{"title":"Health system decarbonization on obstetric and newborn units","authors":"Jordan Emont , Melissa Wang , Kelly Wright","doi":"10.1016/j.semperi.2023.151844","DOIUrl":"10.1016/j.semperi.2023.151844","url":null,"abstract":"<div><p>The healthcare industry makes up 4.6 % of greenhouse gas (GHS) emissions worldwide. Although it is not known what proportion of GHGs come from obstetric<span><span> and newborn<span> units, newborns and pregnant individuals are likely to face some of the largest consequences from climate change. We review the literature in the areas of decarbonization on labor and delivery (L&D) and neonatal units and describe innovations from the fields of surgery and anesthesia. Best practices for L&D include refining disposable equipment packs, decreasing the use of single-use medical devices<span><span>, adequately triaging waste, and decreasing the use of potent anesthetic gases such as </span>nitrous oxide and </span></span></span>desflurane<span>. In neonatal settings, similarly triaging waste and decreasing the use of plastics containing endocrine disrupting chemicals can lower the carbon and environmental footprint and improve neonatal health<span>. Additionally, avoiding unnecessary cesarean deliveries and increasing breastfeeding practices are also likely to improve the carbon footprint of L&D and neonatal units.</span></span></span></p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49682111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Natural disasters resulting from climate change: The impact of hurricanes and flooding on perinatal outcomes","authors":"Melissa A. Suter, Kjersti M. Aagaard","doi":"10.1016/j.semperi.2023.151840","DOIUrl":"10.1016/j.semperi.2023.151840","url":null,"abstract":"<div><p>Although the earth's climate has been continuously changing over billions of years, human influence has accelerated that rate of change. While high latitudes suffer the greatest increase in incremental temperature, moderate latitudes are highly vulnerable due to their temperate/tropical rain storms and hurricanes that bring about extreme flooding events. We and others have shown that there is a link between the occurrence and severity of these climate events and risk of adverse perinatal outcomes. In this review, we will discuss the data and consider interacting near and intermediate sequelae of worsening natural disasters–including food scarcity, disrupted or compromised built environments and infrastructure, and loss of communities with human migration. While certainly tackling these and other proximal mediators of adverse perinatal outcomes will benefit maternal and child health, a failure to meaningfully address the root causes of climate change and resultant environmental chemical exposures will be of little long-term benefit.</p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S014600052300143X/pdfft?md5=56b1517b644669405c16cc6c3cbc1996&pid=1-s2.0-S014600052300143X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41238349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Climate change as a threat multiplier to environmental reproductive justice","authors":"Emily B. Weaver, Laila Gad, Ami R. Zota","doi":"10.1016/j.semperi.2023.151843","DOIUrl":"10.1016/j.semperi.2023.151843","url":null,"abstract":"<div><p><span><span>Legacies of racial capitalism and colonialism drive present day racial disparities in </span>perinatal health outcomes. Climate change amplifies existing social inequalities associated with environmental exposures and </span>reproductive health<span>, of which BIPOC (Black, Indigenous, and people of color) communities bear a disproportionate burden. Through case studies, this article summarizes three examples of climate justice issues with reproductive healthcare outcomes: traffic related air pollution exposure, chemical exposures in personal care products and plastics, and natural disaster frequency. We advocate for incorporation of climate justice and environmental health impact into medical school curriculum, increased prenatal screening<span> for environmental toxins, and physician engagement with local environmental issues.</span></span></p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41238348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kristie Hadley , Jennifer Talbott , Sanjana Reddy , Stefan Wheat
{"title":"Impacts of climate change on food security and resulting perinatal health impacts","authors":"Kristie Hadley , Jennifer Talbott , Sanjana Reddy , Stefan Wheat","doi":"10.1016/j.semperi.2023.151842","DOIUrl":"10.1016/j.semperi.2023.151842","url":null,"abstract":"<div><p>Climate change's impact on global food security is a pressing concern with profound consequences. Climate change disrupts the global food system through a number of mechanisms including extreme weather events, rising food prices, and compromised food quality. In this article, we explore the effect of climate change on food security and the resulting health impacts of poor nutrition on pregnant women and infants in the perinatal period. Inadequate nutrition during pregnancy raises the risk of vitamin deficiencies, obstetric complications, maternal mortality, and infant malnutrition. Climate change exacerbates these challenges and perpetuates intergenerational cycles of poor nutrition. Addressing these issues requires traditional approaches to combating the climate impacts on general food security as well as specific approaches to bridge the food security gender gap. Empowering women as key stakeholders is crucial for overcoming the complex barriers to food insecurity caused by climate change, as well as protecting the well-being of vulnerable populations during the perinatal period.</p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0146000523001453/pdfft?md5=9b021ea04d6e0247b8d918a1bfd50072&pid=1-s2.0-S0146000523001453-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135654002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Simulation-based operations testing in new neonatal healthcare environments","authors":"Rita Dadiz , Jesse Bender , Beverley Robin","doi":"10.1016/j.semperi.2023.151828","DOIUrl":"10.1016/j.semperi.2023.151828","url":null,"abstract":"<div><p><span>In situ simulations, those conducted in the actual clinical environment, confer a high level of contextual fidelity and have been applied to the operations testing of new healthcare environments (HCE) to identify potential threats to patient, family and staff safety. By conducting simulation-based operations testing, these latent safety threats (LSTs) – which are weaknesses in communications, human factors, system process and technologies, and the way they are linked together – can be identified and corrected prior to moving patients into the new HCE. Simulation-based operations testing has extended to the neonatal HCE, as </span>neonatal intensive care units (NICUs) transition from open-bay to single-family room design. In this section, we define LSTs, review simulation-based operations testing in new neonatal and perinatal HCEs, review challenges associated with conducting simulation-based operations testing, and briefly review pre-construction simulation-based user-centered design of new HCEs.</p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41150917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Competency-based assessment in neonatal simulation-based training","authors":"Taylor Sawyer , Megan M. Gray","doi":"10.1016/j.semperi.2023.151823","DOIUrl":"10.1016/j.semperi.2023.151823","url":null,"abstract":"<div><p>Simulation is a cornerstone of training in neonatal clinical care, allowing learners to practice skills in a safe and controlled environment. Competency-based assessment provides a systematic approach to evaluating technical and behavioral skills observed in the simulation environment to ensure the learner is prepared to safely perform the skill in a clinical setting. Accurate assessment of competency requires the creation of tools with evidence of validity and reliability. There has been considerable work on the use of competency-based assessment in the field of neonatology. In this chapter, we review neonatal simulation-based training, examine competency-based assessment tools, explore methods to gather evidence of the validity and reliability, and review an evidence-based approach to competency-based assessment using simulation.</p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41147305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Introduction: Update on simulation in neonatology","authors":"Lindsay C. Johnston , Beverley Robin","doi":"10.1016/j.semperi.2023.151829","DOIUrl":"10.1016/j.semperi.2023.151829","url":null,"abstract":"","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41112847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"TOPICS","authors":"","doi":"10.1053/S0146-0005(23)00153-2","DOIUrl":"10.1053/S0146-0005(23)00153-2","url":null,"abstract":"","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135515801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Virtual simulations for neonatal education","authors":"Rachel A. Umoren , Georg M. Schmölzer","doi":"10.1016/j.semperi.2023.151826","DOIUrl":"10.1016/j.semperi.2023.151826","url":null,"abstract":"<div><p><span>Virtual simulation (VS) education involves the use of virtual reality, augmented reality, mixed reality and screen-based platforms, collectively referred to as extended reality, to provide education and assessment. This novel simulation modality supports experiential learning and increases access to practice opportunities, supplementing manikin-based simulation. VS has been used successfully for </span>neonatal resuscitation training in high and low resource settings. Virtual simulators can be used to objectively assess learner performance in neonatal resuscitation knowledge and skills. When implementing VS for neonatal resuscitation training, key considerations include matching learning objectives with suitable technology, pre-session preparation, supporting learners, and debriefing. Additional research is needed to evaluate the impact of VS applications on clinical practice and patient outcomes.</p></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41153042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}