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SIGNpost 00688

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST *

Post00688 Job + Abstracts + mHealth Course + Policy + News 06 March 2013

CONTENTS
1. Job Posting For Medical Waste (Medwaste) Campaigner
2. Abstract: Healthcare worker safety: a vital component of surgical
capacity development in low-resource settings
3. Abstract: The management of needlestick injuries
4. Abstract: Analysis of needlestick and sharps injuries among medical
staff in upper first-class hospital
5. Abstract: Occupational Medicine Aspects in General and Abdominal
Surgery – Risk of Infection Attributable to Needlestick Injuries (What
the Surgeon should Know)
6. Abstract: Impact of infection control educational activities on rates
and frequencies of percutaneous injuries (PIs) at a tertiary care
hospital in Saudi Arabia
7. Abstract: Infectious risk assessment of unsafe handling practices and
management of clinical solid waste
8. Abstract: Reducing Blood-borne Exposure in Interventional Radiology:
What the IR Should Know
9. Abstract: Addressing Injecting Drug Use in Asia and Eastern Europe
10. Abstract: Transmission of hepatitis C virus among people who inject
drugs: viral stability and association with drug preparation equipment
11. Abstract: Health care workers causing large nosocomial outbreaks: a
systematic review
12. Abstract: Cross sectional study of Australian midwives knowledge and
use of sterile water injections for pain relief in labour
13. Abstract: Temperature and humidity in the storage area of sterile
materials: a literature review
14. Abstract: Review of a new fully liquid, hexavalent vaccine: Hexaxim
15. No Abstract: Sharps injuries are a significant occupational health
risk
16. No Abstract: Improving hand hygiene rates
17. No Abstract: Improving safety in health care
18. No Abstract: “Greed, ignorance, and laziness” are behind medical
injection dangers in US, says official
19. mHealth Alliance and TechChange Offer Second Round of Flagship Online
Course in Response to High Demand
20. 10 best resources for evidence-informed health policy making
21. News
– China: Hospitals Urged to Regulate Services Following Mass Hepatitis C
Infection
– India: Kerala doctor invents syringe that can’t be reused
– Australia: Investigation of cheap Botox ‘sausage factory’
The web edition of SIGNpost is online at:
http://signpostonline.info/archives/1412

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: ign@lists.uq.edu.au

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

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

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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. Job Posting For Medical Waste (Medwaste) Campaigner

Replies to Health Care Without Harm

Please email your resume and thoughtful cover letter, outlining how your
skills and experience will benefit the campaign to Merci Ferrer, Director
(merci@no-harm.org) and copy Joyce Lanuza, Admin/Finance Officer
(joyce@no-harm.org) with the subject line “Medwaste Campaigner”. Deadline
for submission of application is on March 8, 2013. Screening and
interviews will begin immediately. No calls, please. Shortlisted
applicants will be informed via email.

Health Care Without Harm is an Equal Opportunity Employer.
__________________________________________________________________
Health Care Without Harm

JOB POSTING FOR MEDICAL WASTE (Medwaste) CAMPAIGNER

Organizational Overview

Health Care Without Harm Asia is committed to transforming the health care
sector so that it is ecologically sustainable and no longer a source of
harm to the public’s health and the environment. To that end, HCWH is
working to implement ecologically sound and healthy alternatives to health
care practices that pollute the environment and contribute to disease.

Health Care Without Harm is an international coalition of hospitals and
health care systems, medical professionals, community groups, health-
affected constituencies, labor unions, environmental and environmental
health organizations and religious groups that advocates globally
eliminating healthcare practices that harm people and the environment.

Position Overview

Health Care Without Harm is seeking a dynamic and experienced leader to
work as MEDICAL WASTE CAMPAIGNER to assist the organization to counter the
threat from medical waste.

The Medical Waste Campaigner will work closely with the different programs
of Health Care Without Harm (HCWH) Asia, and will have primary
responsibility to develop and execute plans that will promote key areas of
the program such as waste minimization, promotion of appropriate
alternative technology and model hospitals.

He/She will also assist in HCWH global team work, applying his/her
expertise to medical waste issues outside of the region.

Responsibilities:
* Ensure that key stakeholders such as national and local government
agencies, as well as other government related agencies and health care
facilities, are informed and involved on issues of the campaign.
* Develop and oversee the planning, development and implementation of
campaign related policies and programs, more specifically on the issues of
health care waste minimization, promotion of alternative appropriate
technologies for hospital waste disinfection and the creation of model
hospitals.
* Maintain effective relationships with partners in health care waste
management.
In coordination with the Communications and Press Campaigner; design
strategic media plans targeting general media, social media and other
publications that caters key stakeholders
* In coordination with the Director and the International Science and
Policy Coordinator, assist in furthering the goals of the Global team with
regards to medical waste management. Tasks may include conducting
research, reviewing and or drafting technical and policy and campaign-
related documents.
* Other duties that may be assigned by the Director

Qualifications:
* Commitment to the missions of Health Care Without Harm
* Good oral and written communication skills
* Good management and leadership skills
* Flexible, adaptable and goal-oriented
* Must possess the ability to think strategically
* Strong organizational skills, has the ability to take initiative and
manage campaigns
* Willingness to travel on a regular basis
* Understanding of principles of medical waste management strategies,
technologies and scientific research methods
* Ability to assist in on-the-ground implementation of medical waste
management, including site assessment and basic testing and
troubleshooting
* Bachelor’s degree or equivalent experience required. Degree in
Engineering and Health Sciences preferred.

To Apply:

Please email your resume and thoughtful cover letter, outlining how your
skills and experience will benefit the campaign to Merci Ferrer, Director
(merci@no-harm.org) and copy Joyce Lanuza, Admin/Finance Officer
(joyce@no-harm.org) with the subject line “Medwaste Campaigner”. Deadline
for submission of application is on March 8, 2013. Screening and
interviews will begin immediately. No calls, please. Shortlisted
applicants will be informed via email.

Health Care Without Harm is an Equal Opportunity Employer.
__________________________________________________________________
________________________________*_________________________________

2. Abstract: Healthcare worker safety: a vital component of surgical
capacity development in low-resource settings
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23433291

Int J Occup Environ Health. 2012 Oct-Dec;18(4):307-11.

Healthcare worker safety: a vital component of surgical capacity
development in low-resource settings.

Petroze RT, Phillips EK, Nzayisenga A, Ntakiyiruta G, Forrest Calland J.

Department of Surgery, University of Virginia, Charlottesville, VA, USA.

INTRODUCTION: A disparate number of occupational exposures to bloodborne
pathogens occur in low-income countries where disease prevalence is high
and healthcare provider-per-population ratios are low.

METHODS: In an effort to highlight the important role of healthcare worker
safety in surgical capacity building in Rwanda, we measured self-reported
presence of safety materials and compliance with personal protective
equipment in the operating theatre as part of a nationwide survey to
characterize emergency and essential surgical capacity in all government
hospitals.

RESULTS: We surveyed 44 hospitals. While staff report general availability
of safe disposal of sharps and hazardous waste, presence of and compliance
with eye protection was lacking. Staff were cognizant of prevention
measures such as double-gloving and ‘safe receptacles’, as well as
hospital policies for post-exposure prophylaxis for HIV following
needlesticks, but there was little awareness of hepatitis exposure.

CONCLUSIONS: Healthcare worker safety should be a key component of
hospital-level surgical capacity.
__________________________________________________________________
________________________________*_________________________________

3. Abstract: The management of needlestick injuries
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23437024

Dtsch Arztebl Int. 2013 Feb;110(5):61-7.

The management of needlestick injuries.

Himmelreich H, Rabenau HF, Rindermann M, Stephan C, Bickel M, Marzi I,
Wicker S.

Department of Trauma-, Hand- and Reconstructive Surgery, J.W. Goethe
University Hospital, Frankfurt/Main.

BACKGROUND: An estimated 1 million needlestick injuries (NSIs) occur in
Europe each year. The Council Directive 2010/32/EU on the prevention of
NSIs describes minimum requirements for prevention and calls for the
implementation of local, national and Europe-wide reporting systems. The
Directive is to be implemented by all EU member states by 11 May 2013. The
purpose of this study was to assess (and improve) the procedures for the
reporting and treatment of needlestick injuries in a German tertiary-care
hospital.

METHODS: We carried out a prospective observational study of the NSI
reporting system in the hospital over a period of 18 months and determined
the incidence of NSIs, the prevalence of blood-borne pathogens among index
patients, the rate of initiation of post-exposure prophylaxis, and the
rate of serological testing of the affected health care personnel.

RESULTS: 519 instances of NSI were reported to the accident insurance
doctor over the period of the study, which consisted of 547 working days.
86.5% of the index patients underwent serological study for hepatitis B
and C (HBV and HCV) and for the human immune deficiency virus (HIV); this
resulted in two initial diagnoses (one each of active hepatitis B and
hepatitis C) in the index patient. 92 of 449 index patients, or one in
five, was infected with at least one blood-borne pathogen. HIV post-
exposure prophylaxis was initiated in 41 health care workers. One case of
hepatitis C virus transmission arose and was successfully treated. Other
than that, no infection was transmitted.

CONCLUSION: Complete reporting of NSIs is a prerequisite for the
identification of risky procedures and to ensure optimal treatment of the
affected health care personnel. The accident insurance doctor must possess
a high degree of interdisciplinary competence in order to treat NSI
effectively.

Free Article http://www.aerzteblatt.de/int/archive/article?id=134256
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Analysis of needlestick and sharps injuries among medical
staff in upper first-class hospital
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23433157

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2013 Jan;31(1):41-4.

[Analysis of needlestick and sharps injuries among medical staff in upper
first-class hospital].

[Article in Chinese]

Gu Y, Chen C, Cheng KP, Tu ZB, Zhang XJ.

School of Public Health, Southeast University, Nanjing 210009, China.

OBJECTIVE: To investigate the incidence of needlestick and sharps injuries
among the medical staff in an upper first-class hospital and its risk
factors and to provide a basis for the infection control department of
hospital and health administration department to establish the policies
for safe injection.

METHODS: A questionnaire survey was conducted in 800 healthcare
professionals in an upper first-class hospital in Nanjing, China to
investigate the incidence of needlestick and sharps injuries in the past
year. A total of 641 persons completed the questionnaire, including 239
doctors, 348 nurses, and 54 other healthcare workers. The obtained data
were subjected to chi-square test and logistic analysis.

RESULTS: Needlestick and sharps injuries occurred in 373 of 641 healthcare
professionals, with an incidence rate of 58.19%. There were significant
differences in the incidence of needlestick and sharps injuries among the
medical staff of different types or in different departments (P < 0.01).

The syringe needles, glass, scalp infusion needles, and suture needles
were the major medical apparatus that caused needlestick and sharps
injuries; the incidence rate of injury caused by suture needles in doctors
(48.21%) was significantly higher than that in nurses (6.72%) (P < 0.01),
and the incidence rates of injuries caused by syringe needles, scalp
infusion needles, and glass in nurses (71.15%, 59.68%, and 49.04%) were
significantly higher than those in doctors (46.43%, 6.25%, and 16.96%) (P
< 0.01); compared with nurses, the doctors had higher incidence rates of
injuries due to body fluid or tissue sample collection, wound flushing,
suture, and cutting (P < 0.05); compared with doctors, the nurses had
higher incidence rates of injuries due to injection, intravenous infusion,
heparin cap sealing, intravenous infusion line connection, and venous or
arterial blood collection (P < 0.05).

CONCLUSION: Needlestick and sharps injuries are common in medical staff.
The results of the study on risk factors provide a basis for the infection
control department of hospital and health administration department to
establish the policies for safe injection.
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Occupational Medicine Aspects in General and Abdominal
Surgery – Risk of Infection Attributable to Needlestick Injuries (What
the Surgeon should Know)
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23450397

Zentralbl Chir. 2013 Feb;138(1):88-93.

[Occupational Medicine Aspects in General and Abdominal Surgery – Risk of
Infection Attributable to Needlestick Injuries (What the Surgeon should
Know)].

[Article in German]

Darius S, Meyer F, Boeckelmann I.

Bereich Arbeitsmedizin, Otto-von-Guericke-Universitätsklinikum Magdeburg
A. ö. R, Deutschland.

Needlestick, stab, scratch, and cut injuries are a common problem and a
significant health hazard among healthcare workers. The aim of this review
is to give an overview on the risk of infection in general, abdominal and
vascular surgery and to suggest occupational safety measures. Furthermore,
we want to discuss insurance-related aspects.

If medical devices are
contaminated with blood or other body fluids, there is a relevant risk of
infection with hepatitis B virus (HBV), hepatitis C virus (HCV), and human
immunodeficiency virus (HIV). The risk of transmission depends on the
infection status of the patient, and on the immune status of the
healthcare worker. In addition, the risk of infection is affected by the
type and severity of injuries, by the quantity (volume) of blood, the time
between injury and cleaning, and the administration of post-exposure
prophylaxis.

Prevention measures are an important focus in occupational
medicine. Comprehensive programmes to prevent injuries (usage of safety
devices, surgical gloves, and of disposal containers) have to be
continuously considered to minimize risk of infection of healthcare
workers.

Georg Thieme Verlag KG Stuttgart · New York.
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Impact of infection control educational activities on rates
and frequencies of percutaneous injuries (PIs) at a tertiary care
hospital in Saudi Arabia
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23021652

J Infect Public Health. 2012 Aug;5(4):297-303.

Impact of infection control educational activities on rates and
frequencies of percutaneous injuries (PIs) at a tertiary care hospital in
Saudi Arabia.

El Beltagy K, El-Saed A, Sallah M, Balkhy HH.

Department of Infection Prevention and Control, King Abdulaziz Medical
City, Riyadh, Saudi Arabia.

OBJECTIVE: To study the impact of educational activities on the rates and
frequencies of percutaneous injuries (PIs) at a tertiary care hospital in
Saudi Arabia.

METHODS: PI surveillance is a routine activity in King Abdulaziz Medical
City (a 900-bed teaching tertiary health care hospital) in Riyadh using
the Exposure Prevention Information Network (EPINet) data collection tool.
From 2001 through 2003, educational activities were conducted for health
care workers (HCWs) to prevent PIs. The education included lectures on the
risk of unsafe practices that may lead to PIs and how to avoid them. Data
from before (1997-2000) and after (2004-2008) the intervention were
imported from our surveillance system and statistically analyzed.

RESULTS: The total overall rate of PIs per 1000 HCWs was significantly
lower in the post-intervention period than in the pre-intervention period
(14 vs. 32.8/1000 HCWs, respectively). The rates of PIs among nurses and
housekeepers showed a significant decrease (15 vs. 37.6/1000 HCWs and 10
vs. 34.5/1000 HCWs, respectively). The frequency of PIs in the emergency
department (ED) and intensive care units (ICUs) showed a significant
decrease (3.4% for both vs. 12.4% and 13.7%, respectively). PIs associated
with devices, such as needles on IV lines, IV catheters, lancets and
suture needles, showed a significant decrease. PIs occurring during device
disassembly and from inappropriately discarded devices also decreased
significantly.

CONCLUSION: The educational program reduced some categories of PIs,
including the overall rate, the rate among nurses and housekeepers, the
frequency in the ED and ICUs and the frequency among needles on IV lines,
IV catheters, lancets and suture needles. Other PI categories did not
change significantly.

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

7. Abstract: Infectious risk assessment of unsafe handling practices and
management of clinical solid waste
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23435587

Int J Environ Res Public Health. 2013 Jan 31;10(2):556-67.

Infectious risk assessment of unsafe handling practices and management of
clinical solid waste.

Hossain MS, Rahman NN, Balakrishnan V, Puvanesuaran VR, Sarker MZ, Kadir
MO.

Department of Environmental Technology, School of Industrial Technology,
Universiti Sains Malaysia, Penang 11800, Malaysia. akmomar@usm.my.

The present study was undertaken to determine the bacterial agents present
in various clinical solid wastes, general waste and clinical sharp waste.

The waste was collected from different wards/units in a healthcare
facility in Penang Island, Malaysia. The presence of bacterial agents in
clinical and general waste was determined using the conventional bacteria
identification methods.

Several pathogenic bacteria including opportunistic bacterial agent such
as Pseudomonas aeruginosa, Salmonella spp., Klebsiella pneumoniae,
Serratia marcescens, Acinetobacter baumannii, Staphylococcus aureus,
Staphylococcus epidermidis, Enterococcus faecalis, Streptococcus pyogenes
were detected in clinical solid wastes. The presence of specific
pathogenic bacterial strains in clinical sharp waste was determined using
16s rDNA analysis.

In this study, several nosocomial pathogenic bacteria strains of
Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Lysinibacillus
sphaericus, Serratia marcescens, and Staphylococcus aureus were detected
in clinical sharp waste.

The present study suggests that waste generated from healthcare facilities
should be sterilized at the point of generation in order to eliminate
nosocomial infections from the general waste or either of the clinical
wastes.
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Reducing Blood-borne Exposure in Interventional Radiology:
What the IR Should Know
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23435743

Cardiovasc Intervent Radiol. 2013 Feb 22.

Reducing Blood-borne Exposure in Interventional Radiology: What the IR
Should Know.

Tso DK, Athreya S.

Department of Radiology, University of British Columbia, 3350-950W 10th
Avenue, Vancouver, BC, V5Z 4E3, Canada.

Interventional radiologists are at risk of exposure to blood-borne
pathogens in their day-to-day practice. Percutaneous exposure from unsafe
sharps handling, mucocutaneous exposure from body fluid splashes, and
glove perforation from excessive wear can expose the radiologist to
potentially infectious material.

The increasing prevalence of blood-borne pathogens, including hepatitis B
and C, and human immunodeficiency virus, puts nurses, residents, fellows,
and interventional radiologists at risk for occupational exposure.

This review outlines suggestions to establish a culture of safety in the
interventional suite.
__________________________________________________________________
________________________________*_________________________________

9. Abstract: Addressing Injecting Drug Use in Asia and Eastern Europe
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23446827

Curr HIV/AIDS Rep. 2013 Feb 28.

Addressing Injecting Drug Use in Asia and Eastern Europe.

Wu Z, Shi CX, Detels R.

National Center for AIDS/STD Control and Prevention, Chinese Center for
Disease Control and Prevention, 155 Changbai Road, Changping District,
Beijing, 102206, China, wuzunyou@chinaaids.cn.

While the global HIV incidence dropped about 20 % in the past 10 years,
HIV incidences among people who inject drugs (PWID) in Asia and Europe
continue to increase and to account for high proportions of new HIV
infections among PWID globally.

Great changes have been observed in this region, such as progressing from
rejection to acceptance of harm reduction strategies in Asian countries,
but no such change has occurred in Eastern European countries.

China has quickly scaled up harm reduction activities nationwide,
resulting in the decline of HIV incidence and HIV prevalence among PWID
since 2006. However, insufficient scaling up of harm reduction programs in
other countries has failed to slow down their HIV epidemics.

In Eastern European countries where the spread of HIV among PWID is the
most severe, only about 15 % of funding for harm reduction programs are
from domestic sources.

Strong political and financial commitment from countries in this region is
urgently needed to quickly scale up evidence- based harm reduction
strategies in order to prevent the HIV epidemic from spreading rapidly
from PWID to the heterosexual general population.
__________________________________________________________________
________________________________*_________________________________

10. Abstract: Transmission of hepatitis C virus among people who inject
drugs: viral stability and association with drug preparation equipment
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23129759

J Infect Dis. 2013 Jan 15;207(2):281-7.

Transmission of hepatitis C virus among people who inject drugs: viral
stability and association with drug preparation equipment.

Doerrbecker J, Behrendt P, Mateu-Gelabert P, Ciesek S, Riebesehl N,
Wilhelm C, Steinmann J, Pietschmann T, Steinmann E.

Institute of Experimental Virology, Twincore, Centre for Experimental and
Clinical Infection Research, Medical School Hannover and Helmholtz Centre
for Infection Research, Hannover, Germany.

BACKGROUND: Hepatitis C virus (HCV) transmission among people who inject
drugs remains a challenging public health problem. We investigated the
risk of HCV transmission by analyzing the direct association of HCV with
filters, water to dilute drugs, and water containers.

METHODS: Experiments were designed to replicate practices by people who
inject drugs and include routinely used injection equipment. HCV stability
in water was assessed by inoculation of bottled water with HCV. Viral
association with containers was investigated by filling the containers
with water, inoculating the water with HCV, emptying the water, and
refilling the container with fresh water. Transmission risk associated
with drug preparation filters was determined after drawing virus through a
filter and incubating the filter to release infectious particles.

RESULTS: HCV can survive for up to 3 weeks in bottled water. Water
containers present a risk for HCV transmission, as infectious virions
remained associated with water containers after washing. Physical
properties of the water containers determined the degree of HCV
contamination after containers were refilled with water. HCV was also
associated with filter material, in which around 10% of the viral inoculum
was detectable.

CONCLUSIONS: This study demonstrates the potential risk of HCV
transmission among injection drug users who share water, filters, and
water containers and will help to define public health interventions to
reduce HCV transmission.
__________________________________________________________________
________________________________*_________________________________

11. Abstract: Health care workers causing large nosocomial outbreaks: a
systematic review
__________________________________________________________________
http://www.biomedcentral.com/1471-2334/13/98/abstract
BMC Infect Dis. 2013 Feb 22;13(1):98.

Health care workers causing large nosocomial outbreaks: a systematic
review.

Danzmann L, Gastmeier P, Schwab F, Vonberg RP.

BACKGROUNDS: Staff in the hospital itself may be the source of a
nosocomial outbreak (NO). But the role of undetected carriers as an
outbreak source is yet unknown.

METHODS: A systematic review was conducted to evaluate outbreaks caused by
health care workers (HCW). The Worldwide Outbreak Database and PubMed
served as primary sources of data. Articles in English, German or French
were included. Other reviews were excluded. There were no restrictions
with respect to the date of publication.Data on setting, pathogens, route
of transmission, and characteristics of the HCW was retrieved. Data from
large outbreaks were compared to smaller outbreaks.

RESULTS: 152 outbreaks were included, mainly from surgery, neonatology,
and gynecology departments. Most frequent corresponding infections were
surgical site infections, infection by hepatitis B virus, and septicemia.
Hepatitis B virus (27 NO), S. aureus (49 NO) and S. pyogenes (19 NO) were
the predominant pathogens involved. 59 outbreaks (41.5%) derived from
physicians and 56 outbreaks (39.4%) derived from nurses. Transmission
mainly occurred via direct contact. Surgical and pediatric departments
were significantly associated with smaller outbreaks, and gynecology with
larger outbreaks. Awareness of carrier status significantly decreased the
risk of causing large outbreaks.

CONCLUSIONS: As NO caused by HCW represent a rare event, screening of
personnel should not be performed regularly. However, if certain species
of microorganisms are involved, the possibility of a carrier should be
taken into account.

Free full text: http://www.biomedcentral.com/1471-2334/13/98/abstract
__________________________________________________________________
________________________________*_________________________________

12. Abstract: Cross sectional study of Australian midwives knowledge and
use of sterile water injections for pain relief in labour
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22222092

Women Birth. 2012 Dec;25(4):e74-9.

Cross sectional study of Australian midwives knowledge and use of sterile
water injections for pain relief in labour.

Lee N, Martensson LB, Kildea S.

Australian Catholic University, Qld 4014, Australia.
Nigel.Lee@mater.org.au

BACKGROUND: The effectiveness of sterile water injections (SWI) to relieve
back pain in labour is supported by a number of randomised controlled
trials. Although the procedure is available in a number of Australian
maternity units, there is no information regarding the use of SWI by
midwives, in terms of knowledge and availability, clinical application or
technique used. Neither is there any data on midwives who do not use SWI
nor the specific challengers and barriers encountered by midwives
introducing SWI.

METHOD: An invitation to participate in an online survey was emailed to
4700 members of the Australian College of Midwives (ACM) and 484 members
of CRANAplus (Remote Health Organisation). Nine hundred and seventy
midwives completed the survey (19%).

RESULTS: Four hundred and seven (42.5%) midwives currently used SWI in
their practice and five hundred and fifty-one (57.5%) indicated they did
not. Eighty-six percent (n=478/548) indicated they would consider using
SWI and 90% (n=500/547) were interested in obtaining further information
about SWI. The main reasons cited for not using SWI was the lack of a
policy or guideline (n=271, 57.5%) and being unable to access workshops or
resource material (n=68, 14.4%).

CONCLUSION: This study indicates that SWI is not being used by the
majority of midwives participating in the study, although there is a
strong desire by midwives to learn about and explore its use. Greater
access to information and workshops on SWI is highlighted. In response to
the findings of this survey the authors are currently developing an online
resource and training to support units to introduce SWI.

Copyright © 2011 Australian College of Midwives. Published by Elsevier
Ltd. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

13. Abstract: Temperature and humidity in the storage area of sterile
materials: a literature review
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23223740

Rev Esc Enferm USP. 2012 Oct;46(5):1215-20.

[Temperature and humidity in the storage area of sterile materials: a
literature review].

[Article in Portuguese]

Bruna CQ, Graziano KU.

Departamento de Enfermagem Médico Cirúrgica, Escola de Enfermagem,
Universidade de São Paulo, Paulo, SP, Brasil. caquartim@yahoo.com.br

The recommendations for temperature (T°) and relative humidity (RU) for
the storage of sterilized materials in Sterilization Central Supply (SCS)
vary according to different sources, and are not based on theoretical
frameworks or experiments.

The practice shows difficulties in controlling these parameters, leading
to doubts regarding the maintenance of the sterility of these materials.

This article proposed, through a literature review, to identify and
analyze the recommendations for T° and RU for the sterile storage area.

We did not find any literature that justifies the referred
recommendations. Seven articles were included which analyzed the variables
T° and RU in the storage area as factors that could affect the sterility
of the materials, and showed contradictory results regarding these
factors’ interference in maintaining the sterility of the materials.

Free full text http://tinyurl.com/clvhkcm
__________________________________________________________________
________________________________*_________________________________

14. Abstract: Review of a new fully liquid, hexavalent vaccine: Hexaxim
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23441818

Expert Opin Biol Ther. 2013 Feb 27.

Review of a new fully liquid, hexavalent vaccine: Hexaxim.

Nunes MC, Madhi SA.

University of the Witwatersrand, Department of Science and
Technology/Vaccine Preventable Diseases Unit , Johannesburg , South
Africa.

Introduction: The introduction of injectable vaccines targeting new
diseases into childhood immunization programs has resulted in the need for
combination vaccines to reduce the number of injections given during early
childhood and maintain acceptability of targeting multiple pathogens by
vaccination.

Currently, there is only one licensed hexavalent combination
vaccine which targets diphtheria, polio, tetanus, Haemophilus influenzae
type b, hepatitis B and pertussis. A new, fully liquid formulation
hexavalent vaccine ( Hexaxim ) has been developed and is currently
undergoing licensure for use in childhood immunization programs.

Areas covered: Safety and immunogenicity studies of Hexaxim have been
undertaken in a diversity of settings, been evaluated with different
dosing schedules and in comparison to the other licensed hexavalent
vaccine (Infanrix hexa).

This review of published journal articles and conference proceeding is
focused on the studies in which Hexaxim has been evaluated and which are
contributing to its pending licensure. Non-inferiority was demonstrated at
the level of proportion of children developing seroprotective titers or
showing seroconversion following the primary series of vaccine compared to
the same target-antigens included in licensed combination vaccines. Also,
Hexaxim was associated with a favorable safety and tolerability profile
when administered during the first 6 months of life. Adequate and robust
memory responses were elicited following a booster dose in the second year
of life.

Expert opinion: The development of new hexavalent combination vaccines
targeting established pathogens is likely to assist in improving
compliance and timeliness of vaccination in infants. These formulations
will, however, need to be monitored for medium- and long-term
effectiveness amidst growing concern of waning immunity against diseases
such as pertussis when using acellular-pertussis vaccine and possibly
hepatitis B when using combination vaccines. Nevertheless, the development
of such combination vaccines remains necessary to help with the
introduction of other new vaccines into an already crowded childhood
immunization schedules.
__________________________________________________________________
________________________________*_________________________________

15. No Abstract: Sharps injuries are a significant occupational health
risk
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23342856

Nurs N Z. 2012 Nov;18(10):26-8.

Sharps injuries are a significant occupational health risk.

Rich S.
__________________________________________________________________
________________________________*_________________________________

16. No Abstract: Improving hand hygiene rates
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23342864

Nurs N Z. 2012 Nov;18(10):34.

Improving hand hygiene rates.

Jowitt D.
__________________________________________________________________
________________________________*_________________________________

17. No Abstract: Improving safety in health care
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23342859

Nurs N Z. 2012 Nov;18(10):31.

Improving safety in health care.

Jowitt D.

National Division of Infection Control Nurses.
__________________________________________________________________
________________________________*_________________________________

18. No Abstract: “Greed, ignorance, and laziness” are behind medical
injection dangers in US, says official
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23305845

BMJ. 2013 Jan 10;346:f176.

“Greed, ignorance, and laziness” are behind medical injection dangers in
US, says official.

Lenzer J.
__________________________________________________________________
________________________________*_________________________________

19. mHealth Alliance and TechChange Offer Second Round of Flagship Online
Course in Response to High Demand

visit www.techchange.org.
__________________________________________________________________
http://tinyurl.com/bss5rhj

28 February 2013

mHealth Alliance and TechChange Offer Second Round of Flagship Online
Course in Response to High Demand

Enrollment for “Mobile Phones for Public Health” opens today

Washington, D.C. (February 28, 2013) – The mHealth Alliance and TechChange
today announced that a second round of the flagship “Mobile Phones for
Public Health” online course will run June 3-28, 2013. As the field of
mobile health (mHealth) continues to expand, this course provides a
valuable learning and networking experience for people interested and
working in mHealth throughout the world. Online enrollment for the course
opens today.

“The first time we offered this course it was a significant success,
reaching capacity at 100 participants from 35 countries, spanning the
medical field, international development and government agencies,” said
Nick Martin, co-founder and president of TechChange. “We have since heard
from dozens of people who couldn’t participate in the first round and
wanted another chance. We are excited to bring these people not only a
second opportunity to enroll, but an even better, more informative and
engaging course on mobile health.”

The expanded course will include a greater emphasis on building technical
skills and working with telecommunications companies, as well as
governments. It will also provide opportunities to address the policy
implications of mHealth, in addition to topics from the original course
such as SMS (text message) communication programs, smartphone applications
and health information systems for data collection and management. The
course will use interactive exercises, live demonstrations and multimedia
tutorials to engage participants, provide training in the latest tools,
and connect students with experts and fellow practitioners.

“The success of last year’s course and the demand to offer it again
provide a great indication of the growing enthusiasm surrounding mHealth,”
said Patricia Mechael, executive director of the mHealth Alliance. “The
Alliance’s role is to provide information that enables informed decision-
making, so that proven approaches and lessons learned can be applied
systematically to mHealth projects. I encourage those who are interested
in mHealth to take advantage of the opportunity this course offers to
learn from some of the field’s leading experts and to build their own
knowledge and experience.”

To enroll in the course, please visit
http://techchange.org/online-courses/mhealth-mobile-phones-for-public-
health/. Enrollment will be limited to the first 100 accepted and enrolled
individuals. Members of the mHealth Alliance will receive a discount.

###

About the mHealth Alliance: 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 is hosted by the United Nations Foundation, and its
core partners include the Rockefeller Foundation, Vodafone Foundation, UN
Foundation, GSMA and Norad. For more information, visit
http://www.mHealthAlliance.org.

About TechChange: 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 1500
hundred participants from more than 100 countries on their innovative
platform.

For more information visit www.techchange.org.
__________________________________________________________________
________________________________*_________________________________

20. 10 best resources for evidence-informed health policy making
__________________________________________________________________
10 best resources for evidence-informed health policy making

Kaelan A Moat 1,2,3* and John N Lavis 2,3,4,5,6
1Health Policy PhD Program, McMaster University, Hamilton, Canada,
2Program in Policy Decision-making, McMaster University, Hamilton, Canada,
3Centre for Health Economics and Policy Analysis, McMaster University,
Hamilton, Canada, 4McMaster Health Forum, McMaster University, Hamilton,
Canada, 5Department of Clinical Epidemiology and Biostatistics, McMaster
University, Hamilton, Canada and 6Department of Political Science,
McMaster University, Hamilton, Canada

Health Policy and Planning

Published by Oxford University Press in association with The London School
of Hygiene and Tropical Medicine

Website: http://bit.ly/MJQSJf or http://bit.ly/14dSfpA

PDF at: http://bit.ly/O00tOc

…. linking research to policy requires both a comprehensive
understanding of the policy-making process-including the influence of
institutions, interests, ideas and external events-and an awareness of a
number of established strategic approaches that are available to support
the use of relevant research evidence in the formulation of health
policies.

To help guide this understanding, a framework has been developed to
identify and organize key elements that can help one understand ways to
support the use of evidence in the policy-making process (Lavis et al.
2006). These elements are:

* Climate: how those who fund research, universities, researchers and
users of research support or place value on efforts to link research to
action;
* Production of research: how priority setting ensures that users’ needs
are identified and how scoping reviews, systematic reviews and single
studies are undertaken to address these needs;
* Push efforts: how strategies are used to support action based on the
messages arising from research;
* Efforts to facilitate user pull: how ‘one stop shopping’ is provided
for optimally packaged, high-quality reviews either alone or as part of a
national electronic library for health; how these reviews are profiled
during ‘teachable moments such as intense media coverage; and how rapid
response units meet users’ needs for the best research;
* User-pull efforts: how users assess their capacity to use research and
how structures and processes are changed to support the use of research;
* Exchange efforts: how deliberative processes and meaningful
partnerships between researchers and users help them to jointly ask and
answer relevant questions.

This paper employs the elements of the framework to identify and outline
the 10 most useful and publicly available resources from a range of
diverse sources, and in a variety of formats (a mix of reports and
articles, plus a database and listserv), that can help facilitate a better
understanding of supporting the use of research evidence in the health
policy process.

Although this is by no means intended to serve as an exhaustive or
definitive inventory, taken as a whole, each of the included resources
provides an excellent way with which to build a comprehensive
understanding of the various facets of supporting evidence informed health
policy

Twitter http://twitter.com/eqpaho

* * *
This message from the Pan American Health Organization, PAHO/WHO, is part
of an effort to disseminate information Related to: Equity; Health
inequality; Socioeconomic inequality in health; Socioeconomic health
differentials; Gender; Violence; Poverty; Health Economics; Health
Legislation; Ethnicity; Ethics; Information Technology – Virtual
libraries; Research & Science issues. [DD/ KMC Area] Washington DC USA

PAHO/WHO Equity List – Archives – Join/remove:
http://listserv.paho.org/Archives/equidad.html
__________________________________________________________________
________________________________*_________________________________

21. News

– China: Hospitals Urged to Regulate Services Following Mass Hepatitis C
Infection
– India: Kerala doctor invents syringe that can’t be reused
– Australia: Investigation of cheap Botox ‘sausage factory’

Selected news items reprinted under the fair use doctrine of international
copyright law: http://www4.law.cornell.edu/uscode/17/107.html
__________________________________________________________________
China: Hospitals Urged to Regulate Services Following Mass Hepatitis C
Infection
Yang Lina, Xinhua, China (27.02.13)

China’s Ministry of Health is imploring local institutions and health
departments to implement safer practices after 99 people contracted
hepatitis C through contaminated injections from a private clinic in the
city of Donggang in northeast China’s Liaoning province.

The ministry released a circular on February 27 stating that an expert
investigative team cited the scandal as a “major mass hospital infection
incident caused by serious violations of medical regulations and
procedures.” The circular explained that the clinic originally belonged to
the Donggang Social Security Bureau, a public nonprofit medical
institution; however, its surgery department was illegally leased to two
individuals who used new treatment methods that violated normal medical
practices to treat 120 patients with varicose veins from October 22, 2012,
to January 28, 2013. Ninety-nine patients contracted hepatitis C during
these procedures.

The ministry stated in the circular that the incident has uncovered
serious problems regarding safety management, professional practices, and
infection control at some local-level medical institutions. Authorities
are investigating the individuals directly responsible for the incident;
those responsible for the incident may face criminal charges. Others who
took part in the scandal have been fired or suspended.

The ministry urged local health departments to provide stronger
supervision over the safety and service quality of local medical
institutions, and stressed that a ban should be placed on illegally posted
medical advertisements and the contracting of medical work to other groups
and individuals.

To ensure safety, the ministry launched a campaign encouraging local
administrations to check local medical institutions for infection risks by
April 30.
__________________________________________________________________
__________________________________________________________________
http://tinyurl.com/bbcaxfc

India: Kerala doctor invents syringe that can’t be reused
By Indo Asian News Service (IANS) India (24.02.13)

Thiruvananthapuram, Feb 24 (IANS) In a major breakthrough, a doctor in
Kerala has developed a cheap, effective and eco-friendly medical syringe
that can never be reused.

“The Peanut Safe Syringe becomes absolutely redundant after its first use.
Neither the syringe nor the needle can ever be reused. Scavengers will
never be able to collect, repack and sell it in the market,” said Baby
Manoj, a radiologist from Kozhikode, who invented the syringe.

The syringe can be used for injection as well as blood aspiration in a
single sitting. In other syringe models, separate devices are needed for
each procedure.

For his product, Manoj last week received Best Invention Awards for 2011
from the National Research Development Corporation, an undertaking of the
science and technology ministry, and World Intellectual Property
Organisation at a function in New Delhi.

A World Health Organisation report says more than 20 million people are
infected with HIV and hepatitis every year and 1.3 million of them die.
The infection is spreading because around 600 crore used syringes come
back in the market without being sterilised.

Over a million blood infections occur annually in India leading to HIV and
hepatitis, and around 300,000 of the infected people die.

Manoj has developed a disposable syringe whose needle and barrel can be
disabled quickly after injection. He did this by creating a groove around
the hub of the syringe to which the needle is connected.

After use, a slight manual pressure on the groove breaks the needle and
the barrel, which is its critical component.

The needle, which is a major disease-transferring component, is disabled
as the broken piece of the barrel is tightly packed inside the needle’s
plastic connector.

“It is as simple as breaking a peanut shell and so I have called it Peanut
Safe,” he said.

He said the name of the product was derived from a riddle.

“Break open a peanut shell, eat the nuts and nobody will use it again.
This is true of Peanut Safe syringes too. Open the cover and you will get
a syringe which nobody has ever used before. Use it and no one can use it
ever again,” Manoj said.

Manoj has patented the product and plans to start marketing it soon.

http://tinyurl.com/bbcaxfc
__________________________________________________________________
__________________________________________________________________
Australia: Investigation of cheap Botox ‘sausage factory’
Melissa Davey, Sydney Morning Herald, Australia (06.03.13)

AUSTRALIA’S drug regulator is investigating a doctor alleged to be
importing cheap, unapproved versions of the anti-wrinkle drug Botox – and
injecting it into women at two Sydney clinics.

The investigation into Leo van den Heuvel, who works at Ultrasonic
Slimming clinics in Paddington and Gladesville, was launched after a
complaint from the Australasian College of Cosmetic Surgery.

What I do is exactly like in McDonald’s. People come in and are out within
five minutes.

The clinics and the doctor have strenuously denied the allegations.

A patient, Susie Driver, complained to the college after she developed
thrush and a two-week headache after treatment in December. She had
previously bought a voucher from the discount website Groupon to receive
”anti-wrinkle injections” for $139.

According to the college, there is evidence suggesting Dr van den Heuvel
has been buying cheap units through a Chinese website, tootoo.com. Its
complaint to the Therapeutic Goods Administration claims charging $139 for
the injections would mean a financial loss to the doctor, if the genuine
product was being sold.

The clinic has advertised the deal extensively and, in a recent offer,
Groupon said 650 vouchers had been sold.

Ms Driver said that when she redeemed the voucher she was told she would
receive 30 units of Botox over two facial areas, working out at $4.63 a
unit. According to the college, in Australia genuine Botox costs a doctor
about $5.67 a unit. Allowing for the doctor’s costs and profit, it is then
usually sold to the patient at about $13-15 a unit. The college said it
would not be financially viable for doctors to offer Botox at less than
$10 a unit.

Dr van den Heuvel said his product was genuine and he made no profit on
the injections. The low price was to attract new clients. ”What we do is
like a sausage factory,” he said. ”What I do is exactly like in
McDonald’s. People come in and are out within five minutes.”

The US Food and Drug Administration has warned doctors and the public that
unapproved botulinum toxin products may be unsafe or ineffective.
Imported, untested and unapproved botulinum toxin can cause weakness,
drooping eyelids, double vision, breathing difficulty and other dangerous
side effects.

The complaint from college president Colin Moore said:

”According to information provided to the college, Dr van den Heuvel may
be injecting as many as 50 patients per day, thus potentially exposing
thousands of Australians to serious harm.”

Documents from 2010 show a buyer using the name Dr Leo van der Heuvel
inquiring to a foreign website about the cost of the drug. The buyer uses
Dr van der Heuvel’s mobile number and the address of a clinic where he is
a GP.

He denied ordering products from overseas and said he was not responsible
for the online requests bearing his name. ”The internet is a big place,”
he said.

Ms Driver said she was told Botox would be used in the injections.

The Gladesville clinic eventually refunded the price of Ms Driver’s
voucher.

The clinic owner strongly denied any wrongdoing. She said the clinic had
never received any complaints about the injections, which were genuine. Dr
van den Heuvel said he never received complaints.
__________________________________________________________________
________________________________*_________________________________
* 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 Health Systems Policies and
Workforce, WHO, Avenue Appia 20, CH-1211 Geneva 27, Switzerland.
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

The SIGNpost Website is http://SIGNpostOnline.info

The new website 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 posting.

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
__________________________________________________________________

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