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This study assessed the hand hygiene performance in French nursing homes using the consumption of alcohol-based hand rubs (AHRs) as a surrogate. Nursing homes from the 17 French regions were contacted to collect their AHR consumption and occupancy in 2018 and 2019. A total of 1290 nursing homes from 15 French regions participated in the survey. The estimated median number of hand hygiene actions per resident-day was 1.48 (interquartile range: 1.04-2.03) in 2018 and 1.60 (1.10-2.26) in 2019. A significantly higher AHR consumption was observed in public nursing homes with an infection control team or link nurse.

Corruption has found very fertile ground in the health sector. Many studies demonstrate the negative relationship between sustainability and corruption. However, relatively little is known at this time about how to prevent corruption in healthcare organizations (HCOs), and thus to recover the important sustainability of the entire healthcare system. After noticing this gap in the literature, the authors’ aim in undertaking this study was twofold: first, to analyze the current state of knowledge about how Italian HCOs adopt corruption prevention plans in compliance with the National Plan issued by the National Anti-Corruption Authority; second, to identify some clusters of HCOs which represent different adoption patterns of corruption prevention interventions and to classify these HCOs. For these purposes, the authors studied 68 HCOs along 13 dimensions that characterized the corruption prevention plans. The empirical results showed that the HCOs were not fully compliant with the anti-corruption legislation. At the same time, the authors identified three clusters of HCOs with different patterns of anti-corruption prevention interventions. The clusters that adopted some specific interventions seemed to be more sustainable than others.

To report the clinical efficiency and complications in patients treated with retrograde transvenous ethanol embolization of high-flow peripheral arteriovenous malformations (AVMs). Retrograde transvenous ethanol embolization of high-flow AVMs is a technique that can be used to treat AVMs with a dominant outflow vein whenever conventional interventional procedures have proved insufficient.This is a retrospective study of the clinical effectiveness and complications of retrograde embolization in five patients who had previously undergone multiple arterial embolization procedures without clinical success.Clinical outcomes were good in all patients but were achieved at the cost of serious, although transient, complications in three patients.Retrograde transvenous ethanol embolization is a highly effective therapy for high-flow AVMs. However, because of the high complication rate, it should be reserved as a last resort, to be used after conventional treatment options have failed.

Deaths attributed to rising temperatures and heat waves represent a continuing public health concern. Climate change affects social determinants of health and local and global health inequities, especially those negatively impacted by high temperatures. Individuals with chronic health conditions have greater likelihood of mortality due to rising temperatures. Nurses witness the harmful effects of climate change but may not be aware that a patient's worsening symptoms can be due to heat. Nurses need to understand and then educate patients and communities about ways to reduce harm from heat, medication interactions with heat, and what safety measures to take in regions of high heat or during heat waves to best promote health equity and reduce mortality.[J Contin Educ Nurs. 2022;53(10):460–464.]

From its inception, the Nuclear Energy Agency (NEA), which is part of the broader Organisation for Economic Co-operation and Development, has contributed to the development of international radiological protection norms and standards. This continues today, in the form of studies and workshops to assist radiological protection policy makers, regulators and practitioners to develop concepts and approaches to help the international system of radiological protection, as recommended by the International Commission on Radiological Protection (ICRP), to evolve to better serve societal needs. The NEA's Committee on Radiation Protection and Public Health (CRPPH), in providing this support, has collaborated closely with the ICRP and strongly supports the current ICRP recommendation development process. In particular, active dialogue with a broad range of stakeholders is contributing to the evolution of concepts towards consensus on new ICRP recommendations. The CRPPH, as a body of ICRP recommendation practitioners, feels that the public, workers and the environment are well protected by the current radiological protection system, but agrees that a new consolidation and clarification of ICRP recommendations would be of value. The intent of the CRPPH in collaborating with ICRP is to develop a system of radiological protection that is simplified, more coherent, firmly based upon science and more clearly presented than the current system. This paper summarises the more detailed views of the CRPPH on the evolution of the system of radiological protection.

The interaction of ethanol with drugs becomes more and more important because of a constant increase of the consumption of both. While most of the commonly used drugs do not alter the elimination of alcohol there exist a number of drugs which influence the degradation of ethanol by inhibition of the acetaldehyddehydrogenase. In combination with alcohol these drugs lead to an antabus-like reaction. In respect to the influence of ethanol on the metabolic degradation of drugs it must be destinguished between acute and chronic effects of alcohol. Upon acute influence of ethanol we observe an increased efficiency of many drugs. Chronical influence of ethanol on the other hand leads to a reduced action of drugs by enzyme inhibition. Besides the interaction on the level of biotransformation the interaction on the receptor-level is important. This mechanism especially leads to an increased efficiency of drugs which influence the central-nervous system.

Ethanol has been claimed to potentiate greatly the lethality of propoxyphene, although published clinical data suggest only an additive effect. Mice were treated intraperitoneally with various doses of propoxyphene hydrochloride and ethanol. Isobolograms of the data show the combination to be less-than-additive for lethality and loss of motor coordination and, at worst, simply additive for sedation.

Background:  We previously found that activation of the glial cell line‐derived neurotrophic factor (GDNF) pathway in the ventral tegmental area (VTA) reduces ethanol‐drinking behaviors. In this study, we set out to assess the contribution of endogenous GDNF or its receptor GFRα1 to the regulation of ethanol‐related behaviors.Methods:  GDNF and GFRα1 heterozygote mice (HET) and their wild‐type littermate controls (WT) were used for the studies. Ethanol‐induced hyperlocomotion, sensitization, and conditioned place preference (CPP), as well as ethanol consumption before and after a period of abstinence were evaluated. Blood ethanol concentration (BEC) was also measured.Results:  We observed no differences between the GDNF HET and WT mice in the level of locomotor activity or in sensitization to ethanol‐induced hyperlocomotion after systemic injection of a nonhypnotic dose of ethanol and in BEC. However, GDNF and GFRα1 mice exhibited increased place preference to ethanol as compared with their WT littermates. The levels of voluntary ethanol or quinine consumption were similar in the GDNF HET and WT mice, however, a small but significant increase in saccharin intake was observed in the GDNF HET mice. No changes were detected in voluntary ethanol, saccharin or quinine consumption of GFRα1 HET mice as compared with their WT littermates. Interestingly, however, both the GDNF and GFRα1 HET mice consumed much larger quantities of ethanol after a period of abstinence from ethanol as compared with their WT littermates. Furthermore, the increase in ethanol consumption after abstinence was found to be specific for ethanol as similar levels of saccharin intake were measured in the GDNF and GFRα1 HET and WT mice after abstinence.Conclusions:  Our results suggest that endogenous GDNF negatively regulates the rewarding effect of ethanol and ethanol‐drinking behaviors after a period of abstinence.

Aims The aim of this study was to determine whether the sequential application of povidone iodine-alcohol (PVI) followed by chlorhexidine gluconate-alcohol (CHG) would reduce surgical wound contamination to a greater extent than PVI applied twice in patients undergoing spinal surgery. Patients and Methods A single-centre, interventional, two arm, parallel group randomised controlled trial was undertaken, involving 407 patients who underwent elective spinal surgery. For 203 patients, the skin was disinfected before surgery using PVI (10% [w/w (1% w/w available iodine)] in 95% industrial denatured alcohol, povidone iodine; Videne Alcoholic Tincture) twice, and for 204 patients using PVI once followed by CHG (2% [w/v] chlorhexidine gluconate in 70% [v/v] isopropyl alcohol; Chloraprep with tint). The primary outcome measure was contamination of the wound determined by aerobic and anaerobic bacterial growth from samples taken after disinfection. Results The detection of viable bacteria in any one of the samples taken after disinfection (culture-positive) was significantly lower in the group treated with both PVI and CHG than in the group treated with PVI alone (59 (29.1%) versus 85 (41.7%), p = 0.009; odds ratio 0.574; 95% confidence interval, 0.380 to 0.866). Conclusions Antisepsis of the skin with the sequential application of PVI and CHG more effectively reduces the contamination of a surgical wound than PVI alone. Cite this article: Bone Joint J 2017;99-B:1354–65.