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SIGNpost 00818

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST

Post00818   Ebola + NSI + Needles + Abstracts + News 9 September 2015

CONTENTS
1. Getting to Zero: Ebola Response in Action
2. Abstract: An analysis of multimodal occupational exposure leading to
blood borne infections among health care workers
3. Abstract: Prevalence and risk factors of needlestick injuries, sharps
injuries, and blood and body fluid exposures among operating room
nurses in Thailand
4. Abstract: Epidemiology of exposure to HIV/AIDS risky conditions in
healthcare settings: the case of health facilities in Gondar City,
North West Ethiopia
5. Abstract: Human T-cell lymphotropic virus type 1 exposures following
blood-borne virus incidents in central Australia, 2002-2012
6. Abstract: Seroprevalence of hepatitis B and C virus infections among
health students and health care workers in the Najran region,
southwestern Saudi Arabia: the need for national guidelines for health
students
7. Abstract: Occupational Exposure of Shiraz Dental Students to Patients’
Blood and Body Fluid
8. Abstract: Identification of risk factors for hepatitis B and C in
Peshawar, Pakistan
9. Abstract: Outbreak of hepatitis C virus infection associated with
narcotics diversion by an hepatitis C virus-infected surgical
technician
10. Abstract: A qualitative analysis of transitions to heroin injection in
Kenya: implications for HIV prevention and harm reduction
11. Abstract: Reducing Fatal Opioid Overdose: Prevention, Treatment and
Harm Reduction Strategies
12. Abstract: Trends in Injection Drug Use Among High School Students,
U.S., 1995-2013
13. Abstract: Multiple Daily Injections OR Insulin Pump Therapy: Choosing
the Best Option for Your Patient-An Evidence-based Approach
14. Abstract: Three decades of hepatitis B control with vaccination
15. Abstract: Mobile phones: Reservoirs for the transmission of nosocomial
pathogens
16. No Abstract: Medical waste. Dispelling the stigma of trash generated
by healthcare providers
17. No Abstract: Splashes & Sharps: Occupational Exposures in the Health
Care Setting
18. Health Logistics and Supply Chain Management: FREE online courses and
text books
19. News
– Safety Feature for Needle Injections Invented by InventHelp Client
– Global: Special Purpose Needles Market Growth and Forecast,2015-2025 by
Future Market Insights

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__________________________________________________________________
________________________________*_________________________________

1. Getting to Zero: Ebola Response in Action
__________________________________________________________________
Getting to Zero: Ebola Response in Action: See Progress @ the Dashboard

Ebola response in action

Since July 2014, there’s been some real progress towards tackling the
Ebola outbreak. But new cases continue to emerge.

View the interactive dashboard to see the progress made in the Ebola
outbreak. http://apps.who.int/ebola/our-work/achievements

Scroll through our interactive story of the progress made and the
challenges that remain, as we continue to work towards our final goal of
#GettingtoZero.
__________________________________________________________________
________________________________*_________________________________

2. Abstract: An analysis of multimodal occupational exposure leading to
blood borne infections among health care workers
__________________________________________________________________
Free full text http://www.ijpmonline.org/text.asp?2015/58/1/66/151191

Indian J Pathol Microbiol. 2015 Jan-Mar;58(1):66-8.

An analysis of multimodal occupational exposure leading to blood borne
infections among health care workers.

Priya NL1, Krishnan KU, Jayalakshmi G, Vasanthi S.
Author information
1Institute of Microbiology, Madras Medical College, Chennai, Tamil Nadu,
India.

Occupational exposure poses a significant risk of transmission of blood-
borne pathogens to healthcare workers (HCWs). Adherence to standard
precautions, awareness about post exposure prophylaxis is poor in
developing countries.

This retrospective study analyzes the self-reported
cases of occupational exposure in a tertiary care hospital. During the
study period, 105 HCWs sustained occupational exposure to blood and body
fluids.

Majority of the victims 36 (34.2%) were interns and the clinical
practice that led to the occupational exposure was withdrawal of blood
(45.7%).

Good infection control practices and emphasis on appropriate
disposal are needed to increase the occupational safety for HCWs.
__________________________________________________________________
________________________________*_________________________________

3. Abstract: Prevalence and risk factors of needlestick injuries, sharps
injuries, and blood and body fluid exposures among operating room
nurses in Thailand
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26320986

Am J Infect Control. 2015 Aug 26. pii: S0196-6553(15)00799-3.

Prevalence and risk factors of needlestick injuries, sharps injuries, and
blood and body fluid exposures among operating room nurses in Thailand.

Kasatpibal N1, Whitney JD2, Katechanok S3, Ngamsakulrat S3, Malairungsakul
B3, Sirikulsathean P4, Nuntawinit C5, Muangnart T6.

1Division of Nursing Science, Faculty of Nursing, Chiang Mai University,
Chiang Mai, Thailand. Electronic address: nongyaok2003@gmail.com.
2Department of Biobehavioral Nursing and Health Systems, School of
Nursing, University of Washington, Seattle, WA.
3Operating Room and Recovery Room Service, Maharaj Nakorn Chiang Mai
Hospital, Chiang Mai University, Chiang Mai, Thailand.
4Operating Room, Rajavithi Hospital, Bangkok, Thailand.
5Operating Room, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
6Operating Room, Police General Hospital, Bangkok, Thailand.

BACKGROUND: Operating room nurses are at high risk for occupational
exposure to bloodborne pathogens. This study examined the prevalence of
and risk factors for needlestick injuries (NSIs), sharps injuries (SIs),
and blood and body fluid exposures (BBFEs) among operating room nurses in
Thai hospitals.

METHODS: A cross-sectional study was performed in 247 Thai hospitals.
Questionnaires eliciting demographic data and information on injury
occurrence and risk factors were distributed to 2500 operating room
nurses, and 2031 usable questionnaires were returned, for a response rate
of 81.2%. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs)
were calculated using multiple logistic regression analysis.

RESULTS: The prevalence of NSIs, SIs, and BBFEs was 23.7%, 9.8%, and
40.0%, respectively.

Risk factors for NSIs were training without practice (OR, 1.67; 95% CI,
1.29-2.17), haste (OR, 4.81; 95% CI, 3.41-6.79), lack of awareness (OR,
1.36; 95% CI, 1.04-1.77), inadequate staffing (OR, 1.60; 95% CI,
1.21-2.11), and outdated guidelines (OR, 1.69; 95% CI, 1.04-2.74). One
risk factor was identified for SIs: haste (OR, 2.43; 95% CI, 1.57-3.76).

Risk factors for BBFEs were long working hours per week (OR, 2.07; 95% CI,
1.06-4.04), training without practice (OR, 1.55; 95% CI, 1.25-1.91), haste
(OR, 1.66; 95% CI, 1.30-2.13), lack of awareness (OR, 1.54; 95% CI,
1.22-1.95), not wearing protective equipment (OR, 1.61; 95% CI,
1.26-2.06), and inadequate staffing (OR, 1.63; 95% CI, 1.26-2.11).

CONCLUSION: This study highlights the high prevalence of NSIs, SIs, and
BBFEs among Thai operating room nurses. Preventable risk factors were
identified. Appropriate guidelines, adequate staffing, proper training,
and self- awareness may reduce these occurrences.

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

KEYWORDS: Needlestick injuries; Operating room nurses; Prevalence; Risk
factors; Sharps injuries; Splashes
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Epidemiology of exposure to HIV/AIDS risky conditions in
healthcare settings: the case of health facilities in Gondar City,
North West Ethiopia
__________________________________________________________________
Open Access Free article http://www.biomedcentral.com/1471-2458/14/1283

BMC Public Health. 2014 Dec 16;14:1283.

Epidemiology of exposure to HIV/AIDS risky conditions in healthcare
settings: the case of health facilities in Gondar City, North West
Ethiopia.

Beyera GK1, Beyen TK.

1Department of Environmental and Occupational Health and Safety, Institute
of Public Health, College of Medicine and Health Sciences, University of
Gondar, Gondar, Ethiopia. getkoo@yahoo.com.

BACKGROUND: It has been estimated that every year more than quarter a
million health care workers exposed to HIV risky conditions in health care
settings, more so in developing countries, with high incidence of HIV/AIDS
and unsafe practices. Particularly, Sub-Saharan African countries share at
least half of these occupational exposures to HIV risky conditions among
health care workers. The aim of this study was to determine the
epidemiology of health care workers’ exposure to HIV/AIDS risky conditions
and associated factors in the healthcare settings in Gondar city.

METHODS: Institution based quantitative cross sectional study was
conducted from April 1-20, 2014. The study included 401 health care
workers who were selected from the source population by simple random
sampling technique. Data were collected by interviewing health care
workers using structured and pretested questionnaire. After the collected
data entered to EPI INFO version 3.5.3 statistical software and exported
to SPSS version 20.0 for analysis, both binary and multivariable logistic
regressions were done to identify factors associated with exposure to
HIV/AIDS risky conditions.

RESULTS: From a total of 401 health care workers involved in this study,
162(40.4%) reported at least one history of occupational exposure to
HIV/AIDS risky conditions in the last one year. More than half (52.31%) of
physicians and 47.62% of anesthetists were exposed to HIV/AIDS risky
conditions within one year. Lack of training on infection prevention, 5-10
years work experience, long working hours per week, absence of work
guidelines, and dissatisfaction with current job were significantly
associated with accidental occupational exposure to HIV/AIDS risky
conditions.

CONCLUSION: This study found quite high prevalence of health care workers
exposure to HIV/AIDS risky conditions in the health care settings in
Gondar city. Therefore, effective and goal oriented educational programmes
targeting at health care workers and establishment of surveillance systems
for registering, reporting and management of occupational exposures in
health care settings are quite important.
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Human T-cell lymphotropic virus type 1 exposures following
blood-borne virus incidents in central Australia, 2002-2012
__________________________________________________________________
Full Free Article http://cid.oxfordjournals.org/content/59/1/85

Clin Infect Dis. 2014 Jul 1;59(1):85-7.

Human T-cell lymphotropic virus type 1 exposures following blood-borne
virus incidents in central Australia, 2002-2012.

Hewagama S1, Krishnaswamy S1, King L2, Davis J3, Baird R4.

1Infectious Diseases Unit.
2Infection Control and Prevention Unit, Alice Springs Hospital.
3Global and Tropical Health Division, Menzies School of Health Research,
Darwin.
4Department of Microbiology, Royal Darwin Hospital, Casuarina, Northern
Territory, Australia.

We retrospectively audited hospital occupational exposure events over a
10-year period, in a human T-cell lymphotropic virus type 1 (HTLV-1)-
endemic area of Central Australia, and report on 53 individuals exposed to
HTLV-1 with no transmissions documented (95% confidence interval,
0%-1.5%).

This has important implications for the management of exposures including
the role of postexposure prophylaxis.

© The Author 2014. Published by Oxford University Press on behalf of the
Infectious Diseases Society of America. All rights reserved.

KEYWORDS: HTLV-1; needlestick; occupational exposure

Full Free Article http://cid.oxfordjournals.org/content/59/1/85
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Seroprevalence of hepatitis B and C virus infections among
health students and health care workers in the Najran region,
southwestern Saudi Arabia: the need for national guidelines for health
students
__________________________________________________________________
http://www.biomedcentral.com/1471-2458/14/577 Open Access

BMC Public Health. 2014 Jun 9;14:577.

Seroprevalence of hepatitis B and C virus infections among health students
and health care workers in the Najran region, southwestern Saudi Arabia:
the need for national guidelines for health students.

Alqahtani JM, Abu-Eshy SA, Mahfouz AA1, El-Mekki AA, Asaad AM.

1Department of Family and Community Medicine, College of Medicine, King
Khalid University, Abha, P,O, Box 641, Saudi Arabia.
mahfouz2005@gmail.com.

BACKGROUND: The objectives of the study were to study the seroprevalence
of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among
health college students (HS) and health care workers (HCWs) in the Najran
Region of south-western Saudi Arabia and to study the students’ knowledge
of occupational exposure to blood-borne viral infections.

METHODS: A cross-sectional study of a representative sample of 300 HS and
300 HCWs was conducted.

RESULTS: An overall seroprevalence of HBV of 1.7% and 8.7% was found among
HS and HCWs, respectively. Two-thirds of HS (66.7%, 200) and 23.3% (70) of
HCWs lack anti-HBs and are susceptible to HBV infection. An overall
seroprevalence of HCV of 0% and 0.3% was found among the HS and HCWs,
respectively. The present study indicates poor knowledge among HS and
moderate knowledge among HCWs regarding occupationally transmitted blood-
borne diseases, safe injection practices, and standard precautions to
prevent occupationally transmitted blood-borne infections.

CONCLUSION: It is mandatory to develop a structured program to raise
awareness among HS, and current health colleges’ curricula should be
upgraded to address these issues early. The HS should be considered new
recruits to health services in terms of their initial screening for blood-
borne infections and vaccination against HBV. The development of a novel
continuing medical education and pre-employment awareness program for HCWs
is recommended to address the following: blood-borne diseases transmitted
occupationally, standard precautions to prevent occupationally transmitted
blood borne infections, and safe injection practices.

Free http://www.biomedcentral.com/1471-2458/14/577 Open Access
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Occupational Exposure of Shiraz Dental Students to Patients’
Blood and Body Fluid
__________________________________________________________________
Full Free Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554314/

J Dent (Shiraz). 2015 Sep;16(3):206-13.

Occupational Exposure of Shiraz Dental Students to Patients’ Blood and
Body Fluid.

Shaghaghian S1, Golkari A1, Pardis S2, Rezayi A3.

1Dept. of Dental Public Heath, School of Dentistry, Shiraz University of
Medical Sciences, Shiraz, Iran.
2Dept. of Oral and Maxillofacial Pathology, School of Dentistry, Shiraz
University of Medical Sciences, Shiraz, Iran.
3Undergraduate Student, School of Dentistry, Shiraz University of Medical
Sciences, Shiraz, Iran.

STATEMENT OF THE PROBLEM: Exposure to patients’ blood and body fluids
would prone the dental students to the risk of blood borne infections.
Several studies have shown a high prevalence of these exposures in dental
settings particularly in developing countries. However, few studies have
evaluated the epidemiology of these exposures in dental students in Iran.

PURPOSE: To assess the epidemiology of occupational exposures among dental
students and consequently designing the appropriate interventions in order
to prevent these exposures.

MATERIALS AND METHOD: In this cross-sectional study performed during March
to June 2011, all 191 Shiraz clinical dental students were asked to
complete a self-administered questionnaire. This questionnaire included
demographic information and experience of sharp injuries and mucocutaneous
contaminations. Chi square and t-test were employed to evaluate the risk
factors of exposure.

RESULTS: 80%of the participants were exposed to the patients’ blood or
body fluids during their clinical course. No association was found between
the exposure and demographic factors.

*** Injection needle and recapping were the most common causes of these
injuries.

The most common sites that were injured and caused mucocutaneous
contamination were finger and face, respectively.

The most frequent activity causing contamination was using high-speed
rotary instruments.

*** Only 6.4% of the exposures had been reported to the related
authorities and the remains were underreported.

CONCLUSION: Blood and body fluid exposure in dental setting is common and
a lot of them are not reported. To reduce the hazards of these exposures,
infection control authorities should design interventions especially for
mentioned high-risk conditions. They should change dental students’
behavior especially regarding not recapping injection needles and using
eyewear. Dental schools seem to need a management center and a standard
protocol for following up the exposures.

KEYWORDS: Blood; Body Fluids; Dental Students; Occupational Exposure

Free PMC Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554314/
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Identification of risk factors for hepatitis B and C in
Peshawar, Pakistan
__________________________________________________________________
Free Full Article http://dx.doi.org/10.2147/HIV.S67429

HIV AIDS (Auckl). 2015 Aug 17;7:223-31.

Identification of risk factors for hepatitis B and C in Peshawar,
Pakistan.

Shafiq M1, Nadeem M2, Sattar Z3, Khan SM2, Faheem SM4, Ahsan I5, Naheed
R6, Khattak TM2, Akbar S7, Khan MT3, Khan MI1, Khan MZ8.

1Department of Internal Medicine, Khyber Teaching Hospital, University
Town, Peshawar, Pakistan.
2Department of General Surgery, Nishtar Medical College and Hospital, Dera
Ghazi Khan, Punjab, Pakistan.
3Department of Internal Medicine, Khyber Medical College, University
Campus, Peshawar, Pakistan.
4Department of Neurology, King Edward Medical University, Anarkali,
Lahore, Pakistan.
5Department of Internal Medicine, Mayo Hospital, Phoenix, AZ, USA.
6Department of Internal Medicine, Fatima Memorial Hospital, Lahore,
Pakistan.
7Department of Internal Medicine, Lady Reading Hospital, Andar Shehr,
Peshawar, Pakistan.
8Department of Internal Medicine, Hayatabad Medical Complex, Hayat Abad,
Pakistan.

BACKGROUND: Hepatitis B and C need immediate worldwide attention as the
infection rates are too high. More than 240 million people have chronic
(long-term) liver infections. Every year, about 600,000 people die
globally due to the acute or chronic consequences of hepatitis B and more
than 350,000 people die from hepatitis C-related liver diseases.

METHODS: Our study was designed as a case-control, descriptive study. It
was conducted through formal interviews by using structured
questionnaires. A total of 100 cases were included, with four controls for
each case.

RESULTS: This study confirms household contact, history of dental work,
history of surgery, sexual contact, and history of transfusion (blood and
its components) as the main risk factors which are responsible for the
increased prevalence of hepatitis.

CONCLUSION: The important risk factors, responsible for the high
prevalence of hepatitis B and C in our society are household contact,
history of dental work, history of surgery, sexual contact, and history of
transfusion (blood and its components). The odds ratio of probability for
these risk factors are: 4.2 for household contact history, 4.1 for history
of dental work, 3.9 for sexual contact, 2.7 for history of surgery, and
2.1 for history of transfusion. Associations of other predictor variables
(diabetes status, education level, profession, contact sports, intravenous
drug abuse, residence, immunosuppression, and skin tattoos) were not
statistically significant.

KEYWORDS: IV drug abuse; dental work; hepatitis B; hepatitis C; sexual
contact; surgery; transfusion

Free Full Article http://dx.doi.org/10.2147/HIV.S67429
__________________________________________________________________
________________________________*_________________________________

9. Abstract: Outbreak of hepatitis C virus infection associated with
narcotics diversion by an hepatitis C virus-infected surgical
technician
__________________________________________________________________
Free Full Text
http://www.ajicjournal.org/article/S0196-6553(14)01176-6/fulltext

Am J Infect Control. 2015 Jan;43(1):53-8.

Outbreak of hepatitis C virus infection associated with narcotics
diversion by an hepatitis C virus-infected surgical technician.

Warner AE1, Schaefer MK2, Patel PR2, Drobeniuc J3, Xia G4, Lin Y4,
Khudyakov Y4, Vonderwahl CW5, Miller L5, Thompson ND6.

1Division of Disease Control and Environmental Epidemiology, Colorado
Department of Public Health and Environment, Denver, CO. Electronic
address: Amy.warner@state.co.us.
2Prevention and Response Branch, Division of Healthcare Quality Promotion,
Centers for Disease Control and Prevention, Atlanta, GA.
3Assay Development and Diagnostic Reference Laboratory, Division of Viral
Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA.
4Molecular Epidemiology Laboratory, Division of Viral Hepatitis, Centers
for Disease Control and Prevention, Atlanta, GA.
5Division of Disease Control and Environmental Epidemiology, Colorado
Department of Public Health and Environment, Denver, CO.
6Epidemiology and Surveillance Branch, Division of Viral Hepatitis,
Centers for Disease Control and Prevention, Atlanta, GA.

BACKGROUND: Drug diversion by health care personnel poses a risk for
serious patient harm. Public health identified 2 patients diagnosed with
acute hepatitis C virus (HCV) infection who shared a common link with a
hospital. Further investigation implicated a drug-diverting, HCV-infected
surgical technician who was subsequently employed at an ambulatory
surgical center.

METHODS: Patients at the 2 facilities were offered testing for HCV
infection if they were potentially exposed. Serum from the surgical
technician and patients testing positive for HCV but without evidence of
infection before their surgical procedure was further tested to determine
HCV genotype and quasi-species sequences. Parenteral medication handling
practices at the 2 facilities were evaluated.

RESULTS: The 2 facilities notified 5970 patients of their possible
exposure to HCV, 88% of whom were tested and had results reported to the
state public health departments. Eighteen patients had HCV highly related
to the surgical technician’s virus. The surgical technician gained
unauthorized access to fentanyl owing to limitations in procedures for
securing controlled substances.

CONCLUSIONS: Public health surveillance identified an outbreak of HCV
infection due to an infected health care provider engaged in diversion of
injectable narcotics. The investigation highlights the value of public
health surveillance in identifying HCV outbreaks and uncovering a method
of drug diversion and its impacts on patients.

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

KEYWORDS: Drug theft in healthcare; Healthcare associated infections;
Unsafe injection practice

Free Full Text
http://www.ajicjournal.org/article/S0196-6553(14)01176-6/fulltext
__________________________________________________________________
________________________________*_________________________________

10. Abstract: A qualitative analysis of transitions to heroin injection in
Kenya: implications for HIV prevention and harm reduction
__________________________________________________________________

http://www.harmreductionjournal.com/content/12/1/27 Open Access

Harm Reduct J. 2015 Sep 4;12(1):27.

A qualitative analysis of transitions to heroin injection in Kenya:
implications for HIV prevention and harm reduction.

Guise A1, Dimova M2, Ndimbii J3, Clark P4, Rhodes T5.

1Centre for Research on Drugs and Health Behaviour, London School of
Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH,
UK. andy.guise@lshtm.ac.uk.
2School of Oriental and African Studies, Thornhaugh Street, London, WC1H
0XG, UK. md56@soas.ac.uk.
3Kenyan AIDS NGOs Consortium, Jabavu Lane, P.O. Box 69866-00400, Nairobi,
Kenya. jndimbii@kanco.org.
4School of Oriental and African Studies, Thornhaugh Street, London, WC1H
0XG, UK. pc44@soas.ac.uk.
5Centre for Research on Drugs and Health Behaviour, London School of
Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH,
UK. tim.rhodes@lshtm.ac.uk.

BACKGROUND: Heroin injection is emerging as a significant dimension of the
HIV epidemic in Kenya. Preventing transitions to injecting drug use from
less harmful forms of use, such as smoking, is a potentially important
focus for HIV prevention. There is, however, little evidence to support
comprehensive programming in this area, linked to a shortage of analysis
of the social and structural context for transitions, particularly in low-
income settings. We explore accounts of transitions from smoking to
injecting in Kenya to understand the role of individual, social and
structural processes.

METHODS: We combine data from two separate studies conducted in Kenya: an
in-depth qualitative study of HIV care access for people who inject drugs
(study 1) and an ethnographic study of the political economy of the heroin
trade in Kenya (study 2). In-depth interviews with PWID and community
observation from study 1 are triangulated with accounts from stakeholders
involved in the heroin trade and documentary data from study 2.

RESULTS: People who inject drugs link transitions to injecting from
smoking to a range of social and behavioural factors, as well as
particular aspects of the local drug supply and economy. We present these
results in the form of two narratives that account for factors shaping
transitions. A dominant narrative of ‘managing markets and maintaining a
high’ results from a process of trying to manage poverty and a shifting
heroin supply, in the context of deepening addiction to heroin. A
secondary narrative focuses on people’s curiosity for the ‘feeling’ of
injecting, and the potential pleasure from it, with less emphasis on
structural circumstances.

CONCLUSIONS: The narratives we describe represent pathways through which
structural and social factors interact with individual experiences of
addiction to increase the risk of transitions to injecting. In response,
HIV and harm reduction programmes need combinations of different
strategies to respond to varied experiences of transitions. These
strategies should include, alongside behaviour-oriented interventions,
structural interventions to address economic vulnerability and the
policing of the drug supply.

Free full text http://www.harmreductionjournal.com/content/12/1/27
__________________________________________________________________
________________________________*_________________________________

11. Abstract: Reducing Fatal Opioid Overdose: Prevention, Treatment and
Harm Reduction Strategies
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26339206

Yale J Biol Med. 2015 Sep 3;88(3):235-45. eCollection 2015.

Reducing Fatal Opioid Overdose: Prevention, Treatment and Harm Reduction
Strategies.

Hawk KF1, Vaca FE1, D’Onofrio G1.

1Department of Emergency Medicine, Yale University, New Haven,
Connecticut.

The opioid overdose epidemic is a major threat to the public’s health,
resulting in the development and implementation of a variety of strategies
to reduce fatal overdose [1-3]. Many strategies are focused on primary
prevention and increased access to effective treatment, although the past
decade has seen an exponential increase in harm reduction initiatives.

To maximize identification of opportunities for intervention, initiatives
focusing on prevention, access to effective treatment, and harm reduction
are examined independently, although considerable overlap exists.

Particular attention is given to harm reduction approaches, as increased
public and political will have facilitated widespread implementation of
several initiatives, including increased distribution of naloxone and
policy changes designed to increase bystander assistance during a
witnessed overdose [4-7].

KEYWORDS: harm reduction; naloxone; opioid overdose; overdose;
prescription drug abuse
__________________________________________________________________
________________________________*_________________________________

12. Abstract: Trends in Injection Drug Use Among High School Students,
U.S., 1995-2013
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26314917

Am J Prev Med. 2015 Aug 24. pii: S0749-3797(15)00317-7.

Trends in Injection Drug Use Among High School Students, U.S., 1995-2013.

Klevens RM1, Jones SE2, Ward JW3, Holtzman D3, Kann L2.

1Division of Viral Hepatitis, National Center for HIV/AIDS, Viral
Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia. Electronic
address: rmk2@cdc.gov.
2Division of Adolescent and School Health, National Center for HIV/AIDS,
Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia.
3Division of Viral Hepatitis, National Center for HIV/AIDS, Viral
Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia.

INTRODUCTION: Injection drug use is the most frequently reported risk
behavior among new cases of hepatitis C virus infection, and recent
reports of increases in infection are of great concern in many
communities. This study assessed the prevalence and trends in injection
drug use among U.S. high school students.

METHODS: Data were from CDC’s Youth Risk Behavior Surveillance System,
which collects information on health risk behaviors at the national,
state, and large urban school district levels. Analyses were conducted in
2014.

RESULTS: In 2013, 1.7% of high school students nationwide had ever
injected any illegal drug. Nationwide, ever injecting any illegal drug did
not change significantly from 1995 to 2013, except among black non-
Hispanic students. For this subgroup, both a significant linear increase
from 1995 to 2013 and a significant quadratic trend were observed, with
injection drug use increasing from 1995 to 2009 and decreasing from 2009
to 2013. Significant linear increases in injection drug use occurred in
five states (Arkansas, Hawaii, Maine, Maryland, and New York) and six
large urban school districts (Baltimore, Memphis, Miami-Dade County, New
York City, Philadelphia, and Seattle). Significant linear decreases
occurred in three states (Massachusetts, South Dakota, and West Virginia).
Both a significant linear increase and quadratic trend were observed in
Maine; quadratic trends were observed in Tennessee, Utah, and Palm Beach
County, Florida.

CONCLUSIONS: In some geographic areas and population groups, an increasing
or high frequency of injection drug use was found among high school
students, who should be targeted for prevention.

Published by Elsevier Inc.
__________________________________________________________________
________________________________*_________________________________

13. Abstract: Multiple Daily Injections OR Insulin Pump Therapy: Choosing
the Best Option for Your Patient-An Evidence-based Approach
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26338287

Curr Diab Rep. 2015 Oct;15(10):644.

Multiple Daily Injections OR Insulin Pump Therapy: Choosing the Best
Option for Your Patient-An Evidence-based Approach.

Joshi M1, Choudhary P.

1Specialist Registrar in Diabetes and Endocrinology, King’s College
Hospital, Denmark Hill, SE5 9RS, London, UK, drmamtajoshi@yahoo.co.in.

Achieving optimal glucose control with minimal hypoglycemia and minimizing
the impact of diabetes on quality of life are the aims of management of
type 1 diabetes. The main therapeutic options for patients include
multiple daily injections (MDI) and continuous subcutaneous insulin
therapy (CSII).

It is important to differentiate fixed dose MDI with more flexible use,
based on carbohydrate counting and structured education programmes, often
termed functional insulin therapy (FIT), shown to deliver better outcomes.

A significant proportion of patients can achieve optimal glucose control
with either therapy, and for those who are unable to achieve desired
glucose control with MDI, there is a large body of observational data
showing CSII enables them to reduce HbA1c and hypoglycemia, with
associated improvements in diabetes-related quality of life.

However, in many healthcare systems, guidelines restrict the use of CSII
on the basis of cost, with only 20-35 % of patients with type 1 diabetes
across Europe using CSII. Although data support improved glucose control
and quality of life with CSII, we must recognize that insulin pump therapy
is not for everyone and has some downsides such as being attached to a
device or issues with cannulas.

When we sit down with our patients, we have a responsibility to support
those patients with the therapeutic strategy that is best suited to them.

In this paper, we review some of the literature that informs this
decision-making, highlighting areas where CSII offers clear benefits and
also some areas where it may not be appropriate.
__________________________________________________________________
________________________________*_________________________________

14. Abstract: Three decades of hepatitis B control with vaccination
__________________________________________________________________
Open Access Article http://www.wjgnet.com/1948-5182/full/v7/i18/2127.htm

World J Hepatol. 2015 Aug 28;7(18):2127-32.

Three decades of hepatitis B control with vaccination.

Meireles LC1, Marinho RT1, Van Damme P1.

1Liliane C Meireles, Rui Tato Marinho, Department of Gastroenterology and
Hepatology, Centro Hospitalar Lisboa Norte, 1649-035 Lisbon, Portugal.

Hepatitis B virus (HBV) continues to represent a major health problem and
can lead to acute liver failure, acute hepatitis, chronic carriership,
chronic hepatitis of HBV, liver cirrhosis, liver cancer, liver
transplantation and death.

There is a marked difference in the geographic distribution of carriers.
More than 240 million people worldwide are chronic HBV carriers.

Mother-to-child transmission remains the most important mechanism of
infection in countries with a high prevalence of HBV.

Percutaneous/parenteral transmission and unsafe sexual practices are
important mode of spread transmission of HBV in other countries.

Vaccination against HBV is the gold measure for primary prevention and
control of the disease. C

urrently, 179 countries have added HBV vaccination to their routine
vaccination programs with great results.

Neonatal immunization with HBV vaccine has been one of the most highly
effective measures in public health and the first anti-cancer program to
be launched. In this paper we review the achievements for the last three
decades.

KEYWORDS: Cirrhosis; Hepatitis B; Hepatocellular carcinoma; Primary
prevention; Vaccination

Open Access Article http://www.wjgnet.com/1948-5182/full/v7/i18/2127.htm
__________________________________________________________________
________________________________*_________________________________

15. Abstract: Mobile phones: Reservoirs for the transmission of nosocomial
pathogens
__________________________________________________________________
http://www.advbiores.net/text.asp?2015/4/1/144/161553 Open Access

Adv Biomed Res. 2015 Jul 27;4:144.

Mobile phones: Reservoirs for the transmission of nosocomial pathogens.

Pal S1, Juyal D1, Adekhandi S2, Sharma M1, Prakash R3, Sharma N1, Rana A1,
Parihar A1.

1Department of Microbiology and Immunology, Veer Chandra Singh Garhwali
Government Medical Sciences and Research Institute, Srinagar Garhwal,
Uttarakhand, India.
2Department of Medical Microbiology, Post Graduate Institute of Medical
Education and Research, Chandigarh, India.
3Microbial Containment Complex, Maximum Containment laboratory: BSL-IV,
Pashan, National Institute of Virology, Pune, Maharashtra, India.

BACKGROUND: Global burden of hospital-associated infection (HAI) is on the
rise and contributes significantly to morbidity and mortality of the
patients. Mobile phones are indispensible part of communication among
doctors and other health care workers (HCWs) in hospitals. Hands of HCWs
play an important role in transmission of HAI and mobile phones which are
seldom cleaned and often touched during or after the examination of
patients without hand washing can act as a reservoir for transmission of
potent pathogens. This study aimed to investigate the rate of bacterial
contamination of mobile phones among HCWs in our tertiary care hospital
and to compare it with personal mobile phones of non-HCWs (control group).

MATERIALS AND METHODS: The mobile phones and dominant hands of 386
participants were sampled from four different groups, hospital doctors and
staff (132), college faculty and staff (54), medical students (100) and
control group (100). Informed consent and questionnaire was duly signed by
all the participants. Samples were processed according to standard
guidelines.

RESULTS: 316 mobile phones (81.8%) and 309 hand swab samples (80%) showed
growth of bacterial pathogens. The most predominant isolates were
Coagulase-negative Staphylococcus, Staphylococcus aureus, Acinetobacter
species, Escherichia coli, Klebsiella pneumoniae, Pseudomonas species and
Enterococcus species.

CONCLUSION: Hundred percent contamination was found in mobile phones and
hands of HCWs indicating mobile phones can be the potential source of
nosocomial pathogens. Our study results suggest that use of mobile phones
in health care setup should be restricted only for emergency calls. Strict
adherence to infection control policies such as proper hand hygiene
practices should be followed.

KEYWORDS: Acinetobacter; cell phones; health care workers; methicillin-
resistant Staphylococcus aureus; nosocomial pathogens

Open Access http://www.advbiores.net/text.asp?2015/4/1/144/161553
__________________________________________________________________
________________________________*_________________________________

16. No Abstract: Medical waste. Dispelling the stigma of trash generated
by healthcare providers
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26214968

JEMS. 2015 Apr;40(4):36-8.

Medical waste. Dispelling the stigma of trash generated by healthcare
providers.

West K.
__________________________________________________________________
________________________________*_________________________________

17. No Abstract: Splashes & Sharps: Occupational Exposures in the Health
Care Setting
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26201240

Occup Health Saf. 2015 Apr;84(4):42, 44, 46.

Splashes & Sharps: Occupational Exposures in the Health Care Setting.

Goss L.
__________________________________________________________________
________________________________*_________________________________

18. Health Logistics and Supply Chain Management: FREE online courses and
text books

Crossposted with thanks from TECHNET21.org by Andrew Brown at
peoplethatdeliver.org
__________________________________________________________________
Andrew Brown created a new discussion FREE online courses and text books
to be more professional in the field of Health Logistics and Supply Chain
Management

Dear Technet members,

I receive a number of e-mails from people looking to increase their health
logistics and supply chain management skills. Increasing your skills and
competencies in this field is becoming more accessible with many
organisations (eg USAID|DELIVER through JSI, UNFPA, Ipas and others),
offering FREE online courses in various competency areas in health
logistics and supply chain. W

ith WHO and UNICEF modules also coming online in the coming months. IAPHL
have brought together a number of FREE courses at the following link on
their site: http://iaphl.org/resource-library/e-learning-resources/ To
decide which competency areas you need to work on take a look at the
[b]’PtD HSCM Managers and Leaders Competency Framework'[/b]

http://www.peoplethatdeliver.org/news/people-deliver-publishes-supply-
chain-competency-framework-managers-leaders Reflect on how well you
understand each of the competency areas in the six domains. For competency
areas where you think you need development, complete some extra study
through these courses.

If you are looking for more detailed courses then make sure you visit
LAPTOP http://www.rhsupplies.org/activities-resources/tools/laptop/

A resource developed by the Reproductive Health Supplies Coalition in
collaboration with PtD which lists many HSCM courses available globally.
To further help you in your competency development I would like to remind
you of the following two FREE online text books: – Practical guide to
Health Supply chain logistics management

http://apps.who.int/medicinedocs/documents/s20211en/s20211en.pdf –
Managing drug supply 3rd addition, Management Sciences for Health

https://www.msh.org/news-events/press-room/managing-drug-supply-third-
edition-now-available-online

I wish you well in your own professional development and I would encourage
you to visit www.peoplethatdeliver.org for the latest information on what
PtD is doing to help improve the development of human resources for health
supply chains. If you think that PtD can be of help to your organisation
then please contact us.

Regards,
Andrew N Brown
Consultant
PtD Executive Manager
www.peoplethatdeliver.org
__________________________________________________________________
________________________________*_________________________________

19. News

– Safety Feature for Needle Injections Invented by InventHelp Client
– Global: Special Purpose Needles Market Growth and Forecast,2015-2025 by
Future Market Insights
Selected news items reprinted under the fair use doctrine of international
copyright law: http://www4.law.cornell.edu/uscode/17/107.html
__________________________________________________________________
https://tinyurl.com/p9z466d

Safety Feature for Needle Injections Invented by InventHelp Client

By PRWeb, USA (05.09.15)

InventHelp, a Pittsburgh-based invention submission company, is submitting
the NON SLIP GRIP SYRINGE to companies for their review.

PITTSBURGH, PA (PRWEB) September 05, 2015

If you are nervous about either giving or getting shots, you are not
alone. With the frequency of accidental needle sticks, there is a greater
need than ever before for an idea conceived of by an inventor from
Cerritos, Calif.

She developed the patent-pending NON SLIP GRIP SYRINGE to protect medical
staff members and patients against accidental needle punctures. As such,
it prevents surgical team members from dropping a syringe, even with wet
gloves. In other words, it eases the administration of injections and
withdrawal of medications or fluids. At the same time, it prevents cross-
contamination with dirty needles. Furthermore, it allows for more accurate
treatment with a hypodermic needle and will not compromise dosage
measurements. It, therefore, provides enhanced safety and peace of mind
for patients and medical professionals alike. In addition, it is
convenient, effective and easy to use.

The inventor’s experience in patient care inspired the idea. “Working as a
registered nurse, I had stabbed myself with a needle and wanted to prevent
that from happening in the future,” she said.

The original design was submitted to the Orange County office of
InventHelp. It is currently available for licensing or sale to
manufacturers or marketers. For more information, write Dept. 14-OCM-914,
InventHelp, 217 Ninth Street, Pittsburgh, PA 15222, or call (412) 288-1300
ext. 1368. Learn more about InventHelp’s Invention Submission Services at
http://www.InventHelp.com – https://www.youtube.com/user/inventhelp
__________________________________________________________________
__________________________________________________________________
Global: Special Purpose Needles Market Growth and Forecast,2015-2025 by
Future Market Insights

Future Market Insights, Press Release (04.09.15)

Needles and syringes are collectively known as a “sharps”. These are the
most widely used medical disposables around the globe. Needle or syringes
can be defined as the device consisting of a glass, metal, or rubber tube
with a nozzle and piston for sucking in and ejecting liquid in a thin
stream. The main purpose of this needles is to clean wounds by injecting
or sucking fluids into the body

Special purpose needles are the syringes or needle that are made for the
different disease or disability in the body like blood collection needles,
suture needles and etc.

The market of needles, syringes, and disposable needles or we can say for
disposable medical products has expanded considerably due to increase in
the number of outpatient procedures and due to the increasing awareness of
disease such as HIV/AIDS, simplex malaria, typhus and etc.

Special Purpose Needles Market: Drivers and Restraints

Presently, special purpose needles global market is driven by the aging
population, rise in demand of better healthcare infrastructure globally.

Browse Full Report@
http://www.futuremarketinsights.com/reports/special-purpose-needles-market

Special purpose needles global market drives by the aging population,
rising incidence of infectious disease. Demand for better healthcare
infrastructure around the globe, advancement in product designs, increased
emphasis on preventing hospital acquired infections are some of the other
factors that drives the special purpose needles market globally. However,
lack of knowledge and lack of skilled professional act as a barriers for
special purpose needle global market.

Special Purpose Needles Market: Segmentation

Special purpose needles market is segmented into following types:

Fine Aspirating Needles
Biopsy Needles
Blood Collection Needles
Bone Marrow Needles
Catheter Needles
Dental Needles
Epidural Needles
AV Fistula Needles
Pen Needles
Intravenous Needles
Ophthalmic Needles
Spinal Anesthesia Needles
Suture Needles.
Special Purpose Needles Market: Overview

With rise in demand of better healthcare infrastructure around the globe
and rising incidence of infectious disease, the global special purpose
needles market is expected to grow at healthy CAGR in the forecast period
(2012-2025).

Special Purpose Needles Market: Region-wise Outlook

Depending on geographic region, the global special purpose needles market
is segmented into seven key regions: North America, South America, Eastern
Europe, Western Europe, Asia Pacific, Japan, and Middle East & Africa.

Asia pacific represents the largest regional market worldwide due to large
number of population and high development in healthcare sector. While the
North America ranks as the fastest growing market with a double digit
growth rate.

Special Purpose Needles Market: Key players

Some of the key participating market players in special purpose needles
global market are Becton, Dickinson and Company, Ethicon Inc., B. Braun
Medical Inc., Covidien Plc, Argon Medical Devices Inc., Smiths Medical.
Terumo Medical Corporation and others.

The research report presents a comprehensive assessment of the market and
contains thoughtful insights, facts, historical data, and statistically
supported and industry-validated market data. It also contains projections
using a suitable set of assumptions and methodologies. The research report
provides analysis and information according to categories such as market
segments, geographies, types, technology and applications.

Request Report TOC@ http://www.futuremarketinsights.com/toc/rep-gb-583

The report covers exhaustive analysis on:

Market Segments
Market Dynamics
Market Size
Supply & Demand
Current Trends/Issues/Challenges
Competition & Companies involved
Technology
Value Chain
Regional analysis includes

North America (U.S., Canada)
Latin America (Mexico. Brazil)
Western Europe (Germany, Italy, France, U.K, Spain, Nordic countries,
Belgium, Netherlands, Luxembourg)
Eastern Europe (Poland, Russia)
Asia Pacific (China, India, Australia & New Zealand)
Japan
Middle East and Africa (S. Africa, N. Africa)

ABOUT US:

Future Market Insights (FMI) is a leading market intelligence and
consulting firm. We deliver syndicated research reports, custom research
reports and consulting services, which are personalized in nature. FMI
delivers a complete packaged solution, which combines current market
intelligence, statistical anecdotes, technology inputs, valuable growth
insights, an aerial view of the competitive framework, and future market
trends.

Our research services cover global as well as regional emerging markets
such as GCC, ASEAN, and BRICS. Our offerings cover a broad spectrum of
industries including Chemicals, Materials, Energy, Technology, Healthcare,
and Retail. FMI’s operating model blends cross-disciplinary research
experience to deploy in-depth, insightful, and actionable research.

Future Market Insights www.futuremarketinsights.com
__________________________________________________________________
________________________________*_________________________________

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 Service Delivery and Safety (SDS)
Health Systems and Innovation (HIS) at WHO HQ, 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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