Patient perspectives on climate friendly healthcare: an exploratory study in obstetrics and gynaecology.

OBJECTIVE: To investigate patient perspectives on climate change and climate change mitigation strategies in healthcare. METHODS: A cross-sectional survey among gynaecological patients from two Dutch outpatient clinics. Main outcomes included patients' climate-related knowledge and worry, climate friendly healthcare perspectives and willingness to opt for climate friendly treatment alternatives. Multivariable linear regression analyses were performed to explore patient characteristics associated with climate friendly healthcare perspectives. RESULTS: 274 surveys were included. Most patients (79 %) were worried about climate change. Although almost all (91 %) found it important to contribute to climate protection, patients showed hesitance regarding healthcare measures that would impinge on individual choices. 62 % was willing to opt for climate friendly treatments, but this proportion varied by medical condition. Climate-related knowledge and worry were both positively associated with climate friendly healthcare perspectives. CONCLUSION: Gynaecological patients are concerned about climate change and possess substantial self-reported climate-related knowledge. Patients vary in their support of climate action that involves individual patient care, but the majority is open to choose climate friendly treatment alternatives for certain medical conditions. PRACTICE IMPLICATIONS: This exploratory study holds implications for the feasibility of integrating climate impact into clinical decision-making and provides a foundation for normative evidence for decarbonizing healthcare.

Environmental Impact Assessment of Reusable and Disposable Surgical Head Covers.

This life cycle assessment compares the environmental footprint of reusable surgical head covers with single-use disposable surgical head covers.

['Is there a doctor on board?' Reducing air travel associated with international medical conferences]. / 'Is er een dokter aan boord?'.

International medical conferences aim to improve health outcomes, but the associated air travel-related carbon emissions are a significant contributor to the environmental impact of medical scientific activities. The COVID-19 pandemic has urged the medical world to shift towards virtual conferences, decreasing associated carbon emissions by 94% to 99%. However, virtual conferences are still not the norm and doctors are returning to business as usual. Various stakeholders need to be mobilized to minimize carbon-intensive flights to conferences. Doctors, (academic) hospitals, conference organizers and universities all hold a responsibility to incorporate every effort to decarbonize and build climate mitigation into their decisions. These efforts include sustainable travel policies, selecting accessible venues, decentralizing host locations, encouraging low carbon alternatives to air travel, increasing virtual attendance and increasing awareness.

[Seizures in pregnancy: not always eclamptic seizures]. / Een insult tijdens de zwangerschap.

BACKGROUND: The differential diagnosis of seizures during pregnancy is extensive and includes potentially fatal underlying diagnoses. Both pregnancy and non-pregnancy related aetiologies should be considered. CASE DESCRIPTION: A 38-years old pregnant woman presented to the emergency department at 31 weeks and 5 days with generalized tonic-clonic seizures. Initial an eclamptic seizure was suspected. Because the seizures lasted despite treatment with magnesium sulphate and anti-epileptic medication. Imaging of the head was performed and a brain tumour was suspected and a biopsy revealed the presence of a high-grade glioma. At 37 weeks of gestation, labour was induced and the patient delivered a healthy daughter. The patient was then palliatively treated with antiepileptic drugs and chemotherapy. CONCLUSION: Structural brain changes caused by a high-grade gliomas represent a rare cause of seizure during pregnancy, emphasizing the importance of considering non-obstetric causes of seizures in pregnant women.

Ethnic Differences in Health Literacy Among Young Adults in Amsterdam.

BACKGROUND: Ethnic differences in health commence early in life. Ethnic minority young adults have a greater prevalence of unhealthier lifestyles and poorer health outcomes than their peers. Variations in health literacy could contribute to these ethnic inequalities in health but have not yet been investigated in this group. OBJECTIVE: This study investigated ethnic differences in performance-based and self-reported health literacy in young adults and examined whether these differences are explained by educational level, language difficulties, or cultural distance. METHODS: Young adults (age 18-25 years) from Dutch, African Surinamese, South-Asian Surinamese, Ghanaian, Turkish, and Moroccan ethnic backgrounds (N = 2,215) participated in the HELIUS (HEalthy Life in an Urban Setting) study, a cohort study in Amsterdam, the Netherlands. Performance-based health literacy was measured by the Rapid Estimate of Adult Literacy in Medicine in Dutch (REALM-D). Self-reported health literacy was measured by the Chew's Set of Brief Screening Questions (SBSQ). The association between ethnicity and health literacy, and the role of background characteristics was assessed by linear regression analyses. KEY RESULTS: Performance-based health literacy was low (REALM-D <60; range, 0-66) among 17% of the participants. After adjustment for educational level, average levels of REALM-D were lower among participants from a Ghanaian, Turkish, and Moroccan background than those from a Dutch background, whereas the two Surinamese groups did not differ from the Dutch group. Additional adjustment for language difficulties and cultural distance did not explain the differences between the five ethnic minority groups. Self-reported health literacy was low (SBSQ <3; range, 0-4) among 3% of the participants. There were no differences in levels of SBSQ between the ethnic minority groups and the Dutch group. CONCLUSIONS: We found ethnic differences in performance-based health literacy, which largely remained after adjustment for educational level. Further research is needed to gain insight into how young adults from different ethnic groups appraise and apply health information in various contexts. [HLRP: Health Literacy Research and Practice. 2018;2(4):e192-e204.]. PLAIN LANGUAGE SUMMARY: We investigated ethnic differences in health literacy among young adults (age 18-25 years) living in the Netherlands. Compared to the Dutch group, some ethnic minority groups scored lower on performance-based health literacy, independent of educational level. Self-reported health literacy did not differ between Dutch and ethnic minority groups.