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SIGNpost 00809

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST

Post00809 Waste Job + Call 4 Abstracts + Abstract Catch-up    15 July 2015

CONTENTS
1. Deadline Extended: Call For Abstracts: ICAAP12 – International
Conference on AIDS in ASIA and the PACIFIC
2. Consultant Health Care Waste: WHO Terms of reference
3. Hepatitis B vaccination status and needle-stick and sharps-related
Injuries among medical school students in Nepal: a cross-sectional
study
4. Abstract: Benchmarking of percutaneous injuries at the Ministry of
Health hospitals of Saudi Arabia in comparison with the United States
hospitals participating in Exposure Prevention Information Network
(EPINet™)
5. Abstract: Incidence of occupational exposure to blood and body fluids
and measures taken by health care workers before and after exposure in
regional hospitals of a developing country: A multicenter study
6. Abstract: Needle-stick dengue virus infection in a health-care worker
at a Japanese hospital
7. Abstract: Work accidents with biological material occurred in
municipalities of Minas Gerais
8. Abstract: Knowledge and practices of healthcare workers in relation to
bloodborne pathogens in a tertiary care hospital, Western Saudi Arabia
9. Abstract: Needlestick Injuries to Medical Students
10. Abstract: Sharps injury prevention guidance among health care
professionals: A comparison between self-reported and observed
compliance
11. Abstract: Needle size for vaccination procedures in children and
adolescents
12. Abstract: Transdermal delivery of therapeutic agents using dendrimers
(US20140018435A1): a patent evaluation
13. Abstract: Use of mercury-based medical equipment and mercury content
in effluents of tertiary care hospitals in India
14. Abstract: Factors Associated with Hepatitis C Infection among Chronic
HCV Egyptian Patients
15. Abstract: Prioritizing High-Risk Practices and Exploring New Emerging
Ones Associated With Hepatitis C Virus Infection in Egypt
16. Abstract: Hepatitis C virus infection and risk factors in health-care
workers at Ain Shams University Hospitals, Cairo, Egypt
17. Abstract: Harm Reduction: Front Line Public Health
18. Abstract: Barriers and Potential Improvements for Needle and Syringe
Exchange Programs (NSPs) in China: A Qualitative Study from
Perspectives of Both Health and Public Security Sectors
19. Abstract: Self-reported changes in drug use behaviors and syringe
disposal methods following the opening of a supervised injecting
facility in Copenhagen, Denmark
20. Abstract: A Cost Analysis of Hospitalizations for Infections Related
to Injection Drug Use at a County Safety-Net Hospital in Miami,
Florida
21. Abstract: Multiple Skin Abscesses and Myofibrosis of Bilateral Lower
Limbs Following Repeated Intramuscular Injection of Pentazocine with
Concomitant Tuberculous Infection
22. Abstract: A survey of UK practice patterns in the delivery of
intravitreal injections
23. Abstract: In vivo injectable gels for tissue repair
25. Abstract: The West African Ebola outbreak: finishing the job,
preparing for future
26. Abstract: How to use personal protective equipment
27. Abstract: Elevator buttons as unrecognized sources of bacterial
colonization in hospitals
28. Abstract: Factors influencing glove use in student nurses
29. No Abstract: Bloodborne virus exposure from sharps injuries on the
rise
30. No Abstract: Surveillance and prevention of patient blood exposure
accidents

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__________________________________________________________________
________________________________*_________________________________

1. Deadline Extended: Call For Abstracts: ICAAP12 – International
Conference on AIDS in ASIA and the PACIFIC

Hurry, send in your research abstracts!

Deadline is now July 20th! Hurry, send in your research abstracts!

See the link here, and the relevant portions copied in below:
http://www.icaap2015.org/abstracts/track-categories#.VYjukkaPYtE
__________________________________________________________________
Dear SIGN collaborators

Antimicrobial resistance poses the urgent challenge of infection
prevention and control for all patients, first among whom are People
living with HIV/AIDS.

The November 2015 12th ICAAP12- International Conference on AIDS in ASIA
and the PACIFIC, Dhaka, Bangladesh has a track on Infection control in the
HIV era/nosocomial infection / Patient Safety / Safety and AMR.

Deadline is now July 20th! Hurry, send in your research, abstracts!

See the link here, and the relevant portions copied in below:
http://www.icaap2015.org/abstracts/track-categories#.VYjukkaPYtE

9. Infection control in the HIV era/nosocomial infection

A70. Safety and Antimicrobial resistance transmission
A71. Airborne transmission control (Tuberculosis) in HIV care
A72. ART-resistant HIV transmission prevention
A73. Tattooing, cosmetics, blood donation and HIV safety
A74. Implementation research for patient safety and HIV
A75. HIV and safety in pre-natal care, and midwifery
A76. Patient centered safe delivery- innovation based systems for HIV
A77. HIV Patients for Patient Safety

The deadline for abstract submission is 15 July. Not much time.

Mrs Garance Fannie Upham
Deputy General Secretary, AC2BMR / WAAAR World Alliance Against Antibiotic
Resistance (www.waaar.org/)
Editor, “AMR Control 2015″
__________________________________________________________________
________________________________*_________________________________

2. Consultant Health Care Waste: WHO Terms of reference

Deadline for application: 24 JULY 2015

Responses to: hhwater@who.int
__________________________________________________________________
Download Link http://tinyurl.com/pz8yvht

World Health Organization

Terms of reference: Consultant Health Care Waste

Deadline for application: 24 JULY 2015

1. Background

The Water, Sanitation, Hygiene and Health Unit (WSH), within the
Department of Public Health, Social and Environmental Health, is working
in four main areas: normative guidelines, monitoring, capacity building,
and implementation. The overall aim of WSH’s activities are to
significantly reduce the burden of water, sanitation and hygiene (WASH)-
related disease. Three important areas for which there is a current gap in
expertise and staff resources are in health care waste, WASH monitoring in
health care facilities and WASH in emergencies and outbreaks. In
particular there is a pressing need to increase expertise in HQ on health
care waste which has important links with several WHO Departments
including Immunizations, Vaccines and Biologicals, Service Delivery and
Safety and Emergency Response and Management.

2. Purpose and objectives

The purpose of the work is to provide leadership and further develop WHO’s
work in health care waste. The candidate be based in WSH’s Settings Team,
reporting to that Team’s lead. He/she will provide leadership and further
develop WHO’s work in health care waste, linked closely with WHO’s work on
improving WASH in health care facilities. In addition, the candidate will
work closely with the Expanded Programme on Immunization (EPI), regularly
participating in relevant EPI meetings and events and contributing to the
activities of the Immunization Systems Management Group to support polio
eradication and the endgame strategy. Likewise, he/she will collaborate
with Infection Prevention and Control (IPC). Such collaborations involve
co-developing joint guidance, providing coordinated technical support and
responding to country and regional requests and needs.

On monitoring WASH in health care facilities, she/he will collaborate
closely with WSH’s Monitoring Team. This will involve supporting expanded
national monitoring in partnership with Health Sector colleagues and
reporting access under the WHO/UNICEF Joint Monitoring Programme mandate.

Finally, as time allows, the candidate will contribute advice and
technical material to the relevant emergency, and prevention, preparedness
and response teams.

3. Scope of work

To meet the above purpose and objectives, it is expected that the
professional will:

1. Serve as focal point on health care waste at WHO HQ and provide
leadership and technical support, including development of guidelines,
tools and training packages, for use at global, regional and national
level. This includes contributing to Infection Prevention and Control work
on injection safety and development and implementation of a waste strategy
to accompany the new injection safety initiative on single use syringes.

2. Serve as focal point and develop guidelines, in close collaboration
with the Expanded Programme on Immunization unit in the Immunization,
Vaccines and Biologicals department on proper waste management for
immunization related waste particularly during mass campaign settings and
in relation to the appropriate collection, transport and destruction of
vaccine vials targeted for recall.

3. Support WHO’s work on monitoring WASH in health care facilities
including implementation of core and expanded questions in national
assessments, such as the Service Availability and Reliability Assessment,
and reporting of coverage in periodic publications issued by the
WHO/UNICEF Joint Monitoring Programme.

4. Support WHO’s work in emergencies, including representing WHO in the
Global WASH Cluster, strategically communicating WHO’s role in WASH in
emergencies and supporting these obligations through technical advice.

5. Develop good practice documents and guidelines in collaboration other
WHO departments on WASH issues in specific settings including cholera
prevention and control in hotspot communities, aircraft and ship.

4. Deliverables, budget and timeframe

The work will be completed over a period 5 months (1 August-31 December
2015) with an average of 20 working days each month. It is expected that
the consultant will be based at the WHO office in Geneva with 30% travel
as needed, to support implementation efforts on health care waste and
monitoring of WASH in health care facilities. Deployment for emergencies
may be considered depending on national needs and WHO international
obligations. The daily rate will be comerserate with the level of
experience. Payments will be made, monthly, according to the number of
days worked, assuming, generally, 20 days/month and satisfactory
completion of monthly deliverables as outlined in the following table.

[This is an interpolation for ascii text ot the actual table]

[Download TOR for the table of deliverables http://tinyurl.com/pz8yvht ]

|Deliverables | Major Output |Completion date |Estimated work days|

1
-Produce operational guide for safe disposal of vaccines; with focus on
vaccines scheduled for phase-out

-Support development of core and expanded WASH questions for SARA and
other national surveys

-Update and manage health care waste website

-Ongoing: contribute to guidelines drafted around waste management for the
tOPV-bOPV switch and respond to WASH needs on Phase 3 emergencies and
outbreaks

30 August 2015 20

2
-Develop waste strategy document to accompany implementation of new
injection safety initiative on single use syringes

-Manage revisions and finalization of WASH requirements in Ebola Treatment
Centers Document

30-Sept-15 20

3
-Refine/amend training package on health care waste as part of WHO’s new
facility safety plans

-Ongoing: contribute to guidelines drafted around waste management for the
tOPV-bOPV switch and respond to WASH needs on Phase 3 emergencies and
outbreaks

-Present on behalf of WHO at annual WASH cluster meeting in Nairobi

-Develop compendium of waste treatment technologies in conjunction with
global efforts on WASH in health care facilities

-Ongoing: contribute to guidelines drafted around waste management for the
tOPV-bOPV switch and respond to WASH needs on Phase 3 emergencies and
outbreaks

30-Oct-15 20

4
-Support implementation of WASH questions in conjunction with SARA
questionnaire (country to be identified)

-Ongoing: contribute to guidelines drafted around waste management for the
tOPV-bOPV switch and respond to WASH needs on Phase 3 emergencies and
outbreaks

30-Nov-15 20

5
-Ongoing: contribute to guidelines drafted around waste management for the
tOPV-bOPV switch and respond to WASH needs on Phase 3 emergencies and
outbreaks

30 Dec-15 20

Total up to a maximum 100

* Subject to actual cost of ticket and per-diem rate at the time of
travel.

5. Desired profile

The professional should be a highly motivated individual, with the
following qualities:

• Background in public health, preventive or primary care medicine or
water, sanitation and hygiene with experience working in low-resource
countries and settings.

• At least seven years’ relevant, progressive experience working in
environmental health (water, hygiene, sanitation and waste) in developing
countries, including substantive field experience with health care waste
and health care waste disposal technologies.

• Extensive experience in project management, and in developing good
practice documents.

• Experience in organizing multisectoral efforts with ability to
positively engage with a broad range of stakeholders (government,
international organizations, NGOs, media and academics).

• Excellent communication and report writing skills, and the ability to
clearly present findings and draw practical conclusions and
recommendations.

• Written and spoken knowledge of French, Spanish or major Africa or Asian
languages an added advantage.

• Demonstrated experience with Expanded Programme on Immunization a strong
advantage.

• Experience in emergency preparedness and response an added advantage.

Remuneration: Level P4. Pay scale will be defined according to the level
of expertise of the selected candidate.

Application Process:

Qualified applicants should submit their CV along with a cover letter, in
English, highlighting experience and motivation and a proposed rate by 24
July 2015 to hhwater@who.int .

Applications that do not follow these guidelines may not be accepted.

http://tinyurl.com/pz8yvht
__________________________________________________________________
________________________________*_________________________________

3. Hepatitis B vaccination status and needle-stick and sharps-related
Injuries among medical school students in Nepal: a cross-sectional
study
__________________________________________________________________
Open Access Free Full Text http://www.biomedcentral.com/1756-0500/7/774

BMC Res Notes. 2014 Nov 3;7:774. doi: 10.1186/1756-0500-7-774.

Hepatitis B vaccination status and needle-stick and sharps-related
Injuries among medical school students in Nepal: a cross-sectional study.

Bhattarai S1, K C S, Pradhan PM, Lama S, Rijal S.

1B,P, Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal.
surajbpkihs2012@gmail.com.

BACKGROUND: Hepatitis B is a dreadful infectious disease and a major
global health problem. Health-care workers including clinical students are
more vulnerable to such infections and non-sterile occupational exposures
as their daily activities are closely related to patient’s blood and body
fluids.

METHODS: A descriptive cross sectional study was conducted at B.P. Koirala
Institute of Health Sciences (BPKIHS), Dharan, Nepal from July till
October 2012. All medical, dental and nursing students were surveyed for
their Hepatitis B vaccination status and only those students in clinical
rotations were surveyed for the prevalence and pattern of Needle-stick and
Sharps-related Injuries (NSSIs) using a pre-tested, semi-structured, self-
administered questionnaire. Descriptive and inferential statistics was
used to analyze the data.

RESULTS: Majority (86.5%) of students were vaccinated against Hepatitis B
of which 83.7% had completed full doses. Among non-vaccinated students,
43.2% reported the main reason for non-vaccination as lack of vaccination
programs. Out of 210 respondents from clinical rotations, 90 students
(42.8%) reported at least one injury. Among those injured, two students
reported exposure to Human immunodeficiency virus (HIV) positive cases and
four to Hepatitis B virus (HBV) positive cases. Most of the injuries (44%)
occurred during Internal Medicine rotation and the most common sharp
involved (56.3%) was Hypodermic needle. Most injuries (35.6%) occurred
while manipulating needle into patients. Following exposure, only 11.4%
took Post exposure prophylaxis and 19.54% went for a Post-exposure
serology test.

CONCLUSIONS: Needle-stick and Sharps-related Injuries occur frequently
among health care workers including trainee students keeping them at high
risk for acquiring dreadful infections like HBV, HCV and HIV. They need to
be protected from unwarranted hazards by adopting routine Hepatitis B
vaccination programs and by reinforcing education regarding universal
precautions.

Free Article http://www.biomedcentral.com/1756-0500/7/774
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Benchmarking of percutaneous injuries at the Ministry of
Health hospitals of Saudi Arabia in comparison with the United States
hospitals participating in Exposure Prevention Information Network
(EPINet™)
__________________________________________________________________
Free full text
http://www.theijoem.com/ijoem/index.php/ijoem/article/view/467

Int J Occup Environ Med. 2015 Jan;6(1):26-33.

Benchmarking of percutaneous injuries at the Ministry of Health hospitals
of Saudi Arabia in comparison with the United States hospitals
participating in Exposure Prevention Information Network (EPINet™).

Memish ZA, Assiri AM, Eldalatony MM1, Hathout HM.

1Industrial Medicine and Occupational Health, Public Health and Community
Medicine Department, Menoufiya University, Egypt.
mervat.moh.abd@gmail.com.

BACKGROUND: Exposure to blood-borne pathogens from needle-stick and sharp
injuries continues to pose a significant risk to health care workers.
These events are of concern because of the risk to transmit blood-borne
diseases such as hepatitis B virus, hepatitis C virus, and the human
immunodeficiency virus.

OBJECTIVE: To benchmark different risk factors associated with needle-
stick incidents among health care workers in the Ministry of Health
hospitals in the Kingdom of Saudi Arabia compared to the US hospitals
participating in Exposure Prevention Information Network (EPINet™).

METHODS: Prospective surveillance of needle-stick and sharp incidents
carried out during the year 2012 using EPINet™ ver 1.5 that provides
uniform needle stick and sharp injury report form.

RESULTS: The annual percutaneous incidents (PIs) rate per 100 occupied
beds was 3.2 at the studied MOH hospitals. Nurses were the most affected
job category by PIs (59.4%). Most PIs happened in patients’ wards in the
Ministry of Health hospitals (34.6%). Disposable syringes were the most
common cause of PIs (47.20%). Most PIs occurred during use of the syringes
(36.4%).

CONCLUSION: Among health care workers, nurses and physicians appear
especially at risk of exposure to PIs. Important risk factors of injuries
include working in patient room, using disposable syringes, devices
without safety features. Preventive strategies such as continuous training
of health care workers with special emphasis on nurses and physicians,
encouragement of reporting of such incidents, observation of sharp
handling, their use and implementation of safety devices are warranted.

Free full text
http://www.theijoem.com/ijoem/index.php/ijoem/article/view/467
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Incidence of occupational exposure to blood and body fluids
and measures taken by health care workers before and after exposure in
regional hospitals of a developing country: A multicenter study
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26159497

Am J Infect Control. 2015 Jul 6. pii: S0196-6553(15)00533-7.

Incidence of occupational exposure to blood and body fluids and measures
taken by health care workers before and after exposure in regional
hospitals of a developing country: A multicenter study.

Sabermoghaddam M1, Sarbaz M2, Lashkardoost H3, Kaviani A4, Eslami S5,
Rezazadeh J6.

1Department of Anesthesiology and Critical Care, Qaem Hospital, School of
Medicine, Mashhad University of Medical Sciences, Mashhad, I.R. Iran.
2Health Information Technology and Medical Records Department, School of
Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad,
I.R. Iran; Department of Medical Informatics, School of Medicine, Mashhad
University of Medical Sciences, Mashhad, I.R. Iran.
3School of Public Health, North Khorasan University of Medical Sciences,
Bojnurd, I.R. Iran.
4Imam Ali Hospital, North Khorasan University of Medical Sciences,
Bojnurd, I.R. Iran.
5Department of Medical Informatics, School of Medicine, Mashhad University
of Medical Sciences, Mashhad, I.R. Iran; Pharmaceutical Research Center,
School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, I.R.
Iran; Department of Medical Informatics, Academic Medical Center,
University of Amsterdam, Amsterdam, The Netherlands.
6Department of Nursing, School of Nursing and Midwifery, North Khorasan
University of Medical Sciences, Bojnourd, I.R. Iran; Samen al a’eme
Hospital, Social Security Organization, Bojnurd, I.R. Iran. Electronic
address: rezazadeh.1988@gmail.com.

This cross-sectional study was conducted on 371 health care workers
working in government hospitals in the Northern Khorasan province of Iran.

Exposure to sharp objects was 44% and 31% of participants had a history of
being in contact with blood or body fluids of patients.

Among health care workers who had needlestick injuries, 82 had a positive
hepatitis B surface antibody titer measured after injury.

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

KEYWORDS: Blood splatter; Needle stick injury; Sharp objects injury;
Standard precautions
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Needle-stick dengue virus infection in a health-care worker
at a Japanese hospital
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26084918

J Occup Health. 2015 Jun 17.

Needle-stick dengue virus infection in a health-care worker at a Japanese
hospital.

Ohnishi K1.

1Department of Infectious Diseases, Tokyo Metropolitan Bokutoh General
Hospital.

OBJECTIVES: About 160 patients in Japan were infected with dengue virus by
mosquito’s bites in the summer and autumn of 2014. In this report, I
describe a case of occupational dengue virus infection by needle-stick
injury from the 1990s to alert health-care workers to the fact that dengue
virus is among the causative agents responsible for occupational
infectious disease even in Japan.

CASE: A Japanese female in her thirties, a nurse at our hospital in Tokyo,
was admitted to our hospital in January 1992 three days after the onset of
fever, headache, and general malaise. She had never been overseas. Five
days before the onset of her symptoms, she had pricked her finger with an
injection needle used to draw blood from a febrile patient infected with
dengue virus. She was diagnosed with dengue virus infection based on three
findings: detection of the dengue virus genome in serum, isolation of
dengue virus from serum, and serum samples positive for IgM antibodies
against dengue virus.

CONCLUSION: The patient contracted dengue virus infection via a needle-
stick injury at our hospital. Although this occurred more than two decades
ago, in 1992, health-care workers should still be mindful of the risk of
dengue virus infection via needle-stick injury even in Japan.

Free full text
www.jstage.jst.go.jp/article/joh/advpub/0/advpub_14-0224-CS/_article
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Work accidents with biological material occurred in
municipalities of Minas Gerais
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/24676078

Rev Bras Enferm. 2014 Jan-Feb;67(1):119-26.

[Work accidents with biological material occurred in municipalities of
Minas Gerais].

[Article in Portuguese]

Julio RS1, Filardi MB1, Marziale MH2.

1Curso de Enfermagem, Centro Universitario do Sul de Minas, Varginha, MG,
Brasil.
2Centro Colaborador da OMS para o Desenvolvimento da Pesquisa em
Enfermagem, Escola de Enfermagem de Ribeirao Preto, Universidade de Sao
Paulo, Ribeirao Preto, SP, Brasil.

The study aimed to identify the profile accidents involving exposure to
biological material occurring in Minas Gerais. A descriptive study carried
out by querying the Information System for Notifiable Diseases, 50 cities
in south of Minas Gerais State, Brazil, in the period of 2007-2011.

Were recorded 460 accidents, and about half occurred among nursing
assistants and technicians, followed by nurses and physicians.

There were more accidents due to improper disposal of sharps. Among the
source patients, there was a 8.0% prevalence of positive serology for HIV,
1.0% for HBsAg, 6.0% for anti-HBc and 3% for anti-HCV.

Among the injured 14.0% were not immunized to hepatitis B; however, the
vaccine and immunoglobulin prescription was lower than necessary.

The results will subsidize the plan preventive measures and new approach
towards the occurrence of such accidents.
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Knowledge and practices of healthcare workers in relation to
bloodborne pathogens in a tertiary care hospital, Western Saudi Arabia
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/24515949

J Community Health. 2014 Oct;39(5):959-64.

Knowledge and practices of healthcare workers in relation to bloodborne
pathogens in a tertiary care hospital, Western Saudi Arabia.

Al-Zahrani AO1, Farahat F, Zolaly EN.

1Family Medicine Department, Armed Forces Hospital, Taif, Saudi Arabia.

To assess knowledge and practices of healthcare workers (HCWs) in relation
to bloodborne pathogens in a tertiary care hospital, western Saudi Arabia.
Self-administered questionnaire was distributed assessing demographic
characteristics, knowledge and practices of physicians, nurses and
technicians on risks of exposure and prophylaxis against human
immunodeficiency virus, hepatitis B virus and hepatitis C virus
infections.

A total of 466 participants (151; 32.4 % physicians and 315; 67.6 %
nurses/technicians) completed the questionnaire.

Almost two thirds of the physicians (60.9 %) and half of the
nurses/technicians (47.6 %) had history of exposure to risks of bloodborne
infection.

Although both physicians and nurses/technicians showed acceptable level of
knowledge about risks of bloodborne infections, modest proportion knew the
correct actions including reporting following exposure.

Behavioral-based in-service training interventions and strict policy
should be implemented to promote compliance of HCWs to the protective
measures against hazards of bloodborne infection.
__________________________________________________________________
________________________________*_________________________________

9. Abstract: Needlestick Injuries to Medical Students
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26086540

Gesundheitswesen. 2015 Jun 18.

[Needlestick Injuries to Medical Students].

[Article in German]

Siegmann S1, Muth T1, Kluth W1, Hofbauer U1, Angerer P1, Schwarze S1.

1Institut für Arbeitsmedizin und Sozialmedizin, Heinrich Heine Universität
Düsseldorf, Düsseldorf.

The study aimsed at surveying and analysing the prevailing risks for
medical students due to so-called needlestick injuries, i.e., injuries to
the skin by handling sharp objects by which blood of patients can be
transmitted to the health professional.

After introducing preventive measures in a typical German university
hospital, a total of 1,903 students of human medicine in their clinical
period from 2009 to 2012 (from a total of 2,024 subjects – a rate of
94.0%) were questioned in detail about potential needlestick or other
injuries related to their work. The results show that such injuries happen
particularly during the clinical period of the medical studies: While only
20.6% of the students indicated a needlestick injury at the beginning of
this period, half of the students (50.9%) had experienced at least one
injury at the end of the clinical period.

The activities mentioned most frequently were taking of blood samples and
injections. Needlestick injuries happened most frequently in surgical
units, in internal medicine, and in gynaecology.

Accidents happened mostly during secondary employment, medical
traineeship, or in the context of practical nursing. In consequence,
measures for improvement of the primary prevention should start with
training on the one hand: Only briefing seems to be insufficient –
intensive exercises in using stick-proof instruments seems to be more
promising. On the other hand, the comprehensive introduction of stick-
proof instruments has to be supported.

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

10. Abstract: Sharps injury prevention guidance among health care
professionals: A comparison between self-reported and observed
compliance
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26072716

Am J Infect Control. 2015 Jun 11. pii: S0196-6553(15)00513-1.

Sharps injury prevention guidance among health care professionals: A
comparison between self-reported and observed compliance.

Kim YG1, Jeong IS2, Park SM3.

1Department of Nursing, Pusan National University Hospital, Busan, South
Korea.
2College of Nursing, Pusan National University, Yangsan, South Korea.
Electronic address: jeongis@pusan.ac.kr.
3Department of Nursing, Pusan National University Yangsan Hospital,
Yangsan, South Korea.

BACKGROUND: This study was performed to compare self-report and
observation methods for measuring compliance with double gloving (DG) and
the hands-free technique (HFT).

METHODS: The participants were 81 health care professionals (29 nurses, 52
doctors) working in 22 operating rooms in a tertiary hospital in Busan
(South Korea). All participants were asked to complete a self-report
questionnaire. Additionally, compliance with DG and the HFT was observed
from March-May 2014. Data were analyzed using descriptive statistics, ?2
test, and ? statistic using SPSS version 18.0 (SPSS, Chicago, IL).

RESULTS: The participants who always complied with DG and the HFT were
30.9% and 7.7% according to the self-report method, respectively, and
30.9% and 0.0% according to direct observation, respectively. The ? value
comparing the self-report and observation methods was 0.557 for all study
participants, 0.259 for nurses, and 0.668 for doctors for DG. The ? value
was 0.027 for all participants, 0.131 for nurses, and 0.020 for doctors
for the HFT.

CONCLUSION: DG compliance and HFT compliance showed moderate and low
levels of agreement between the 2 methods, respectively. Doctors showed
higher agreement than nurses between the 2 methods for DG compliance but
similar to nurses for HFT compliance. Therefore, the levels of compliance
with DG may be measured by either the self-report or observation methods
for doctors.

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

KEYWORDS: Double gloving; Hands-free technique; Needlestick injuries
__________________________________________________________________
________________________________*_________________________________

11. Abstract: Needle size for vaccination procedures in children and
adolescents
__________________________________________________________________
Free Full Text
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010720.pub2/full

Cochrane Database Syst Rev. 2015 Jun 18;6:CD010720.

Needle size for vaccination procedures in children and adolescents.

Beirne PV1, Hennessy S, Cadogan SL, Shiely F, Fitzgerald T, MacLeod F.

1Department of Epidemiology and Public Health, University College Cork,
4th Floor, Western Gateway Building, Western Road, Cork, Ireland.

BACKGROUND: Hypodermic needles of different sizes (gauges and lengths) can
be used for vaccination procedures. The gauge (G) refers to the outside
diameter of the needle tubing. The higher the gauge number, the smaller
diameter of the needle (eg a 25 G needle is 0.5 mm in diameter and is
narrower than a 23 G needle (0.6 mm)). Many vaccines are recommended for
injection into muscle (intramuscularly), although some are delivered
subcutaneously (under the skin) and intradermally (into skin). Choosing an
appropriate length and gauge of a needle may be important to ensure that a
vaccine is delivered to the appropriate site and produces the maximum
immune response while causing the least possible harm. There are some
conflicting guidelines regarding the lengths and gauges of needles that
should be used for vaccination procedures in children and adolescents.

OBJECTIVES: To assess the effects of using needles of different lengths
and gauges for administering vaccines to children and adolescents on
vaccine immunogenicity (the ability of the vaccine to elicit an immune
response), procedural pain, and other reactogenicity events (adverse
events following vaccine administration).

SEARCH METHODS: We searched the Cochrane Central Register of Controlled
Trials (The Cochrane Library 2014, Issue 10), MEDLINE and MEDLINE in
Progress via Ovid (1947 to November 2014), EMBASE via Ovid (1974 to
November 2014), and CINAHL via EBSCOhost (1982 to November 2014). We also
searched reference lists of articles and textbooks, the proceedings of
vaccine conferences, and three clinical trial registers.

SELECTION CRITERIA: Randomised controlled trials evaluating the effects of
using hypodermic needles of any gauge or length to administer any type of
vaccine to people aged from birth to 24 years.

DATA COLLECTION AND ANALYSIS: Three review authors independently extracted
trial data and assessed the risk of bias. We contacted trial authors for
additional information. We rated the quality of evidence using the GRADE
system.

MAIN RESULTS: We included five trials involving 1350 participants. Data
for the primary review outcomes were either absent (for the incidence of
vaccine- preventable diseases) or limited (for procedural pain and
crying). The available evidence was compromised by the use of surrogate
immunogenicity outcomes, incomplete blinding of outcome assessors, and
imprecision for some outcomes. The evidence from two small trials was
insufficient to allow any confident statements to be made about the
effects of the needles evaluated in the trials on vaccine immunogenicity
and reactogenicity.The remaining three trials (1135 participants)
contributed data to comparisons between 25 G 25 mm, 23 G 25 mm, and 25 G
16 mm needles. These trials involved infants predominantly aged two to six
months undergoing intramuscular vaccination in the anterolateral thigh
using the World Health Organization (WHO) injection technique (skin
stretched flat, needle inserted at a 90° angle and up to the needle hub in
healthy infants). The vaccines administered were combination vaccines
containing diphtheria, tetanus, and whole-cell pertussis antigens (DTwP).
In some trials, the vaccines also contained Haemophilus influenzae type b
(DTwP-Hib) and hepatitis B (DTwP-Hib-HepB) antigen components.We found
moderate quality evidence from one trial that there is probably little or
no difference in immune response, defined in terms of the proportion of
seroprotected infants, between using 25 G 25 mm, 23 G 25 mm, or 25 G 16 mm
needles to administer a series of three doses of a DTwP-Hib vaccine at
ages two, three, and four months (numbers of participants in analyses
range from 309 to 402. Immune response to pertussis antigen not
measured).25 mm needles (either 23 G or 25 G) probably lead to fewer
severe local reactions (extensive redness and swelling) and fewer non-
severe local reactions (any redness, swelling, tenderness or hardness
(composite outcome)) after DTwP- Hib vaccination compared with 25 G 16 mm
needles. We estimate that one fewer infant will experience a severe local
reaction after the first vaccine dose for every 25 infants vaccinated with
the longer rather than the shorter needle (number needed to treat (NNT) 25
(95% confidence interval (CI) 15 to 100)). We estimate that one fewer
infant will experience a non-severe local reaction at 24 hours after the
first, second, and third vaccine doses for every five to eight infants
vaccinated with the longer rather than the shorter needle (NNTs range from
5 (95% CI 4 to 10) to 8 (95% CI 5 to 34)) (moderate quality evidence, one
trial for first and second doses, two trials for third dose, numbers of
participants in analyses range from 413 to 528).Using a wider gauge needle
(23 G 25 mm) may slightly reduce procedural pain (low quality evidence)
and probably leads to a slight reduction in the duration of crying time
immediately after vaccination (moderate quality evidence) compared with a
narrower gauge (25 G 25 mm) needle (one trial, 320 participants). The
effects are probably not large enough to be of any clinical relevance. The
25 G 25 mm needle may produce a small reduction in the incidence of local
reactions after each dose of a DTwP vaccine compared with the 23 G 25 mm
needle, but the effect estimates are imprecise (low quality evidence, two
trials, numbers of participants in analyses range from 100 to 459).The
comparative effects of 23 G 25 mm, 25 G 25 mm, and 25 G 16 mm needles on
the incidence of post-vaccination fever, persistent inconsolable crying,
and other systemic events such as drowsiness, loss of appetite, and
vomiting are uncertain due to the very low quality of the evidence.

AUTHORS’ CONCLUSIONS: Using 25 mm needles (either 23 G or 25 G) for
intramuscular vaccination procedures in the anterolateral thigh of infants
using the WHO injection technique probably reduces the occurrence of local
reactions while achieving a comparable immune response to 25 G 16 mm
needles.

These findings are applicable to healthy infants aged two to six months
receiving combination DTwP vaccines with a reactogenic whole-cell
pertussis antigen component.

These vaccines are predominantly used in developing countries.

The applicability of the findings to vaccines with acellular pertussis
components and other vaccines with different reactogenicity profiles is
uncertain.

Free Full Text
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010720.pub2/full
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12. Abstract: Transdermal delivery of therapeutic agents using dendrimers
(US20140018435A1): a patent evaluation
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26150049

Expert Opin Ther Pat. 2015 Jul 6:1-6.

Transdermal delivery of therapeutic agents using dendrimers
(US20140018435A1): a patent evaluation.

Yang J1, Hu J, He B, Cheng Y.

1East China Normal University, Shanghai Key Laboratory of Regulatory
Biology and School of Life Sciences , Shanghai, 200241 , PR China
yycheng@mail.ustc.edu.cn.

Transdermal drug delivery offers a number of advantages over systematic
administrations such as oral administration and intravenous injection.
However, most therapeutic agents are limited in transdermal delivery due
to the presence of a stratum corneum barrier.

A number of chemical penetration enhancers were used to facilitate the
penetration of drugs with poor skin permeability across the barrier, but
these enhancers are usually associated with safety concerns such as skin
irritation and immune response.

The current patent application by Hong et al. provides the potential use
of surface-engineered dendrimers for transdermal delivery of therapeutic
agents. It systemically demonstrates the effect of dendrimer generation,
surface chemistry and hydrophobicity on the skin permeability of
dendrimers. The most efficient dendrimer shows nearly 30% skin permeation
when its surface was conjugated with endoxifen, a drug widely used for the
treatment of breast cancers.

The described technique provides an efficient and safe method for the
delivery of therapeutic agents, especially chemopreventive compounds and
anticancer drugs.

KEYWORDS: conjugates; dendrimer; drug delivery; transdermal
__________________________________________________________________
________________________________*_________________________________

13. Abstract: Use of mercury-based medical equipment and mercury content
in effluents of tertiary care hospitals in India
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25716525

Environ Monit Assess. 2015 Mar;187(3):145.

Use of mercury-based medical equipment and mercury content in effluents of
tertiary care hospitals in India.

Peshin SS1, Halder N, Jathikarta C, Gupta YK.

1Department of Pharmacology, All India Institute of Medical Sciences, New
Delhi, 110029, India, sspeshin@gmail.com.

Environmental pollution due to mercury has raised serious concern over the
last few decades. Various anthropogenic sources including the health
sector play a vital role in increasing the mercury load on the
environment. Mercury poses an important health issue because of its
indiscriminate disposal into the environment.

There are numerous mercury- containing devices being used in the health-
care setup. The objective of the study was to obtain information on the
procurement and consumption of mercury-containing items in the current
year, the methods adopted for disposal and the contamination of the
hospital effluents with mercury.

A questionnaire-based study was conducted in government and corporate
hospitals from different states of India, for the quantitative assessment
of use of mercury-based items in tertiary care hospitals in India
(n?=?113).

The results showed that mercury-containing items are still being used in
India. The most common method adopted for disposal was collection in
plastic bags and labeling them as hazardous waste. The hospital effluents
contained mercury below the permissible limits.

In view of the environmental pollution due to mercury and its adverse
impact on health, efforts by the government are on for phasing out
mercury- containing equipment from the health-care setup in India.
__________________________________________________________________
________________________________*_________________________________

14. Abstract: Factors Associated with Hepatitis C Infection among Chronic
HCV Egyptian Patients
__________________________________________________________________
Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4449500/

Iran J Public Health. 2014 Nov;43(11):1510-8.

Factors Associated with Hepatitis C Infection among Chronic HCV Egyptian
Patients.

W Abd El-Wahab E1, Mikheal A2, Sidkey F3, Shatat HZ1.

11. Dept. of Tropical Health, High Institute of Public Health, Alexandria
University , Egypt.
21. Dept. of Tropical Health, High Institute of Public Health, Alexandria
University , Egypt ; 3. Damanhour Fever Hospital, Ministry of Health and
Population, Damanhour , Egypt.
32. Dept. of Internal Medicine, Faculty of Medicine, Alexandria University
, Egypt.

BACKGROUND: Identification of risk factors of acute hepatitis C virus
(HCV) infection in Egypt is crucial for developing appropriate prevention
strategies. There are few community-based studies on the epidemiology and
risk factors of hepatitis C infection in Egypt, which could not provide
enough information. Clear identification of past and current risk factors
for infection is of utmost importance so that intervention programs can be
appropriately focused. This study aims to provide up-to-date information
about changes in the incidence of individual risk factors for HCV
infection transmission in Egypt.

METHODS: A total of 396 chronic HCV patients on follow-up treatment at
liver center in El-Qabbary General Hospital in Alexandria were evaluated
retrospectively regarding the potential iatrogenic, community acquired and
behavioral HCV risk factors. Risk factors for HCV transmission were found
in all study populations.

RESULTS: At least three identifiable risk factors were reported by each
participant. Some behavioral and community-acquired exposures that entail
several risky behaviors particularly, unsafe sexual practices were
exclusively established among males. We report a significant decline in
prevalence of HCV transmission through blood transfusion, parenteral
treatment, hospitalization, surgery, non medicalized circumcision, Hijiama
done by informal practitioner, tattooing, folk body piercing and
threading, sharing hygiene and sharp items, and the use of communal barber
or manicure sets among younger age cluster.

CONCLUSION: The pattern of risk differed among older patients compared to
younger age group suggesting improved medical care and infection control
measures and raised public health awareness regarding the different modes
of viral transmission.

KEYWORDS: Chronic HCV patients; Egypt; HCV; Risk factors

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4449500/
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________________________________*_________________________________

15. Abstract: Prioritizing High-Risk Practices and Exploring New Emerging
Ones Associated With Hepatitis C Virus Infection in Egypt
__________________________________________________________________
Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4441892/

Iran J Public Health. 2014 Oct;43(10):1385-94.

Prioritizing High-Risk Practices and Exploring New Emerging Ones
Associated With Hepatitis C Virus Infection in Egypt.

Metwally A1, Mohsen A1, Saleh R1, Foaud W1, Ibrahim N1, Rabaah T1, El-
Sayed M2.

1. Community Medicine Research Department, National Research Center ,
Cairo, Egypt.
2. Faculty of Medicine, Ain Shams University , Cairo, Egypt.

BACKGROUND: The aim of this study was to identify and prioritize the risky
behaviors and explore the newly emerging pi related to Egyptian habits
that may lead to HCV transmission.

METHODS: From January 2011 until January 2012, a case control study
matched on socio demographic factors was conducted comparing 540 hepatitis
C patients and their contacts who were HCV serologically negative (102
subjects). They were randomly selected from six governorates representing
Upper Egypt, Lower Egypt, Middle and Canal regions. The questionnaire
covered demographic data, risk exposures, behaviors, and practices for HCV
infection. Focus group discussions were done with groups of professionals
in Hepatology to discuss the observed emerging risk practices in Egypt.

RESULTS: In univariate analysis, invasive medical procedures, wound
stitches, illiteracy and marriage were significantly associated with HCV
infection. Among women, delivery at home by traditional birth attendant
was associated with 3 times (OR=2.91, CI=1.23-6.98) and 4 times (OR=3.94,
CI= 1.44-11.35) increase in HCV risk than delivery at hospital and by
doctors respectively. Among males, shaving at barbershops was associated
with 2 fold increase in the risk of infection (OR=2.6, CI=1.44-4.89).
Newly observed emerging risk practices were: sharing scarves’ pins by
veiled women in same houses, sharing loofah for personal cleaning and
sharing toothpaste among family members.

CONCLUSION: Increasing risk of HCV infection in Egypt reinforces the need
for strict implementation of effective HCV prevention programs according
to the prevailing risk behaviours.

KEYWORDS: Emerging practices; Hepatitis C; Risk factors; Risk practices

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4441892/
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16. Abstract: Hepatitis C virus infection and risk factors in health-care
workers at Ain Shams University Hospitals, Cairo, Egypt
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26074220

East Mediterr Health J. 2015 May 19;21(3):199-212.

Hepatitis C virus infection and risk factors in health-care workers at Ain
Shams University Hospitals, Cairo, Egypt.

Okasha O1, Munier A2, Delarocque-Astagneau E2, El Houssinie M3, Rafik M4,
Bassim H4, Hamid MA5,6, Mohamed MK3, Fontanet A2,7.

1Department of Community, Environmental and Occupational Medicine, Faculty
of Medicine, Ain Shams University, Cairo, Egypt. omar.okasha@uta.fi.
2Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France.
3Department of Community, Environmental and Occupational Medicine, Faculty
of Medicine, Ain Shams University, Cairo, Egypt.
4Department of Clinical Pathology, Faculty of Medicine, Ain Shams
University, Cairo, Egypt.
5Viral Hepatitis Research Laboratory, National Hepatology and Tropical
Medicine Research Institute, Cairo, Egypt.
6Department of Microbiology, Faculty of Medicine, Minya University, Minya,
Egypt.
7Conservatoire National des Arts et Mériers, Paris, France.

The objectives of this study were to document the background prevalence
and incidence of HCV infection among HCWs in Ain Shams University
Hospitals in Cairo and analyse the risk factors for HCV infection.

A cross-sectional survey was conducted in 2008 among 1770 HCWs. Anti-HCV
prevalence was age-standardized using the Cairo population. A prospective
cohort was followed for a period of 18 months to estimate HCV incidence.

The crude anti-HCV prevalence was 8.0% and the age-standardized
seroprevalence was 8.1%. Risk factors independently associated with HCV
seropositivity were: age, manual worker, history of blood transfusions and
history of parenteral anti-schistosomiasis treatment.

The estimated incidence of HCV infection was 7.3 per 1000 person-years.
HCWs in this setting had a similar high HCV seroprevalence as the general
population of greater Cairo.
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17. Abstract: Harm Reduction: Front Line Public Health
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26080038

J Addict Dis. 2015 Jun 16:0.

Harm Reduction: Front Line Public Health.

Stancliff S1, Phillips BW, Maghsoudi N, Joseph H.
Author information
1a Harm Reduction Coalition , New York , New York , USA.

Drug use is public health problem associated with high mortality and
morbidity, and is often accompanied by suboptimal engagement in health
care.

Harm reduction is a pragmatic public health approach encompassing all
goals of public health: improving health, social well-being and quality of
life. Harm reduction prioritizes improving the lives of people who use
drugs in partnership with those served without a narrow focus on
abstinence from drugs.

Evidence has shown that harm reduction oriented practice can reduce
transmission of blood-borne illnesses, and other injection related
infections as well as preventing fatal overdose. (Word Count: 93).

KEYWORDS: Harm reduction; buprenorphine; drug treatment; injection drug
use; methadone; naloxone; needle and syringe programmes; opioid overdose;
public health; safe injection facilities; syringe access
__________________________________________________________________
________________________________*_________________________________

18. Abstract: Barriers and Potential Improvements for Needle and Syringe
Exchange Programs (NSPs) in China: A Qualitative Study from
Perspectives of Both Health and Public Security Sectors
__________________________________________________________________
Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4482722/

PLoS One. 2015 Jun 26;10(6):e0130654.

Barriers and Potential Improvements for Needle and Syringe Exchange
Programs (NSPs) in China: A Qualitative Study from Perspectives of Both
Health and Public Security Sectors.

Koo FK1, Chen X2, Chow EP3, Jing J4, Zheng J2, Zhao J2, Zhang L5.
Author information
1Sydney Nursing School, The University of Sydney, Sydney, NSW, Australia.
2Hunan Provincial Centers for Disease Control and Prevention, Hunan,
China.
3The Kirby Institute, UNSW Australia, Sydney, NSW, Australia; Central
Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash
University, Melbourne, VIC, Australia; Melbourne Sexual Health Centre,
Alfred Health, Melbourne, VIC, Australia.
4Research Center for Public Health, Tsinghua University, Beijing, China.
5The Kirby Institute, UNSW Australia, Sydney, NSW, Australia; Central
Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash
University, Melbourne, VIC, Australia; Research Center for Public Health,
Tsinghua University, Beijing, China.

This study explores the acceptability, the barriers to the implementation
of needle and syringe exchange programs (NSPs) and the potential
improvement strategies in China from the perspectives of governmental
health and public security officials.

Purposive sampling was used for recruitment of participants who had been
involved in NSPs implementation. Semi-Structured individual interviews
were conducted in Mandarin to address three aspects of NSPs: (1)
participants’ attitudes towards NSPs, (2) participants’ opinions on the
effectiveness and barriers of NSPs, and (3) suggestions for improving the
program. Content analysis was used to analyse the translated interview
data. A total of 68 participants from 12 Hunan counties were interviewed
(34 from each of the Bureau of Health and the Narcotic Division).

Both groups recognised the importance and effectiveness of NSPs in HIV
prevention, but public security officials regarded NSPs as a temporary
intervention in place of punitive measures.

Most health officials (32/34) regarded the main barriers to its
implementation as administrative and structural, whereas participants from
Narcotics Division (n=24) questioned the legitimacy of NSPs and concerned
about the poor management of drug users’ risk behaviours.

Close cooperation between the health and public security sectors,
engagement of the drug user community and an enabling policy environment
were reportedly to be critical for potential improvements of NSPs in
China.

Misconceptions about NSPs encourage drug users’ addictive behaviour, and
an unclear leadership and insufficient support de-motivate the
participants from the Bureau of Health and the Narcotics Division to
actively support the program implementation.

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4482722/
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19. Abstract: Self-reported changes in drug use behaviors and syringe
disposal methods following the opening of a supervised injecting
facility in Copenhagen, Denmark
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4226898/

Harm Reduct J. 2014 Oct 28;11(1):29.

Self-reported changes in drug use behaviors and syringe disposal methods
following the opening of a supervised injecting facility in Copenhagen,
Denmark.

Kinnard EN1, Howe CJ, Kerr T, Skjødt Hass V, Marshall BD.

1Department of Behavioral and Social Sciences, Brown University School of
Public Health, 121 South Main Street, Box G-S-121-4, Providence, RI 02912,
USA. Elizabeth_Kinnard@brown.edu.

BACKGROUND: In Denmark, the first standalone supervised injecting facility
(SIF) opened in Copenhagen’s Vesterbro neighborhood on October 1, 2012.
The purpose of this study was to assess whether use of services provided
by the recently opened SIF was associated with changes in injecting
behavior and syringe disposal practices among people who inject drugs
(PWID). We hypothesized that risk behaviors (e.g., syringe sharing), and
unsafe syringe disposal (e.g., dropping used equipment on the ground) had
decreased among PWID utilizing the SIF.

METHODS: Between February and August of 2013, we conducted interviews
using a survey (in English and Danish) with forty-one people who reported
injecting drugs at the SIF. We used descriptive statistics and McNemar’s
test to examine sociodemographic characteristics of the sample, current
drugs used, sites of syringe disposal before and after opening of the SIF,
and perceived behavior change since using the SIF.

RESULTS: Of the interviewed participants, 90.2% were male and the majority
were younger than 40 years old (60.9%). Three-quarters (75.6%) of
participants reported reductions in injection risk behaviors since the
opening of the SIF, such as injecting in a less rushed manner (63.4%),
fewer outdoor injections (56.1%), no longer syringe sharing (53.7%), and
cleaning injecting site(s) more often (43.9%). Approximately two-thirds
(65.9%) of participants did not feel that their frequency of injecting had
changed; five participants (12.2%) reported a decrease in injecting
frequency, and only two participants (4.9%) reported an increase in
injecting frequency. Twenty-four (58.5%) individuals reported changing
their syringe disposal practices since the opening of the SIF; of those,
twenty-three (95.8%) reported changing from not always disposing safely to
always disposing safely (McNemar’s test p-value < 0.001).

CONCLUSIONS: Our findings suggest that use of the Copenhagen SIF is
associated with adoption of safer behaviors that reduce harm and promote
health among PWID, as well as practices that benefit the Vesterbro
neighborhood (i.e., safer syringe disposal). As a public health
intervention, Copenhagen’s SIF has successfully reached PWID engaging in
risk behavior. To fully characterize the impacts of this and other Danish
SIFs, further research should replicate this study with a larger sample
size and prospective follow-up.

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4226898/
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________________________________*_________________________________

20. Abstract: A Cost Analysis of Hospitalizations for Infections Related
to Injection Drug Use at a County Safety-Net Hospital in Miami,
Florida
__________________________________________________________________
Full Free Text http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4468183/

PLoS One. 2015 Jun 15;10(6):e0129360.

A Cost Analysis of Hospitalizations for Infections Related to Injection
Drug Use at a County Safety-Net Hospital in Miami, Florida.

Tookes H1, Diaz C2, Li H3, Khalid R4, Doblecki-Lewis S5.

1Department of Internal Medicine, Jackson Memorial Hospital, Miami,
Florida, United States of America.
2Department of Medical Education, University of Miami Miller School of
Medicine, Miami, Florida, United States of America.
3Department of Public Health Sciences, University of Miami Miller School
of Medicine, Miami, Florida, United States of America.
4Department of Jackson Health System Research, Jackson Memorial Hospital,
Miami, Florida, United States of America.
5Department of Internal Medicine, Division of Infectious Diseases,
University of Miami Miller School of Medicine, Miami, Florida, United
States of America.

BACKGROUND: Infections related to injection drug use are common. Harm
reduction strategies such as syringe exchange programs and skin care
clinics aim to prevent these infections in injection drug users (IDUs).
Syringe exchange programs are currently prohibited by law in Florida. The
goal of this study was to estimate the mortality and cost of injection
drug use-related bacterial infections over a 12-month period to the county
safety-net hospital in Miami, Florida. Additionally, the prevalence of HIV
and hepatitis C virus among this cohort of hospitalized IDUs was
estimated.

METHODS AND FINDINGS: IDUs discharged from Jackson Memorial Hospital were
identified using the International Classification of Diseases, Ninth
Revision, codes for illicit drug abuse and endocarditis, bacteremia or
sepsis, osteomyelitis and skin and soft tissue infections (SSTIs). 349
IDUs were identified for chart abstraction and 92% were either uninsured
or had publicly funded insurance. SSTIs, the most common infection, were
reported in 64% of IDUs. HIV seroprevalence was 17%. Seventeen patients
(4.9%) died during their hospitalization. The total cost for treatment for
injection drug use- related infections to Jackson Memorial Hospital over
the 12-month period was $11.4 million.

CONCLUSIONS: Injection drug use-related bacterial infections represent a
significant morbidity for IDUs in Miami-Dade County and a substantial
financial cost to the county hospital. Strategies aimed at reducing risk
of infections associated with injection drug use could decrease morbidity
and the cost associated with these common, yet preventable infections.

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4468183/
__________________________________________________________________
________________________________*_________________________________

21. Abstract: Multiple Skin Abscesses and Myofibrosis of Bilateral Lower
Limbs Following Repeated Intramuscular Injection of Pentazocine with
Concomitant Tuberculous Infection
__________________________________________________________________
Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489418/

J Orthop Case Reports. 2015 Jan-Mar;5(1):9-11.

Multiple Skin Abscesses and Myofibrosis of Bilateral Lower Limbs Following
Repeated Intramuscular Injection of Pentazocine with Concomitant
Tuberculous Infection.

Agashe VM1, Patil H1, Gundavda MK1.

1Department of Orthopaedics, P.D. Hinduja Hospital and MRC, Mahim, Mumbai.
India.

INTRODUCTION: Prescription drug abuse is a major health problem across the
globe. Various complications associated with repeated injection of
pentazocine are reported in the literature, including skin fibrosis, skin
abscesses and ulceration, abnormal skin pigmentation and fibrous myopathy.

CASE REPORT: We present a case of 48 year male with history of pentazocine
abuse. Patient developed multiple abscesses in both lower limbs with
polymicrobial infection, one of them being mycobacterium tuberculosis. He
also developed fibrous myopathy leading to stiff hip and knee.

CONCLUSION: This case highlights the significance of the precaution that
should be taken when prescribing opioid analgesics, such as pentazocine,
as routine painkillers. With free over the counter access to these drugs
in India and many developing countries, awareness of this complication is
important so that unwanted side effects can be avoided.

KEYWORDS: Fibrous myopathy; Multiple skin abscesses; Mycobacterium
tuberculosis; Pentazocine

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489418/
__________________________________________________________________
________________________________*_________________________________

22. Abstract: A survey of UK practice patterns in the delivery of
intravitreal injections
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26094833

Ophthalmic Physiol Opt. 2015 Jul;35(4):450-4.

A survey of UK practice patterns in the delivery of intravitreal
injections.

Samia-Aly E1, Cassels-Brown A2, Morris DS3, Stancliffe R4, Somner JE5.

1Addenbrooke’s Hospital, Cambridge, UK.
2Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
3Cardiff Eye Unit, University Hospital of Wales, Cardiff, Wales, UK.
4The Centre for Sustainable Healthcare, Oxford, UK.
5Vision and Eye Research Unit, Postgraduate Medical Institute, Anglia
Ruskin University, Cambridge, UK.

PURPOSE: To assess UK practice patterns related to the prescription of
antibiotics before, during and after intravitreal injections, the location
where injections are carried out and the qualifications of those
administering the injections.

METHODS: Every ophthalmology unit featured in the Royal College of
Ophthalmologists (UK) training directory was contacted. A healthcare
professional involved in giving intravitreal injections at each
institution completed a questionnaire regarding local practice patterns.

RESULTS: A response rate of 85% (115/136) was achieved. Seventy four
percent of hospitals (85/115) gave take home antibiotics post intravitreal
injection. Twenty three percent (26/115) of hospitals employed non-medical
healthcare professionals to administer injections and 83% (96/115)
administered intravitreal injections in a dedicated clean room as opposed
to an operating theatre.

CONCLUSION: Practice patterns for intravitreal injection vary
considerably. Guidelines alone do not appear to be effective in reducing
practices which are considered wasteful and other approaches need to be
developed.

© 2015 The Authors Ophthalmic & Physiological Optics © 2015 The College of
Optometrists.

KEYWORDS: anti-bacterial agents; conservation of natural resources;
economics; intravitreal injections; macular degeneration; physician’s
practice patterns
__________________________________________________________________
________________________________*_________________________________

23. Abstract: In vivo injectable gels for tissue repair
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/21780306
Wiley Interdiscip Rev Nanomed Nanobiotechnol. 2011 Nov-Dec;3(6):589-606.

In vivo injectable gels for tissue repair.

Hilborn J1.

1Department of Materials Chemistry, Uppsala University, Uppsala 75121,
Sweden. hilborn@mkem.uu.se.

The desire to reduce healthcare costs while improving outcomes drives
minimally invasive methods to replacing traditional surgical procedures.

Various treatments that would previously have needed open-type surgeries
can be carried out using endoscopes, catheters, and needles.

These advantages have become especially obvious for tissue engineering and
regenerative medicine with in vivo gel injectable nanomaterials. In this
review, the state of the art in this rapidly developing field is given.

This is done by contrasting functional evaluation in vitro with in vivo
followed by describing (1) synthetic materials, (2) the body’s own
polymers, (3) polymers in nature, (4) self-assembled peptides, and (5) new
innovations and combinations.

With increased understanding of the relationship between material
characteristics and the outcome in vivo more rational design criteria are
emerging.

Copyright © 2011 John Wiley & Sons, Inc.
__________________________________________________________________
________________________________*_________________________________

24. Abstract: Impact of the International Nosocomial Infection Control
Consortium (INICC) Multidimensional Hand Hygiene Approach During 3
Years in 6 Hospitals in 3 Mexican Cities
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26067748

J Patient Saf. 2015 Jun 10.

Impact of the International Nosocomial Infection Control Consortium
(INICC) Multidimensional Hand Hygiene Approach During 3 Years in 6
Hospitals in 3 Mexican Cities.

Miranda-Novales MG1, Sobreyra-Oropeza M, Rosenthal VD, Higuera F, Armas-
Ruiz A, Pérez-Serrato I, Torres-Hernández H, Zamudio-Lugo I, Flores-Ruiz
EM, Campuzano R, Mena-Brito J, Sánchez-López M, Chávez-Gómez A, Rivera-
Morales J, Valero-Rodríguez JE.

1From the *Hospital de Pediatría, Centro Médico Nacional Siglo XXI, IMSS,
Mexico City, Mexico; †Hospital de la Mujer, Mexico City, Mexico,
‡International Nosocomial Infection Control Consortium (INICC), Buenos
Aires, Argentina; §Hospital General de México, Mexico City, Mexico;
?Centro Médico La Raza IMSS, Mexico City, Mexico; ¶Hospital General de la
Celaya, Celaya, Mexico; and **Hospital General de Irapuato, Irapuato,
Mexico.

OBJECTIVES: To evaluate the impact of the International Nosocomial
Infection Control Consortium (INICC) multidimensional hand hygiene (HH)
approach in Mexico, and analyze predictors of poor HH compliance.

METHODS: From June 2002 to April 2006, we conducted a prospective,
observational, before-and-after study in 8 intensive care units (ICUs)
from 6 hospitals in 3 cities of Mexico. The approach included
administrative support, availability of supplies, education and training,
reminders in the workplace, process surveillance, and performance
feedback.

RESULTS: A total of 13,201 observations for HH opportunities were done in
each ICU, during randomly selected 30-minute periods. Overall, HH
compliance increased from 45% to 79% (95% confidence interval [CI],
69.1-86.5; P = 0.01). Univariate and multivariate analyses showed that
several variables were significantly associated with poor HH compliance:
males versus females (61% versus 66%; 95% CI, 0.91-0.96; P = 0.0001),
physicians versus nurses (62% versus 67%; 95% CI, 0.91-0.97; P = 0.0001),
and adult versus neonatal ICUs (67% versus 54%; 95% CI, 0.79-0.84; P =
0.0001), among others.

CONCLUSIONS: Hand hygiene programs should focus on variables found to be
predictors of poor HH compliance.
__________________________________________________________________
________________________________*_________________________________

25. Abstract: The West African Ebola outbreak: finishing the job,
preparing for future
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26160255

Trans R Soc Trop Med Hyg. 2015 Jul 9. pii: trv053.

The West African Ebola outbreak: finishing the job, preparing for future.

Parsons C1, Naeem Ahmad U2.

1London School of Tropical Medicine & Hygiene, Keppel Street, London, WC1E
7HT, UK clareemmaparsons@hotmail.com.
2Royal London Hospital, Whitechapel Road, London, E1 1BB, UK.

As the West African Ebola Outbreak moves towards the final stages, we must
consider the importance of remaining work and take heed of lessons learned
in preparation for future outbreaks.

Several issues pertinent to preparedness must be considered, including the
remaining animal reservoir and potential for sexual transmission. Testing
must be accessible and contact tracing robust to trace the last patient.

Improved infection control procedures alongside education and training
require guaranteed supply chains and ongoing funding.

Effort must be sustained to prevent an even greater catastrophe than the
one inflicted on West Africa today.

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

KEYWORDS: Ebola; Healthcare systems; Outbreak; West Africa
__________________________________________________________________
________________________________*_________________________________

26. Abstract: How to use personal protective equipment
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26012067

Nurs Times. 2014 Dec 17-2015 Jan 13;110(51):14-6.

How to use personal protective equipment.

Pang V, Carter Y, Scott J, Salazar G, Johnson V.

This article offers a refresher on what personal protective equipment
(PPE) is, how to choose the right PPE and how to wear and remove it
safely.

PPE aims to improve staff and patient safety, but self-contamination
commonly occurs during its removal; failure to remove PPE carefully can
lead to contamination of the user’s skin, own clothes, uniform or scrubs,
hair, face and hands.

The importance of correct PPE use has been highlighted by the ebola crisis
and NHS preparations to deal with patients who are infected.
__________________________________________________________________
________________________________*_________________________________

27. Abstract: Elevator buttons as unrecognized sources of bacterial
colonization in hospitals
__________________________________________________________________
Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4242253/

Open Med. 2014 Jul 8;8(3):e81-6. eCollection 2014.

Elevator buttons as unrecognized sources of bacterial colonization in
hospitals.

Kandel CE1, Simor AE2, Redelmeier DA3.

1Christopher E. Kandel, MD, is a resident in internal medicine at the
University of Toronto, Toronto, Ontario.
2Andrew E. Simor, MD, FRCPC, is a Professor of Medicine and of Laboratory
Medicine and Pathobiology at the University of Toronto, Head of the
Department of Microbiology and the Division of Infectious Diseases at
Sunnybrook Health Sciences Centre, and a Senior Scientist at the
Sunnybrook Research Institute, Toronto, Ontario.
3Donald A. Redelmeier, MD, FRCPC, MSHSR, FACP, is a Professor of Medicine
at the University of Toronto, the Director of Evaluative Clinical Sciences
at the Sunnybrook Research Institute, a Staff Physician in the Division of
General Internal Medicine at Sunnybrook Health Sciences Centre, and a
Senior Scientist at the Institute for Clinical Evaluative Sciences,
Toronto, Ontario.

BACKGROUND: Elevators are ubiquitous and active inside hospitals,
potentially facilitating bacterial transmission. The objective of this
study was to estimate the prevalence of bacterial colonization on elevator
buttons in large urban teaching hospitals.

METHODS: A total of 120 elevator buttons and 96 toilet surfaces were
swabbed over separate intervals at 3 tertiary care hospitals on weekdays
and weekends in Toronto, Ontario. For the elevators, swabs were taken from
2 interior buttons (buttons for the ground floor and one randomly selected
upper- level floor) and 2 exterior buttons (the “up” button from the
ground floor and the “down” button from the upper-level floor). For the
toilet surfaces, swabs were taken from the exterior and interior handles
of the entry door, the privacy latch, and the toilet flusher. Samples were
obtained using standard bacterial collection techniques, followed by
plating, culture, and species identification by a technician blind to
sample source.

RESULTS: The prevalence of colonization of elevator buttons was 61% (95%
confidence interval 52%-70%). No significant differences in colonization
prevalence were apparent in relation to location of the buttons, day of
the week, or panel position within the elevator. Coagulase-negative
staphylococci were the most common organisms cultured, whereas
Enterococcus and Pseudomonas species were infrequent. Elevator buttons had
a higher prevalence of colonization than toilet surfaces (61% v. 43%, p =
0.008).

CONCLUSIONS: Hospital elevator buttons were commonly colonized by
bacteria, although most pathogens were not clinically relevant. The risk
of pathogen transmission might be reduced by simple countermeasures.

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4242253/
__________________________________________________________________
________________________________*_________________________________

28. Abstract: Factors influencing glove use in student nurses
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26016134

Nurs Times. 2014 Dec 3-9;110(49):18-21.

Factors influencing glove use in student nurses.

Ratcliffe S, Smith J.

BACKGROUND: Gloves can prevent infection but their use among student
nurses is inconsistent.

AIM: To explore pre-registration student nurses’ views of non-sterile
glove use in clinical practice.

METHOD: An online survey was conducted and focus groups carried out among
third-year student nurses.

RESULTS: The online survey showed that gloves were often worn
inappropriately, while the focus groups revealed students conformed to
their mentors’ use of gloves.

DISCUSSION: Student nurses’ decisions on wearing gloves seem to be based
on the culture of the clinical care environment rather than trust policy.
Glove overuse deprives patients of therapeutic touch and may lead to
contact dermatitis in nurses.

CONCLUSION: All student nurses must be able to identify clinical
situations when gloves are not indicated, using appropriate risk
assessment.
__________________________________________________________________
________________________________*_________________________________

29. No Abstract: Bloodborne virus exposure from sharps injuries on the
rise
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26012063

Nurs Times. 2014 Dec 17-2015 Jan 13;110(51):8.

Bloodborne virus exposure from sharps injuries on the rise.

Merrifield N.
__________________________________________________________________
________________________________*_________________________________

30. No Abstract: Surveillance and prevention of patient blood exposure
accidents
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26050393

Rev Infirm. 2014 Oct;204:8.

[Surveillance and prevention of patient blood exposure accidents].

[Article in French]

[No authors listed]
__________________________________________________________________
________________________________*_________________________________

New WHO Injection Safety Guidelines

WHO is urging countries to transition, by 2020, to the exclusive use of
the new “smart” syringes, except in a few circumstances in which a syringe
that blocks after a single use would interfere with the procedure.

The new guideline is:

WHO Guideline on the use of Safety-Engineered Syringes for Intramuscular,
Intradermal and Subcutaneous Injections in Health Care

It is available for free download or viewing at this link:
www.who.int/injection_safety/global-campaign/injection-safety_guidline.pdf

PDF Requires Adobe Acrobat Reader [620 KB]
__________________________________________________________________
________________________________*_________________________________
Making all injections safe brochure

This is an illustrated summary brochure for the general public.

pdf, 554kb [6 pages]

www.who.int/injection_safety/global-campaign/injection-safety_brochure.pdf
__________________________________________________________________
________________________________*_________________________________

SIGN Meeting 2015

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

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

A report of the meeting will be posted ASAP
__________________________________________________________________
________________________________*_________________________________
* 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
__________________________________________________________________
________________________________*_________________________________
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
__________________________________________________________________

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