National Overview Research Articles

Digital competence and digital technology: a curriculum analysis of Norwegian early childhood teacher education

ABSTRACT This paper explores how digital competence and digital technology are addressed in Norwegian early childhood teacher education (ECTE). The aim is to provide a national overview of the ECTE institutions’ programme and relevant course plans to identify how the preservice teachers are being prepared for their future professional life as digitally competent early childhood teachers. We have conducted a summative content analysis of national regulations, national guidelines, programme and course plans by drawing on Goodlad et al.’s curriculum theory. The findings demonstrate that digital competence and digital technology are clearly emphasised and addressed at the ideological curriculum level but less so at the formal and perceived levels. Data shows that there is a need to define and operationalise professional digital competence from an ECTE perspective. Furthermore, there is a need to more explicitly describe the learning outcomes in the programme and course plans, focusing on both theoretical and practical aspects.

Defining the “Community” in Community College: A National Overview and Implications for Racial Imbalance in Texas

At least 38 states have created service areas or “districts” for each of their community colleges. However, little is known about the geographic boundaries of community college districts and the policymaking process that defines them. We studied state policy documents nationally and the actual district boundaries of Texas community colleges to investigate the larger policymaking processes of determining boundaries. We found significant variation across the United States, including in who determines the boundaries and whether the districts have associated tuition reductions. In our case study, we also found evidence that the majority of Texas’s community college districts appear to reflect their larger local environments, although a small number may exhibit evidence of racial imbalance.

Panorama institucional do trabalho grupal com homens autores de violência contra mulher no Brasil

Abstract The Maria da Penha Law assists male perpetrators of violence in rehabilitation centers translated, in practice, into group activities. This study offers a national overview of these actions by conducting a literature review and bibliographical and documental research. Groups were identified by searches on LILACS/VHL, MEDLINE/PUBMED, COCHRANE LIBRARY, EMBASE, the Brazilian Digital Library of Theses and Dissertations (BDTD), and the Coordination for the Improvement of Higher Education Personnel’s (CAPES) journal portal, published maps and national listing of initiatives with male perpetrators of violence, and a web search. Of the 309 groups identified, 271 answered an electronically sent questionnaire from April to May 2021. Results draw an overview showing the active institutions; the way men are referred to them; the existence of networking and approximation to social movements; information about facilitating teams; goals; evaluation methodology; and the main results and difficulties highlighted by these groups. This study also confirmed gaps, such as the absence of a national public policy that welcomes and encourages local organizations; facilitators’ lack of ongoing training; the absence or scarcity of financial contribution; and especially the fragile evaluation and monitoring of activities.

A national overview of paediatric and adolescent and young adult surgical neuro-oncology in Pakistan.

To build a comprehensive brain tumour database that will allow us to analyse in detail the prevalence, demographics, and outcomes of the disease in paediatric, adolescent, and young adult age groups. A national cross-sectional study was conducted at 32 centres, and data regarding patient demographics and brain tumours were collected. This data was then stratified based on age groups, healthcare sectors, socioeconomic status, tumour types, and surgical outcomes. Most of the patients who were diagnosed with brain tumours belonged to a lower socioeconomic background and went to public sector hospitals. More males were diagnosed with and treated for brain tumours in the paediatric, adolescent, and young adult populations. The most common tumour in the paediatric population was medulloblastoma (23.7%) and the most common tumour in the adolescent (27.8%) and young adult population (34.7%) was glioma. Significant improvement in KPS scores were seen for: craniopharyngioma (p = 0.001), meningioma (p < 0.0005) and pituitary adenoma (p < 0.0005). This study shows that in all three age groups, there was a greater prevalence in males. Most of the patients belonged to a lower-middle-income class background and most patients presented to public sector hospitals. Greater knowledge of these parameters unique to each age group is the key to understanding and alleviating the burden of disease. Cancer registries, specifically brain tumour registries that keep up-to-date records of these patients, are essential to identify and keep track of these unique parameters to advance medical research and treatment strategies, ultimately lowering the disease burden.

Radiotherapy-specific quality indicators at national level: How to make it happen

Purpose /objectiveTo promote best practice and quality of care, the Belgian College of Physicians for Radiotherapy Centers established a set of radiotherapy specific quality indicators for benchmarking on a national level. This paper describes the development, the collected QIs, the observed trends and the departments’ evaluation of this initiative. Material and methodsThe Donabedian approach was used, focussing on structural, process and outcome QIs. The criteria for QI selection were availability, required for low-threshold regular collection, and applicability to guidelines and good practice. The QIs were collected yearly and individualized reports were sent out to all RT departments. In 2021, a national survey was held to evaluate the ease of data collection and submission, and the perceived importance and validity of the collected QIs. Results18 structural QI and 37 process and outcome parameters (n = 25 patients/pathology/department) were collected. The participation rate amounted to 95 % overall. The analysis gave a national overview of RT activity, resources, clinical practice and reported acute toxicities. The individualized reports allowed departments to benchmark their performance.The 2021 survey indicated that the QIs were overall easy to collect, relevant and reliable. The collection of acute recorded toxicities was deemed a weak point due to inter-observer variabilities and lack of follow-up time. ConclusionQI collection on a national level is a valuable process in steering quality improvement initiatives. The feasibility and relevance was demonstrated with a high level of participation. The national initiative will continue to evolve as a quality monitoring and improvement tool.

Prevalence of pharmacological and non-pharmacological coping mechanisms for anxiety management during the COVID-19 pandemic: investigating the transition to online learning among medical students

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic had a devastating effect on college students worldwide. Here, the authors aimed to determine the prevalence of anxiety and its related coping strategies, provide a theoretical basis for understanding self-prescription, and identify the factors contributing to stress and anxiety in medical students during the pandemic.MethodsThe authors conducted a cross-sectional study among medical students in Saudi Arabia from September to November 2020. They assessed anxiety using the GAD-7 scale based on seven core symptoms. The authors also examined perceived psychological stress using a single-item measure of stress, the factors contributing to stress during the transition to online learning and examinations, and related coping strategies. The Statistical Package for Social Sciences (SPSS) version 26.0 was used to examine the data for both descriptive and inferential analyses. Chi-square test, one-way ANOVA, and univariate linear regression were used to test the research hypotheses.ResultsThe authors collected and analyzed data from 7116 medical students distributed across 38 medical colleges. Among them, 40% reported moderate to severe anxiety symptoms. Pre-clinical and female students experienced more stress than clinical and male students. 12.19% (n = 868) of respondents reported using medication during their college years. Among those, 58.9% (n = 512) had moderate to severe anxiety, and the most commonly used drug was propranolol (45.4%, n = 394). Among the studied sample, 40.4% (n = 351) decreased their medication use after switching to online teaching. Most students used these medications during the final exam (35.8%, n = 311) and before the oral exam (35.5%, n = 308). In terms of coping strategies, males were much more likely to use substances than females, who mainly resorted to other strategies.ConclusionsThis study provides a national overview of the impact of COVID-19 on the mental health of medical students. The results indicated that the pandemic is associated with highly significant levels of anxiety. These findings can provide theoretical evidence for the need for supportive psychological assistance from academic leaders in this regard.

A large-sample investigation into uncertain climate change impacts on high flows across Great Britain

Abstract. Climate change may significantly increase flood risk globally, but there are large uncertainties in both future climatic changes and how these propagate into changing river flows. Here, the impact of climate change on the magnitude and frequency of high flows is analysed for Great Britain (GB) to provide the first spatially consistent GB projections to include both climate ensembles and hydrological model parameter uncertainties. We use the latest high-resolution (12 km) regional climate model ensemble from the UK Climate Projections (UKCP18). These projections are based on a perturbed-physics ensemble of 12 regional climate model simulations and allow exploration of climate model uncertainty beyond the variability caused by the use of different models. We model 346 larger (&gt;144 km2) catchments across GB using the DECIPHeR hydrological modelling framework. Generally, results indicated an increase in the magnitude and frequency of high flows (Q10, Q1, and annual maximum) along the western coast of GB in the future (2050–2075), with increases in annual maximum flows of up to 65 % for western Scotland. In contrast, median flows (Q50) were projected to decrease across GB. Even when using an ensemble based on a single regional climate model (RCM) structure, all flow projections contained large uncertainties. While the RCM parameters were the largest source of uncertainty overall, hydrological modelling uncertainties were considerable in eastern and south-eastern England. Regional variations in flow projections were found to relate to (i) differences in climatic change and (ii) catchment conditions during the baseline period as characterised by the runoff coefficient (mean discharge divided by mean precipitation). Importantly, increased heavy-precipitation events (defined by an increase in 99th percentile precipitation) did not always result in increased flood flows for catchments with low runoff coefficients, highlighting the varying factors leading to changes in high flows. These results provide a national overview of climate change impacts on high flows across GB, which will inform climate change adaptation, and highlight the impact of hydrological model parameter uncertainties when modelling climate change impact on high flows.

Organisational survey for acute stroke care in Vietnam: Regional Collaboration Programme

ObjectivesLow-middle income countries, such as Vietnam have a greater burden from stroke than high-income countries. Few health professionals have stroke specialist training, and the quality of care may vary between hospitals. To support improvements to stroke care, we aimed to gain a better understanding of the resources available in hospitals in Vietnam to manage acute stroke. Materials and methodsThe survey questions were adapted from the Australian Organisational Survey of Stroke Services (Stroke Foundation). The final 65 questions covered the topics: hospital size and admissions for stroke; use of clinical protocols and assessments conducted; team structure and coordination; communication and team roles. The survey was distributed electronically or via paper form in Vietnamese to clinical leaders of 91 eligible hospitals (November–December 2020). Data were summarised descriptively. ResultsSixty-six (73%) hospitals responded, and doctors predominately completed the survey (98%). Approximately 70% of hospitals had a stroke unit; median 630 acute strokes/year (IQR: 250-1200) and >90% used stroke clinical protocols. The daytime nurse-patient ratio was 1:4. There was a perceived lack of access to allied health staff, including psychologists/neuropsychologists, occupational therapists, and speech pathologists. Only 50% reported having a standardised rehabilitation assessment process. ConclusionsThis is the first large-scale cross-sectional, national overview of stroke services in Vietnam. Future research should include a systematic clinical audit of stroke care to confirm aspects of the data from these hospitals. Repeating the survey in future years will enable the tracking of progress and may influence capacity building for stroke care in Vietnam.

What does the UK Police National Database tell us about the future of police intelligence?

Abstract Developments in technology are transforming society, creating more opportunities for offenders and complicating the policing landscape. The challenge for law enforcement is to identify criminal patterns from an offender’s electronic traces and to provide actionable intelligence. However, these traces are held by diverse police forces and are rarely connected. In 2011, to overcome this challenge, the Police National Database (PND) was launched to provide a national intelligence overview from local data. This study examines the database, using a mixed-methods approach. Descriptive and inferential analyses of PND usage data highlight that different forces use the PND, and its various capabilities, with different levels of frequency. Thematic analyses of interviews and focus groups with PND users identified: specific examples of PND use, as well as its perceived strengths, perceived deficiencies, and future considerations. Implications for policing practice are discussed.

Fundamentals of care in pre-registration nursing curricula: Results of a national survey

The Fundamentals of Care is a conceptual framework, grounded on the nurse establishing a relationship with the patient to enable the integration of physical, psychological, and relational aspects of nursing to deliver essential patient care. There is an imperative on schools of nursing to teach and assess nursing students to achieve clinical competency. The Nursing Council of New Zealand provide schools of nursing with an educational framework to guide how nursing students are educated. However, curricular content specific to fundamentals of care (FoC) is minimally researched, making areas of strength or gaps in curricula unclear. This paper provides a national overview of undergraduate pre-registration nursing curricula in Aotearoa New Zealand exploring what and how schools of nursing teach and assess FoC. This was achieved using a cross-sectional descriptive survey. Survey responses were received from 17 course coordinators and involved completing an online anonymous questionnaire. Data was collected between July 2019 and February 2020 and analysed using descriptive statistics. Data analysis revealed variations in how FoC is taught and suggests that the FoC curriculum is non-standardised. Schools appear to design their own curricula and individually decide the educational approaches they use to teach and assess FoC. Furthermore, while mouth and general skin care are commonly featured across FoC teaching, there was a limited focus on eye and perineal care. This study highlights the variance in how FoC is taught and the non-standardised design approach used by schools of nursing in Aotearoa New Zealand. Knowing this, provides schools of nursing and the Nursing Council of New Zealand with an opportunity to discuss and potentially develop a national evidenced-based FoC education strategy. Collaborating with international nursing councils could enhance the development of such a strategy.

Age and COVID-19 mortality in the United States: a comparison of the prison and general population

PurposeThe USA has a rapidly aging prison population that, combined with their poorer health and living conditions, is at extreme risk for COVID-19. The purpose of this paper is to compare COVID-19 mortality trends in the US prison population and the general population to see how mortality risk changed over the course of the pandemic. The authors first provide a national overview of trends in COVID-19 mortality; then, the authors assess COVID-19 deaths among older populations using more detailed data from one US state.Design/methodology/approachThe authors used multiple publicly available data sets (e.g. Centers for Disease Control and prevention, COVID Prison Project) and indirect and direct standardization to estimate standardized mortality rates covering the period from April 2020 to June 2021 for the US and for the State of Texas.FindingsWhile 921 COVID-19-related deaths among people in US prisons were expected as of June 5, 2021, 2,664 were observed, corresponding to a standardized mortality ratio of 2.89 (95%CI 2.78, 3.00). The observed number of COVID-19-related deaths exceeded the expected number of COVID-19-related deaths among people in prison for most of the pandemic, with a substantially widening gap leading to a plateau about four weeks after the COVID-19 vaccine was introduced in the USA. In the state population, the older population in prison is dying at younger ages compared with the general population, with the highest percentage of deaths among people aged 50–64 years.Research limitations/implicationsPeople who are incarcerated are dying of COVID-19 at a rate that far outpaces the general population and are dying at younger ages.Originality/valueThis descriptive analysis serves as a first step in understanding the dynamic trends in COVID-19 mortality and the association between age and COVID-19 death in US prisons.

Indigenous-Led Nature-Based Solutions for the Climate Crisis: Insights from Canada

This article provides an international and national overview of climate change and biodiversity frameworks and is focused on emerging evidence of Indigenous leadership and collaborations in Canada. After introducing the international context and describing the national policy landscape, we provide preliminary evidence documenting emerging national, regional, and local examples of Indigenous-led collaborative conservation projects and nature-based climate change solutions for the climate crisis. Based on our preliminary data, we suggest that Indigenous peoples and communities are well-positioned and currently have and will continue to play important roles in the protection, conservation management, and restoration of lands and waters in Canada and globally. These efforts are critical to the global mitigation, sequestration, and storage of greenhouse gases (GHGs) precipitating the climate crisis while also building adaptive resiliency to reduce impacts. Emerging Canadian evidence suggests that there are a diversity of co-benefits that Indigenous-led nature-based solutions to climate change and biodiversity protection bring, enabled by creating ethical space for reconciliation and conservation collaborations.

Pathways to the emergency department - a national, cross-sectional study in Sweden

BackgroundSwedish Emergency Departments (EDs) see 2.6 million visits annually. Sweden has a strong tradition of health care databases, but information on patients’ pathways to the ED is not documented in any registry.The aim of this study was to provide a national overview of pathways, degree of medical acuteness according to triage, chief complaints, and hospital admission rates for adult patients (≥18 years) visiting Swedish EDs during 24 h.MethodsA national cross-sectional study including all patients at 43 of Sweden’s 72 EDs during 24 h on April 25th, 2018. Pathway to the ED, medical acuteness at triage, admission and basic demographics were registered by dedicated assessors present at every ED for the duration of the study. Descriptive data are reported.ResultsA total of 3875 adult patients (median age 59; range 18 to 107; 50% men) were included in the study. Complete data for pathway to the ED was reported for 3693 patients (98%). The most common pathway was self-referred walk-in (n = 1310; 34%), followed by ambulance (n = 920; 24%), referral from a general practitioner (n = 497; 1 3%), and telephone referral by the national medical helpline “1177” (n = 409; 10%). In patients 18 to 64 years, self-referred walk-in was most common, whereas transport by ambulance dominated in patients > 64 years.Of the 3365 patients who received a medical acuteness level at triage, 4% were classified as Red (Immediate), 18% as Orange (very urgent), 47% as Yellow (Urgent), 26% as Green (Standard), and 5% as Blue (Non-Urgent).Abdominal or chest pain were the most common chief complaints representing approximately 1/3 of all presentations.Overall, the admission rate was 27%. Arrival by ambulance was associated with the highest rate of admission (53%), whereas walk-in patients and telephone referrals were less often admitted.ConclusionSelf-referred walk-in was the overall most common pathway followed by ambulance. Patients arriving by ambulance were often elderly, critically ill and often admitted to in-patient care, whereas arrival by self-referred walk-in was more common in younger patients.

Analyzing prerelease consumer buzz and information cascades within the film industry: are there differences by gender and age groups?

ABSTRACT The concept of prerelease consumer buzz (PRCB) is a relatively new phenomenon. It is the excitement generated by consumers in anticipation of a forthcoming new product, film, song, or play. The PRCB is closely associated with information cascades because the buzz generated can be a mechanism for driving consumers to experience the said new product. Earlier research has called for scholars to test the pervasiveness of the concept, but there is also concern that current studies only adopt a national overview. We have addressed these concerns using a large original dataset, collected weekly for approximately 1 year. We analyze the determinants of information cascades and PRCB by considering films premiered in the USA and the UK. More specifically, we examine online user ratings by differing demographic clusters of the population (by sex and age) and through the qualitative characteristics of films (i.e., genre). Our results demonstrate that males between the ages of 18–29-years are more compliant to information cascades and expert reviewers are more likely to instigate herding behavior.

Objective structured clinical examinations (OSCEs) for students’ training and assessment in the French respiratory medicine departments in 2021: An overview

BackgroundMedical professional performances can be assessed by objective structured clinical examinations (OSCEs) where medical trainees go through a series of simulated clinical situations. OSCEs are now the gold standard for the assessment of medical students’ competence during their training. In France, the first national OSCEs will take place in May 2024 and respiratory teachers will be involved in this reform and will use OSCEs for students’ training and assessment in respiratory medicine. Students training regarding this final OSCE may vary across medical faculties and may impact students' results. Therefore, we aimed to provide a national overview of OSCE's training performed by respiratory teachers and their interest in developing a common French databank of OSCEs. MethodsWe conducted a national anonymous online survey among the members of the French college of respiratory teachers (CEP), from 2021 February the 15th to 2021 June the 15th. The survey consisted of 32 questions. ResultsAmong 118 French pulmonologists teachers, 52 (45%) responded to the survey. We received a response from at least one of each of the French Medical Universities. Twenty-two (42%) had received specific training on how to conduct an OSCE. Twenty-eight (54%) of respondents used OSCEs for training purposes and 24 (46%) for assessment purposes, for less than 1 year in more than half of the participants. The average satisfaction scores out of 10 about OSCEs was 7.3 ± 1.7 for training and 7.4 ± 1.5 for students’ assessment. Respondents were willing (8.9 ± 1.8 out of ten) to develop a common databank to share OSCEs subjects in respiratory medicine in France. ConclusionsThis survey confirms heterogeneity in the training and the use of OSCEs among French respiratory teachers. However, a common national databank could be a useful tool to reduce these disparities.

Role of perioperative nursing in anesthesia: a national overview.

To assess the actions performed by the operating room nurse during anesthesia and their behavior for patient safety regarding the reporting on adverse events, and to analyze their knowledge about anesthetic practices. This is a cross-sectional study carried out using an electronic questionnaire consisting of socio-demographic, professional practice, knowledge in anesthesia, patient safety, and professional practice questions, conducted from January to March 2019 with operating room nurses. One hundred nurses participated, 89 (89%) being women, with a mean age of 41.09 years (SD = 9.36), time of undergraduate completion of 14.33 years (SD = 8.34). The average attendance was 4.69 operating rooms (SD = 2.07) per nurse, with an emphasis on action before induction (49; 49%). Professionals reported performance of simultaneous activities (72; 72%) and insufficient number of employees (57; 57%) as difficulties of their daily practice. Among the participants, 77 (77%) correctly cited the periods of general anesthesia and 80.4% always reported the occurrence of an adverse event. Nurses identified their role in anesthesia, with limitations for assistance from multiple activities and lack of professionals.

Talking Trash: The Rhetoric of Waste Bins

There is no mythical “land of away.” We have a trash problem, and plastic is a major contributor. In 2015, we generated 34.5 million tons of municipal solid plastic waste (EPA, “National Overview”), and it is only a part of our waste. Ironically, plastic containers, from household cans to plastic liners to the large green curbside bins, held that solid waste at one time—and were soon to be their own contribution to the 3.4 million tons. The banality, opacity, and capacity of our waste bins facilitate consumer culture. Reflective design, however, can help us query our trash practices by defamiliarizing the trashcan through making its attributes and properties visible and explorable. “Talking Trash” is an act of reflective design in which I wove a waste bin from the environmental articles of various magazines. Next, I set up a Twitter account, @Talking_Trash_, to tweet about items I was placing in the bin. Then, I considered the pedagogical value of Talking Trash and similar reflective design projects in environment humanities classes. Ultimately, I argue that our trashcans engage in a rhetoric of the everyday that encourages consumer practice and waste-world-making. Talking Trash provides insight into the public and private natures of waste, the revealing and concealing our bins promote, and the affordances of materiality present in our waste bins. Talking Trash is an intervention of hope.

Investing in the future of science: Assessing UK environmental science engagement with school‐aged children

Societal Impact StatementCurrently, there is no national overview of environmental science engagement in the United Kingdom. Children are key stakeholders in the future of science more generally and environmental science specifically. Appraising the situation immediately before the United Kingdom first entered lockdown due to the COVID‐19 pandemic allows both assessment of the achievements of the UK environmental science engagement field before the impacts of the changes resulting from the pandemic, and an up‐to‐date baseline by which to assess those impacts and identify existing gaps to be addressed post‐pandemic. Results indicate that support is needed to increase reach and recognition of the importance of engagement, particularly in rural areas and outside Southeast England.Summary Scoping research was carried out as the first step towards addressing knowledge gaps around engagement of school‐aged children with environmental science in the United Kingdom. Key objectives were identifying which institutions carry out this engagement, its scope and where further engagement is needed, and assessing visibility of projects. Examples of good practice were also highlighted to inform the wider community. This was carried out via systematic online searches and an online survey of UK‐based environmental science engagement professionals, February to March 2020. Most projects were operating locally with a smaller proportion also operating nationally or internationally. Remote engagement comprised a low proportion of delivery, with most projects engaging children in school during school time, using practical sessions. Universities, charities, trusts and societies comprised the majority of hosting institutions. Visiting a low number of schools, a low number of times per year was common, although some projects reached thousands of children in many schools. There was a focus on reaching children aged 7–14 years, relatively evenly split between primary and secondary phases. All major environmental science themes were well represented. Most evaluation and reporting was simple and descriptive, and while key areas for expansion included widening reach in terms of numbers and geography, funding was highlighted as a barrier to achieving this. Results give a snapshot of the state of play before the United Kingdom entered lockdown during the COVID‐19 pandemic, also providing a baseline by which to assess impacts post‐pandemic.

Countrywide screening of spatiotemporal overlap between coastal and marine recreation and waterbirds in Denmark

Coastal zones are important for recreational activities and waterbirds. However, recreational activities may have negative implications for birdlife, which calls for balancing of both types of use by integrated coastal and marine planning and management. Successful integrated management and planning require spatiotemporal knowledge about the species needing protection and the outdoor recreation activities. This paper examines water-oriented outdoor recreation in Denmark in terms of activities, seasonality and geographical distribution, and presents a national screening of spatiotemporal overlap between coastal and marine recreational activities and waterbirds based on 10,291 responses and 6,499 geographical positions. In total 77.6% of the Danish population participated in water-oriented outdoor recreation activities at least once within a year. The most frequent activities were to move along or stay on the coast/shore (63.9%), to bathe and swim (34.4%) and to observe nature and wildlife (20.3%). Overlap between recreation and waterbirds, representing potential conflicts, ranged from 0.8% in winter on water to 27.7% in summer on the coast. The results revealed significant negative effects between recreational activities and abundance of waterbirds during spring and summer on the water. The results also indicate that most recreational activities use areas with no or low densities of waterbirds. Successful coastal and marine planning requires application of management tools that include educational and interpretative initiatives to enhance coexistence. However, for detailed management, more studies are urgently needed of spatiotemporal patterns, adaptations, conflicts and coexistence between recreational activity and waterbirds. The results support integrated planning and management of water-based recreation in conjunction with waterbirds by: - Providing spatially explicit year-round data on recreational and waterbird use of coastal and marine areas. - Obtaining the first ever national overview of potential areas of conflict and of possibilities for coexistence between coastal and marine recreation and waterbirds. - Identifying specific local areas in need of management action and more detailed studies of effects and impacts of coastal and marine recreation on waterbirds.

Prise en compte des critères environnementaux dans la commande publique des produits de santé

Healthcare products (HP) have a significant carbon footprint that must be included by regulation in the facility's purchasing policy. A national overview of the inclusion of environmental criteria (EC) in the public procurement (PP) of HP in hospitals has been carried out. Thirty EC were identified in the literature. Two questionnaires were proposed: (i) for buyers that analyze the level of "importance" and "ease of application" for public tenders (PT), and (ii) for suppliers that declare their commitments and evidence. Six regional buyers and 28suppliers participated. Buyers recognize the "importance" of sustainable development (SD) but are more reticent about the "applicability" of EC in PT. The environmental rating remains low: on average 4.38 (0.25-10.00) % of the total rating. Only 12EC are integrated within some PT. Suppliers report a high and diversified commitment to SD: 18suppliers sent 474evidence. Buyers and suppliers converge on the optimization of primary packaging and the establishment of a minimum order or delivery group. Since the efficiency of PP is inevitable, EC that combines SD and savings should be prioritized. The integration of additional EC, simple and easily documented, allowing cost containment for both suppliers and buyers, is possible to promote sustainable purchasing.