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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.

Effective access control techniques are in demand, as electronically assisted healthcare services require the patient’s sensitive health records. In emergency situations, where the patient’s well-being is jeopardized, different healthcare actors associated with emergency cases should be granted permission to access Electronic Health Records (EHRs) of patients. The research objective of our study is to develop machine learning techniques based on patients’ time sequential health metrics and integrate them with an Attribute Based Access Control (ABAC) mechanism. We propose an ABAC mechanism that can yield access to sensitive EHRs systems by applying prognostic context handlers where contextual information, is used to identify emergency conditions and permit access to medical records. Specifically, we use patients’ recent health history to predict the health metrics for the next two hours by leveraging Long Short Term Memory (LSTM) Neural Networks (NNs). These predicted health metrics values are evaluated by our personalized fuzzy context handlers, to predict the criticality of patients’ status. The developed access control method provides secure access for emergency clinicians to sensitive information and simultaneously safeguards the patient’s well-being. Integrating this predictive mechanism with personalized context handlers proved to be a robust tool to enhance the performance of the access control mechanism to modern EHRs System.

Nearly three billion people in low- and middle-income countries (LMICs) rely on polluting fuels, resulting in millions of avoidable deaths annually. Polluting fuels also emit short-lived climate forcers and greenhouse gases (GHGs). Liquefied petroleum gas (LPG) and grid-based electricity are scalable alternatives to polluting fuels but have raised climate and health concerns. Here, we compare emissions and climate impacts of a business-as-usual household cooking fuel trajectory to four large-scale transitions to gas and/or grid electricity in 77 LMICs. We account for upstream and end-use emissions from gas and electric cooking, assuming electrical grids evolve according to the 2022 World Energy Outlook’s “Stated Policies” Scenario. We input the emissions into a reduced-complexity climate model to estimate radiative forcing and temperature changes associated with each scenario. We find full transitions to LPG and/or electricity decrease emissions from both well-mixed GHG and short-lived climate forcers, resulting in a roughly 5 millikelvin global temperature reduction by 2040. Transitions to LPG and/or electricity also reduce annual emissions of PM2.5 by over 6 Mt (99%) by 2040, which would substantially lower health risks from Household Air Pollution. Primary input data was collected from the following sources: Baseline household fuel choices - WHO household energy database (https://www.nature.com/articles/s41467-021-26036-x) End-use emissions - US EPA lifecycle assessment of household fuels (https://cfpub.epa.gov/si/si_public_record_report.cfm?dirEntryId=339679&Lab=NRMRL&simplesearch=0&showcriteria=2&sortby=pubDate&timstype=Published+Report&datebeginpublishedpresented) Upstream emissions - Argonne National Labs GREET Model (https://greet.es.anl.gov/index.php) Current and future population estimates - UNECA (http://data.un.org/Explorer.aspx?d=EDATA) Input data was processed by defining household fuel choice scenarios, estimating national household fuel consumption based on these scenarios, and applying fuel-specific emission factors to create country-specific emission pathways. These emission pathways were input into the FaIR model (https://zenodo.org/record/5513022#.Yt_jfHbMLb0) which generated additional data for each scenario including time series of pollution concentrations, radiative forcing, and temperature changes. All data is provided in CSV format. Nothing proprietary is required. 

This dataset contains terrestrial fluxes of nitrous oxide (N2O), methane (CH4) and ecosystem respiration (carbon dioxide (CO2)) calculated from static chamber measurements in riparian buffers of oil palm plantations on mineral soil, in Riau, Sumatra, Indonesia. Measurements were made monthly, from January 2019 until September 2021, with a break from April 2019 to October 2019 to allow for felling and replanting, and another break from January 2021 to June 2021 due to Covid-19 restrictions. To help to reduce the environmental impact of oil palm plantations, riparian buffers are now required by regulations in many Southeast Asian countries. The experiments were conducted to investigate the impact of greenhouse gas emissions from the riparian buffers. Research was funded through NERC grant NE/R000131/1 Sustainable Use of Natural Resources to Improve Human Health and Support Economic Development (SUNRISE) Greenhouse gas concentrations were measured using static chambers, enclosed for 45 minutes. Multiple regressions (including linear and hierarchical multiple regression) were fitted to calculate the best fit flux, using the RCflux R package, written by Dr Peter Levy (UKCEH).

Twenty-minute neighbourhoods highlight the importance of well-connected and mixed-used neighbourhoods and communities with proximate access to employment, essential services, public transport, and open spaces. Shorter distances together with re-prioritised public spaces encourage more active transport choices, resulting in public health benefits and reduced environmental pollution. Higher liveability brought about by mixed-use developments enables people to have equitable access to local facilities, amenities, and employment opportunities, promoting vibrancy, social cohesion, and intergenerational connections. The attributes of 20-minute neighbourhoods also combine to create places, that are acknowledged as friendly for all ages, address changing needs across the life course, and provide better support for the ageing population. Furthermore, there are indications that 20-minute neighbourhoods may be more resilient against many of the negative impacts of stringent public health protocols such as those implemented in periods of lockdown during the Covid-19 pandemic. In this article, we evaluate and compare planning policies and practices aimed at establishing 20-minute neighbourhoods in Melbourne (Australia) and Scotland (the UK). Using case studies, we discuss similarities and differences involved in using place-based approaches of 20-minute neighbourhoods to address 21st-century challenges in key areas of health and wellbeing, equity, environmental sustainability, and community resilience.

In the light of the COP27 Climate Change Conference, the concept of the circular economy has come to the fore with promotion of reuse and recycling of appliances and materials from electronics to clothes. This concept has not been widely taken up by healthcare systems. In this perspective article, we discuss the idea of the circular economy and how, by extension, the concept of "circular medicine" with optimised hospital and medical clinic waste recycling might be promoted in the context of better stewardship of resources in healthcare management.

Recently, robots have been widely adopted in the hospitality and tourism industry. Efficient robots can help hoteliers and tourism suppliers with their repetitive or manual labor. Due to the coronavirus disease (COVID-19) pandemic, there is an increasing number of publications on robotic applications in hospitality and tourism. However, a comprehensive literature review of this realm remains lacking. Therefore, to provide a holistic view of the existing literature on robotic applications in hospitality and tourism, this study reviewed 86 extant robotic application-related articles by conducting descriptive analysis and content analysis. The findings of this study showed that most of the existing relevant studies were conducted from the perspective of consumers in the hospitality context. Potential future research directions for academics are identified herein. Practical implications on robotic adoption are also provided for industry practitioners.

Climate change threatens to undermine the past 50 years of gains in public health. In response, the National Health Service (NHS) in England has been working since 2008 to quantify and reduce its carbon footprint. This Article presents the latest update to its greenhouse gas accounting, identifying interventions for mitigation efforts and describing an approach applicable to other health systems across the world.A hybrid model was used to quantify emissions within Scopes 1, 2, and 3 of the Greenhouse Gas Protocol, as well as patient and visitor travel emissions, from 1990 to 2019. This approach complements the broad coverage of top-down economic modelling with the high accuracy of bottom-up data wherever available. Available data were backcasted or forecasted to cover all years. To enable the identification of measures to reduce carbon emissions, results were disaggregated by organisation type.In 2019, the health service's emissions totalled 25 megatonnes of carbon dioxide equivalent, a reduction of 26% since 1990, and a decrease of 64% in the emissions per inpatient finished admission episode. Of the 2019 footprint, 62% came from the supply chain, 24% from the direct delivery of care, 10% from staff commute and patient and visitor travel, and 4% from private health and care services commissioned by the NHS.This work represents the longest and most comprehensive accounting of national health-care emissions globally, and underscores the importance of incorporating bottom-up data to improve the accuracy of top-down modelling and enabling detailed monitoring of progress as health systems act to reduce emissions.Wellcome Trust.

Water resource management in the UK is multifaceted, with a complexity of issues arising from acute and chronic stressors. Below average rainfall in spring 2020 coincided with large-scale changes to domestic water consumption patterns, arising from the first UK-wide COVID-19 lockdown, resulting in increased pressure on nationwide resources. A sector wide survey, semi-structured interviews with sector executives, meteorological data, water resource management plans and market information were used to evaluate the impact of acute and chronic threats on water demand in the UK, and how resilience to both can be increased. The COVID-19 pandemic was a particularly acute threat: water demand increased across the country, it was unpredictable and hard to forecast, and compounding this, below average rainfall resulted in some areas having to tanker in water to ‘top up’ the network. This occurred in regions of the UK that are ‘water stressed’ as well as those that are not. We therefore propose a need to look beyond ‘design droughts’ and ‘dry weather average demand’ to characterise the management and resilience of future water resources. As a sector, we can learn from this acute threat and administer a more integrated approach, combining action on the social value of water, the implementation of water trading and the development of nationwide multi-sectoral resilience plans to better respond to short and long-term disruptors.

The report “Effects of Air Temperature Modified by Vulnerability Factors” was prepared as a milestone by researchers in the EU Project EXHAUSTION*. This report summarises the evidence on the interactive effects of high air temperature and various vulnerability factors, including the environmental, socio-economic, and individual behavioral factors on heart- and lung-related deaths and diseases (cardiopulmonary mortality and morbidity) across Europe. The study was conducted at the city, small-area (e.g., municipalities), and individual level. The findings show a greater vulnerability to heat for people living in urban areas with dense population, high air pollution levels, low coverage of green spaces, as well as areas with low Gross Domestic Product. Moreover, people with chronic pre-existing diseases and the elderly were found to be at greater risk. The findings highlight the urgent need to improve the urban environment as well as the health status and living conditions in European cities to contrast the impacts of heat and future climate change. This report alerts stakeholders and policymakers that targeted climate change adaptation measures need to be considered to protect vulnerable population and thereby increase European resilience to climate change.