysis was conducted and pooled odds ratio (OR) estimates were calculated separately for hypertension and preeclampsia using meta-analysis. We also conducted several secondary analyses, including (a) studies conducted before versus after January 1, 1998; (b) studies in United States versus other countries; and (c) studies that accounted for ≥3 versus fewer or no potential confounders, among others. RESULTS: Significant positive associations were observed between hypertension and hypospadias (OR 1.68; 95% CI 1.46-1.93), as well as preeclampsia and hypospadias (OR 2.18; 95% CI 1.63-2.91). The direction and magnitude of effect was comparable for the majority of secondary analyses conducted. CONCLUSIONS: Our results indicate that maternal hypertensive disorders are positively associated with hypospadias in offspring. Further research is needed to better understand the mechanisms involved, and to ultimately develop public health strategies geared toward prevention of hypospadias.