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SIGNpost 00861

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST

Post00861 World Hep Day 2016 + Safe Injection South Asia 13 July 2016

CONTENTS
0. Moderators Note
1. World Hepatitis Day 2016: Know hepatitis – Act now
2. Abstract: Towards safe injection practices for prevention of hepatitis
C transmission in South Asia: Challenges and progress
3. Abstract: The global burden of viral hepatitis from 1990 to 2013:
findings from the Global Burden of Disease Study 2013
4. Abstract: Reporting of occupational exposures to blood and body fluids
in the primary dental care setting in Scotland: an evaluation of
current practice and attitudes
5. Abstract: Does an Insulin Double-Checking Procedure Improve Patient
Safety?
6. Abstract: Surveillance of injecting-related injury and diseases in
people who inject drugs attending a targeted primary health care
facility in Sydney’s Kings Cross
7. Abstract: Drug use in prisons: strategies for harm reduction (ANRS-
PRIDE Program)
8. Abstract: Effects of combination approach on harm reduction programs:
the Taiwan experience
9. Abstract: Innovation of a syringe needle auto-detaching device for
clinicians
10. Abstract: AutoSyP: A Low-Cost, Low-Power Syringe Pump for Use in Low-
Resource Settings
11. Abstract: Influence of material properties on gloves’ bacterial
barrier efficacy in the presence of microperforation
12. Abstract: Acquisition of bacteria on health care workers’ hands after
contact with patient privacy curtains
13. Intro No Abstract: Acute Hepatitis C Sustained by a Cardiac Surgeon
After a Needlestick Injury: A Case of “Murphy’s Law”?
14. Jobs: Short-term experts Procurement and Supply Management of
health commodities
15. News
– Yellow Fever: WHO cites 2-month window for battling yellow fever
– Global: Viral hepatitis ‘kills as many as Aids or TB’
– MA USA: City of Gloucester responds to discarded needles found in public
places

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0. Moderators Note
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1. World Hepatitis Day 2016: Know hepatitis – Act now

World Hepatitis Day, 28 July 2016 is an opportunity to step up national
and international efforts on hepatitis and urge partners and Member States
to support the roll-out of the first Global Health Sector Strategy on
viral hepatitis for 2016–2021, which was approved during the Sixty-ninth
World Health Assembly in May 2016.

http://www.who.int/campaigns/hepatitis-day/2016/en/
__________________________________________________________________

http://www.who.int/campaigns/hepatitis-day/2016/event/en/

World Hepatitis Day 2016: Know hepatitis – Act now

Event announcement

Background

World Hepatitis Day, 28 July 2016 is an opportunity to step up national
and international efforts on hepatitis and urge partners and Member States
to support the roll-out of the first Global Health Sector Strategy on
viral hepatitis for 2016–2021, which was approved during the Sixty-ninth
World Health Assembly in May 2016.

The new strategy introduces the first-ever global targets for viral
hepatitis. These include a 30% reduction in new cases of hepatitis B and
C, and a 10% reduction in mortality by 2020.

Key approaches will be to expand vaccination programmes for hepatitis B;
focus on preventing mother-to-child transmission of hepatitis B; improve
injection, blood and surgical safety; “harm reduction” services for people
who inject drugs; and increase access to diagnosis and treatment for
hepatitis B and C.

Read the Global health sector strategy on viral hepatitis 2016-2021
http://www.who.int/hepatitis/strategy2016-2021/ghss-hep/en/index.html

World Hepatitis Day – 28 July 2016

Know hepatitis – Act now

On World Hepatitis Day, 28 July 2016, WHO calls on policy-makers, health
workers and the public to “Know hepatitis – Act now”.

The Organization urges them to inform themselves about the infection, take
positive action to know their status by getting tested, and finally seek
treatment to reduce needless deaths from this preventable and treatable
infection.

Activities will take place around the world to improve public knowledge of
the risk of hepatitis, and enhance access to hepatitis testing and
treatment services.

Know hepatitis – Are you at risk?

– Viral hepatitis affects 400 million people globally and, given the size
of the epidemic, anyone and everyone can be at risk.

Know hepatitis – Get tested

– An estimated 95% of people with hepatitis are unaware of their
infection. Hepatitis tests are complex and can be costly, with poor
laboratory capacity in many countries.

Know hepatitis – Demand treatment

– Globally, lack of awareness, and poor access to hepatitis treatment
services mean that most people who need treatment do not receive it.

– Over 90% of people with hepatitis C can be completely cured of the virus
within 3–6 months.

– Appropriate treatment of hepatitis B and C can prevent the development
of the major life-threatening complications of chronic liver disease:
cirrhosis and liver cancer.

– WHO advises that by scaling up treatment, 7 million lives can be saved
between 2015 and 2030, with communities benefiting from economic gains.

– Read the Messages of the World Hepatitis Day 2016
http://www.who.int/campaigns/hepatitis-day/2016/messages/en/index.html
__________________________________________________________________

Viral hepatitis – a group of infectious diseases known as hepatitis A, B,
C, D, and E – affects hundreds of millions of people worldwide, causing
acute and chronic liver disease and killing close to 1.4 million people
every year, mostly from hepatitis B and C. It is estimated that only 5% of
people with chronic hepatitis know of their infection, and less that 1%
have access to treatment.
__________________________________________________________________
________________________________*_________________________________

2. Abstract: Towards safe injection practices for prevention of hepatitis
C transmission in South Asia: Challenges and progress

“Core tip: The reuse of syringes in healthcare has been consistently
identified as major route of hepatitis B and C transmission in Pakistan
and India. Injection use and reuse is common in Pakistan, India and other
South Asian countries.”

“This paper synthesizes literature on injection use, re-use and potential
interventions to reduce injection use and reuse to prevent hepatitis C
transmission and hence overall disease burden. We also propose a multi-
level model to guide further research, interventions and programs to
prevent unnecessary injection use and reuse.”
__________________________________________________________________

http://www.wjgnet.com/1007-9327/full/v22/i25/5837.htm

World J Gastroenterol. Jul 7, 2016; 22(25): 5837-5852 Open Access
Towards safe injection practices for prevention of hepatitis C
transmission in South Asia: Challenges and progress

Naveed Zafar Janjua, Zahid Ahmad Butt, Bushra Mahmood, Arshad Altaf

Naveed Zafar Janjua, Clinical Prevention Services, British Columbia Centre
for Disease Control, Vancouver, BC V5Z 4R4, Canada
Naveed Zafar Janjua, Zahid Ahmad Butt, Bushra Mahmood, School of
Population and Public Health, University of British Columbia, Vancouver,
BC V6T 1Z3, Canada
Arshad Altaf, Service Delivery and Safety, World Health Organization,
Geneva 27, Switzerland

Author contributions: Janjua NZ conceived the idea, designed the study and
wrote first draft; all authors contributed to the literature review,
critical revision and editing, and approval of the final version.

Conflict-of-interest statement: None to declare.

Data sharing statement: All data presented in this paper are available in
the cited references.
AIM: To summarize the available information about injection use and its
determinants in the South Asian region.

METHODS: We searched published and unpublished literature on injection
safety in South Asia published during 1995-2016 using the keywords
“injection”“unsafe injection” and “immunization injection” and combined
these with each of the countries and/or their respective states or
provinces in South Asia. We used a standardized questionnaire to abstract
the following data from the articles: the annual number of injections per
capita, the proportion of injections administered with a reused syringe or
needle, the distribution of injections with respect to prescribers and
providers and determinants of injection use.

RESULTS: Although information is very limited for certain countries (i.e.,
Bhutan, Maldives and Sri Lanka), healthcare injection use is very common
across South Asia, with cross-country rates ranging from 2.4 to 13.6
injections/person/year.

Furthermore, recent studies show that 5% to 50% of these injections are
provided with reused syringes, thus creating potential to transmission of
blood-borne pathogens.

Qualified and unqualified practitioners, especially in the private sector,
are the major drivers behind injection use, but patients also prefer
injections, especially among the rural, poor or uneducated in certain
countries.

According to available data, Pakistan and India have recently taken steps
towards achieving safe injection. Potential interventions include the
introduction of reuse prevention devices, and patient-, community- and
patient/community and provider-centered interventions to change population
and practitioner behavior.

CONCLUSION: Injection use is common in South Asian countries. Multilevel
interventions aiming at patients, providers and the healthcare system are
needed to reduce injection use and reuse.

Key Words: Unsafe injections, Hepatitis C, Hepatitis B, South Asia,
Prescription practices

Core tip: The reuse of syringes in healthcare has been consistently
identified as major route of hepatitis B and C transmission in Pakistan
and India. Injection use and reuse is common in Pakistan, India and other
South Asian countries. This paper synthesizes literature on injection use,
re-use and potential interventions to reduce injection use and reuse to
prevent hepatitis C transmission and hence overall disease burden. We also
propose a multi-level model to guide further research, interventions and
programs to prevent unnecessary injection use and reuse.

Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group
Inc. All rights reserved.

http://www.wjgnet.com/1007-9327/full/v22/i25/5837.htm Open Access
__________________________________________________________________
________________________________*_________________________________

3. Abstract: The global burden of viral hepatitis from 1990 to 2013:
findings from the Global Burden of Disease Study 2013
__________________________________________________________________

https://dx.doi.org/10.1016/S0140-6736(16)30579-7

Lancet. 2016 Jul 6. pii: S0140-6736(16)30579-7. Free article Registration
required
The global burden of viral hepatitis from 1990 to 2013: findings from the
Global Burden of Disease Study 2013.

Stanaway JD, Flaxman AD, Naghavi M, Fitzmaurice C, Vos T, Abubakar I, Abu-
Raddad LJ, Assadi R, Bhala N, Cowie B, Forouzanfour MH, Groeger J,
Hanafiah KM, Jacobsen KH, James SL, MacLachlan J, Malekzadeh R, Martin NK,
Mokdad AA, Mokdad AH, Murray CJ, Plass D, Rana S, Rein DB, Richardus JH,
Sanabria J, Saylan M, Shahraz S, So S, Vlassov VV, Weiderpass E, Wiersma
ST, Younis M, Yu C, El Sayed Zaki M, Cooke GS.
Lancet. 2016 Jul 6. pii: S0140-6736(16)30579-7. doi: 10.1016/
S0140-6736(16)30579-7

Background: With recent improvements in vaccines and treatments against
viral hepatitis, an improved understanding of the burden of viral
hepatitis is needed to inform global intervention strategies. We used data
from the Global Burden of Disease (GBD) Study to estimate morbidity and
mortality for acute viral hepatitis, and for cirrhosis and liver cancer
caused by viral hepatitis, by age, sex, and country from 1990 to 2013.

Methods: We estimated mortality using natural history models for acute
hepatitis infections and GBD’s cause-of-death ensemble model for cirrhosis
and liver cancer. We used meta-regression to estimate total cirrhosis and
total liver cancer prevalence, as well as the proportion of cirrhosis and
liver cancer attributable to each cause. We then estimated cause-specific
prevalence as the product of the total prevalence and the proportion
attributable to a specific cause. Disability-adjusted life-years (DALYs)
were calculated as the sum of years of life lost (YLLs) and years lived
with disability (YLDs).

Findings: Between 1990 and 2013, global viral hepatitis deaths increased
from 0·89 million (95% uncertainty interval [UI] 0·86–0·94) to 1·45
million (1·38–1·54); YLLs from 31·0 million (29·6–32·6) to 41·6 million
(39·1–44·7); YLDs from 0·65 million (0·45–0·89) to 0·87 million (0·61–
1·18); and DALYs from 31·7 million (30·2–33·3) to 42·5 million (39·9–
45·6). In 2013, viral hepatitis was the seventh (95% UI seventh to eighth)
leading cause of death worldwide, compared with tenth (tenth to 12th) in
1990.

Interpretation: Viral hepatitis is a leading cause of death and disability
worldwide. Unlike most communicable diseases, the absolute burden and
relative rank of viral hepatitis increased between 1990 and 2013. The
enormous health loss attributable to viral hepatitis, and the availability
of effective vaccines and treatments, suggests an important opportunity to
improve public health.

Funding: Bill & Melinda Gates Foundation.
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Reporting of occupational exposures to blood and body fluids
in the primary dental care setting in Scotland: an evaluation of
current practice and attitudes
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/25146830

Br Dent J. 2014 Aug;217(4):E7.
Reporting of occupational exposures to blood and body fluids in the
primary dental care setting in Scotland: an evaluation of current practice
and attitudes.

Leavy P1, Templeton A2, Young L3, McDonnell C4.

1Dental Officer and Scottish Dental Postgraduate Remote and Rural Fellow,
Abban Street Dental Clinic, 22A Abban Street, Inverness, IV3 8HH.
2Research Fellow, Translation Research in a Dental Setting (TRiaDS),
Dundee Dental Education Centre, Frankland Building, Smalls Wynd, Dundee,
DD1 4HN.
3Research and Development Manager, Scottish Dental Clinical Effectiveness
Programme (SDCEP), Dundee Dental Education Centre, Frankland Building,
Smalls Wynd, Dundee, DD1 4HN.
4Consultant Occupational Health Physician, HSE Mid-Western Regional
Hospital, Dooradoyle, County Limerick, Ireland.

OBJECTIVES: To evaluate experience, practice and beliefs regarding
occupational exposures to blood and oral fluids among a random sample of
300 dentists working in Scotland’s NHS primary dental services.

METHOD: A cross-sectional postal survey assessed occupational exposure
policies and procedures, recent occupational exposure incidence and
current management. Beliefs were measured using constructs from the theory
of planned behaviour, shown to influence behaviour in this population.

RESULTS: Forty-two percent of dentists responded. Fourteen percent had
sustained an occupational exposure in the previous 12 months; of those,
35% did not report their exposure. All respondents’ practices had
protocols in place for managing and reporting dental team member sharps
injuries. Most (82%) had protocols for mucocutaneous exposures. Less than
half (48%) had a protocol for managing and reporting patient exposures to
blood or saliva. Dentists placed significantly more importance (z-score
-4.44, p value <0.001) and necessity (z-score -4.17, p value <0.001) on
reporting patient exposure than dentist occupational exposure.

CONCLUSION: This study suggests that while dentists generally have
positive beliefs about reporting occupational exposures, there are gaps in
practice.

Comment in

Summary of: Reporting of occupational exposures to blood and body fluids
in the primary dental care setting in Scotland: an evaluation of current
practice and attitudes. [Br Dent J. 2014]
https://www.ncbi.nlm.nih.gov/pubmed/25146809
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Does an Insulin Double-Checking Procedure Improve Patient
Safety?
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/26866326

J Nurs Adm. 2016 Mar;46(3):154-60.

Does an Insulin Double-Checking Procedure Improve Patient Safety?

Modic MB1, Albert NM, Sun Z, Bena JF, Yager C, Cary T, Corniello A, Kaser
N, Simon J, Skowronsky C, Kissinger B.

1Author Affiliations: Clinical Nurse Specialist (Dr Modic), Office of
Nursing Education and Professional Practice Development, Cleveland Clinic;
Associate Chief Nursing Officer (Dr Albert), Office of Nursing Research
and Innovation, Biostatistician (Mr Sun), Quantitative Health Sciences,
and Biostatistician (Mr Bena), Quantitative Health Sciences, Cleveland
Clinic Health System; and Volunteer (Ms Yager), Department of Volunteer
Services, Clinical Nurse Specialists (Mss Cary, Corniello, Kaser, Simon,
and Skowronsky), and Clinical Instructor (Mr Kissinger), Office of Nursing
Education and Professional Practice Development, Cleveland Clinic, Ohio.

OBJECTIVE: The aim of this study was to examine the effectiveness of a
subcutaneous insulin double-checking preparation intervention on insulin
administration errors.

BACKGROUND: Insulin accounts for 3.5% of medication-related errors. The
Joint Commission and Institute for Safe Medication Practices recommend a
2-nurse double-checking procedure when preparing insulin.

METHODS: This study used a randomized, controlled, nonblinded, intent-to-
treat methodology.

RESULTS: In total, 266 patients were enrolled, and over 4 weeks of data
collection, there were 5238 opportunities for insulin administration.
Overall, 3151 insulin administration opportunities had no errors; the
double-checking group had more no-error periods than usual care. Of error
types, wrong time was predominant, but less prevalent in the double-
checking group. Omission errors were uncommon and occurred less in the
double-checking group.

CONCLUSIONS: The subcutaneous insulin double-checking preparation
procedure led to less insulin administration errors; however, timing
errors were most prevalent and are not resolved with double-checking
interventions.
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Surveillance of injecting-related injury and diseases in
people who inject drugs attending a targeted primary health care
facility in Sydney’s Kings Cross
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/25827187

Aust N Z J Public Health. 2015 Apr;39(2):182-7.
Surveillance of injecting-related injury and diseases in people who inject
drugs attending a targeted primary health care facility in Sydney’s Kings
Cross.

Ivan M1, van Beek I, Wand H, Maher L.

1The Kirby Institute for Infection and Immunity, Faculty of Medicine,
University of New South Wales.

OBJECTIVE: This study examined the prevalence of injecting-related
injuries and diseases (IRIDs) and associated risk factors among people who
inject drugs (PWID) attending a primary health care facility in Sydney’s
Kings Cross.

METHODS: We calculated prevalence of a wide range of IRIDs utilising data
reported by 702 PWID who completed a clinician-administered survey at
their first visit. Multivariable logistic regressions identified factors
independently associated with at least one episode of: i) cutaneous and
ii) non- cutaneous IRIDs.

RESULTS: Lifetime prevalence of cutaneous IRIDs was 23%. Forty-two per
cent of PWID with a history of abscess attended hospital at their most
recent episode. Female gender, lifetime receptive syringe sharing (RSS),
injecting while in custody, and ever injecting in places other than the
arm were independently associated with reporting at least one episode of
cutaneous IRIDs. Ever injecting in sites other than the arm, injecting for
five or more years and lifetime history of RSS were independently
associated with at least one episode of non-cutaneous IRIDs.

CONCLUSIONS: IRIDs are a substantial health issue for PWID. Their ongoing
surveillance is warranted particularly in primary care settings targeting
PWID to inform prevention and early management, thus reducing
complications that may require hospital admission.

© 2015 Public Health Association of Australia.

KEYWORDS: injecting-related injury and diseases; people who inject drugs;
primary care
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Drug use in prisons: strategies for harm reduction (ANRS-
PRIDE Program)
__________________________________________________________________

http://dx.doi.org/10.1590/1413-81232015217.28442015

Cien Saude Colet. 2016 Jun;21(7):2081-8. Free full text
Drug use in prisons: strategies for harm reduction (ANRS-PRIDE Program).

Michel L1.

1Centre de Recherche en Épidémiologie et Santé des Populations, Centre
Pierre Nicole. 27 Rue Pierre Nicole. 75005 Paris France.
laurentnmichel@gmail.com.

The existence of risky practices related to drug use inside prisons is a
reality everywhere and is a major issue for the community as a whole.

The level of implementation of harm reduction (HR) measures recommended by
the World Health Organization (WHO) and the United Nations Office on Drugs
and Crime (UNODC) is very often poor and reveals inadequate concern about
public health issues in the prison environment, without any respect for
the principle of equivalence for prevention and health assistance with the
general community.

In 2009, the French National Agency for Research on AIDS and Viral
Hepatitis (ANRS) developed a comprehensive research program focusing on
the prevention of infectious risks in prison settings. Different steps
were defined and scheduled, and included i) an inventory of harm reduction
(HR) measures, ii) a qualitative survey on the reality of risky practices,
iii) an assessment of the social acceptability of HR measures, and iv) an
intervention trial exploring the feasibility of upgrading existing HR
strategies.

A progressive implementation of this program has shown it is feasible,

but in France, it requires tenacity, simple long-term objectives, support
from a scientific authority, pedagogical interventions for all involved,
as well as constant discussion with the authorities.

The implementation of this program in other countries is equally simple to
manage.

Free full text http://dx.doi.org/10.1590/1413-81232015217.28442015
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Effects of combination approach on harm reduction programs:
the Taiwan experience
__________________________________________________________________

https://dx.doi.org/10.1186/s12954-016-0112-3

Harm Reduct J. 2016 Jul 4;13(1):23. Open Access Article
Effects of combination approach on harm reduction programs: the Taiwan
experience.

Lin T1,2, Chen CH3, Chou P4.

1Community Medicine Research Center and Institute of Public Health,
National Yang-Ming University, No.155, Section 2, Ni-Long Street, Taipei,
11221, Taiwan.
2Taiwan AIDS Foundation, No. 410, 8F, Nanjing W. Rd., Tatung Dist.,
Taipei, 10343, Taiwan.
3Taiwan Centers for Disease Control, Ministry of Health and Welfare, No.6,
Linsen S. Rd., Zhongzheng Dist., Taipei, 10050, Taiwan.
4Community Medicine Research Center and Institute of Public Health,
National Yang-Ming University, No.155, Section 2, Ni-Long Street, Taipei,
11221, Taiwan. pschou@ym.edu.tw.

BACKGROUND: In 2003, a major epidemic of human immunodeficiency virus
emerged among injection drug users in Taiwan. In response to the twin
epidemics of HIV and intravenous drug addiction, the government
implemented comprehensive harm reduction programs beginning in 2005.
Collected data from relevant agencies were used to explore the impact of
the harm reduction programs on HIV and illicit drug use.

METHODS: This study divided 2002-2015 into three intervention phases and
used the surveillance data and statistics on the HIV epidemic, drug abuse,
and the intervention from relevant agencies to explore the correlations
between different variables in different intervention periods and the
combination effects of interventions on the HIV epidemic.

RESULTS: In the pre-intervention phase, the growth of the HIV epidemic
followed the rapidly increasing number of heroin users, reaching a peak in
2005. After the initiation of harm reduction programs, the HIV epidemic
ceased growing, even rapidly declining with the expansion of needle and
syringe exchange programs and opioid substitution therapy; however, the
number of heroin users remained high. When the implementation of the
needle and syringe exchange programs and the opioid substitution therapy
program reached the plateau level in the consolidation phase, the number
of heroin users also decreased rapidly. The combination effects of the
harm reduction programs in this period also pushed levels of HIV infection
below those before this outbreak.

CONCLUSIONS: The HIV epidemic among injection drug users incorporates the
dual problems of drug addiction and needle-sharing behaviors, so the use
of a single intervention will not resolve all of the problems. Facing a
severe HIV epidemic among injection drug users, quickly scaling up and
promoting comprehensive harm reduction programs is a good strategy that
can be used to simultaneously reverse the HIV epidemic and to resolve the
illicit drug use problems. More research is needed to find out the reasons
behind why there were cases that declined opioid substitution therapy, so
that efforts can be undertaken to avoid the epidemic rebounding.

KEYWORDS: Combination intervention approaches; Comprehensive harm
reduction programs; Forced withdrawal; Human immunodeficiency virus;
Injection drug users; Needle and syringe exchange programs; Opioid
substitution therapy; Relapse
__________________________________________________________________
________________________________*_________________________________

9. Abstract: Innovation of a syringe needle auto-detaching device for
clinicians
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/25813516

Technol Health Care. 2015;23(4):523-8.
Innovation of a syringe needle auto-detaching device for clinicians.

Chen CC1, Chen SC2, Shih YY3, Chen YL4.

1Department of Management Information Systems, Hwa Hsia University of
Technology, New Taipei City, Taiwan.
2Department of Physical Medical & Rehabilitation, School of Medicine,
College of Medicine, Taipei Medical University, Taipei, Taiwan.
3Department of Physical Medical & Rehabilitation, Tao-Yuan Ghang-Gung
Memorial Hospital, Taiwan.
4Department of Digital Technology Design, National Taipei University of
Education, Taipei, Taiwan.

BACKGROUND: Needle-stick injuries accounts for a great proportion of all
medical accidents in developing and undeveloped countries. The main cause
of needle-stick accident injuries is the medical personnel’s
“recovering” the needle action after injection.

OBJECTIVE: This study applies an electronic technique to the needling
instrument for the purpose of automatically detaching the needle. The
proposed method can effectively avoid needle-stick accident injury when
“recovering” the needle.

METHODS: The syringe needle auto-detaching device includes an abutment on
which there is a turntable mechanism composed of a pedestal, a turn-table
and a driving unit. A photo interrupter on the pedestal detects the
rotational angle of the turntable and controls the stepping motor through
a control circuit. An optical sensor is located on the upper end of the
sensing mechanism. When the syringe is inserted into the syringe plughole
the exposed portion of the needle will be detected by the optical sensor.
After the syringe is placed into the plughole, its needle will be detected
by the sensor. At this time the needle will be detached from the syringe
and automatically fall down into the needle collection box.

RESULTS: The syringe needle auto-detaching device was fatigue tested for
an extensive period of time (A group: 1000 times/day for 3 ml, B group:
1000 times/day for 5 ml, C group: 1000 times/day for 3 ml and 5 ml
staggered, D group: 1000 times/day for 3 ml and 5 ml randomized). The
needle and syringe detachment rates were 100% in all test groups.

CONCLUSIONS: The syringe needle auto-detaching device developed in this
study, in that the clinician performs only one step to dispose a needle.
Six syringe needle sets can be managed sequence second by second. The
proposed device without all of the risk factors of the traditional syringe
needle detachment device.

KEYWORDS: Needle-stick; medical treatment; needle recovering; needling
instrument
__________________________________________________________________
________________________________*_________________________________

10. Abstract: AutoSyP: A Low-Cost, Low-Power Syringe Pump for Use in Low-
Resource Settings
__________________________________________________________________

http://www.ajtmh.org/content/early/2016/06/30/ajtmh.16-0285.long

Am J Trop Med Hyg. 2016 Jul 5. pii: 16-0285. Open Access Article
AutoSyP: A Low-Cost, Low-Power Syringe Pump for Use in Low-Resource
Settings.

Juarez A1, Maynard K2, Skerrett E2, Molyneux E3, Richards-Kortum R4, Dube
Q3, Oden ZM5.

1Rice 360: Institute for Global Health Technologies, Rice University,
Houston, Texas. Basic Health International, San Salvador, El Salvador.
2Rice 360: Institute for Global Health Technologies, Rice University,
Houston, Texas.
3Department of Paediatrics, Queen Elizabeth Central Hospital, Blantyre,
Malawi.
4Rice 360: Institute for Global Health Technologies, Rice University,
Houston, Texas. Department of Bioengineering, Rice University, Houston,
Texas.
5Rice 360: Institute for Global Health Technologies, Rice University,
Houston, Texas. Department of Bioengineering, Rice University, Houston,
Texas. moden@rice.edu.

This article describes the design and evaluation of AutoSyP, a low-cost,
low-power syringe pump intended to deliver intravenous (IV) infusions in
low-resource hospitals.

A constant-force spring within the device provides mechanical energy to
depress the syringe plunger. As a result, the device can run on
rechargeable battery power for 66 hours, a critical feature for low-
resource settings where the power grid may be unreliable.

The device is designed to be used with 5- to 60-mL syringes and can
deliver fluids at flow rates ranging from 3 to 60 mL/hour.

The cost of goods to build one AutoSyP device is approximately $500.

AutoSyP was tested in a laboratory setting and in a pilot clinical study.
Laboratory accuracy was within 4% of the programmed flow rate.

The device was used to deliver fluid to 10 healthy adult volunteers and 30
infants requiring IV fluid therapy at Queen Elizabeth Central Hospital in
Blantyre, Malawi. The device delivered fluid with an average mean flow
rate error of -2.3% ± 1.9% for flow rates ranging from 3 to 60 mL/hour.

AutoSyP has the potential to improve the accuracy and safety of IV fluid
delivery in low-resource settings.

© The American Society of Tropical Medicine and Hygiene.
__________________________________________________________________
________________________________*_________________________________

11. Abstract: Influence of material properties on gloves’ bacterial
barrier efficacy in the presence of microperforation
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27388267

Am J Infect Control. 2016 Jul 4. pii: S0196-6553(16)30487-4.
Influence of material properties on gloves’ bacterial barrier efficacy in
the presence of microperforation.

Bardorf MH1, Jäger B2, Boeckmans E3, Kramer A1, Assadian O4.

1Institute for Hygiene and Environmental Medicine, University Medicine
Greifswald, Greifswald, Germany.
2Institute of Biometry and Medical Computer Science, University Medicine
Greifswald, Greifswald, Germany.
3Ansell Healthcare Europe NV, Brussels, Belgium.
4Institute for Skin Integrity and Infection Prevention, School of Human &
Health Sciences, University of Huddersfield, Huddersfield, United Kingdom.
Electronic address: o.assadian@hud.ac.uk.

BACKGROUND: Medical examination gloves and surgical gloves protect the
wearer directly and the patient indirectly from the risk of contamination.
Because of concerns related to latex allergy, an increasing trend toward
the use of synthetic gloves made of materials other than latex is
observable. However, currently it is unknown if the physical properties of
different materials may influence bacterial passage in case of a glove
puncture.

METHODS: We examined 9 different medical examination gloves from various
manufacturers made of nitrile (n?=?4), latex (n?=?3), or neoprene (n?=?2).
Additionally, 1 latex surgical glove each with and without antibacterial
chlorhexidine gluconate coating and 1 synthetic surgical glove made of
thermoplastic elastomer were included in the experiments. The studied
materials were perforated following a standardized procedure, and direct
bacterial passage was measured under dynamic conditions. Glove elasticity
at 1?cm up to 2.5?cm elongation was measured following EN 455-2.

RESULTS: Nitrile gloves demonstrated higher material stiffness compared
with latex gloves. Medical examination gloves made of nitrile and neoprene
showed a 10-fold higher bacterial passage through a standardized puncture
compared with latex gloves. All surgical gloves showed a lower bacterial
passage compared with the tested examination gloves.

CONCLUSION: Bacterial passage through punctures is correlated with the
stiffness or elasticity of the glove material. Therefore, gloves made of
latex may have an increased protective effect in case of a glove breach.
Whenever gloves are purchased and selected, a risk-benefit assessment
should be conducted, balancing the risk of allergy against the degree of
required protection in case of a glove puncture.

Copyright © 2016 Association for Professionals in Infection Control and
Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

KEYWORDS: Bacterial passage; Latex; Nitrile; Perforation
__________________________________________________________________
________________________________*_________________________________

12. Abstract: Acquisition of bacteria on health care workers’ hands after
contact with patient privacy curtains
__________________________________________________________________

https://www.ncbi.nlm.nih.gov/pubmed/27388269

Am J Infect Control. 2016 Jul 4. pii: S0196-6553(16)30435-7.
Acquisition of bacteria on health care workers’ hands after contact with
patient privacy curtains.

Larocque M1, Carver S2, Bertrand A1, McGeer A3, McLeod S2, Borgundvaag B4.
Author information
1Mount Sinai Hospital, Toronto, ON, Canada.
2Mount Sinai Hospital, Toronto, ON, Canada; Schwartz/Reisman Emergency
Medicine Institute, Toronto, ON, Canada.
3Mount Sinai Hospital, Toronto, ON, Canada; Division of Infectious
Diseases, Department of Medicine, University of Toronto, Toronto, ON,
Canada; Division of Medical Microbiology, Department of Laboratory
Medicine and Pathology, University of Toronto, Toronto, ON, Canada.
Electronic address: amcgeer@mtsinai.on.ca.
4Mount Sinai Hospital, Toronto, ON, Canada; Schwartz/Reisman Emergency
Medicine Institute, Toronto, ON, Canada; Department of Family and
Community Medicine, University of Toronto, Toronto, ON, Canada.

To determine whether pathogenic bacteria could be transferred to health
care workers by touching privacy curtains, imprints of health care
workers’ fingertips were obtained when participants were approached, after
hand hygiene with alcohol handrub, and directly after handling curtains.

Participants’ hands were heavily contaminated at baseline, in some cases
with potentially pathogenic species.

Half of the participants (n?=?30) acquired bacteria on their fingertips
from handling curtains, illustrating that privacy curtains may be involved
in the transmission of infection to emergency department patients.

Copyright © 2016 Association for Professionals in Infection Control and
Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

KEYWORDS: Bacterial contamination; hand hygiene
__________________________________________________________________
________________________________*_________________________________

13. Intro No Abstract: Acute Hepatitis C Sustained by a Cardiac Surgeon
After a Needlestick Injury: A Case of “Murphy’s Law”?
__________________________________________________________________
Zentralbl Chir. 2016 Jul 7. [Epub ahead of print]
[Acute Hepatitis C Sustained by a Cardiac Surgeon After a Needlestick
Injury: A Case of “Murphy’s Law”?]

[Article in German]

Wicker S1, Wutzler S2, Marzi I2, Rabenau HF3.

1Betriebsärztlicher Dienst, Universitätsklinikum Frankfurt, Deutschland.
2Klinik für Unfall-, Hand- und Wiederherstellungschirurgie,
Universitätsklinikum Frankfurt, Deutschland.
3Institut für Medizinische Virologie, Universitätsklinikum Frankfurt,
Deutschland.

DOI: 10.1055/s-0042-110659

Einleitung

Im Rahmen einer Herzklappenoperation kam es am 14. Januar 20XX zu einer
Nadelstichverletzung (NSV) bei einem Kardiochirurgen. Der Kardiochirurg
wurde von seinem Assistenten während des abschließenden Hautverschlusses
mit einer Subkutannadel oberflächlich ins Fingerendglied gestochen. Bei
dem Indexpatienten handelte es sich um einen Patienten mit bekannter HIV-
und Hepatitis-C-Infektion (HCV). Die HIV-Viruslast lag zum Zeitpunkt der
NSV bei bestehender antiretroviraler Therapie des Indexpatienten unter der
Nachweisgrenze, Anti-HCV waren positiv, eine HCV-PCR zur Bestimmung der
Viruslast des Indexpatienten wurde nicht durchgeführt. Der Kardiochirurg
stellte sich unmittelbar nach dem Vorfall beim D-Arzt vor, der die NSV als
Arbeitsunfall der zuständigen Berufsgenossenschaft meldete.
From Google Translate (with help):

Introduction

As part of a cardiac valve surgery occurred on January 14, 20XX to a
needlestick injury ( NSI ) in a Cardiac Surgeon . The Cardiac Surgeon was
stung by his assistant during the final skin closure with a hypodermic
needle into the superficial Finger end . If the index patient there was a
patients with known HIV and hepatitis C infection ( HCV ). The HIV viral
load was at the time of NSI among existing antiretroviral treatment of the
index patient below the detection limit , anti – HCV were positive , HCV –
PCR to determine the viral load of the index patient was not performed .
The Cardiac Surgeon turned immediately after the incident reported the NSA
as an occupational accident
__________________________________________________________________
________________________________*_________________________________

14. Jobs: Short-term experts Procurement and Supply Management of
health commodities

Crossposted from E-DRUG with thanks. e-drug mailing list:
e-drug@healthnet.org http://lists.healthnet.org/mailman/listinfo/e-drug
__________________________________________________________________
E-DRUG: Short-term experts Procurement and Supply Management of
health commodities – French speaking experts especially welcome!
ResultsinHealth (RiH) is an international advisory agency, working in a
variety of public health areas in developing and industrialised countries.
Its mission is to improve the health of populations, and to strengthen
access to essential health care. RiH has a strong focus on using evidence
to develop practical and innovative solutions. For more information about
RiH, please visit www.resultsinhealth.org

ResuiltsinHealth has major responsibilities for procurement and supply
management (PSM) oversight in over 70 countries, through a collaborative
agreement with PricewaterhouseCoopers and the Global Fund to Fight AIDS,
Tuberculosis and Malaria (the ‘Global Fund’). Products procured under
Global Fund grants include medicines, diagnostics, lab materials, medical
equipment, and preventive materials such as long-lasting insecticide
treated nets, condoms, and other.

To effectively handle these responsibilities, RiH is looking for
independent experts who are well experienced in assessing systems to
procure and manage health products, and who can produce high quality
advice to the Global Fund. Assignments will be on a short-term basis.

Responsibilities

Assessments relate to the full cycle of product selection, quantification
of needs, procurement, quality assurance, storage, distribution, inventory
management, and their appropriate use. Experts will assess and monitor PSM
systems, with the aim of ensuring best practice and risk minimization for
the Global Fund. Activities may involve onsite assessment visits, as well
as desk reviews of PSM related planning and monitoring documentation.
Requests come often at short notice, and responses must be swift. Onsite
work typically requires 1-2 weeks visits, and reporting is generally
required shortly thereafter.

Qualifications

Successful candidates have a university degree in pharmacy, in health, or
in a related area, and several years of experience in international
procurement and supply chain management of health products. Several years
of hands-on experience is a non-negotiable requirement. Training in
pharmaceutical procurement, international tendering, pharmaceutical supply
chain management and/or project management are highly desirable, as is
experience in the management and implementation of HIV/AIDS, Malaria and/
or Tuberculosis control programmes in developing countries.

Requirements

RiH experts have a strong commitment to health and development, and a
special interest in issues related to public health. They have an open
mindset, flexible attitudes, and an entrepreneurial approach. Strong
interpersonal skills are indispensable, as are self-management skills and
an ability to deliver in a timely fashion. They express themselves clearly
and concisely, especially in written form.

Languages

Good verbal and written knowledge of English is a key requirement. All
reports will have to be written in the English language. Whereas experts
of all languages are warmly welcomed, those with French language skills
are especially welcome. PSM experts who live in, or close to, Global Fund
`high impact’ countries (in particular in the African, Asian, Eastern
European and Central Asian regions) will have an advantage.

RiH support

RiH works with a system of peer-review and discussion within the wider RiH
team. Senior PSM experts coach new colleagues to strengthen their skills
and experience. Deliverables are reviewed to ensure consistency with
internationally accepted good practice, regulations and requirements.
Given RiH’s strong evidence-based approach, emphasis is placed on the
promotion of objectively verifiable data and reference sources. All
services are coordinated by RiH’s central coordination team in Leiderdorp,
The Netherlands.

Applications should be sent by email to Team.GF@resultsinhealth.org.
Please include the following information:
– Curriculum Vitae
– Short letter of presentation (½ – 1 page), describing your
abilities to meet the essential requirements
– Names and contact details of a minimum of 2 references

RiH is known for establishing long-term win-win collaborations with
independent experts, and we look forward to receiving new colleagues in
our expanding team of short-term collaborators.

Should you know of colleagues who are interested to hear of our call for
short-term experts, please feel free to share this alert.

Hilbrand Haak
ResultsinHealth
Zijlbaan 46
2352 BN Leiderdorp
The Netherlands
T +31 71 760 1200
F +31 71 523 3592
E haakh@resultsinhealth.org
W www.resultsinhealth.org
__________________________________________________________________
________________________________*_________________________________

15. News

– Yellow Fever: WHO cites 2-month window for battling yellow fever

– Global: Viral hepatitis ‘kills as many as Aids or TB’

– MA USA: City of Gloucester responds to discarded needles found in public
places

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/jopq3yh
Yellow Fever: WHO cites 2-month window for battling yellow fever

by Stephanie Soucheray, CIDRAP News, USA (07.07.16)

“We’re seeing a change in the nature of the yellow fever outbreaks we’re
dealing with.”

That’s how Bruce Aylward, M.D., World Health Organization (WHO) interim
executive director of outbreaks and health emergencies, began a briefing
today on yellow fever in which he discussed the current outbreak in Angola
and the Democratic Republic of the Congo (DRC) and what’s being done to
address it.

Aylward said the WHO is going to launch a massive vaccination campaign
over the next 2 months, using diluted doses and vaccines donated from
Brazil to inoculate 15.5 million in the border areas between Angola and
the DRC and in Kinshasa. This is in addition to current vaccine efforts
being made near outbreak areas.

Vaccination must be swift

The scale of the vaccine campaign is unprecedented, Aylward said. Since
January, when yellow fever first appeared in Luanda, Angola, 14.5 million
people have been vaccinated in that city and surrounding areas.

The campaign launching this month will bring the total number of
vaccinated people to 30 million. Aylward said the WHO, in collaboration
with Gavi, the Vaccine Alliance, Angola, and the DRC, needs to work fast
to vaccinate during the dry months, when mosquito populations are down.

“We have a 2-month window to belt this thing,” he said.

“I often see in the press that the problem is that there’s not enough
vaccine,” said Aylward. “That’s not the problem; the problem is that the
vaccine is not used effectively enough or fast enough to stop the
outbreak.”

Twice vaccine efforts in the past 6 months have drained the global
stockpile of the yellow fever vaccine, which usually stands at 6 million.
Aylward said that, to cover the targeted populations, diluted vaccines,
one-fifth the standard dose, will be used in urban areas, along with 5
million donated vaccines from Brazil. Yellow fever is endemic in Brazil
but not currently a threat to public health.

“Our primary focus is Kinshasa; we want 8 million people vaccinated in
August,” said Aylward. Three million people in anterior Angola and 4.3
million along the DRC-Angola corridor will also be vaccinated.

The cost of the campaign is $34 million. Aylward said $14 million is
currently available from Gavi and vaccine donations, but the gap of $20
million will have to be filled by donors. The governments of Angola and
the DRC are expected to shoulder much of the cost, as well.

The vaccine is inexpensive, about $1 to make and $1.50 to administer,
according to the WHO. Alyward said adults in urban areas like Kinshasa are
the best candidates for diluted doses, which would offer protection for at
least 1 year. Children, he said, should still get the full vaccine dose,
because fractioned dosing hasn’t been tested on that population.

*** Earlier this week, Reuters reported there was a syringe shortage in
Kinshasa. Alyward explained that the shortage was misrepresented: Diluted
yellow fever vaccine doses need to be administered with a smaller needle,
as they are given subcutaneously and not intramuscularly. WHO estimates it
will have enough of the smaller syringes by August.

Changing epidemiology

Aylward said the current outbreak is “a clarion call” to rethink strategy
on yellow fever control.

Yellow fever is a mosquito-borne hemorrhagic virus, endemic in 47
countries. Thirty-three of those countries are in Africa, with the rest in
Latin America.

In 2006, countries in West Africa began a yellow fever vaccination
campaign that was successful at getting 100 million children aged 9 months
to 2 years vaccinated, as well as the rural populations who lived near the
primates that host the disease. The problem, Aylward explained, is that
yellow fever is no longer a rural disease, and the children who’ve been
vaccinated haven’t yet contributed to population, or herd, immunity.

“There’s no evidence of change in virus,” said Aylward. “What we’re seeing
is a changing world.” Aylward said the rapid urbanization of Africa over
the last 10 years and increased movement and mobility of people have made
routine rural vaccination programs ineffective.

Most people who’ve contracted the disease during this outbreak are middle-
aged, too old to have benefited from last decade’s vaccine efforts and too
young to have gained immunity through exposure.

As of this week, the WHO has reported 3,552 cases in Angola, with 355
deaths. The DRC reports 1,300 cases.

Noting that there have been only 10 deaths from yellow fever in the past 2
weeks, Aylward said the low mortality rate wasn’t surprising, as both
Angola and the DRC have had an active response to the outbreak.

Surveillance to prevent international spread
While international spread is a concern to the WHO, the fact that yellow
fever has not traveled beyond the outbreak zone since April is somewhat
reassuring, Aylward. In March, 2 cases of Angolan yellow fever appeared in
Kenya. In April, 11 guest workers traveled from Angola to China and came
down with the disease.

Heightened surveillance, especially along land borders, will be key to
preventing the spread of yellow fever, Aylward said. He applauded Brazil,
a country with endemic yellow fever, for donating its vaccine supply,
adding that guarding vaccine stockpiles in countries where there’s no
current outbreak is not helpful.

Increased cases in the Americas
In other yellow fever news, the Pan American Health Organization (PAHO)
released an epidemiologic update today on cases in Brazil, Colombia, and
Peru. These cases are not related to the outbreak in Angola.

According to the report, Peru now has 106 suspected cases, 42 of them
confirmed, and 9 deaths. The number of cases in that country is now more
than the number of cases in the last 9 years combined. Most cases (58)
have been in Junin department.

Brazil has a confirmed case in an area where the disease is endemic and
where there were recent monkey illnesses. Colombia is increasing vaccine
coverage in the three municipalities near recent jungle outbreaks in non-
human primates.
__________________________________________________________________
__________________________________________________________________

http://www.bbc.com/news/health-36717828
Global: Viral hepatitis ‘kills as many as Aids or TB’

By Smitha Mundasad, BBC News, UK (07.07.16)

Viral hepatitis is one of the leading killers across the globe, with a
death toll that matches Aids or tuberculosis, research in the Lancet
suggests.

The report estimates that hepatitis infections and their complications led
to 1.45m deaths in 2013 – despite the existence of vaccines and
treatments.

World Health Organization data shows there were 1.2m Aids-related deaths
in 2014, while TB led to 1.5m deaths.

The WHO has put forward a global strategy to tackle hepatitis.
‘Startling findings’

Researchers say these plans must be put into action urgently to tackle the
crisis.

Viral hepatitis refers to five different forms of virus (known as A, B, C,
D, E) – some can be spread through contact with infected bodily fluids and
others (A and E) through contaminated food or water.

Most deaths worldwide are due to B and C, which can cause serious liver
damage and predispose people to liver cancer. But because people don’t
always feel the symptoms of the initial infection, they can be unaware of
the long-term damage until it is too late.

Scientists from Imperial College London and the University of Washington
examined data from 183 countries, collected between 1990 and 2013.

They found the the number of deaths linked to viral hepatitis rose by more
than 60% over two decades – partly due to a growing population.
Deaths from diseases such as TB and malaria have dropped.

Dr Graham Cooke of Imperial College London described the findings as
startling.

He said: “Although there are effective treatments and vaccines for viral
hepatitis, there is very little money invested in getting these to
patients – especially compared to malaria, HIV/AIDS and TB.

“We have tools at our disposal to treat this disease – we have vaccines to
treat hepatitis A and B and we have new treatments for C.

“However the price of new medicines is beyond the reach of any country –
rich or poor.”

The study suggests the problem is biggest in East Asia.

But unlike many other diseases, deaths from viral hepatitis were higher in
high and middle income countries than in lower income nations.

The WHO hepatitis strategy, which was put forward in May 2016, includes
targets to reduce new cases of hepatitis B and C by 30% by 2020, alongside
a 10% reduction in mortality.

The WHO says countries and organisations will need to expand vaccination
programmes, focus on preventing mother-to-child transmission of hepatitis
B and increase access to treatment for hepatitis B and C, to help ensure
these targets are met.
__________________________________________________________________
__________________________________________________________________

https://tinyurl.com/z7pyhrk Infographic at the link
MA USA: City of Gloucester responds to discarded needles found in public
places

Wicked Local Manchester, Massachusetts USA (05.07.16)

GLOUCESTER

Gloucester Mayor Sefatia Romeo Theken, Police Chief Leonard Campanello and
Department of Public Works Director Michael Hale seek to inform the public
about a number of initiatives being undertaken to diminish the number of
discarded hypodermic needles being left in the City of Gloucester.

Gloucester, like virtually every community in the nation, is in the midst
of an unprecedented spike in heroin and opioid abuse. Discarded needles
are a concern in every city in the Commonwealth, but department heads in
Gloucester are committed to not only cleaning up the streets and gathering
spots but to also preventing used needles from becoming potentially
dangerous litter in the first place.

With the support of Mayor Romeo Theken, the North Shore Health Project
will be applying for a waiver from the Massachusetts Department of Public
Health for the establishment of a Pilot Program for the exchange of
needles in the City of Gloucester. This is part of a comprehensive Harm
Reduction Program that will include testing, education, Narcan
distribution and referral to treatment. Pending DPH approval, the site is
scheduled to open in mid-September.

An important goal of the program is to reduce the amount of needles
discarded on city streets and to reduce the likelihood that dirty needles
will be reused by those with substance use disorders. Dirty needles can
lead to transmission of disease and a host of other problems for
intravenous drug users.

Used syringes and other sharps should always be placed in a sharps
container and disposed of safely — either at a drop-off site or in a
mail-back program. Do not clip, bend, or recap needles and always keep
sharps and containers away from children and pets.

Established drop off sites in the city:

— North Shore Health Project, 5 Center St. Phone: 978-283-0101

— Addison Gilbert Hospital, 298 Washington St., Main Fisher Entrance
Phone: 978-283-4000

— Gloucester Police Department, 197 Main St. Phone: 978-283-1212

“Dirty and improperly disposed needles pose a problem for everyone, from
users, to tourists, to children who may come across them,” Mayor Romeo
Theken said. “Gloucester does not ignore our citizens who have asked for
leadership and safety in our community, but the reality is that we’re in
the middle of a nationwide heroin epidemic which cannot be ignored, even
here. We offer treatment options, we conduct outreach, and we are
committed to proper needle disposal as a sanitation and quality of life
issue that we must tackle as a community, together.”

In addition to the exchange program, Gloucester Public Works will have
crews in the city assigned to clean up any litter from streets, parks, and
beaches. Special attention will be paid to the Niles Beach area, where
multiple syringes have been spotted in recent weeks.

“Our public works crews, in cooperation with Mayor Romeo Theken’s office,
are on the lookout for discarded needles and other litter,” Director Hale
said. “This is a quality of life issue for our community, and we are
committed to cleaning up and working with the city to raise awareness.”
Gloucester Police will also step up patrols at town parks and beaches to
dissuade drug use in public gathering places.

“The rise of heroin and other opioids across the nation has a ripple
effect, and discarded needles are another way this crisis affects a
community,” Chief Campanello said.

Finally, the City and Police Department have taken great strides with the
Gloucester ANGEL Initiative toward addressing addiction from its root
causes. Since the program’s inception in June 2015, dozens of used needles
have been turned into police by program participants, who are then
transported for treatment across Massachusetts and the nation.

The city reminds all residents: If you find a needle on a sidewalk or
other public way, do not pick it up, instead please call the Gloucester
Police Department non-emergency line at 978-283-1212. Provide the location
of the needle with as much detail as possible so that the responding
officer can locate the waste.
__________________________________________________________________
________________________________*_________________________________

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 unsubscribe by email: signmoderator@googlegroups.com

The SIGNpost Website is http://SIGNpostOnline.info

The SIGNpost website provides an archive of all SIGNposts, meeting
reports, field reports, documents, images such as photographs, posters,
signs and symbols, and video.
__________________________________________________________________
________________________________*_________________________________

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 GoogleGroups

Subscribe or unsubscribe by email: signmoderator@googlegroups.com
__________________________________________________________________

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