Climate Change and Sustainability in Kidney Care in Canada: A Knowledge, Attitudes, and Practices (KAP) Survey by the Canadian Society of Nephrology's Sustainable Nephrology Action Planning Committee
Bibliographic record
Abstract
Background: Climate change impacts kidney health while threatening the stability of kidney care delivery systems, while health care itself has a significant environmental impact. Knowledge and attitude of Canadian kidney care providers toward climate change is unknown, and there are limited published data on environmental sustainability measures in kidney care in Canada. This study aimed to (1) assess knowledge and attitude about climate change among Canadian kidney care providers; (2) establish the current state of kidney care sustainability activities in Canada. Methods: An electronic KAP survey, created by the Canadian Society of Nephrology - Sustainable Nephrology Action Planning (CSN-SNAP) committee, was distributed to kidney care providers across Canada. Results: A total of 386 individuals completed the survey, while an additional 130 incomplete answers were provided. Most respondents (79%) identified as women and 26%, 31% and 26% were aged 30-39, 40-49 and 50-59 years, respectively. Consultant nephrologists and kidney nurses comprised 23% and 44% of respondents, respectively. Most respondents were either extremely (25%), very (46%) or moderately (23%) concerned about climate change; and similarly extremely (23%), very (39%) or moderately (28%) concerned about the amount of waste generated in their kidney care program. Respondents deemed reducing the carbon footprint important in both their personal lives (very 39%; important 35%; fairly 17%), and in the kidney care services they provide (very 34%; important 37%; fairly 18%). The sustainable strategies most frequently incorporated into kidney care were reduced use of office consumables and equipment, water saving taps, waste management (mostly bins, including recycling), clinical care consumables' use prioritized by expiry dates, virtual care options to minimize unnecessary transportation, and medication stewardship strategies. Conclusions: Most Canadian kidney care providers are highly concerned about climate change and think it is important to reduce the environmental impact in both their personal lives, as well as in the kidney care services they provide. Few sustainable strategies are incorporated into kidney care services across the country.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".