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SIGNpost 00646

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST *SAFE INJECTION GLOBAL NETWORK*

Post00646 Reminders, Calls & Conferences + Abstracts + News 2 May 2012

CONTENTS
1. Reminder: Call for information: injections per person per year and
equipment reuse
2. Conference: Infection Control Africa Network (ICAN) 27th to 29th
November, 2012
3. Call for abstracts – ICAN 2012
4. What could you prove with $100,000?
5. Reminder: Call for needle-free intradermal delivery devices for upcoming
clinical trial
6. Abstract: Hepatitis B virus infection and waste collection: Prevalence,
risk factors, and infection pathway
7. Abstract: Patient Notification for Bloodborne Pathogen Testing due to
Unsafe Injection Practices in the US Health Care Settings, 2001-2011
8. Abstract:Injection safety practices among nursing staff of mission
hospitals in Benin City, Nigeri
9. Abstract: An investigation of an outbreak of viral hepatitis B in modasa
town, gujarat, India
10. Abstract: Injection practices of healthcare professionals in a Tertiary
Care Hospital
11. Abstract: Occupational exposure to human immunodeficiency virus in
health care providers: a retrospective analysis
12. Abstract: WISE recommendations to ensure the safety of injections in
diabetes
13. Abstract: Sharps exposures among otolaryngology-head and neck surgery
residents
14. Abstract: Standardised drug labelling in intensive care: results of an
international survey among ESICM members
15. Abstract: Community-based provision of injectable contraceptives in
Madagascar: ‘task shifting’ to expand access to injectable
contraceptives
16. Abstract: High Prevalence of Hepatitis C Infection among High Risk
Groups in Kohgiloyeh and Boyerahmad Province, Southwest Iran
17. Abstract: Modelling hepatitis C transmission over a social network of
injecting drug users
18. Abstract: Canada moving backwards on illegal drugs
19. Abstract: Preventable drug-related morbidity in community pharmacy:
development and piloting of a complex intervention
20. Abstract: An overview of anthrax infection including the recently
identified form of disease in injection drug users
21. Abstract: Mycotic Pseudoaneurysms Due to Injection Drug Use: A Ten-Year
Experience
22. Abstract: Management of occupational dermatitis in healthcare workers:
a systematic review
23. Abstract: Laws pertaining to healthcare-associated infections: a review
of 3 legal requirements
24. No Abstract: Hepatitis C Virus Transmission in People Who Inject Drugs:
Swabs May Not Be The Main Culprit
25. No Abstract: Synopsis of the WISE meeting
26. No Abstract: WISE (Workshop on Injection Safety in Endocrinology)
recommendations. Editorial
27. No Abstract: Mobile phones in hospital settings: a serious threat to
infection
28. No Abstract: Canada’s Insite decision: a victory for public health
29. No Abstract: Drug prohibition: it’s broke, now go and fix it
30. No Abstract: The policymaker’s Hippocratic oath
31. The 15th ICID will be held in Bangkok, Thailand on June 13-16, 2012
32. Healthcare Quarterly. Special Issue. Patient Safety
33. News
– Ireland: €10k payout for man who sat on syringe needle in hotel
– Canada: Abbotsford plunges into needle plan
– USA: Pennsylvania Patient Safety Authority Issues Annual Report for 2011
– Action Training Systems Releases Bloodborne Pathogens Training Program
for Emergency Responders
– PDMS Blood Test Container Could Change How Diagnostics Are Performed,
Researchers Say (VIDEO)
– UK: Abstinence Alone Does Not Work
– EU: Supervised injectable heroin treatment is expensive but cost
effective, report says

The web edition of SIGNpost is online at:
http://signpostonline.info/archives/1035

More information follows at the end of this SIGNpost!

Please send your requests, notes on progress and activities, articles,
news, and other items for posting to: sign@lists.uq.edu.au

Normally, items received by Tuesday will be posted in the Wednesday
edition.

Subscribe or un-subscribe by email to: sign.moderator@gmail.com, or to
sign@who.int

Visit the WHO injection safety website and the SIGN Alliance Secretariat
at: http://www.who.int/injection_safety/en/

Visit the SIGNpostOnline archives at: http://signpostonline.info

Selected updates and breaking news items on the SIGN Moderator Facebook
page at: http://facebook.com/SIGN.Moderator

Selected updates at: http://twitter.com/#!/signmoderator
__________________________________________________________________
________________________________*_________________________________

1. Reminder: Call for information: injections per person per year and
equipment reuse
__________________________________________________________________
Call for information: injections per person per year and equipment reuse

Selma Khamassi, WHO

The WHO Injection Safety programme and the SIGN Secretariat are in the
process of updating information on the number of injections per person per
year as well as on reuse rates of injection equipment.

This will help to update the global burden of diseases from unsafe
injection practices from the 2000 data.

We need this information from 2006 to 2011. Except (for the data) from
Demographic and Health Surveys (DHS), and a few other publications, not
much information is available on this topic.

I would like to ask any member of the network who has such information,
whether it is at the national level or from specific studies in hospitals,
to share this information with me by sending the study to: Selma Khamassi:
khamassis@who.int

Your contribution will be acknowledged among the references used for this
work.

Thank you very much for your collaboration in this work.
__________________________________________________________________
________________________________*_________________________________

2. Conference: Infection Control Africa Network (ICAN) 27th to 29th
November, 2012
__________________________________________________________________
Infection Prevention & Control Africa Network (IPCAN)

Invitation

Dear Friends and Colleagues

As Chair of the Infection Control Africa Network (ICAN), it is my great
pleasure to invite you to the Fourth ICAN African Conference to be held at
the Waterfront in Cape Town, South Africa from the 27th to 29th November,
2012. This year, we decided to move away from the more peaceful rural
settings of Stellenbosch wine estates to the vibrant heart of Cape Town-
the Waterfront!

The 3rd Conference in Namibia 2011, was a great success, extremely well
organised and supported by the Namibian Government- the opening address was
given by the National Minister of Health, Namibia. It is becoming evident
that the ICAN conferences are growing from strength to strength with
enormous support from the WHO, both Africa and Headquarters. There were
several exciting suggestions from the membership which have been
incorporated into the 2012 programme. I do hope there will be something for
everyone both socially and scientifically, and we encourage you to network,
set up links and make new friends and meet old ones in Cape Town.

There will be three world class keynote speakers: Dr David Livermore (UK),
Dr Michael Tapper (USA) and Prof Meredith Minkler (USA) on antibiotics
resistance, tuberculosis and community based participatory research
respectively. There will be parallel sessions both in the morning and the
afternoon, as well as free communications.

You are invited to submit abstracts based on original scientific research;
papers from Africa will be given priority but all abstracts are welcome-
both for oral presentation and poster sessions. It is possible that
bursaries may be made available for some promising young scientists so
please visit the website for information. Selected papers will be published
in Antimicrobial Resistance and Infection Control (ARIC), a newly launched
open access journal. We welcome industry to actively participate- meet
scientists from Africa and become involved in good IPC practices.

There are three Meet-the-Expert lectures and one of these has been set up
in memory of Yves Chartier (WHO) whose untimely accidental death left the
entire community who worked with healthcare waste management, shocked. It
shall be called the Yves Chartier Memorial Lecture – this year to be
delivered by Prof Babacar Ndoye from Senegal.

As requested by our membership, the 26th Nov, 2012 will be a refresher or
training day preceding the start of the main conference. There will be four
parallel sessions on topics chosen by the membership and will be run by
experts in their field. In keeping with the ethos of ICAN, it will give
the audience an opportunity to interact closely with their tutors and
discuss professional matters towards setting up working groups under the
ICAN umbrella.

The venue will be the new, state of the art conference facility situated in
the heart of the Waterfront- the challenge will be to keep the scientific
programme interesting enough to entice the participants away from the
shopping!

On behalf of ICAN we extend a warm welcome to you- join us in Cape Town –
26th to 29th Nov 2012!

Prof Shaheen Mehtar
Chair ICAN
www.ICANetwork.co.za
__________________________________________________________________
________________________________*_________________________________

3. Call for abstracts – ICAN 2012
__________________________________________________________________
ICAN 2012 Call for abstracts

Submission deadline: 30 July 2012

In order to submit an abstract for review you need to create an account and
then login to the abstract submission system:

Guidelines for Authors

Abstracts may be submitted electronically only via the conference website –
if there are any problems please contact the conference organisers

Go To: http://www.icanetwork.co.za/conference-2011/call-for-abstracts

Abstracts sent by mail, direct e-mail, or fax cannot be accepted

The abstracts must be submitted in English

All abstracts will be reviewed and may be selected for oral or poster
presentation

The time allotted for each oral presentation will depend on the session to
which the abstract is allocated but it usually is a 15 minute presentation
including questions.

English will be the language for all oral and poster presentations
Notification of acceptance by the Local Scientific Committee will be mailed
to the author

Failure to register by the presenting author by 15th September, 2012 will
automatically imply that the paper will be withdrawn and the abstract will
not be included in the Final Program.
__________________________________________________________________
________________________________*_________________________________

4. What could you prove with $100,000?

The submission deadline is May 15, 2012!
__________________________________________________________________
What could you prove with $100,000?

Gates Foundation seeks bold new ideas to optimize immunization systems

New lifesaving vaccines being developed and introduced in immunization
programs around the world require immunization supply systems that are up
to the task of ensuring that those vaccines reach the people who need them
most.

A new call for proposals from the Bill & Melinda Gates Foundation seeks
bold new strategies to increase the effectiveness and reliability of
immunization systems. The Gates Foundation Grand Challenges Explorations
grant program offers US$100,000 grants to help prove the potential of
innovative approaches to optimize immunization systems.

A search for daring solutions

Anyone with a good idea is eligible to submit a two-page proposal,
including engineers, public health specialists, entrepreneurs, and students
working in a nongovernmental organization, ministry of health, university,
or company. Launched in 2008, Grand Challenges Explorations grants have
already been awarded to 602 researchers from 44 countries. Successful
projects may be eligible for additional funding up to $1 million.

Priority areas for funding include: vaccine product characteristics, supply
system design, environmental impact, information systems, human resources,
and vaccination acceptance.

Proposed solutions should be daring in premise and clearly different from
approaches currently under investigation or in use, with a focus on the
operational aspects of immunization systems. Ideas also must have the
potential to be scaled up or reproduced in multiple low-resource settings.

The future of immunization supply systems

The call for proposals builds on work facilitated by Project Optimize – a
collaboration between PATH and the World Health Organization – to develop a
common vision for the future of immunization supply systems and logistics.

* More information

Gates Grand Challenges Explorations call for proposals
http://tinyurl.com/immunizationsystems

The Gates Grand Challenges Explorations program
www.grandchallenges.org/vxf

Project Optimize
www.path.org/projects/project-optimize.php
http://www.who.int/immunization_delivery/optimize/en/

__________________________________________________________________
________________________________*_________________________________

5. Reminder: Call for needle-free intradermal delivery devices for upcoming
clinical trial

Full applications and supporting materials are due May 14, 2012.

Kindly SIGNposted by Emily Griswold at PATH
__________________________________________________________________
http://www.path.org/news/an120416-needlefree-devices.php.

Call for needle-free intradermal delivery devices for upcoming clinical
trial

In collaboration with the Bill & Melinda Gates Foundation, PATH invites
letters of interest and applications from technology manufacturers willing
to provide eligible needle-free intradermal (ID) delivery devices for usein
a clinical trial of reduced-dose inactivated polio vaccine (IPV) scheduled
for 2013 in China.

Vision

Ensuring wide-scale access to IPV is a key goal of polio eradication
efforts and post-eradication planning. The Bill & Melinda Gates Foundation
plans to support a clinical trial to evaluate the dose-saving potential
ofIPV when it is delivered intradermally, which could extend vaccine supply
and make IPV more affordable for immunization programs in developing
countries. Needle-free delivery devices that facilitate safer, easier, and
more consistent ID delivery of vaccinecould also enable ID delivery of IPV
by less-experienced health workers or trained volunteers.

Eligibility

To be eligible, devices must be needle free with a disposable,
autodisabling fluid path and capable of delivering 0.1 ml of IPV
intradermally in infants and children. Manually powered devices suitable
for use either ina clinic or in a mobile campaign setting are preferred.
Multiple devices that meet these requirements may be included in the trial.

Final device selections will be made by the Bill & Melinda Gates
Foundation. Please also note that the Bill & Melinda Gates Foundation
reserves the right to withdraw this request for applications and/or cancel
the plannedtrial at any time.

How to apply

Letters of interest are requested by April 27, 2012.
Full applications and supporting materials are due May 14, 2012.

Applications should include:

A cover letter with a description of the materials enclosed.
Instructions for use for the device.

A completed response questionnaire (see Annex 1 [317 KB PDF]).
Supporting documentation, where appropriate.

Please email the letter of interest and full application to
vaccinetech@path.org.

Relevant materials can also be mailed to:

Emily Griswold
PATH
PO Box 900922
Seattle, WA 98109
USA

For questions and guidance on this opportunity, please contact PATH
(primary) at vaccinetech@path.org or Linda Venczel at
linda.venczel1@gatesfoundation.org.

More information
New vaccine tools for polio from PATH
http://sites.path.org/vaccinedevelopment/polio/

Vaccine technologies at PATH
http://www.path.org/our-work/vaccine-delivery.php

PATH www.path.org
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Hepatitis B virus infection and waste collection: Prevalence,
risk factors, and infection pathway
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22544469
Am J Ind Med. 2012 Apr 27.

Hepatitis B virus infection and waste collection: Prevalence, risk factors,
and infection pathway.

Rachiotis G, Papagiannis D, Markas D, Thanasias E, Dounias G,
Hadjichristodoulou C.

Medical Faculty, Department of Hygiene and Epidemiology, School of Science,
University of Thessaly, Larissa, Greece. gsrachmed@yahoo.com.

BACKGROUND: Waste collectors have a potential risk of infectious diseases.
The aim of the study was to assess; the prevalence of hepatitis B (HBV),
risk factors for infection and possible ways of virus transmission among
municipal solid waste workers (MSWWs) in a municipality of central Greece.

METHODS: A cross-sectional study was conducted among the employees of a
municipality in Central Greece. The prevalence of an HBV infection
biological marker (anti-Hbc) and its association with exposure to waste,
socio-demographic factors, and history of occupational injuries with sharp
objects/needle sticks was examined among 208 employees.

RESULTS: The prevalence of HBV infection among the municipal waste
collectors was 23%. Logistic regression analysis showed that exposure to
waste (OR?=?4.05;95%CI?=?1.23-13.33) and age (OR?=?5.22;95% CI?=?1.35-20.1)
were independently associated with the anti-Hbc positivity. Moreover, waste
collectors who reported occupational injuries with needle sticks were at
higher risk of HBV infection (RR?=?2.64; 95% CI?=?1.01-6.96).

CONCLUSIONS: Occupational exposure to waste is a possible risk factor for
HBV infection. Occupational injury with sharp instruments could be a means
of hepatitis B virus transmission. Immunization of MSWWs and adoption of
more safe ways for waste collection could be considered in order to control
the risk of

HBV infection. Am. J. Ind. Med. © 2012 Wiley Periodicals, Inc. Copyright ©
2012 Wiley Periodicals, Inc.
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Patient Notification for Bloodborne Pathogen Testing due to
Unsafe Injection Practices in the US Health Care Settings, 2001-2011
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22525612

Med Care. 2012 Apr 19.

Patient Notification for Bloodborne Pathogen Testing due to Unsafe
Injection Practices in the US Health Care Settings, 2001-2011.

Guh AY, Thompson ND, Schaefer MK, Patel PR, Perz JF.

Divisions of *Healthcare Quality Promotion †Viral Hepatitis, Centers for
Disease Control and Prevention, Atlanta, GA.

BACKGROUND: Syringe reuse and other unsafe injection practices can expose
patients to bloodborne pathogens (eg, hepatitis B and C viruses and human
immunodeficiency virus). Evidence of such infection control lapses has
resulted in patient notifications, but the scope and magnitude of these
events have not been well characterized.

OBJECTIVES: To summarize patient notification events resulting from unsafe
injection practices in the US health care settings.

METHODS: We examined records of events that involved communications to
groups of patients, conducted during 2001-2011, advising bloodborne
pathogen testing stemming from potential exposures to unsafe injection
practices.

RESULTS: We identified 35 patient notification events related to unsafe
injection practices in at least 17 states, resulting in an estimated total
of 130,198 patients notified. Among the identified notification events, 83%
involved outpatient settings and 74% occurred since 2007, including the 4
largest events (>5000 patients per event). The primary breach identified (=
16 events; 44%) was syringe reuse to access shared medications (eg, single-
dose or multidose vials). Twenty-two (63%) notifications stemmed from the
identification of viral hepatitis transmission, whereas 13 (37%) were
prompted by the discovery of unsafe injection practices, absent evidence of
bloodborne pathogen transmission.

CONCLUSIONS: Unsafe injection practices represent a form of medical error
that have manifested as large-scale adverse events, affecting thousands of
patients in a wide variety of health care settings. Our findings suggest
that increased oversight and attention to basic infection control are
needed to maintain patient safety, along with research to identify best
practices for triggering and managing patient notifications.
__________________________________________________________________
________________________________*_________________________________

8. Abstract:Injection safety practices among nursing staff of mission
hospitals in Benin City, Nigeri
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22199046

Ann Afr Med. 2012 Jan-Mar;11(1):36-41.

Injection safety practices among nursing staff of mission hospitals in
Benin City, Nigeria.

Omorogbe VE, Omuemu VO, Isara AR.

Department of Community Health, University of Benin Teaching Hospital,
Benin City, Edo State, Nigeria.

BACKGROUND/OBJECTIVE OF THE STUDY: Injection safety has over the years
become important in view of the many diseases that are transmitted through
unsafe injection practice. The objective was to assess the knowledge and
practice of injection safety by nurses in mission hospitals in Benin City,
Nigeria.

MATERIALS AND METHODS: A descriptive cross-sectional study was carried out.
A structured interviewer-administered questionnaire was the tool for data
collection. All the nurses (122) who gave their consent in the mission
hospitals were studied. Data were analyzed using SPSS version 13.

RESULTS: The mean age of the respondents was 32.0 ± 8.9 years. The
knowledge of injection safety among the respondents was poor (55.7%) while
their practice of it was found to be good (48.4%) and excellent (47.5%).
Knowledge was significantly influenced by the age, sex, and years of
experience of the nurses. Twenty-eight (23.0%) and 40 (32.8%) respondents
recap used needles regularly and sometimes respectively. Majority (71
[58.2%]) of the respondents had sustained needle stick injuries but only 4
(0.6%) respondents had a postexposure prophylaxis.

CONCLUSION: This study showed that the knowledge of injection safety was
poor among the nurses in mission hospitals in Benin City but their practice
of injection safety was encouraging. There is need for the mission
hospitals to organize regular training workshops on injection safety to
improve the knowledge and practice of injection safety among their nurses.

Free full text – Open PDF: http://tinyurl.com/6tprmrg
__________________________________________________________________
________________________________*_________________________________

9. Abstract: An investigation of an outbreak of viral hepatitis B in modasa
town, gujarat, India
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22529628

J Glob Infect Dis. 2012 Jan;4(1):55-9.

An investigation of an outbreak of viral hepatitis B in modasa town,
gujarat, India.

Patel DA, Gupta PA, Kinariwala DM, Shah HS, Trivedi GR, Vegad MM.

Department of Microbiology, B.J. Medical College and Civil Hospital,
Ahmedabad, Gujarat, India.

BACKGROUND: Most outbreaks of viral hepatitis in India are caused by
hepatitis E. Recently in the year 2009, Modasa town of Sabarkantha district
in Gujarat witnessed the outbreak of hepatitis B.

PURPOSE: An attempt was made to study the outbreak clinically and
serologically, to estimate the seropositivity of hepatitis B Virus among
the cases and their contacts and to know the seroprevalence of hepatitis B
envelope antigen (HBeAg) and IgM antibody against hepatitis B core antigen
(IgM HBcAb) out of all the Hepatitis B surface Antigen (HBsAg) positive
ones.

MATERIALS AND METHODS: Eight hundred and fifty-six (856) cases and 1145
contacts were evaluated for hepatitis B markers namely HBsAg, HBeAg and IgM
HBcAb by enzyme-linked immuno Sorbent Assay (ELISA) test.

RESULTS: This outbreak of viral hepatitis B in Modasa, Gujarat was most
likely due to unsafe injection practices. Evidence in support of this was
collected by Government authorities. Most of the patients and approximately
40% of the surveyed population gave history of injections in last 1.5-6
months. Total 664/856 (77.57%) cases and 20/1145 (1.75%) contacts were
found to be positive for HBsAg. 53.41% of the positive cases and 52.93% of
the positive contacts were HBeAg-positive and thus in a highly infectious
stage.

CONCLUSIONS: Inadequately sterilized needles and syringes are an important
cause of transmission of hepatitis B in India. Our data reflects the high
positivity rate of a hepatitis B outbreak due to such unethical practices.
There is a need to strengthen the routine surveillance system, and to
organise a health education campaign targeting all health care workers
including private practitioners, especially those working in rural areas,
as well as the public at large, to take all possible measures to prevent
this often fatal infection.

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3326959/
__________________________________________________________________
________________________________*_________________________________

10. Abstract: Injection practices of healthcare professionals in a Tertiary
Care Hospital
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22541265

J Infect Public Health. 2012 Apr;5(2):177-81.

Injection practices of healthcare professionals in a Tertiary Care
Hospital.

Rehan HS, Chopra D, Sah RK, Chawla T, Agarwal A, Sharma GK.

Department of Pharmacology, Lady Hardinge Medical College, New Delhi – 110
001, India.

BACKGROUND: Unsafe injection practices are prevalent worldwide and may
result in spread of infection. Thus the present study was planned to
observe the injection practices of healthcare professionals (HCP),
including aseptic precautions and disposal of used syringes/needle.

MATERIALS AND METHODS: Injection practices were observed in the outpatients
and inpatients departments. Questionnaire was designed, tested and
administered for this purpose.

RESULTS: 130 patients receiving injections were observed. Overall injection
practices of the HCP were satisfactory. However, unsafe practices with
respect to not washing hands (95.4%), not wearing/changing gloves (61.6%),
recapping of needles (12.2%), wiping of needle with swab (15.4%) and
breaking of ampoule with solid object (44.4%) were observed.

CONCLUSION: The problem of unsafe injections can be successfully addressed
by organizing continuing medical education/symposium/workshops for
improving the knowledge, attitude and practices of the HCP. Periodic
monitoring and such interventions may also further improve safe injection
practices.

Copyright © 2012 King Saud Bin Abdulaziz University for Health Sciences.
Published by Elsevier Ltd. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

11. Abstract: Occupational exposure to human immunodeficiency virus in
health care providers: a retrospective analysis
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22529540

Indian J Community Med. 2012 Jan;37(1):45-9.

Occupational exposure to human immunodeficiency virus in health care
providers: a retrospective analysis.

Aggarwal V, Seth A, Chandra J, Gupta R, Kumar P, Dutta AK.

Department of Pediatrics, Kalawati Saran Children’s Hospital and Lady
Hardinge Medical College, New Delhi, India.

OBJECTIVES: To determine the population at risk, risk factors, and outcome
of occupational exposure to blood and body fluids in health care providers.

MATERIALS AND METHODS: Retrospective review of two and half year data of
ongoing surveillance of occupational exposure to blood and body fluids in a
tertiary care hospital.

RESULTS: 103 Health Care Providers (HCP) reported an occupational exposure
to blood and body fluids during the period under review. These comprised 72
(69.9%) doctors, 20 (19.4%) nursing personnel, and 11 (10.6%) cleaning
staff. Of the doctors, 65% were interns. 53.4% HCP had work experience of
less than one year. Circumstances of exposure included clinical procedures
(48%), sweeping/handling used sharps (29%), recapping (16%), and surgery
(6.9%). 74.3% of the exposures were due to non-compliance with universal
precautions and were thus preventable.

* The device most frequently implicated in causing injury was hollow bore
needle (n=85, 82.5%). Human Immunodeficiency Virus (HIV) status of the
source was positive in 6.8% cases, negative in 53.4% cases, and unknown in
remaining 39.8% cases.

Postexposure prophylaxis (PEP) was indicated in 100 (97.08%) cases and was
initiated within 2 h of exposure in 26.8% HCP. In 23.2% HCP, PEP initiation
was delayed beyond 72 h of exposure due to late reporting. Thirteen HCP
received expanded and the remaining received basic regime. Of the 82 HCP
followed up, 15 completed the full course, while 55 stopped PEP after the
first dose due to negative source status. Twelve HCP with exposure to blood
of unknown HIV status discontinued PEP despite counseling. Complete follow-
up for seroconversion was very poor among the HCP. HIV status at 6 month of
exposure is not known for any HCP.

CONCLUSIONS: Failure to follow universal precautions including improper
disposal of waste was responsible for majority of occupational exposures.
HCP need to be sensitized regarding hospital waste management, management
of occupational exposure, need for PEP, and continued follow-up.

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3326807/
__________________________________________________________________
________________________________*_________________________________

12. Abstract: WISE recommendations to ensure the safety of injections in
diabetes
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22305440

Diabetes Metab. 2012 Jan;38 Suppl 1:S2-8.

WISE recommendations to ensure the safety of injections in diabetes.

Strauss K; WISE Consensus Group.
Collaborators (58)

European Medical Association, BD, POB 13, Erembodegem-Dorp 86, B-9320
Erembodegem-Aalst, Belgium. kenneth_strauss@Europe.bd.com

AIM: Injections and fingersticks administered to patients with diabetes in
health care settings present a risk of blood exposure to the injector as
well as other workers in potential contact with sharps. Such exposures
could lead to transmission of bloodborne pathogens such as hepatitis and
HIV. A recent EU Directive requires that where such risks have been
identified, processes and devices must be put in place to reduce or
eliminate the risk. The aim of this paper is to provide formal guidelines
on the application of this Directive to diabetes care settings. These
evidence-based recommendations were written and vetted by a large group of
international safety experts.

METHODS: A systematic literature search was conducted for all peer-reviewed
studies and publications which bear on sharps safety in diabetes. Initially
a group of experts reviewed this literature and drafted the
recommendations. These were then presented for review, debate and revision
to 57 experts from 14 countries at the WISE workshop in October, 2011.
After the WISE meeting, the revised Recommendations were circulated
electronically to attendees on three occasions, each time in a new
iteration with revisions.

RESULTS: Each recommendation was graded by the weight it should have in
daily practice and by its degree of support in the medical literature. The
topics covered include Risks of Sharps Injury and Muco-cutaneous Exposure,
The EU Directive, Device Implications, Injection Technique Implications,
Education and Training (Creating a “Safety Culture”), Value, Awareness and
Responsibility.

CONCLUSION: These safety recommendations provide practical guidance and
fill an important gap in diabetes management. If followed, they should help
ensure safe, effective and largely injury-free injections and fingersticks.
They will serve as the roadmap for applying the new EU Directive to
diabetes care.

Copyright © 2012 Elsevier Masson SAS. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

13. Abstract: Sharps exposures among otolaryngology-head and neck surgery
residents
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22258933

Laryngoscope. 2012 Mar;122(3):578-82.

Sharps exposures among otolaryngology-head and neck surgery residents.

Vanhille DL, Maiberger PG, Peng A, Reiter ER.

Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth
University, Richmond, Virginia 23298-0146, USA.

OBJECTIVES/HYPOTHESIS: Examine the incidence of sharps exposures among
otolaryngology residents, assess characteristics of exposures, and
determine rates of reporting these potentially career- and life-impacting
exposures.

STUDY DESIGN: Cohort study of otolaryngology-head and neck surgery
residents.

METHODS: Survey was administered online to otolaryngology residents in the
spring of 2008, gathering demographic information, characteristics of
sharps exposures, and residents’ self-reporting of sharps exposures.

RESULTS: Among 1,407 otolaryngology residents nationwide, 231 completed the
survey. Of these, 168 (72.7%) had at least one sharps exposure during
residency, with most due to solid-bore needles (51.7%) and occurring in the
operating room (67%). Fifty percent of residents reported exposures
occurring in postgraduate year (PGY)-3 or PGY-4, whereas exposures occurred
at slightly lower rates in the other PGYs. There was no difference in
incidence of sharps exposures based on gender (Fisher exact test, P =
.2742) or history of sharps exposure during medical school (Fisher exact
test, P = .7559). Seventy-four participants had an exposure that they did
not report to the hospital, with the most common reason for not reporting
being the perceived burden of the hospital testing protocol.

CONCLUSIONS: Otolaryngology residents report a high rate of sharps
exposures during residency training, with a significant number of these
exposures going unreported. Better education may be needed to help decrease
these often preventable workplace exposures and to improve compliance with
reporting and testing procedures.

Copyright © 2011 The American Laryngological, Rhinological, and Otological
Society, Inc.
__________________________________________________________________
________________________________*_________________________________

14. Abstract: Standardised drug labelling in intensive care: results of an
international survey among ESICM members
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22527084

Intensive Care Med. 2012 Apr 20.

Standardised drug labelling in intensive care: results of an international
survey among ESICM members.

Balzer F, Wickboldt N, Spies C, Walder B, Goncerut J, Citerio G, Rhodes A,
Kastrup M, Boemke W.

Department of Anaesthesiology and Intensive Care Medicine, Campus Charité
Mitte and Charité Campus Virchow-Klinikum, Charité-University Medicine
Berlin, Augustenburger Platz 1, 13353, Berlin, Germany,
felix.balzer@charite.de.

PURPOSE: Standardised coloured drug labels may increase patient safety in
the intensive care unit (ICU). The rates of adherence to standardised drug
syringe labelling (DSL) in European and non-European ICUs, and the
standards applied are not known. The aim of this survey among ESICM members
was to assess if and what standardised drug syringe labelling is used, if
the standards for drug syringe labelling are similar internationally and if
intensivists expect that standardised DSL should be delivered by the
pharmaceutical industry.

METHODS: A structured, web-based, anonymised survey on standardised DSL,
performed among ESICM members (March-May 2011; Clinicaltrials.gov
NCT01232088). Descriptive data analysis was performed and Fisher’s exact
test was applied where applicable.

RESULTS: Four hundred eighty-two submissions were analysed (20 % non-
European). Thirty-five percent of the respondents reported that
standardised drug labelling was used hospital-wide, and 39 % reported that
standardised DSL was used in their ICU (Europe: Northern 53 %, Western 52
%, Eastern 17 %, Southern 22 %). The International Organization of
Standardization (ISO) 26825 norm in its original form was used by 30 %, an
adapted version by 19 % and local versions by 45 %; 6 % used labels that
were included in the drug’s packaging. Eighty percent wished that the
pharmaceutical industry supplied ISO 26825 norm labelling together with the
drugs.

CONCLUSIONS: Standardised DSL is not widely applied in European and non-
European ICUs and mostly does not adhere strictly to the ISO norm. The
frequency and quality of DSL differs to a great extent among European
regions. This leaves much room for improvement.
__________________________________________________________________
________________________________*_________________________________

15. Abstract: Community-based provision of injectable contraceptives in
Madagascar: ‘task shifting’ to expand access to injectable
contraceptives
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/21257652

Health Policy Plan. 2012 Jan;27(1):52-9.

Community-based provision of injectable contraceptives in Madagascar: ‘task
shifting’ to expand access to injectable contraceptives.

Hoke TH, Wheeler SB, Lynd K, Green MS, Razafindravony BH, Rasamihajamanana
E, Blumenthal PD.

Family Health International, Research Triangle Park, NC 27709, USA.
thoke@fhi.org

INTRODUCTION: Injectable contraceptives are now the most popular
contraceptive methods in sub-Saharan Africa. Injectables have not been an
option for African women lacking convenient access to health facilities,
however, since very few family planning programmes permit community-based
distribution (CBD) of injectables by non-medically trained workers.
Committed to reducing unmet contraceptive need among remote, rural
populations, the Ministry of Health and Family Planning (MOHFP) of
Madagascar sought evidence regarding the safety, effectiveness and
acceptability of CBD of injectables.

METHODS: The MOHFP joined implementing partners in training 61 experienced
CBD agents from 13 communities in provision of injectables. Management
mechanisms for injectables were added to the CBD programme’s pre-existing
systems for record keeping, commodity management and supervision. After 7
months of service provision, an evaluation team reviewed service records
and interviewed CBD workers and their supervisors and clients.

RESULTS: CBD workers demonstrated competence in injection technique,
counselling and management of clients’ re-injection schedule. CBD of
injectables appeared to increase contraceptive use, with 1662 women
accepting injectables from a CBD worker. Of these, 41% were new family
planning users. All CBD agents wished to continue providing this service,
and most supervisors indicated the programme should continue. Nearly all
clients interviewed said they intended to return to the CBD worker for re-
injection and would recommend this service to a friend.

CONCLUSIONS: This experience from Madagascar is among the first evidence
from sub- Saharan Africa documenting the feasibility, effectiveness and
acceptability of CBD services for injectable contraceptives. This evidence
influenced national and global policy makers to recommend expansion of the
practice. CBD of injectables is an example of effective task shifting of a
clinical practice as a means of extending services to underserved
populations without further burdening clinicians.
__________________________________________________________________
________________________________*_________________________________

16. Abstract: High Prevalence of Hepatitis C Infection among High Risk
Groups in Kohgiloyeh and Boyerahmad Province, Southwest Iran
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22519374

Arch Iran Med. 2012 May;15(5):271-4.

High Prevalence of Hepatitis C Infection among High Risk Groups in
Kohgiloyeh and Boyerahmad Province, Southwest Iran.

Sarkari B, Eilami O, Khosravani A, Sharifi A, Tabatabaee M, Fararouei M.

Center for Basic Researches in Infectious Diseases, Shiraz University of
Medical Sciences, Shiraz, Iran. Khosravani2us@yahoo.com.

BACKGROUND: Detection of Hepatitis C virus (HCV)-infected people in each
community assists with infection prevention and control. This study aims
to evaluate the prevalence of HCV infection among high risk groups in
Kohgiloyeh and Boyerahmad Province, Southwest Iran.

METHODS: This was a cross-sectional study conducted from 2009-2010 in
Kohgiloyeh and Boyerahmad Province. High risk groups for HCV were the
subjects of this study. Blood samples were taken from 2009 individuals at
high risk for HCV that included inmates, injecting drug users (IDUs),
health care workers, patients on maintenance hemodialysis, hemophilic
patients, and those with histories of blood transfusions. Patients were
residents of Yasuj, Gachsaran, and Dehdasht (3 main townships in the
province). Samples were analyzed by ELISA for anti-HCV antibodies.
Demographic features of participants were recorded by a questionnaire
during sample collection. Data were analyzed by SPSS version 13 software.

RESULTS: Of 2009 subjects, HCV antibodies were detected in 172 (8.6%). Rate
of infection was higher in males (11.4%) compared to females (3.2%). Rate
of infection in inmates was 11.7% while this rate was 42.4% in IDUs, 4.2%
in health care workers, and 6.1% in thalassemic patients. Significant
correlation was found between HCV infection, history of imprisonment, and
thalassemia.

CONCLUSION: Results of this study have provided epidemiologic features of
HCV and its risk factors in Kohgiloyeh and Boyerahmad Province, Southwest
Iran. This information may assist in preventing the spread of HCV infection
in this and other similar settings in the region. The findings of this
study may help in improving surveillance and infection control in the
community through management and monitoring of infected individuals.

Free full text http://www.ams.ac.ir/AIM/NEWPUB/12/15/5/005.pdf
__________________________________________________________________
________________________________*_________________________________

17. Abstract: Modelling hepatitis C transmission over a social network of
injecting drug users
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22185979

J Theor Biol. 2012 Mar 21;297:73-87.

Modelling hepatitis C transmission over a social network of injecting drug
users.

Rolls DA, Daraganova G, Sacks-Davis R, Hellard M, Jenkinson R, McBryde E,
Pattison PE, Robins GL.

Department of Medicine-RMH, University of Melbourne, VIC 3010, Australia.
drolls@unimelb.edu.au

Hepatitis C virus (HCV) is a blood-borne virus that disproportionately
affects people who inject drugs (PWIDs). Based on extensive interview and
blood test data from a longitudinal study in Melbourne, Australia, we
describe an individual-based transmission model for HCV spread amongst
PWID. We use this model to simulate the transmission of HCV on an empirical
social network of PWID.

A feature of our model is that sources of infection can be both network
neighbours and non-neighbours via “importing”. Data- driven estimates of
sharing frequency and rate of importing are provided. Compared to an
appropriately calibrated fully connected network, the empirical network
provides some protective effect on the time to primary infection.

We also illustrate heterogeneities in incidence rate of infection, both
across and within node degrees (i.e., number of network partners). We
explore the reduced risk of infection from spontaneously clearing cutpoint
nodes whose infection status oscillates, both in theory and in simulation.

Further, we show our model-based estimate of per-event transmission
probability largely agrees with previous estimates at the lower end of the
range 1-3% commonly cited.

Copyright © 2011 Elsevier Ltd. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

18. Abstract: Canada moving backwards on illegal drugs
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22530535

Can J Public Health. 2012 Mar-Apr;103(2):125-7.

Canada moving backwards on illegal drugs.

Hyshka E, Butler-McPhee J, Elliott R, Wood E, Kerr T.

Addiction and Mental Health Research Lab, School of Public Health,
University of Alberta, Edmonton, AB.

Internationally, illegal drug use remains a major public health problem. In
response, many countries have begun to shift their illegal drug policies
away from enforcement and towards public health objectives. Recently, both
the Global Commission on Drug Policy and the Supreme Court of Canada have
endorsed this change in direction, supporting empirically sound illegal
drug policies that reduce criminalization and stigmatization of drug users
and bolster treatment and harm reduction efforts.

Until recently, Canada was a participant in this growing movement towards
rational drug policy. Unfortunately, in recent years, policy changes have
made Canada one of the few remaining advocates of a “war-on-drugs”
approach. Indeed, the current government has implemented a number of new
illegal drug policies that contradict well-established scientific evidence
from public health, criminology and other fields. As such, their approach
is expected to do little to reduce the harms associated with substance use
in Canada.

The authors call on the current government to heed the recommendations of
the Global Commission’s report and learn from the many countries that are
innovating in illegal drug policy by prioritizing evidence, human rights
and public health.
__________________________________________________________________
________________________________*_________________________________

19. Abstract: Preventable drug-related morbidity in community pharmacy:
development and piloting of a complex intervention
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22527474

Int J Clin Pharm. 2012 Apr 17.

Preventable drug-related morbidity in community pharmacy: development and
piloting of a complex intervention.

Pereira Guerreiro M, Martins AP, Cantrill JA.

iMED.UL, Faculdade de Farmácia da Universidade de Lisboa (FFUL), Lisbon,
Portugal, mara.guerreiro@sapo.pt.

Background: Preventable drug-related morbidity (PDRM) arising in the
community is a problem of unacceptable magnitude. Effective interventions
to reduce this problem will avoid unnecessary patient harm and waste of
resources for the health care system. Objective To develop and pilot an
intervention to manage the risk of PDRM in community pharmacy, underpinned
by validated PDRM indicators.

Setting: Portuguese community pharmacy.

Method: Our work was informed by the Medical Research Council framework for
the development and evaluation of complex interventions. Human error theory
was considered as a theoretical framework for developing the intervention.
Additionally, this stage consisted of a literature review, followed by two
focus groups (17 community pharmacists) and interviews with 8 professional
leaders. A 4-component intervention, was developed: (1) operationalisation
of 4 validated PDRM indicators in dispensing encounters (‘dispensing’
indicators), and operationalisation of 25 validated indicators in patients
enrolled in pharmaceutical care programmes (‘follow-up’ indicators), (2)
pharmacist resource pack, (3) pharmacists’ training and (4) support scheme.
Piloting consisted of a feasibility study in 15 community pharmacies and an
acceptability study with participating pharmacists (n = 16).

Main outcome measures: Proportion of cases with counselling (dispensing
indicators); proportion of cases assessable, proportion of cases at risk
and proportion of cases with risk minimisation actions (follow-up
indicators).

Results: Operationalization of dispensing indicators resulted in
counselling in 44.1 % of cases (n = 666). Factors influencing acceptability
included pharmacists’ perceptions of patients’ characteristics, interest
and informational needs, as well as perceptions on the relevance of safety
information. For follow-up indicators, data were available to assess most
cases (93/105, 88.6 %). About half of the assessable cases were at risk of
a PDRM event (n = 49; 51.6 %); pharmacists undertook risk minimization
actions in 23 cases (46.9 %). Lack of time and inter-professional issues
emerged as important factors influencing acceptability.

Conclusions: A novel risk management intervention was developed.
Feasibility and acceptability of the 4-component intervention in Portuguese
community pharmacy provided ‘proof of concept’, whilst highlighting aspects
that need further refinement to better measure and maximise efficacy in
future evaluative research.
__________________________________________________________________
________________________________*_________________________________

20. Abstract: An overview of anthrax infection including the recently
identified form of disease in injection drug users
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22527064

Intensive Care Med. 2012 Apr 24.

An overview of anthrax infection including the recently identified form of
disease in injection drug users.

Hicks CW, Sweeney DA, Cui X, Li Y, Eichacker PQ.

Cleveland Clinic Lerner College of Medicine, Cleveland, OH, 44122, USA.

PURPOSE: Bacillus anthracis infection (anthrax) can be highly lethal. Two
recent outbreaks related to contaminated mail in the USA and heroin in the
UK and Europe and its potential as a bioterrorist weapon have greatly
increased concerns over anthrax in the developed world.

METHODS: This review summarizes the microbiology, pathogenesis, diagnosis,
and management of anthrax.

RESULTS AND CONCLUSIONS: Anthrax, a gram-positive bacterium, has typically
been associated with three forms of infection: cutaneous, gastrointestinal,
and inhalational. However, the anthrax outbreak among injection drug users
has emphasized the importance of what is now considered a fourth disease
form (i.e., injectional anthrax) that is characterized by severe soft
tissue infection.

While cutaneous anthrax is most common, its early stages are distinct and
prompt appropriate treatment commonly produces a good outcome. However,
early symptoms with the other three disease forms can be nonspecific and
mistaken for less lethal conditions. As a result, patients with
gastrointestinal, inhalational, or injectional anthrax may have advanced
infection at presentation that can be highly lethal. Once anthrax is
suspected, the diagnosis can usually be made with gram stain and culture
from blood or tissue followed by confirmatory testing (e.g., PCR).

While antibiotics are the mainstay of anthrax treatment, use of adjunctive
therapies such as anthrax toxin antagonists are a consideration. Prompt
surgical therapy appears to be important for successful management of
injectional anthrax.
__________________________________________________________________
________________________________*_________________________________

21. Abstract: Mycotic Pseudoaneurysms Due to Injection Drug Use: A Ten-Year
Experience
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22534261

Ann Vasc Surg. 2012 Apr 24.

Mycotic Pseudoaneurysms Due to Injection Drug Use: A Ten-Year Experience.

Jayaraman S, Richardson D, Conrad M, Eichler C, Schecter W.

Department of Surgery, University of California, San Francisco, CA.

BACKGROUND: Arterial injury and infection due to repetitive injection drug
use can result in mycotic pseudoaneurysm predisposing to hemorrhage, distal
embolism, limb loss, and death. We hypothesized that debridement of the
infected artery, followed by immediate vascular reconstruction, results in
successful limb salvage in these patients.

METHODS: The setting was a county hospital. A retrospective review of all
patients diagnosed with lower extremity pseudoaneurysms by the Departments
of Surgery and Radiology between 2000 and 2009 was conducted. Outcome
measures were patient characteristics, site(s) of lesion, type and results
of imaging, type of operation, length of hospital stay, and complications.

RESULTS: Sixteen patients had 17 pseudoaneurysms. One of the patients had
two mycotic pseudoaneurysms in the same region separated by a period of 10
months. Culture of the wall of the first pseudoaneurysm was not performed.
The second pseudoaneurysm was culture positive. The 15 remaining mycotic
pseudoaneurysms were all culture positive. Nine patients were men, and the
median age of the patient group was 37 years. Common femoral
pseudoaneurysms were the most frequent (76%). Symptoms included swelling
(94%), pain (82%), and erythema (75.6%). A rapidly expanding pulsatile
expansile mass was present in four of the patients. Computed tomography and
percutaneous angiography were done in seven and four of the patients,
respectively, and were diagnostic in all cases studied. Resection and
reconstruction with autologous vein was the most common procedure (seven),
followed by cadaveric grafting (four), synthetic grafting (two), ligation
(two), and primary repair (two). Muscle flaps were used in 76.5% of the
cases. Complications included anastomotic dehiscence (n = 3), acute
thrombosis (n = 1), ischemia (n = 1), abscess (n = 1), and compartment
syndrome (n = 1). Three of these patients required a second vascular
reconstruction. One patient ultimately required an amputation. No
postoperative deaths occurred. Methicillin-resistant Staphylococcus aureus
was cultured from 13 of the 16 arterial walls.

CONCLUSION: Methicillin-resistant Staphylococcus aureus is the predominant
organism causing mycotic aneurysms of the common and superficial femoral
arteries owing to injection drug use at San Francisco General Hospital.
Wide debridement of the infected artery and reconstruction with an in-line
reversed saphenous vein or cryopreserved vascular allograft is a safe and
effective method of treatment. Long-term follow-up studies are needed to
determine the durability of this method of treatment.

Copyright © 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc.
All rights reserved.
__________________________________________________________________
________________________________*_________________________________

22. Abstract: Management of occupational dermatitis in healthcare workers:
a systematic review
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22034544

Occup Environ Med. 2012 Apr;69(4):276-9.

Management of occupational dermatitis in healthcare workers: a systematic
review.

Smedley J, Williams S, Peel P, Pedersen K; Dermatitis Guideline Development
Group.
Collaborators (12)

Health and Work Development Unit, Royal College of Physicians, 11 St
Andrews Place, London NW1 4LE, UK. hwdu@rcplondon.ac.uk

OBJECTIVES: This systematic review informed evidence-based guidelines for
the management of occupational dermatitis, with a particular focus on
healthcare workers.

METHODS: A multidisciplinary guideline group formulated questions about the
management of healthcare workers with dermatitis. Keywords derived from
these questions were used in literature searches. We appraised papers and
developed recommendations using the Scottish Intercollegiate Guideline
Network (SIGN) methodology.

RESULTS: Literature searches identified 1677 papers; 11 met the quality
standard (SIGN grading ++ or +). A small body of evidence indicated that
dermatitis is more likely to be colonised with micro-organisms than normal
skin, but there was insufficient evidence about the risk of transmission to
patients. There was limited evidence that using alcohol gel for hand
decontamination is less damaging to skin than antiseptics or soap. A small
body of evidence showed that conditioning creams improve dermatitis, but
are not more effective than their inactive vehicle. A small inconsistent
body of evidence showed that workplace skin care programmes improve
dermatitis.

CONCLUSIONS: Healthcare workers should seek early treatment for dermatitis
and should be advised about the risk of bacterial colonisation. Work
adjustments should be considered for those with severe or acute dermatitis
who work with patients at high risk of hospital-acquired infection.
Healthcare workers with dermatitis should follow skin care programmes, and
use alcohol gel where appropriate for hand decontamination. Further
research should explore whether healthcare workers with dermatitis are more
likely to transmit infection to their patients, and whether health
surveillance is effective at reducing dermatitis.
__________________________________________________________________
________________________________*_________________________________

23. Abstract: Laws pertaining to healthcare-associated infections: a review
of 3 legal requirements
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22173526

Infect Control Hosp Epidemiol. 2012 Jan;33(1):75-80.

Laws pertaining to healthcare-associated infections: a review of 3 legal
requirements.

Reagan J, Hacker C.

HAI Focus, Edgewood, New Mexico 87015, USA. juliereagan@mac.com

We reviewed US state and territorial healthcare-associated infection (HAI)
laws, specifically addressing 3 legal requirements: data submission,
reporting of data to the public, and inclusion of facility identifiers in
public reports.

The majority of US states and territories have HAI laws.

The 3 studied legal provisions are all commonly included in state HAI laws
in varying forms; however, only a minority of states and territories
specifically mandate all 3 legal requirements.

The laws of the remaining states vary considerably.
__________________________________________________________________
________________________________*_________________________________

24. No Abstract: Hepatitis C Virus Transmission in People Who Inject Drugs:
Swabs May Not Be The Main Culprit
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22535997.1

J Infect Dis. 2012 Apr 25.

Hepatitis C Virus Transmission in People Who Inject Drugs: Swabs May Not Be
The Main Culprit.

Maher L, Wand H.

Kirby Institute (formerly the National Centre for HIV Epidemiology and
Clinical Research) University of NSW, Sydney, Australia.
__________________________________________________________________
________________________________*_________________________________

25. No Abstract: Synopsis of the WISE meeting
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22305439

Diabetes Metab. 2012 Jan;38 Suppl 1:S15-26.

Synopsis of the WISE meeting.

Strauss K.

European Medical Association, BD, POB 13, Erembodegem-Dorp 86, B-9320
Erembodegem-Aalst, Belgium. kenneth_strauss@europe.bd.com
__________________________________________________________________
________________________________*_________________________________

26. No Abstract: WISE (Workshop on Injection Safety in Endocrinology)
recommendations. Editorial
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22305438

Diabetes Metab. 2012 Jan;38 Suppl 1:S1.

WISE (Workshop on Injection Safety in Endocrinology) recommendations.
Editorial.

Wittmann A.
__________________________________________________________________
________________________________*_________________________________

27. No Abstract: Mobile phones in hospital settings: a serious threat to
infection
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22474906

Occup Health Saf. 2012 Mar;81(3):42-4.

Mobile phones in hospital settings: a serious threat to infection.

Singh A, Purohit B.

Department of Public Health Dentistry, People’s College Dental Sciences,
Bhopal, India. drabhinav.singh@gmail.com
__________________________________________________________________
________________________________*_________________________________

28. No Abstract: Canada’s Insite decision: a victory for public health
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22184103

Policy Polit Nurs Pract. 2011 Aug;12(3):131-2.

Canada’s Insite decision: a victory for public health.

Keepnews DM.
__________________________________________________________________
________________________________*_________________________________

29. No Abstract: Drug prohibition: it’s broke, now go and fix it
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22104589

Int J Drug Policy. 2012 Jan;23(1):22-3.

Drug prohibition: it’s broke, now go and fix it.

Wodak A.

St Vincent’s Hospital, Darlinghurst, NSW 2010, Australia.
awodak@stvincents.com.au

Comment on Int J Drug Policy. 2012 Jan;23(1):6-15.
__________________________________________________________________
________________________________*_________________________________

30. No Abstract: The policymaker’s Hippocratic oath
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/21852092

Int J Drug Policy. 2012 Jan;23(1):21-2.

The policymaker’s Hippocratic oath.

Felbab-Brown V.

Fellow in Foreign Policy, Brookings Institution, Washington, DC, USA.
vfelbabbrown@brookings.edu

Comment on Int J Drug Policy. 2012 Jan;23(1):6-15.
__________________________________________________________________
________________________________*_________________________________

31. The 15th ICID will be held in Bangkok, Thailand on June 13-16, 2012
__________________________________________________________________
15th International Congress on Infectious Diseases (ICID)

The 15th ICID will be held in Bangkok, Thailand on June 13-16, 2012

A complete listing of the program including:
Plenary Speakers
Special Sessions
Awards

For up-to-the-minute information, go to
http://www.isid.org/icid/symposia.shtml

On-line Registration is also available.

Plenary Speakers:
Treating Hepatitis B in 2012 – C.L. Lai (China)
Finding a Cure for HIV: The Need for Science, Collaboration and Advocacy –
S. Lewin (Australia)
Infection Control – D. Pittet (Switzerland)
The Future of Dengue – D. Gubler (Singapore)
Killed Oral Cholera Vaccines: From Concept to Public Health Reality – J.
Clemens (Republic of Korea)
Confronting TB in the Era of HIV – S. Lawn (South Africa)

15th ICID Participating Organizations, Premier Sponsors and Sponsors
including sponsored sessions available at the congress
__________________________________________________________________
________________________________*_________________________________

32. Healthcare Quarterly. Special Issue. Patient Safety

Crossposted from the EQUIDAD Listserve with thanks.
http://listserv.paho.org/Archives/equidad.html
__________________________________________________________________

Healthcare Quarterly. Special Issue. Patient Safety

Healthcare Quarterly Vol. 15 Special Issue |

Available online at: http://bit.ly/HYHJsG

Editorial
G. Ross Baker

“…Much of the focus in the past decade has been on problems identified in
major national patient safety studies. But other important issues have also
emerged. Pat Croskerry (2012) notes that diagnostic error has received
limited attention although it is a major contributor to adverse events and
malpractice litigation. Croskerry traces the source of diagnostic error to
the psychology of decision-making and cognitive bias. He urges greater
emphasis on diagnostic reasoning in medical education and a continuing
focus on these skills in practice.

Safety is an issue outside of institutional settings too. Lynn Stevenson
and her colleagues (2012) argue that home care is fundamentally different
from hospital-based care and that we need to develop patient safety
practices that are client- and family-centred and adaptable to the broad
range of settings in which home care is delivered.

Each of these papers provides a lens through which to view a critical
issue. While their coverage is not exhaustive, together they offer a
perspective on our achievements and the challenges we still face. In a
paper examining the strategic elements for broadening our efforts on
patient safety and quality of care, I argue that we need to emphasize the
business case for safety, move current initiatives to a broader scale and
invest in capacity for and capability of leadership and staff to improve
(Baker 2012).

The gains of the past decade have been impressive, but we need to hard-wire
and extend these efforts in our current system to ensure their impact and
sustainability….”

Perspective
Partners in Patient Safety
Hugh Macleod and Wendy Nicklin

Making Healthcare Safer
The Challenges of Making Care Safer: Leadership and System Transformation
G. Ross Baker

The Culture Of Patient Safety
Reporting, Learning and the Culture of Safety
W. Ward Flemons and Glenn McRae

Teamwork And Communication
Productive Complications: Emergent Ideas in Team Communication and Patient
Safety
Lorelei Lingard

Human Factors In Patient Safety
From Discovery to Design: The Evolution of Human Factors in Healthcare
Joseph A. Cafazzo and Olivier St-Cyr

Workplace Redesign
Redesigning the Workplace for 21st Century Healthcare
Patricia O’Connor, Judith Ritchie, Susan Drouin and Christine L. Covell

Managing Healthcare-Acquired Infections
Healthcare-Associated Infections: New Initiatives and Continuing Challenges
Michael Gardam, Paige Reason and Leah Gitterman

Medication Reconciliation
Medication Reconciliation in the Hospital: What, Why, Where, When, Who and
How?
Olavo Fernandes and Kaveh G. Shojania

Diagnostic Safety
Perspectives on Diagnostic Failure and Patient Safety
Pat Croskerry

Surgical Checklist
Surgical Safety Checklist: Improved Patient Safety through Effective
Teamwork
Chris Hayes

Transitions Of Care
Toward Safer Transitions: How Can We Reduce Post-Discharge Adverse Events?
Irfan A. Dhalla, Tara O’Brien, Francoise Ko and Andreas Laupacis

Safety In The Community
Safety in Home Care: Thinking Outside the Hospital Box
Lynn Stevenson, Ariella Lang, Marilyn Macdonald, Jana Archer and Christina
Berlanda

“Materials provided in this electronic list are provided “as is”. Unless
expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and
not necessarily of The Pan American Health Organization PAHO/WHO or its
country members”.
__________________________________________________________________
________________________________*_________________________________

33. News

– Ireland: €10k payout for man who sat on syringe needle in hotel
– Canada: Abbotsford plunges into needle plan
– USA: Pennsylvania Patient Safety Authority Issues Annual Report for 2011
– Action Training Systems Releases Bloodborne Pathogens Training Program
for Emergency Responders
– PDMS Blood Test Container Could Change How Diagnostics Are Performed,
Researchers Say (VIDEO)
– UK: Abstinence Alone Does Not Work
– EU: Supervised injectable heroin treatment is expensive but cost
effective, report says

Selected news items reprinted under the fair use doctrine of international
copyright law: http://www4.law.cornell.edu/uscode/17/107.html
__________________________________________________________________
Ireland: €10k payout for man who sat on syringe needle in hotel
By Ray Managh, Herald.ie, Ireland (01.05.12)

THE brother of a murder victim has been awarded €10,000 in compensation
after sitting on a syringe needle in Dublin’s North Star Hotel.

Derek Ledden feared he would contract a blood borne infectious disease
after sitting on a needle, a judge heard.

The 31-year-old told Judge Alison Lindsay in the Circuit Civil Court that
he had to abstain from having sex with his girlfriend until he received a
HIV and hepatitis all-clear six months after the incident and it had put a
strain on their relationship.

Barrister John Moher said Mr Ledden, of Upper Oriel Street, Dublin, had
suffered a traumatic experience six years ago when his brother Stephen had
been murdered in a mistaken identity shooting at their home.

He had started abusing valium afterwards but had successfully beaten the
habit almost a year before the needle stick injury on August 16, 2010, when
he had started abusing the drug again.

sting

Mr Ledden told Mr Moher he joined a group of friends for drinks in the
North Star Hotel, Amiens Street, Dublin, and had sat down on a stool when
he felt a sting in his left buttock.

He jumped up and there was a bit of a commotion at the table when they
discovered a needle on the floor. He had been taken by ambulance to the
Mater Hospital where two small puncture wounds had been found on his
buttock.

He told the court that in view of the possibility of acquiring a blood
borne disease he had been given tablets to treat a possible hepatitis B and
HIV infection. He attended follow up blood tests in the infectious disease
clinic and despite having been told that the risk of infection was low the
doctors could not be 100pc sure. He got the all clear six months later.

Judge Lindsay said a needle had been found on the floor and there had been
a breach of the duty of care by the hotel to Mr Ledden in terms of
observation and cleaning of the premises.

He awarded Mr Ledden €10,000 damages and costs against the hotel owner, BC
McGettigan Limited, which has its registered office in Waterloo Lane,
Ballsbridge, Dublin.
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Canada: Abbotsford plunges into needle plan
By Rochelle Baker, Abbotsford Times, Canada (30.04.12)

Fraser Health sticks it to safe injection sites, suggests needle exchange
is the best option for Abbotsford

Fraser Health Authority released a proposed harm reduction plan centered
around needle distribution for the City of Abbotsford on Monday.

The proposed plan, authored by FHA public health director David Portesi,
does not propose establishing a safe injection site within Abbotsford.

The proposed needle exchange plan would likely need to serve a minimum of
500 intravenous drug users living in the Abbotsford area, and distribute
about 120,000 needles annually, stated the report.

The top three suggested sites for a proposed needle exchange were near the
Salvation Army’s Centre of Hope along the West Railway corridor; a site
near the intersection of Peardonville Road and South Fraser Way, or in the
Jubilee Park area.

The city is currently reviewing its current anti-harm reduction bylaw that
prohibits any harm reduction measures, such as needle exchanges or
supervised injection sites.

Abbotsford has a high rate of hospital admissions due to illicit drug
overdoses compared to Surrey and Burnaby/New Westminster areas, which have
needle distribution programs, data from the report shows.

Abbotsford was only second to New Westminster for the rate of people
admitted to hospital because of overdoses in a comparison that included
Surrey and Burnaby, data in the report showed.

However, Portesi stated last week that if New Westminster’s numbers, which
are volatile due to its small population, were combined with neighbouring
Burnaby, a more accurate hospital overdose rate would result, leaving
Abbotsford at the top of the pack.

New Westminster’s overdose hospital admission rate was 23.6 per 100,000
people, between 2006/07 and 2010/11.

Abbotsford’s rate was 21.9, Surrey’s was 17.3 and Burnaby’s was 11.4.

Deaths from overdoses in Abbotsford are also above the FHA regional rate
and the provincial rate, noted the report. Abbotsford’s illicit drug
mortality rate from 2005 to 2009 was 8.08 per 100,000 people, while the
Fraser Health regional rate was 6.86 and the provincial rate was 7.79.

Vancouver, Surrey and New Westminster’s mortality rates – which were 11.79,
11.07 and 9.01 respectively – were also higher than the provincial rate.

Abbotsford also has a high rate of new hepatitis C infections, which Fraser
Health believes can be tied to the city’s lack of harm reduction services
and addicts re-using dirty needles and crack pipes.

Abbotsford’s infection rate for 2010 was 64.4 per cent versus a provincial
rate of 54.9 and a Canadian rate of 33.7 in 2009.

Fraser Health has been pressing the city to establish harm reduction
measures in Abbotsford for years.

A “very crude estimate” of the number of injection drug users in the
community is anywhere from 280 to 470, according to Fraser Health.

But Portesi recently said the numbers are likely very conservative because
illicit drug users are often unwilling to identify themselves.

Fraser Health recommends a needle exchange program to reduce the risk of
transmitting blood borne diseases such as HIV and Hep C.

Such programs also allow drug users to come into regular contact with
professionals who can direct clients to other necessary healthcare services
or treatment.

The report cited evidence-based research that indicates providing needles
to addicts does not increase drug use, does not negatively impact drug
treatment or increase the number of needles found in the street.

The harm reduction plan provided possible needle distribution methods such
as using a fixed location or a mobile site, such as a van or bus.

A fixed site has the advantage of delivering other educational,
counselling, testing and healthcare services.

A mobile bus would allow the delivery of other services over a greater
area, and perhaps reduce any community opposition that would arise over a
permanent location, noted the report.

Outreach worker or peer distribution of needles are more cost effective
models but are limited when it comes to providing access to other services.

Fraser Health, which would oversee the harm reduction program, plans to
establish partnerships with Abbotsford stakeholders, including the IDU
community, the Abbotsford Police Department, the city and community and
business organizations.

The program would be implemented should the city retract its anti-harm
reduction bylaw.

But steps that could be undertaken immediately include setting up a harm
reduction community advisory board and establishing needle disposal
services at Abbotsford Regional Hospital.

Abbotsford Mayor Bruce Banman said Monday that the report will come before
council at an upcoming meeting.

Banman said while he wouldn’t support a supervised injection site, he
personally favoured a needle exchange program.

The harm reduction measure would address public safety concerns around
dirty discarded needles on the street, reduce the transmission of disease,
be cost-effective and provide drug users with a “measure of dignity,” he
said.

“From a human perspective, if [a needle exchange] stops the transference of
AIDS, we should use it,” said Banman, “and prevent the death sentence of a
contaminated needle.”

© Copyright (c) Abbotsford Times
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USA: Pennsylvania Patient Safety Authority Issues Annual Report for 2011
Pennsylvania Patient Safety Authority Press Release, PRNewswire, USA
(30.04.12) [Edited]

HARRISBURG, Pa., April 30, 2012 /PRNewswire via COMTEX/ — The report
highlights increases in its educational programs and collaboration efforts
to improve patient safety within Pennsylvania’s healthcare facilities

The Pennsylvania Patient Safety Authority issued its 2011 Annual Report
highlighting increases in its educational programs and collaborations that
focus on topics such as preventing wrong-site surgery and decreasing
healthcare-associated infections.

“In 2011, the Patient Safety Authority broadened its scope of educational
activities by increasing the number of educational courses and
collaborations to include areas such as reducing healthcare-associated
infections in ambulatory surgical facilities,” Stanton N. Smullens, M.D.,
acting chair of the Pennsylvania Patient Safety Authority said. “Because of
the increase in educational programs and the Patient Safety Liaison
program, the attendance at the educational programs has more than doubled.”

The Patient Safety Liaison (PSL) program began in August 2008. Overseen by
the Authority’s Director of Educational Programs, each PSL has between
65-100 healthcare facilities that they meet with regularly to ensure the
Patient Safety Officers (PSOs) are aware of the valuable resources
available to them from the Authority and other patient safety leaders.

“The positive, collegial relationships the PSLs have developed with PSOs
enables the Authority to work closely with the healthcare facilities to
develop educational programs and collaborations that are needed to improve
patient safety in specific areas,” Smullens said. “Some new educational
programs offered in 2012 include training healthcare facility staff to
investigate patient safety problems, Just Culture(TM) and using teamwork
and communication to improve patient safety.

“Through the PSL program, relationships among competing healthcare
facilities have also improved because of the common goal to improve safety
in areas such as preventing mislabeling of blood samples and wrong-site
surgery,” Smullens added.

Through a U.S. federal grant program called “Partnership for Patients,” the
Authority has partnered with the Hospital and Healthsystem Association of
Pennsylvania (HAP) and will receive approximately $1.6 million over two
years to focus statewide on decreasing falls, wrong-site surgery and
adverse drug events.

“The Authority was poised to take the wrong-site surgery and falls
collaborations statewide after successful regional efforts in reducing
these events,” Smullens said. “The federal grant gave the Authority the
revenue needed to do all three simultaneously.”

Smullens said one regional collaborative with 19 healthcare facilities
eliminated all wrong-site surgeries in operating rooms for over one year
and a regional falls collaborative reduced harmful falls by 31 percent.

Other acute care collaborations sponsored by the Authority include programs
to improve the preoperative screening and assessment process in ASFs and to
help prevent surgical-site infections.

For more information about the Authority’s educational programs and
collaborations go to Addendums E and F in the 2011 Annual Report at
www.patientsafetyauthority.org .

Smullens said the Annual Report also highlights efforts to combat
healthcare-associated infections in nursing homes. “Last year, the
Authority assessed ten nursing homes to determine how they prevent
healthcare-associated infections,” Smullens said. “The program gave the
Authority valuable information on the structure and function of nursing
home infection control programs by measuring the level of implementation in
several key areas like hand hygiene, process monitoring, and environmental
measures to prevent infections that occur in the nursing home environment.”

……..

Smullens said the Authority also joined a multi-agency collaboration to
improve healthcare worker vaccination rates.

“Less than sixty-five percent of healthcare workers get vaccinated
annually,” Smullens said. “Research shows low healthcare worker vaccination
rates have been linked to hospital influenza outbreaks.”

Smullens said Authority research shows nursing homes with mandatory worker
vaccination programs had 22% lower combined seasonal lower respiratory
tract/influenza-like illness rates from October 2010 through March 2011.

“The Authority research shows that over nineteen hundred respiratory tract
infections could have been prevented if all Pennsylvania nursing homes had
mandatory worker vaccination programs in place,” Smullens said. “The
Authority will continue to educate nursing homes on its findings and the
importance of mandatory vaccination programs in preventing infections.”

Other healthcare-associated infection topics published in Advisory articles
in 2011 include: skin and soft tissue infections in long-term care,
preventing bloodborne disease transmission associated with *** unsafe
infection practices and central-line-associated bloodstream infection
prevention.

For more information about events data and healthcare-associated infection
data in hospitals and nursing homes go to Addendum H of the 2011 Annual
Report at www.patientsafetyauthority.org .

Other Highlights of the Authority’s 2011 Annual Report include:

2011 Detailed Overview of Data Reported Through PA-PSRS

Between January 1 and December 31, 2011, Pennsylvania acute care facilities
submitted 228,835 reports through the Pennsylvania Patient Safety Reporting
System (PA-PSRS). To date, over 1.5 million reports have been submitted
through PA-PSRS. Approximately, 3.5 percent were Serious Events (events
that caused harm), while 96.5 percent were Incidents or near-misses (events
that did not cause harm).

“Overall, reporting in 2011 increased for Serious Events [7%] and Incidents
[1%],” Smullens said. “The majority of the Serious Event increase can be
attributed to an increase [11%] in reports related to complications of
procedures/treatments/tests.

For more details about the Authority data and breakdowns by event type,
gender and age groups go to Addendum B of the 2011 Annual Report.

2011 Annual User Survey Results

Facilities continue to make changes to improve patient safety according to
the Authority’s annual user survey. In November 2011, the Authority asked
registered primary contacts at healthcare facilities in Pennsylvania to
participate in an online survey. Those contacts include: Infection
Prevention Designees (IPDs) and PSOs.

“Facilities continue to find Patient Safety Advisories useful [99%],
relevant [98%], readable [100%], high in scientific quality [100%] and high
in educational value [100%],” Smullens said. “Also, almost all of the
respondents [99%] rated the PSL program as valuable.”

For more information on the annual user survey, go to Addendum G of the
2011 Annual Report.

………

For more information about the Pennsylvania Patient Safety Advisory and
subscribers, go to Addendums C and D of the 2011 Annual Report.

The complete Annual Report for 2011, as well as additional information
about the Patient Safety Authority, is accessible on the Authority’s
website www.patientsafetyauthority.org .

Copyright (C) 2012 PR Newswire. All rights reserved
__________________________________________________________________
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Action Training Systems Releases Bloodborne Pathogens Training Program for
Emergency Responders
Press Release. PRWEB, Poulsbo, WA USA, (27.04.12)

Bloodborne Pathogens is the first title in the new three-part series,
Infection Control & Prevention, by Action Training Systems. This is a high-
quality, competency-based multimedia program to educate emergency
responders on how to identify risks associated with bloodborne pathogens,
engineering controls and safe work practices to prevent or minimize their
exposure and what to do if an exposure occurs.

Emergency responders are at risk of occupational exposure to blood and
other body fluids during their care of patients in the pre-hospital field.
Knowing how to manage this risk and what precautions to take are essential
to responder safety. Action Training Systems’ new program on Bloodborne
Pathogens helps instructors fulfill the initial or annual training
requirements mandated by the Occupational Safety and Health Administration
(OSHA) by providing an overview of the standard and describing how
responders can minimize and protect themselves from exposure to bloodborne
pathogens. This title includes information on the Needlestick Safety and
Prevention Act, as well as the Ryan White Comprehensive AIDS Resources
Emergency (CARE) Act.

The training program presents types of bloodborne pathogens of concern to
emergency care providers, including HBV, HCV and HIV. It reviews standards
and requirements outlined in OSHA’s Bloodborne Pathogens standard. The use
of standard precautions, safe work practices and engineering controls to
minimize the risk of occupational exposure are defined and demonstrated
throughout the program. The program ends by demonstrating what actions to
take after an exposure incident.

There are two other titles in the Infection Control & Prevention Series to
be released late 2012, including Airborne Pathogens & Other Diseases and
Infection Control Practices.

About Action Training Systems

Action Training Systems has over 23 years of experience and knowledge in
training programs for emergency responders. The company provides high-
quality content and video demonstrations on DVD as well as interactive
computer-based training (CBT) and scorable simulation courses that all run
on the Iluminar Learning Management System (LMS) software platform.
Other training systems by ATS include the Essentials of Fire Fighting,
HAZMAT, Emergency Medical Responder, Fire Service Recue, First on Scene,
Fire Officer 1, Industrial Fire Brigades and much more. Their training is a
valuable resource to a variety of industry professionals including-but not
limited to-firefighters, law enforcement, industrial first responders,
private security, private ambulance, military, safety officers, HAZMAT
teams, search and rescue, utility workers and all other emergency
responders.

For information, visit http://www.action-training.com.
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http://news.sciencemag.org/sciencenow/2012/04/video-tiny-container-could-
make.html

PDMS Blood Test Container Could Change How Diagnostics Are Performed,
Researchers Say (VIDEO)
By Jon Cartwright, Science Now, (26.04.12)

Good news for people who hate big needles: Researchers have invented a
device that could allow diagnostics to be performed with just a single drop
of blood. The apparatus is a container a few millimeters wide that consists
of a conductive base covered with an elastic layer of polydimethylsiloxane
or PDMS, a silicone compound. When liquid is dripped on the PDMS, the layer
wraps around the ensuing droplet thanks to its surface tension-the same
force that causes water to curl upward at the sides of a glass. In this
configuration, the droplet cannot escape.

WATCH VIDEO http://tinyurl.com/c2ugwse

To release it, the researchers simply insert a thin electrode: Together
with the conductive base, the electrode creates an electric field which
forces the PDMS layer to unwrap (as seen above). The researchers believe
that their container, which is described in a paper published online today
in the Proceedings of the Royal Society A, could enable blood tests to be
performed with a single drop of blood, because it would enable droplets to
be transported without evaporating or becoming contaminated. That would
reduce patient discomfort, and possibly save time.

What’s more, the researchers think their container could deliver minute
quantities of drugs to diseased cells, thereby avoiding having to
administer potentially harmful drugs to the entire body.
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UK: Abstinence Alone Does Not Work
Mary O’Hara, The Guardian, UK (25.04.12)

Several influential charities have decried a government blueprint for a
recovery-based drug treatment system as “dangerously and deeply flawed” and
an “ideological attack” on established interventions.

The blueprint document, “Putting Full Recovery First,” was published in
March and is supported by eight government agencies, including the
Department of Health. It comforms to the official governmental drug
strategy published in December 2010.

Opponents include top HIV/AIDS charities the Terrence Higgins Trust (THT)
and the National AIDS Trust (NAT), and the drugs/human rights charity
Release. The coalition wrote to Drugs Minister Lord Henley and Prime
Minister David Cameron warning the plan would be “disastrous” for drug-
dependent people.

The charities say the plan overreaches governmental strategies to
prioritize abstinence and “full recovery” above “proven” drug treatments
such as methadone for heroin addiction. Conservative Member of Parliament
David Burrowes helped draft the plan and disagrees, adding that charities
and service providers collaborated on the document.

The coalition labeled the full recovery concept as disingenuous considering
the propensity for relapse and the potential for transmitting blood-borne
viruses should “evidence-based interventions” like needle-exchange programs
cease. The charities upheld evidence crediting NEPs for the low HIV
prevalence among UK injecting drug users (IDUs), and they acknowledged
substitute treatments for reducing overdose rates.

Advocates also fear the plan’s compensation of service providers per person
becoming “chemical-free” trivializes “the complex nature of drug
dependence.” The coalition noted that the absence of a comprehensive cost
analysis could find service providers trying to ensure their compensation
by excluding those less likely to recover fully. THT Policy Director Lisa
Power admonished Britain against abandoning the harm-reduction models that
have helped curb the spread of HIV among IDUs, which also helped protect
the heterosexual population.
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EU: Supervised injectable heroin treatment is expensive but cost effective,
report says
Rory Watson, News BMJ (23.04.12) [Extract]

BMJ 2012;344:e2942

Medicinal heroin is being used successfully in several countries as a
second line treatment for chronic heroin users previously considered
untreatable, says a new report from the European Monitoring Centre for
Drugs and Drug Addiction.

The report describes the treatment as “an important clinical step forward”
and provides an overview of research on the subject setting out evidence
and clinical experience gained in Denmark, Germany, the Netherlands, the
United Kingdom, and Switzerland, countries where supervised injectable
heroin treatment is legally available to long term, refractory opioid
users. In Spain and Canada it may be used in research trials.

Presenting the report, Wolfgang Götz, the centre’s …
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________________________________*_________________________________
* SAFETY OF INJECTIONS brief yourself at: www.injectionsafety.org

A fact sheet on injection safety is available at:
http://www.who.int/mediacentre/factsheets/fs231/en/index.html

* Visit the WHO injection safety website and the SIGN Alliance Secretariat
at: http://www.who.int/injection_safety/en/

* Download the WHO Best Practices for Injections and Related Procedures
Toolkit March 2010 [pdf 2.47Mb]:
http://whqlibdoc.who.int/publications/2010/9789241599252_eng.pdf

Use the Toolbox at: http://www.who.int/injection_safety/toolbox/en/

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791 3680, Facsimile: +41 22 791 4836, E- mail: sign@who.int
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SIGN meets annually to aid collaboration and synergy among SIGN network
participants worldwide.

The 2010 annual Safe Injection Global Network meeting was held from 9
to 11 November 2010 in Dubai, The United Arab Emirates.

The SIGN 2010 meeting report pdf, 1.36Mb is available on line at:
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The report is navigable using bookmarks and is searchable. Viewing
requires the free Adobe Acrobat Reader at: http://get.adobe.com/reader/

Translation tools are available at: http://www.google.com/language_tools
or http://www.freetranslation.com
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Use of trade names and commercial sources is for identification only and
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SIGNpost Website

The new website http://SIGNpostOnline.info is a work in progress and will
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We would like your help in building this archive. Please send your old
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The SIGN Internet Forum was established at the initiative of the World
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