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SIGNpost 00853

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST

Post00853  SIGNpost Note + Extract + Abstracts + News 18 May 2016

CONTENTS
0. Moderators Note: Moving to a new Listserv at the end of May 2016
1. Extract: Should it be a trigger to establish a medical regulatory body
in Korea?: A case of hepatitis C epidemic due to reuse of disposable
syringes in a local clinic in Seoul
2. Abstract: Impact of Safety-Engineered Devices on the Incidence of
Occupational Blood and Body Fluid Exposures Among Healthcare Personnel
in an Academic Facility, 2000-2014
3. Abstract: Prevalence and Reporting of Needle Stick Injuries: A Survey
of Surgery Team Members in Kermanshah University of Medical Sciences in
2012
4. Abstract: Clinical review: the hospital of the future – building
intelligent environments to facilitate safe and effective acute care
delivery
5. Abstract: Client-Level Coverage of Needle and Syringe Program and High-
Risk Injection Behaviors: A Case Study of People Who Inject Drugs in
Kermanshah, Iran
7. Abstract: The effect of on-site and outreach-based needle and syringe
programs in people who inject drugs in Kermanshah, Iran
8. Abstract: The Significance of Harm Reduction as a Social and Health
Care Intervention for Injecting Drug Users: An Exploratory Study of a
Needle Exchange Program in Fresno, California
9. Abstract: Risk Factors for Complications during Outpatient Parenteral
Antimicrobial Therapy for Adult Orthopedic and Neurosurgical Infections
10. Abstract: Functional Evaluation of the Reusable JuniorSTAR® Half-Unit
Insulin Pen
11. Abstract: Multiple withdrawals from single-use vials: a study on
sterility
12. Abstract: Knowledge, Attitude, and Practices of Healthcare Personnel
Regarding the Transmission of Pathogens via Fomites at a Tertiary Care
Hospital in Karachi, Pakistan
13. Abstract: A police education programme to integrate occupational
safety and HIV prevention: protocol for a modified stepped-wedge study
design with parallel prospective cohorts to assess behavioural
outcomes
14. Abstract: Patient Comfort During Contrast Media Injection in Coronary
Computed Tomographic Angiography Using Varying Contrast Media
Concentrations and Flow Rates: Results From the EICAR Trial
15. Abstract: Relative Bioavailability of a Single Dose of Belimumab
Administered Subcutaneously by Prefilled Syringe or Autoinjector in
Healthy Subjects
16. Abstract: Loss of confidence in vaccines following media reports of
infant deaths after hepatitis B vaccination in China
17. No Abstract: Reducing Insulin Syringe Reuse Can Help Lower Cost of
Insulin Waste In Brazil
18. No Abstract: Infection control II: A practical guide to getting to zero
19. News
– Philippines: Dispatches: The Philippines’ Unaddressed HIV Epidemic
– Indonesia: ‘No more money for our needles’
– UK: Horror as mums find upstanding needles on swings and slides at
children’s play area
– Ontario Canada: Oneida shores a medical waste dump from dirty drug
needles washing up from London: residents
– Australia: Used syringes found in Elanora skate park on the Gold Coast
by parent
– NY USA: NYC’s First City Park Syringe Disposal Unit Is Shaped Like A Daisy
– New Hampshire USA: Hospital Wants Help on Hep-C Settlements

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0. Moderators Note: Moving to a new Listserv at the end of May 2016
__________________________________________________________________
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1. Extract: Should it be a trigger to establish a medical regulatory body
in Korea?: A case of hepatitis C epidemic due to reuse of disposable
syringes in a local clinic in Seoul
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722171/

J Educ Eval Health Prof. 2015 Dec 30;12:58. Free PMC Article
Should it be a trigger to establish a medical regulatory body in Korea?: A
case of hepatitis C epidemic due to reuse of disposable syringes in a
local clinic in Seoul.

Huh S1.

1Department of Parasitology and Institute of Medical Education, College of
Medicine, Hallym University, Chuncheon, Korea.

Free PMC Article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722171/
__________________________________________________________________
Extract Extract Extract Extract Extract Extract Extract Extract
__________________________________________________________________
Should it be a trigger to establish a medical regulatory body in Korea?:
A case of hepatitis C epidemic due to reuse of disposable syringes in a
local clinic in Seoul.

A case of hepatitis C epidemic was reported at a local clinic in Seoul,
Korea, according to official reports by the Korea Centers for Disease
Control and Prevention (KCDC) on November 22 and December 4, 2015 [1].
Prior to December 4, 2015, 78 anti-hepatitis C virus seropositive visitors
(7.8%) out of 1,055 examined were found. Seropositive visitors all
received infusion treatment at the local clinic. Of the 78 positive
visitors, hepatitis C virus DNA was detected in 55, meaning infection was
present, although there were no cases of severe complication. This
situation was first reported to KCDC on November 19, 2015. KCDC dispatched
epidemiology officers to the local clinic, where they interviewed related
persons and searched the medical records. They concluded that the
hepatitis C epidemic originated from reuse of disposable syringes during
fluid infusion, enabling transmission of the hepatitis C virus through
contaminated blood. The seropositive rate of hepatitis C viral infection
in Korean adults was reported to be 0.7% in 2012-2014
(https://knhanes.cdc.go.kr); therefore, the 7.8% positive rate could not
be explained as community acquired infection. The hepatitis C virus
genotype 1a, the genotype of the positive visitors, was also detected in
the clinic’s environmental samples. The local clinic was shut down
immediately and visitors received follow-up screening for blood-borne
infectious diseases. A physician from the local clinic confessed that he
had been disabled due to cerebral hemorrhage since 2012, resulting
specifically in cerebral and language disabilities. He also stated that
the reuse of disposable syringes occurred after his cerebral illness.

After a briefing of the above case, the Ministry of Health and Welfare
announced follow-up measures to prevent future instances of this
unbelievable accident. First, enforcement of medical regulation is to be
processed after organizing an “Ad hoc committee for improvement of medical
license registration” in December 2015; a new policy proposal will be
completed by February 2016. The health status criteria concerning
physicians who should not practice will be discussed in the committee.
Second, continuing medical education is to be enforced. Third, medical
personnel associations such as the Korean Medical Association (KMA) are to
be provided with authority to report unethical practice by members to the
government after investigation by the ethics committee.

Continues at the link
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722171/

* Articles from Journal of Educational Evaluation for Health Professions
are provided here courtesy of National Health Personnel Licensing
Examination Board of the Republic of Korea
__________________________________________________________________
________________________________*_________________________________

2. Abstract: Impact of Safety-Engineered Devices on the Incidence of
Occupational Blood and Body Fluid Exposures Among Healthcare Personnel
in an Academic Facility, 2000-2014
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26856246

Infect Control Hosp Epidemiol. 2016 May;37(5):497-504.
Impact of Safety-Engineered Devices on the Incidence of Occupational Blood
and Body Fluid Exposures Among Healthcare Personnel in an Academic
Facility, 2000-2014.

Kanamori H1, Weber DJ1, DiBiase LM1, Pitman KL2, Consoli SA2, Hill J2,
Sickbert-Bennett EE1, Rutala WA1.

11Division of Infectious Diseases,University of North Carolina,Chapel
Hill,North Carolina.
23Occupational Health Service,University of North Carolina Health
Care,Chapel Hill,North Carolina.

BACKGROUND Legislative actions and advanced technologies, particularly
dissemination of safety-engineered devices, have aided in protecting
healthcare personnel from occupational blood and body fluid exposures
(BBFE).

OBJECTIVE To investigate the trends in BBFE among healthcare personnel
over 15 years and the impact of safety-engineered devices on the incidence
of percutaneous injuries as well as features of injuries associated with
these devices.

METHODS Retrospective cohort study at University of North Carolina
Hospitals, a tertiary care academic facility. Data on BBFE in healthcare
personnel were extracted from Occupational Health Service records
(2000-2014). Exposures associated with safety-engineered and conventional
devices were compared. Generalized linear models were applied to measure
the annual incidence rate difference by exposure type over time.

RESULTS A total of 4,300 BBFE, including 3,318 percutaneous injuries
(77%), were reported. The incidence rate for overall BBFE was
significantly reduced during 2000-2014 (incidence rate difference, 1.72;
P=.0003). The incidence rate for percutaneous injuries was also
dramatically reduced during 2001-2006 (incidence rate difference, 1.37;
P=.0079) but was less changed during 2006-2014. Percutaneous injuries
associated with safety-engineered devices accounted for 27% of all BBFE.
BBFE was most commonly due to injecting through skin, placing intravenous
catheters, and blood drawing.

CONCLUSIONS Our study revealed significant overall reduction in BBFE and
percutaneous injuries likely due in part to the impact of safety-
engineered devices but also identified that a considerable proportion of
percutaneous injuries is now associated with these devices. Additional
prevention strategies are needed to further reduce percutaneous injuries
and improve design of safety-engineered devices. Infect Control Hosp
Epidemiol 2016;37:497-504.
__________________________________________________________________
________________________________*_________________________________

3. Abstract: Prevalence and Reporting of Needle Stick Injuries: A Survey
of Surgery Team Members in Kermanshah University of Medical Sciences in
2012
__________________________________________________________________

http://www.ccsenet.org/journal/index.php/gjhs/article/view/49243

Glob J Health Sci. 2015 Aug 19;8(3):245-51.
Prevalence and Reporting of Needle Stick Injuries: A Survey of Surgery
Team Members in Kermanshah University of Medical Sciences in 2012.

Khatony A1, Abdi A, Jafari F, Vafaei K.

1nursing and midwifery school, Kermanshah University of Medical Sciences,
Kermanshah, Iran. Akhatony@gmail.com.

BACKGROUND: Surgeons are one of the groups, most highly exposed to the
risk of needle stick injuries at work. The present study aims to determine
the prevalence and reporting of needle stick injuries during the first 6
months of 2012, in faculty surgeons affiliated to the Kermanshah
University of Medical Sciences.

METHODS: In a cross-sectional descriptive-analytical survey, 29 surgeons
were studied based on the census method. A reliable and valid
questionnaire was used as a research instrument to collect the data. Data
was analyzed using SPSS v.16 and based on descriptive and inferential
statistics.

RESULTS: Among 29 recruited surgeons, 5 (17.2%) had needle stick injuries
during the 6 months, only one of whom had followed the established
guidelines about reporting and following treatment. The most common
instrument causing injury was the suture needle (60%). Significant
differences were found in both groups of the injured and non-injured in
term of gender (X(2)=5.612, P= 0.003), and number of patients (Z= 2.40,
P=0.016) and daily working hours (Z=2.85, P=0.04).

CONCLUSIONS: In relation to the relatively high prevalence of needle stick
injuries among the surgeons and their lack of reporting, it is suggested
that the Safety Guidelines in the operating room are carefully observed.
Moreover, safer and lower risk surgical Instruments should be used.

Free full text PDF http://dx.doi.org/10.5539/gjhs.v8n3p245
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Clinical review: the hospital of the future – building
intelligent environments to facilitate safe and effective acute care
delivery
__________________________________________________________________

http://ccforum.biomedcentral.com/articles/10.1186/cc11142

Crit Care. 2012 Dec 12;16(2):220.
Clinical review: the hospital of the future – building intelligent
environments to facilitate safe and effective acute care delivery.

Pickering BW1, Litell JM, Herasevich V, Gajic O.

1Department of Anesthesiology, Division of Critical Care Medicine, Mayo
Clinic, 200 First Street SW, Rochester, MN 55905, USA.
pickering.brian@mayo.edu

The translation of knowledge into rational care is as essential and
pressing a task as the development of new diagnostic or therapeutic
devices, and is arguably more important. The emerging science of health
care delivery has identified the central role of human factor ergonomics
in the prevention of medical error, omission, and waste. Novel informatics
and systems engineering strategies provide an excellent opportunity to
improve the design of acute care delivery. In this article, future
hospitals are envisioned as organizations built around smart environments
that facilitate consistent delivery of effective, equitable, and error-
free care focused on patient-centered rather than provider-centered
outcomes.

Free BMC Article http://ccforum.biomedcentral.com/articles/10.1186/cc11142
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Client-Level Coverage of Needle and Syringe Program and High-
Risk Injection Behaviors: A Case Study of People Who Inject Drugs in
Kermanshah, Iran
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4741237/

Addict Health. 2015 Summer-Autumn; 7(3-4): 164–173.
Client-Level Coverage of Needle and Syringe Program and High-Risk
Injection Behaviors: A Case Study of People Who Inject Drugs in
Kermanshah, Iran.

Noroozi M1, Mirzazadeh A2, Noroozi A3, Mehrabi Y4, Hajebi A5, Zamani S6,
Sharifi H7, Higgs P8, Soori H9.

1PhD Candidate, Department of Epidemiology, School of Public Health,
Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2Assistant Professor, Global Health Sciences, University of California,
San Francisco, CA, USA AND Regional Knowledge Hub and WHO Collaborating
Centre for HIV Surveillance, Institute for Futures Studies in Health,
Kerman University of Medical Sciences, Kerman, Iran.
3Psychiatrist, Iranian National Center for Addiction Studies (INCAS),
Iranian Institute for Reduction of High-Risk Behaviors AND School of
Advanced Technologies in Medicine, Tehran University of Medical Sciences,
Tehran, Iran.
4Professor, Department of Epidemiology, School of Public Health, Shahid
Beheshti University of Medical Sciences, Tehran, Iran.
5Associate Professor, Mental Health Research Center and Department of
Community Psychiatry, School of Behavioral Sciences and Mental Health,
Tehran Institute of Psychiatry, Iran University of Medical Sciences,
Tehran, Iran.
6Assistant Professor, Global Fund to Fight AIDS, Tuberculosis and Malaria,
Geneva, Switzerland.
7Assistant Professor, Regional Knowledge Hub and WHO Collaborating Centre
for HIV Surveillance, Institute for Futures Studies in Health, Kerman
University of Medical Sciences, Kerman, Iran.
8Senior Fellow, National Drug Research Institute, Faculty of Health
Sciences, Curtin University, Melbourne, Australia.
9Professor, Safety Promotion and Injury Prevention Research Center AND
Department of Epidemiology, School of Public Health, Shahid Beheshti
University of Medical Sciences, Tehran, Iran.

BACKGROUND: Needle-syringe programs (NSP) have been running in Iran since
2002. However, the coverage of such program among the NSP clients at the
individual level was not studies yet. This study aimed to determine the
client coverage of NSP and its correlation with high injection-related
risk behaviors.

METHODS: A cross-sectional survey was conducted in Kermanshah province,
Iran, in 2014. 230 people who inject drugs (PWID) recruited from two drop-
in centers (DICs) from April to September 2014, participated in a face-to-
face interview to provide information related individual coverage of NSP,
demographic characteristics, and injecting behaviors 30 days prior to the
interview.

FINDINGS: Overall, the average of syringe coverage was 158% [95%
confidence interval (CI) = 65.7-205.5], while 56% (95% CI = 40-97) have
individual converge less than 100%. Needle/syringe sharing was
significantly higher among individual with low NSP coverage [adjusted odds
ratio (AOR) = 2.6, 95% CI = 1.3-6.2]. About 85% participants with coverage
of less than 100% reported reuse of syringe within the last 30 days (AOR =
3.2, 95% CI = 1.4-7.7).

CONCLUSION: PWID are different regarding their NSP individual-level
converges. There are certain clusters of PWID, who do not receive
sufficient number of syringes. Given that insufficient individual syringe
coverage level is highly associated with injection risk behaviors, reasons
for such low converge need to be assessed and addressed carefully.

KEYWORDS: Effectiveness; Individual-coverage; Iran; Needle-syringe
programs; Risk behaviors

Free PMC Article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4741237/
__________________________________________________________________
________________________________*_________________________________

7. Abstract: The effect of on-site and outreach-based needle and syringe
programs in people who inject drugs in Kermanshah, Iran
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26764125

Int J Drug Policy. 2016 Jan;27:127-31. Free Full Text
The effect of on-site and outreach-based needle and syringe programs in
people who inject drugs in Kermanshah, Iran.

Nazari SS1, Noroozi M2, Soori H3, Noroozi A4, Mehrabi Y3, Hajebi A5,
Sharifi H6, Higgs P7, Mirzazadeh A8.
Author information
1Safety Promotion and Injury Prevention Research Center, Department of
Epidemiology, School of Public Health, Shahid Beheshti University of
Medical Sciences, Tehran, Iran.
2Department of Psychiatry, University of Social Welfare and Rehabilitation
Sciences, Tehran, Iran.
3Department of Epidemiology, School of Public Health, Shahid Beheshti
University of Medical Sciences, Tehran, Iran.
4School of Advanced Technologies in Medicine (SATM), Tehran University of
Medical Sciences (TUMS), Tehran, Iran; Iranian National Center for
Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk
Behaviors, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
5Mental Health Research Center, Tehran Institute of Psychiatry, School of
Behavioral Sciences and Mental Health, Iran University of Medical
Sciences, Tehran, Iran.
6Regional Knowledge Hub, and WHO Collaborating Centre for HIV
Surveillance, Institute for Futures Studies in Health, Kerman University
of Medical Sciences, Kerman, Iran.
7National Drug Research Institute, Faculty of Health Sciences, Curtin
University, Australia.
8Regional Knowledge Hub, and WHO Collaborating Centre for HIV
Surveillance, Institute for Futures Studies in Health, Kerman University
of Medical Sciences, Kerman, Iran; Global Health Sciences, University of
California, San Francisco, CA, USA. Electronic address:
ali.mirzazadeh@ucsf.edu.

BACKGROUND: Needle and syringe programs (NSPs) are widely used to reduce
harms associated with drug injecting. This study assessed the effect of
facility-based (on-site services at drop-in centre) and outreach models of
NSP on injection risk behaviours.

METHODS: Self-reported data from 455 people who injected drugs (PWID)
during 2014 in Kermanshah, Iran, were examined to measure demographic
characteristics and risk behaviors. Self-reported and program data were
also assessed to identify their main source of injection equipment.
Participants were divided into three sub-groups: facility-based NSP users,
outreach NSP users and non-users (comparison group). Coarsened exact
matching was used to make the three groups statistically equivalent based
on age, place of residence, education and income, and groups were compared
regarding the proportion of borrowing or lending of syringes/cookers,
reusing syringes and recent HIV testing.

RESULTS: Overall, 76% of participants reported any NSP service use during
the two months prior to interview. Only 23% (95%CI: 17-27) reported
outreach NSP as their main source of syringes. Using facility-based NSP
significantly decreased recent syringe borrowing (OR: 0.27, 95%CI:
0.10-0.70), recent syringe reuse (OR: 0.38, 95%CI: 0.23-0.68) and
increased recent HIV testing (OR: 2.60, 95%CI: 1.48-4.56). Similar effects
were observed among outreach NSP users; in addition, the outreach NSP
model significantly reduced the chance of lending syringes (OR: 0.31,
95%CI: 0.15-0.60), compared to facility-based NSP (OR: 1.25, 95%CI:
0.74-2.17).

CONCLUSION: These findings suggest that the outreach NSP model is as
effective as facility-based NSP in reducing injection risk behaviours and
increasing the rate of HIV testing. Outreach NSP was even more effective
than facility-based in reducing the lending of syringes to others. Scaling
up outreach NSP is an effective intervention to further reduce
transmission of HIV via needle sharing.

Copyright © 2015 Elsevier B.V. All rights reserved.

KEYWORDS: Injection risk behaviours; Matching; Needle and syringe
programs; People who inject drugs
__________________________________________________________________
________________________________*_________________________________

8. Abstract: The Significance of Harm Reduction as a Social and Health
Care Intervention for Injecting Drug Users: An Exploratory Study of a
Needle Exchange Program in Fresno, California
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27167664

Soc Work Public Health. 2016 May 11:1-10.
The Significance of Harm Reduction as a Social and Health Care
Intervention for Injecting Drug Users: An Exploratory Study of a Needle
Exchange Program in Fresno, California.

Clarke K1, Harris D1, Zweifler JA2, Lasher M2, Mortimer RB2, Hughes S2.

1a Department of Social Work , California State University , Fresno ,
California, USA.
2b Department of Family & Community Medicine , University of California,
San Francisco, Fresno Medical Education Program , Fresno , California ,
USA.

Infectious disease remains a significant social and health concern in the
United States. Preventing more people from contracting HIV/AIDS or
Hepatitis C (HCV), requires a complex understanding of the interconnection
between the biomedical and social dimensions of infectious disease. Opiate
addiction in the US has skyrocketed in recent years. Preventing more cases
of HIV/AIDS and HCV will require dealing with the social determinants of
health.

Needle exchange programs (NEPs) are based on a harm reduction approach
that seeks to minimize the risk of infection and damage to the user and
community.

This article presents an exploratory small-scale quantitative study of the
injection drug using habits of a group of injection drug users (IDUs) at a
needle exchange program in Fresno, California. Respondents reported
significant decreases in high risk IDU behaviors, including sharing of
needles and to a lesser extent re-using of needles. They also reported
frequent use of clean paraphernalia.

Greater collaboration between social and health outreach professionals at
NEPs could provide important frontline assistance to people excluded from
mainstream office-based services and enhance efforts to reduce HIV/AIDS or
HCV infection.

KEYWORDS: abscess; harm reduction; injecting drug users; needle-exchange
programs; social determinants of health
__________________________________________________________________
________________________________*_________________________________

9. Abstract: Risk Factors for Complications during Outpatient Parenteral
Antimicrobial Therapy for Adult Orthopedic and Neurosurgical Infections
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26741876

South Med J. 2016 Jan;109(1):53-60.
Risk Factors for Complications during Outpatient Parenteral Antimicrobial
Therapy for Adult Orthopedic and Neurosurgical Infections.

Felder KK1, Marshall LM1, Vaz LE1, Barnes PD1.

1From the Departments of Infectious Diseases and Orthopedics and
Rehabilitation, Oregon Health and Science University, Portland.

OBJECTIVES: Outpatient parenteral antimicrobial therapy (OPAT) is an
effective way of treating infections, but complications are common. We
identified patient characteristics and OPAT treatment factors associated
with increased risk of OPAT-related complications.

METHODS: We used a retrospective cohort design that assessed 337 adult
patients treated with OPAT for orthopedic and neurosurgical infections
between August 1, 2008 and May 30, 2010. Independent variables included
demographics, infection characteristics, lead time factors, OPAT treatment
factors, and comorbid conditions. Multivariable log-binomial regression
was used to estimate the risk of OPAT complications.

RESULTS: The mean patient age was 55 years (range 19-87), 86% had an
orthopedic infection, and 44% were treated with intravenous vancomycin.
OPAT complications were seen in 45% (152/337) of the cohort. Risk ratios
for OPAT complications were 1.9 (95% confidence interval 1.4-2.5) in
patients having no primary care provider, 1.7 (95% confidence interval
1.3-2.1) for those treated with vancomycin.

CONCLUSIONS: Identifying specific patient characteristics and OPAT
treatment factors could facilitate OPAT process improvements to reduce the
risk of OPAT complications for vulnerable patients.
__________________________________________________________________
________________________________*_________________________________

10. Abstract: Functional Evaluation of the Reusable JuniorSTAR® Half-Unit
Insulin Pen
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/25633967

J Diabetes Sci Technol. 2015 May;9(3):625-31.
Functional Evaluation of the Reusable JuniorSTAR® Half-Unit Insulin Pen.

Klonoff D1, Nayberg I2, Rabbone I3, Domenger C4, Stauder U5, Oualali H5,
Danne T6.

1Diabetes Research Institute, Mills-Peninsula Health Services, San Mateo,
CA, USA dklonoff@diabetestechnology.org.
2Diabetes Research Institute, Mills-Peninsula Health Services, San Mateo,
CA, USA.
3S.S.V.U. Endocrinologia e Diabetologia, Ospedale Infantile Regina
Margherita, Turin, Italy.
4Sanofi, Paris, France.
5Sanofi, Frankfurt, Germany.
6Kinder und Jugendkrankenhaus “Auf der Bult,” Diabetes Centre for Children
and Adolescents, Hannover, Germany.

BACKGROUND: The functional performance of the JuniorSTAR(®) (Sanofi,
Paris, France) half-unit insulin pen was evaluated through a series of
specific objective tests to assess the dose accuracy, pen weight,
injection force, and dialing torque.

METHOD: Pens (n = 60) were tested under standard atmospheric conditions
with 3 different types of insulins manufactured by Sanofi (insulin
glargine, insulin glulisine, and biphasic insulin isophane). The dose
accuracy was tested according to the ISO 11608-1:2012 standards. Injection
doses of 0.010, 0.155, and 0.300 ml were evaluated. For mean weight
evaluation, the pens without the cartridge were weighed on precision
balances. The injection force was measured using a texture analyzer and
the dialing torque was measured using a torque meter.

RESULTS: JuniorSTAR met the ISO 11608-1:2012 criteria for dose accuracy as
all the delivered doses were within the predefined limits for all types of
insulin tested. The mean weight of the JuniorSTAR pen was 33.4 g (SD =
0.075). The mean injection force was 6.0 N (SD = 0.8), 4.3 N (SD = 0.4),
and 5.1 N (SD = 0.6) for insulin glargine, insulin glulisine, and biphasic
insulin isophane, respectively. The mean dialing torque was 5.09 Ncm (SD =
0.29) and 5.88 Ncm (SD = 0.53) for setting and correcting a dose,
respectively.

CONCLUSIONS: Together with results from a previously reported usability
survey, these results show that the JuniorSTAR reusable, half-unit pen is
a lightweight and accurate device for insulin delivery with a dialing
torque and injection force suitable for young people with type 1 diabetes.

© 2015 Diabetes Technology Society.

KEYWORDS: JuniorSTAR®; dose accuracy; half-unit; injection force; insulin
pen; weight

Full Free Article http://dst.sagepub.com/content/9/3/625.long
__________________________________________________________________
________________________________*_________________________________

11. Abstract: Multiple withdrawals from single-use vials: a study on
sterility
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/25769293

Int J Pharm. 2015 May 15;485(1-2):160-3.

 

Multiple withdrawals from single-use vials: a study on sterility.

Ripoll Gallardo A1, Meneghetti G2, Ragazzoni L3, Kroumova V4, Ferrante D5,
Ingrassia PL6, Ruzza P7, Dell’Era A8, Boniolo E9, Koraqe G10, Faggiano
F11, Della Corte F12.

1CRIMEDIM – Research Center in Emergency and Disaster Medicine, University
of Piemonte Orientale A. Avogadro, Novara, Italy. Electronic address:
ripoll@med.unipmn.it.
2CRIMEDIM – Research Center in Emergency and Disaster Medicine, University
of Piemonte Orientale A. Avogadro, Novara, Italy. Electronic address:
meneghettigrazia@gmail.com.
3CRIMEDIM – Research Center in Emergency and Disaster Medicine, University
of Piemonte Orientale A. Avogadro, Novara, Italy. Electronic address:
luca.ragazzoni@med.unipmn.it.
4Department of Virology and Microbiology, Ospedale Maggiore della Carità,
Novara, Italy. Electronic address:
vesselina.kroumova@maggioreosp.novara.it.
5CPO-Piemonte and Unit of Medical Statistics and Epidemiology, Department
of Translational Medicine, University of Piemonte Orientale, Novara,
Italy. Electronic address: daniela.ferrante@med.unipmn.it.
6CRIMEDIM – Research Center in Emergency and Disaster Medicine, University
of Piemonte Orientale A. Avogadro, Novara, Italy. Electronic address:
pierluigi.ingrassia@med.unipmn.it.
7Department of Virology and Microbiology, Ospedale Maggiore della Carità,
Novara, Italy. Electronic address: p.tagliani@libero.it.
8Department of Virology and Microbiology, Ospedale Maggiore della Carità,
Novara, Italy. Electronic address: angeladellera58@yahoo.it.
9CRIMEDIM – Research Center in Emergency and Disaster Medicine, University
of Piemonte Orientale A. Avogadro, Novara, Italy. Electronic address:
ester1086@libero.it.
10CRIMEDIM – Research Center in Emergency and Disaster Medicine,
University of Piemonte Orientale A. Avogadro, Novara, Italy. Electronic
address: gjergji33@yahoo.it.
11Department of Translational Medicine, Università del Piemonte Orientale
Amedeo Avogadro, Novara, Italy. Electronic address:
fabrizio.faggiano@med.unipmn.it.
12CRIMEDIM – Research Center in Emergency and Disaster Medicine,
University of Piemonte Orientale A. Avogadro, Novara, Italy. Electronic
address: dellacorte.f@gmail.com.

BACKGROUND: Reutilization of single-use vials containing medical drugs is
still under discussion. This practice has been adopted as a standard to
avoid drug wastage, particularly in developing countries and in the
aftermath of disasters. Some studies have assessed sterility of
medications stored in single-use vials after utilization as multiple
doses; however, most of these were limited to one single drug, included a
low number of samples and did not consider an intermediate transfer step
from the vial to a disposable syringe. The purpose of this study was to
assess microbial contamination of samples withdrawn over three days from
disposable syringes prepared from single-use vials.

METHODS: A prospective sterility study was conducted. A total of 600
initial samples were prepared from six-hundred 10 mL single-use vials of
physiological solution into six-hundred 20 mL disposable syringes. Samples
were prepared in three different standard operating rooms, on six
different days and by the same operator, using basic sterile technique.
All syringes were capped, placed together in a non-sterile steel
container, covered with a clean drape and stored in the refrigerator at
4°C under non-sterile conditions. Using basic sterile technique, four
samples were withdrawn daily and cultured from each syringe over the next
3 days. Microbial growth was examined on Sabouraud agar and chocolate agar
culture media.

RESULTS: A total of 7200 samples were collected and 14,400 cultures were
performed. No evidence of microbial growth in any of the culture media
plates was found.

CONCLUSION: This study demonstrated that contents initially stored in
single-use vials and subsequently transferred into disposable syringes in
an operating room using sterile technique, maintain sterility after 4
withdrawals per day for a total of 3 days.

Copyright © 2015 Elsevier B.V. All rights reserved.

KEYWORDS: Disposable equipment; Drug contamination; Drug packaging; Drug
storage; Single-use vial; Syringes/microbiology
__________________________________________________________________
________________________________*_________________________________

12. Abstract: Knowledge, Attitude, and Practices of Healthcare Personnel
Regarding the Transmission of Pathogens via Fomites at a Tertiary Care
Hospital in Karachi, Pakistan
__________________________________________________________________

http://ofid.oxfordjournals.org/content/3/1/ofv208 Free Full Article

Open Forum Infect Dis. 2015 Dec 22;3(1):ofv208.
Knowledge, Attitude, and Practices of Healthcare Personnel Regarding the
Transmission of Pathogens via Fomites at a Tertiary Care Hospital in
Karachi, Pakistan.

Aftab HB1, Zia B1, Zahid MF1, Raheem A2, Beg MA2.

1Medical Graduate , Aga Khan University.
2Department of Pathology and Laboratory Medicine , Aga Khan University ,
Karachi , Pakistan.

Background.  Fomites are objects that can become colonized and serve as
vectors in the transmission of pathogenic microorganisms. Literature
examining the knowledge of healthcare personnel about this method of
spread of infection is lacking.

We conducted a study to assess the knowledge, attitude, and practices of
healthcare personnel across different areas of patient care regarding the
spread of infections at a tertiary care hospital in Karachi, Pakistan.

Methods.  A descriptive, cross-sectional study was conducted among
healthcare personnel using a self-administered questionnaire. The
questionnaire contained sections pertaining to demographic details and
knowledge, attitude, and practices regarding fomites and their role in the
transmission of pathogens.

Results.  Three hundred and fifty-three participants completed the
questionnaire: 168 were male and 185 were female. Laboratory coats,
stethoscopes, and bedside curtains were most frequently identified as
fomites by the participants. Medical students had significantly lower mean
scores in the knowledge and attitude sections than consultant physicians,
resident physicians, and nurses. Nurses scored higher than consultant
physicians, resident physicians, and medical students regarding practices
that minimize fomite-borne spread of infections. 95% of the participants
scored above 50% on the knowledge component of the questionnaire, but only
32.3% scored above 50% in the practices section.

Conclusions.  Our results show a large gap between the knowledge about
fomites acting as vectors in the spread of pathogens and practices done to
minimize this spread. Possessing adequate knowledge is ineffectual until
and unless it is translated into the proper application of infection
control practices. Incorporating awareness sessions and exercises into
curricula are a reasonable way to raise awareness regarding this subject.

KEYWORDS: contamination; fomites; hospital-acquired infections; resistant
pathogens; transmission
__________________________________________________________________
________________________________*_________________________________

13. Abstract: A police education programme to integrate occupational
safety and HIV prevention: protocol for a modified stepped-wedge study
design with parallel prospective cohorts to assess behavioural
outcomes
__________________________________________________________________

http://bmjopen.bmj.com/content/5/8/e008958.long

BMJ Open. 2015 Aug 10;5(8):e008958. Open Access
A police education programme to integrate occupational safety and HIV
prevention: protocol for a modified stepped-wedge study design with
parallel prospective cohorts to assess behavioural outcomes.

Strathdee SA1, Arredondo J1, Rocha T1, Abramovitz D1, Rolon ML2, Patiño
Mandujano E3, Rangel MG4, Olivarria HO5, Gaines T1, Patterson TL1,
Beletsky L6.

1Department of Medicine, University of California San Diego, La Jolla,
California, USA.
2Department of Medicine, University of California San Diego, La Jolla,
California, USA Xochicalco University, Tijuana, Baja California, Mexico.
3Xochicalco University, Tijuana, Baja California, Mexico.
4U.S.-Mexico Border Health Commission, Mexico Section, Tijuana, Baja
California, Mexico.
5Secretary of Municipal Public Safety, Tijuana, Baja California, México.
6Department of Medicine, University of California San Diego, La Jolla,
California, USA School of Law and Bouvé College of Health Sciences,
Northeastern University, Boston, Massachusetts, USA.

INTRODUCTION: Policing practices are key drivers of HIV among people who
inject drugs (PWID). This paper describes the protocol for the first study
to prospectively examine the impact of a police education programme (PEP)
to align law enforcement and HIV prevention. PEPs incorporating HIV
prevention (including harm reduction programmes like syringe exchange)
have been successfully piloted in several countries but were limited to
brief pre-post assessments; the impact of PEPs on policing behaviours and
occupational safety is unknown.

OBJECTIVES: Proyecto ESCUDO (SHIELD) aims to evaluate the efficacy of the
PEP on uptake of occupational safety procedures, as assessed through the
incidence of needle stick injuries (NSIs) (primary outcome) and changes in
knowledge of transmission, prevention and treatment of HIV and viral
hepatitis; attitudes towards PWID, adverse behaviours that interfere with
HIV prevention and protective behaviours (secondary outcomes).

METHODS/ANALYSIS: ESCUDO is a hybrid type I design that simultaneously
tests an intervention and an implementation strategy. Using a modified
stepped-wedge design involving all active duty street-level police
officers in Tijuana (N = ∼ 1200), we will administer one 3 h PEP course to
groups of 20-50 officers until the entire force is trained. NSI incidence
and geocoded arrest data will be assessed from department-wide de-
identified data. Of the consenting police officers, a subcohort (N=500)
will be randomly sampled from each class to undergo pre-PEP and post-PEP
surveys with a semiannual follow-up for 2 years to assess self-reported
NSIs, attitudes and behaviour changes. The impact on PWIDs will be
externally validated through a parallel cohort of Tijuana PWIDs.

ETHICS/DISSEMINATION: Research ethics approval was obtained from the USA
and Mexico. Findings will be disseminated through open access to protocol
materials through the Law Enforcement and HIV Network.

TRIAL REGISTRATION NUMBER: NCT02444403.

Published by the BMJ Publishing Group Limited.

KEYWORDS: EDUCATION & TRAINING (see Medical Education & Training);
EPIDEMIOLOGY; OCCUPATIONAL & INDUSTRIAL MEDICINE; PREVENTIVE MEDICINE;
PUBLIC HEALTH

Free Article http://bmjopen.bmj.com/content/5/8/e008958.long
__________________________________________________________________
________________________________*_________________________________

14. Abstract: Patient Comfort During Contrast Media Injection in Coronary
Computed Tomographic Angiography Using Varying Contrast Media
Concentrations and Flow Rates: Results From the EICAR Trial
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27164459

Invest Radiol. 2016 May 10.
Patient Comfort During Contrast Media Injection in Coronary Computed
Tomographic Angiography Using Varying Contrast Media Concentrations and
Flow Rates: Results From the EICAR Trial.

Kok M1, Mihl C, Hendriks BM, Altintas S, Eijsvoogel NG, Kietselaer BL,
Wildberger JE, Das M.

1From the *Department of Radiology, †CARIM, School for Cardiovascular
Diseases, and ‡Department of Cardiology, Maastricht University Medical
Center, Maastricht, the Netherlands.

PURPOSE: Pain sensation and extravasation are potential drawbacks of
contrast media (CM) injection during computed tomographic angiography. The
purpose was to evaluate safety and patient comfort of higher flow rates in
different CM protocols during coronary computed tomographic angiography.

METHODS: Two hundred consecutive patients of a double-blind randomized
controlled trial (NCT02462044) were analyzed. Patients were randomized to
receive 94 mL of prewarmed iopromide 240 mg I/mL at 8.3 mL/s (group I), 75
mL of 300 mg I/mL at 6.7 mL/s (group II), or 61 mL of 370 mg I/mL at 5.4
mL/s (group III), respectively. Iodine delivery rate (2.0 g I/s) and total
iodine load (22.5 g I) were kept identical. Outcome was defined as
intravascular enhancement, patient comfort during injection, and injection
safety, expressed as the occurrence of extravasation. Patients completed a
questionnaire for comfort, pain, and stress during CM injection. Comfort
was graded using a 5-point scale, 1 representing “very bad” and 5 “very
well.” Pain was graded using a 10-point scale, 0 representing “no pain”
and 10 “severe pain.” Stress was graded using a 5-point scale, 1
representing “no stress” and 5 “unsustainable stress.”

RESULTS: Mean enhancement levels within the coronary arteries were as
follows: 437 ± 104 Hounsfield units (HU) (group I), 448 ± 111 HU (group
II), and 447 ± 106 HU (group III), with P ≥ 0.18. Extravasation occurred
in none of the patients. Median (interquartile range) for comfort, pain,
and stress was, respectively, 4 (4-5), 0 (0-0), and 1 (1-2), with P ≥
0.68.

CONCLUSIONS: High flow rates of prewarmed CM were safely injected without
discomfort, pain, or stress. Therefore, the use of high flow rates should
not be considered a drawback for CM administration in clinical practice.
__________________________________________________________________
________________________________*_________________________________

15. Abstract: Relative Bioavailability of a Single Dose of Belimumab
Administered Subcutaneously by Prefilled Syringe or Autoinjector in
Healthy Subjects
__________________________________________________________________

http://onlinelibrary.wiley.com/doi/10.1002/cpdd.219/full

Clin Pharmacol Drug Dev. 2016 May;5(3):208-15. Free Open Access Text
Relative Bioavailability of a Single Dose of Belimumab Administered
Subcutaneously by Prefilled Syringe or Autoinjector in Healthy Subjects.

Struemper H1, Murtaugh T2, Gilbert J3, Barton ME4, Fire J5, Groark J4, Fox
NL5, Roth D4, Gordon D4.

1PAREXEL, Research Triangle Park, NC, USA.
2Quintiles, Overland Park, KS, USA.
3GlaxoSmithKline, Hertfordshire, UK.
4GlaxoSmithKline, King of Prussia, PA, USA.
5GlaxoSmithKline, Potomac, MD, USA.

Intravenous belimumab is approved for the treatment of systemic lupus
erythematosus; subcutaneous self-administration would enable greater
patient access.

This study assessed relative bioavailability, tolerability, and safety of
1 subcutaneous dose of self-administered belimumab by healthy subjects
using a single-use autoinjector or prefilled syringe.

Subjects (randomized 1:1:1:1) self-administered belimumab 200 mg
subcutaneously (abdomen or thigh) by prefilled syringe or autoinjector.
Pharmacokinetics, adverse events (AEs), injection-site pain, and
administration errors were recorded.

Of 81 subjects, 5 experienced administration errors and were excluded from
pharmacokinetic analyses. Mean serum belimumab concentration profiles were
similar for both devices, with a weak trend toward higher concentrations
for thigh injection compared with abdominal injections.

Maximum observed serum concentration was slightly higher with the
autoinjector (27.0 vs 25.3 µg/mL) and area under the concentration-time
curve slightly lower (701 vs 735 day · μg/ mL), compared with the
prefilled syringe.

Incidence of AEs was 51% (41 of 81 subjects; headache was most common),
with no serious or severe AEs. Median injection-site pain scores were low
(0 after 1 hour).

Device handling was reported as acceptable by ≥95% of autoinjector users
and ≥90% of prefilled syringe users for each characteristic assessed.
These results support the use of either device for belimumab subcutaneous
administration.

© 2015, The Authors. Clinical Pharmacology in Drug Development Published
by Wiley Periodicals, Inc. on behalf of The American College of Clinical
Pharmacology.

KEYWORDS: autoinjector; belimumab; bioavailability; pharmacokinetics;
subcutaneous
__________________________________________________________________
________________________________*_________________________________

16. Abstract: Loss of confidence in vaccines following media reports of
infant deaths after hepatitis B vaccination in China
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27174834

Int J Epidemiol. 2016 Apr;45(2):441-9.
Loss of confidence in vaccines following media reports of infant deaths
after hepatitis B vaccination in China.

Yu W1, Liu D1, Zheng J1, Liu Y1, An Z1, Rodewald L2, Zhang G3, Su Q3, Li
K3, Xu D3, Wang F3, Yuan P3, Xia W4, Ning G3, Zheng H3, Chu Y3, Cui J3,
Duan M3, Hao L3, Zhou Y3, Wu Z3, Zhang X3, Cui F3, Li L3, Wang H3.
Author information
1National Immunization Program, Chinese Center for Disease Control and
Prevention, Beijing, China and.
2World Health Organization Office in China, Beijing, China.
3National Immunization Program, Chinese Center for Disease Control and
Prevention, Beijing, China and hqwang@vip.sina.com.
4World Health Organization Office in China, Beijing, China
hqwang@vip.sina.com.

BACKGROUND: China reduced hepatitis B virus (HBV) infection by 90% among
children under 5 years old with safe and effective hepatitis B vaccines
(HepB). In December 2013, this success was threatened by widespread media
reports of infant deaths following HepB administration. Seventeen deaths
and one case of anaphylactic shock following HBV vaccination had been
reported.

METHODS: We conducted a telephone survey to measure parental confidence in
HepB in eleven provinces at four points in time; reviewed maternal HBV
status and use of HepB for newborns in birth hospitals in eight provinces
before and after the event; and monitored coverage with hepatitis B
vaccine and other programme vaccines in ten provinces.

RESULTS: HepB from the implicated company was suspended during the
investigation, which showed that the deaths were not caused by HepB
vaccination. Before the event, 85% respondents regarded domestic vaccines
as safe, decreasing to 26.7% during the event. During the height of the
crisis, 30% of parents reported being hesitant to vaccinate and 18.4%
reported they would refuse HepB.

Use of HepB in the monitored provinces decreased by 18.6%, from 53 653
doses the week before the event to 43 688 doses during the week that
Biokangtai HepB was suspended. Use of HepB within the first day of life
decreased by 10% among infants born to HBsAg- negative mothers, and by 6%
among infants born to HBsAg-positive mothers. Vaccine refusal and HepB
birth dose rates returned to baseline within 2 months; confidence
increased, but remained below baseline.

CONCLUSIONS: The HBV vaccine event resulted in the suspension of a safe
vaccine, which was associated with a decline of parental confidence, and
refusal of vaccination. Suspension of a vaccine can lead to loss of
confidence that is difficult to recover. Timely and credible
investigation, accompanied by proactive outreach to stakeholders and the
media, may help mitigate negative impact of future coincidental adverse
events following immunization.

© The Author 2016; all rights reserved. Published by Oxford University
Press on behalf of the International Epidemiological Association.

KEYWORDS:
Hepatitis B vaccination; coincidental death; communication; vaccine
confidence
__________________________________________________________________
________________________________*_________________________________

17. No Abstract: Reducing Insulin Syringe Reuse Can Help Lower Cost of
Insulin Waste In Brazil
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26534590

Value Health. 2015 Nov;18(7):A858.

Reducing Insulin Syringe Reuse Can Help Lower Cost of Insulin Waste In
Brazil.

DiMario S1, Chandran A1.

1Becton Dickinson, Franklin Lakes, NJ, USA.
__________________________________________________________________
________________________________*_________________________________

18. No Abstract: Infection control II: A practical guide to getting to
zero
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27158090

Am J Infect Control. 2016 May 5. pii: S0196-6553(16)00275-3.

Infection control II: A practical guide to getting to zero.

Horowitz HW1.

1Division of Infectious Diseases and Immunology and New York City Health &
Hospitals/Bellevue Infection Control Department, Department of Medicine,
NYU School of Medicine, New York, New York. Electronic address:
Harold.horowitz@nyumc.org.

KEYWORDS: Hospital-associated infections; NHSN reporting
__________________________________________________________________
________________________________*_________________________________

19. News

– Philippines: Dispatches: The Philippines’ Unaddressed HIV Epidemic

– Indonesia: ‘No more money for our needles’

– UK: Horror as mums find upstanding needles on swings and slides at
children’s play area

– Ontario Canada: Oneida shores a medical waste dump from dirty drug
needles washing up from London: residents

– Australia: Used syringes found in Elanora skate park on the Gold Coast
by parent

– NY USA: NYC’s First City Park Syringe Disposal Unit Is Shaped Like A
Daisy

– New Hampshire USA: Hospital Wants Help on Hep-C Settlements

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/hr5hmya

Philippines: Dispatches: The Philippines’ Unaddressed HIV Epidemic

Carlos H. Conde, Researcher, Human Rights Watch Asia Division (17.05.16)

The Philippine government observed what it described as the world’s first
“AIDS Hour” on May 14. Department of Health Secretary Janette Garin said
the awareness-raising event was “a concrete example of the Philippines
doing [its] part in the global effort against HIV and AIDS.”

[Photo: EXPAND Campaign supporters lights on around 1,638 candles
representing the number of dead victims claimed by HIV/AIDS in the
Philippines since 1984 as part of their commemoration of International
AIDS Candlelight Memorial Day in Quezon city, metro Manila in the
Philippines May 14, 2016. © 2016 Reuters]

Raising awareness is a key part of tackling the Philippines HIV epidemic,
now the fastest-growing in the world. But by omitting HIV prevention
measures for men-who-have-sex-with-men (MSMs) and people who inject drugs
(PWIDs), the AIDS Hour is the government’s latest missed opportunity to
educate and assist people at highest risk of contracting the virus.

The government has rolled-out sound programs to address the epidemic,
including expanding public access to free testing and establishing
treatment centers. But it is failing to take effective measures to help
reduce HIV transmission among MSMs and PWIDs. Reducing HIV transmission
among MSMs – particularly those between 15-24 years of age – requires
targeted education campaigns on condom use and safe sex. The government
has ignored these approaches, failing to initiate a mass education program
involving television and billboard ads promoting condom use and safe sex
for the MSM population. The government has also not implemented an
effective national education curriculum that teaches safe sex and HIV
prevention to students.

The country’s HIV epidemic among PWIDs is concentrated in Cebu City. In
2013, a staggering 52 percent of people who inject drugs there were
infected with HIV, up from 0.4 percent in 2007, according to the
Philippine National AIDS Council’s 2014 annual report. Yet the government
has criminalized the most effective strategy to reduce HIV transmission
among PWIDs – access to clean hypodermic needles. The Dangerous Drugs Act
criminalizes the possession and distribution of drug paraphernalia such as
syringes without a doctor’s prescription. The government scuttled a long-
running clean needle program in the city in 2015. That prohibition
encourages needle-sharing among PWIDs, which increases the risk of HIV
transmission. Providing clean needles, experts and advocates agree, would
be a key step in the right direction. Health experts warn that obstructive
government policies are only worsening the epidemic, causing it to spill
over into nearby towns and cities.

Awareness about HIV/AIDS is important. But the HIV emergency in the
Philippines demands urgent action and making the so-far dangerously
overlooked epidemic among MSMs and PWIDs a top priority.
__________________________________________________________________
__________________________________________________________________

http://www.insideindonesia.org/no-more-money-for-our-needles
Indonesia: ‘No more money for our needles’

Written by Sari Damar Ratri, Inside Indonesia 124: Apr-Jun 2016 (17.05.16)

Photo: Preparing the injection – Sari Damar RatriPreparing the injection –
Sari Damar Ratri

The first time I met Veni* she was carrying boxes of clean needles from
the Centre for Health Research at the University of Indonesia. She is an
outreach worker whose life has been entangled with the physical and social
harms of drug use. Her first husband was a drug user who sometimes earned
money from drug dealing. While he struggled with his addiction, Veni was
left to find ways to provide for her family. After 15 years Veni finally
ended the marriage as she felt she couldn’t be her husband’s ‘guardian
angel’ any more.

The experience of coping with her ‘junkie’ ex-husband had a profound
impact on Veni and in 2008 she became involved in harm reduction, a global
intervention program aimed at minimising the medical and social problems
associated with illegal drug use. It does this by encouraging the use of
legal substitution drugs, like methadone and subuxone, and distributing
free clean needles and condoms.

Veni’s involvement in harm reduction started when she was invited to give
a testimonial as the wife of an injecting drug user (IDU). Soon after, she
was recruited by several non-government agencies (NGOs) in Jakarta to do
outreach work meeting with drug users, distributing clean needles and
referring those who want access to treatment. She has found outreach work
a positive way to share her experience of living with a drug user while,
at the same time, earning enough money to provide for her children. Veni
believes that she is not only helping drug users and their families but
also helping to manage the emotional pain and trauma of her past.

Incubation period

After the first case of HIV/AIDS was identified in Bali in 1987, Indonesia
started one of the largest harm reduction programs in Asia. Focusing upon
one of the highest risk groups, IDUs, harm reduction has come to dominate
efforts to impede the spread of HIV/AIDS. The first case of HIV
transmitted via unsafe drug injection was reported in 1995, by 2005 unsafe
drug injection caused 38.9 per cent of total reported cases. Some scholars
believe that the number of drug users increased significantly after the
fall of the Suharto regime in 1998 due to a combination of the impacts of
economic collapse, high unemployment and an upsurge in social and
political violence. The numbers of intravenous drug users are still
growing.

Post-Suharto presidents have introduced limited measures to try and stem
this. During the presidency of Megawati, for example, a memorandum of
understanding was signed between the National Narcotics Board and the
National AIDS Commission in response to the increasing number of IDU-
related HIV cases. Methadone therapy was introduced for putau (low grade
heroin) dependencies in Jakarta and Bali. In 2004, the Yudhoyono
administration successfully sought international funding to create an IDU
Intervention Unit which managed 22 NGOs and two Health Ministry programs
across six provinces. By the end of 2006, a decree from the Ministry of
Health had established guidelines for harm reduction implementation. The
government’s support for methadone therapy programs was also reflected in
subsidies and the establishment of methadone treatment in some community
health centres.

Despite these measures, studies examining harm reduction implementation in
Indonesia have identified significant gaps between rhetoric and practice.
Perhaps most alarmingly, instead of reducing addiction as intended, harm
reduction measures have often resulted in new poly-drug dependencies
involving combinations of prescribed substitution drugs. Lack of adequate
information and supervision has made it harder for IDUs to manage
substitution drug use while struggling with their dependencies to illegal
drugs. Many IDUs are using both methadone and anti-depressants – mostly
without supervision of a doctor – in order to achieve their desired
physical and mental states. This is prohibited within the treatment regime
as harm reduction, in order to be successful, demands that only methadone
is used.

High-risk moment

Veni and her friend Maulana* started talking about these impacts of harm
reduction implementation during an outreach annual meeting in December
2014. The conversation began from their shared pessimism regarding what’s
been achieved to date and what still needs to be done. ‘What is harm
reduction really trying to accomplish? We have been doing this work for
more than ten years, but drug users are still vulnerable’ said Veni.
Despite harm reduction programs having run for so long there remains a
lack of basic support services for drug users.

The main focus of current harm reduction programs is the distribution of
clean needles for IDUs. This is related to the government’s national
action plan that at least 30 per cent of the country’s IDUs should have
access to substitution drugs, and 70 per cent should have access to
sterile needles. However, another important goal of the harm reduction
program – to improve the socio-economic conditions of IDUs’ – continues to
receive little attention and few resources.

IDUs face a number of difficult challenges in finding work and
participating in treatment programs creates further impediments as most
treatments are held during office hours. Providing take-home doses has
been used as one means of overcoming this problem; however, difficulty in
finding and keeping regular employment is part of a vicious cycle for IDUs
participating in harm reduction programs.

Uncertainty over job security and the sustainability of existing programs
has also been felt by outreach workers. The HIV Cooperation Programme in
Indonesia – Australia Aid (or HCPI–AusAid) has been the largest financial
support body for harm reduction; however, funding ended in December 2015.
Veni and Maulana are unsure about what the future holds. ‘We don’t know
anything yet, all we know is that we can still work until October’ said
Veni. Maulana is more sceptical. ‘Without HCPI–AusAid, NGOs won’t be able
to continue distributing clean needles in Jakarta. Even the syringes for
the harm reduction program in community health centres are provided by
HCPI–AusAid.’

The benefits of clean needle distribution are limited not only by the
termination of HCPI–AusAid funding but also by the current Indonesian
government’s steadfast adherence to a ‘zero tolerance’ policy towards
illegal drug use. Many injectors are reluctant to carry clean needles with
them for fear that police would treat it as proof that they use illegal
drugs. Thus, HIV prevention programmes for IDUs are at risk because clean
needles are no longer distributed in user hot spots.

Although the National AIDS commission still has stocks of syringes that
can be used as a buffer, these are said to be of low quality. Some users
even prefer to use second-hand syringes. Taufan*, a subuxone user, said
‘the pistons of syringes from the AIDS commission are easily broken. They
are useless for IDUs’. President Widodo may have declared a national
‘Darurat Narkoba’ (Drug Emergency), but this has not included the
provision of necessary basic supports for drug users.

With the HCPI–AusAID coming to an end, the availability of syringes for
IDUs is now at stake. Most financial support for programs delivered by
community health centres comes from the national budget through the
Ministry of Health, and this is likely to be delayed due to a convoluted
bureaucracy. According to Presidential Decree No. 12/2013 regarding health
insurance, treatment for HIV/AIDS patients will continue to be provided,
with the exception of drug-related therapy. However, with minimal
financial support from the government for syringe exchanges and
institutionalised discrimination against drug users affecting their access
to adequate health care, Indonesia is likely to face greater problems.

Indonesia’s current drug policy still puts many users through the criminal
justice system, with harm reduction based in a total abstinence paradigm
implemented by poorly-resourced rehabilitation centres. In spite of this,
the National Narcotic Board declared that it would rehabilitate 100 000
drug users by the end of 2015. It is not surprising, considering the lack
of sufficient infrastructure, resources and qualified staff to run
existing rehabilitation centres, that this target was not reached.
Moreover, it reflects the government’s continued misunderstanding of the
nature of addiction itself, which cannot be adequately addressed while
drug users continue to be criminalised.

In the words of Taufan, ‘Indonesia doesn’t really have any disaster
preparedness; all we’re doing is fighting against the fire. By the end of
the day, it’s all too late.’ Does this mean we should say good-bye to
Indonesia’s target of zero new HIV cases by 2030?

*Not their real names.

Sari Damar Ratri (sdratri@ekuator.or.id) is a medical anthropologist at
Yayasan Ekuator, a research foundation that focuses on the study of
inequality and marginalisation in Indonesia. She is currently working as
media-communication manager at the Centre for Gender and Sexuality
Studies, Faculty of Social and Political Sciences, University of
Indonesia. Her research on harm reduction implementation in Indonesia was
part of the University of Amsterdam’s Chemical Youth Project funded by
European Research Council (ERC).

Inside Indonesia 124: Apr-Jun 2016
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https://tinyurl.com/h5f7n3t
UK: Horror as mums find upstanding needles on swings and slides at
children’s play area

[Photo: The needle was standing upwards on a seat of a swing at Nanny Goat
Park.]

A MUM has described her shock after finding upstanding needles on swings
and slides at a children’s play area.

Chantelle Critchley visited Nanny Goat Park in Fingerpost on Saturday
morning and was cleaning one of the swing seats when she discovered a
syringe pointing upwards.

She then found a series of needles placed at the foot of slides dotted
around the play area.

After Chantelle posted a warnining on the Star’s Facebook page today, it
was shared more than 1,000 times.

Readers reacted with horror to the images and her description of what
happened.

Chantelle wrote: “Please be careful at your local parks! This morning I
took my two children to Nanny Goat Park in Fingerpost, as my son got to
the swing I noticed it was all sticky so told him to go on the slide why I
cleaned it with a baby wipe.

“As I went to clean it I saw this used needle that has been purposely
stood up! On further inspection found four more placed around the park at
the bottom of slides!”

Zoe Dyas was another park user to contact the Star. She wrote: “Needles
stuck upwards in the baby swing at Nanny Goat Park Also covered in spit.
“Me and a few others found six to seven dirty used needles around the
slide (and) on the grass.”

The comments prompted an outpouring of anger on Facebook.

Baz Sacko wrote: “I’m from Fingerpost, this is disgusting I was gonna take
my two over there on route to my mum’s. “I’m gobsmacked, glad you spotted
this before someone got hurt or worse infected with something, this was
rife in the 80s all over St Helens but never over parks and that.”

Louise Duckworth wrote: “Thank you for sharing. “My daughter goes to this
park with her friends. I text her right away telling her to stay away.
“How anyone can be so cruel is beyond me.I pray no child got hurt and the
disgusting,vile person is caught…”

Harold Murphy, a community leader in Fingerpost, wrote: “I am glad that
you noticed the needles, I hate to think what could have happened.

“Councillor Lisa Preston has received phone calls this morning about this
incident and on Monday I hope to speak to her and the police and get
something sorted out. “I want to assure everyone that our group are
concerned and also disgusted a stop has got to be put on this sort of
behaviour we dont want this in Fingerpost.

“I would like to express my thanks to you for bringing this to our
attention and I will do all I can to help.”
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https://tinyurl.com/jgunrb5
Ontario Canada: Oneida shores a medical waste dump from dirty drug needles
washing up from London: residents

National News | May 13, 2016 by APTN National News | 0 Comments
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By Delaney Windigo & Kenneth Jackson, APTN News, Ontario Canada (13.05.16)

LONDON, Ont. – With a convocation of eagles soaring high above the Thames
River in Oneida territory Anthony Nicholas’ sharp eye spots something
buried in the ground.

The orange tip is just barely visible in deep silt left behind on the
floodplains of the river that receded weeks ago.

“I bet you if we dig down it’s the entire needle,” said Nicholas.

He couldn’t be more right.

Pulling the silty-sand away with a stick exposes a used hypodermic needle
syringe about six inches in the ground. The sharp end of the needle
pointing nearly straight up protected by its orange cap.

[A hypodermic needle syringe found on in the flood plains of the Thames
River on Oneida Nation of the Thames territory. The needle was buried in
the sand. Residents are convinced the needle, one of many found, came from
London, some 20 km up river. Kenneth Jackson/APTN photo]

It’s just one of several needles found that day, but Nicholas and fellow
resident Darryl Chrisjohn have been finding them all over the floodplains,
as well as empty saline packages, tourniquets and condoms.

But it’s the needles that have them the most concerned – first found when
a fisherman came across one weeks ago.

“We’ve been finding syringes without the caps and with the caps,” said
Nicholas.

A quick look around the area shows there isn’t house in sight, and the
shores are a few hundred metres from a gravel road.

“Nobody is coming here to shoot up,” said Chrisjohn who looks up the
waterway that leads to the London.

[Anthony Nicholas points to a needle found in the flood plains of the
Thames River along the Oneida Nation of the Thames territory. The
community has found dozens of needles they say washed up from London, some
20 km up river. Kenneth Jackson/ APTN photo]

Both are convinced the needles are coming from the city during the spring
thaw when the raging river can easily rise more than 10 metres.

They fear the entire flood plains has become a medical waste dump.

Both men have warned people to stay away from the spot used mainly by
fishermen and their kids.

“It’s really changed the lifestyle here. I’m not sure what the future is
going to hold if we can’t be safe down here with our kids and ourselves as
to be aware of needles being found like this one here and who else knows
what’s in this junk pile that’s coming down from the city,” said Nicholas.

A quick look at a map shows London is about 30 kilometres from the Oneida
of the Thames territory.

APTN National News traveled to London and it didn’t take long to find
discarded needles.

A walk along the Thames in downtown London found about 50 needles in a few
hundred metres, including a large stash under the bridge at Carfrae park,
as both sides of the river appeared to be popular places for addicts.

[A stash of needles and paraphernalia underneath the bridge at Carfrae
park in London, Ontario. Kenneth Jackson/APTN photo]

Tom Cull is a local resident and university professor who five years ago
started a volunteer group to pick up litter along the river once a month
during the spring and summer months.

Cull said he quickly learned they were going to find more than chip bags
and old coffee cups.

His group was just out two weeks before he took APTN out for a walk along
the Thames May 3.

“We stopped counting around 300 needles in one clean up and I would say
over the five years we’ve been doing this, we’ve collected thousands of
needles,” said Cull. “Put it this way, we’ve never had a clean-up where we
don’t collect needles.”

As it turns out, London has one of the highest intravenous drug problems
in the country.

There are about 16 needle drop boxes throughout the city – by the river,
parks and playgrounds.

[A needle drop box next to a children’s playground in London, Ontario’s
Ivey Park. Kenneth Jackson/APTN photo]

In 2015, London’s needle exchange program distributed 2.7 million needles.

Nearly 800,000 needles are unaccounted for.

They ended up in parks, city streets and the river.

The city said there could be other ways needles may have been returned it
doesn’t track such as “public recreation facilities, some social service
agencies, restaurants, businesses, landlords and schools.”

It’s a large jump in distribution from 2013 when roughly 1.86 million were
handed out and 2.3 million in 2014.

“Unfortunately there’s medical waste throughout the community, along the
river I think is because it’s more likely for people to be residing or
camping out along the river,” said Sonja Burke, of the Regional HIV/AIDS
Connection, which operates the city’s needle exchange program.

Burke said there are times in the year when the needles left behind on the
shores of the Thames get washed down river.

“I think it’s important to understand there are two things, one in the
spring, the water rises obviously and a lot of the litter including the
syringes will get washed down,” she said. “Second of all we do have a high
population of individuals who are experiencing homelessness in London
right now.”

Burke said while several organizations in the city collect discarded
needles there isn’t dedicated funding focused squarely on the recovery of
them.

That’s something Cull would like to see happen, who also been campaigning
for more needle boxes to be placed throughout the city.

“I would like to see the city as a whole get more serious about litter,
get more serious about the environment and get more serious about water
quality and the needles is just one piece of that puzzle,” he said.

For now the Regional HIV/AIDS Connection agency plans to introduce a new
pilot project by giving out little needle disposal containers in the hopes
to get people to properly dispose of the needles.

“We don’t do a one for one, so people don’t have to return the same amount
of needles in order to access needles, so encouraging people to dispose of
needles appropriately can be difficult at times,” said Shaya Dhinsa,
manager of sexual health for Middlesex-London Public Health.

APTN took the concerns of the Oneida residents to London’s public health
and a spokesperson questioned how needles could wash so far down the
river.

“It’s a good question. I don’t know how you would show that cause and
effect,” the spokesperson said.

But for Nicholas and Chrisjohn they’re convinced the needles on their
territory are coming from London with so many of them ending up in and
around the water.

Both traveled to London to walk the Thames themselves. They immediately
found needles in Ivey park in downtown by the Forkes, where the Thames
begins its route towards Oneida.

“I don’t see it getting any better if this going to keep coming year after
year or every time it floods,” said Nicholas.

Chrisjohn doesn’t just want to see the needles stop ending up in the river
he wants the land on his territory clean up.

“It needs to be cleaned up ASAP,” he said.

It’s difficult to tell how many needles could be on the Oneida flood
plains as much of the land is covered in deep silt.

[Can you spot the floating needle? Kenneth Jackson/APTN photo]

They’re also concerned with how the needles are affecting the water.

“It’s very concerning and I know it concerns the fishermen and the hunters
that are along the river cause we’re mostly the ones that are active down
here. You know the water is everyone’s concern. It’s not just our
concern,” said Nicholas.
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https://tinyurl.com/hrq9ekz
Australia: Used syringes found in Elanora skate park on the Gold Coast by
parent

By Kristy Muir, Gold Coast Bulletin, Gold Coast Australia (13.05.16)

[Photo: Used syringes have been found in Elanora over the last two months.
Pictured is a dirty needle, similar to the one found this week by an
Elanora State School parent.]

PARENTS of Elanora State School are outraged that dirty needles are being
dumped at a busy children’s park.

Tracey Duhig this week found a syringe wedged in a log fence between the
car park and the skate park at Pines Lane. It is the second syringe in the
past two months found in the local area. “I parked there on Monday morning
with no issues,” Mrs Duhig said. “But in the afternoon I parked in exactly
the same spot at 2.30pm and got out of my car to find a syringe.”

The Elanora resident said she was angry that someone could be so
irresponsible and she had notified Gold Coast Council, the school and
police about the used needle.

“I have two young girls, seven and four,” she said. “I was glad that it
was me who found it and not a child after school. “So many kids play at
the park after school and it is a popular spot for parents to collect
their children.

“In April a syringe was found near the Elanora C&K kindergarten, at the
oval which is right next to the school.”

“The sad thing is that the school has not issued any kind of warning or
information to parents so they can have a discussion with their children
about being safe.”

A spokesman for the Department of Education and Training said: “The safety
of staff and students is the department’s number one priority.

“The Elanora State School principal took immediate action to warn the
community of

potential dangers after receiving a report of a syringe found outside
school grounds

on Tuesday 10 May,” he said.

The school community will be notified through a number of channels
including a warning in the parent newsletter this week and a email to all
administrative staff to discuss this issue at student assemblies this
week.”

A Gold Coast City Council spokeswoman said: “Incidents of syringes being
discarded carelessly are isolated and not something we keep statistics
for.

“Council does everything it can to keep our parks clean but we also rely
on the public to do the right thing.”

Queensland Health said people who receive a needle-stick injury in a
public place should seek medical attention as soon as possible. It is
important as some medications and vaccinations work best if taken soon
after exposure, it said. A health practitioner should also give advice on
the possible need for and timing of HIV, hepatitis B or hepatitis C
testing.
__________________________________________________________________
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http://gothamist.com/2016/05/12/syringe_disposal_daisies.php
NY USA: NYC’s First City Park Syringe Disposal Unit Is Shaped Like A Daisy

By Emma Whitford, The Gothamist, New York City, NY USA (12.05.16)

[Photo: 051216_Daisy.jpeg (via Washington Heights Corner Project)]

A Manhattan nonprofit that provides health services to intravenous drug
users unveiled the city’s first public syringe drop box in any city park
this week, located in the Haven Park Underpass near 177th Street and New
Haven Avenue in Fort Washington Park. Shaped like a daisy with three
hollow stems for depositing syringes, the drop box is a 24-hour disposal
option for users who might otherwise leave dirty needles on the ground.
The Corner Project, which has worked with drug users in the neighborhood
since the late aughts, collaborated with the Parks Department to install
the pilot project. Corner Project member Sarah Deutsch said on Thursday
that the location is highly strategic—in 2014 her group tracked every
single stray syringe in the neighborhood using GPS. The Washington Heights
underpass is close to three of the most heavily concentrated syringe
pickup spots.

“We chose the daisy shape to be integrated into the design and the
landscape of the park,” Deutsch told reporters on Tuesday. “The aesthetic
is to be natural and really blend in, but also to stand out to those who
know what it is and need to know what it is.”

Based on a design recently implemented in Vancouver, the drop box has
capacity for more than 100 needles, and is lined with a biohazard bag. The
Corner Project will check it every day for the first month, and transfer
the needles to sharp containers to be incinerated in an upstate facility
by the biohazard waste disposal company Stericycle.
Deutsch clarified on Thursday that while hospitals and health care
facilities are technically supposed to accept used syringes for safe
disposal, hospitals are busy and tend not to advertise the service. Some
nonprofits have drop boxes in front of their offices, but Deutsch only
knows of two in Manhattan—the Lower East Side Harm Reduction Center on
Allen Street, and the Positive Health Project on 37th Street.
According to city statistics, 886 New Yorkers died of heroin overdoses in
2015, up from 800 in 2014. The city requires NYPD officers to carry the
anti-overdose drug nalaxone, which is also available over-the-counter at
city pharmacies.

[Photo: 051216_Daisy2.jpeg Making the daisy (via Washington Heights
Corner Project)]

Last month Mayor de Blasio announced a three-year, $5.5 million plan to
distribute an additional 7,500 nalaxone kits city-wide. The city’s new
Heroin and Prescription Opioid Public Awareness Task Force will also match
users who have had nonfatal overdoses with social workers. The Mayor’s
plan does not call for supervised injection facilities, where drug users
might shoot up safely under the supervision of healthcare workers. The
controversial concept has the support of City Council Health Committee
Chair Corey Johnson, and Assemblywoman Linda Rosenthal at the state level.
“People need to become more educated and look more deeply into this
crisis,” Rosenthal told us in a recent interview about SIFs. “It’s the
same thing as when the city started giving out free condoms. It didn’t
mean people would go out and start having sex, it meant that they were
going to have sex with or without. It’s just acknowledging the reality of
a behavior, and trying to make it safer.”

The Corner Project isn’t planning on expanding its drop box project until
they’ve taken stock of how much use it’s getting, but Deutsch says several
syringes have already been collected in the last few days.
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https://tinyurl.com/jdhwedn
New Hampshire USA: Hospital Wants Help on Hep-C Settlements

By PAMELA BAKER, Courthouse News Service, USA (11.05.16)

EXETER, N.H. (CN) — The last hospital to employ the drug addict
responsible for infecting dozens with hepatitis C filed a federal
complaint against its staffing agent.

Claims have been swirling through courts across the country for years over
the hepatitis outbreak unleashed by former radiology technician David
Kwiatkowski, whom a federal judge sentenced in 2013 to 39 years behind
bars.

An opioid addict registered to work as a traveling cardiac catheterization
technician, Kwiatkowski got his fix by stealing syringes at work, filled
with powerful painkillers like fentanyl. After injecting himself with the
narcotics, contaminating the needle with his own hepatitis-infected blood,
Kwiatkowski refilled the used syringes with saline and put them back into
hospital supply rooms.

This routine played out at 19 hospitals in eight states that employed
Kwiatkowski from 2003 to 2012, when he was finally caught, fired and
arrested, according to a new complaint by Kwiatkowski’s last employer,
Exeter Hospital.

Thousands others across the country had to be tested, and Exeter Hospital
says Kwiatkowski infected at least 32 of its patients with his strain of
hep-C.

Last year, the hospital reached confidential settlements with 188 patients
who all tested negative for hepatitis but faced emotional distress from
the testing process itself.

The hospital’s May 6 complaint seeks to hold American HealthCare Services
Association liable for statutory contribution.

Michigan-based “AHSA holds itself out as the largest hospital vendor
management association in the United States,” the complaint states. Exeter
Hospital says Kwiatkowski came to work for its cardiac catheterization lab
via AHSA’s staffing contract with a company called Triage.

“In total disregard of its duty, AHSA failed to properly monitor the
performance and compliance of Triage,” the complaint states. Triage is not
a party to the complaint.

“The aforesaid breaches by Triage resulted in Kwiatkowski being placed at
Exeter Hospital, notwithstanding the fact that he was addicted to opioids;
was infected with hepatitis-C; and had resigned from or been terminated
from at least four prior hospital positions as a direct result of his
drug-related misconduct,” the complaint states.

Exeter Hospital says AHSA had a duty “to fully investigate or report to
the appropriate authorities Kwiatkowski’s illegal drug diversion and use.”
By its own standards, AHSA “should have known” the traveling cardiac
catheterization technician was unfit for employment, according to the
complaint.

Exeter Hospital contends that the settlements are “disproportionate to
[its] actual responsibility” for the outbreak.

In addition to studying the proportionate fault of the AHSA, the hospital
also wants attorneys’ fees.

It is represented by Robert Dewhirst with Devine Millimet & Branch in
Manchester. Neither Devine Millimet nor ASHA returned requests for
comment.
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________________________________*_________________________________

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, SIGN meeting
reports, images such as photographs, posters, signs and symbols, and
video.

Email mailto:sign.moderator@gmail.com
__________________________________________________________________
________________________________*_________________________________

The SIGN Internet Forum was established at the initiative of the World
Health Organization’s Department of Essential Health Technologies.

The SIGN Secretariat home is the Service Delivery and Safety (SDS)
Health Systems and Innovation (HIS) at WHO HQ, Geneva Switzerland.

The SIGN Forum is moderated by Allan Bass and is hosted on the University
of Queensland computer network. http://www.uq.edu.au
__________________________________________________________________

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