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

SIGNpost 00837

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST

Post00837 Abstracts + Abstracts Catch Up Part 2 27 January 2016

CONTENTS
0. Moderators Note
1. Abstract: The exposure rate to hepatitis B and C viruses among medical
waste handlers in three government hospitals, Southern Ethiopia
2. Abstract: Public Health Risks from Mismanagement of Healthcare Wastes
in Shinyanga Municipality Health Facilities, Tanzania
3. Abstract: Knowledge and Practice on Injection Safety among Primary
Health Care Workers in Kaski District, Western Nepal
4. Abstract: Sharps injuries among emergency department nurses in one
tertiary care hospital in Ghana
5. Abstract: Epidemic history and iatrogenic transmission of blood-borne
viruses in mid-20th century Kinshasa
6. Abstract: Systematic Reviews: Epidemiology of hepatitis C virus
exposure in Egypt: Opportunities for prevention and evaluation
7. Abstract: Using medical student observers of infection prevention, hand
hygiene, and injection safety in outpatient settings: A cross-sectional
survey
8. Abstract: Immunization practices of pediatricians for children younger
than five years in coastal South India
9. Abstract: Culture of safety: A foundation for patient care
10. Abstract: Social marketing of low dead space syringes in Vietnam:
findings from a 1-year pilot program in Hanoi, Thai Nguyen, and Ho Chi
Minh City
11. Abstract: Women’s injection drug practices in their own words: a
qualitative study
13. Abstract: Syringe Service Programs for Persons Who Inject Drugs in
Urban, Suburban, and Rural Areas – United States, 2013
14. Abstract: Considerations in the sterile manufacture of polymeric
microneedle arrays
15. Abstract: Intra-articular injections
16. Abstract: Unknown Safety and Efficacy of Smartphone Bolus Calculator
Apps Puts Patients at Risk for Severe Adverse Outcomes
17. Abstract: An outbreak of Mycobacterium tuberculosis infection
associated with acupuncture in a private clinic of Zhejiang Province,
China, 2012
18. Abstract: Atlanto-axial infection after acupuncture
19. Abstract: Immune responses after fractional doses of inactivated
poliovirus vaccine using newly developed intradermal jet injectors: a
randomized controlled trial in Cuba
20. Abstract: Does chondrolysis occur after corticosteroid-analgesic
injections? An analysis of patients treated for adhesive capsulitis of
the shoulder
21. Abstract: Impact of universal gowning and gloving on health care
worker clothing contamination
22. Abstract: Ebola virus disease: The use of fluorescents as markers of
contamination for personal protective equipment

The web edition of SIGNpost is online at:

SIGNpost 00837

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!
__________________________________________________________________
________________________________*_________________________________

0. Moderators Note
__________________________________________________________________

This is part 2 of the annual year end abstract catch up!
Part 3 next week.
__________________________________________________________________
________________________________*_________________________________

1. Abstract: The exposure rate to hepatitis B and C viruses among medical
waste handlers in three government hospitals, Southern Ethiopia
__________________________________________________________________

Full Free Text
http://e-epih.org/journal/view.php?doi=10.4178/epih/e2016001

Epidemiol Health. 2016 Jan 5.
The exposure rate to hepatitis B and C viruses among medical waste
handlers in three government hospitals, Southern Ethiopia.

Amsalu A1, Worku M2, Tadesse E2, Shimelis T2.

1Department of Medical Microbiology, College of Medicine and Health
Sciences, School of Biomedical and Laboratory Sciences, University of
Gondar, Gondar, Ethiopia, Gondar, Ethiopia.
2Department of Medical Laboratory Science, College of Medicine and Health
Sciences, Hawassa University, Hawassa, Ethiopia, Hawassa, Ethiopia.

OBJECTIVES: The aim of this study was to assess the exposure rate to HBV
and HCV infections and potential risk factors among medical waste
handlers.

METHODS: A cross-sectional study was conducted from December, 2014 to
January, 2015. A total of 152 medical waste handlers (MWHs) and 82 non-
medical waste handlers’ (NMWHs) were studied. Serum samples were collected
from the study participants and screened for HBsAg, anti-HBc and anti-HCV
markers using rapid immunochromatography assay. While, MWHs were also
screened for anti-HBs marker.

RESULTS: The respective prevalence of HBsAg, anti-HBc and anti-HCV were
1.3%, 39.4% and 0.7% in MWHs compared to a respective rate 2.4%, 17.1%,
and 1.2% in NMWHs. Of all MWHs, 58.6% were still susceptible to HBV
infection. There was significant difference in rate of lifetime exposure
to HBV infection in MWHs compared with NMWHs [OR =3.168; 95%CI =
1.636-6.134]. However, no significant rate difference was observed with
respect to current HBV infection [OR = 0.533; 95%CI = 0.074-3.858] or
anti-HCV status [OR = 0.536; 95%CI = 0.033-8.689]. Age older than 40 years
and MWHs working in a hospital laundry were independent predictors of
lifetime exposure to HBV infection. Eleven (7.2%) respondents were
vaccinated against HBV.

CONCLUSIONS: Lifetime exposure to HBV infection was significantly higher
in MWHs as compared to NMWHs. As most of the MWHs were not vaccinated
against HBV infection they are still susceptible and at higher risk of
contracting the infection. Screening upon hire followed by vaccination of
MWHs is recommended to reduce the transmission of HBV.

KEYWORDS: Medical waste handlers; Vaccination; hepatitis C virus;
Hepatitis B virus

Free full text
http://e-epih.org/journal/view.php?doi=10.4178/epih/e2016001
__________________________________________________________________
________________________________*_________________________________

2. Abstract: Public Health Risks from Mismanagement of Healthcare Wastes
in Shinyanga Municipality Health Facilities, Tanzania
__________________________________________________________________

http://www.hindawi.com/journals/tswj/2015/981756/ Free Full Text

ScientificWorldJournal. 2015;2015:981756.
Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga
Municipality Health Facilities, Tanzania.

Kuchibanda K1, Mayo AW1.

1Department of Water Resources Engineering, University of Dar es Salaam,
P.O. Box 35136, Dar es Salaam, Tanzania.

The increase of healthcare facilities in Shinyanga municipality has
resulted in an increase of healthcare wastes, which poses serious threats
to the environment, health workers, and the general public.

This research was conducted to investigate management practices of
healthcare wastes in Shinyanga municipality with a view of assessing
health risks to health workers and the general public.

The study, which was carried out in three hospitals, involved the use of
questionnaires, in-depth interview, and observation checklist. The results
revealed that healthcare wastes are not quantified or segregated in all
the three hospitals.

Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed
of by on-site incineration and burning and some wastes are disposed off-
site.

At Kolandoto DDH only on-site burning and land disposal are practiced,
while at Kambarage UHC healthcare solid wastes are incinerated, disposed
of on land disposal, and burned.

Waste management workers do not have formal training in waste management
techniques and the hospital administrations pay very little attention to
appropriate management of healthcare wastes.

In light of this, it is evident that management of healthcare solid wastes
is not practiced in accordance with the national and WHO’s recommended
standards.

Free Full Article http://www.hindawi.com/journals/tswj/2015/981756/
__________________________________________________________________
________________________________*_________________________________

3. Abstract: Knowledge and Practice on Injection Safety among Primary
Health Care Workers in Kaski District, Western Nepal
__________________________________________________________________

https://tinyurl.com/zja2f3z Free Full Text

Malays J Med Sci. Jan-Feb 2016; 23(1): 44-55
Knowledge and Practice on Injection Safety among Primary Health Care
Workers in Kaski District, Western Nepal

Sudesh Gyawali1, Devendra Singh Rathore2, P Ravi Shankar3, Vikash Kumar
Kc4, Nisha Jha5, Damodar Sharma1

1 Department of Pharmacology, Manipal College of Medical Sciences,
Pokhara,
Kaski, Pin code: 33700, Nepal
2 NIMS Institute of Pharmacy, NIMS University, Shobha Nagar, Jaipur-Delhi
Highway, Jaipur, Pin code: 303121, India
3 Department of Pharmacology, Xavier University School of Medicine,
Oranjestad, Aruba, Kingdom of the Netherlands
4 Department of Statistics, Prithvi Narayan Multiple Campus, Pokhara,
Kaski,
Pin code 33700, Nepal
5 Department of Clinical Pharmacology and Therapeutics, KIST Medical
College, Imadol, Lalitpur, Pin code: 44705, Nepal

Background: Unsafe injection practice can transmit various blood borne
infections. The aim of this study was to assess the knowledge and practice
of injection safety among injection providers, to obtain information about
disposal of injectable devices, and to compare the knowledge and practices
of urban and rural injection providers.

Methods: The study was conducted with injection providers working at
primary health care facilities within Kaski district, Nepal. Ninety-six
health care workers from 69 primary health care facilities were studied
and 132 injection events observed. A semi-structured checklist was used
for observing injection practice and a questionnaire for the survey.
Respondents were interviewed to complete the questionnaire and obtain
possible explanations for certain observed behaviors.

Results: All injection providers knew of at least one pathogen transmitted
through use/ re-use of unsterile syringes. Proportion of injection
providers naming hepatitis/jaundice as one of the diseases transmitted by
unsafe injection practice was significantly higher in urban (75.6%) than
in rural (39.2%) area. However, compared to urban respondents (13.3%), a
significantly higher proportion of rural respondents (37.3%) named
Hepatitis B specifically as one of the diseases transmitted. Median
(inter-quartile range) number of therapeutic injection and injectable
vaccine administered per day by the injection providers were 2 (1) and 1
(1), respectively. Two handed recapping by injection providers was
significantly higher in urban area (33.3%) than in rural areas (21.6%).
Most providers were not aware of the post exposure prophylaxis guideline.

Conclusion: The knowledge of the injection providers about safe injection
practice was acceptable. The use of safe injection practice by providers
in urban and rural health care facilities was almost similar. The
deficiencies noted in the practice must be addressed. Keywords: health
personnel, injection, injection safety, needle stick injury, Nepal

http://journal.usm.my/journal/7OA5mjms231.pdf
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Sharps injuries among emergency department nurses in one
tertiary care hospital in Ghana
__________________________________________________________________
https://www.ncbi.nlm.nih.gov/pubmed/26796286

Int Emerg Nurs. 2016 Jan 12. pii: S1755-599X(15)00132-9.
Sharps injuries among emergency department nurses in one tertiary care
hospital in Ghana.

Lori JR1, McCullagh MC2, Krueger A2, Oteng R3.

1University of Michigan School of Nursing, Ann Arbor, MI, USA. Electronic
address: jrlori@umich.edu.
2University of Michigan School of Nursing, Ann Arbor, MI, USA.
3University of Michigan Hurley Medical Center, Flint, MI, USA.

Exposure to bloodborne pathogens is the most serious occupational health
risk encountered within the healthcare profession worldwide. The World
Health Organization estimates that 3 million healthcare workers experience
percutaneous injuries each year.

The objectives of this study were to: (1) examine the frequency of sharps
injuries, and (2) assess the adequacy, understanding, and use of post-
exposure protocols within a sample of the nursing staff at a busy tertiary
care emergency department in the Ashanti Region of Ghana.

A mixed-methods descriptive study design was used including key informant
interviews to develop the survey, a structured survey of emergency
department nursing staff, and document review.

Overall, the emergency department staff was well informed regarding the
risks of sharps injury and the immediate steps to take in the event of a
sharps injury.

However, few staff could list essential post-exposure follow-up steps.
Over one-quarter (28.9%) of emergency nurses reported a sharps injury
during a one-year period according to hospital records.

The high incidence of sharps injuries indicates an urgent and pressing
need for policy and educational interventions to address the infectious
disease risk to this group of emergency department staff.

Copyright © 2015 Elsevier Ltd. All rights reserved.

KEYWORDS: Bloodborne pathogen transmission; Ghanaian healthcare workers;
Healthcare worker safety; Infectious diseases; Sharps injury prevention
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Epidemic history and iatrogenic transmission of blood-borne
viruses in mid-20th century Kinshasa
__________________________________________________________________

Free Full Article
http://jid.oxfordjournals.org/content/early/2016/01/13/infdis.jiw009.long

J Infect Dis. 2016 Jan 14. pii: jiw009.
Epidemic history and iatrogenic transmission of blood-borne viruses in
mid-20th century Kinshasa.

Hogan C1, Iles J2, Frost EH1, Giroux G1, Cassar O3, Gessain A3, Dion MJ1,
Ilunga V4, Rambaut A5, Yengo-Ki-Ngimbi AÉ6, Behets F7, Pybus OG2, Pépin
J1.

1Université de Sherbrooke, Sherbrooke, Canada.
2University of Oxford, Oxford, United Kingdom.
3Institut Pasteur, Paris, France Centre National de la Recherche
Scientifique, UMR 3569, Paris, France.
4Programme ESP/UNC-DRC, Kinshasa, Democratic Republic of Congo.
5University of Edinburgh, Edinburgh, United Kingdom.
6Université de Kinshasa, Kinshasa, Democratic Republic of Congo.
7Programme ESP/UNC-DRC, Kinshasa, Democratic Republic of Congo University
of North Carolina, Chapel Hill, USA.

BACKGROUND: The HIV-1 pandemic was ignited in Léopoldville (Kinshasa),
Belgian Congo. Factors that jumpstarted its early expansion remain
unclear. Non-lethal Hepatitis C and human T-cell lymphotropic viruses can
be used to investigate past iatrogenic transmission.

METHODS: We undertook a cross-sectional study of elderly inhabitants of
Kinshasa, with serological assays, amplification and sequencing. Risk
factors were assessed through logistic regression. Phylogenetic methods
reconstructed the genetic history of HCV.

RESULTS: 217/839 (25.9%) participants were HCV-seropositive; 26 (3.1%)
were HTLV-1-seropositive. Amplification products were obtained from 118
HCV-seropositives; subtypes 4k (n=47) and 4r (n=38) were most common.
Independent risk factors for HCV subtype 4r were intramuscular
tuberculosis therapy, intravenous injections at Hospital A, intravenous
injections before 1960 and injections at a colonial-era venereology
clinic. Intravenous injections at Hospital B and antimalarials were
associated with HCV subtype 4k. Risk factors for HTLV-1 included
intravenous injections at Hospitals C or D, and transfusions. Evolutionary
analysis of viral sequences revealed independent exponential amplification
of HCV subtypes 4r and 4k from the 1950s onwards.

CONCLUSIONS: Iatrogenic transmission of HCV and HTLV-1 occurred in
mid-20th century Kinshasa, at the same time and place HIV-1 emerged.
Iatrogenic routes may have contributed to the early establishment of the
pandemic.

© The Author 2016. Published by Oxford University Press for the Infectious
Diseases Society of America. All rights reserved. For permissions, e-mail
journals.permissions@oup.com.
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Systematic Reviews: Epidemiology of hepatitis C virus
exposure in Egypt: Opportunities for prevention and evaluation
__________________________________________________________________

http://www.wjgnet.com/1948-5182/full/v7/i28/2849.htm Free Full Text

World J Hepatol. 2015 Dec 8;7(28):2849-58.
Epidemiology of hepatitis C virus exposure in Egypt: Opportunities for
prevention and evaluation.

Miller FD1, Elzalabany MS1, Hassani S1, Cuadros DF1.

1F DeWolfe Miller, Department of Tropical Medicine, Medical Microbiology
and Pharmacology, John A. Burns School of Medicine, University of Hawaii,
Honolulu, HI 96813, United States.

AIM: To critically evaluate the current epidemiology data on exposures,
rather than infection, to hepatitis C virus (HCV) transmission and
recommend epidemiologic strategies to fill gaps.

METHODS: Standard methods for identifying and evaluating relevant
epidemiologic literature and available data were used.

RESULTS: There is a large body of literature on the epidemiology of HCV
transmission in Egypt that collectively identifies ongoing iatrogenic
exposures as the major driver for HCV transmission due to short comings in
infection control and standard procedures. Additional epidemiologic
studies on HCV transmission that requires the participation of human
subject is unwarranted. Alternatively, very little literature was found on
the epidemiology of exposure to HCV, infection control, and safe injection
practices.

The information that is available on patterns of HCV exposure shows high
frequencies of inadequate infection control, problems in sterilization in
health care facilities, low rates of hand washing, untrained personnel,
lack of stated policies in facilities, HCV contamination of instruments
and very large injection frequencies with low but very significant syringe
and needle reuse.

There is an important need to increase the number, size, and diversity of
epidemiologic studies on HCV exposures, patterns of risk factors for
infection, infection control, and safe injection practices.

In addition to health care facilities evaluation, relevant knowledge
attitude and practice studies are recommended.

CONCLUSION: Epidemiologic methods on HCV exposure can be used to
characterize the magnitude of exposures to HCV infection, target
interventions to reduce exposures, and provide the best method for
evaluating interventions by demonstrating the reduction of exposure to HCV
infection.

KEYWORDS: Egypt; Epidemic; Epidemiology; Exposure; Hepatitis C virus;
Prevention

Free Article http://www.wjgnet.com/1948-5182/full/v7/i28/2849.htm
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Using medical student observers of infection prevention, hand
hygiene, and injection safety in outpatient settings: A cross-sectional
survey
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26804308

Am J Infect Control. 2016 Jan 21. pii: S0196-6553(15)01222-5.
Using medical student observers of infection prevention, hand hygiene, and
injection safety in outpatient settings: A cross-sectional survey.

Thompson D1, Bowdey L2, Brett M3, Cheek J4.

1New Mexico Department of Health, Santa Fe, NM. Electronic address:
dlt3@cornell.edu.
2New Mexico Department of Health, Santa Fe, NM.
3University of New Mexico Hospital, Albuquerque, NM.
4Family and Community Medicine, University of New Mexico School of
Medicine, Albuquerque, NM.

BACKGROUND: Health care-associated infection outbreaks have occurred in
outpatient settings due to lapses in infection prevention. However, little
is known about the overall infection prevention status in outpatient
environments.

METHODS: A cross-sectional design was employed to assess infection
prevention policies and practices at 15 outpatient sites across New Mexico
in 2014 during a medical student outpatient rotation. A standardized
infection prevention checklist was completed via staff interview;
observations of injection safety practices and hand hygiene behavior were
conducted. Aggregate data were analyzed using Excel (Microsoft, Redmond,
WA) and Stata (version 12.1, Stata Corp, College Station, TX) statistical
software.

RESULTS: Medical practice staff interviews reported a mean of 92.8%
(median, 96.7%; range, 75.0%-98.9%) presence of recommended policies and
practices. One hundred sixty-three injection safety observations were
performed that revealed medication vial rubber septums were disinfected
with alcohol 78.4% (95% confidence interval [CI], 71.1%-84.7%) of the time
before piercing. Three hundred thirty hand hygiene observations revealed
33.9% (95% CI, 28.8%-39.1%) use of alcohol-based handrub, 29.1% (95% CI,
24.2%-34.0%) use of soap and water, and 37.0% (95% CI, 31.8%-42.4%) use of
no hand hygiene.

DISCUSSION AND CONCLUSION: These findings support the need for ongoing
infection prevention quality improvement initiatives in outpatient
settings and underscore the importance of assessing both self-report and
observed behavior of infection prevention compliance.

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

KEYWORDS: Health care-associated infections; Policies; Practices; Quality
improvement
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Immunization practices of pediatricians for children younger
than five years in coastal South India
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/25318472

J Prim Care Community Health. 2015 Apr;6(2):116-20.
Immunization practices of pediatricians for children younger than five
years in coastal South India.

Mithra P P1, Unnikrishnan B2, T R2, Kumar N2, Chatterjee PK2, Holla R2.

1Kasturba Medical College (Manipal University), Mangalore, India
prasanna.mithra@manipal.edu ppmithra@gmail.com.
2Kasturba Medical College (Manipal University), Mangalore, India.

CONTEXT: Immunization helps in controlling infectious diseases. Child
immunization is an important component of child survival programs in
India, which mainly follows the National Immunization Schedule. Also, many
of the injection practices followed are not safe.

AIMS: To study the practices of pediatricians toward the immunization of
children younger than 5 years and injection-related waste management.

SETTINGS AND DESIGN: Cross-sectional study carried out in the city of
Mangalore, a rapidly developing city in southern India.

METHODS AND MATERIAL: All the practicing pediatricians were included in
the study and an interview was done on prior appointment using pretested
interview schedule in March 2012, after obtaining clearance from the
institutional ethics committee. Data were analyzed using the Statistical
Package for Social Sciences version 11.5.

RESULTS: Among the 54 practicing pediatricians in Mangalore, 42 were
included in this study after exclusion criteria were applied. Among them,
71.4% were following the National Immunization Schedule, 5% did not prefer
to give combination vaccines, 17% reported vaccine failure at least once
in their practice, and 85.7% motivated the parents for future doses.
Distance to the clinic and affordability were the major reasons for loss
of follow-up. Only 38.1% used auto-disabled syringes, 11.9% did not
observe the children following the immunization, and 45.2% did not use
color coding for disposal of injection-related wastes. Mechanical hub
cutters were preferred by 41% of the respondents.

CONCLUSION: The study showed the diversity in immunization practices. The
National Immunization Schedule is the most commonly followed schedule.
However, the safety of the injection practices was limited.

© The Author(s) 2014.

KEYWORDS: children younger than 5 years; immunization; pediatricians;
south India
__________________________________________________________________
________________________________*_________________________________

9. Abstract: Culture of safety: A foundation for patient care
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26653161

Semin Pediatr Surg. 2015 Dec;24(6):283-7.
Culture of safety: A foundation for patient care.

Tsao K1, Browne M2.

1Department of Pediatric Surgery, University of Texas Medical School at
Houston, 6431 Fannin St, Suite 5.256 Houston, TX 77030. Electronic
address: Kuojen.Tsao@uth.tmc.edu.
2Division of Pediatric Surgery and Urology, Children?s Hospital of the
Lehigh Valley Health Network, Allentown, PA.

The 1999 IOM report on patient safety identified the house of medicine as
a culture that tolerated injury at a frightening level.

Identifying other industries that had cultures that would not tolerate
such levels of error has begun to change the culture of healthcare to a
more “high-reliability” culture.

Various organizational and standardized communication tools have been
imported from the military, airline, and energy industries to flatten the
hierarchy and improve the reliability of communication and handoffs in
healthcare.

Reporting structures that focus on the effectiveness of the team and the
system, more than blaming the individual, have demonstrated noticeable
improvements in safety and changed culture.

Further sustained efforts in developing a culture focused on safety as a
priority is needed for sustainable reduction of harm, and improve the
reliability of care.

Copyright © 2015 Elsevier Inc. All rights reserved.

KEYWORDS: Crew resource management; High-reliability organization; Medical
error; Patient safety culture
__________________________________________________________________
________________________________*_________________________________

10. Abstract: Social marketing of low dead space syringes in Vietnam:
findings from a 1-year pilot program in Hanoi, Thai Nguyen, and Ho Chi
Minh City
__________________________________________________________________

https://tinyurl.com/gkw7yub Open Access Full Free Article

Harm Reduct J. 2015 May 30;12:15.
Social marketing of low dead space syringes in Vietnam: findings from a 1-
year pilot program in Hanoi, Thai Nguyen, and Ho Chi Minh City.

Huong NT1, Mundy G2, Neukom J3, Zule W4, Tuan NM5, Tam NM6.
Author information
1Population Services International, Washington, USA. huongngo@psi.org.vn.
2Population Services International, Washington, USA. garyjm67@gmail.com.
3Population Services International, Washington, USA. jneukom@psi.org.vn.
4Research Triangle Institute International, Durham, USA. zule@rti.org.
5Population Services International, Washington, USA.
tuannguyen@psi.org.vn.
6Vietnam Administration for HIV/AIDS Control/Ministry of Health, Hanoi,
Vietnam. minhtam71@yahoo.com.

BACKGROUND: Although a growing body of evidence suggests that low dead
space syringes may reduce the risk of human immunodeficiency virus (HIV)
and Hepatitis C virus infection associated with sharing syringes among
people who inject drugs, there is little evidence of effective approaches
to motivate people who inject drugs (PWID) to shift from high to low dead
space syringes.

METHODS: Using a mix of consumer and trade marketing approaches, informed
by rapid assessments of both the syringe market and PWID preferences,
practices, and behaviors in Hanoi and Ho Chi Minh City, Population
Services International (PSI) Vietnam piloted an intervention to increase
the use of low dead space syringes (LDSS) in the three provinces of Hanoi,
Ho Chi Minh City, and Thai Nguyen, where an estimated 31% of PWID are HIV
positive and 58% are living with hepatitis C virus (HCV).

RESULTS: This paper provides a summary of the social marketing activities
implemented and results achieved by PSI Vietnam during an initial 1-year
pilot period from December 2012 to December 2013 in these three provinces
to explore their effectiveness in motivating PWID to use low dead space
syringes. We found major increases in sales of LDSS accompanied by
increases in reported use and consistent use of LDSS among PWID in the
three provinces included in the pilot program and a positive and
independent association (odds ratio (OR) 21.08; 95% confidence interval
(CI) 10.6-27.3) between LDSS use and exposure to social marketing
activities. We also found that LDSS use had a stronger association with
perceptions of LDSS product quality than with perceptions regarding LDSS
potential to reduce HIV transmission risk and use.

CONCLUSIONS: We conclude that social marketing interventions have an
important role to play in widening access to and the use of LDSS for PWID,
as they address the need for PWID to find LDSS when and where they need
them and also promote the benefits of LDSS use to PWID. High coverage of
these activities among PWID appears to be the key in achieving these
successes.

https://tinyurl.com/gkw7yub Open Access Full Free Article
__________________________________________________________________
________________________________*_________________________________

11. Abstract: Women’s injection drug practices in their own words: a
qualitative study
__________________________________________________________________

https://tinyurl.com/h66xkme Open Access Full Free Article

Harm Reduct J. 2015 Mar 7;12:6.
Women’s injection drug practices in their own words: a qualitative study.

Tuchman E1.

1Silver School of Social Work, New York University, 1 Washington Square
North, Room 402, New York, NY, 1003, USA. ellen.tuchman@nyu.edu.

BACKGROUND: There are significant gender differences in injection drug
practices and relative risks involved for women who inject drug compared
with men. This qualitative study aims to explore the social, contextual,
and behavioral dimensions of injecting practices among women who inject
drugs.

METHODS: Participants were selected by purposive venue-based sampling from
a syringe exchange program in 2012-2013. In-depth interviews were
conducted with 26 women to elicit detailed perspectives regarding
injection drug use practices and women-focused decision-making. All
interviews were transcribed verbatim and analyzed with Atlas.ti.

RESULTS: Participant’s mean age was 43.2 years, 48% Caucasian, 36% African
American, and 16% Latina, poorly educated, mostly single, and heroin self-
injectors. Three themes emerged; a) transitioning from non-injection to
injection drug use; b) patterns and variations of initiation to injecting;
and c) shifting toward autonomy or reliance on others. Women were
predominantly influenced to transition to injection drug use by other
women with their claims that injecting was a way to curtail their daily
drug expenditure. More than half the women received their first injection
from another woman in their social network rather than a male sexual
partner. Self-injecting women exhibited agency around the circumstances of
injection safety and potential risks. Other women revealed that their
inability to inject themselves could and did make them dependent on others
for unsafe injection practices.

CONCLUSIONS: The finding that many women were influenced to transition to
injection drug use and receive the first injection from a woman is
contrary to literature claims that male sexual partners introduce and
initiate women to injection drug use.

Self-injecting women possessed capacity to act in a way that produced the
results they wanted, not sharing prepared drugs or injecting equipment. In
stark contrast, women assisted with injections could and did make them
vulnerable to unsafe injecting.

Findings support early prevention strategies that discourage women’s
transition from non- injection to injection and development of female
peer-driven experiential interventions to dispel myths for non-injection
women and to increase personal capability to self-inject for women who
require assistance with injecting, to reduce injection-related harm.
__________________________________________________________________
________________________________*_________________________________

13. Abstract: Syringe Service Programs for Persons Who Inject Drugs in
Urban, Suburban, and Rural Areas – United States, 2013
__________________________________________________________________

http://dx.doi.org/10.15585/mmwr.mm6448a3

MMWR Morb Mortal Wkly Rep. 2015 Dec 11;64(48):1337-41.
Syringe Service Programs for Persons Who Inject Drugs in Urban, Suburban,
and Rural Areas – United States, 2013.

Des Jarlais DC, Nugent A, Solberg A, Feelemyer J, Mermin J, Holtzman D.

Reducing human immunodeficiency virus (HIV) infection rates in persons who
inject drugs (PWID) has been one of the major successes in HIV prevention
in the United States. Estimated HIV incidence among PWID declined by
approximately 80% during 1990-2006 (1).

More recent data indicate that further reductions in HIV incidence are
occurring in multiple areas (2). Research results for the effectiveness of
risk reduction programs in preventing hepatitis C virus (HCV) infection
among PWID (3) have not been as consistent as they have been for HIV;
however, a marked decline in the incidence of HCV infection occurred
during 1992-2005 in selected U.S. locations when targeted risk reduction
efforts for the prevention of HIV were implemented (4). Because syringe
service programs (SSPs)* have been one effective component of these risk
reduction efforts for PWID (5), and because at least half of PWID are
estimated to live outside major urban areas (6), a study was undertaken to
characterize the current status of SSPs in the United States and determine
whether urban, suburban, and rural SSPs differed.

Data from a recent survey of SSPs(†) were analyzed to describe program
characteristics (e.g., size, clients, and services), which were then
compared by urban, suburban, and rural location. Substantially fewer SSPs
were located in rural and suburban than in urban areas, and harm reduction
services(§) were less available to PWID outside urban settings.

Because increases in substance abuse treatment admissions for drug
injection have been observed concurrently with increases in reported cases
of acute HCV infection in rural and suburban areas (7), state and local
jurisdictions could consider extending effective prevention programs,
including SSPs, to populations of PWID in rural and suburban areas.

Free full text http://dx.doi.org/10.15585/mmwr.mm6448a3
__________________________________________________________________
________________________________*_________________________________

14. Abstract: Considerations in the sterile manufacture of polymeric
microneedle arrays
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/25787335

Drug Deliv Transl Res. 2015 Feb;5(1):3-14.
Considerations in the sterile manufacture of polymeric microneedle arrays.

McCrudden MT1, Alkilani AZ, Courtenay AJ, McCrudden CM, McCloskey B,
Walker C, Alshraiedeh N, Lutton RE, Gilmore BF, Woolfson AD, Donnelly RF.

1Medical Biology Centre, School of Pharmacy, Queen’s University Belfast,
97 Lisburn Road, Belfast, BT9 7BL, UK.

We describe, for the first time, considerations in the sterile manufacture
of polymeric microneedle arrays.

Microneedles (MN) made from dissolving polymeric matrices and loaded with
the model drugs ovalbumin (OVA) and ibuprofen sodium and hydrogel-forming
MN composed of “super-swelling” polymers and their corresponding
lyophilised wafer drug reservoirs loaded with OVA and ibuprofen sodium
were prepared aseptically or sterilised using commonly employed
sterilisation techniques.

Moist and dry heat sterilisation, understandably, damaged all devices,
leaving aseptic production and gamma sterilisation as the only viable
options.

No measureable bioburden was detected in any of the prepared devices, and
endotoxin levels were always below the US Food & Drug Administration
limits (20 endotoxin units/device).

Hydrogel-forming MN were unaffected by gamma irradiation (25 kGy) in terms
of their physical properties or capabilities in delivering OVA and
ibuprofen sodium across excised neonatal porcine skin in vitro. However,
OVA content in dissolving MN (down from approximately 101.1 % recovery to
approximately 58.3 % recovery) and lyophilised wafer-type drug reservoirs
(down from approximately 99.7 % recovery to approximately 60.1 % recovery)
was significantly reduced by gamma irradiation, while the skin permeation
profile of ibuprofen sodium from gamma-irradiated dissolving MN was
markedly different from their non-irradiated counterparts.

It is clear that MN poses a very low risk to human health when used
appropriately, as evidenced here by low endotoxin levels and absence of
microbial contamination. However, if guarantees of absolute sterility of
MN products are ultimately required by regulatory authorities, it will be
necessary to investigate the effect of lower gamma doses on dissolving MN
loaded with active pharmaceutical ingredients and lyophilised wafers
loaded with biomolecules in order to avoid the expense and inconvenience
of aseptic processing.

METHODS: Surveys were performed first during the BUGG intervention study
period (July-September 2012) with universal gowning/gloving and again
after BUGG study conclusion (October-December 2012), with resumption of
usual care. During each phase, HCW clothing was sampled at the beginning
and near the end of each shift. Cultures were performed using broth
enrichment followed by selective media. Acquisition was defined as having
a negative clothing culture for samples taken at the beginning of a shift
and positive clothing culture at for samples taken at the end of the
shift.

RESULTS: A total of 348 HCWs participated (21-92 per site), including 179
(51%) during the universal gowning/gloving phase. Overall, 51 (15%) HCWs
acquired commonly pathogenic bacteria on their clothing: 13 (7.1%) HCWs
acquired bacteria during universal gowning/gloving, and 38 (23%) HCWs
acquired bacteria during usual care (odds ratio [OR], 0.3; 95% confidence
interval [CI], 0.2-0.6). Pathogens identified included S. aureus (25
species, including 7 methicillin-resistant S. aureus [MRSA]), Enterococcus
spp. (25, including 1 vancomycin-resistant Enterococcus [VRE]),
Pseudomonas spp. (4), Acinetobacter spp. (4), and Klebsiella (2).

CONCLUSION: Nearly 25% of HCWs practicing usual care (gowning and gloving
only for patients with known resistant bacteria) contaminate their
clothing during their shift. This contamination was reduced by 70% by
gowning and gloving for all patient interactions.
__________________________________________________________________
________________________________*_________________________________

15. Abstract: Intra-articular injections
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26591314

Rev Med Brux. 2015 Sep;36(4):281-7.
[Intra-articular injections].

[Article in French]

Chapelle Ch.

It is not unusual for a specialist or general practitioner to be presented
with a pathology which necessitates the use of an intra-articular
injection of corticosteroids, hyaluronic acid or a local anaesthetic.

It would seem to be interesting to update and to precise the techniques
and methods of intraarticular injections which have appeared in recent
international publications, when we know that 30 % of the injections given
into the knee and so called “dry” are incorrect and, therefore,
inefficient.

The indication of an articular injection depends, firstly, on the
diagnosis which should be done with great care; after which should be an
objective analysis complete with secondary effects linked to both the
injection and the product used.

The conditions of asepsis, the choice of needles and quantities of the
injection and even the ways of the injections should be reviewed in
detail. The last studies clearly question the secondary effects of the
cartilage degradations of the cortisone given as an intra-articular
injection and shows its efficiency on the pain and inflammatory phenomonen
in osteoarthritis.

Studies on hyaluronic acid are often contradictory going from a modest
result to an important pain relief but it is necessary to be aware that
the objective criteria are difficult to interpret.

The use of local anaesthetics in intra-articular is limited by the few
indications in view of the major risk of aggravating the pre-existing
lesions by the disappearing signs of pain.
__________________________________________________________________
________________________________*_________________________________

16. Abstract: Unknown Safety and Efficacy of Smartphone Bolus Calculator
Apps Puts Patients at Risk for Severe Adverse Outcomes
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26798082

J Diabetes Sci Technol. 2016 Jan 21. pii: 1932296815626457.
Unknown Safety and Efficacy of Smartphone Bolus Calculator Apps Puts
Patients at Risk for Severe Adverse Outcomes.

Hirsch IB1, Parkin CG2.

1School of Medicine, University of Washington, Seattle, WA, USA.
2CGParkin Communications, Boulder City, NV, USA chris@cgparkin.org.

Manual calculation of bolus insulin dosages can be challenging for
individuals treated with multiple daily insulin injections (MDI) therapy.
Automated bolus calculator capability has recently been made available via
enhanced blood glucose meters and smartphone apps.

Use of this technology has been shown to improve glycemic control and
reduce glycemic variability without changing hypoglycemia; however, the
clinical utility of app-based bolus calculators has not been demonstrated.
Moreover, recent evidence challenges the safety and efficacy of these
smartphone apps.

Although the ability to automatically calculate bolus insulin dosages
addresses a critical need of MDI-treated individuals, this technology
raises concerns about efficacy of treatment and the protection of patient
safety. This article discusses key issues and considerations associated
with automated bolus calculator use.

© 2016 Diabetes Technology Society.

KEYWORDS: MDI; bolus advisor; bolus calculator; diabetes; insulin;
multiple daily insulin injections; smartphone
__________________________________________________________________
________________________________*_________________________________

17. Abstract: An outbreak of Mycobacterium tuberculosis infection
associated with acupuncture in a private clinic of Zhejiang Province,
China, 2012
__________________________________________________________________

http://www.ijidonline.com/article/S1201-9712(14)01643-9/fulltext

Int J Infect Dis. 2014 Dec;29:287-91. Open Access
An outbreak of Mycobacterium tuberculosis infection associated with
acupuncture in a private clinic of Zhejiang Province, China, 2012.

He F1, Hu D2, Yu X3, Li F1, Chen E1, Wang X1, Huang D2, Lin Z2, Lin J4.

1Zhejiang Provincial Center for Disease Control and Prevention, 3399
Binsheng Road, Binjiang District, Hangzhou, 310051, Zhejiang Province,
People’s Republic of China.
2Yongjia Center for Disease Control and Prevention, Yongjia, Zhejiang
Province, People’s Republic of China.
3Wenzhou Center for Disease Control and Prevention, Wenzhou, Zhejiang
Province, People’s Republic of China.
4Zhejiang Provincial Center for Disease Control and Prevention, 3399
Binsheng Road, Binjiang District, Hangzhou, 310051, Zhejiang Province,
People’s Republic of China. Electronic address: zjlinjunfen@163.com.

BACKGROUND: Acupuncture carries the potential risk of transmission of
pathogenic microorganisms from the environment to the patient, and from
one patient to another. An outbreak of tuberculosis at a private clinic in
eastern China was investigated to identify the source of infection, mode
of transmission, and risk factors for infection.

METHODS: A probable case was one who had the onset of unexplained pain,
swelling, or abscess in the area of invasive treatment between January 1,
2011 and February 23, 2012. A confirmed case was a probable case with
positive laboratory test results for Mycobacterium tuberculosis. Patient
history and the frequency of invasive treatment were compared between 56
probable and confirmed cases and 98 controls in a case-control study.

RESULTS: Fifty-six of 2561 patients (2.2%) who had visited the clinic
developed tuberculosis. The odds ratio (OR) of M. tuberculosis infection
increased with the frequency of clinic visits (Chi-square for trend=
28.943, p=0.000). Multivariate analysis showed that the frequency of
acupuncture (Chi-square=24.258, adjusted p-value=0.000) and sharing
acupuncture needles (Chi-square=8.936, adjusted p-value=0.003) were risk
factors for M. tuberculosis infection. Thirty-two pus sample and nine
sputum sample cultures were M. tuberculosis-positive.

CONCLUSIONS: This outbreak was caused by acupuncture and was transmitted
through sharing acupuncture needles contaminated with M. tuberculosis.

Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights
reserved.

KEYWORDS: Acupuncture; Case–control study; Mycobacterium tuberculosis;
Outbreak

Open Access Free full text
http://www.ijidonline.com/article/S1201-9712(14)01643-9/fulltext
__________________________________________________________________
________________________________*_________________________________

18. Abstract: Atlanto-axial infection after acupuncture
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26655668

BMJ Case Rep. 2015 Dec 11;2015. pii: bcr2015212110.
Atlanto-axial infection after acupuncture.

Robinson A1, Lind CR2, Smith RJ1, Kodali V3.

1Department of Medicine, Geraldton Regional Hospital, Geraldton, Western
Australia, Australia.
2University of Western Australia, Perth, Australia Neurosurgical Service
of Western Australia, Sir Charles Gairdner Hospital, Perth, Australia.
3Department of Medicine, Geraldton Regional Hospital, Geraldton, Western
Australia, Australia University of Western Australia, Perth, Australia.

A 67-year-old man presented with neck cellulitis following acupuncture for
cervical spondylosis. Blood cultures were positive for methicillin-
sensitive Staphylococcus aureus. Increased neck pain and bacteraemia
prompted MRI, which showed atlanto-axial septic arthritis without signs of
infection of the tissues between the superficial cellulitic area and the
atlanto-axial joint, thus making direct extension of infection unlikely.

It is more likely that haematogenous spread of infection resulted in
seeding in the atlanto-axial joint, with the proximity of the arthritis
and acupuncture site being coincidental. Acupuncture is a treatment option
for some indolent pain conditions. As such, acupuncture services are
likely to be more frequently utilised.

A history of acupuncture is rarely requested by the admitting doctor and
seldom offered voluntarily by the patient, especially where the site of
infection due to haematogenous spread is distant from the needling
location.

Awareness of infectious complications following acupuncture can reduce
morbidity through early intervention.

2015 BMJ Publishing Group Ltd.
__________________________________________________________________
________________________________*_________________________________

19. Abstract: Immune responses after fractional doses of inactivated
poliovirus vaccine using newly developed intradermal jet injectors: a
randomized controlled trial in Cuba
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/25448109

Vaccine. 2015 Jan 3;33(2):307-13.
Immune responses after fractional doses of inactivated poliovirus vaccine
using newly developed intradermal jet injectors: a randomized controlled
trial in Cuba.

Resik S1, Tejeda A2, Mach O3, Fonseca M1, Diaz M1, Alemany N2, Garcia G2,
Hung LH1, Martinez Y1, Sutter R4.

1Instituto Pedro Kouri, Havana, Cuba.
2Centro Provincial de Higiene, Epidemiologia y Microbilogia, Camaguey,
Cuba.
3The World Health Organization, Geneva, Switzerland. Electronic address:
macho@who.int.
4The World Health Organization, Geneva, Switzerland.

INTRODUCTION: The World Health Organization recommends that, as part of
the new polio endgame, a dose of inactivated poliovirus vaccine (IPV) be
introduced by the end of 2015 in all countries using only oral poliovirus
vaccine (OPV). Administration of fractional dose (1/5th of full dose) IPV
(fIPV) intradermally may reduce costs, but its administration is
cumbersome with BCG needle and syringe. We evaluated performance of two
newly developed intradermal-only jet injectors and compared the immune
response induced by fIPV with that induced by full-dose IPV.

METHODS: Children between 12 and 20 months of age, who had previously
received two doses of OPV, were enrolled in Camaguey, Cuba. Subjects
received a single dose of IPV (either full-dose IPV intramuscularly with
needle and syringe or fIPV intradermally administered with one of two new
injectors or with BCG needle or a conventional needle-free injector).
Serum was tested for presence of poliovirus neutralizing antibodies on day
0 (pre-IPV) and on days 3, 7 and 21 (post-vaccination).

RESULTS: Complete data were available from 74.2% (728/981) subjects.
Baseline median antibody titers were 713, 284, and 113 for poliovirus
types 1, 2, and 3, respectively. Seroprevalence at study end were similar
across the intervention groups (= 94.8%). The immune response induced with
one new injector was similar to BCG needle and to the conventional
injector; and superior to the other new injector. fIPV induced
significantly lower boosting response compared to full-dose IPV. No safety
concerns were identified.

INTERPRETATION: One of the two new injectors demonstrated its ability to
streamline intradermal fIPV administration, however, further
investigations are needed to assess the potential contribution of fIPV in
the polio endgame plan.

Copyright © 2014 Elsevier Ltd. All rights reserved.

KEYWORDS: Inactivated poliovirus vaccine; Intradermal administration;
Poliomyelitis
__________________________________________________________________
________________________________*_________________________________

20. Abstract: Does chondrolysis occur after corticosteroid-analgesic
injections? An analysis of patients treated for adhesive capsulitis of
the shoulder
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26803933

J Shoulder Elbow Surg. 2016 Jan 21. pii: S1058-2746(15)00575-3.
Does chondrolysis occur after corticosteroid-analgesic injections? An
analysis of patients treated for adhesive capsulitis of the shoulder.

Baumgarten KM1, Helsper E2.

1Orthopedic Institute, Sioux Falls, SD, USA; Sanford School of Medicine,
University of South Dakota, Vermillion, SD, USA. Electronic address:
kbaumga@yahoo.com.
2Sanford School of Medicine, University of South Dakota, Vermillion, SD,
USA.

BACKGROUND: Clinical studies using continuous infusions of local
anesthetics and basic science studies that model injections of local
anesthetics have shown chondrotoxicity. However, clinical studies do not
exist that have assessed for the risk of chondrolysis in nonarthritic
joints exposed to single or intermittent corticosteroid or analgesic
injections. Currently, there are no data available to guide the clinician
on the safety of using these injections in clinical practice.

MATERIALS AND METHODS: A retrospective review of patients treated for
adhesive capsulitis of the shoulder with at least 1 intra-articular
injection of a corticosteroid and anesthetic was performed. The inclusion
criteria were a diagnosis of adhesive capsulitis and a minimum 2-year
follow-up. Prospective follow-up was performed to obtain patient-
determined outcome scores, range of motion, and radiographs to determine
the presence of chondrolysis.

RESULTS: Fifty-six patients with a mean age of 52.5?±?7.2 years were
enrolled at a mean follow-up of 54 months. The mean number of injections
performed was 1.5 ± 0.7 (range, 1-4). At final follow-up, the mean Western
Ontario Osteoarthritis of the Shoulder score was 91.4%?±?14.2%;
Disabilities of the Arm, Shoulder and Hand score, 6.7?±?9.6; Shoulder Pain
and Disability Index score, 7.4?±?11.4; and Single Assessment Numeric
Evaluation score, 92.7%?±?10.1%. The Shoulder Activity Score was
8.3?±?4.7. Passive and active forward elevation, external rotation,
internal rotation, and cross-body adduction showed no significant
differences compared with the unaffected contralateral shoulder. There was
no radiographic evidence of chondrolysis in any patient.

CONCLUSIONS: This study did not show chondrolysis in patients treated with
an intra-articular corticosteroid and local anesthetic for adhesive
capsulitis. The findings of this study do not support the cessation of
using intra-articular analgesic-corticosteroid injections for the
treatment of adhesive capsulitis.

LEVEL OF EVIDENCE: Level IV; Case Series; Treatment Study.

Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees.
Published by Elsevier Inc. All rights reserved.

KEYWORDS: Chondrolysis; adhesive capsulitis; analgesic; corticosteroid;
injection
__________________________________________________________________
________________________________*_________________________________

21. Abstract: Impact of universal gowning and gloving on health care
worker clothing contamination
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/25782898

Infect Control Hosp Epidemiol. 2015 Apr;36(4):431-7.
Impact of universal gowning and gloving on health care worker clothing
contamination.

Williams C1, McGraw P1, Schneck EE2, LaFae A3, Jacob JT3, Moreno D4, Reyes
K4, Cubillos GF5, Kett DH5, Estrella R6, Morgan DJ7, Harris AD7, Drees M1.
Author information
11Department of Medicine,Christiana Care Health System,Newark,Delaware.
22Department of Laboratory Medicine,Christiana Care Health
System,Newark,Delaware.
33Department of Medicine,Emory University School of
Medicine,Atlanta,Georgia.
44Department of Medicine,Henry Ford Hospital,Detroit,Michigan.
55Department of Medicine,University of Miami Miller School of
Medicine,Miami,Florida.
66Department of Medicine,University Health System,San Antonio,Texas.
77Department of Epidemiology & Public Health,University of Maryland School
of Medicine,Baltimore,Maryland.

OBJECTIVE: To determine whether gowning and gloving for all patient care
reduces contamination of healthcare worker (HCW) clothing, compared to
usual practice.

DESIGN: Cross-sectional surveys.

SETTING: Five study sites were recruited from intensive care units (ICUs)
randomized to the intervention arm of the Benefits of Universal Gown and
Glove (BUGG) study.

PARTICIPANTS: All HCWs performing direct patient care in the study ICUs
were eligible to participate.
__________________________________________________________________
________________________________*_________________________________

22. Abstract: Ebola virus disease: The use of fluorescents as markers of
contamination for personal protective equipment
__________________________________________________________________

http://www.idcasereports.com/article/S2214-2509(14)00046-8/abstract
Open Access Free Full Article

IDCases. 2014 Dec 24;2(1):27-30.
Ebola virus disease: The use of fluorescents as markers of contamination
for personal protective equipment.

Bell T1, Smoot J2, Patterson J3, Smalligan R4, Jordan R4.

1Center for Tropical Medicine and Infectious Diseases, Texas Tech
University Health Science Center, 1400 Coulter Road, Amarillo, TX 79106,
USA.
2SiMCentral, Texas Tech University Health Science Center, 1600 Wallace
Blvd, Amarillo, TX 79106, USA.
3Office of Communications and Marketing, Texas Tech University Health
Science Center, 1400 Coulter Road, Amarillo, TX 79106, USA.
4Department of Internal Medicine, Texas Tech University Health Science
Center, 1400 Coulter Road, Amarillo, TX 79106, USA.

The recent Ebola virus disease (EVD) outbreak has created interest in
personal protective equipment (PPE) content and usage. PPE testing has
historically been done by individual component, rather than as a bundle
for contact isolation.

Fluorescent agents are commonly used in training for infection control
techniques.

The purpose of our study was to compare 2 PPE bundles and to evaluate the
feasibility of fluorescent markers as an assessment tool for PPE
effectiveness. Eight healthcare providers volunteered for this preliminary
study. Participants were randomized to 1 of 2 PPE bundles that meet
current (October 20, 2014) CDC recommendations. One PPE bundle utilized
commercial EVD-recommended components. The other PPE bundle used
components already available at local hospitals or retail stores.
Participants were also randomized to standard or high volume exposures
(HVE) to simulate fluid splash. Each participant was assisted in PPE
donning and doffing by an experienced trainer. A training mannequin was
contaminated with fluorescent agents to simulate bodily fluids.
Participants were then given clinical tasks to care for the EVD “patient.”
De-gowned participants were examined under “black light” for fluorescence
indicative of contamination.

One participant in each PPE arm had evidence of contamination. One of the
contamination events was suspected during the patient care exercise. The
other contamination event was not suspected until black light examination.
In spite of a large difference in cost of PPE, the two bundle arms
performed similarly. Bundle testing using fluorescent markers could help
identify optimal PPE systems.

KEYWORDS: Ebola; Fluorescent; PPE; Personal protective equipment; Training
__________________________________________________________________
________________________________*_________________________________

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
__________________________________________________________________

Comments are closed.