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

SIGNpost 00787

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST

Post00787 Low Hanging Fruit? + Abstracts + .R + News 04 February 2015

CONTENTS
1. Abstract: Hepatitis B and C seroprevalence among health care workers in
a tertiary hospital in Rwanda
2. Abstract: Knowledge, attitude, and performance of medical staff of
teaching healthcare settings about hepatitis B and C in Isfahan, Iran
3. Abstract: Low-hanging fruit for human factors design in infection
prevention–still too high to reach?
4. Abstract: The serious and ongoing issue of needlestick in Australian
healthcare settings
5. Abstract: A quality improvement initiative to reduce needlestick
injuries
6. Abstract: Healthcare Worker Adherence to Follow-up After Occupational
Exposure to Blood and Body Fluids at a Teaching Hospital in Brazil
7. Abstract: Review of naloxone safety for opioid overdose: practical
considerations for new technology and expanded public access
8. Abstract: Drug injecting and HIV risk among injecting drug users in Hai
Phong, Vietnam: a qualitative analysis
9. Abstract: Hepatitis C Virus Antibody Prevalence, Demographics and
Associated Factors among Persons Screened at Hawai’i Community-based
Health Settings, 2010-2013
10. Abstract: Aerosol immunisation for TB: matching route of vaccination
to route of infection
11. Abstract: Hepatitis B vaccine knowledge and vaccination status among
health care workers of Bahir Dar City Administration, Northwest
Ethiopia: a cross sectional study
12. Abstract: Effect of a single inactivated poliovirus vaccine dose on
intestinal immunity against poliovirus in children previously given
oral vaccine: an open-label, randomised controlled trial
13. Abstract: Incidence of endophthalmitis after intravitreal injection:
is antibioprophylaxis mandatory?
14. Abstract: Infection prevention and mass vaccination training for U.S.
point of dispensing staff and volunteers: A national study
15. Extract No Abstract: Atypical mycobacterial infection in insulin
injection sites
16. Abstract: OutbreakTools: a new platform for disease outbreak analysis
using the R software [Link to resources]
17. No Abstract: Is it necessary to perform hand hygiene for healthcare
workers before initial patient environment contact?
18. News
– USA: At least 5 workers stuck with needles at Vancouver motel
– Ebola: British health worker being tested for Ebola after needle injury
– USA: Mom finds pile of dirty syringes near elementary school
– Sweden: Swedish drug users need syringe exchange programmes

The web edition of SIGNpost is online at:
http://signpostonline.info/archives/1806

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.moderator@gmail.com

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

Like SIGNpost on Facebook at: https://www.facebook.com/SIGN.Moderator
and get updates on your device!

________________________________*_________________________________

1. Abstract: Hepatitis B and C seroprevalence among health care workers in
a tertiary hospital in Rwanda
__________________________________________________________________
http://tinyurl.com/kgt4fv3

Trans R Soc Trop Med Hyg. 2015 Jan 30. pii: trv004.

Hepatitis B and C seroprevalence among health care workers in a tertiary
hospital in Rwanda.

Kateera F1, Walker TD2, Mutesa L3, Mutabazi V4, Musabeyesu E5,
Mukabatsinda C6, Bihizimana P3, Kyamanywa P3, Karenzi B1, Orikiiriza JT7.

1Rwanda Military Hospital, Kigali, Rwanda.
2University Teaching Hospital of Butare, Rwanda School of Medicine and
Pharmacy, College of Medicine and Health Sciences, University of Rwanda,
Rwanda timwalkerd@gmail.com.
3School of Medicine and Pharmacy, College of Medicine and Health Sciences,
University of Rwanda, Rwanda.
4Medical Research Centre, Rwanda Biomedical Centre, Rwanda.
5King Faisal Hospital, Kigali, Rwanda.
6University Teaching Hospital of Kigali, Rwanda.
7Rwanda Military Hospital, Kigali, Rwanda Infectious Diseases Institute,
School of Medicine and Health Sciences, Makerere University, Uganda
Department of Immunology, Trinity College, Dublin, Ireland.

BACKGROUND: Hepatitis B (HBV) and hepatitis C (HCV) are significant global
public health challenges with health care workers (HCWs) at especially
high risk of exposure in resource-poor settings. We aimed to measure HBV
and HCV prevalence, identify exposure risks and evaluate hepatitis-related
knowledge amongst Rwandan tertiary hospital HCWs.

METHODS: A cross sectional study involving tertiary hospital employees was
conducted from October to December 2013. A pre-coded questionnaire was
used to collect data on HCWs’ socio-demographics, risk factors and
knowledge of blood-borne infection prevention. Blood samples were drawn
and screened for hepatitis B surface antigen (HBsAg) and anti-HCV
antibodies.

RESULTS: Among 378 consenting HCWs, the prevalence of HBsAg positivity was
2.9% (11/378; 95% CI 1.9 to 4.6%) and anti-HCV positivity 1.3% (5/378; 95%
CI 0.7 to 2.7%). Occupational exposure to blood was reported in 57.1%
(216/378). Of the 17 participants (4.5%; 17/378) who reported having
received the HBV vaccine, only 3 participants (0.8%) had received the
three-dose vaccination course. Only 42 HCWs (42/378; 11.1%) were aware
that a HBV vaccine was available. Most HCW (95.2%; 360/378) reported
having been tested for HIV in the last 6 months.

CONCLUSIONS: Despite their high workplace exposure risk, HBV and HCV sero-
prevalence rates among HCWs were low. The low HBV vaccination coverage and
poor knowledge of preventative measures among HCWs suggest low levels of
viral hepatitis awareness despite this high exposure.

© The Author 2015. Published by Oxford University Press on behalf of Royal
Society of Tropical Medicine and Hygiene.

KEYWORDS: Health care workers; Hepatitis B; Hepatitis C; Rwanda

Free Full Text http://tinyurl.com/kgt4fv3
__________________________________________________________________
________________________________*_________________________________

2. Abstract: Knowledge, attitude, and performance of medical staff of
teaching healthcare settings about hepatitis B and C in Isfahan, Iran
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25625106

Adv Biomed Res. 2014 Dec 31;3:267.

Knowledge, attitude, and performance of medical staff of teaching
healthcare settings about hepatitis B and C in Isfahan, Iran.

Ataei B1, Meidani M1, Khosravi M2, Khorvash F3, Akbari M4.

1Department of Infectious Diseases, Infectious Diseases and Tropical
Medicine Research Center, Isfahan University of Medical Sciences, Isfahan,
Iran.
2School of Medicine, Isfahan University of Medical Sciences, Isfahan,
Iran.
3Nosocomical Infection Research Center, Isfahan University of Medical
Sciences, Isfahan, Iran.
4Epidemiologist, School of Medicine, Isfahan University of Medical
Sciences, Isfahan, Iran.

BACKGROUND: hospital personnel are at high risk of exposure, infection,
and transmission of viral hepatitis. The present study aimed at
investigating the knowledge, attitude, and performance of health service
providers to provide them with the information required for their
educational promotion on viral hepatitis.

MATERIALS AND METHODS: This cross-sectional study was conducted on 400
staff of the forenamed healthcare settings such as on nurses, midwives,
licensed practical nurses, and lab officials in Isfahan, Iran, in 2012. A
checklist including demographic data and questions associated with the
knowledge (18 questions), attitude (4 questions), and performance (15
questions) on hepatitis B and C was completed by the participants.

RESULTS: A total of 388 participants completed the checklist.
Participants’ knowledge on the ways of transmission, prevalence,
vaccination, and prevention methods was moderate (total score = 58.56 ±
10.1 percent) and the attitude was generally positive. Proper vaccination
was carried out by 81.4% of the participants. Accidental injury by a
needle was reported in 47.7% of the participants, but only 37.6% of them
reported it to higher authorities and of them only 13.7% received
appropriate treatment. Only 44.3% and 11.6% of participants reported
always using gloves and masks, respectively, and 58.8% of the staff
covered the needle cap before transferring it to the safety box.

CONCLUSIONS: Due to excessive contact with patients, a paramedic-educated
society is expected to have an optimal level of knowledge, attitude, and
performance related to viral hepatitis. Our results from the checklists
showed that medical personnel are not appropriately aware of viral
hepatitis and their performance, too, is not satisfactory. Further
continuous training is required and there needs to be more emphasis on
actions regarding behaviors with high risk of infection transmission.

KEYWORDS: Attitude; Iran; hepatitis B; hepatitis C; knowledge; performance

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4298875/
__________________________________________________________________
________________________________*_________________________________

3. Abstract: Low-hanging fruit for human factors design in infection
prevention–still too high to reach?
__________________________________________________________________
Am J Infect Control. 2014 Jun;42(6):679-81.

Low-hanging fruit for human factors design in infection prevention–still
too high to reach?

Clack L1, Kuster SP1, Giger H1, Giuliani F2, Sax H3.

1Division of Infectious Diseases and Infection Control, University
Hospital of Zurich, Zurich, Switzerland.
2Quality Management and Patient Safety, University Hospital of Zurich,
Zurich, Switzerland.
3Division of Infectious Diseases and Infection Control, University
Hospital of Zurich, Zurich, Switzerland. Electronic address:
hugo.sax@mac.com.

Human factors design interventions have been suggested to mitigate
infection risk in health care. Among such solutions, many are easily
identified and theoretically simple and quick to realize. These are called
low-hanging fruit.

We present a case of infection risk associated with syringe manipulation
that could easily be solved by introducing user-centered design solutions.
Yet, organizational complexity makes implementation of such solutions
hardly reachable.

We therefore advocate embedding human factors macroergonomic expertise on
an organizational level.

Copyright © 2014 Association for Professionals in Infection Control and

Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

KEYWORDS: Device design; Infection control; Macroergonomics;
Organizational complexity; Risk management
__________________________________________________________________
________________________________*_________________________________

4. Abstract: The serious and ongoing issue of needlestick in Australian
healthcare settings
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25632726

Collegian. 2014;21(4):295-9.

The serious and ongoing issue of needlestick in Australian healthcare
settings.

Murphy CL.

Australian healthcare workers and especially nurses repeatedly have their
safety and health jeopardized through occupational exposures to blood and
body fluids. Percutaneous or needlestick injuries are especially
concerning and consistent.

The purpose of this article is to again draw attention to the serious and
costly issue of needlestick injuries in Australian healthcare settings.

Specifically it considers the context of needlestick injuries and safety
engineered devices within Standard 3 of the Australian Commission on
Safety and Quality in Health Care’s National Standards reform agenda.

Given that Standard 3 alone will likely be insufficient to reduce
needlestick injuries, this article also discusses improvements and current
challenges in international needlestick injury reduction in an attempt to
stimulate key opinion leader consideration of Australia adopting similar
strategies.
__________________________________________________________________
________________________________*_________________________________

5. Abstract: A quality improvement initiative to reduce needlestick
injuries
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25627533

Nurs Stand. 2015 Jan 28;29(22):37-42.

A quality improvement initiative to reduce needlestick injuries.

Beynon A1.

1Emergency department, Peterborough City Hospital, Peterborough,
Cambridgeshire, England.

Peterborough and Stamford Hospitals NHS Foundation Trust introduced sharp-
safe needles in January 2013; these became a part of general practice by
April 2013.

A service evaluation was undertaken to investigate whether the
introduction of sharp-safe needles had reduced the incidence of
needlestick injuries.

Results showed that 608 percutaneous injuries were sustained during the
use and disposal of sharps between April 2010 and March 2014. A total of
122 injuries occurred following the introduction of the new sharp-safe
needles (2013-2014), which was a 26% reduction compared with the previous
year (2012-2013, n = 165).

These results could mean that the sharp-safe needles reduced the rate of
injuries. A definitive evaluation of the effectiveness of the sharp-safe
needles was not possible given the limited data available since their
introduction.

KEYWORDS: Blood-borne infection; HIV; health service evaluation; incident
reporting; needlestick injuries; nursing care; quality improvement; sharps
injuries
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Healthcare Worker Adherence to Follow-up After Occupational
Exposure to Blood and Body Fluids at a Teaching Hospital in Brazil
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25636318

Ann Occup Hyg. 2015 Jan 30. pii: meu117.

Healthcare Worker Adherence to Follow-up After Occupational Exposure to
Blood and Body Fluids at a Teaching Hospital in Brazil.

Escudero DV1, Furtado GH2, Medeiros EA2.

1Infection Control Division, Department of Infectious Diseases, Hospital
São Paulo, Escola Paulista de Medicina, Universidade Federal de São Paulo,
São Paulo, Brazil daniv.escudero@gmail.com.
2Infection Control Division, Department of Infectious Diseases, Hospital
São Paulo, Escola Paulista de Medicina, Universidade Federal de São Paulo,
São Paulo, Brazil.

Healthcare workers (HCWs) are at a high risk for exposure to pathogens in
the workplace. The objective of this study was to evaluate HCW adherence
to follow-up after occupational exposure to blood and body fluids at a
tertiary care university hospital in the city of São Paulo, Brazil.

Data were collected from 2102 occupational exposures to blood and body
fluids reports, obtained from the Infection Control Division of the
Universidade Federal de São Paulo/Escola Paulista de Medicina/Hospital São
Paulo, in São Paulo, Brazil, occurring between January of 2005 and
December of 2011. To evaluate adherence to post-exposure follow-up among
the affected HCWs, we took into consideration follow-up visits for
serological testing. For HCWs exposed to materials from source patients
infected with human immunodeficiency virus (HIV), hepatitis B virus (HBV),
or hepatitis C virus (HCV), as well as from source patients of unknown
serological status, follow-up serological testing was scheduled for 3 and
6 months after the accident. For those exposed to materials from source
patients co-infected with HIV and HCV, follow-up evaluations were
scheduled for 3, 6, and 12 months after the accident.

During the study period, there were 2056 accidental exposures for which
data regarding the serology of the source patient were available. Follow-
up evaluation of the affected HCW was recommended in 612 (29.8%) of those
incidents. After the implementation of a post-exposure protocol involving
telephone calls and official letters mailed to the affected HCW, adherence
to follow-up increased significantly, from 30.5 to 54.0% (P = 0.028).
Adherence was correlated positively with being female (P = 0.009), with
the source of the exposure being known (P = 0.026), with the source
patient being HIV positive (P = 0.029), and with the HCW having no history
of such accidents (P = 0.047).

Adherence to the recommended serological testing was better at the
evaluation scheduled for 3 months after the exposure (the initial
evaluation) than at those scheduled for 6 and 12 months after the exposure
(P = 0.004). During the study period, there was one confirmed case of HCW
seroconversion to HCV positivity.

The establishment of a protocol that involves the immediate supervisor of
the affected HCWs, in the formal summoning of those HCWs is necessary in
order to increase the rate of adherence to post-exposure follow-up.

© The Author 2015. Published by Oxford University Press on behalf of the
British Occupational Hygiene Society.

KEYWORDS: accidental exposure; blood and body fluids; bloodborne
pathogens; follow-up; healthcare workers; hepatitis C seroconversion;
occupational exposure
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Review of naloxone safety for opioid overdose: practical
considerations for new technology and expanded public access
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25642320

Ther Adv Drug Saf. 2015 Feb;6(1):20-31.

Review of naloxone safety for opioid overdose: practical considerations
for new technology and expanded public access.

Wermeling DP1.

1University of Kentucky College of Pharmacy, 789 South Limestone Street,
Lexington, KY 40536, USA.

Opioid overdose and mortality have increased at an alarming rate prompting
new public health initiatives to reduce drug poisoning. One initiative is
to expand access to the opioid antidote naloxone. Naloxone has a long
history of safe and effective use by organized healthcare systems and
providers in the treatment of opioid overdose by paramedics/emergency
medicine technicians, emergency medicine physicians and anesthesiologists.

The safety of naloxone in a prehospital setting administered by
nonhealthcare professionals has not been formally established but will
likely parallel medically supervised experiences. Naloxone dose and route
of administration can produce variable intensity of potential adverse
reactions and opioid withdrawal symptoms: intravenous administration and
higher doses produce more adverse events and more severe withdrawal
symptoms in those individuals who are opioid dependent.

More serious adverse reactions after naloxone administration occur rarely
and may be confounded by the effects of other co-intoxicants and the
effects of prolonged hypoxia. One component of the new opioid harm
reduction initiative is to expand naloxone access to high-risk individuals
(addicts, abusers, or patients taking high-dose or extended-release
opioids for pain) and their close family or household contacts. Patients
or their close contacts receive a naloxone prescription to have the
medication on their person or in the home for use during an emergency.
Contacts are trained on overdose recognition, rescue breathing and
administration of naloxone by intramuscular injection or nasal spraying of
the injection prior to the arrival of emergency medical personnel.

The safety profile of naloxone in traditional medical use must be
considered in this new context of outpatient prescribing, dispensing and
treatment of overdose prior to paramedic arrival. New naloxone delivery
products are being developed for this prehospital application of naloxone
in treatment of opioid overdose and prevention of opioid-induced
mortality.

KEYWORDS: antidote; drug-delivery systems; naloxone; opioid; overdose
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Drug injecting and HIV risk among injecting drug users in Hai
Phong, Vietnam: a qualitative analysis
__________________________________________________________________
http://www.biomedcentral.com/1471-2458/15/32/abstract

BMC Public Health. 2015 Jan 29;15(1):32.

Drug injecting and HIV risk among injecting drug users in Hai Phong,
Vietnam: a qualitative analysis.

Ahmed T, Long T, Huong P, Stewart D.

Background: Hai Phong, located in northern Vietnam, has become a high HIV
prevalence province among Injecting Drug Users (IDUs) since the infection
shifted from the southern to the northern region of the country. Previous
research indicates high levels of drug and sex related risk behaviour
especially among younger IDUs.

Our recent qualitative research provides a deeper understanding of HIV
risk behaviour and highlights views and experiences of IDUs relating to
drug injecting and sharing practices.

Methods: Fifteen IDUs participated in semi-structured interviews conducted
in September-October, 2012. Eligible participants were selected from those
recruited in a larger scale behavioural research project and identified
through screening questions. Interviews were conducted by two local
interviewers in Vietnamese and were audiotaped. Ethical procedures,
including informed consent and participants¿ understanding of their right
to skip and withdraw, were applied. Transcripts were translated and double
checked. The data were categorised and coded according to themes. Thematic
analysis was conducted and a qualitative data analysis thematic framework
was used.

Results: Qualitative analysis highlighted situational circumstances
associated with HIV risks among IDUs in Hai Phong and revealed three
primary themes: (i) places for injecting, (ii) injecting drugs in small
groups, and (iii) sharing practices.

Our results showed that shared use of jointly purchased drugs and group
injecting were widespread among IDUs without adequate recognition of these
as HIV risk behaviours.

Frequent police raids generated a constant fear of arrest. As a
consequence, the majority preferred either rail lines or isolated public
places for injection, while some injected in their own or a friend¿s home.
Price, a heroin crisis, and strong group norms encouraged collective
preparation and group injecting.

Risk practices were enhanced by a number of factors: the difficulty in
getting new syringes, quick withdrawal management, punitive attitudes,
fear of arrest/imprisonment, lack of resources, incorrect self-assessment,
and risk denial. Some of the IDU participants emphasised self-care
attitudes which should be encouraged to minimise HIV transmission risk.

Conclusion: The IDUs¿ experiences in Hai Phong identified through our data
broaden our qualitative understanding about the HIV transmission risk
among IDUs and emphasize the need to strengthen harm reduction services in
Vietnam.

Free full text http://www.biomedcentral.com/1471-2458/15/32/abstract
__________________________________________________________________
________________________________*_________________________________

9. Abstract: Hepatitis C Virus Antibody Prevalence, Demographics and
Associated Factors among Persons Screened at Hawai’i Community-based
Health Settings, 2010-2013
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/25628977

Hawaii J Med Public Health. 2015 Jan;74(1):9-15.

Hepatitis C Virus Antibody Prevalence, Demographics and Associated Factors
among Persons Screened at Hawai’i Community-based Health Settings,
2010-2013.

Takeuchi LC1, Pham TK1, Katz AR1.

1Department of Public Health Sciences, University of Hawai’i at Manoa,
Honolulu, HI.

We sought to determine the prevalence of HCV infection and identify
factors associated with HCV infection among clients presenting to
community-based health settings in Hawai’i from 2010-2013. An earlier
report on this study population covered the period from December 2002
through May 2010. Since 2010, the HCV screening inclusion criteria have
been relaxed, and the program has greatly expanded.

Clients from 26 community-based sites were administered questionnaires,
and were screened for HCV antibodies from January 2010 through April 2013
(N = 8,588).

Univariate and multivariate logistic regression analyses were performed.
HCV antibody prevalence was 5.9% compared with 11.9% from 2002-2010.
Persons aged 45-65 years had the highest HCV antibody prevalence (8.4%)
compared with all other age groups.

Significant independent variables associated with HCV antibody prevalence
were injection drug use, blood transfusion before July 1992, and having an
HCV-infected sexual partner.

While characteristics associated with HCV infection remained essentially
unchanged from those identified in the earlier analysis, the expansion of
screening sites and less restrictive inclusion criteria led to a much
larger study population and a concurrent decrease in overall HCV antibody
prevalence. However, while the highest age-specific prevalence remained
the same for both screening periods, the prevalence among younger persons
(< 30 years old) doubled (from 2.4% to 4.7%).

By expanding the HCV screening program and relaxing the inclusion
criteria, a greater number of HCV-infected persons and a greater
proportion of younger persons with HCV infection were identified while
still maintaining a focus on at-risk individuals.

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4300540/
__________________________________________________________________
________________________________*_________________________________

10. Abstract: Aerosol immunisation for TB: matching route of vaccination
to route of infection
__________________________________________________________________
Trans R Soc Trop Med Hyg. 2015 Jan 30. pii: tru206.

Aerosol immunisation for TB: matching route of vaccination to route of
infection.

Manjaly Thomas ZR1, McShane H2.

1The Jenner Institute, Old Road Campus Research Building, Roosevelt Drive,
Oxford, OX3 7DQ, UK.
2The Jenner Institute, Old Road Campus Research Building, Roosevelt Drive,
Oxford, OX3 7DQ, UK helen.mcshane@ndm.ox.ac.uk.

TB remains a very significant global health burden. There is an urgent
need for better tools for TB control, which include an effective vaccine.
Bacillus Calmette-Guérin (BCG), the currently licensed vaccine, confers
highly variable protection against pulmonary TB, the main source of TB
transmission. Replacing BCG completely or boosting BCG with another
vaccine are the two current strategies for TB vaccine development.

Delivering a vaccine by aerosol represents a way to match the route of
vaccination to the route of infection. This route of immunisation offers
not only the scientific advantage of delivering the vaccine directly to
the respiratory mucosa, but also practical and logistical advantages.

This review summarises the state of current TB vaccine candidates in the
pipeline, reviews current progress in aerosol administration of vaccines
in general and evaluates the potential for TB vaccine candidates to be
administered by the aerosol route.

© The Author 2015. Published by Oxford University Press on behalf of Royal
Society of Tropical Medicine and Hygiene.
__________________________________________________________________
________________________________*_________________________________

11. Abstract: Hepatitis B vaccine knowledge and vaccination status among
health care workers of Bahir Dar City Administration, Northwest
Ethiopia: a cross sectional study
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25637342

BMC Infect Dis. 2015 Jan 31;15(1):30.

Hepatitis B vaccine knowledge and vaccination status among health care
workers of Bahir Dar City Administration, Northwest Ethiopia: a cross
sectional study.

Abeje Fekadu G, Azage M.

Background: Hepatitis B infection is a major public health problem in
Ethiopia. Health care workers are at increased risk of acquiring hepatitis
B infection due to occupational exposure. There is effective and safe
vaccine against hepatitis B infection. But many health care workers in
developing countries are not vaccinated. There is no study in Ethiopia
that describes hepatitis B vaccine knowledge and vaccination status of
health care workers.

Therefore, this study was done to assess hepatitis B vaccination status
and knowledge among health care workers¿ of Bahir Dar city administration,
Northwest Ethiopia.

Methods: Institution based cross sectional study design was employed from
April 1 to 30, 2012.

All healthcare workers who were working in Health care facilities of Bahir
Dar city administration were the study populations. A total of 374 health
care workers were included in the study. Simple random sampling technique
was used to select eligible study participants from the list of health
care workers. Self administered questionnaire was used to collect data.
The completeness of questionnaires was checked every day by facilitators
and principal investigators. Data were entered and analyzed with
statistical package for social sciences version 16.0 software.

Result: In this study, 64.7% of respondents perceived their risk of
acquiring hepatitis B infection very high or high. Only 52% of the
respondents were knowledgeable about hepatitis B infection. In this study,
only 62% of health care workers were knowledgeable about hepatitis B
vaccine. From the total of 370 respondents, only 20(5.4%) reported that
they took three or more doses of hepatitis B vaccine.

Conclusion: Hepatitis B vaccination status of health care workers in the
study area was low. Health care workers¿ knowledge about hepatitis B
infection and hepatitis B vaccine was also low as all health care workers
should be knowledgeable.

Free full text http://www.biomedcentral.com/1471-2334/15/30/abstract
__________________________________________________________________
________________________________*_________________________________

12. Abstract: Effect of a single inactivated poliovirus vaccine dose on
intestinal immunity against poliovirus in children previously given
oral vaccine: an open-label, randomised controlled trial
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25018120

Lancet. 2014 Oct 25;384(9953):1505-12.

Effect of a single inactivated poliovirus vaccine dose on intestinal
immunity against poliovirus in children previously given oral vaccine: an
open-label, randomised controlled trial.

John J1, Giri S1, Karthikeyan AS1, Iturriza-Gomara M2, Muliyil J1, Abraham
A1, Grassly NC3, Kang G1.

1Christian Medical College, Vellore, Tamil Nadu, India.
2Christian Medical College, Vellore, Tamil Nadu, India; Institute of
Infection and Global Health, University of Liverpool, Liverpool, UK.
3Christian Medical College, Vellore, Tamil Nadu, India; Department of
Infectious Disease Epidemiology, Imperial College London, London, UK.
Electronic address: n.grassly@imperial.ac.uk.

BACKGROUND: Intestinal immunity induced by oral poliovirus vaccine (OPV)
is imperfect and wanes with time, permitting transmission of infection by
immunised children. Inactivated poliovirus vaccine (IPV) does not induce
an intestinal mucosal immune response, but could boost protection in
children who are mucosally primed through previous exposure to OPV. We
aimed to assess the effect of IPV on intestinal immunity in children
previously vaccinated with OPV.

METHODS: We did an open-label, randomised controlled trial in children
aged 1-4 years from Chinnallapuram, Vellore, India, who were healthy, had
not received IPV before, and had had their last dose of OPV at least 6
months before enrolment. Children were randomly assigned (1:1) to receive
0·5 mL IPV intramuscularly (containing 40, 8, and 32 D antigen units for
serotypes 1, 2, and 3) or no vaccine. The randomisation sequence was
computer generated with a blocked randomisation procedure with block sizes
of ten by an independent statistician. The laboratory staff did blinded
assessments. The primary outcome was the proportion of children shedding
poliovirus 7 days after a challenge dose of serotype 1 and 3 bivalent OPV
(bOPV). A second dose of bOPV was given to children in the no vaccine
group to assess intestinal immunity resulting from the first dose. A per-
protocol analysis was planned for all children who provided a stool sample
at 7 days after bOPV challenge. This trial is registered with Clinical
Trials Registry of India, number CTRI/2012/09/003005.

FINDINGS: Between Aug 19, 2013, and Sept 13, 2013, 450 children were
enrolled and randomly assigned into study groups. 225 children received
IPV and 225 no vaccine. 222 children in the no vaccine group and 224
children in the IPV group had stool samples available for primary analysis
7 days after bOPV challenge. In the IPV group, 27 (12%) children shed
serotype 1 poliovirus and 17 (8%) shed serotype 3 poliovirus compared with
43 (19%) and 57 (26%) in the no vaccine group (risk ratio 0·62, 95% CI
0·40-0·97, p=0·0375; 0·30, 0·18-0·49, p<0·0001). No adverse events were
related to the study interventions.

INTERPRETATION: The substantial boost in intestinal immunity conferred by
a supplementary dose of IPV given to children younger than 5 years who had
previously received OPV shows a potential role for this vaccine in
immunisation activities to accelerate eradication and prevent outbreaks of
poliomyelitis.

FUNDING: Bill & Melinda Gates Foundation.

Comment in Polio endgame management: focusing on performance with or
without inactivated poliovirus vaccine. [Lancet. 2014]

Free Full Text [registration may be required] http://tinyurl.com/mwl4e5k
__________________________________________________________________
________________________________*_________________________________

13. Abstract: Incidence of endophthalmitis after intravitreal injection:
is antibioprophylaxis mandatory?
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/24655790

J Fr Ophtalmol. 2014 Apr;37(4):273-9.

[Incidence of endophthalmitis after intravitreal injection: is
antibioprophylaxis mandatory?].

[Article in French]

Ramel JC1, Bron AM1, Isaico R1, Meillon C1, Binquet C2, Creuzot-Garcher
C3.

1Service d’ophtalmologie, hôpital Général, CHU de Dijon, 3, rue du
Faubourg-Raines, 21000 Dijon, France.
2Service d’épidémiologie, CHU de Dijon, 3, rue du Faubourg-Raines, 21000
Dijon, France.
3Service d’ophtalmologie, hôpital Général, CHU de Dijon, 3, rue du
Faubourg-Raines, 21000 Dijon, France. Electronic address:
catherine.creuzot-garcher@chu-dijon.fr.

INTRODUCTION: Endophthalmitis is the most dreaded complication after
intravitreal injection. With the rise of antiangiogenics their rate is
getting higher each year. The use of antibioprophylaxis is controversial.
We tried to evaluate the impact of antibioprophylaxis on intravitreal
injection endophthalmitis incidence.

METHODS: All patients who received intravitreal injections between January
2007 and October 2012 were included in this retrospective study. Until
June 2012 all patients had antibiotics the days following the injection.
From July 2012 the antibiotic was replaced by an antiseptic immediately
after the injection.

RESULTS: An overall number of 11,450 injections were performed. The
overall rate of endophthalmitis was 6/11,450 (0.052%). The incidence of
endophthalmitis in the group with antibiotics was 3/10,144 injections
(0.03%), 2 were culture proven (0.02%). The incidence in the group without
antibiotics was 3/1306 (0.23%). The difference was significant (P=0.024).

CONCLUSION: The incidence of endophthalmitis post-intravitreal injections
seems to be lower when using antibiotics. However, a prospective study is
mandatory to draw more robust conclusions. Copyright © 2014 Elsevier
Masson SAS. All rights reserved.

KEYWORDS: Antibioprophylaxie; Antibioprophylaxis; Antibiotic;
Antibiotique; Endophtalmie; Endophthalmitis; Incidence; Infection;
Injection intravitréenne; Intravitreal injection
__________________________________________________________________
________________________________*_________________________________

14. Abstract: Infection prevention and mass vaccination training for U.S.
point of dispensing staff and volunteers: A national study
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25637434

Am J Infect Control. 2015 Jan 27. pii: S0196-6553(14)01333-9.

Infection prevention and mass vaccination training for U.S. point of
dispensing staff and volunteers: A national study.

Rebmann T1, Loux TM2, Zink TK3, Swick Z4, Wakefield M3.

1Department of Environmental and Occupational Health, Institute for
Biosecurity, College for Public Health & Social Justice, Saint Louis
University, St Louis, MO. Electronic address: rebmannt@slu.edu.
2Department of Biostatistics, College for Public Health & Social Justice,
Saint Louis University, St Louis, MO.
3Department of Environmental and Occupational Health, Institute for
Biosecurity, College for Public Health & Social Justice, Saint Louis
University, St Louis, MO.
4Oregon Military Department, Oregon Office of Emergency Management,
Portland, OR.

BACKGROUND: Points of dispensing (PODs) are deployed for medical
countermeasure mass dispensing. However, infection prevention and vaccine
administration pre-event training offered and just-in-time (JIT) education
planned for POD workers have not been assessed.

METHODS: Disaster planners were sent an online questionnaire in 2013.
McNemar tests compared training offered to staff versus volunteers and
pre-event training versus JIT training.

RESULTS: In total, 301 disaster planners participated. The most frequent
pre-event training included hand hygiene (59.1% and 28.0%) and personal
protective equipment (PPE) selection (52.1% and 24.1%) for staff and
volunteers, respectively.

Few provided pre-event training on the cold chain technique (14.8% and
5.1%) or smallpox vaccine administration (4.7% and 2.3%) for staff or
volunteers. For all topics except smallpox vaccine administration, more
staff than volunteers received pre-event training (P < .01).

The most frequent planned JIT training includes hand hygiene (79.8% and
73.5%) and PPE selection (79.4% and 70.0%) to staff and volunteers. For
all topics, more JIT education is planned for staff than volunteers (P <
.001). More JIT training is planned than has been given pre-event for all
topics (P < .001).

CONCLUSION: More pre-event training is needed on infection prevention and
vaccine administration to ensure safe and successful POD deployment.

Copyright © 2015 Association for Professionals in Infection Control and
Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

KEYWORDS: Anthrax; Bioterrorism; Disaster; Mass dispensing; Pandemic;
Preparedness; Smallpox; Vaccine
__________________________________________________________________
________________________________*_________________________________

15. Extract No Abstract: Atypical mycobacterial infection in insulin
injection sites
__________________________________________________________________
http://qjmed.oxfordjournals.org/content/early/2015/01/30/qjmed.hcv029

QJM. 2015 Jan 30. pii: hcv029.

Atypical mycobacterial infection in insulin injection sites.

Yew TW1, Chandran NS2, Tan KB3, Thai AC2.

1Department of Medicine, National University Health System, 1E Kent Ridge
Road, NUHS Tower Block, Level 10, Singapore 119228.
tong_wei_yew@nuhs.edu.sg.
2Department of Medicine, National University Health System, 1E Kent Ridge
Road, NUHS Tower Block, Level 10, Singapore 119228.
3Department of Pathology, National University Health System, Lower Kent
Ridge Road, Singapore 119704.

Free full text http://tinyurl.com/n75vbho
__________________________________________________________________
__________________________________________________________________

Extract Extract Extract Extract Extract Extract

A 65-year-old man with long-standing type 2 diabetes on subcutaneous
insulin therapy presented with multiple abdominal wall abscesses. The
abscesses were drained and he received one week’s course of co-amoxiclav
based on tissue culture which grew Serratia marcescens. However, similar
lesions recurred over the next three months. He did not have fever and was
otherwise well. Glycaemic control was suboptimal (HbA1c 64–75mmol/mol).
Examination showed multiple erythematous papules and nodules of varying
sizes scattered over the lower abdomen (Figure 1a). Some nodules were
fluctuant and discharged purulent fluid. On further questioning it became
evident that the lesions corresponded to insulin injections sites.

Biopsy of a larger nodule showed dense inflammation in the superficial and
deep dermis, with focal collections of multi-nucleated histiocytes forming
granulomas. Ziehl–Neelsen stain showed an isolated acid-fast bacillus.
However, culture was negative for acid-fast bacilli after eight weeks.

Molecular testing for Mycobacterium tuberculosis was negative. Stains and
cultures for bacteria and fungus were negative. A diagnosis of cutaneous
atypical mycobacterial infection was made.

Ciprofloxacin and clarithromycin were empirically started. All insulin
vials, syringes and needles were replaced. The lesions gradually resolved
with post-inflammatory hyperpigmentation after 38 weeks of therapy (Figure
1b).

Atypical mycobacterium is an infrequent aetiology of skin infections
associated with injections such as those of mesotherapy,1,2 insulin
injections3,4 and insulin pump.5,6 Diabetes and the reuse of nondisposable
needles in the past are predisposing factors3 but cases have been reported
even with disposable needles.4

The reason for such infection in this patient was unclear as he used
alcohol swabs before injections and denied reusing the needles. There was
no other similarly affected patients to suggest a contaminated batch of
insulin preparation.

It is important to consider mycobacterial infection in recurrent or
persistent cutaneous abscesses despite conventional antibiotic therapy
among patients with diabetes on insulin injections.
__________________________________________________________________
________________________________*_________________________________

16. Abstract: OutbreakTools: a new platform for disease outbreak analysis
using the R software [Link to resources]
__________________________________________________________________
http://www.sciencedirect.com/science/article/pii/S1755436514000206

Epidemics. 2014 Jun;7:28-34.

OutbreakTools: a new platform for disease outbreak analysis using the R
software.

Jombart T1, Aanensen DM2, Baguelin M3, Birrell P4, Cauchemez S5, Camacho
A6, Colijn C7, Collins C8, Cori A8, Didelot X8, Fraser C8, Frost S9, Hens
N10, Hugues J11, Höhle M12, Opatowski L13, Rambaut A14, Ratmann O8,
Soubeyrand S15, Suchard MA16, Wallinga J17, Ypma R17, Ferguson N8.

The investigation of infectious disease outbreaks relies on the analysis
of increasingly complex and diverse data, which offer new prospects for
gaining insights into disease transmission processes and informing public
health policies.

However, the potential of such data can only be harnessed using a number
of different, complementary approaches and tools, and a unified platform
for the analysis of disease outbreaks is still lacking.

In this paper, we present the new R package OutbreakTools, which aims to
provide a basis for outbreak data management and analysis in R.
OutbreakTools is developed by a community of epidemiologists,
statisticians, modellers and bioinformaticians, and implements classes and
methods for storing, handling and visualizing outbreak data.

It includes real and simulated outbreak datasets. Together with a number
of tools for infectious disease epidemiology recently made available in R,

OutbreakTools contributes to the emergence of a new, free and open-source
platform for the analysis of disease outbreaks.

Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

KEYWORDS: Bioinformatics; Epidemics; Epidemiology; Free; Infectious
disease; Public health; R; Software

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4058532/
__________________________________________________________________

Resources

Availability: OutbreakTools 0.1–0 is distributed on CRAN (
http://cran.r-project.org/) and available for R 3.0.2 on Windows, Mac OSX,
and Linux platforms. It can be installed as any other package using the
graphical user interface or typing the instruction:
install.packages(“OutbreakTools”)

Licence: GNU General Public Licence (GPL) =2.

Website: http://sites.google.com/site/therepiproject/r-pac/about

Documentation: besides the usual package documentation, OutbreakTools is
released with a tutorial which can be opened by typing:
vignette(“OutbreakTools”). More documentation can be found on the
project’s website.

Development: the development of OutbreakTools is hosted on Sourceforge:
http://sourceforge.net/projects/hackout/

New contributions are welcome and encouraged.
__________________________________________________________________
________________________________*_________________________________

17. No Abstract: Is it necessary to perform hand hygiene for healthcare
workers before initial patient environment contact?
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25627773

Infect Control Hosp Epidemiol. 2015 Jan;36(1):115-6.

Is it necessary to perform hand hygiene for healthcare workers before
initial patient environment contact?

Liu RH1, Xie DS2.

11Department of Infection Control,the First College of Clinical Medical
Science,China Three Gorges University & Yichang Central People’s
Hospital,Yichang,Hubei,China.
22Department of Infection Control,Taihe Hospital,Hubei University of
Medicine,Shiyan,Hubei,China.
__________________________________________________________________
________________________________*_________________________________

18. News

– USA: At least 5 workers stuck with needles at Vancouver motel
– Ebola: British health worker being tested for Ebola after needle injury
– USA: Mom finds pile of dirty syringes near elementary school
– Sweden: Swedish drug users need syringe exchange programmes

Selected news items reprinted under the fair use doctrine of international
copyright law: http://www4.law.cornell.edu/uscode/17/107.html
__________________________________________________________________
http://tinyurl.com/pckldah

USA: At least 5 workers stuck with needles at Vancouver motel

kgw.com, USA (02.02.15)

VANCOUVER, Wash. – A Vancouver motel was fined more than $112,000 after an
investigation found that five workers were stuck with used hypodermic
needles in the past two years.

In August 2014, a complaint was filed against the Vancouver Motel 6,
located at 221 NE Chkalov Drive, alleging that workers had been exposed to
used needles while they were cleaning rooms at the budget lodging
facility.

The Washington Department of Labor and Industries investigated the motel
and found that not only were workers exposed to used hypodermic needles,
but the motel didn’t give employees who were stuck with needles hepatitis
B vaccines.

The motel also did not have safe containers for throwing away contaminated
needles and didn’t train staff on how to use chemical cleaners, which is
required by law.

The Vancouver Motel 6 was fined a total of $112,450, for four “willful
violations of the health standards that protect workers from biological
hazards,” according to L&I spokeswoman Elaine Fischer.

She said none of the employees exposed to the used needles appear to have
continuing health impacts, and unless they develop work-related illnesses
as a result of the exposure, they will not receive any compensation.

The funds will instead go into a supplemental pension fund for workers who
are disabled and the families of employees who have died on the job.

This is not the first time the Vancouver Motel 6 has violated labor laws.
In 2011 and 2012, the motel was inspected and cited for serious
violations.

Serious violations are defined as a work environment where there’s
“substantial probability that worker death or serious physical harm could
result,” Fischer said.

The motel has 15 days to appeal the latest citations. The owner of the
motel, Rocky Patel, said he would appeal the fine.
__________________________________________________________________
__________________________________________________________________
http://tinyurl.com/ookx468

Ebola: British health worker being tested for Ebola after needle injury

by Stephen Addison, Reuters (31.01.15)

LONDON(Reuters) – A British military healthcare worker was flown back to
England from Sierra Leone on Saturday following a needle-stick injury
sustained while treating a person with Ebola, the Public Health England
(PHE) service said on Saturday.

The patient, who has not been named, has been taken for testing to the
Royal Free Hospital in London.

“They are likely to have been exposed to the Ebola virus but, at this
time, have not been diagnosed with Ebola and do not have symptoms,” PHE
said in a statement.

Last week, a British nurse who had been critically ill with Ebola after
working in Sierra Leone was discharged from the same hospital after making
a full recovery.

The Royal Free, Britain’s main center for Ebola cases, also successfully
treated British aid worker William Pooley who contracted the virus in West
Africa last year.

To date, more than 21,700 cases of Ebola have been reported in nine
countries, including nearly 8,650 deaths, according to the World Health
Organization, although it said this week it believed the disease was
declining.

(Reporting by Stephen Addison; Editing by Raissa Kasolowsky)
__________________________________________________________________
__________________________________________________________________
http://tinyurl.com/k5z8kd2

USA: Mom finds pile of dirty syringes near elementary school

By: Caiti Currey, KXLY Spokane WA USA (30.01.15)

COEUR D’ALENE, Idaho

With three different schools along 9th Street in Coeur d’Alene, most of
the foot traffic is children. So, you can understand neighbors’ concerns
when they found the street littered with dirty syringes, many still with
used needles attached to them.

Jessica O’Brien and her family are one of the many who frequently walk up
and down 9th; last Sunday on one of their walks something caught the eye
of O’Brien and her husband.

“There were just more and more pieces, and broken pieces, some still had
needles in them,” O’Brien said.

Syringes; her guess, about 50 of them, littering the street along with
their orange caps.

“There’s no way to tell if they’re used, if there is something in them I
didn’t even really no who to contact at first,” O’Brien said.

After finding many of them toward the path to Borah Elementary School she
called the police.

“Said they’d send somebody down to talk to me and that it wasn’t their
first call they had of the day,” said O’Brien.

She said nobody ever came. Though many of the syringes were crushed in the
street or picked up by neighbors, on Friday at least a dozen remained,
including some with needles still attached.

“There’s a lot less and I’m happy about. But they are certainly not all
gone,” said O’Brien

Coeur d’Alene Police Detective Bryan Alexander said a patrol car did stop
by and noted it looked like a snow plow had come and cleaned most of them
up.

“Sometimes we do show up and you don’t know,” said Alexander.

The detective said their ultimate goal to keep the community safe, if you
feel there’s more to be done don’t hesitate to call them out.

“That’s why we’re here to serve the public and the community,” Alexander
said.

Alexander adds whatever you do, don’t pick them up yourself, you never
know how or what they were used for. In this case, it’s a question police
still don’t know the answer to.

But Jessica and her daughter shouldn’t have to worry about them on their
walks anymore.

“I just want it picked up,” O’Brien said.

© 2015 KXLY.com. All rights reserved.
__________________________________________________________________
__________________________________________________________________
www.west-info.eu/swedish-drug-users-need-syringe-exchange-programmes/

Sweden: Swedish drug users need syringe exchange programmes

by Ivano Abbadessa, West – Welfare Society Territory (28.01.15)

Needle and syringe exchange programmes should be introduced across the
country, Sweden’s Public Health Agency (Folkhälsomyndigheten) writes in a
new report. Asking the public authorities to introduce nationwide programs
to improve access and distribution of clean needles and syringes just as
already happens in many other European countries, including Italy.

The goal is to reduce the increasing risk of hepatitis B, C and HIV.
Around 800 people a year currently contract hepatitis C in Sweden as a
result of dirty needles or syringes. Syringe exchange activities,
providing access to safe injection equipment, is central to reducing the
risk of spreading infection, said experts.

Approximately 8000 people inject drugs in Sweden, according to national
statistics body Statistics Sweden. The median age for starting to take
drugs among that group is 14 or 15.

West is an online newspaper aimed at providing the latest breaking news on
welfare policies.
__________________________________________________________________
________________________________*_________________________________

SIGN Meeting 2015

The Safe Injection Global Network SIGN meeting is 23-24 February 2015 at
WHO Headquarters in Geneva Switzerland

The main topic of the meeting will be the new injection safety policy
recommendation and developing the appropriate strategies for
implementation in countries worldwide.

The Keynote speaker will be Dr Margaret Chan, the Director-General of WHO.

Dr. Chan will launch the new IS policy which recommends the use of safety
engineered injection devices for reuse prevention and sharps injury
protection.
__________________________________________________________________
________________________________*_________________________________
* 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
__________________________________________________________________
________________________________*_________________________________

The 2010 annual Safe Injection Global Network meeting to aid collaboration
and synergy among SIGN network participants worldwide 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/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 SIGNpost website provides 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 Secretariat home is the Department of Health Systems Policies and
Workforce, Geneva Switzerland.

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.