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SIGNpost 00820

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST

Post00820   SIGN Tools RFI + Supply + Abstracts + News   19 September 2015

CONTENTS
1. Open Call (2): Revising and Updating the Injection Safety Tools
2. New: Supply Chain Compass: a web-based tool diagnoses the maturity of
public health supply chains
3. Abstract: Hospital Housekeepers: Victims of ineffective Hospital Waste
Management
4. Abstract: Biomedical waste management: study on the awareness and
practice among healthcare workers in a tertiary teaching hospital
5. Abstract: Safety and efficacy of intranasally administered medications
in the emergency department and prehospital settings
6. Abstract: Health care-associated hepatitis C virus infection
7. Abstract: Study on risk factors of hepatitis C virus infection among
Han population in Henan province
8. Abstract: Knowledge of Case Workers and Correctional Officers towards
HIV and HCV Infections: Opportunity for Public Health Education in the
Correctional System
9. Abstract: Filtration of crushed tablet suspensions has potential to
reduce infection incidence in people who inject drugs
10. Abstract: Risk of HIV and hepatitis B and C over time among men who
inject image and performance enhancing drugs in England and Wales:
results from cross-sectional prevalence surveys, 1992-2013
11. Abstract: The Global Fund to Fight AIDS, Tuberculosis and Malaria’s
investments in harm reduction through the rounds-based funding model
(2002-2014)
12. Abstract: Far From “Just a Poke”: Common Painful Needle Procedures and
the Development of Needle Fear
13. Abstract: Procedural and Physical Interventions for Vaccine
Injections: Systematic Review of Randomized Controlled Trials and
Quasi-Randomized Controlled Trials
14. Abstract: Psychological Interventions for Vaccine Injections in
Children and Adolescents: Systematic Review of Randomized and Quasi-
Randomized Controlled Trials
15. Abstract: Disinfection with sodium hypochlorite in hospital
environmental surfaces in the reduction of contamination and infection
prevention: a systematic review
16. No Abstract: The inaugural Healthcare Infection Society Middle East
Summit: ‘No action today. No cure tomorrow.’
17. World Hepatitis Summit harnesses global momentum to eliminate viral
hepatitis
18. News
– California USA: Santa Barbara Medical Clinic Shut Down for Unsafe
Injection Practices May Reopen
– California USA: SF’s Needle Disposal Program is Effective but Not
Always Welcome
– Kentucky USA: Needle-exchange program quietly protects public health

The web edition of SIGNpost is online at:
http://signpostonline.info/archives/1901

More information follows at the end of this SIGNpost!

Please send your requests, notes on progress and activities, articles,
news, and other items for posting to: sign.moderator@gmail.com

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

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

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

Visit the SIGNpostOnline archives at: http://signpostonline.info

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

1. Open Call (2): Revising and Updating the Injection Safety Tools
__________________________________________________________________
The Injection Safety website and tools need some revision.

This is an open call for everyone, particularly experts to kindly visit
the Injection Safety Toolbox page at
http://www.who.int/injection_safety/toolbox/en/

Please review:

– the Policy Management tools

– the Technical Tools for Assessing, Planning, and Implementing injection
safety

– the Resources in the Document Centre with content spanning the period
from 1999 to the present

Please suggest which tools require revision

And if you see a need: What new tools should be developed?

Please reply to ALTAF, Arshad <altafa@who.int> by 20 September 2015
__________________________________________________________________
________________________________*_________________________________

from: ALTAF, Arshad <altafa@who.int>
to: SIGN Alliance
date: Monday, Sep 14, 2015
subject: Injection Safety Tools: Revision

Dear SIGN Alliance,

I would like to update all of you on some of the recent developments and
future plans for injection safety. After Selma Khamassi’s departure I
have taken over the difficult task of moving the injection safety agenda
forward. Selma did a formidable job of working on injection safety during
her tenure.

Now I have joined WHO HQ as a Consultant and one of my primary
responsibilities is to move the injection safety agenda forward in light
of the newly launched “Injection Safety Guidelines”
www.who.int/injection_safety/global-campaign/injection-safety_guidline.pdf

Some of you may know me and for those who do not, I have been working very
closely with SIGN and WHO on this topic since early 2000s and have gained
an indepth understanding of the topic and related matters. I also had an
added advantage because I come from Pakistan which is one of the most
seriously unsafe injections affected countries in the world.

The Injection Safety website and tools present there need some revision
and this is an open call for everyone, particularly experts to kindly
visit http://www.who.int/injection_safety/toolbox/en/ and review and
suggest which tools require revision and if there are any suggestions for
new ones those will also be welcomed.

You can send your responses to altafa@who.int

I look forward to receiving your valuable feedback and suggestions. We
shall wait for your feedback till 20th of September 2015.

Kind regards.

Dr Arshad Altaf, MBBS MPH

Consultant
Injection Safety
Service Delivery and Safety (SDS)
Health Systems and Innovation (HIS)
Room 4163, Tel +41 76 757 9559
World Health Organization
20, Av Appia, CH-1211 Geneva 27, Switzerland
__________________________________________________________________
________________________________*_________________________________

2. New: Supply Chain Compass: a web-based tool diagnoses the maturity of
public health supply chains
__________________________________________________________________
By: USAID | DELIVER PROJECT

Dear Colleagues,

Two new publications focusing on Supply Chain Compass, a web-based tool
that diagnoses the maturity of public health supply chains, are now
available on the USAID | DELIVER PROJECT website:

1. Diagnosing Supply Chain Maturity: Supply Chain Compass Tool Helps Three
Countries
2. Diagnose Your Public Health Supply Chain with Compass

Diagnosing Supply Chain Maturity: Supply Chain Compass Tool Helps Three
Countries is a success story that discusses implementation of the tool in
India, Madagascar, and Zanzibar and summarizes how each country benefited
from its use.

Diagnose your Public Health Supply Chain with Compass is a flyer that
provides a quick introduction to Supply Chain Compass, listing the key
managerial and functional areas the tool covers, as well as providing a
summary of what is to be gained by using it.

Download Diagnosing Supply Chain Maturity: Supply Chain Compass Tool Helps
Three Countries at: http://bit.ly/1jwrlxw

Download Diagnose your Public Health Supply Chain with Compass at:
http://bit.ly/1nwcuzw
__________________________________________________________________
________________________________*_________________________________

3. Abstract: Hospital Housekeepers: Victims of ineffective Hospital Waste
Management
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26359679

Arch Environ Occup Health. 2015 Sep 11:0.

Hospital Housekeepers: Victims of ineffective Hospital Waste Management.

Ream PS1, Tipple AF1, Salgado TA1, Souza AC2, Souza SM1, Galdino-Júnior
H1, Alves SB1.

1a Postgraduate Program in Nursing College of Nursing, College of Nursing,
Federal University of Goias , Goiania , Brazil.
2b Department of Nursing , Nutrition and Physiotherapy, Pontifical
Catholic University of Goias , Goiania , Brazil.

BACKGROUND: Improper waste management exposes hospital housekeepers to
biological risk.

OBJECTIVES: To identify the frequency and profile of exposure incidents,
classify the role of sharps waste and compare the first and last
occurrence for hospital housekeepers with multiple exposure incidents.

METHODS: Retrospective epidemiological study using Brazilian records from
1989 to 2012. Data analyzed: hospital treatment records and the state
notification database. Probabilistic linkage: LinkPlus.

DATA ANALYSIS: SPSS.

RESULTS: There were 996 (11.6%) injuries with 57 (6.1%) workers reporting
multiple occurrences, for a total of 938workers. These were primarily
needlestick injuries (98.5%), involving blood (85.6%), caused by
hypodermic needles (75.1%), and improper sharps disposal (70.8%). The
number of workers completing vaccination after their first and before
their last injury was statistically significant.

CONCLUSION: Additional efforts to prevent and manage exposure incidents
are needed.

KEYWORDS: Hazardous waste; Hospital housekeeping; Needlestick injuries;
Occupational health; Occupational injuries
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Biomedical waste management: study on the awareness and
practice among healthcare workers in a tertiary teaching hospital
__________________________________________________________________
Free full text http://www.ijmm.org/text.asp?2015/33/1/129/148411

Indian J Med Microbiol. 2015 Jan-Mar;33(1):129-31.

Biomedical waste management: study on the awareness and practice among
healthcare workers in a tertiary teaching hospital.

Joseph L, Paul H, Premkumar J; Rabindranath, Paul R, Michael JS1.

1Department of Clinical Microbiology , Christian Medical College and
Hospital, Vellore, Tamil Nadu, India.

Bio-medical waste has a higher potential of infection and injury to the
healthcare worker, patient and the surrounding community. Awareness
programmes on their proper handling and management to healthcare workers
can prevent the spread of infectious diseases and epidemics.

This study was conducted in a tertiary care hospital to assess the impact
of training, audits and education/implementations from 2009 to 2012 on
awareness and practice of biomedical waste segregation.

Our study reveals focused training, strict supervision, daily
surveillance, audits inspections, involvement of hospital administrators
and regular appraisals are essential to optimise the segregation of
biomedical waste.

Free full text http://www.ijmm.org/text.asp?2015/33/1/129/148411
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Safety and efficacy of intranasally administered medications
in the emergency department and prehospital settings
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26346210

Am J Health Syst Pharm. 2015 Sep 15;72(18):1544-54.

Safety and efficacy of intranasally administered medications in the
emergency department and prehospital settings.

Corrigan M1, Wilson SS1, Hampton J2.

1Megan Corrigan, Pharm.D., BCPS, is Emergency Medicine Clinical
Pharmacist, Department of Pharmacy, Advocate Illinois Masonic Medical
Center, Chicago. Suprat Saely Wilson, Pharm.D., BCPS, is Emergency
Medicine Clinical Pharmacist Specialist, Department of Pharmacy Services,
Detroit Receiving Hospital, Detroit, MI. Jeremy Hampton, Pharm.D., BCPS,
is Clinical Specialist Emergency Medicine, Truman Medical Center, Kansas
City, MO, and Clinical Assistant Professor, School of Pharmacy, University
of Missouri-Kansas City, Kansas City.
2Megan Corrigan, Pharm.D., BCPS, is Emergency Medicine Clinical
Pharmacist, Department of Pharmacy, Advocate Illinois Masonic Medical
Center, Chicago. Suprat Saely Wilson, Pharm.D., BCPS, is Emergency
Medicine Clinical Pharmacist Specialist, Department of Pharmacy Services,
Detroit Receiving Hospital, Detroit, MI. Jeremy Hampton, Pharm.D., BCPS,
is Clinical Specialist Emergency Medicine, Truman Medical Center, Kansas
City, MO, and Clinical Assistant Professor, School of Pharmacy, University
of Missouri-Kansas City, Kansas City. hamptonjp@umkc.edu.

PURPOSE: The safety and efficacy of medications that may be administered
via the intranasal route in adult patients in the prehospital and
emergency department (ED) settings are reviewed.

SUMMARY: When medications of appropriate molecular character and
concentration are delivered intranasally, they are quickly transported
across this capillary network and delivered to the systemic circulation,
thereby avoiding the absorption-limiting effects of first-pass metabolism.
Therapeutic drug concentrations are rapidly attained in the cerebrospinal
fluid, making intranasal administration a very effective mode of delivery.
To optimize the bioavailability of intranasally administered drugs,
providers must minimize the barriers to absorption, minimize the volume by
maximizing the concentration, maximize the absorptive surface of the nasal
mucosa, and use a delivery system that maximizes drug dispersion and
minimizes drug runoff. Medications can be instilled into the nasal cavity
with syringes or droppers by applying a few drops at a time or via
atomization. The intranasal route of administration may be advantageous
for patients who require analgesia, sedation, anxiolysis, termination of
seizures, hypoglycemia management, narcotic reversal, and benzodiazepine
reversal in the ED or prehospital settings. Medications that have been
studied in the adult population include fentanyl, sufentanil,
hydromorphone, ketamine, midazolam, haloperidol, naloxone, flumazenil, and
glucagon. The available data do indicate, however, that intranasal
administration may be a safe, effective, and well tolerated route of
administration.

CONCLUSION: Based on the published literature, intranasal administration
of fentanyl, sufentanil, ketamine, hydromorphone, midazolam, haloperidol,
naloxone, glucagon, and, in limited cases, flumazenil may be a safe,
effective, and well-tolerated alternative to intramuscular or intravenous
administration in the prehospital and ED settings.

Copyright © 2015 by the American Society of Health-System Pharmacists,
Inc. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Health care-associated hepatitis C virus infection
__________________________________________________________________
Free Full Text http://www.wjgnet.com/1007-9327/full/v20/i46/17265.htm

World J Gastroenterol. 2014 Dec 14;20(46):17265-78.

Health care-associated hepatitis C virus infection.

Pozzetto B1, Memmi M1, Garraud O1, Roblin X1, Berthelot P1.

1Bruno Pozzetto, Meriam Memmi, Olivier Garraud, Xavier Roblin, Philippe
Berthelot, Groupe Immunité des Muqueuses et Agents Pathogènes (GIMAP
EA3064), Faculty of Medecine of Saint-Etienne, University of Lyon, 42023
Saint-Etienne, France.

Hepatitis C virus (HCV) is a blood-borne pathogen that has a worldwide
distribution and infects millions of people. Care-associated HCV
infections represented a huge part of hepatitis C burden in the past via
contaminated blood and unsafe injections and continue to be a serious
problem of public health.

The present review proposes a panorama of health care-associated HCV
infections via the three mode of contamination that have been identified:
(1) infected patient to non-infected patient; (2) infected patient to non-
infected health care worker (HCW); and (3) infected HCW to non infected
patient.

For each condition, the circumstances of contamination are described
together with the means to prevent them.

*** As a whole, the more important risk is represented by unsafe practices
regarding injections, notably with the improper use of multidose vials
used for multiple patients.

The questions of occupational exposures and infected HCWs are also
discussed.

In terms of prevention and surveillance, the main arm for combating care-
associated HCV infections is the implementation of standard precautions in
all the fields of cares, with training programs and audits to verify their
good application. HCWs must be sensitized to the risk of blood-borne
pathogens, notably by the use of safety devices for injections and good
hygiene practices in the operating theatre and in all the invasive
procedures.

The providers performing exposed-prone procedures must monitor their HCV
serology regularly in order to detect early any primary infection and to
treat it without delay.

With the need to stay vigilant because HCV infection is often a hidden
risk, it can be hoped that the number of people infected by HCV via health
care will decrease very significantly in the next years.

KEYWORDS: Antiviral drugs; Health care worker; Health care-associated
infection; Hemodialysis; Hepatitis C virus; Occupational exposure;
Standard precautions; Unsafe injections

Free Full Text http://www.wjgnet.com/1007-9327/full/v20/i46/17265.htm
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Study on risk factors of hepatitis C virus infection among
Han population in Henan province
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25582370

Zhonghua Yu Fang Yi Xue Za Zhi. 2014 Nov;48(11):985-9.

[Study on risk factors of hepatitis C virus infection among Han population
in Henan province].

[Article in Chinese]

Li J1, Ma Y2, Yang W2, Sun D2, Zhu Q2, Wang Z3.

1Institute for Prevention and Control of STD and AIDS , Henan Provincial
Center for Diseases Control and Prevention,Zhengzhou 450016, China.
2Institute for Prevention and Control of STD and AIDS , Henan Provincial
Center for Diseases Control and Prevention, Zhengzhou 450016, China.
3Institute for Prevention and Control of STD and AIDS , Henan Provincial
Center for Diseases Control and Prevention, Zhengzhou 450016, China.
Email: wangzhe@hncdc.com.cn.

OBJECTIVE: To study the risk factors of hepatitis C Virus Infection among
Han population in Henan Province, providing evidence for the development
of targeted prevention and control measures.

METHODS: In this 1: 1 matched case-control study, data of 134 cases and
134 controls were collected in seven hospitals from June 2013 to September
2013. Case group with the following conditions: Han nationality, first
diagnosed hepatitis C in 2013, Current address and investigation belong to
the same district (county), above 18 years old; with the following
conditions can’t into case group: not to cooperate with the investigation,
late-stage Hepatitis C patients. Control group with the following
conditions: Han nationality, with the matched case patients the same
gender, in the same hospital for treatment , from the same district
(county), the age difference = 5 years old and in the same age group. With
the following conditions can’t into control group:not to cooperate with
the investigation, diagnosed with hepatitis B, hepatitis C patients.
Collect 3 ml blood samples to test anti-HCV. Single factors were analyzed
with ?(2) between case and control, risk factors were analyzed with
logistic regression model.

RESULTS: The ratio about blood donation, blood transfusion, operation and
acupuncture of cases were 35.1% (47/134), 27.6% (37/134), 42.5% (57/134),
12.7% (17/134), with differences compared to those of controls (2.2%
(3/134), 5.2% (7/134), 21.6% (29/134), 5.2% (7/134))(?(2) values were
47.60, 24.47, 13.42 and 4.58, all P values <0.05). Compared with those
never received blood transfusion and those never donated blood, former
blood receptors and blood donors had higher risk of hepatitis C
infection(OR: 2.01, 95%CI:1.32-3.05; OR:2.68, 95%CI:1.85-3.88).

RESULTS: of multiple nonconditional logistic regression analysis showed
that Plasma donors and whole blood donors had higher risk of hepatitis C
infection than those never donated plasma and blood (OR:76.71, 95%CI:
10.25-574.25; OR:10.23, 95%CI: 2.15-48.70).

CONCLUSION: Blood transfusion and abnormal blood are independent risk
factors among Han population in Henan Province of hepatitis C infection.
The Plasma donors, blood donors and with the increase in the times of
blood transfusion, the risk of hepatitis C infection is increase.
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Knowledge of Case Workers and Correctional Officers towards
HIV and HCV Infections: Opportunity for Public Health Education in the
Correctional System
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26356737

P R Health Sci J. 2015 Sep;34(3):135-41.

Knowledge of Case Workers and Correctional Officers towards HIV and HCV
Infections: Opportunity for Public Health Education in the Correctional
System.

Pérez CM1, Santos Mdel C2, Torres A2, Grana C3, Albizu-García C3.
Author information
1Department of Biostatistics and Epidemiology, Graduate School of Public
Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
2Department of Social Sciences, Graduate School of Public Health,
University of Puerto Rico Medical Sciences Campus, San Juan, PR.
3Center for Evaluation and Sociomedical Research, Department of Health
Services Administration, Graduate School of Public Health, University of
Puerto Rico Medical Sciences Campus, San Juan, PR.

OBJECTIVE: Given the heavy burden of hepatitis C virus (HCV) and human
immunodeficiency virus (HIV) infections in correctional facilities, we
examined knowledge about these infections among case workers and
correctional officers in penal institutions in Puerto Rico.

METHODS: We used data from a cross-sectional study of state prisons,
commissioned by the Puerto Rico Department of Correction and
Rehabilitation, to assess knowledge about HCV and HIV (10 items each)
among 256 case workers and correctional officers from 18 penal
institutions selected in the prison system. Total scores for each scale
ranged from 0 to 10 points, with higher scores reflecting more knowledge.

RESULTS: Of 256 participants, 64.8% were males, 39.6% were aged 30-39
years, and 70.3% were case workers. The percentage of correct responses
for knowledge items ranged from 8.5% to 97.0% for HCV infection and from
38.7% to 99.6% for HIV infection. The vast majority (>96%) of participants
knew that injection drug users should be tested for HCV infection and that
sharing of needle injection equipment and multiple sex partners increase
the risk of HIV infection. However, misconceptions about routes of
transmission for these viral infections were found, with larger gaps in
knowledge for HCV infection. Mean knowledge scores for HCV and HIV
infections were 4.20±0.17 and 6.95±0.22, respectively, being significantly
(p<0.05) higher for case workers.

CONCLUSION: The findings about HCV and HIV knowledge in an important
segment of the correctional system staff support the urgent need for
increasing educational opportunities for correctional staff.

KEYWORDS: HCV infection; HIV infection; Knowledge; Prison staff; Public
health education
__________________________________________________________________
________________________________*_________________________________

9. Abstract: Filtration of crushed tablet suspensions has potential to
reduce infection incidence in people who inject drugs
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25196921

Drug Alcohol Rev. 2015 Jan;34(1):67-73.

Filtration of crushed tablet suspensions has potential to reduce infection
incidence in people who inject drugs.

Ng H1, Patel RP, Bruno R, Latham R, Wanandy T, McLean S.

1Division of Pharmacy, School of Medicine, University of Tasmania, Hobart,
Australia.

INTRODUCTION AND AIMS: The medical complications of injecting preparations
from crushed tablets can be severe, and most can be attributed to the
injection of insoluble particles and micro-organisms. Previously we have
shown that most of the particles can be removed by filtration, but it was
not known whether bacteria could also be filtered in the presence of a
high particle load. This study aims to determine the feasibility of
filtration to remove bacteria from injections prepared from tablets.

DESIGN AND METHODS: Injections were prepared from crushed slow-release
morphine tablets, in mixed bacterial suspensions of Staphylococcus aureus,
Streptococcus pyogenes and Pseudomonas aeruginosa. The injection
suspensions were passed through syringe filters of porosity 0.45 or
0.20?µm, or combined 0.8 then 0.2?µm, and the bacterial load was counted.

RESULTS: Bacterial concentrations in unfiltered injections were
2.5-4.3?×?10(6) colony forming units mL(-1) . Both the 0.20 and 0.45?µm
filters blocked unless a prefilter (cigarette filter) was used first. The
0.2?µm filter and the combined 0.8/0.2?µm filter reduced the bacteria to
the limit of detection (10 colony forming units mL(-1) ) or below.
Filtration through a 0.45?µm filter was slightly less effective.

DISCUSSION AND CONCLUSIONS: Use of a 0.2?µm filter, together with other
injection hygiene measures, offers the prospect of greatly reducing the
medical complications of injecting crushed tablets and should be
considered as a highly effective harm reduction method. It is very likely
that these benefits would also apply to other illicit drug injections,
although validation studies are needed.

© 2014 Australasian Professional Society on Alcohol and other Drugs.

KEYWORDS: filtration; harm reduction; injecting drug use; micro-organism;
pharmaceutical opioid
__________________________________________________________________
________________________________*_________________________________

10. Abstract: Risk of HIV and hepatitis B and C over time among men who
inject image and performance enhancing drugs in England and Wales:
results from cross-sectional prevalence surveys, 1992-2013
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26361173

J Acquir Immune Defic Syndr. 2015 Sep 8.

Risk of HIV and hepatitis B and C over time among men who inject image and
performance enhancing drugs in England and Wales: results from cross-
sectional prevalence surveys, 1992-2013.

Hope VD1, Harris R, McVeigh J, Cullen KJ, Smith J, Parry JV, DeAngelis D,
Ncube F.

11Public Health England, 61 Colindale Avenue, London NW9 5EQ, United
Kingdom 2Centre for Research on Drugs and Health Behaviour, London School
of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United
Kingdom 3Centre for Public Health, Liverpool John Moores University,
Liverpool L3 2ET, United Kingdom 4Public Health Wales, Temple of Peace &
Health, Cathays Park, Cardiff CF10 3NW, United Kingdom 5MRC Biostatistics
Unit, Cambridge Institute of Public Health, Robinson Way, Cambridge CB2
0SR, United Kingdom.

BACKGROUND: Infection risks among people who inject drugs (PWID) are
widely recognised, but few studies have focused on image and performance
enhancing drugs (IPEDs). Globally, concern about IPED injection has
increased and, in the United Kingdom, IPEDs injectors have become the
largest group using Needle and Syringe Programmes. Blood borne virus (BBV)
prevalence trends among IPED injectors are explored.

METHOD: Data from two surveys of IPED injectors (2010-11; 2012-13) and the
national bio-behavioural surveillance system for PWID (1992-97; 1998-2003;
2004-09) were merged. Psychoactive drug injectors and women were excluded.
Logistic regression analyses explored temporal changes.

RESULTS: Between 1992 and 2009, median age increased from 25 to 29 years
(N=1,296), years injecting from 2 to 4. There were 53 men who had sex with
men (MSM). Overall, 0.93% had HIV, 4.4% ever had hepatitis B (HBV), and
3.9% hepatitis C (HCV, from 1998, N=1,083). In multivariable analyses, HIV
increased in 2004-09 (adjusted Odds Ratio (AOR)=10 [95%CI 0.94-106] vs.
1992-2003), and remained elevated (AOR=4.12, 95%CI 0.31-54, 2012-13); HBV
also increased in 2004-09 (AOR=3.98, 95%CI 1.59-9.97). HCV prevalence
increase was only borderline significant (AOR=2.47, 95%CI 0.90-6.77,
2010-11). HIV and HBV were associated with MSM, and HCV with sharing
needles/syringes. Uptake of diagnostic testing for HIV and HCV, and HBV
vaccination increased (to 43%, 32% and 44% respectively). Condom use was
consistently poor; needle/syringe sharing occurred.

CONCLUSION: BBV prevalences among IPEDs injectors have increased, and for
HIV is now similar to that among psychoactive drug injectors. Targeted
interventions to reduce risks are indicated.
__________________________________________________________________
________________________________*_________________________________

11. Abstract: The Global Fund to Fight AIDS, Tuberculosis and Malaria’s
investments in harm reduction through the rounds-based funding model
(2002-2014)
__________________________________________________________________
Open Access http://www.ijdp.org/article/S0955-3959(15)00236-4/abstract

Int J Drug Policy. 2015 Aug 13. pii: S0955-3959(15)00236-4.

The Global Fund to Fight AIDS, Tuberculosis and Malaria’s investments in
harm reduction through the rounds-based funding model (2002-2014).

Bridge J1, Hunter BM2, Albers E3, Cook C4, Guarinieri M5, Lazarus JV6,
MacAllister J7, McLean S8, Wolfe D9.

1International Drug Policy Consortium, United Kingdom. Electronic address:
jbridge@idpc.net.
2King’s College London, United Kingdom.
3International Network of People Who Use Drugs, United Kingdom.
4Harm Reduction International, United Kingdom.
5The Global Fund to Fight AIDS, Tuberculosis and Malaria, Switzerland.
6CHIP, Rigshospitalet, University of Copenhagen, Denmark.
7amfAR, The Foundation for AIDS Research, United States.
8International HIV/AIDS Alliance, United Kingdom.
9Open Society Foundations, United States.

BACKGROUND: Harm reduction is an evidence-based, effective response to HIV
transmission and other harms faced by people who inject drugs, and is
explicitly supported by the Global Fund to Fight AIDS, Tuberculosis and
Malaria. In spite of this, people who inject drugs continue to have poor
and inequitable access to these services and face widespread stigma and
discrimination. In 2013, the Global Fund launched a new funding model-
signalling the end of the previous rounds-based model that had operated
since its founding in 2002. This study updates previous analyses to assess
Global Fund investments in harm reduction interventions for the duration
of the rounds-based model, from 2002 to 2014.

METHODS: Global Fund HIV and TB/HIV grant documents from 2002 to 2014 were
reviewed to identify grants that contained activities for people who
inject drugs. Data were collected from detailed grant budgets, and
relevant budget lines were recorded and analysed to determine the
resources allocated to different interventions that were specifically
targeted at people who inject drugs.

RESULTS: 151 grants for 58 countries, plus one regional proposal,
contained activities targeting people who inject drugs-for a total
investment of US$ 620million. Two-thirds of this budgeted amount was for
interventions in the “comprehensive package” defined by the United
Nations. 91% of the identified amount was for Eastern Europe and Asia.

CONCLUSION: This study represents an updated, comprehensive assessment of
Global Fund investments in harm reduction from its founding (2002) until
the start of the new funding model (2014). It also highlights the overall
shortfall of harm reduction funding, with the estimated global need being
US$ 2.3billion for harm reduction in 2015 alone. Using this baseline, the
Global Fund must carefully monitor its new funding model and ensure that
investments in harm reduction are maintained or scaled-up. There are
widespread concerns regarding the withdrawal from middle-income countries
where harm reduction remains essential and unfunded through other sources:
for example, 15% of the identified investments were for countries which
are now ineligible for Global Fund support.

Copyright © 2015 The Authors. Published by Elsevier B.V. All rights
reserved.

KEYWORDS: HIV; Harm reduction; Investment tracking; People who inject
drugs; The Global Fund

Free full text http://dx.doi.org/10.1016/j.drugpo.2015.08.001
__________________________________________________________________
________________________________*_________________________________

12. Abstract: Far From “Just a Poke”: Common Painful Needle Procedures and
the Development of Needle Fear
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26352920

Clin J Pain. 2015 Oct;31(10 Suppl):S3-S11.

Far From “Just a Poke”: Common Painful Needle Procedures and the
Development of Needle Fear.

McMurtry CM1, Pillai Riddell R, Taddio A, Racine N, Asmundson GJ, Noel M,
Chambers CT, Shah V; HELPinKids&Adults Team.

1*Department of Psychology, University of Guelph, Guelph †Children’s
Health Research Institute ‡Department of Paediatrics, Western University,
London §Department of Psychology, York University ?The Hospital for Sick
Children ¶Department of Psychiatry #Leslie Dan Faculty of Pharmacy
¶¶Health Policy Management and Evaluation, Faculty of Medicine, University
of Toronto ??Mount Sinai Hospital, Toronto, ON **Department of Psychology,
University of Regina, Regina, SK ‡‡Departments of Pediatrics, Psychology
and Neuroscience, Dalhousie University §§Centre for Pediatric Pain
Research, IWK Health Centre, Halifax, NS, Canada ††Department of
Psychology, University of Calgary, AB, Canada.

BACKGROUND: Vaccine injections are the most common painful needle
procedure experienced throughout the lifespan. Many strategies are
available to mitigate this pain; however, they are uncommonly utilized,
leading to unnecessary pain and suffering. Some individuals develop a high
level of fear and subsequent needle procedures are associated with
significant distress.

OBJECTIVE: The present work is part of an update and expansion of a 2009
knowledge synthesis to include the management of vaccine-related pain
across the lifespan and the treatment of individuals with high levels of
needle fear. This article will provide a conceptual foundation for
understanding: (a) painful procedures and their role in the development
and maintenance of high levels of fear; (b) treatment strategies for
preventing or reducing the experience of pain and the development of fear;
and (c) interventions for mitigating high levels of fear once they are
established.

RESULTS: First, the general definitions, lifespan development and
functionality, needle procedure-related considerations, and assessment of
the following constructs are provided: pain, fear, anxiety, phobia,
distress, and vasovagal syncope. Second, the importance of unmitigated
pain from needle procedures is highlighted from a developmental
perspective. Third, the prevalence, course, etiology, and consequences of
high levels of needle fear are described. Finally, the management of
needle-related pain and fear are outlined to provide an introduction to
the series of systematic reviews in this issue.

DISCUSSION: Through the body of work in this supplement, the authors aim
to provide guidance in how to treat vaccination-related pain and its
sequelae, including high levels of needle fear.
__________________________________________________________________
________________________________*_________________________________

13. Abstract: Procedural and Physical Interventions for Vaccine
Injections: Systematic Review of Randomized Controlled Trials and
Quasi-Randomized Controlled Trials
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26352919

Clin J Pain. 2015 Oct;31(10 Suppl):S20-37.

Procedural and Physical Interventions for Vaccine Injections: Systematic
Review of Randomized Controlled Trials and Quasi-Randomized Controlled
Trials.

Taddio A1, Shah V, McMurtry CM, MacDonald NE, Ipp M, Riddell RP, Noel M,
Chambers CT; HELPinKids&Adults Team.

1*Clinical Social and Administrative Pharmacy, Leslie Dan Faculty of
Pharmacy §Faculty of Medicine, University of Toronto †Child Health
Evaluative Sciences, Research Institute, The Hospital for Sick Children,
Toronto, Ontario ††Department of Paediatrics, The Hospital for Sick
Children ‡Department of Pediatrics, Mount Sinai Hospital ‡‡Department of
Psychology, York University, Toronto ?Department of Psychology, University
of Guelph, Guelph, Ontario ¶Children’s Health Research Institute
#Department of Paediatrics, Western University, London, ON **Department of
Paediatrics, IWK Health Centre, Dalhousie University and Canadian Center
for Vaccinology ??Department of Pediatrics and Psychology, Faculty of
Science, Dalhousie University, IWK Health Centre, Halifax, NS, Canada
§§Department of Psychology, University of Calgary, AB, Canada.

BACKGROUND: This systematic review evaluated the effectiveness of physical
and procedural interventions for reducing pain and related outcomes during
vaccination.

DESIGN/METHODS: Databases were searched using a broad search strategy to
identify relevant randomized and quasi-randomized controlled trials. Data
were extracted according to procedure phase (preprocedure, acute,
recovery, and combinations of these) and pooled using established methods.

RESULTS: A total of 31 studies were included. Acute infant distress was
diminished during intramuscular injection without aspiration (n=313):
standardized mean difference (SMD) -0.82 (95% confidence interval [CI]:
-1.18, -0.46). Injecting the most painful vaccine last during vaccinations
reduced acute infant distress (n=196): SMD -0.69 (95% CI: -0.98, -0.4).
Simultaneous injections reduced acute infant distress compared with
sequential injections (n=172): SMD -0.56 (95% CI: -0.87, -0.25). There was
no benefit of simultaneous injections in children. Less infant distress
during the acute and recovery phases combined occurred with vastus
lateralis (vs. deltoid) injections (n=185): SMD -0.70 (95% CI: -1.00,
-0.41). Skin-to- skin contact in neonates (n=736) reduced acute distress:
SMD -0.65 (95% CI: -1.05, -0.25). Holding infants reduced acute distress
after removal of the data from 1 methodologically diverse study (n=107):
SMD -1.25 (95% CI: -2.05, -0.46). Holding after vaccination (n=417)
reduced infant distress during the acute and recovery phases combined: SMD
-0.65 (95% CI: -1.08, -0.22). Self-reported fear was reduced for children
positioned upright (n= 107): SMD -0.39 (95% CI: -0.77, -0.01). Non-
nutritive sucking (n=186) reduced acute distress in infants: SMD -1.88
(95% CI: -2.57, -1.18). Manual tactile stimulation did not reduce pain
across the lifespan. An external vibrating device and cold reduced pain in
children (n=145): SMD -1.23 (95% CI: -1.58, -0.87). There was no benefit
of warming the vaccine in adults. Muscle tension was beneficial in
selected indices of fainting in adolescents and adults.

CONCLUSIONS: Interventions with evidence of benefit in select populations
include: no aspiration, injecting most painful vaccine last, simultaneous
injections, vastus lateralis injection, positioning interventions, non-
nutritive sucking, external vibrating device with cold, and muscle
tension.
__________________________________________________________________
________________________________*_________________________________

14. Abstract: Psychological Interventions for Vaccine Injections in
Children and Adolescents: Systematic Review of Randomized and Quasi-
Randomized Controlled Trials
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26348163

Clin J Pain. 2015 Oct;31(10 Suppl):S72-89.

Psychological Interventions for Vaccine Injections in Children and
Adolescents: Systematic Review of Randomized and Quasi-Randomized
Controlled Trials.

Birnie KA1, Chambers CT, Taddio A, McMurtry CM, Noel M, Pillai Riddell R,
Shah V; HELPinKids&Adults Team.

1Departments of *Psychology and Neuroscience ‡Pediatrics, Dalhousie
University †Centre for Pediatric Pain Research, IWK Health Centre,
Halifax, NS §Leslie Dan Faculty of Pharmacy, University of Toronto ?The
Hospital for Sick Children ‡‡York University §§Mount Sinai Hospital
??Faculty of Medicine, University of Toronto, Toronto ¶Department of
Psychology, University of Guelph, Guelph #Children’s Health Research
Institute **Department of Paediatrics, Western University, London, ON
††Department of Psychology, University of Calgary, AB, Canada.

BACKGROUND: This systematic review evaluated the effectiveness of
psychological interventions for reducing vaccination pain and related
outcomes in children and adolescents.

DESIGN/METHODS: Database searches identified relevant randomized and
quasi-randomized controlled trials. Data were extracted and pooled using
established methods. Pain, fear, and distress were considered critically
important outcomes.

RESULTS: Twenty-two studies were included; 2 included adolescents.
Findings showed no benefit of false suggestion (n=240) for pain
(standardized mean difference [SMD] -0.21 [-0.47, 0.05]) or distress (SMD
-0.28 [-0.59, 0.11]), or for use of repeated reassurance (n=82) for pain
(SMD -0.18 [-0.92, 0.56]), fear (SMD -0.18 [-0.71, 0.36]), or distress
(SMD 0.10 [-0.33, 0.54]). Verbal distraction (n=46) showed reduced
distress (SMD -1.22 [-1.87, -0.58]), but not reduced pain (SMD -0.27
[-1.02, 0.47]). Similarly, video distraction (n=328) showed reduced
distress (SMD -0.58 [-0.82, -0.34]), but not reduced pain (SMD -0.88
[-1.78, 0.02]) or fear (SMD 0.08 [-0.25, 0.41]). Music distraction
demonstrated reduced pain when used with children (n=417) (SMD -0.45
[-0.71, -0.18]), but not with adolescents (n=118) (SMD -0.04 [-0.42,
0.34]). Breathing with a toy (n= 368) showed benefit for pain (SMD -0.49
[-0.85, -0.13]), but not fear (SMD -0.60 [-1.22, 0.02]); whereas breathing
without a toy (n=136) showed no benefit for pain (SMD -0.27 [-0.61, 0.07])
or fear (SMD -0.36 [-0.86, 0.15]). There was no benefit for a breathing
intervention (cough) in children and adolescents (n=136) for pain (SMD
-0.17 [-0.41, 0.07]).

CONCLUSIONS: Psychological interventions with some evidence of benefit in
children include: verbal distraction, video distraction, music
distraction, and breathing with a toy.
__________________________________________________________________
________________________________*_________________________________

15. Abstract: Disinfection with sodium hypochlorite in hospital
environmental surfaces in the reduction of contamination and infection
prevention: a systematic review
__________________________________________________________________
Free Full Text http://dx.doi.org/10.1590/S0080-623420150000400020

Rev Esc Enferm USP. 2015 Aug;49(4):681-8.

Disinfection with sodium hypochlorite in hospital environmental surfaces
in the reduction of contamination and infection prevention: a systematic
review.

[Article in English, Portuguese]

Pereira SS1, Oliveira HM2, Turrini RN1, Lacerda RA1.

1Departamento de Enfermagem Médico-Cirúrgica, Escola de Enfermagem,
Universidade de São Paulo, São Paulo, SP, BR.
2Programa de Pós-Graduação em Enfermagem na Saúde do Adulto, Escola de
Enfermagem, Universidade de São Paulo, São Paulo, SP, BR.

OBJECTIVE: To search for evidence of the efficiency of sodium hypochlorite
on environmental surfaces in reducing contamination and prevention of
healthcare-associated infection HAIs.

METHODS: systematic review in accordance with the Cochrane Collaboration.

RESULTS: We analyzed 14 studies, all controlled trials, published between
1989-2013. Most studies resulted in inhibition of microorganism growth.
Some decreased infection, microorganism resistance and colonization, loss
of efficiency in the presence of dirty and surface-dried viruses.

CONCLUSION: The hypochlorite is an effective disinfectant, however, the
issue of the direct relation with the reduction of HAIs remains. The
absence of control for confounding variables in the analyzed studies made
the meta-analysis performance inadequate.

The evaluation of internal validity using CONSORT and TREND was not
possible because its contents were not appropriate to laboratory and
microbiological studies.

As a result, there is an urgent need for developing specific protocol for
evaluating such studies.

Free full text http://dx.doi.org/10.1590/S0080-623420150000400020
__________________________________________________________________
________________________________*_________________________________

16. No Abstract: The inaugural Healthcare Infection Society Middle East
Summit: ‘No action today. No cure tomorrow.’
__________________________________________________________________
J Hosp Infect. 2015 Aug 22. pii: S0195-6701(15)00305-9.

The inaugural Healthcare Infection Society Middle East Summit: ‘No action
today. No cure tomorrow.’

Otter JA1.

1Infection Prevention and Control, Imperial College Healthcare NHS Trust,
London, UK. Electronic address: jonathan.otter@kcl.ac.uk.

The Healthcare Infection Society (HIS) decided to run its Spring Meeting
in Dubai this year as the inaugural HIS Middle East Summit. The conference
was well attended, with delegates from all over the world. Most of the
presentations can be viewed on the HIS website.

HIS Middle East Infection Prevention Summit.

Available at: http://www.his.org.uk/events/his-mid/#.VYq-KxtVhBc
__________________________________________________________________
________________________________*_________________________________

17. World Hepatitis Summit harnesses global momentum to eliminate viral
hepatitis
__________________________________________________________________
www.who.int/mediacentre/news/releases/2015/eliminate-viral-hepatitis/en/

World Hepatitis Summit harnesses global momentum to eliminate viral
hepatitis

WHO News release

2 SEPTEMBER 2015 ¦ GLASGOW – Participants at the first-ever World
Hepatitis Summit will urge countries to develop national programmes that
can ultimately eliminate viral hepatitis as a problem of public health
concern.

“We know how to prevent viral hepatitis, we have a safe and effective
vaccine for hepatitis B, and we now have medicines that can cure people
with hepatitis C and control hepatitis B infection,” said Dr Gottfried
Hirnschall, Director of the WHO’s Global Hepatitis Programme. “Yet access
to diagnosis and treatment is still lacking or inaccessible in many parts
of the world. This summit is a wake-up call to build momentum to prevent,
diagnose, treat – and eventually eliminate viral hepatitis as a public
health problem.”

Around 400 million people are currently living with viral hepatitis, and
the disease claims an estimated 1.45 million lives each year, making it
one of the world’s leading causes of death. Hepatitis B and C together
cause approximately 80% of all liver cancer deaths, yet most people living
with chronic viral hepatitis are unaware of their infection.

The summit, co-sponsored by WHO and the World Hepatitis Alliance, and
hosted in Glasgow by the Scottish Government this week, is the first high-
level global meeting to focus specifically on hepatitis, attracting
delegates from more than 60 countries. The aim is to help countries
enhance action to prevent viral hepatitis infection and ensure that people
who are infected are diagnosed and offered treatment.

Policymakers, patient groups, physicians and other key stakeholders
attending the summit aim to issue a declaration underlining their belief
that the elimination of viral hepatitis is possible and urging governments
to work with WHO to define and agree on global targets for prevention,
diagnosis and treatment.

WHO is launching a new manual for the development and assessment of
national viral hepatitis plans at the summit. Policymakers and other key
stakeholders at the 3-day meeting (2-4 September) are also discussing the
draft WHO Global Health Sector Strategy on Viral Hepatitis, which sets
targets for 2030. The targets include a 90% reduction in new cases of
chronic hepatitis B and C, a 65% reduction in hepatitis B and C deaths,
and treatment of 80% of eligible people with chronic hepatitis B and C
infections.

The World Summit, which is intended to become an annual event, aims to
focus attention on a public health approach to viral hepatitis and to be a
central forum for countries to share their experience and best practices
to drive rapid advances in national responses.

“This summit is about empowering countries to take the practical steps
needed at a national level. It has brought here to Scotland patients’
groups and civil society from across the world to support countries in
doing this. We can eliminate viral hepatitis as a major global killer but
we must all work together to make that vision a reality,” said Charles
Gore, President of the World Hepatitis Alliance.

Putting in place a well-funded and comprehensive response is a challenge
for many governments who have a high burden of hepatitis-related diseases.
In sub-Saharan Africa and East Asia between 5-10% of the population is
chronically infected with hepatitis B. High rates of chronic infections
are also found in the Amazon and the southern parts of eastern and central
Europe. Hepatitis C is found worldwide. Infection rates are high in Africa
and Central and East Asia, and approximately two-thirds of people who
inject drugs are infected with hepatitis C.

An increasing number of countries are taking action to address viral
hepatitis. They include Egypt, which has substantially increased the
number of people receiving treatment for hepatitis C in recent years;
Georgia, which has set a goal for the national elimination of hepatitis C;
and Mongolia, which has endorsed a comprehensive strategy for the control
of viral hepatitis.
__________________________________________________________________
________________________________*_________________________________

18. News

– California USA: Santa Barbara Medical Clinic Shut Down for Unsafe
Injection Practices May Reopen
– California USA: SF’s Needle Disposal Program is Effective but Not
Always Welcome
– Kentucky USA: Needle-exchange program quietly protects public health

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/njwucvu

California USA: Santa Barbara Medical Clinic Shut Down for Unsafe
Injection Practices May Reopen

By Lara Cooper, Noozhawk (15.09.15)

A local medical office that was shut down due to unsafe injection
practices may reopen after changes have been made, according to a
statement from the Santa Barbara County Public Health Department.

The office of Dr. Allen Thomashefsky, located at 2320 Bath St., #301 in
Santa Barbara, was shut down by the county on March 19, after the
discovery that a former patient may have acquired Hepatitis C from an
injection received there.

Further investigation found that five patients who visited the office on
the same day contracted new cases of the Hepatitis C. Seven patients were
identified as testing positive for the disease.

County health has been working to reach out to hundreds of former patients
that may have been affected to urge them to be tested for blood-borne
diseases.

On Tuesday, the county said County Health Officer Dr. Charity Dean had
rescinded the order that closed the office, and that the action “follows a
number of measures that have been implemented to assure infection control
practices are maintained at the medical office.”

Since the closure, “a number of key actions have been taken by Dr.
Thomashefsky, including adopting a detailed and extensive Infection
Control Manual, hiring a consultant who will be monitoring infection
control practices on an ongoing basis, and local monitoring by Public
Health officials,” the statement said.

Thomashefsky also has a practice in Ashland, Oregon that has remained open
but has been prohibited since April from ordering or administering any
injections that aren’t immunizations recommended by the CDC and cannot
retrieve or process any blood or tissue samples unless it is sent to a
certified laboratory.

Public Health officials in Oregon are also notifying Thomashefsky’s
patients that they should be tested for blood-borne diseases.
__________________________________________________________________
__________________________________________________________________
https://tinyurl.com/njj74av

California USA: SF’s Needle Disposal Program is Effective but Not Always
Welcome

By Jeremy Lybarger, SFWeekly Sanfrancisco, California USA (09.09.15)

Conspicuously absent from this summer’s tirade against the homeless —
which began with the Chronicle and peaked with Mayor Lee’s vow to bar the
homeless from the city’s Super Bowl festivities — are complaints about
needles on the street.

We’ve read about poop and urine ad nauseam, but kvetching about dirty
needles, once de rigeur for declamations about the sorry state of our
streets, has been absent from the public shame crusade.

That’s because despite a supposed spike in people on the street, there are
fewer needles. Over the past six months, 311 has reported a decrease in
needle-related complaints, says Eileen Loughran of the Department of
Public Health. She credits the city’s sharps container program, whereby
intravenous drug users can dispose of needles in locked steel boxes. There
are 10 such boxes in the city, all but four of them in the Tenderloin.

The needle-disposal program, launched in 2009, is a collaboration between
DPH and the San Francisco AIDS Foundation, which is tasked with checking
the boxes twice a week. Each box holds 200 to 300 syringes (the largest,
at GLIDE, holds a thousand). Hollis Cambodia from the San Francisco Drugs
Users Union deems the boxes “100 percent effective,” so much so that
“dozens more” are needed elsewhere in the city.

Despite their effectiveness, sharps containers aren’t always welcome —
even in the Tenderloin. To install a new container, every neighbor and
business within 300 feet must approve. Katie Bouche of the SFAF says some
neighbors fear that installing a box will entice drug users to loiter.

Then there’s the matter of pacing. Jennifer Friedenbach, executive
director of the Coalition on Homelessness, says her organization was
denied a sharps container on its block of Turk Street, despite having “the
enthusiastic blessings” of the neighbors. According to Loughran, the
Coalition’s request was denied because 311 didn’t support that stretch of
Turk between Hyde and Larkin being a “hotspot” for discarded needles (the
closest boxes are three blocks away).

“Plus, we can’t have four or five boxes all going up at once,” she adds.

This month, DPH and the Mayor’s Office of Economic and Workforce
Development began tallying used needles in UN Plaza in Civic Center. There
are no sharps containers there, but as a locus of opiate overdoses (driven
by a surge of fentanyl in the city’s heroin market), UN Plaza could be the
11th location in the city’s sharps container program.

“A box won’t necessarily solve all issues, it’s just one mechanism among
multiple approaches,” Loughran says.

Needle-exchange programs are another mechanism, but after business hours,
options for disposal are scant. And outside of the Tenderloin, they’re
almost nonexistent.

“Most people want boxes in the TL,” Bouche says, “but would there be a
different response in other neighborhoods? We just don’t know.”
__________________________________________________________________
__________________________________________________________________
https://tinyurl.com/nozo34h

Kentucky USA: Needle-exchange program quietly protects public health

Over 100 Clean Needles Distributed In Needle-Exchange Program

Lexington Herald Leader, WTVQ Lexington, Kentucky, USA (09.09.15)

LEXINGTON, Ky. (WTVQ) – This is the second week for a needle-exchange
program for heroin users in Lexington.

According to the Lexington-Fayette Co. Health Department, nine people
participated in the program last Friday. Workers say they received 259
used needles and gave out 170 clean needles on the first day of their
needle-exchange program.

The free program is available every Friday from 1:30 p.m. to 4:00 p.m. at
650 Newtown Pike. Participants can remain anonymous. The only
requirement is to bring in dirty needles to be exchanged for clean ones.
__________________________________________________________________
________________________________*_________________________________

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
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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
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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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