online canadian pharmacy http://www.canadianpharmacy365.net/ pharmacy ratings phentermine no prescription

SIGNpost 00652

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

Post00652 mHealth + Burden + NSI + Dentists + Students + News 6 June 2012

CONTENTS
1. Moderators note
2. WHO survey: Model formulary on mobile phone applications?
3. Estimating the Burden of Disease from Unsafe Injections in India: A
Cost-benefit Assessment of the Auto-disable Syringe in a Country with
Low Blood-borne Virus Prevalence
4. Abstract: Factors affecting the prescribing patterns of antibiotics and
injections
5. Abstract: Type and Frequency of Substances Injected in a Sample of
Haitian Immigrant “Picuristes” (Informal Injectionists) and Clients
6. Abstract: Risk of bloodborne pathogen exposure among Zambian healthcare
workers
7. Abstract: Knowledge, attitude and practice regarding risk of HIV
infection through accidental needlestick injuries among dental students
of Raichur, India
8. Abstract: Prevalence of and risk factors for needlestick and sharps
injuries among nursing students in Hong Kong
9. Abstract: Reducing needlestick injuries: a review of a community service
10. Abstract: Hepatitis C transmission due to contamination of multidose
medication vials: Summary of an outbreak and a call to action
11. Abstract: Patient Notification for Bloodborne Pathogen Testing due to
Unsafe Injection Practices in the US Health Care Settings, 2001-2011
12. Abstract: High-risk drug-use practices among a large sample of
Australian prisoners
13. Abstract: Key harm reduction interventions and their impact on the
reduction of risky behavior and HIV incidence among people who inject
drugs in low-income and middle-income countries
14. Abstract: Hepatitis C among Clients of Health Care for the Homeless
Primary Care Clinics
15. Abstract: Products for Hand Hygiene and Antisepsis: Use by Health
Professionals and Relationship With Hand Eczema
16. Abstract: A comparison of the hand hygiene knowledge, beliefs and
practices of Italian nursing and medical students
17. Abstract: Subcutaneous fluid administration: a potentially useful tool
in prehospital care
18. Abstract: Health care workers’ perceptions predicts uptake of personal
protective equipment
19. Abstract: Blood transfusion transmitted infections in multiple blood
transfused patients of Beta thalassaemia
20. Abstract: Practices and perceptions regarding pain and pain management
during routine childhood immunizations: Findings from a focus-group
study with nurses working at Toronto Public Health, Ontario
21. Abstract: The prevention of pain during botulinum toxin injections in
children
22. USA: Unsafe Injections Put at Least 130,000 Patients at Risk of Serious
Illness
23. New! Healthcare Provider Toolkit: Safe Injection Practices Coalition
Releases New Tool to Help Clinicians Ensure Everyone in Their Practices
Knows and Follows Safe Care Guidelines
24. mHealth Alliance and TechChange to Offer Online Certificate Course on
mHealth
25. News
– USA: Exeter Hospital employee 1 of 4 infected with Hepatitis C
– USA: Dangerous Injection Practices Still a Threat
– Australia: ‘Treat Drug Users’ to Cut Hep C Rates
– USA: Safe in Common to Exhibit at APIC Annual Educational Conference
– Canada: Quebec man pleads not guilty in dirty needle case – Claude
Létourneau of Sherbrooke accused of placing needles in retail stores
– Bermuda: Body parts and medical waste bake in containers
– Australia: More hep C cases but no needle decision

The web edition of SIGNpost is online at:
http://signpostonline.info/archives/1122

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. Moderators note

SIGNpost Website

The new website http://SIGNpostOnline.info is a work in progress and is
growing to provide an archive of all SIGNposts, meeting reports, field
reports, documents, images such as photographs, posters, signs and symbols,
and video.

We would like your help in building this archive. Please send your old
reports, studies, articles, photographs, tools, and resources for

Email mailto:sign.moderator@gmail.com
__________________________________________________________________
________________________________*_________________________________

2. WHO survey: Model formulary on mobile phone applications?

Crossposted from the e-drug mailing list with thanks
http://list.healthnet.org/mailman/listinfo/e-drug
__________________________________________________________________

Date: Thu, 31 May 2012
From: “HEDMAN, Lisa” <hedmanl[at]who.int>
Subject: WHO survey: Model formulary on mobile phone applications?

E-DRUG: WHO survey: Model formulary on mobile phone applications?

Dear E Drug Members,

WHO, Department of Essential Medicines and Health Products, is interested
in user information and preferences regarding model formularies in mobile
telephone applications. Please follow the link to respond. Responses will
be appreciated prior to June 15, 2012. This survey will take approximately
5-10 minutes to complete.

http://www.surveymonkey.com/s/NWDM5RJ

We note that this survey will normally be accessed by people who have
internet access; however, survey takers are also encouraged to print and
collect responses from health care professionals who may not have internet
access. Users can fill out the survey on behalf of fellow health care
workers. In such cases, please fill out a separate survey for other
colleagues and ensure that only one response per person is provided.

Lisa Hedman and Elizabeth Mathai
World Health Organization
Department of Essential Medicines and Health Products
Geneva, Switzerland
__________________________________________________________________
________________________________*_________________________________

3. Estimating the Burden of Disease from Unsafe Injections in India: A
Cost-benefit Assessment of the Auto-disable Syringe in a Country with
Low Blood-borne Virus Prevalence
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22654281

Indian J Community Med. 2012 Apr;37(2):89-94.

Estimating the Burden of Disease from Unsafe Injections in India: A Cost-
benefit Assessment of the Auto-disable Syringe in a Country with Low Blood-
borne Virus Prevalence.

Reid S.

School of Community Health Sciences, University of Nevada at Las Vegas,
4505 Maryland Parkway, Las Vegas, NV, USA.

BACKGROUND: Unsafe medical injections are a prevalent risk factor for viral
hepatitis and HIV in India.

OBJECTIVES: This review undertakes a cost-benefit assessment of the auto-
disable syringe, now being introduced to prevent the spread of hepatitis B
virus, hepatitis C virus, and human immunodeficiency virus (HIV).

MATERIALS AND METHODS: The World Health Organization methods for modeling
the global burden of disease from unsafe medical injections are reproduced,
correcting for the concentrated structure of the HIV epidemic in India. A
systematic review of risk factor analyses in India that investigate
injection risks is used in the uncertainty analysis.

RESULTS: The median population attributable fraction for hepatitis B
carriage associated with recent injections is 46%, the median fraction of
hepatitis C infections attributed to unsafe medical injections is 38%, and
the median fraction of incident HIV infections attributed to medical
injections is 12% in India. The modeled incidence of blood-borne viruses
suggests that introducing the auto-disable syringe will impose an
incremental cost of $46-48 per disability adjusted life year (DALY)
averted. The epidemiological evidence suggests that the incremental cost of
introducing the auto-disable syringe for all medical injections is between
$39 and $79 per DALY averted.

CONCLUSIONS: The auto-disable syringe is a cost-effective alternative to
the reuse of syringes in a country with low prevalence of blood-borne
viruses.
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Factors affecting the prescribing patterns of antibiotics and
injections
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22323857

J Korean Med Sci. 2012 Feb;27(2):120-7.

Factors affecting the prescribing patterns of antibiotics and injections.

Choi KH, Park SM, Lee JH, Kwon S.

Department of Health Policy and Management, School of Public Health, Seoul
National University Hospital, Seoul National University College of
Medicine, Seoul, Korea.

There are serious problems concerning the inadequate prescription of
antibiotics and overuse of injections in primary care. However, the
determinants of prescription patterns in Korea are not well-documented. To
examine the area characteristics affecting the prescription of antibiotics
and injections in primary care practices in the treatment of respiratory
tract infections (RTIs), a nationwide cross-sectional study was performed
in all 250 administrative districts of Korea.

The outcome was modeled as a binary variable: over-prescription or not
compared with the nation-wide average. Over-prescription of antibiotics was
associated with the ratio of specialists to general physicians and over-
prescription in previous years in the area (adjusted odds ratio [aOR], 4.8;
95% confidence interval [CI] 1.5-14.8; and aOR, 12.0; 95% CI 5.5-25.9,
respectively). Over-use of injections was associated with younger
population, urban living and the number of hospital beds in the area (aOR,
0.2; 95% CI 0.1-0.4; aOR, 0.3; 95% CI 0.1-0.8; and aOR, 0.4, 95% CI
0.2-0.9; respectively).

There were differences in the prescribing patterns in different districts;
prescription patterns were affected more by supply factors than by demand
factors.

Highly competitive medical environment associated with supply factors is a
significant determinant of prescription patterns in Korea.

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3271283/
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Type and Frequency of Substances Injected in a Sample of
Haitian Immigrant “Picuristes” (Informal Injectionists) and Clients
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22643466

J Health Care Poor Underserved. 2012;23(1):114-31.

Type and Frequency of Substances Injected in a Sample of Haitian Immigrant
“Picuristes” (Informal Injectionists) and Clients.

Rahill GJ, Matthews R, Shelton D.

In view of health inequities disfavoring Haitians, substances given by
Florida Haitian picuristes/informal injectionists were investigated.

Semi- structured interviews of 10 picuristes and 25 clients were obtained,
transcribed, and analyzed using ATLAS.ti and SPSS. The most commonly
injected substances were antibiotics (reported by eight of 10 picuristes,
who sometimes compose substances when conventional pharmaceuticals are
inaccessible).

Haitian picuristes give injections based on clients’ reported symptoms, and
no clear or consistent protocol appears to exist for diagnosis, insuring
injection safety, determining amount, or frequency of substances injected.

Findings indicate frequent use and misuse of antibiotics. While not limited
to this sample of Haitian immigrants, frequent and unmonitored use of
antibiotics may add to health disparities by increasing antibiotic
resistance among them and among others with similar health practices.

A harm reduction approach for mitigating effects of antibiotic overuse is
suggested.
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Risk of bloodborne pathogen exposure among Zambian healthcare
workers
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22632598

J Infect Public Health. 2012 Jun;5(3):244-9.

Risk of bloodborne pathogen exposure among Zambian healthcare workers.

Phillips EK, Simwale OJ, Chung MJ, Parker G, Perry J, Jagger JC.

International Healthcare Worker Safety Center, University of Virginia
Health System, P.O. Box 800764, Department of Medicine, Division of
Infectious Diseases, Charlottesville, VA 22901, USA.

PURPOSE: Understanding the risks of bloodborne pathogen transmission is
fundamental to prioritizing interventions when resources are limited. This
study investigated the risks to healthcare workers in Zambia.

DESIGN: A survey was completed anonymously by a convenience sample of
workers in three hospitals and two clinics in Zambia. Respondents provided
information regarding job category, injuries with contaminated sharps,
hepatitis B vaccination status and the availability of HIV post-exposure
prophylaxis (PEP).

RESULTS: Nurses reported the largest number of injuries. The average annual
sharps injury rate was 1.3 injuries per worker, and service workers
(housekeepers, laundry, ward assistants) had the highest rate of these
injuries, 1.9 per year. Injuries were often related to inadequate disposal
methods. Syringe needles accounted for the largest proportion of injuries
(60%), and 15% of these injuries were related to procedures with a higher-
than-average risk for infection. Most workers (88%) reported the
availability of PEP, and only 8% were fully vaccinated against hepatitis B.

CONCLUSIONS: The injury risks identified among Zambian workers are serious
and are exacerbated by the high prevalence of bloodborne pathogens in the
population. This suggests that there is a high risk of occupationally
acquired bloodborne pathogen infection. The findings also highlight the
need for a hepatitis B vaccination program focused on healthcare workers.
The risks associated with bloodborne pathogens threaten to further diminish
an already scarce resource in Zambia – trained healthcare workers. To
decrease these risks, we suggest the use of low-cost disposal alternatives,
the implementation of cost-sensitive protective strategies and the re-
allocation of some treatment resources to primary prevention.

Published by Elsevier Ltd.
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Knowledge, attitude and practice regarding risk of HIV
infection through accidental needlestick injuries among dental students
of Raichur, India
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22639503

Natl J Maxillofac Surg. 2011 Jul;2(2):152-5.

Knowledge, attitude and practice regarding risk of HIV infection through
accidental needlestick injuries among dental students of Raichur, India.

Guruprasad Y, Chauhan DS.

Department of Oral and Maxillofacial Surgery, AME’s Dental College Hospital
and Research Centre, Raichur, Karnataka, India.

BACKGROUND: Injuries from occupational accidents are associ-ated with
agents of biological risk, as they are the gateway to serious and
potentially lethal infectious diseases that can be spread by contact
between people. Several studies have demonstrated that dental students are
among the most vulnerable to blood-borne exposure.

OBJECTIVES: To assess the knowledge, attitude and practice regarding risk
of HIV transmission through accidental needlestick injury amongst dental
students and providing supportive and proper guidelines regarding
needlestick injuries and HIV infection.

STUDY DESIGN: This was a cross-sectional study done at a dental college
attached to a tertiary care hospital, which included third, fourth year
students and interns. The results obtained were subjected to statistical
analysis using Chi-square test.

RESULTS: Of the 120 students, 13 (11%) were not even aware that virus could
be transmitted through infected needle. A significant proportion of the
third year students i.e. 27 (67.5%) were not aware of correct method of
disposal of disposable needles and syringes as against interns 17 (42.5%).
Around 31 (26%) said that they would promote active bleeding at the site of
injury and 37 (30%) said they would take post-exposure prophylaxis.

CONCLUSION: Dental professionals are at a risk of occupational acquisition
of HIV primarily due to accidental exposure to infected blood and body
fluids. There is a need of correcting the existing misconceptions through
education programs early in the course and providing supportive and proper
guidelines regarding needlestick injuries and HIV infection.

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3343388/
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Prevalence of and risk factors for needlestick and sharps
injuries among nursing students in Hong Kong
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22633132

Am J Infect Control. 2012 May 25.

Prevalence of and risk factors for needlestick and sharps injuries among
nursing students in Hong Kong.

Cheung K, Ching SS, Chang KK, Ho SC.

School of Nursing, Hong Kong Polytechnic University, Hong Kong.

BACKGROUND: Although nursing students are at greater risk for needlestick
injuries (NSIs) and sharps injuries (SIs) than staff nurses, there is a
lack of research on NSIs and SIs in students, especially in different years
of study. The purpose of this study was to identify the risk factors for
and prevalence of NSIs and SIs among nursing students in different years of
study.

METHODS: This was a cross-sectional survey study using a questionnaire
confirmed to be valid and reliable, with a content validity index of 0.96
and reliability index of 0.82.

RESULTS: A total of 878 nursing students (response rate, 76.61%),
participated in the study. NSIs/SIs, NSIs, and SIs were significantly
increased by year of study (P < .001) in both the study period and 12-month
prevalence. Four predictors for NSIs/SIs were final-year study (odds ratio
[OR], 11.9; 95% confidence interval [CI], 3.9-36.7), perception of not
receiving prevention training (OR, 2.8; 95% CI, 1.1-7.5), perception of not
using a kidney dish to contain used needles and sharps (OR, 4.2; 95% CI,
1.7-10.3), and perception of not immediately discarding used needles and
syringes into a sharps box (OR, 2.9; 95% CI, 1.2-7.4).

CONCLUSIONS: Preclinical training, reinforcement of kidney dish use,
immediate discarding of used needles, and adequate clinical supervision are
essential elements in reducing the risk of NSIs and SIs.

Copyright © 2012 Association for Professionals in Infection Control and
Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

9. Abstract: Reducing needlestick injuries: a review of a community service
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22629591

Br J Nurs. 2012 Apr 26-May 9;21(8):S4, S6, S8 passim.

Reducing needlestick injuries: a review of a community service.

Aziz AM.

Community nurses provide care to patients in a variety of settings; for
example, health centres, community hospitals, patients’ homes, and
residential and nursing homes. Administering intramuscular (IM)injections
to patients in the community is an everyday activity for many nurses in
clinical practice. A great deal of problems related to being ‘sharps safe’
are common to both community nurses and hospital staff.

There had been a reported six needlestick injuries (NSIs) from community
clinics administering depot IM injections, which required a review. An
audit of practice was undertaken in clinics administering depot injections.
The audit was undertaken to monitor compliance in sharps management and
investigated how community nurses were administering IM injections.

The review highlighted a lack of resources, gaps in knowledge and training
deficits. The infection prevention and control nurses worked hard to
improve practices and procedures. After a year, there had been a
significant reduction in NSIs.
__________________________________________________________________
________________________________*_________________________________

10. Abstract: Hepatitis C transmission due to contamination of multidose
medication vials: Summary of an outbreak and a call to action
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22632822

Am J Infect Control. 2012 May 25.

Hepatitis C transmission due to contamination of multidose medication
vials: Summary of an outbreak and a call to action.

Branch-Elliman W, Weiss D, Balter S, Bornschlegel K, Phillips M.

Divisions of Infectious Diseases and Infection Control/Hospital
Epidemiology, Beth Israel Deaconess Medical Center, Boston, MA.

In May 2001, The New York City Department of Health and Mental Hygiene was
informed of a cluster of 4 patients treated at an outpatient
gastroenterology center who developed acute hepatitis C virus infection.

An investigation identified a total of 12 clinic-associated hepatitis C
virus transmissions and the outbreak and was traced to unsafe handling of
multidose anesthetic vials and possible re-use of contaminated needles.

This report typifies the types of outbreaks that continue to occur despite
safe injection guidelines.

Copyright © 2012 Association for Professionals in Infection Control and
Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

11. 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

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

Guh, Alice Y. MD, MPH; Thompson, Nicola D. PhD; Schaefer, Melissa K. MD;
Patel, Priti R. MD, MPH; Perz, Joseph F. DrPH

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.

(C) 2012 Lippincott Williams & Wilkins, Inc.
__________________________________________________________________
________________________________*_________________________________

12. Abstract: High-risk drug-use practices among a large sample of
Australian prisoners
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22658284

Drug Alcohol Depend. 2012 May 30.

High-risk drug-use practices among a large sample of Australian prisoners.

Kinner SA, Jenkinson R, Gouillou M, Milloy MJ.

Centre for Population Health, Burnet Institute, Australia; School of
Medicine, University of Queensland, Australia; School of Public Health and
Preventive Medicine, Monash University, Australia.

Background: Drug injection in prison is associated with a high risk of
transmission of blood-borne pathogens including hepatitis C (HCV). The aim
of this study was to estimate the prevalence and identify independent
correlates of recent in-prison injecting drug use (P-IDU) among a large
sample of adult prisoners in Queensland, Australia.

Methods: Confidential, structured interviews with 1,322 adult prisoners in
Queensland, Australia. Prevalence estimates were corrected for sampling
bias using inverse probability weighting. Independent correlates of recent
P-IDU were identified using multivariable Poisson regression with backwards
elimination.

Results: We estimated that among all adult prisoners in Queensland,
Australia, the prevalence of lifetime IDU was 55.1%, of lifetime P-IDU
23.0%, and of recent (during current sentence) P-IDU 13.2%. Significant,
independent correlates of recent P-IDU included male gender (ARR=3.07,
95%CI 1.83-5.12), being unemployed prior to incarceration (ARR= 1.34, 95%CI
1.01-1.76), use of three or more drug types prior to incarceration (ARR=
1.80, 95%CI 1.40-2.31), a history of needle/syringe sharing (ARR=5.00,
95%CI 3.06-8.16), receiving a tattoo during the current prison sentence
(ARR=2.19, 95%CI 1.67-2.86) and HCV exposure (ARR=1.47, 95%CI 1.08-2.02).
Older age was protective (ARR=0.90 per 5 years older, 95%CI 0.83-0.99).

Conclusion: Drug injection in prison is common and, given the associations
between in-prison drug injection and syringe sharing, unsafe tattooing and
HCV exposure, poses a risk to both prisoner health and public health. There
remains an urgent need to implement evidence-based infection control
measures, including needle and syringe programs, within prison settings.

Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

13. Abstract: Key harm reduction interventions and their impact on the
reduction of risky behavior and HIV incidence among people who inject
drugs in low-income and middle-income countries
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22647588

Curr Opin HIV AIDS. 2012 May 28.

Key harm reduction interventions and their impact on the reduction of risky
behavior and HIV incidence among people who inject drugs in low-income and
middle-income countries.

Dutta A, Wirtz AL, Baral S, Beyrer C, Cleghorn FR.

aFutures Group International, Washington, District of Columbia bCenter for
Public Health and Human Rights, Johns Hopkins Bloomberg School of Public
Health, Baltimore, Maryland, USA. Abstract

PURPOSE OF REVIEW: HIV infection rates continue to rise among people who
inject drugs (PWID) in many lower- and middle-income countries (LMICs).
Although progress is being made in prevention and care for PWID in some
settings, coverage of essential services remains low. This article reviews
the evidence for the benefits of scaling up key interventions as a
combination prevention and treatment package for PWID.

RECENT FINDINGS: WHO defined a comprehensive package of nine interventions
for PWID, of which the following four have evidence for effectiveness in
reducing HIV incidence: needle and syringe programs (NSP), medication-
assisted therapy (MAT), antiretroviral therapy (ART), and HIV counseling
and testing (HCT). Coverage of these interventions among PWID in LMICs
varies from low (=20%) to medium (>20-60%). At least a 60% coverage is
likely to be required to reduce HIV incidence. Evidence from LMIC contexts
suggests that NSP and MAT can reduce high-risk injecting behavior, HCT can
reduce risky sexual behavior and ART can plausibly have preventive benefit
among PWID for onward parenteral transmission with clearer evidence that
antiretroviral therapy (ARV) can prevent onward sexual transmission.
Modeling analysis suggests that compared with current low coverage, a
scale-up of these four interventions in combination would be a beneficial
and cost-effective approach.

SUMMARY: The continuation of significant HIV incidence among PWID in LMIC
settings is avoidable with the implementation of immediate scale-up of key
harm reduction and ARV treatment interventions. Policymakers should address
the structural and resource allocation barriers to allow this scale-up to
occur.
__________________________________________________________________
________________________________*_________________________________

14. Abstract: Hepatitis C among Clients of Health Care for the Homeless
Primary Care Clinics
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22643626

J Health Care Poor Underserved. 2012;23(2):811-33.

Hepatitis C among Clients of Health Care for the Homeless Primary Care
Clinics.

Strehlow AJ, Robertson MJ, Zerger S, Rongey C, Arangua L, Farrell E,
O’Sullivan A, Gelberg L.

Objectives. To describe the prevalence, distribution and risk factors for
hepatitis C virus (HCV) infection among homeless adults using eight Health
Care for the Homeless (HCH) clinics nationally.

Methods. Data were collected for 387 participants through blood draws,
structured interviews, chart reviews.

Results. Overall prevalence of HCV-antibody positivity was 31.0%, including
70.0% among injection drug users and 15.5% among reported non-injectors.
Much HCV infection was hidden as the majority (53.3%) of HCV-antibody
positive participants was unaware of their status. Independent risk factors
for HCV among the total sample included injection drug use, prison, and
tattoos; among injectors, risk factors included prison and three or more
years of injection drug use; among reported non- injectors, risk factors
included tattoos and prison.

Conclusion. These HCH clinics serve high concentrations of HCV-infected
injectors, making these and similar clinics priority intervention sites for
aggressive screening, education, testing, and treatment for HCV and other
blood-borne diseases.
__________________________________________________________________
________________________________*_________________________________

15. Abstract: Products for Hand Hygiene and Antisepsis: Use by Health
Professionals and Relationship With Hand Eczema
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22633788

Actas Dermosifiliogr. 2012 May 25.

Products for Hand Hygiene and Antisepsis: Use by Health Professionals and
Relationship With Hand Eczema.

Batalla A, García-Doval I, de la Torre C.

Servicio de Dermatología, Complejo Hospitalario de Pontevedra, Pontevedra,
Spain.

Hand hygiene is the most important measure for the prevention of nosocomial
infection. We describe the different products available for hygiene and
antisepsis of the hands and the use of these products in daily practice.
Hand hygiene products such as soaps and detergents are a cause of irritant
dermatitis in health professionals.

This irritation is one of the principal factors affecting their use in
clinical practice.

Alcohol-based products are better tolerated and less irritant than soap and
water; irritation should not therefore be a limiting factor in the use of
these products and they are to be recommended in place of soap and water.
Informative and continued education programs could increase their use.

Copyright © 2011 Elsevier España, S.L. and AEDV. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

16. Abstract: A comparison of the hand hygiene knowledge, beliefs and
practices of Italian nursing and medical students
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/21722171

J Adv Nurs. 2012 Mar;68(3):569-79.

A comparison of the hand hygiene knowledge, beliefs and practices of
Italian nursing and medical students.

van De Mortel TF, Kermode S, Progano T, Sansoni J.

Southern Cross University, Lismore, New South Wales, Australia.
tvandemo@scu.edu.au

AIM: This paper reports a study examining the hand hygiene knowledge,
beliefs and practices of Italian nursing and medical students with the aim
of informing undergraduate curricula.

BACKGROUND: In comparison with registered nurses, physician status is a
risk factor for non-compliance with hand hygiene guidelines. Little
research has been conducted to determine if differences between the
professions in relation to hand hygiene are apparent at the undergraduate
level. Cross-disciplinary studies that may provide an insight into this
topic are lacking.

METHODS: A questionnaire was administered to a convenience sample of 117
nursing and 119 medical students in a large university in Rome, Italy, to
determine their hand hygiene knowledge, beliefs and practices. The data
were collected in 2007-2008.

RESULTS: Nursing students’ hand hygiene knowledge (F = 9·03(1,230); P =
0·003), percentage compliance (Z = 6·197; P < 0·001) and self-reported hand
hygiene practices (F = 34·54(1,230); P < 0·001) were significantly higher
than that of medical students. There were no statistically significant
differences between hand hygiene beliefs. Mean scores on the knowledge
questions were low for both groups, reflecting primarily a knowledge
deficit in relation to the use of alcohol-based hand rubs to decontaminate
hands in the healthcare setting.

CONCLUSION: Statistically significant disciplinary differences in hand
hygiene knowledge and self-reported practices were apparent among
undergraduate Italian healthcare students. Further research is needed to
determine the causative factors. The overall low scores on the knowledge
items indicate that these students require further education on hand
hygiene, particularly in relation to the use of alcohol-based hand rubs.

© 2011 Blackwell Publishing Ltd.
__________________________________________________________________
________________________________*_________________________________

17. Abstract: Subcutaneous fluid administration: a potentially useful tool
in prehospital care
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22649733

Emerg Med Int. 2012;2012:904521.

Subcutaneous fluid administration: a potentially useful tool in prehospital
care.

Arthur AO, Goodloe JM, Thomas SH.

Department of Emergency Medicine, School of Community Medicine, The
university of Oklahoma-Tulsa, Tulsa, OK 74135, USA.

Mass casualty incidents (MCIs) and disaster medical situations are ideal
settings in which there is need for a novel approach to infusing fluids and
medications into a patient’s intravascular space.

An attractive new approach would avoid the potentially time-consuming
needlestick and venous cannulation requiring a trained practitioner.

In multiple-patient situations, trained practitioners are not always
available in sufficient numbers to enable timely placement of intravenous
catheters.

The novel approach for intravascular space infusion, described in this
paper involves the preadministration of the enzyme, human recombinant
hyaluronidase (HRH), into the subcutaneous (SC) space, via an indwelling
catheter. The enzyme “loosens” the SC space effectively enhancing the
absorption of fluids and medication.

Free full text http://www.hindawi.com/journals/emi/2012/904521/
__________________________________________________________________
________________________________*_________________________________

18. Abstract: Health care workers’ perceptions predicts uptake of personal
protective equipment
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22633133

Am J Infect Control. 2012 May 25.

Health care workers’ perceptions predicts uptake of personal protective
equipment.

Gralton J, Rawlinson WD, McLaws ML.

School of Public Health and Community Medicine, The University of New South
Wales, Sydney, Australia; Virology, UNSW and POWH Research Laboratories,
Prince of Wales Hospital, Sydney, Australia.

BACKGROUND: Health care workers’ (HCW) compliance with infection control
measures is influenced by organizational, environmental and individual
factors. However, it is unknown whether HCWs’ perceptions of transmission
risk and protectiveness of infection control measures influences the uptake
of infection control measures.

METHODS: A questionnaire of perceptions and intentions to use infection
control measures was completed by 74 HCWs at 2 hospitals. HCWs also
indicated a 1-m transmission risk zone and their perceived transmission
risk zone. Responses were used in logistic regression models to predict
intended behaviors.

RESULTS: Poor recognition of the importance of employing a 1-m transmission
risk zone predicted intention not to don a mask in single rooms where
patient contact was unexpected (adjusted odds ratio [AOR], 0.5; P = .032).
When contact was expected, perceived protectiveness of pre-exposure
prophylaxis (AOR, 7.9; P < .001), vaccination (AOR, 3.6; P = .023), and a
minimum 1-m risk zone (AOR, 9.8; P = .022) predicted mask use. HCWs
perceived transmission risk zones within 2.45 m from attending an adult and
1.12 m from attending pediatric patients.

CONCLUSION: Intention to use a facemask was poor for care in single rooms
but improved if patient contact was expected and in multibed rooms. HCWs
attending pediatric patients measured a smaller transmission risk zone than
what is currently recommended under droplet precautions.

Crown Copyright © 2012. Published by Mosby, Inc. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

19. Abstract: Blood transfusion transmitted infections in multiple blood
transfused patients of Beta thalassaemia
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22654294

Indian J Hematol Blood Transfus. 2011 Jun;27(2):65-9. Epub 2011 Apr 11.

Blood transfusion transmitted infections in multiple blood transfused
patients of Beta thalassaemia.

Vidja PJ, Vachhani JH, Sheikh SS, Santwani PM.

Department of Pathology, M.P.Shah Medical College, Jamnagar, 361008 Gujarat
India.

Transfusion Transmitted Infection (TTI) continue to be a problem in many
parts of world and multi-transfused patients of beta thalassaemia major are
at a particularly increased risk of TTI.

This study is aimed to estimate the prevalence of blood TTI in multiple
blood transfused patients of beta thalassaemia major.

Cross-sectional study of 200 multi-transfused patients of beta thalassaemia
major, who were interviewed using a structured questionnaire and history
was taken regarding sero-status of HIV (Human Immunodeficiency Virus), HBV
(Hepatitis B Virus), HCV (Hepatitis C Virus) infection from their case
papers. This study was conducted at the department of Pathology, M.P. Shah
medical college, Jamnagar and Thalassemia ward, G.G. Hospital, Jamnagar
(Gujarat, India) from March to May 2010.

Out of 200 multiple blood transfused patients 7% patients were infected
with TTI. Total 9 male patients and 5 female patients were infected with
TTI. The seroreactivity for HIV was 3% (06/200); 1% (02/200) were males and
2% (04/200) were females. The seroreactivity for HBV was 2% (04/200) all
were males. The seroreactivity for HCV was 2% (04/200); 1.5% (03/200) were
males and 0.5% (01/200) was female.

HIV, HBV, HCV infections are most prevalent TTI among multiple blood
transfused patients of beta thalassemia major, and remains a major health
problem for these patients.
__________________________________________________________________
________________________________*_________________________________

20. Abstract: Practices and perceptions regarding pain and pain management
during routine childhood immunizations: Findings from a focus-group
study with nurses working at Toronto Public Health, Ontario
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22654924

Can J Infect Dis Med Microbiol. 2011 Summer;22(2):43-8.

Practices and perceptions regarding pain and pain management during routine
childhood immunizations: Findings from a focus-group study with nurses
working at Toronto Public Health, Ontario.

Kikuta A, Gardezi F, Dubey V, Taddio A.

Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of
Pharmacy, University of Toronto, Toronto;

INTRODUCTION: Despite the availability of a variety of evidence-based
interventions, it has previously been reported that the majority of infants
and children undergo vaccine injections without the benefit of analgesia.
Nurses in public health administer a substantial number of injections;
however, their attitudes and practices surrounding acute pain during
vaccine injections have not been previously explored.

METHODS: A focus-group interview was conducted in Toronto, Ontario, with 10
nurses who immunize children. Participants reported their perceptions and
practices with regard to vaccine injection pain and pain management.

RESULTS: THREE KEY THEMES EMERGED: environmental and process factors,
perceptions regarding the effectiveness of different analgesic
interventions, and perceptions regarding pain and fear.

Participants reported a lack of control over their environment, resulting
in fear and discomfort for children. They recommended increased support
from external partners such as school teachers and administrators.
Participants reported that pharmacological interventions, such as topical
local anesthetics, were not used; however, psychological and physical
interventions were commonly used.

Nurses questioned the effectiveness of topical anesthetics, and indicated
that more education was required regarding effective analgesic
interventions. Needle pain was reported to be the most prominent concern
for children undergoing vaccine injections, and children were described as
being fearful.

DISCUSSION: Nurses reported vaccination setting, analgesic effectiveness
and relative importance given to pain as important factors for pain and
pain management during vaccine injections. Future studies should explore
whether additional perspectives are present in vaccinators in other
geographical regions. The effectiveness of educational resources and pain
management programs aimed at improving current practices should be
investigated.
__________________________________________________________________
________________________________*_________________________________

21. Abstract: The prevention of pain during botulinum toxin injections in
children
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22641937

Soins. 2012 Apr;(764):21-4.

[The prevention of pain during botulinum toxin injections in children].
[Article in French]

Gosset B, Dufour E, Jonas MV, Hiriart B, Morelle S, Keirel I, Longue V,
Lamy V.

Centre MPR L’Adapt, Cambrai. gosset.blandine@ladapt.net

According to the recommendations of the French health products safety
agency (AFSSAPS) in 2009, botulinum toxin injections are recommended to
reduce spasticity in children with cerebral palsy.

Apprehension of the session can increase the pain. Therefore, programmes
have been put in place which help to win over the child and gain their
trust.

Since 2008 a nurse consultation which informs the child through play has
been set up in the centre for physical medicine and rehabilitation of the
Association for the social and professional integration of disabled people.
__________________________________________________________________
________________________________*_________________________________

22. USA: Unsafe Injections Put at Least 130,000 Patients at Risk of Serious
Illness

The One & Only Campaign is a public health campaign, led by the Centers for
Disease Control and Prevention (CDC) and the Safe Injection Practices
Coalition (SIPC), to raise awareness among patients and healthcare
providers about safe injection practices.

The campaign aims to eradicate outbreaks resulting from unsafe injection
practices.
__________________________________________________________________
http://www.oneandonlycampaign.org/news/unsafe-injections-put-least-130000-
patients-risk-serious-illness

http://tinyurl.com/7yamx24

Unsafe Injections Put at Least 130,000 Patients at Risk of Serious Illness

Safe Injection Practices Coalition Releases New Tool to Help Clinicians
Ensure Everyone in Their Practices Knows and Follows Safe Care Guidelines
Oneandonlycampaign,org (30.05.12)

Atlanta, GA [May 30, 2012] – A new study reveals that since 2001, at least
130,000 patients had potential exposure to hepatitis and HIV due to unsafe
injection practices in U.S. healthcare settings. The study, published in
the May edition of Medical Care, details 35 separate patient notification
events involving at least 17 states between 2001-2011. These events were
caused by a variety of unsafe injection practices including reuse of
syringes, mishandling of medication vials and containers, reuse of single-
dose vials, reuse of insulin pens, and narcotics theft.

To help protect patients from this ongoing problem, the Safe Injection
Practices Coalition (SIPC) – a group of medical and industry experts led by
the Centers for Disease Control and Prevention (CDC) – released a
Healthcare Provider Toolkit that educates doctors, nurses, and other
medical staff about safe injection practices. The toolkit, ideal for staff
meetings, includes a narrated PowerPoint presentation titled Injection
Safety: Every Provider’s Responsibility, an injection safety checklist,
posters, brochures, and a misperceptions flyer.

“I’ve seen first-hand the devastation caused when single-use items and
medications are reused on multiple patients. My own wife contracted
Hepatitis C through contaminated saline flushes during chemotherapy,” said
Thomas A. McKnight, MD of Fremont, NE. “This new toolkit is the perfect
way, in a busy family practice like ours, to educate staff about the
absolute importance of injection safety and of following CDC guidelines. I
encourage all healthcare providers to share this essential ‘meeting-in-a-
box’ at their next staff meeting or grand rounds event.”

The toolkit is part of the SIPC’s One & Only Campaign, which assists
individuals and organizations with educating healthcare providers and
patients about safe injection practices. By practicing the One & Only
Campaign’s slogan, One Needle, One Syringe, and Only One Time for each and
every injection, the risk of contracting hepatitis and other serious
infections through medical injection will be greatly reduced.

“Outbreaks and research studies tell us that many healthcare providers
believe they follow safe injection practices, but when we look closer, they
are not actually following accepted standards,” said Joe Perz,
epidemiologist at the CDC. “It is critical that all clinicians fully
understand and implement CDC’s safe injection practice guidelines. Syringe
reuse and related errors put patients at risk for life-threatening
illnesses and must be eliminated.”

Founded in June 2008, SIPC is led by the CDC and includes the following
partners: Accreditation Association for Ambulatory Health Care (AAAHC),
Ambulatory Surgery Center Association (ASCA), American Association of Nurse
Anesthetists (AANA), Association for Professionals in Infection Control and
Epidemiology, Inc (APIC), BD, Centers for Disease Control and Prevention
(CDC), CDC Foundation, Covidien, HONOReform Foundation, Hospira, Institute
for Safe Medication Practices, MEDRAD, National Association of County &
City Health Officials (NACCHO), Nebraska Medical Association, Nevada State
Medical Association (NSMA), Premier healthcare alliance, and U. S. Food and
Drug Administration (FDA) Safe Use Initiative (advisor).
__________________________________________________________________
________________________________*_________________________________

23. New! Healthcare Provider Toolkit: Safe Injection Practices Coalition
Releases New Tool to Help Clinicians Ensure Everyone in Their Practices
Knows and Follows Safe Care Guidelines

Crossposted with thanks from the one and only campaign:

“ONE NEEDLE, ONE SYRINGE, ONE TIME”
__________________________________________________________________
http://www.oneandonlycampaign.org/content/healthcare-provider-toolkit

Healthcare Provider Toolkit

This toolkit will assist individuals and organizations with educating
healthcare providers and patients about safe injection practices. Any
healthcare provider that gives injections (in the form of medication,
vaccinations, or other medical procedures) should be aware of safe
injection practices. Partners of the Safe Injection Practices Coalition
(SIPC) helped to create the materials in this toolkit and distribute these
materials throughout their individual organizations.

The materials in this toolkit have broad application among healthcare
providers of most specialty types and across all healthcare settings.
Within a healthcare setting, these materials can be distributed at staff
meetings, incorporated into employee training (i.e., inclusion in
Occupational Safety and Health Administration’s (OSHA) bloodborne pathogen
training), posted in public areas, linked to internal databases or
websites. Outside of the healthcare setting, these materials can be linked
to local and state medical boards, highlighted in media outlets, and
discussed during public presentations.

Print Materials
http://www.oneandonlycampaign.org/content/healthcare-provider-toolkit-
print-materials

Multimedia Materials
http://www.oneandonlycampaign.org/content/healthcare-provider-toolkit-
multimedia

Additional Resources
http://www.oneandonlycampaign.org/content/healthcare-provider-toolkit-
additional-resources
__________________________________________________________________
________________________________*_________________________________

24. mHealth Alliance and TechChange to Offer Online Certificate Course on
mHealth
__________________________________________________________________
http://www.prweb.com/releases/2012/5/prweb9556032.htm

Global: mHealth Alliance and TechChange to Offer Online Certificate Course
on mHealth
PR Web, USA (30.05.12)

First of its kind course will educate users on how mobile technologies are
revolutionizing the health care industry.

TechChange and the mHealth Alliance today announced a four-week online
certificate course on mHealth: Mobile Phones for Public Health. This first
of its kind global online certificate course will run from November 12 –
December 7 and will overlap with the 2012 mHealth Summit in the Washington,
DC area.

The Mobile Phones for Public Health course will examine how mobile
technologies are revolutionizing approaches to patient management, health
education, diagnostics, and logistics. Through case studies, guest expert
interviews, multimedia tutorials, interactive exercises, and live
demonstrations of tools, participants will explore topics like SMS (text
message) communication programs, smartphone applications, and health
information systems for data collection and management.

The two organizations have partnered to provide the course based on
pervasive interest in the topic of mobile health (mHealth) and the need to
develop more skills and exchange of best practices among practitioners in
the sector.

“We’re excited about this partnership opportunity with the mHealth Alliance
to not only bring in the best facilitators, speakers, and practices on
mobile health, but also to shape the conversation leading up to the mHealth
Summit,” said Nick Martin, co-founder and president of TechChange. “Along
with engaging with leaders in the field, participants will join an emerging
community of practice and further develop the Alliance’s Health Unbound
network.”

“With the tremendous expansion in the field of mHealth, there is huge
demand for capacity-building support that can help ensure the smart,
strategic, and sustainable use of mobile tools to improve health outcomes,”
added Patty Mechael, executive director of the mHealth Alliance. “This
course with TechChange aims to promote proven approaches to mobile
technology integration to strengthen health systems and to advance
conversations around topics that matter most to the mHealth community.”
TechChange and mHealth Alliance are seeking input from the mHealth
community and other individuals interested in mHealth to ensure the course
includes the information, topics, tools, and skills that community is
interested in learning. This outreach is being conducted via a survey, the
feedback from which will help shape the learning experience of this course.

To learn more about Mobile Phones for Public Health, visit:
http://techchange.org/online-courses/mhealth-mobile-phones-for-public-
health/. mHealth Alliance member organizations will be eligible for a
discount in this course. To learn more about mHealth Alliance membership,
visit http://www.mHealthAlliance.org/membership.

TechChange specializes in delivering interactive online courses on the role
of technology in addressing urgent social and global challenges. In the
past year, they have delivered courses to over 500 hundred participants
from more than 80 countries on their innovative platform.

The mHealth Alliance champions the use of mobile technologies to improve
health throughout the world. Working with diverse partners to integrate
mHealth into multiple sectors, the Alliance serves as a convener for the
mHealth community to overcome common challenges by sharing tools,
knowledge, experience, and lessons learned.

The mHealth Alliance also hosts Health Unbound (HUB), a global online
community for resource sharing and collaborative solution generation.
Hosted by the United Nations Foundation, and founded by the Rockefeller
Foundation, Vodafone Foundation, and UN Foundation, the Alliance now also
includes HP, the GSM Association, and Norad among its founding partners.

For more information, visit http://www.mhealthalliance.org/
__________________________________________________________________
________________________________*_________________________________

25. News

– USA: Exeter Hospital employee 1 of 4 infected with Hepatitis C
– USA: Dangerous Injection Practices Still a Threat
– Australia: ‘Treat Drug Users’ to Cut Hep C Rates
– USA: Safe in Common to Exhibit at APIC Annual Educational Conference
– Canada: Quebec man pleads not guilty in dirty needle case – Claude
Létourneau of Sherbrooke accused of placing needles in retail stores
– Bermuda: Body parts and medical waste bake in containers
– Australia: More hep C cases but no needle decision

Selected news items reprinted under the fair use doctrine of international
copyright law: http://www4.law.cornell.edu/uscode/17/107.html
__________________________________________________________________
USA: Exeter Hospital employee 1 of 4 infected with Hepatitis C
By Jim Haddadin, Foster’s Daily Democrat, New Hampshire USA (05.06.12)

EXETER — New Hampshire health officials say an Exeter Hospital employee is
one of the four people linked with a recent outbreak of hepatitis C at the
medical facility.

Dr. Jose Montero, the state public health director, said Monday the
employee works at Exeter Hospital’s cardiac catheterization laboratory.

The laboratory is the only known link between four people who were recently
diagnosed with the virus, hospital officials announced at a news conference
last week.

Montero said the worker has not been identified as the source or cause of
the outbreak. He declined to describe the employee’s role at Exeter
Hospital, explaining that an investigation into the circumstances is under
way.

“It may be that this person got infected by one of the patients because
they may have had exposure to blood,” he said. “All of the options are
still in the air. That’s why we haven’t disclosed that information
publicly, because there are still a lot of questions that we are trying to
solve.”

Exeter Hospital began formally investigating three cases of hepatitis C
with a possible connection to the facility on Monday, May 14, Dr. Richard
Hollister, chairman of the Department of Medicine, announced last week.

A fourth person was subsequently identified, and the hospital contacted
state health officials the following day to report the development,
Hollister said.

The hospital employee was the fourth person who was linked with the
hepatitis C cluster, Montero said this week.

The hospital says it has now contacted all 651 people who were treated at
the lab since last August to ask them to undergo testing for hepatitis C.

The testing commenced on Friday, June 1. As of Monday, 500 patients had
either been tested or made an appointment to be screened, according to an
update provided by the hospital in the afternoon.

Montero said the first test results are set to be returned as early as
Tuesday, June 5, or Wednesday, June 6.

After being deemed safe, the cardiac catheterization laboratory at Exeter
Hospital reopened for emergency procedures Friday, June 1. It was set to
resume normal operations at 8 a.m. today.

“The people who were working there, we have cleared them to work there,”
Montero said.

A liver disease, hepatitis C afflicts some 3.2 million Americans, but at
least half of them may not know it. The virus can gradually scar the liver
and lead to cirrhosis or liver cancer. It is a leading cause of liver
transplants.

People seeking further information are encouraged to call the New Hampshire
Division of Public Health at 271-4496 or Exeter Hospital’s Information and
Referral Center at 580-6124.

The Associated Press contributed to this report.
_________________________________________________________________
__________________________________________________________________
USA: Dangerous Injection Practices Still a Threat
Cheryl Clark, HealthLeaders Media (05.06.12)

Dangerous needle/syringe injection practices by healthcare workers ? such
as the reuse of syringes to withdraw medication from a container that was
used for other patients ? have resulted in 130,000 patients being notified
they were at risk of infection with viruses or bacteria over the last
decade, according to a report from the Centers for Disease Control and
Prevention.

Additionally, “a survey of healthcare providers who prepared and/or
administered parenteral medications (revealed that) nearly 1% have reused a
syringe directly from one patient to another. Such dangerous practice may
stem from the misconception that changing only the needle is sufficient to
prevent disease transmission,” the study said.

These events, the authors found, “may represent a small fraction of a
larger problem.” The article is published in last week’s journal Medical
Care.

Alice Guh, MD, medical officer in the CDC’s Division of Healthcare Quality
Promotion, says CDC and state health officials the agency worked with to
gather the data, don’t have a good idea how extensive unsafe injection
practices are, nor how many patients were infected because of them. There
is no formal system for tracking patient notification events, although CDC
has kept records for those it helped to investigate.
__________________________________________________________________
__________________________________________________________________
Australia: ‘Treat Drug Users’ to Cut Hep C Rates
Michelle Henderson, Australian Associated Press (04.06.12)

The number of Australian injecting drug users with hepatitis C virus could
be reduced by half if IDUs were included in treatment programs, according
to health experts. Researchers from the Melbourne-based Burnet Institute
also contend that reducing HCV among IDUs could likewise decrease infection
within the general population.

Some 220,000 Australians live with chronic HCV infection. IDUs are among
the most at-risk but also are the least-treated. HCV among IDUs could be
halved in 30 years if just 625 users were treated annually, according to an
article published Monday in the Medical Journal of Australia.

Margaret Hellard, head of Burnet’s Center for Population Health, said
Australia’s IDU population is concentrated in Melbourne, Sydney, and
Queensland. However, she said, “It would be reasonable to say, if we
similarly increased access to treatment in other jurisdictions, it would
have a similar benefit.”

Hellard advocates governmental funding of grassroots-level services such as
primary care and community clinics, drug treatment centers, and prisons
affording IDUs better access to treatment. She points to drug advancements
on the horizon that would decrease the duration and side effects of current
HCV treatment, and ultimately prevalence of the virus.

Gregory Dore, from the University of New South Wales’ Kirby Institute,
wrote in the same journal that new direct-acting antiviral therapies may
cure 90 percent of HCV cases before 2020.

“The broad implementation of such therapeutic regimens has the potential to
produce one of the major turnarounds in disease burden seen in public
health and clinical medicine,” said Dore.
__________________________________________________________________
__________________________________________________________________
USA: Safe in Common to Exhibit at APIC Annual Educational Conference
PRESS RELEASE, PRNewswire(04.06.12)

Non-Profit to Raise Awareness and Support for Needlestick Safety and Safer
Engineering Controls Among Audience of Infection Prevention Personnel

SAN ANTONIO, June 4, 2012 /PRNewswire via COMTEX/ — Safe in Common, a non-
profit organization of healthcare safety advocates, announced it will
exhibit at the Association for Professionals in Infection Control and
Epidemiology’s (APIC) 39th Annual Educational Conference & International
Meeting, which will be held in San Antonio, Texas from June 4 through June
6.

During its year-long Needlestick Safety Advocacy Tour, Safe in Common is
engaging healthcare personnel at a series of U.S. conferences to raise
awareness of needlestick safety and promote safer engineering controls.
Some 5.6 million U.S. healthcare personnel are at risk of occupational
exposure to HIV, hepatitis C and other life-threatening bloodborne diseases
transmitted via needlestick or sharps related injuries.

Dr. Mary Foley, RN, PHD, Chairperson of Safe in Common said, “Each year,
thousands of healthcare personnel dedicated to infection prevention attend
the APIC Conference. These are the people Safe in Common really speaks to –
those who are on the frontline of preventing infection among healthcare
personnel. Healthcare professionals attending APIC understand how
terrifying a needlestick or sharps injury can be, regardless of whether a
bloodborne disease such as HIV or hepatitis C is ultimately contracted.”

As part of SIC’s presence at APIC, the Organization will encourage
healthcare personnel to take the Needlestick Safety Pledge as a step toward
preventing needlestick and sharps related injuries.

Safe in Common’s work to eradicate needlestick and sharps related injuries
and to promote the adoption of safer engineering controls will resonate
with APIC’s audience of healthcare personnel, and is in line with this
year’s conference theme being “Infection Prevention: Improving Outcomes,
Saving Lives.”

“One thing that continues to astound me as we talk to more people across
the country is how pervasive these needlestick and sharps injuries are, but
they don’t have to be,” said Dr. Foley. “We have worked hard these past few
months to create a community of peers who share these concerns and seek a
common voice for change.”

Safe in Common will be exhibiting at Booth 514, where healthcare workers
can meet Dr. Foley, discuss Safe in Common’s mission and sign the
Needlestick Safety Pledge.

Safe in Common believes that all healthcare workers deserve access to the
simplest, safest available technologies so that they can work within an
environment that is free from the risks of life-changing needlestick
injuries. SIC encourages government agencies to remain diligent in their
enforcement and promotion of the Needlestick Safety Act until all
occupational needlestick injuries are eradicated.

For more information about Safe in Common and the Organization’s ongoing
work to raise awareness of needlestick safety and promote utilizing safer
engineering controls that protect healthcare workers from unnecessary
needlestick and sharps related injuries, please visit
http://www.safeincommon.org .

About Safe in Common

Safe in Common is a non-profit organization established to enhance and save
the lives of U.S. healthcare personnel at risk of harm from needlestick
injuries. It is led by Chairperson Mary Foley, PhD, RN, former President of
the American Nursing Association and other industry leaders. To learn more
about the Needlestick Safety Pledge and its goal of promoting and
strengthening the Federal Needlestick Safety and Prevention Act, go to
www.facebook.com/safeincommon and follow Safe in Common on Twitter at
www.twitter.com/safeincommon .

SOURCE Safe in Common http://www.safeincommon.org
Copyright (C) 2012 PR Newswire. All rights reserved
__________________________________________________________________
__________________________________________________________________
Canada: Quebec man pleads not guilty in dirty needle case – Claude
Létourneau of Sherbrooke accused of placing needles in retail stores
CBC News, Canada (01.06.12)

Claude Létourneau, the man charged with hiding bloody needles in clothes at
Quebec retail stores, pleaded not guilty at the Sherbrooke courthouse on
Friday morning.

Létourneau, 49, was charged with 29 counts of armed assault, after DNA
evidence lifted from the syringes linked him to the incidents.

“It is with pride and relief that we are happy to announce this arrest,”
said Gaétan Labbé, director of the Sherbrooke police department.

Eight people have pricked themselves with the syringes and have undergone
testing to ensure they were free of infections. They are awaiting test
results.

Twenty-five needles have been found since January.

The last needle was found on May 24 at The Bay in Carrefour de l’Estrie, a
shopping centre in Quebec’s Eastern Townships.

Police said the suspect was arrested Thursday morning, the second time
authorities have picked him up in the last two weeks.

He was arrested earlier for uttering threats to a co-worker.

Police said he is known to authorities.

Police say they discovered a link between Létourneau and a case of bloody
needles in Lévis in 2002.

He is undergoing a psychiatric evaluation.

Létourneau will remain in custody until his next court appearance, on June
14.

The City of Sherbrooke and its police force had offered a $5,000 reward for
information in the case.
__________________________________________________________________
__________________________________________________________________
http://www.royalgazette.com/article/20120601/NEWS/706019991

Bermuda: Body parts and medical waste bake in containers
By Jonathan Bell, The Royal Gazette, Bermuda (01.06.12)

Medical waste, including human parts and bloodied hospital gowns, was left
“baking” inside shipping containers off the hospital grounds, according to
sources close to King Edward VII Memorial Hospital.

The biomedical waste was kept at the special waste facility at Sally Port
at Dockyard, sources told The Royal Gazette, after KEMH’s specialised
incinerator broke down several weeks ago.

International standard practices for biomedical waste state that hazardous
waste must not be kept at room temperature beyond 24 hours, one source told
this newspaper, adding: “They definitely should not be sitting in a
container in high heat for a month. This breaks every standard of practice
for handling biomedical waste.”

Recent temperatures have climbed close to 80F.

Human parts can range from amputated limbs to organs and tissue samples
from autopsies, miscarriages and birth waste. Soiled dressings and bandages
are also considered pathological waste.

Other hazards include infectious waste from patients with HIV and
hepatitis, and materials from surgeries and laboratories.

The KEMH “bio-oxidiser” normally reduces such medical waste to ash — along
with all “sharps”, as discarded needles, razors and catheters are known by
staff.

According to a hospital spokesperson, the machine is now back in
commission, and the West End storage was the safest option available during
the wait.

However, persons familiar with hospital procedure spoke anonymously to this
newspaper, fearing that the backlog of waste presented a serious hazard to
workers.

“You can’t have body parts in containers,” one said. “That stuff has got to
be secure, especially needles. That’s why they should have contingency
plans. The staff who will have to open up the containers want hazmats.”

A hazmat suit is a full-body protective garment.

Another source told us that up to as many as eight shipping containers,
several of which are believed to be new, have been stored over the course
of roughly a month at Sally Port, adjacent to Snorkel Park

“Of the eight containers, there are four new containers. They all contain
hazardous and biological waste such as human parts, contaminated needles,
bloodied gowns and all the blood-saturated material from the operating room
surgeries.

“They are baking and incubating inside these containers, in cardboard boxes
that will wilt under the extreme temperatures and will then have to be
brought back and re-boxed by handlers. Heaven forbid if during this process
someone unsuspecting gets stuck by a contaminated syringe.”

The source also questioned how the shipping containers would be dealt with
afterward.

“My other concern is that since the four blue containers are brand new,
what will become of them after being in contact with the contaminated waste
material?

“Are they going to be put back in circulation to then transport our food,
produce and goods to the local stores?”

Biomedical waste is bagged and boxed each day at the hospital.

The Paget facility generates large volumes of it, according to individuals
familiar with the procedure.

The Royal Gazette was told: “Each container takes more than 100 boxes. In a
day, they can burn 2,000 lbs of the stuff.”

Storage units could be seen outside the hospital, which are understood to
be permanent on-site.

A dozen shipping containers could also be seen this week on the Sally Port
grounds, although their purpose or contents could not be identified.

Asked for comment, a Bermuda Hospitals Board spokesperson said the
incinerator had been out of commission for several weeks while custom parts
were built.

“Unfortunately, given Bermuda’s size, there is no other solution for
medical waste processing on-Island. While repairs were carried out, a
temporary solution was needed to store the waste until it could be
processed. Following discussion with multiple government departments,
including Works and Engineering and Environment, it was agreed to
temporarily store it in sealed containers at Sally Port.”

Added the spokesperson: “This was certainly not, nor was it ever meant to
be, a viable long-term solution, but it was the safest way to store the
waste while the maintenance was undertaken. These containers will now be
appropriately processed by the bio-oxidiser.”

The machine was described as “a specialised piece of equipment that BHB
uses to incinerate biomedical waste. Biomedical waste includes materials
that have been in contact with blood, and equipment such as used IV tubing,
suction canisters, and haemodialysis products, and it requires special
processing techniques to dispose of it safely”.

The spokesperson said: “BHB is in the advanced stages of sourcing
replacement technology to ensure that in the future Bermuda will not have a
single point of failure for disposing of biomedical waste.”

—-
Dunkley: Situation is shocking

Shadow Health Minister Michael Dunkley said the off-site storage of
hospital medical waste had left him “shocked and very disturbed”.

Added Senator Dunkley: “One must question how we have adhered to accepted
standards during this breakdown. I find it quite surprising and
unacceptable that in such a critical facility to the Island as the hospital
we would be reliant on any key piece of equipment without having an
acceptable back up in place.

“There are many questions that need to be answered in addition to those
poised by the source for this story but suffice it to say that this matter
has been handled very poorly and the Bermuda Hospitals Board and the
Minister for Health should review this matter fully so we learn from what
has transpired and make sure it does not happen again.”

Sen Dunkley added: “It is obvious that all equipment must be serviced if it
is to function as required and furthermore equipment can break down from
time to time.

“As the hospital spokesperson noted they will now ensure that we do not
have a single point of failure for disposing of biomedical waste. This
approach, albeit a little late, is fully supported and we should learn from
this lesson and look at other systems at the hospital to also ensure
adequate backup.”
—-
Useful website: www.bermudahospitals.bm.
__________________________________________________________________
__________________________________________________________________
Australia: More hep C cases but no needle decision
ABC Online, Australia (31.05.12)

The ACT Government says there have been six more cases of hepatitis C
infection among inmates at the Territory’s jail.

The Government is considering a needle exchange program for the Alexander
Maconochie Centre (AMC), in a bid to reduce infection rates.

Chief Minister Katy Gallagher says she personally supports the introduction
of a needle exchange scheme at the prison, but unions representing
corrections staff are opposed.

Ms Gallagher says the issue is proving difficult to solve.

“Six people have contracted hepatitis C, that comes at a cost to taxpayers
as well and I think that shows exactly what a difficult issue this is,” she
said.

“People prefer not to think about prisoners needing additional help because
they are a marginalised group.

“I’ve got to look at it from every point of view and every angle.”

Ms Gallagher says she has had dozens of meetings with various groups in a
bid to find a solution.

“I have probably had over 20 meetings with different groups over the last
six to eight months on this issue,” she said.

“I’ve met with groups from outside the Territory, inside the Territory, law
reform advocates, correctional staff, unions.

“I’ve met with anyone I can meet with to try and get to the end of this
which is the best way forward.”

Vince McDevitt from the ACT Community Public Sector Union (CPSU) says
prisoners are more likely to contract infections from high risk activities
outside jail than inside.

“Almost two out of three prisoners in the AMC … it’s around 65 per cent,
are hep C positive already,” he said.

“The vast majority of these people presented to the jail with the
infection, it was pre-existing.”

Mr McDevitt says the AMC should not be the testing ground for a new
program.

“There’s a good reason why not a single jail in this country has a needle
syringe program,” he said.

“These are institutions that have been around for hundreds of years, and
here we are, Canberra, in the scheme of things had a jail for half an hour,
and we want to be pioneers in this very complex and difficult issue.”

Opposition health spokesman Jeremy Hanson says the Canberra Liberals remain
opposed to a needle exchange program.

“We won’t be introducing one and if we do get into government in October
and if the Government has introduced one, we will repeal it,” he said.
__________________________________________________________________
________________________________*_________________________________
* 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/

Get SIGN files on the web at: http://signpostonline.info/signfiles-2
get SIGNpost archives at: http://signpostonline.info/archives-by-year

Like on Facebook: http://facebook.com/SIGN.Moderator

The SIGN Secretariat, the Department of Essential Health Technologies,
WHO, Avenue Appia 20, CH-1211 Geneva 27, Switzerland. Telephone: +41 22
791 3680, Facsimile: +41 22 791 4836, E- mail: sign@who.int
__________________________________________________________________
________________________________*_________________________________

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:
http://www.who.int/entity/injection_safety/toolbox/sign2010_meeting.pdf

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
__________________________________________________________________
________________________________*_________________________________
All members of the SIGN Forum are invited to submit messages, comment on
any posting, or to use the forum to request technical information in
relation to injection safety.

The comments made in this forum are the sole responsibility of the writers
and does not in any way mean that they are endorsed by any of the
organizations and agencies to which the authors may belong.

Use of trade names and commercial sources is for identification only and
does not imply endorsement.

The SIGN Forum welcomes new subscribers who are involved in injection
safety.

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

SIGNpost Website

The new website http://SIGNpostOnline.info is a work in progress and will
grow to provide an archive of all SIGNposts, meeting reports, field
reports, documents, images such as photographs, posters, signs and symbols,
and video.

We would like your help in building this archive. Please send your old
reports, studies, articles, photographs, tools, and resources for

Email mailto:sign.moderator@gmail.com
__________________________________________________________________
________________________________*_________________________________

The SIGN Internet Forum was established at the initiative of the World
Health Organization’s Department of Essential Health Technologies. The
SIGN Forum is moderated by Allan Bass and is hosted on the University of
Queensland computer network. http://www.uq.edu.au
__________________________________________________________________

Comments are closed.