Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene

Previously published guidelines provide comprehensive recommendations for hand hygiene in healthcare facilities. The intent of this document is to highlight practical recommendations in a concise format, update recommendations with the most current scientific evidence, and elucidate topics that warrant clarification or more robust research. Additionally, this document is designed to assist healthcare facilities in implementing hand hygiene adherence improvement programs, including efforts to optimize hand hygiene product use, monitor and report back hand hygiene adherence data, and promote behavior change. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates

Decoupling processes in block-and-ash flows: field evidence and analogue modelling.

Pyroclastic density currents are among the most dangerous hazards during explosive volcanic eruptions, typically having catastrophic and lasting impacts on society, infrastructure, and landscape evolution of the area. After the eruption of Unzen volcano, Japan, in 1991, during which 43 people were killed when pyroclastic surges unexpectedly separated from the parental flows, the possibility of decoupling in block‐and‐ash flows and the potential hazard of this was recognized. In the following years, decoupling has been documented at several composite volcanoes, but still not enough is known about the mechanics of pyroclastic currents, which allow the detachment of ash cloud surges. In this thesis, several processes thought to initiate decoupling in pyroclastic currents, such as entrainment of substrate at the flow base or of air at the flow front, elutriation of fines into the upper ash cloud surge or simple gravity segregation, are investigated. These mechanisms lead to increased non‐uniformity and stratification, which is a prerequisite for the onset of decoupling in small‐volume block‐and‐ash flows. Other mechanisms such as topographic control over block‐and‐ash flow dynamics are also considered, with examples confirming the importance of topographic influence for flow stratification and decoupling in block and‐ ash flows. Detailed field studies at Tarawera Volcano, New Zealand, have provided comprehensive descriptions of the distribution and sedimentology of block‐and‐ash flow deposits emplaced during the Kaharoa eruptive episode in AD 1314 ± 12, and these confirm the importance of changes in topography on flow dynamics. Topographic variations causes channeling, blocking and deceleration of the basal flow parts at Tarawera Volcano, while the upper flow parts are unconfined and decoupled, leading to detached ash cloud surge deposits beyond the limits of the main block‐and‐ash flow deposits. Interaction of the advancing flow with the substrate resulted in dynamic interaction. Deformation features and erosion gullies confirm the highly erosive nature of the flows. Laboratory‐scaled simulations of aqueous glycerol solutions and glass particulate currents are used as quantitative semi‐guides for pyroclastic flow behaviour, with special regard to decoupling caused by irregular topographies

<it>BCL2</it>-938C > A and <it>CALCA</it>-1786T > C polymorphisms in aseptic loosened total hip arthroplasty

Abstract The search for influencing factors and new pathways in aseptic loosening of arthroplasties is a major focus of recent studies. Analyses of polymorphisms of genes revealed a correlation between a specific allele variant and aseptic loosening. The BCL2 gene encoding Bcl-2 with its BCL2 -938C > A polymorphism is a crucial factor of cell cycle control and cell survival. The CALCA -1786T > C polymorphism belongs to the CALCA gene encoding alpha-Calcitonin Gene Related Peptide (CGRP) and Calcitonin. Both proteins are important in bone metabolism and capable to influence the process of aseptic loosening. To date, no studies are reported for aseptic loosening with these two single nucleotide polymorphisms (SNPs). In a retrospective study we determined the distribution of the BCL2-938C > A and the CALCA-1786T > C polymorphisms in 87 subjects with aseptic loosened hip arthroplasties using RFLP and pyrosequencing analysis. Genotype distribution with prognosis of the hip arthroplasty showed neither an association with clinical characteristics of the patients nor the implantation technique. We were unable to detect any influence of these polymorphisms on time to aseptic loosening.</p