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ABSTRACT. Alcohol-based hand rub (ABHR) is an effective hand hygiene measure to mitigate and prevent infectious disease transmission in healthcare facilities (HCFs); however, availability and affordability in low- and middle-income countries are limited. We sought to establish centralized local production of ABHR using a district-wide approach to increase provider access at all public HCFs in Kabarole and Kasese Districts in Western Uganda. Partner organizations worked with district governments to adapt and implement the WHO protocol for local ABHR production at the district scale. These groups identified and upgraded sites for ABHR production and storage to ensure recommended security, ventilation, and air conditioning. District governments selected technicians for training on ABHR production. Raw materials were sourced within Uganda. Alcohol-based hand rub underwent internal quality control by the production officer and external quality control (EQC) by a trained district health inspector before distribution to HCFs. We assessed ABHR production and demand from March 2019 to December 2020. All ABHR batches (N = 316) met protocol standards (alcohol concentration: 75.0–85.0%) with a mean of 79.9% (range: 78.5–80.5%). Internal quality control measurements (mean alcohol concentration: 80.0%, range: 79.5–81.0%) matched EQC measurements (mean: 79.8%, range: 78.0–80.0%). Production units supplied ABHR to 127 HCFs in Kasese District (100%) and 31 HCFs in Kabarole District (56%); 94% of HCFs were small (dispensary or next higher level). This district-wide production met quality standards and supplied ABHR to many HCFs where facility-level production would be unfeasible. Low- and middle-income countries may consider district models to expand ABHR production and supply to smaller HCFs.

This study follows a multi-disciplinary approach to implementing an Energy Community (ECs) in Vega de Valcarce, a rural community in Spain. ECs are entities that encompass collective actions of citizens and other actors towards the open, democratic governance of renewable energy sources; ECs can take various technical and organisational forms. This study developed and evaluated socially accepted, technically optimal and feasible options for the implementation of the EC at Vega de Valcarce. We conducted a participatory multi-criteria analysis incorporating the results of mixed-integer linear programming for energy system optimisation and regulatory analysis of ECs under Spanish law. Our study showed that the main objectives of local stakeholders are the reduction of the energy bill and emissions. The limited liability company fulfilled legal and regulatory restrictions the best by implementing a bigger-sized EC. We summarise the key challenges of implementing an EC in a rural context, mainly legal and financial, and conclude with recommendations on how to overcome these. While contributing to understanding the roll-out of ECs in Spain and Europe, our research aims to provide a structured approach for the uptake of renewable energy in rural areas.

Monitoring the scale of pharmaceuticals, illicit and licit drugs consumption is important to assess the needs of law enforcement and public health, and provides more information about the different trends within different countries. Community drug use patterns are usually described by national surveys, sales and seizure data. Wastewater-based epidemiology (WBE) has been shown to be a reliable approach complementing such surveys.This study aims to compare and correlate the consumption estimates of pharmaceuticals, illicit drugs, alcohol, nicotine and caffeine from wastewater analysis and other sources of information. Wastewater samples were collected in 2015 from 8 different European cities over a one week period, representing a population of approximately 5 million people. Published pharmaceutical sale, illicit drug seizure and alcohol, tobacco and caffeine use data were used for the comparison.High agreement was found between wastewater and other data sources for pharmaceuticals and cocaine, whereas amphetamines, alcohol and caffeine showed a moderate correlation. methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA) and nicotine did not correlate with other sources of data. Most of the poor correlations were explained as part of the uncertainties related with the use estimates and were improved with other complementary sources of data.This work confirms the promising future of WBE as a complementary approach to obtain a more accurate picture of substance use situation within different communities. Our findings suggest further improvements to reduce the uncertainties associated with both sources of information in order to make the data more comparable.

The ten countries that joined the European Union (EU) in 2004 (Cyprus, Czechia, Estonia, Hungary, Lithuania, Latvia, Malta, Poland, Slovakia, and Slovenia) have experienced faster economic growth and slower declines in energy consumption than traditional EU members. As designing of low-carbon policies requires accurate CO2 emission accounting, this study describes the evolving trajectories of CO2 emissions from 2005 to 2017 of 2004 EU accession members by providing detailed emission inventories by 28 types of energy and 47 socioeconomic sectors. We further quantify the contributions of four socioeconomic drivers (i.e., economic growth, energy structure, carbon intensity, and energy intensity) to the emission changes. The results show that the total CO2 emissions of the ten countries decreased by 7.50% from 2010 (506.81 Mt) to 2016 (468.78 Mt), which is lower than the average decline rate of other EU members (10.52%). Although the effect of economic growth contributed the most to emission increase (15.44%), it is completely offset by the decline in carbon intensity (-18.82%). We also discuss potential roadmaps towards carbon neutrality by designing 33 scenarios based on the European Union Low-Carbon Development Map 2050. We find that carbon neutrality cannot be achieved unless the share of renewable energy sources reaches 60% and more than half of existing coal and gas power plants are upgraded to Carbon Capture Storage (CCS) technology. These changes require the implementation of both short-term and long-term strategies.

The use of alcohol among road users injured in road traffic crashes and admitted to three major hospitals in Cameroon was studied. Alcohol use was measured using breathalyzers, and data on age, gender, education level, religion, type of road user, time of the crash, crash characteristics, and injury severity were recorded using a questionnaire. Of the 350 participants, 30.9% had blood alcohol concentrations (BACs) above 0.08% (legal limit for drivers); the proportion was highest among motorcycle riders (36.5%), followed by pedestrians (24.8%) and motor vehicle drivers (18.9%). The proportion with BAC above 0.08% was highest on weekend nights and among those who were most seriously injured. Those who reported being Muslims had a lower prevalence of alcohol. Multivariable logistic regression analysis confirmed those associations. Many road traffic injuries could have been avoided if the patient had not consumed alcohol. Actions should therefore be taken to reduce the proportion of alcohol-impaired road users. Supplemental data for this article is available online at https://doi.org/10.1080/17457300.2022.2030365 .

Background: The present paper describes the results of a rating study performed by a group of European Union (EU) drug experts using the multi-criteria decision analysis model for evaluating drug harms. Methods: Forty drug experts from throughout the EU scored 20 drugs on 16 harm criteria. The expert group also assessed criteria weights that would apply, on average, across the EU. Weighted averages of the scores provided a single, overall weighted harm score (range: 0–100) for each drug. Results: Alcohol, heroin and crack emerged as the most harmful drugs (overall weighted harm score 72, 55 and 50, respectively). The remaining drugs had an overall weighted harm score of 38 or less, making them much less harmful than alcohol. The overall weighted harm scores of the EU experts correlated well with those previously given by the UK panel. Conclusion: The outcome of this study shows that the previous national rankings based on the relative harms of different drugs are endorsed throughout the EU. The results indicates that EU and national drug policy measures should focus on drugs with the highest overall harm, including alcohol and tobacco, whereas drugs such as cannabis and ecstasy should be given lower priority including a lower legal classification.