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SIGNpost 00840

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST

Post00840 Subscribers + CC GLO + map + Abstracts + News 17 February 2016

CONTENTS
1. 1350 plus subscribers on SIGN post forum!
2. Moderators Note: SIGNpost Subscribers
3. The WHO Global Learning Opportunities (GLO) has announced 2016
pharmaceutical cold chain related courses
4. mapCrowd – online data collection platform for hepatitis C information
5. Abstract: Frequency and determinants of Hepatitis B and C virus in
general population of Farash Town, Islamabad
6. Abstract: Knowledge and practices of infection control among healthcare
workers in a Tertiary Referral Center in North-Western Nigeria
7. Abstract: Occupational exposure to infection risk and use of personal
protective equipment by emergency medical personnel in the Republic of
Korea
8. Abstract: Needle size for vaccination procedures in children and
adolescents
9. Abstract: A Model-Based Product Evaluation Protocol for Comparison of
Safety-Engineered Protection Mechanisms of Winged Blood Collection
Needles
10. Abstract: Developing a Brief Scale to Measure HIV Transmission Risk
Among Injecting Drug Users
11. Abstract: Going into the groin: Injection into the femoral vein among
people who inject drugs in three urban areas of England
12. Abstract: Health Outcomes Associated with Illicit Prescription Opioid
Injection: A Systematic Review
13. Abstract: Decreasing Hepatitis C Virus Infection in Thailand in the
Past Decade: Evidence from the 2014 National Survey
14. Abstract: HIV infection among persons who inject drugs: Ending old
epidemics and addressing new outbreaks
15. Abstract: Intra-Articular Corticosteroids in Addition to Exercise for
Reducing Pain Sensitivity in Knee Osteoarthritis: Exploratory Outcome
from a Randomized Controlled Trial
17. Abstract: Successful development of a direct observation program to
measure health care worker hand hygiene using multiple trained
volunteers
18. Abstract: Curtains hide risks to health and hygiene
19. News

– Texas USA: Syringe Access Fund announces $2.6 million in grants

– Canada: Start prison-based needle and syringe programs, researchers
suggest The Liberal government should implement prison-based needle and
syringe programs to address rates of HIV and hepatitis C, proponents
say

– Seattle Washington USA: “What If You Got Pricked?” Seattle Group To
Teach Cleaning Up Dirty Needles
The web edition of SIGNpost is online at:

SIGNpost 00840

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. 1350 Plus Subscribers on SIGNpost Forum!

Many thanks to our colleague Arshat Altaf, Injection Safety Consultant at
WHO Headquarters (and acting SIGN Secretariat) for his welcome comments.
__________________________________________________________________
from: ALTAF, Arshad <altafa[at]who.int>
to: sign.moderator <sign.moderator@gmail.com>
date: Thu, Feb 11, 2016
subject: 1350 plus subscribers on SIGN post forum!
Dear Colleagues,
Allan informed me today that there are 1350 plus subscribers of this forum
which is not a small number by any mean, particularly in this day and age
where every day something new springs up inviting you to be part of it.

I realize that many of you may not notice all items but in every weekly
post there is always something worth reading.

Unsafe injections are still affecting patients and communities around us.

The WHO HQ team along with its partners in country and regional offices
are striving to make the injection safety campaign in three pilot
countries (Egypt, India and Uganda) successful.

Besides that we are also focusing on developing educational tools and
revamping the injection safety page.

We need your support to improve the situation in all regions.

Kind regards.

Arshad
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
E-mail: altafa[at]who.int
__________________________________________________________________
________________________________*_________________________________

2. Moderators Note: SIGNpost
Many thanks to our colleague Arshat Altaf, Injection Safety Consultant at
WHO Headquarters and acting SIGN Secretariat, for his welcome comments
above.

Many thanks are due to our continuing and new subscribers and readers!

Following the recent interruptions to our archive website at
http://signpostonline.info we reviewed the subscriber logs and found there
were an additional 698 subscribers via the website. We also reviewed the
rest of the subscriber base and the estimated readership follows.

SIGNpost serves the injection safety community with news. information and
a mostly chronological and timely archive of peer review articles on
injection safety and related infection control that are of specific
interest to our readers.

SIGNpost exists in 3 media formats: An email newsletter via mail listserve
technology, an archival website that provides email notifications and an
RSS feed for all new posts http://signpostonline.info, and a Facebook page
https://www.facebook.com/SIGN.Moderator.

Here are the current subscriber numbers:

SIGNpost listserve: 650
[estimated live email addresses from 728 subscribers]

signpostonline.info: 698 subscribers [RSS unknown]

facebook.com/SIGN.Moderator 78 Following
Injection safety for all,

best regards,
allan
__________________________________________________________________
________________________________*_________________________________

3. The WHO Global Learning Opportunities (GLO) has announced 2016
pharmaceutical cold chain related courses

Crossposted from TechNet-21 with thanks http://technet-21.org
__________________________________________________________________
Dear Colleagues,

The WHO Global Learning Opportunities (GLO) has announced 2016
pharmaceutical cold chain related courses and I would like to share the
dates:

AUTHENTIC ONLINE COURSES

e-Pharmaceutical cold chain management (2015 Hermes Golden Award in e-
learning category)

2 May – 22 July 2016
5 September – 25 November 2016

http://epela.net/epela_web/introduction.html

http://epela.net/epela_web/apply_online.html

e-VVM based vaccine management

18 April – 17 June 2016
3 October – 2 December 2016

http://epela.net/epela_web/evvm.html

http://epela.net/epela_web/apply_online_evvm.html

As for the authentic e-learning courses, pelase visit the first links to
see the details of the courses and use the second link to apply online.

In 2016, we will also have 2 bus courses, one in Greece and one in Turkey.
The Greece course will run through 4-7 May 2016 and the Turkey one through
6-11 June 2016. Attached please find the INTRODUCTION document that
describes both courses in detail as well as the application form for the
wheels courses. Please note that we have a long waiting list from 2015
applications and I encourage you to apply as soon as possible to secure
your seat on the bus. Pharmaceutical Cold Chain management on Wheels
course was awarded with European Excellence Award by the IQPC in 2010.

Looking forward to hearing from you.

Cheers and all the best,

UMIT

*****************************************************

Dr. Umit Kartoglu, MD, DPH
Scientist
HIS/EMP/RSS, Room L261
World Health Organization
Avenue Appia 20, CH-1211 Geneva 27
Switzerland
Tel: +41 22 791 4972; Fax: +41 22 791 4384
Mobile phone: +41 79 475 5561
e-mail: kartogluu[at]who.int
__________________________________________________________________
________________________________*_________________________________

4. mapCrowd – online data collection platform for hepatitis C information

Crosposted from E-DRUG Digest, Vol 13, Issue 10 with thanks.
www.e-drug@healthnet.org

e-drug mailing list http://lists.healthnet.org/mailman/listinfo/e-drug
__________________________________________________________________

Date: Wed, 10 Feb 2016 06:22:31 +0100
From: “Etienne Guillard” <etienne.guillard@solthis.org>
E-DRUG: mapCrowd – online data collection platform for hepatitis C
information
Dear friends, colleagues, and fellow advocates,

Médecins du Monde (MdM) and Treatment Action Group (TAG) are pleased to
announce the launch of ‘mapCrowd’ (www.mapCrowd.org), an innovative
online resource and data collection platform for gathering and sharing
hepatitis C information.

Following a successful trial period in which we obtained data from 23
countries, we are now making mapCrowd publicly available so that experts
and advocates from other countries can help scale up this vital
informational resource. mapCrowd is designed for people with HCV,
activists, clinicians, researchers, and the wider international health
community. Currently, it is available in English and French, and will be
expanded in the coming weeks to include Arabic, Chinese, Spanish, and
Russian.

We have also just published our first Key Findings Report
http://mapcrowd.org/public/pdf/EN_mapCrowd_Report.pdf

which details six key conclusions that we have drawn from our preliminary
analysis of the mapCrowd data.

We encourage you to visit mapCrowd.org, download and read the Key Findings
Report, and share these resources among your network.

If you or someone you know is interested in participating as a voluntary
mapCrowd data contributor, please visit http://mapcrowd.org/en/inscription

With your help, mapCrowd will be able to shed even more light on national
hepatitis C conditions, to inform advocacy and ultimately break down
barriers to diagnostic and treatment access around the world.

Thank you for your support,

The mapCrowd team: Chloé Forette, Jason Rizzo, Julie Bouscaillou, Karyn
Kaplan, Niklas Luhmann and Tracy Swan.

Etienne Guillard <etienne.guillard@solthis.org>
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Frequency and determinants of Hepatitis B and C virus in
general population of Farash Town, Islamabad
__________________________________________________________________

http://pjms.com.pk/index.php/pjms/article/view/7047

Pak J Med Sci. 2015 Nov-Dec;31(6):1394-8.
Frequency and determinants of Hepatitis B and C virus in general
population of Farash Town, Islamabad.

Asad M1, Ahmed F2, Zafar H3, Farman S4.
Author information
1Dr. Munazza Asad, MBBS, FCPS. Associate Professor of Physiology, Al-
Nafees Medical College and Hospital, Isra University, Islamabad, Pakistan.
2Dr. Farah Ahmed, MBBS, MSPH, MBA. Assistant Professor of Community
Medicine, Al-Nafees Medical College and Hospital, Isra University,
Islamabad, Pakistan.
3Dr. Humaira Zafar, MBBS, MPhil. Assistant Professor of Pathology, Al-
Nafees Medical College and Hospital, Isra University, Islamabad, Pakistan.
4Mr. Sabir Farman, Statistician, Al-Nafees Medical College and Hospital,
Isra University, Islamabad, Pakistan.

BACKGROUND AND OBJECTIVE: Both Hepatitis B virus (HBV) and hepatitis C
virus (HCV) infections are rapidly spreading in the developing countries.
Both of them are blood borne and are transmitted through un-screened blood
transfusion, inadequately sterilized needles and equipment.

According to WHO’s criteria of endemicity, Pakistan has high disease
burden of Hepatitis B and C. The present study was planned to determine
the frequency and to identify the risk factors of hepatitis B and C virus
in the general community of Farash town.

METHODS: This descriptive study was carried out in Al Nafees Medical
Hospital Lab, from January 2013 to December 2013. Both the genders and all
age groups were included in the study. All the patients who fulfilled the
inclusion criteria had given a written consent. Data was collected through
questionnaire and was analyzed on Statistical Package for Social Sciences
(SPSS) version 21.

RESULTS: Three-hundred and forty five patients were studied. Among these
92 (27%) were males and 253(73%) were female, 33% of them had hepatitis C,
9% had hepatitis B. History of injections was reported in all of the
patients. Visit to community barbers was present in 58.6% and 41% cases of
hepatitis B and C. History of dental procedures was obtained in 7(24%) and
15(13%) patients of hepatitis B and C.

CONCLUSION: Major contributors for Hepatitis B and C in Farash town are
use of unsterilized therapeutic injections and visit to community barbers.
Education of the barbers regarding sterilization may help in reducing the
burden of infection in this community.

KEYWORDS: Hepatitis B; Hepatitis C; Risk Factors

Free PMC Article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4744288/

Full text PDF at http://pjms.com.pk/index.php/pjms/article/view/7047
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Knowledge and practices of infection control among healthcare
workers in a Tertiary Referral Center in North-Western Nigeria
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26857935

Ann Afr Med. 2016 Jan-Mar;15(1):34-40.
Knowledge and practices of infection control among healthcare workers in a
Tertiary Referral Center in North-Western Nigeria.

Iliyasu G1, Dayyab FM, Habib ZG, Tiamiyu AB, Abubakar S, Mijinyawa MS,
Habib AG.

1Department of Medicine, College of Health Sciences, Bayero University
Kano, Kano, Nigeria.

BACKGROUND: Healthcare acquired infections (HCAIs) otherwise call
nosocomial infection is associated with increased morbidity and mortality
among hospitalized patients and predisposes healthcare workers (HCWs) to
an increased risk of infections. The study explores the knowledge and
practices of infection control among HCW in a tertiary referral center in
North-Western Nigeria.

MATERIALS AND METHODS: This is a cross-sectional study. A self-
administered structured questionnaire was distributed to the study group
(of doctors and nurses). Data on knowledge and practice of infection
control were obtained and analyzed. Study population were selected by
convenience sampling.

RESULTS: A total of 200 responses were analyzed, 152 were nurses while 48
were doctors. The median age and years of working experience of the
respondents were 35 years (interquartile range [IQR] 31-39) and 7 years
(IQR 4-12), respectively.

Most of the respondents 174/198 (87.9%) correctly identified hand washing
as the most effective method to prevent HCAI, with nurses having better
knowledge 139/152 (91%) (P = 0.001).

Majority agreed that avoiding injury with sharps 172/200 (86%), use of
barrier precaution 180/200 (90%) and hand hygiene 184/200 (92%)
effectively prevent HCAI.

Only 88/198 (44.4%), 122/198 (61.6%), and 84/198 (42.4%) of the
respondents were aware of the risks of infection following exposure to
human immunodeficiency virus, hepatitis B virus and hepatitis C virus-
infected blood, respectively.

About 52% of doctors and 76% of nurses (P = 0.002) always practice hand
hygiene in between patient care.

CONCLUSION: Gaps have been identified in knowledge and practice of
infection control among doctors’ and nurses’ in the study; hence, it will
be beneficial for all HCW to receive formal and periodic refresher
trainings.
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Occupational exposure to infection risk and use of personal
protective equipment by emergency medical personnel in the Republic of
Korea
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26874405

Am J Infect Control. 2016 Feb 10. pii: S0196-6553(15)01292-4.
Occupational exposure to infection risk and use of personal protective
equipment by emergency medical personnel in the Republic of Korea.

Oh HS1, Uhm D2.

1Department of Nursing, College of Health and Welfare, Woosong University,
Daejeon, Republic of Korea.
2Department of Emergency Medical Technology, Daejeon University, Daejeon,
Republic of Korea. Electronic address: dchuhm@dju.kr.

BACKGROUND: Few studies of occupational exposure (OE) to infectious risk
among emergency medical personnel (EMP) or their use of personal
protective equipment (PPE) have been conducted in the Republic of Korea.

OBJECTIVE: To determine the status of OE to infectious risks and use of
PPE.

METHODS: A convenience sample of 907 questionnaires (response rate, 88.5%)
was collected from September 1, 2014, to January 31, 2015, in 5
metropolitan Korean cities.

RESULTS: Respiratory diseases were significantly prevalent (44.5%) and
influenza (29.5%) was the most frequently reported illness. An exposure
report was only made in 19.5% of cases. The primary reason for OE report
noncompletion was the complexity of the reporting process (23.9%). A total
of 365 participants reported OE to body fluids and blood (40.2%) with
needlestick injury being the most frequent OE type (17.6%). More than 5
years of job experience (47.8%) (P?<?.001) and region (city) (P?=?.003)
significantly increased OE to body fluids and blood. Puncture-resistant
containers (71.9%) and disposable gloves (68.9%) were used. Job training
and education on infection risks and use of PPE were not uniformly
conducted (77.5%). Anxiety about OE to risk of infection from patients was
common among EMP (63.2%).

CONCLUSIONS: EMP experienced significant OE to infectious risk and use PPE
inadequately. Surveillance and education programs regarding OE should be
developed.

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

KEYWORDS: Emergency; Exposure; Health care workers; Infection control;
Prehospital
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Needle size for vaccination procedures in children and
adolescents
__________________________________________________________________

Free Full Text
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010720.pub2/full

Cochrane Database Syst Rev. 2015 Jun 18;6:CD010720.
Needle size for vaccination procedures in children and adolescents.

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

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

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

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

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

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

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

MAIN RESULTS: We included five trials involving 1350 participants. Data
for the primary review outcomes were either absent (for the incidence of
vaccine-preventable diseases) or limited (for procedural pain and crying).
The available evidence was compromised by the use of surrogate
immunogenicity outcomes, incomplete blinding of outcome assessors, and
imprecision for some outcomes. The evidence from two small trials was
insufficient to allow any confident statements to be made about the
effects of the needles evaluated in the trials on vaccine immunogenicity
and reactogenicity.The remaining three trials (1135 participants)
contributed data to comparisons between 25 G 25 mm, 23 G 25 mm, and 25 G
16 mm needles.

These trials involved infants predominantly aged two to six months
undergoing intramuscular vaccination in the anterolateral thigh using the
World Health Organization (WHO) injection technique (skin stretched flat,
needle inserted at a 90° angle and up to the needle hub in healthy
infants).

The vaccines administered were combination vaccines containing diphtheria,
tetanus, and whole-cell pertussis antigens (DTwP). In some trials, the
vaccines also contained Haemophilus influenzae type b (DTwP-Hib) and
hepatitis B (DTwP-Hib-HepB) antigen components.

We found moderate quality evidence from one trial that there is probably
little or no difference in immune response, defined in terms of the
proportion of seroprotected infants, between using 25 G 25 mm, 23 G 25 mm,
or 25 G 16 mm needles to administer a series of three doses of a DTwP-Hib
vaccine at ages two, three, and four months (numbers of participants in
analyses range from 309 to 402.

Immune response to pertussis antigen not measured).25 mm needles (either
23 G or 25 G) probably lead to fewer severe local reactions (extensive
redness and swelling) and fewer non-severe local reactions (any redness,
swelling, tenderness or hardness (composite outcome)) after DTwP-Hib
vaccination compared with 25 G 16 mm needles. We estimate that one fewer
infant will experience a severe local reaction after the first vaccine
dose for every 25 infants vaccinated with the longer rather than the
shorter needle (number needed to treat (NNT) 25 (95% confidence interval
(CI) 15 to 100)).

We estimate that one fewer infant will experience a non-severe local
reaction at 24 hours after the first, second, and third vaccine doses for
every five to eight infants vaccinated with the longer rather than the
shorter needle (NNTs range from 5 (95% CI 4 to 10) to 8 (95% CI 5 to 34))
(moderate quality evidence, one trial for first and second doses, two
trials for third dose, numbers of participants in analyses range from 413
to 528).

Using a wider gauge needle (23 G 25 mm) may slightly reduce procedural
pain (low quality evidence) and probably leads to a slight reduction in
the duration of crying time immediately after vaccination (moderate
quality evidence) compared with a narrower gauge (25 G 25 mm) needle (one
trial, 320 participants). The effects are probably not large enough to be
of any clinical relevance. The 25 G 25 mm needle may produce a small
reduction in the incidence of local reactions after each dose of a DTwP
vaccine compared with the 23 G 25 mm needle, but the effect estimates are
imprecise (low quality evidence, two trials, numbers of participants in
analyses range from 100 to 459).The comparative effects of 23 G 25 mm, 25
G 25 mm, and 25 G 16 mm needles on the incidence of post-vaccination
fever, persistent inconsolable crying, and other systemic events such as
drowsiness, loss of appetite, and vomiting are uncertain due to the very
low quality of the evidence.

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

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

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

Free Full Text
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010720.pub2/full
__________________________________________________________________
________________________________*_________________________________

9. Abstract: A Model-Based Product Evaluation Protocol for Comparison of
Safety-Engineered Protection Mechanisms of Winged Blood Collection
Needles
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26868306

Infect Control Hosp Epidemiol. 2016 Feb 12:1-7.
A Model-Based Product Evaluation Protocol for Comparison of Safety-
Engineered Protection Mechanisms of Winged Blood Collection Needles.

Haupt C1, Spaeth J2, Ahne T2, Goebel U2, Steinmann D1.

11Occupational Medical Service,University Medical Center
Freiburg,Freiburg,Germany.
22Department of Anaesthesiology and Intensive Care Medicine,University
Medical Center Freiburg,Freiburg,Germany.

OBJECTIVE To evaluate differences in product characteristics and user
preferences of safety-engineered protection mechanisms of winged blood
collection needles.

DESIGN Randomized model-based simulation study.

SETTING University medical center.

PARTICIPANTS A total of 33 third-year medical students.

METHODS Venipuncture was performed using winged blood collection needles
with 4 different safety mechanisms: (a) Venofix Safety, (b) BD Vacutainer
Push Button, (c) Safety-Multifly, and (d) Surshield Surflo. Each needle
type was used in 3 consecutive tries: there was an uninstructed first
handling, then instructions were given according to the operating manual;
subsequently, a first trial and second trial were conducted.

Study end points included successful activation, activation time, single-
handed activation, correct activation, possible risk of needlestick
injury, possibility of deactivation, and preferred safety mechanism.

RESULTS The overall successful activation rate during the second trial was
equal for all 4 devices (94%-100%).

Median activation time was (a) 7 s, (b) 2 s, (c) 9 s, and (d) 7 s.

Single-handed activation during the second trial was (a) 18%, (b) 82%, (c)
15%, and (d) 45%.

Correct activation during the second trial was (a) 3%, (b) 64%, (c) 15%,
and (d) 39%.

Possible risk of needlestick injury during the second trial was highest
with (d).

Possibility of deactivation was (a) 0%, (b) 12%, (c) 9%, and (d) 18%.

Individual preferences for each system were (a) 11, (b) 17, (c) 5, and (d)
0. The main reason for preference was the comprehensive safety mechanism.

CONCLUSION Significant differences exist between safety mechanisms of
winged blood collection needles.

Infect. Control Hosp. Epidemiol. 2016;1-7.
__________________________________________________________________
________________________________*_________________________________

10. Abstract: Developing a Brief Scale to Measure HIV Transmission Risk
Among Injecting Drug Users
__________________________________________________________________

Free Full Article http://jhrba.com/?page=article&article_id=26159

Int J High Risk Behav Addict. 2015 Dec 12;4(4):e26159.
Developing a Brief Scale to Measure HIV Transmission Risk Among Injecting
Drug Users.

Shahesmaeili A1, Haghdoost AA2, Soori H3.

1Regional Knowledge Hub and WHO Collaborating Center for HIV Surveillance,
Institute for Future Studies in Health, Kerman University of Medical
Sciences, Kerman, IR Iran; Research Center for Modeling in Health,
Institute for Future Studies in Health, Kerman University of Medical
Sciences, Kerman, IR Iran.
2Research Center for Modeling in Health, Institute for Future Studies in
Health, Kerman University of Medical Sciences, Kerman, IR Iran.
3Safety Promotion and Injury Prevention Research Center, Shahid Beheshti
University of Medical Sciences, Tehran, IR Iran.

BACKGROUND: One of the main concerns of policymakers is to measure the
impact of harm reduction programs and different interventions on the risk
of HIV transmission among Injecting Drug Users (IDUs). Looking
simultaneously at multiple factors and conditions that affect the risk of
HIV transmission may provide policymakers a better insight into the mixed
nature of HIV transmission.

OBJECTIVES: The present study aimed to design a simple, brief, and multi-
dimensional scale for measuring HIV transmission risk among IDUs.

PATIENTS AND METHODS: From October 2013 to March 2014, we conducted face-
to-face interviews with 147 IDUs. Eligible participants were individuals
18 years or older who had injected drugs at least once during the last
year and had not participated in similar studies within the 2 months
before the interview. To design a scale for measuring HIV transmission
risk, we specified 11 items, which address different dimensions of HIV
risk taking behaviors/situations based on experts’ opinion. We applied
exploratory factor analysis (EFA) with principal component extraction to
develop scales. Eigen values greater than 1 were used as a criterion for
factor extraction.

RESULTS: We extracted 7 items based on first factor, which were accounted
for 21% of the variations. The final scale contained 7 items: 4 items were
related to injecting practice and 3 items related to sexual behaviors. The
Cronbach’s a coefficient was 0.66, acceptable for such a brief scale.

CONCLUSIONS: Applying a simple and brief scale that incorporates the
different dimensions of HIV transmission risk may provide policymakers and
harm reductionists with a better understanding of HIV transmission in this
key group and may be advantageous for evaluating intervention programs.

KEYWORDS: Intravenous Drug Abuse; Iran; Needle Sharing; Sexual Behaviour;
Transmission

Free Full Article http://jhrba.com/?page=article&article_id=26159
__________________________________________________________________
________________________________*_________________________________

11. Abstract: Going into the groin: Injection into the femoral vein among
people who inject drugs in three urban areas of England
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/25913887

Drug Alcohol Depend. 2015 Jul 1;152:239-45.
Going into the groin: Injection into the femoral vein among people who
inject drugs in three urban areas of England.

Hope VD1, Scott J2, Cullen KJ3, Parry JV4, Ncube F3, Hickman M5.

1Centre for Infectious Disease Surveillance and Control, Public Health
England, London, UK; Centre for Research on Drugs & Health Behaviour,
London School of Hygiene & Tropical Medicine, London, UK. Electronic
address: vivian.hope@phe.gov.uk.
2Department of Pharmacy & Pharmacology, University of Bath, Bath, UK.
3Centre for Infectious Disease Surveillance and Control, Public Health
England, London, UK.
4Microbiology Services, Public Health England, London, UK; Centre for
Research on Drugs & Health Behaviour, London School of Hygiene & Tropical
Medicine, London, UK.
5School of Social and Community Medicine, University of Bristol, Bristol,
UK.

BACKGROUND: There have been increasing concerns about injection into the
femoral vein – groin injecting – among people who inject drugs in a number
of countries, though most studies have been small. The extent, reasons and
harms associated with groin injecting are examined.

METHOD: Participants were recruited using respondent driven sampling
(2006-2009). Weighted data was examined using bivariate analyses and
logistic regression.

RESULTS: The mean age was 32 years; 25% were women (N=855). During the
preceding 28 days, 94% had injected heroin and 13% shared
needles/syringes. Overall, 53% reported ever groin injecting, with 9.8%
first doing so at the same age as starting to inject.

Common reasons given for groin injecting included: “Can’t get a vein
elsewhere” (68%); “It is discreet” (18%); and “It is quicker” (14%).
During the preceding 28 days, 41% had groin injected, for 77% this was the
only body area used (for these “It is discreet” was more frequently given
as a reason). In the multivariable analysis, groin injection was
associated with: swabbing injection sites; saving filters for reuse; and
receiving opiate substitution therapy. It was less common among those
injecting into two body areas, and when other people (rather than
services) were the main source of needles. Groin injection was more common
among those with hepatitis C and reporting ever having deep vein
thrombosis or septicaemia.

CONCLUSIONS: Groin injection was common, often due to poor vascular
access, but for some it was out of choice. Interventions are required to
reduce injecting risk and this practice.

Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights
reserved.

KEYWORDS: Bacterial infections; Femoral vein; People who inject drugs;
Risk behaviours; Viral infections
__________________________________________________________________
________________________________*_________________________________

12. Abstract: Health Outcomes Associated with Illicit Prescription Opioid
Injection: A Systematic Review
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26670724

J Addict Dis. 2015 Dec 15:0.
Health Outcomes Associated with Illicit Prescription Opioid Injection: A
Systematic Review.

Lake S1,2, Kennedy MC1,2.

1a British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital
, 608-1081 Burrard Street, Vancouver , BC , CANADA , V6Z 1Y6.
2b School of Population and Public Health, University of British Columbia
, 2206 East Mall, Vancouver , BC , CANADA , V6T 1Z9.

Prescription opioid (PO) injection is a growing concern among people who
use illicit drugs. Little is known about the potential health-related
harms of injecting POs.

We therefore undertook a systematic review to identify health outcomes
associated with injecting POs. We searched the PubMed, Ovid MEDLINE®,
EMBASE, Journals@Ovid, CINAHL, PsycInfo, Web of Science® Core Collection,
CAB Direct, and ERIC databases to identify English articles published
between January 1990 and February 2015 that matched our inclusion
criteria. Potentially relevant articles were those examining a clinical
health outcome among people who use illicit drugs, in which a sub-group
injects POs. The International Classification of Diseases (ICD-10) was
used to clinically classify health outcomes. In total, we identified and
summarized 31 studies that met the inclusion criteria. We used a modified
version of the Downs and Black checklist to assess individual study
quality and identify sources of bias.

Findings supported associations between PO injection and hepatitis C
infection, substance dependence and other mental health indicators, and
lower general health. Associations with HIV, overdose, and cutaneous
infection were less consistent and varied according to PO type(s). We
identified several potential sources of bias as well as a need for more
longitudinal research and more rigorous confounding adjustment.

Our findings highlight a need to consider the growing popularity of PO
injection in efforts to reduce drug- related harm among people who inject
drugs.

KEYWORDS: Prescription opioids; injection drug use; opioid analgesics;
people who inject drugs; systematic review
__________________________________________________________________
________________________________*_________________________________

13. Abstract: Decreasing Hepatitis C Virus Infection in Thailand in the
Past Decade: Evidence from the 2014 National Survey
__________________________________________________________________

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0149362
Free full text

PLoS One. 2016 Feb 12;11(2):e0149362.
Decreasing Hepatitis C Virus Infection in Thailand in the Past Decade:
Evidence from the 2014 National Survey.

Wasitthankasem R1, Posuwan N1, Vichaiwattana P1, Theamboonlers A1,
Klinfueng S1, Vuthitanachot V2, Thanetkongtong N2, Saelao S3, Foonoi M3,
Fakthongyoo A3, Makaroon J4, Srisingh K5, Asawarachun D6, Owatanapanich
S7, Wutthiratkowit N8, Tohtubtiang K9, Yoocharoen P10, Vongpunsawad S1,
Poovorawan Y1.

1Center of Excellence in Clinical Virology, Faculty of Medicine,
Chulalongkorn University, Bangkok, Thailand.
2Chumpare Hospital, Chum Phae, Khon Kaen, Thailand.
3Uttaradit Hospital, Mueang, Uttaradit, Thailand.
4Lablae Hospital, Lablae, Uttaradit, Thailand.
5Naresuan University Hospital, Mueang, Phitsanulok, Thailand.
6Phra Nakhon Si Ayutthaya Hospital, Phra Nakhon Si Ayutthaya, Thailand.
7King Narai Hospital, Khao Sam Yot, Lop Buri, Thailand.
8Narathiwat Ratchanakarin Hospital, Mueang, Narathiwat, Thailand.
9Trang Hospital, Mueang, Trang, Thailand.
10Bureau of General Communicable Diseases, Department of Disease Control,
Ministry of Public Health, Nonthaburi, Thailand.

Hepatitis C virus (HCV) infection affects = 180 million individuals
worldwide especially those living in developing countries. Recent advances
in direct-acting therapeutics promise effective treatments for chronic HCV
carriers, but only if the affected individuals are identified. Good
treatment coverage therefore requires accurate epidemiological data on HCV
infection.

In 2014, we determined the current prevalence of HCV in Thailand to assess
whether over the past decade the significant number of chronic carriers
had changed. In total, 5964 serum samples from Thai residents between 6
months and 71 years of age were obtained from 7 provinces representing all
4 geographical regions of Thailand and screened for the anti-HCV antibody.
Positive samples were further analyzed using RT-PCR, sequencing, and
phylogenetic analysis to identify the prevailing HCV genotypes. We found
that 56 (0.94%) samples tested positive for anti-HCV antibody (mean age =
36.6±17.6 years), while HCV RNA of the core and NS5B subgenomic regions
was detected in 23 (41%) and 19 (34%) of the samples, respectively. The
seropositive rates appeared to increase with age and peaked in individuals
41-50 years old.

These results suggested that approximately 759,000 individuals are
currently anti-HCV-positive and that 357,000 individuals have viremic HCV
infection.

These numbers represent a significant decline in the prevalence of HCV
infection. Interestingly, the frequency of genotype 6 variants increased
from 8.9% to 34.8%, while the prevalence of genotype 1b declined from 27%
to 13%.

These most recent comprehensive estimates of HCV burden in Thailand are
valuable towards evidence-based treatment coverage for specific population
groups, appropriate allocation of resources, and improvement in the
national public health policy.

Free full text
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0149362
__________________________________________________________________
________________________________*_________________________________

14. Abstract: HIV infection among persons who inject drugs: Ending old
epidemics and addressing new outbreaks
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26836787

AIDS. 2016 Feb 1.
HIV infection among persons who inject drugs: Ending old epidemics and
addressing new outbreaks.

Des Jarlais DC1, Kerr T, Carrieri P, Feelemyer J, Arasteh K.

1aMount Sinai Beth Israel, New York City, USA bUrban Health Research
Initiative British Columbia Centre for Excellence in HIV/AIDS, Vancouver
Canada cINSERM, U912 (SESSTIM), Marseille, France.

AIDS among persons who inject drugs, first identified in December 1981,
has become a global epidemic. Injecting drug use has been reported in 148
countries and HIV infection has been seen among persons who inject drugs
in 61 countries.

Many locations have experienced outbreaks of HIV infection among persons
who inject drugs, under specific conditions that promote very rapid spread
of the virus.

In response to these HIV outbreaks, specific interventions for persons who
inject drugs include needle/syringe exchange programs, medicated assisted
treatment (with methadone or buprenorphine) and antiretroviral therapy.

Through a “combined prevention” approach, these interventions
significantly reduced new HIV infections among persons who inject drugs in
several locations including New York City, Vancouver and France.

The efforts effectively ended the local HIV epidemic among persons who
inject drugs in those locations.

This review examines possible processes through which combined prevention
programs may lead to ending HIV epidemics.

However, notable outbreaks of HIV among persons who inject drugs have
recently occurred in several countries, including in Athens, Greece, Tel-
Aviv, Israel, Dublin Ireland, as well as in Scott County, Indiana USA.

This review also considers different factors that may have led to these
outbreaks. We conclude with addressing the remaining challenges for
reducing HIV infection among persons who inject drugs.
__________________________________________________________________
________________________________*_________________________________

15. Abstract: Intra-Articular Corticosteroids in Addition to Exercise for
Reducing Pain Sensitivity in Knee Osteoarthritis: Exploratory Outcome
from a Randomized Controlled Trial
__________________________________________________________________

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0149168
Free full text

PLoS One. 2016 Feb 12;11(2):e0149168.
Intra-Articular Corticosteroids in Addition to Exercise for Reducing Pain
Sensitivity in Knee Osteoarthritis: Exploratory Outcome from a Randomized
Controlled Trial.

Soriano-Maldonado A1, Klokker L2, Bartholdy C2,3, Bandak E2, Ellegaard K2,
Bliddal H2, Henriksen M2,3.

1Department of Physical Education and Sport, Faculty of Sport Sciences,
University of Granada, Granada, Spain.
2The Parker Institute, Copenhagen University Hospital Bispebjerg and
Frederiksberg, Frederiksberg, Denmark.
3Department of Physical and Occupational Therapy, Copenhagen University
Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark.

OBJECTIVE: To assess the effects of one intra-articular corticosteroid
injection two weeks prior to an exercise-based intervention program for
reducing pain sensitivity in patients with knee osteoarthritis (OA).

DESIGN: Randomized, masked, parallel, placebo-controlled trial involving
100 participants with clinical and radiographic knee OA that were
randomized to one intra-articular injection on the knee with either 1 ml
of 40 mg/ml methylprednisolone (corticosteroid) dissolved in 4 ml
lidocaine (10 mg/ml) or 1 ml isotonic saline (placebo) mixed with 4 ml
lidocaine (10 mg/ml). Two weeks after the injections all participants
undertook a 12-week supervised exercise program. Main outcomes were
changes from baseline in pressure-pain sensitivity (pressure-pain
threshold [PPT] and temporal summation [TS]) assessed using cuff pressure
algometry on the calf. These were exploratory outcomes from a randomized
controlled trial.

RESULTS: A total of 100 patients were randomized to receive either
corticosteroid (n = 50) or placebo (n = 50); 45 and 44, respectively,
completed the trial. Four participants had missing values for PPT and one
for TS at baseline; thus modified intention-to-treat populations were
analyzed. The mean group difference in changes from baseline at week 14
was 0.6 kPa (95% CI: -1.7 to 2.8; P = 0.626) for PPT and 384 mm×sec (95%
CI: -2980 to 3750; P = 0.821) for TS.

CONCLUSIONS: These results suggest that adding intra-articular
corticosteroid injection 2 weeks prior to an exercise program does not
provide additional benefits compared to placebo in reducing pain
sensitivity in patients with knee OA.

TRIAL REGISTRATION: EU clinical trials (EudraCT): 2012-002607-18.

Free full text
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0149168
__________________________________________________________________
________________________________*_________________________________

17. Abstract: Successful development of a direct observation program to
measure health care worker hand hygiene using multiple trained
volunteers
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26874409

Am J Infect Control. 2016 Feb 10. pii: S0196-6553(15)01288-2.
Successful development of a direct observation program to measure health
care worker hand hygiene using multiple trained volunteers.

Linam WM1, Honeycutt MD2, Gilliam CH3, Wisdom CM2, Bai S4, Deshpande JK5.

1Pediatric Infectious Diseases Section, Department of Pediatrics,
University of Arkansas for Medical Sciences, Little Rock, AR. Electronic
address: wlinam@uams.edu.
2Infection Prevention and Control Department, Arkansas Children’s
Hospital, Little Rock, AR.
3Infection Prevention and Control Department, St. Jude Children’s Research
Hospital, Memphis, TN.
4Biostatistics Section, Department of Pediatrics, University of Arkansas
for Medical Sciences, Little Rock, AR.
5Departments of Pediatrics and Anesthesiology, University of Arkansas for
Medical Sciences, Little Rock, AR.

BACKGROUND: Direct observation of health care worker (HCW) hand hygiene
(HH) remains the gold standard, but implementation is challenging. Our
objective was to develop an accurate HH observation program using multiple
HCW volunteers.

METHODS: HH compliance was defined as correct HH performed before and
after contact with a patient or a patient’s environment. HCW volunteers
from each unit at our children’s hospital were trained by infection
preventionists to covertly collect HH observations during routine care
using an electronic tool. Questionnaires sent to observers in February and
December 2014 recorded demographic characteristics, observation time, and
scenarios assessing accuracy. HCWs were surveyed regarding their awareness
that their HH behavior was being recorded.

RESULTS: There were 146 HH observers. The majority of observers reported
making 1-2 observations per shift (65%) and taking?=10 minutes recording
an observation (85%). Between January 2012 and December 2014 there were
22,484 HH observations (average, 622 per month), including nurses (46%),
physicians (21%), and other HCWs (33%). Observers correctly recorded HH
behavior more than 90% of the time in 5 of the 6 scenarios. Most HCWs
(86%) were unaware they were being observed.

CONCLUSION: A direct observation program staffed by multiple HCW
volunteers can inexpensively and accurately collect HCW HH data.

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

KEYWORDS: Patient safety measures; Performance measurement; Quality
improvement
__________________________________________________________________
________________________________*_________________________________

18. Abstract: Curtains hide risks to health and hygiene
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/25027902

Nurs Stand. 2014 Jul 21;28(46):27.
Curtains hide risks to health and hygiene.

Winter G.

Curtains around hospital beds can harbour pathogens that pose an infection
risk to patients and staff.

A recent study by researchers at a Nottingham hospital identified curtains
as a potential source of an outbreak of group A streptococcus (GAS)
infection. Good hand hygiene is crucial to reduce the risks of
contamination.
__________________________________________________________________
________________________________*_________________________________

19. News

– Texas USA: Syringe Access Fund announces $2.6 million in grants

– Canada: Start prison-based needle and syringe programs, researchers
suggest The Liberal government should implement prison-based needle and
syringe programs to address rates of HIV and hepatitis C, proponents
say

– Seattle Washington USA: “What If You Got Pricked?” Seattle Group To
Teach Cleaning Up Dirty Needles

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/j9psmew
Texas USA: Syringe Access Fund announces $2.6 million in grants

Tammye Nash, Dallas Voice, Dallas Texas USA (16.02.16)

Officials with the Syringe Access Fund announced today (Tuesday, Feb. 16),
that the agency in January awarded 58 grants, totaling $2.6 million over
the next two years, that are focused on policy and implementation support
for syringe exchange programs.

Two of the grants are going to Texas agencies: Austin Harm Reduction
Coalition in San Marcos and Border AIDS Partnership in El Paso.

According to statistics provided by the Syringe Access Fund, infected
needles result in 3,000-5,000 new cases of HIV and approximately 10,000
new cases of hepatitis C each year in the U.S. Scientific evidence has
shown that syringe exchange programs significantly reduce transmission of
HIV, hepatitis C and other blood-borne illnesses without promoting drug
use, the Syringe Access Fund officials say.

The grants come about a month after President Obama signed new legislation
removing the federal ban on needle exchange programs. That legislation,
which the president signed in December, was passed in the wake of the
largest HIV outbreak in Indiana’s history last year, in which more than
188 people were newly infected, mainly through injecting drugs with dirty
needles.

CDC officials have estimated the lifetime treatment costs associated with
the Scott County outbreak may exceed $100 million.

The Syringe Access Fund, the largest private grant-making collaborative
supporting syringe exchange programs, was founded in 2004 and is supported
by the Elton John AIDS Foundation, (the now closed) Irene Diamond Fund,
Levi Strauss Foundation, Open Society Foundations and AIDS United. Syringe
Access Fund has distributed nearly $18 million through 347 grants to 161
organizations in 32 states, the District of Columbia and Puerto Rico.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/hc9pwwm
Canada: Start prison-based needle and syringe programs, researchers
suggest The Liberal government should implement prison-based needle and
syringe programs to address rates of HIV and hepatitis C, proponents say.

By Kristy Kirkup, The Canadian Press,Toronto Star, Canada (12.02.16)

[ Photo: Prison watchdog Howard Sapers said his office has previously
recommended that the Correctional Service of Canada explore all harm-
reduction options, including needle-exchange programs. Sean Kilpatrick /
The Canadian Press File Photo ]

Prison watchdog Howard Sapers said his office has previously recommended
that the Correctional Service of Canada explore all harm-reduction
options, including needle-exchange programs.

OTTAWA—The Liberal government should implement prison-based needle and
syringe programs to address rates of HIV and hepatitis C estimated to be
10 to 30 times higher than in the general population, proponents say.

Emily van der Meulen of Ryerson University, the lead author of a recent
study, said she wants to see the government review evidence on the
effectiveness of programs that have operated in countries like Switzerland
for more than 20 years.

“I’m hopeful that the government will look to this evidence, as well as to
our recent research report,” she said.

The issue is about health and human rights, she noted, adding that prisons
where such programs have been implemented have seen substantial benefits,
including reduced rates of needle-sharing and overdoses.

It would also be cost-effective, she said.

“The costs associated with HIV and hepatitis C virus are very high in
prison — roughly $30,000 per year for HIV treatment and about $60,000 for
hepatitis C,” she said.

“Research has shown that needle and syringe programs are among the most
cost-effective health measures for people who use drugs, whether in the
community or in prison.”

Canada lags behind on implementing such programs, said Sandra Ka Hon Chu
of the Canadian HIV/AIDS Legal Network.

“We have the resources in Canada to implement these programs,” she said.
“We have the evidence in Canada to implement these programs. There are
many groups across the country who support these programs.”

As the implementation push continues, the issue is playing out in court. A
former prisoner, along with organizations including the HIV/AIDS legal
network, filed a lawsuit against the government in September 2012 because
it did not make needles and syringes available in prison to prevent the
spread of HIV and hepatitis C.

In an interview with The Canadian Press, prison watchdog Howard Sapers
said his office has previously recommended that the Correctional Service
of Canada explore all harm-reduction options, including needle-exchange
programs.

There are particular issues related to incarceration that accelerate the
spread of infectious diseases, especially those that are blood-borne,
Sapers said.

“You have a high density of people living in fairly confined spaces. You
also have contraband drug use, often injectable drug use. You have prison
tattooing and you also have sexual contact. All of these activities really
increase the chances of spreading disease and we see that manifest in
things like HIV rates, which are much higher inside an institution than
they are in the community outside the institution, and hepatitis rates.”
In a statement on Friday, a spokesperson for Public Safety Minister Ralph
Goodale said the government cannot comment on the prison-based needle
exchange and syringe issue due to the ongoing litigation.

The government is committed to implementing evidence-based policies, said
press secretary Scott Bardsley.

The minister has also been mandated to address gaps in services to
indigenous peoples and those suffering from mental illnesses in the
criminal justice system, including the often-interrelated issue of
addictions, he said.

Aboriginal women were identified as a particularly high-risk group because
they reported the highest rates of HIV and hepatitis C infections,
according to a 2007 study by the Correctional Service of Canada.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/hk898tq
Seattle Washington USA: “What If You Got Pricked?” Seattle Group To Teach
Cleaning Up Dirty Needles

By Lindsay Cohen, KOMO News, Seattle Washington USA (10.02.16)

A neighborhood group plans to teach Seattle residents how to pick up
heroin needles.

Regulars at Mineral Springs Park, 1500 N 105th St, say heroin use at the
park is at an all-time high — and the dirty needles that come with it
have become a health hazard.

“There’s needles everywhere. We’re trying to clean it up, but a lot of us
don’t want to pick up needles,” said Sean Phillips, who has lived in the
neighborhood all of his adult life. “It’s very frustrating.”

On Tuesday, he pointed to the 14th hole on the park’s popular disc golf
course. Under a hand-crafted bench made out of driftwood and old tree
limbs sat piles of old syringes, bright orange caps, and more.

“It’s gotten worse over the past three years,” he added. “Very upset.
Frustrated.”

Heroin deaths spiked in by nearly 60 percent the Seattle / King County
metropolitan area in 2014, according to a study by the University of
Washington. The problem of discarded dirty needles seems to go along with
that — including in parks, on streetcorners, and in alleyways, said Mike
Cuarda with the North Precinct Advisory Council.

“The local businesses would tell us they were finding syringes in their
bathrooms,” Cuarda said. “Our group — we saw a need and so we just kind
of ran with it.”

Cuarda is now spearheading a free class to help teach people what to do
when they encounter dirty needles. The one-hour training course, on
February 20th, isn’t a solution, Cuarda said, but rather a way to keep
public areas clean and safe.

“We’re not promoting (the clean-ups),” he added. “Most these people are
doing it anyway. We just want it to be safe.”

One of those people picking up trash in his spare time is Jonathan Ortiz.
The die-hard disc golfer keeps a rake hidden along the golf course to
clean up trash and debris, along with needles and more.

“It’s disheartening. It’s unsafe for me. And it makes me feel like I
shouldn’t be here,” Ortiz said. “But that’s the turmoil that I face.
Because I want to be here.”

The free training session will be held at the University Masonic Lodge,
4338 University Way NE, from 10-11 am on February 20th. Sharps containers
will be offered, and a public health expert will speak, Cuarda said.

“Sometimes what we’ll do is we’ll grab two twigs that are around and
clench it and kind of throw it somewhere else,” said Ortiz, of cleaning up
the used needles around the park. “But that kind of sucks.”

“What if you got pricked?” he continued. “How bad would your day be?”
__________________________________________________________________
________________________________*_________________________________

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

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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
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The comments made in this forum are the sole responsibility of the writers
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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
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* Subscribe or un-subscribe by email to: sign.moderator@gmail.com, or to
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The SIGNpost Website is http://SIGNpostOnline.info

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We would like your help in building this archive. Please send your old
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________________________________*_________________________________

The SIGN Internet Forum was established at the initiative of the World
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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
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