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SIGNpost 00638

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST *SAFE INJECTION GLOBAL NETWORK*

Post00638 Abstracts + Abstracts + Funds + Market 07 March 2012

CONTENTS

1. Abstract: Case-control study of hepatitis B and hepatitis C in older
adults: Do healthcare exposures contribute to burden of new infections?
2. Abstract: Infection control systems in transition: the challenges for
post-Soviet Bloc countries
3. Abstract: Clinical issues-march 2012 [Multidose Vials]
4. Abstract: Sharps injury prevention for hospital workers
5. Abstract: Needlestick injuries: a survey of doctors working at Tertiary
Care Hospitals of Rawalpindi
6. Abstract: Prevention of healthcare-associated infections in general
practice: Current practice and drivers for change in a French study
8. Abstract: Occupational hazards to dental staff
9. Abstract: Anti-HCV prevalence in the general population of Lithuania
10. Abstract:Prevalence of hepatitis C virus infection and human
immunodeficiency virus in a cohort of Egyptian hemophiliac children
11. Abstract: Toddlers’ choice: Yo-Yoing diabetes control or deci-unit
insulin dosing?
12. Abstract: Safe injection practices for administration of propofol
13. Abstract: A harm reduction paradox: Comparing China’s policies on
needle and syringe exchange and methadone maintenance
14. Abstract: HIV risk behaviours among injecting drug users in Northeast
India following scale-up of a targeted HIV prevention programme
15. Abstract:Injectable and Oral Contraceptive Use and Cancers of the
Breast, Cervix, Ovary, and Endometrium in Black South African Women:
Case-Control Study
16. Abstract: To ask or not to ask?: The results of a formative assessment
of a video empowering patients to ask their health care providers to
perform hand hygiene
17. Abstract: Measuring healthcare worker hand hygiene activity: current
practices and emerging technologies
18. Abstract: A Pan-European and Canadian prospective survey to evaluate
patient satisfaction with the SoloSTAR insulin injection device in type
1 and type 2 diabetes
19. Abstract: Prestress as an optimal biomechanical parameter for needle
penetration
20. Abstract: Reducing oral flora contamination of intravitreal injections
with face mask or silence
21. Abstract: Is it true that injecting palmar finger skin hurts more than
dorsal skin? New level 1 evidence
22. Abstract: An evaluation of sharp safety intravenous cannula devices
23. No Abstract: Risk factor analysis of sharp medical instrument injuries
24. Martket Report: Global Special Purpose Needles Market to Reach $4.0
Billion by 2017, According to New Report by Global Industry Analysts,
Inc.
25. Funding: Engaging Local Indigenous Organizations in Developing HIV/AIDS
Monitoring and Evaluation Capacity in Ukraine under the President’s
Emergency Plan for AIDS Relief (PEPFAR)
26. Patient Safety Research: Introductory Course (On-Line)
27. News
– China: Wrong treatment leads to Hepatitis C cases
– China: AIDS fight set to get new boost
– USA: HIV rate among US intravenous drug users falls: CDC
– USA: HIV among injection drug users declines

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__________________________________________________________________
________________________________*_________________________________

1. Abstract: Case-control study of hepatitis B and hepatitis C in older
adults: Do healthcare exposures contribute to burden of new infections?
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22383058

Hepatology. 2012 Mar 2. doi: 10.1002/hep.25688.

Case-control study of hepatitis B and hepatitis C in older adults: Do
healthcare exposures contribute to burden of new infections?

Perz JF, Grytdal S, Beck S, Fireteanu AM, Poissant T, Rizzo E, Bornschlegel
K, Thomas A, Balter S, Miller J, Klevens M, Finelli L.

Centers for Disease Control and Prevention. JPERZ@CDC.GOV.

BACKGROUND: Reports of hepatitis B and hepatitis C virus transmission
associated with unsafe medical practices have been increasing in the United
States. However, the contribution of healthcare exposures to the burden of
new infections is poorly understood outside of recognized outbreaks.

METHODS: We conducted a case-control study at 3 health departments that
perform enhanced viral hepatitis surveillance in New York and Oregon.
Reported cases of symptomatic acute hepatitis B and hepatitis C occurring
in persons aged = 55 years from 2006-2008 were enrolled. Controls were
identified using telephone directories and matched to individual cases by
age group (55-59 years, 60-69 years, and =70 years) and residential ZIP
code. Data collection covered exposures within 6 months prior to symptom
onset (cases) or date of interview (controls).

RESULTS: Forty-eight (37 hepatitis B; 11 hepatitis C) case- and 159
control-patients were enrolled. Case-patients were more likely than
controls to report one or more behavioral risk exposures, including sexual
or household contact with an HBV or HCV patient, >1 sex partner, illicit
drug use or incarceration (21% of cases vs 4% of controls exposed; matched
Odds Ratio [mOR]=7.1; 95%CI 2.1, 24.1).

Case-patients were more likely than controls to report hemodialysis (8% of
cases; mOR=13.0; 95%CI 1.5, 115); injections in a healthcare setting (58%;
mOR=2.7; 95%CI 1.3, 5.3); and surgery (33%; mOR=2.3; 95%CI 1.1, 4.7). In a
multivariate model, behavioral risks (adjusted OR [aOR]=5.4, 95%CI 1.5,
19.0; 17% attributable risk), [*] injections (aOR=2.7, 95%CI 1.3, 5.8; 37%
attributable risk) and hemodialysis (aOR=11.5, 95%CI 1.2, 107; 8%
attributable risk) were associated with case status.

CONCLUSION: Healthcare exposures may represent an important source of new
HBV and HCV infections among older adults.

Copyright © 2012 American Association for the Study of Liver Diseases.
__________________________________________________________________
________________________________*_________________________________

2. Abstract: Infection control systems in transition: the challenges for
post-Soviet Bloc countries
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22377387

J Hosp Infect. 2012 Feb 27.

Infection control systems in transition: the challenges for post-Soviet
Bloc countries.

Ider BE, Adams J, Morton A, Whitby M, Clements A.

University of Queensland, School of Population Health, Brisbane,
Queensland, Australia.

BACKGROUND: Just two decades ago, 30 of today’s countries in Europe and
Asia had socialist governments under Soviet dominance or direct
administration. Intensive health system reforms have altered infection
control in many of these countries. However, much of the literature from
these countries is difficult to access by international scientists.

AIM: To summarize existing infection control policies and practices in
post- Soviet Bloc countries.

METHODS: In addition to PubMed and Google search engines, we explored local
websites and grey literature. In total, 192 references published in several
languages were reviewed.

FINDINGS: Infection control in these countries is in the midst of
transition. Three groups of countries were identified. First, Eastern
European and Baltic countries building surveillance systems for specific
pathogens and antibiotic use; second, European post-Soviet Bloc countries
focusing on the harmonization of recently established infection control
infrastructure with European surveillance programmes; third, countries such
as those formerly in the Union of Soviet Socialist Republics, Mongolia and
post-conflict Eastern European countries that are in the first stages of
reform. Poor commitment, resource scarcity and shortages of expertise were
identified. Underreporting of official infection control statistics is
widespread.

CONCLUSIONS: Guidance from international organizations has been crucial in
initiating and developing contemporary infection control programmes. More
support from the international community will be needed for the third group
of countries, where infection control has remained a neglected issue.

Copyright © 2012 The Healthcare Infection Society. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

3. Abstract: Clinical issues-march 2012 [Multidose Vials]
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22381560

AORN J. 2012 Mar;95(3):406-13.

Clinical issues-march 2012.

Denholm B.

AORN Center for Nursing Practice.

Using multidose vials

Key words: multidose vials, cross contamination, single-dose vials, safe
injection practices.

Perioperative incremental local anesthetic injections Key words: multiple
injections, safe injection practices, incremental doses, local anesthetics.

Placing unsterile solutions on the sterile field Key words: safe medication
practices, unsterile solutions, nonmedications, chemical solutions.
Sterilizing or disinfecting ureteroscopes and colonoscopes

Key words: flexible scopes, cystoscopy, ureteroscopy, colon reanastomosis,
high-level disinfection.

Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Free full text:
http://www.aornjournal.org/article/S0001-2092(11)01384-6/fulltext
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Sharps injury prevention for hospital workers
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22152510

Int J Occup Saf Ergon. 2011;17(4):455-61.

Sharps injury prevention for hospital workers.

Toraman AR, Battal F, Ozturk K, Akcin B.

Sema Hospital, Istanbul, Turkey. artoraman@semahastanesi.com.tr

Objectives. The purpose of this study was to collect data on self-reported
sharps injuries to develop best practices to reduce them.

Methods. Data on sharps injuries were collected for the period of January-
October 2008 using Adverse Event Notification Forms already in use at Sema
Hospital.

Results. On average, 0.2% of all self-reported injuries were sharps
injuries averaging one injury per month. Housekeeping staff sustained 64%
of such injuries, nurses sustained 36% (5 incidents). Outpatient clinics
experienced the most injuries at 28%, followed by the Internal Diseases
Inpatient Unit with 21% and the Medical Waste Room with 14%. Injuries often
occurred during contact with medical waste bags (28%) and while replacing
full sharp-boxes (14%).

Conclusion. In summary, reducing needle stick injuries is an important
component of the occupational and patient safety program at Sema Hospital.
The research described in this study allowed the hospital to provide
targeted interventions to increase awareness of the risks of needle stick
injuries and reduce such injuries.

The steps used in the study can be used in any health care organization in
the world to design a customized improvement plan to reduce risk and
injury.
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Needlestick injuries: a survey of doctors working at Tertiary
Care Hospitals of Rawalpindi
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22368906

J Pak Med Assoc. 2011 Jan;61(1):63-5.

Needlestick injuries: a survey of doctors working at Tertiary Care
Hospitals of Rawalpindi.

Khurram M, Ijaz K, Bushra HT, Khan NY, Bushra H, Hussain W.

Department of Medicine, Rawalpindi Medical College, Rawalpindi.

OBJECTIVES: To document frequency, nature and predisposing factors for
needlestick injuries (NSI) in doctors working at tertiary care hospitals of
Rawalpindi.

METHODS: This cross sectional survey was conducted at Department of
Medicine, Rawalpindi Medical College from July 2009 to April 2010. Five
hundred doctors working at various tertiary care hospitals of Rawalpindi
were contacted. Each doctor was provided a specifically designed proforma
focusing on number, nature, and predisposing factors for NSI which was
defined as percutaneous injury caused by hollow-bore needles, suturing
needles, scalpel blades and lancets. Frequency and percentage of collected
data was sought.

RESULTS: Out of 500, 61.8% (n = 309) doctors returned the filled proformas.
Females were 50.8% (n = 158). History of NSI was present in 85.1% (n = 263)
participants of which most common was from syringe needle (47.52%; n =
125), surgical stitch needle (20.9%; n = 55), and surgical blade (9.5%; n =
25). Most of NSI took place while recapping needles (33%; n = 87), surgical
procedures (27.7%; n = 73), and drawing blood samples (26.2%; n = 69).
Majority of these doctors 42.5% (n = 112) attributed NSI to stress, 37.6%
(n = 99) to over work, and 19.7% (n = 52) to carelessness.

CONCLUSION: NSI due to syringe and surgical stitch needle are very frequent
in doctors working at various tertiary care hospitals of Rawalpindi. Most
of these are sustained while recapping needle and surgical procedures in
stressful and overworked circumstances.
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Prevention of healthcare-associated infections in general
practice: Current practice and drivers for change in a French study
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22361764

Indian J Med Microbiol. 2012 Jan;30(1):69-75.

Prevention of healthcare-associated infections in general practice: Current
practice and drivers for change in a French study.

Gignon M, Farcy S, Schmit JL, Ganry O.

Medical School, University of Picardy, 3 rue des Louvels, F-80000; Public
Health Department, Amiens University Hospital, Amiens, France.

Purpose: The fight against Healthcare-associated infections is a public
health priority and a major challenge for the safety and quality of care.
The objective was to assess hygiene in general practitioners’ (GPs’) office
and identify barriers to and drivers for better practice. Materials and

Methods: We performed a cross-sectional study in which a questionnaire was
sent to a randomly selected, representative sample of 800 GPs. We used a
self-administered questionnaire. The first part assessed current practice
and the second part focused on barriers and motivating factors for better
practice. We performed a descriptive statistical analysis of the responses
to closed questions and a qualitative analysis of the responses to open-
ended questions.

Results: Only a third of the GPs were aware of the current guidelines.
Disposable equipment was used by 31% of the GPs. For the remainder, only
38% complied with the recommended procedures for sterilisation or
disinfection.

Seventy-two percent of the GPs washed their hands between consultations in
the office.

A significant minority of physicians disregarded the guidelines by never
wearing gloves to perform sutures (11%), treat wounds (10%), fit
intrauterine devices (18%) or perform injections (18%).

The main barriers to good practice were the high cost of modifications and
lack of time/space. Two third of the GPs did not intend to change their
practices. The drivers for change were pressure from patients (4.8 on a
scale of 1 to 7), inspection by the health authorities (4.8) and the fear
of legal action (4.4).

Conclusions: Our results show that there are significant differences
between current practice and laid- down professional guidelines. Policies
for improvement of hygiene must take into account barriers and motivating
factors.

Free full text http://tinyurl.com/7sd4stl
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Occupational hazards to dental staff
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22363355

Dent Res J (Isfahan). 2012 Jan;9(1):2-7.

Occupational hazards to dental staff.

Ayatollahi J, Ayatollahi F, Ardekani AM, Bahrololoomi R, Ayatollahi J,
Ayatollahi A, Owlia MB.

Infectious and Tropical Diseases Research Center, Yazd, Iran.

Dental professionals are predisposed to a number of occupational hazards.
These include exposure to infections (including Human Immunodeficiency
Virus and viral hepatitis); percutaneous exposure incidents, dental
materials, radiation, and noise; musculoskeletal disorders; psychological
problems and dermatitis; respiratory disorders; and eye insults.

Percutaneous exposure incidents remain a main concern, as exposure to
serious infectious agents is a virtual risk. Minimizing percutaneous
exposure incidents and their consequences should continue to be considered,
including sound infection control practices, continuing education, and
hepatitis B vaccination.

Basically, for any infection control strategies, dentists should be aware
of individual protective measures and appropriate sterilization or other
high-level disinfection utilities.

Strained posture at work disturbs the musculoskeletal alignment and leads
to stooped spine. The stooped posture also involved certain groups of
muscles and joints. This may lead to diseases of the musculoskeletal
system. Continuous educating and appropriate intervention studies are
needed to reduce the complication of these hazards.

So, it is important for dentists to remain constantly up-to-date about
measures on how to deal with newer strategies and dental materials, and
implicates the need for special medical care for this professional group.

Free full text:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3283973/
__________________________________________________________________
________________________________*_________________________________

9. Abstract: Anti-HCV prevalence in the general population of Lithuania
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22367136

Med Sci Monit. 2012 Feb 20;18(3):PH28-35.

Anti-HCV prevalence in the general population of Lithuania.

Liakina V, Valantinas J.

Centre of Hepatology, Gastroenterology and Dietetics, Clinic of
Gastroenterology, Nephrourology and Surgery, Faculty of Medicine, Vilnius
University, Lithuania.

Background: The aim of this study was to assess risk factors for HCV
acquisition and prevalence of anti-HCV in the general population of
Lithuania.

Material/Methods: The study enrolled 1528 randomly selected adults from the
5 biggest cities of Lithuania and its rural regions. Screening for anti-HCV
was performed by analysis of peripheral capillary blood with lateral flow
immunochromatography and confirmation of positive cases by peripheral
venous blood testing with 2-step chemiluminescent microparticle
immunoassay.

Results: Anti-HCV prevalence in Lithuania is 2.78% and according to the
standard European population the adjusted anti-HCV rate is 2.85%. It is
more prevalent among men (crude rates: 4.02% males vs. 1.49% females,
p=.0030) and this does not depend on age. Vilnius and Kaunas regions have
higher infection rates than smaller rural regions (2.92% and 3.01% vs.
2.24%, 0.74% and 1.35%).

Nowadays among our population HCV infection spreads mainly via intravenous
drug use (OR=42.5, p<.0001). HCV transmission occurs through blood
transfusions (OR=6.4, p=.0002), tooth removal (OR=4.1, p=.0048), childbirth
(OR=5.0, p=.0224), multiple and a long-term hospitalization (OR=3.0,
p=.0064), tattooing (OR=4.4, p=.0013), open traumas (OR=3.7, p=.0009) and
intrafamilially (OR=11.3, p=.0002).

Conclusions: 2.78% of the population is anti-HCV-positive. The anti-HCV
rate is higher in Vilnius and Kaunas in comparison with other regions. HCV
spreads mainly through intravenous drug use, but intrafamilial and some
nosocomial routes are also important. The anti-HCV prevalence did not
depend on age. Despite active prevention of nosocomial HCV transmission,
the incidence of HCV infection does not decrease due to virus spread mostly
in “trusted networks” of intravenous drug users.
__________________________________________________________________
________________________________*_________________________________

10. Abstract:Prevalence of hepatitis C virus infection and human
immunodeficiency virus in a cohort of Egyptian hemophiliac children
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22366833

Ann Saudi Med. 2012 Jan;32(2):200-2.

Prevalence of hepatitis C virus infection and human immunodeficiency virus
in a cohort of Egyptian hemophiliac children.

Abdelwahab MS, El-Raziky MS, Kaddah NA, Abou-Elew HH.

Departments of Pediatrics and Clinical Pathology, Cairo University, Cairo,
Egypt magywahab@ yahoo.com.

BACKGROUND AND OBJECTIVE: The risk of blood-borne infections, especially
hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection
still remains in developing countries among children receiving blood
products as hemophiliacs, but the risk is not known in Egypt. The objective
of this study was to detect the prevalence of HCV and HIV infection among
hemophiliac children to know the magnitude of the problem and determine
potential risk factors.

PATIENTS AND METHODS: This was a cross-sectional study conducted on 100
hemophiliac children that assessed the liver clinically and by laboratory
tests. All children were screened for HCV and HIV antibodies by enzyme-
linked immunosorbent assay. Those with positive HCV antibody titre were
tested by polymerase chain reaction (HCV-PCR).

RESULTS: Forty were positive for HCV antibodies with 19 children (47.5%)
HCV-PCR positive as well. The mean age, average frequency of bleeds/year,
dose of replacement therapy/year and alanine aminotransferase (ALT) levels
were significantly high in HCV-antibody and PCR positive patients as
compared to HCV antibody and PCR negative ones. None of our patients had
clinical evidence of hepatic involvement or was co-infected with HIV.

CONCLUSION: HIV infection does not appear to be a current health problem in
Egyptian hemophiliac children though the prevalence of HCV infection is
still high.
__________________________________________________________________
________________________________*_________________________________

11. Abstract: Toddlers’ choice: Yo-Yoing diabetes control or deci-unit
insulin dosing?
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22375164

World J Diabetes. 2012 Feb 15;3(2):35-7.

Toddlers’ choice: Yo-Yoing diabetes control or deci-unit insulin dosing?

Abul-Ainine SA, Abul-Ainine AA.

Sarah AA Abul-Ainine, Foundation Year Doctor Royal Bolton Hospital, Bolton,
BL4 0JR, England, United Kingdom.

While the incidence of toddlers’ diabetes is soaring, their mainstay
insulins were withdrawn, namely the weak 10% or 20% insulin mixtures (WIM),
which were injected only once or twice daily. Consequently, toddlers are
coerced to use an insulin pump, multi-dose insulin regime (MuDIR), mix or
dilute insulins. This paper highlights the difficulties and proposes a
simple solution.

While an insulin pump is the best available option, it is
not readily available for everyone. Mixing insulins is not sufficiently
precise in small doses. Although diluting insulin would allow precise
dosing and reduce the dose variability secondary to dribbling after
injections, it, like insulin mixing, deprives children from using the pen
and related child-friendly accessories.

In MuDIR, we inject 4-5 small doses
of insulin instead of 1-2 daily larger doses of WIM. Thus, on using a half
unit (½unit) insulin pen, a dose of 0.5, 1, 1.5 and 2 units are adjusted in
steps of 100%, 50%, 33% or 25%; unlike the advisable 5%-20%. This does not
easily match the tiny erratic meals of grazing toddlers. Maternal anxiety
peaks on watching yo-yoing glycemia. Carers have to accept either
persistently high sugar or wild fluctuation. The risks of such poor
glycemic pattern are increasingly recognized.

Using insulin U20 in a ½unit
disposable pen allows deci-unit dosing, with 5%-20% dose-tuning, greater
accuracy on delivering small doses and reduction of dose variability from
dribbling.

Deci-unit dosing may help avoid wide glycemic swings and provide
the affordable alternative to insulin pumps for toddlers. Deci-unit pen
materializes the Human Rights of Children, a safer and effective treatment.
__________________________________________________________________
________________________________*_________________________________

12. Abstract: Safe injection practices for administration of propofol
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22381555

AORN J. 2012 Mar;95(3):365-72 .

Safe injection practices for administration of propofol.

King CA, Ogg M.

Sepsis and postoperative infection can occur as a result of unsafe
practices in the administration of propofol and other injectable
medications.

Investigations of infection outbreaks have revealed the causes to be
related to bacterial growth in or contamination of propofol and unsafe
medication practices, including reuse of syringes on multiple patients, use
of single-use medication vials for multiple patients, and failure to
practice aseptic technique and adhere to infection control practices.

Surveys conducted by AORN and other researchers have provided additional
information on perioperative practices related to injectable medications.

In 2009, the US Food and Drug Administration and the Centers for Disease
Control and Prevention convened a group of clinicians to gain a better
understanding of the issues related to infection outbreaks and injectable
medications.

The meeting participants proposed collecting data to persuade clinicians to
adopt new practices, developing guiding principles for propofol use, and
describing propofol-specific, site- specific, and practitioner-specific
injection techniques. AORN provides resources to help perioperative nurses
reduce the incidence of postoperative infection related to medication
administration.

Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

13. Abstract: A harm reduction paradox: Comparing China’s policies on
needle and syringe exchange and methadone maintenance
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22377341

Int J Drug Policy. 2012 Feb 27.

A harm reduction paradox: Comparing China’s policies on needle and syringe
exchange and methadone maintenance.

Smith K, Bartlett N, Wang N.

Department of Epidemiology, University of North Carolina, Chapel Hill,
N.C., USA; National Center for AIDS/STD Control and Prevention, Beijing,
China.

BACKGROUND: China has launched methadone maintenance treatment (MMT) and
needle and syringe exchange programmes (NSEP) as part of the country’s HIV
prevention strategy amongst injection drug users. MMT is expanding, with
backing from multiple government ministries, however, NSEP have received
less political support and funding.

METHODS: Semi-structured, serial interviews were conducted with key
informants, knowledgeable about China’s harm reduction policies. Concurrent
content analysis allowed for revision of the interview guide throughout the
data collection process. This was combined with a systematic analysis of
official government policy documents on NSEP and MMT, including white
papers, legal documents, and policy statements.

FINDINGS: Early consensus between public security and public health sectors
regarding methadone’s dual use in HIV prevention as well as method of drug
control created broad institutional support for MMT programmes amongst
policy makers. In contrast, NSEP were seen as satisfying only the HIV
prevention goals of the public health sector, and were perceived as
condoning illicit drug use. Furthermore, NSEP’s roots in China, as an
experimental collaboration with international groups, created suspicion
regarding its role in China’s drug control policy. NSEP and MMT’s distinct
paths to policy development are reflected in the complex and occasionally
contradictory nature of China’s harm reduction strategy.

CONCLUSIONS: These discrepancies highlight the need for a more politically
sustainable and comprehensive integration of harm reduction projects.
Recommendations include improved evaluation methods for NESP, NSEP-MMT
cross-referral system, and stronger NSEP advocacy within the non-profit and
public health sectors.

Copyright © 2011 Elsevier B.V. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

14. Abstract: HIV risk behaviours among injecting drug users in Northeast
India following scale-up of a targeted HIV prevention programme
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22375900
Full text http://www.biomedcentral.com/1471-2458/11/S6/S9

BMC Public Health. 2011 Dec 29;11 Suppl 6:S9.

HIV risk behaviours among injecting drug users in Northeast India following
scale-up of a targeted HIV prevention programme.

Armstrong G, Humtsoe C, Kermode M.

Nossal Institute for Global Health, University of Melbourne, Victoria,
Australia. g.armstrong@unimelb.edu.au.

BACKGROUND: In the Northeast Indian states of Manipur and Nagaland there
has been an ongoing HIV epidemic among injecting drug users (IDUs) since
the mid-1990s. Project ORCHID is an Avahan-funded HIV prevention project
that has been working in selected districts of Manipur and Nagaland since
2004. It supports local partner non-government organisations (NGOs) to
deliver a range of harm reduction interventions, and currently reaches
approximately 14,500 IDUs across the two states. To assess changes in HIV
risk behaviours two Behavioural Tracking Surveys (BTS) were undertaken
among IDUs in 2007 and 2009.

METHODS: The BTS used respondent driven sampling (RDS) to recruit adult
male IDUs (18 years of age and above) from Ukhrul and Chandel districts in
Manipur, and Kiphire and Zunheboto districts in Nagaland. This paper
reports on analysis of socio-demographics, drug use and injecting
practices, sexual behaviour and condom use, knowledge of HIV, and exposure
to interventions. Descriptive data were analysed using RDSAT, and odds
ratios were calculated in SPSS.

RESULTS: The proportion of IDUs reporting NOT sharing needles / syringes at
last injection increased substantially in Ukhrul (59.6% to 91.2%) and
Zunheboto (45.5% to 73.8%), remained high in Chandel (97.0% to 98.9%), and
remained largely unchanged in Kiphire (63.3% to 68.8%). The use of condoms
with regular partners was low in all districts at both time points. In
Ukhrul, Kiphire and Zunheboto the proportion of IDUs using condoms during
sexual intercourse with a casual partner increased substantially to
approximately 70-85%, whilst in Chandel the increase was only marginal
(57.4% to 63.6%). Exposure to NGO HIV prevention interventions was
significantly associated (p<0.05) with lower odds of sharing needles during
the previous month (Nagaland, OR=0.63; Manipur, OR 0.35).

CONCLUSION: Despite district-level differences, the results from this BTS
study indicate that exposure to HIV prevention services, predominately
delivered in this region by NGOs, is associated with a reduced likelihood
of engaging in HIV risk behaviours. IDUs using HIV prevention services are
more likely to engage in safe injecting and sexual practices, and effort is
required to sustain / increase opportunities for IDUs to access these
services. These outcomes are a noteworthy achievement in a very challenging
context.

Free full text http://www.biomedcentral.com/1471-2458/11/S6/S9
__________________________________________________________________
________________________________*_________________________________

15. Abstract:Injectable and Oral Contraceptive Use and Cancers of the
Breast, Cervix, Ovary, and Endometrium in Black South African Women:
Case-Control Study
__________________________________________________________________
http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001182

PLoS Med 9(3): e1001182.

Injectable and Oral Contraceptive Use and Cancers of the Breast, Cervix,
Ovary, and Endometrium in Black South African Women: Case-Control Study

Margaret Urban1,2*, Emily Banks3,4, Sam Egger5, Karen Canfell5,6, Dianne
O’Connell5,6,7,8, Valerie Beral9, Freddy Sitas5,6,7

1 NHLS/MRC Cancer Epidemiology Research Group, National Health Laboratory
Services, Johannesburg, South Africa, 2 Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa, 3 National
Centre for Epidemiology and Population Health, The Australian National
University, Canberra, Australia, 4 The Sax Institute, Sydney, Australia, 5
Cancer Council New South Wales, Sydney, Australia, 6 Sydney Medical School
– Public Health, University of Sydney, Sydney, Australia, 7 School of
Public Health and Community Medicine, University of New South Wales,
Sydney, Australia, 8 School of Medicine and Public Health, University of
Newcastle, Newcastle, Australia, 9 Cancer Epidemiology Unit, University of
Oxford, Oxford, United Kingdom

Background: Oral contraceptives are known to influence the risk of cancers
of the female reproductive system. Evidence regarding the relationship
between injectable contraceptives and these cancers is limited, especially
in black South Africans, among whom injectable contraceptives are used more
commonly than oral contraceptives.

Methods and Findings: We analysed data from a South African hospital-based
case-control study of black females aged 18-79 y, comparing self-reported
contraceptive use in patients with breast (n = 1,664), cervical (n =
2,182), ovarian (n = 182), and endometrial (n = 182) cancer, with self-
reported contraceptive use in 1,492 control patients diagnosed with cancers
with no known relationship to hormonal contraceptive use. We adjusted for
potential confounding factors, including age, calendar year of diagnosis,
education, smoking, alcohol, parity/age at first birth, and number of
sexual partners. Among controls, 26% had used injectable and 20% had used
oral contraceptives.

For current and more recent users versus never users of oral or injectable
contraceptives, the odds ratios (ORs) for breast cancer were significantly
increased in users of oral and/or injectable contraceptives (OR 1.66, 95%
CI 1.28-2.16, p<0.001) and separately among those exclusively using oral
(1.57, 1.03-2.40, p = 0.04) and exclusively using injectable (OR 1.83,
1.31-2.55, p<0.001) contraceptives; corresponding ORs for cervical cancer
were 1.38 (1.08-1.77, p = 0.01), 1.01 (0.66-1.56, p = 0.96), and 1.58
(1.16-2.15, p = 0.004).

There was no significant increase in breast or cervical cancer risk among
women ceasing hormonal contraceptive use =10 y previously (p = 0.3 and p =
0.9, respectively). For durations of use =5 y versus never use, the ORs of
ovarian cancer were 0.60 (0.36-0.99, p = 0.04) for oral and/or injectable
contraceptive use and 0.07 (0.01-0.49, p = 0.008) for injectable use
exclusively; corresponding ORs for endometrial cancer were 0.44 (0.22-0.86,
p = 0.02) and 0.36 (0.11-1.26, p = 0.1).

Conclusions: In this study, use of oral and of injectable hormonal
contraceptives was associated with a transiently increased risk of breast
and cervical cancer and, for long durations of use, with a reduced risk of
ovarian and endometrial cancer. The observed effects of injectable and of
oral contraceptives on cancer risk in this study did not appear to differ
substantially.

Free full text:
http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001182
__________________________________________________________________
________________________________*_________________________________

16. Abstract: To ask or not to ask?: The results of a formative assessment
of a video empowering patients to ask their health care providers to
perform hand hygiene
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22130348

J Patient Saf. 2010 Jun;6(2):80-5.

To ask or not to ask?: The results of a formative assessment of a video
empowering patients to ask their health care providers to perform hand
hygiene.

Garcia-Williams A, Brinsley-Rainisch K, Schillie S, Sinkowitz-Cochran R.

Division of Healthcare Quality Promotion, National Center for Preparedness,
Detection, and Control of Infectious Diseases, Centers for Disease Control
and Prevention, U.S. Department of Health and Human Services, Atlanta,
Georgia, USA.

OBJECTIVES: To formatively evaluate the Hand Hygiene Saves Lives video and
explore the perceptions and expectations of health care providers and
laypersons regarding hand hygiene (HH), health care-associated infections,
and patient empowerment using the Health Belief Model as a framework.

METHODS: Four focus groups were conducted in February 2008 among laypersons
(n = 18) and health care providers (n = 17). Qualitative data were coded
for themes, and quantitative Likert scales ranging from 1 (not at all) to 5
(very) were analyzed using SPSS.

RESULTS: Health care-associated infections were perceived to be somewhat
common (mean, 3.4) and HH as very important (mean, 4.9). Laypersons
reported being significantly more likely to ask their nurses (2.5 versus
4.3; P = 0.001) and physicians (3.3 versus 4.3; P = 0.010) to perform HH
after viewing the video. The video’s target audience was perceived to be
families (42.0%) or patients (39.1%) and the message to be the importance
of HH (45.5%) or creating comfort about asking (24.2%).

CONCLUSIONS: Empowering patients using tools such as a video may be an
important patient safety advance to improve HH in health care settings and
prevent health care-associated infections.
__________________________________________________________________
________________________________*_________________________________

17. Abstract: Measuring healthcare worker hand hygiene activity: current
practices and emerging technologies
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/21931253

Infect Control Hosp Epidemiol. 2011 Oct;32(10):1016-28.

Measuring healthcare worker hand hygiene activity: current practices and
emerging technologies.

Boyce JM.

Hospital of Saint Raphael, Yale University School of Medicine, New Haven,
Connecticut, USA. jboyce@srhs.org

Monitoring hand hygiene compliance and providing healthcare workers with
feedback regarding their performance are considered integral parts of
multidisciplinary hand hygiene improvement programs.

Observational surveys conducted by trained personnel are currently
considered the “gold standard” method for establishing compliance rates,
but they are time-consuming and have a number of shortcomings. Monitoring
hand hygiene product consumption is less time-consuming and can provide
useful information regarding the frequency of hand hygiene that can be used
to give caregivers feedback.

Electronic counting devices placed in hand hygiene product dispensers
provide detailed information about hand hygiene frequency over time, by
unit and during interventions. Electronic hand hygiene monitoring systems
that utilize wireless systems to monitor room entry and exit of healthcare
workers and their use of hand hygiene product dispensers can provide
individual and unit-based data on compliance with the most common hand
hygiene indications. Some systems include badges (tags) that can provide
healthcare workers with real-time reminders to clean their hands upon
entering and exiting patient rooms.

Preliminary studies suggest that use of electronic monitoring systems is
associated with increased hand hygiene compliance rates and that such
systems may be acceptable to care givers.

Although there are many questions remaining about the practicality,
accuracy, cost, and long-term impact of electronic monitoring systems on
compliance rates, they appear to have considerable promise for improving
our efforts to monitor and improve hand hygiene practices among healthcare
workers.
__________________________________________________________________
________________________________*_________________________________

18. Abstract: A Pan-European and Canadian prospective survey to evaluate
patient satisfaction with the SoloSTAR insulin injection device in type
1 and type 2 diabetes
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22027323

J Diabetes Sci Technol. 2011 Sep 1;5(5):1224-34.

A Pan-European and Canadian prospective survey to evaluate patient
satisfaction with the SoloSTAR insulin injection device in type 1 and type
2 diabetes.

Hancu N, Czupryniak L, Genestin E, Sourij H.

University of Medicine, Cluj-Napoca, Romania. nhancu@umfcluj.ro

OBJECTIVE: This study evaluated patient satisfaction with SoloSTAR®
(sanofi-aventis), a prefilled insulin pen device for injection of insulin
glargine or insulin glulisine.

METHODS: This was a 6-8-week multicenter (n = 652), observational,
prospective Pan- European and Canadian registry study in patients with
diabetes mellitus (n = 6542) who recently switched to or started treatment
with insulin glargine and/or insulin glulisine using SoloSTAR or were
insulin naïve. At the baseline visit, patients were asked to evaluate their
satisfaction with their previous device, if applicable. After 6-8 weeks of
SoloSTAR use, patients were asked to rate their satisfaction.

RESULTS: Overall, 6481 patients (mean age 54 years, 48.7% male, 72% type 2
diabetes) were analyzed in this study. Of these, 4995 (77.1%) patients had
used insulin before the study and 1641 (32.9%) and 3395 (68.0%) patients
had previously used prefilled and/or reusable pens, respectively. During
the study, SoloSTAR was used to administer insulin glargine and/or insulin
glulisine by 97.3% and 36.0% of patients, respectively (both: 27.0%). Most
patients rated SoloSTAR as “excellent/good” for ease of use (97.9%),
learning to use (98.3%), selecting the dose (97.6%), and reading the dose
(95.1%). Most patients rated ease of use (88.4%) and injecting a dose
(84.5%) with SoloSTAR as “much easier/easier” versus their previous pen.
Overall, 98% planned to continue using SoloSTAR. No safety concerns were
reported.

CONCLUSION: This European and Canadian survey shows that SoloSTAR was well
accepted in this large patient population. Most patients preferred SoloSTAR
to their previous pen and planned to continue SoloSTAR use.

© 2011 Diabetes Technology Society.
__________________________________________________________________
________________________________*_________________________________

19. Abstract: Prestress as an optimal biomechanical parameter for needle
penetration
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22381739

J Biomech. 2012 Feb 28.

Prestress as an optimal biomechanical parameter for needle penetration.

Butz KD, Griebel AJ, Novak T, Harris K, Kornokovich A, Chiappetta MF, Neu
CP.

School of Mechanical Engineering, Purdue University, West Lafayette, IN
47907, USA.

Drug delivery requires precise intradermal and subcutaneous injections of
formulations to clinically relevant penetration depths. However,
penetration depth is confounded by skin deflection, which occurs prior to
and during penetration as the skin surface deforms axially with the needle,
and which varies profoundly due to differing intrinsic mechanical (e.g.
viscoelastic) tissue properties, disease state, aging, and ethnicity.

Herein, an ex vivo model was utilized to study factors that affect skin
deflection and the efficacy of injection, including prestress applied at
the tissue surface, needle gauge, velocity, and actuation depth. The
application of prestress minimized skin deflection during needle
penetration and allowed for needle actuation to the targeted penetration
depths with minimum variability.

The force required to achieve target penetration depths was found to
increase with prestress and decrease with needle gauge.

Our findings emphasize the need for prestress applied to the skin surface
to minimize variation in skin properties and administer formulations for
intradermal and subcutaneous treatments with maximum precision.

Copyright © 2012 Elsevier Ltd. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

20. Abstract: Reducing oral flora contamination of intravitreal injections
with face mask or silence
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22374155

Retina. 2012 Mar;32(3):473-6.

Reducing oral flora contamination of intravitreal injections with face mask
or silence.

Doshi RR, Leng T, Fung AE.

From the Department of Ophthalmology, California Pacific Medical Center,
San Francisco, California; Byers Eye Institute, Stanford University School
of Medicine, Palo Alto, California; and Pacific Eye Associates, California
Pacific Medical Center, San Francisco, California.

PURPOSE: : To provide experimental evidence to support or refute the
proposition that the use of surgical face masks and/or avoidance of talking
can decrease the dispersion of respiratory flora during an intravitreal
injection.

METHODS: : Ten surgeons recited a 30-second standardized script with blood
agar plates positioned 30 cm below their mouths. The plates were divided
into 4 groups, with 10 plates per group. In Group 1, participants did not
wear a face mask. In Group 2, participants wore a standard surgical mask.
In Group 3, no mask was worn, but plates were pretreated with 5% povidone-
iodine. In Group 4, no mask was worn, and participants remained silent for
30 seconds. The plates were then incubated at 37°C for 24 hours, and the
number of colony-forming units (CFUs) was determined.

RESULTS: : Mean bacterial growth were as follows: Group 1, 8.6 CFUs per
subject; Group 2, 1.1 CFUs per subject; Group 3, 0.1 CFUs per subject; and
Group 4, 2.4 CFUs per subject. Differences between the groups were
statistically significant (P < 0.05), with the exception of Group 2 versus
Group 4 (P = 0.115).

CONCLUSION: : The use of a face mask and avoidance of talking each
significantly decreased the dispersion of bacteria. Even without these
interventions, plates pretreated with povidone-iodine demonstrated the
least bacterial growth.
__________________________________________________________________
________________________________*_________________________________

21. Abstract: Is it true that injecting palmar finger skin hurts more than
dorsal skin? New level 1 evidence
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22379437

Free: http://www.springerlink.com/content/712152wt20781005/

Hand (N Y). 2011 Mar;6(1):47-9.

Is it true that injecting palmar finger skin hurts more than dorsal skin?
New level 1 evidence.

Wheelock ME, Leblanc M, Chung B, Williams J, Lalonde DH.

BACKGROUND: Since the first texts on local anesthesia were written in the
early 1900s, it has been widely quoted and believed that dorsal finger skin
is less sensitive to needlestick pain than volar finger skin. The result is
that the most commonly used finger block for local anesthesia is the dorsal
two injection technique.

METHODS: In this study, the needlestick discomfort associated with dorsal
and volar finger skin was compared in a group of 78 volunteers who had the
long finger of both hands poked with a 25 G needle; one in the midline of
the volar side and the other in the lateral web space of the dorsal side.
Volunteers then completed a pain scale for each needlestick and ranked
which technique they would prefer for future injections.

RESULTS: We found that there was no significant difference in needlestick
pain or preference of future needle location between the dorsal and volar
aspects of the finger.

CONCLUSIONS: We provide level 1 evidence that the needlestick of the SIMPLE
block which has one needlestick on the volar side of the finger is not more
painful than the needlestick of the dorsal finger block.

Free: http://www.springerlink.com/content/712152wt20781005/
__________________________________________________________________
________________________________*_________________________________

22. Abstract: An evaluation of sharp safety intravenous cannula devices
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22324237

Nurs Stand. 2011 Dec 14-2012 Jan 3;26(15-17):42-9.

An evaluation of sharp safety intravenous cannula devices.

Ford J, Phillips P.

Surgical Materials Testing Laboratory, Princess of Wales Hospital,
Bridgend. joanna@smtl.co.uk

This article describes an evaluation of seven sharp safety intravenous (IV)
cannula devices in six Welsh NHS hospitals and the Welsh Ambulance Service.

Products analysed included six passive devices designed to engage the
safety feature automatically on withdrawal of the needle from the cannula
and one active device that requires a button to be pressed to activate it.
The companies concerned provided the devices and appropriate training.

Participating healthcare workers used the safety device instead of the
conventional device to perform IV cannulations during the evaluation and
each type of device was evaluated in random order Participants filled in a
questionnaire for each device and then a further questionnaire comparing
each one at the end of the process.

Results showed that two of the passive devices were the most preferred.
Most users stated that they would use either of these devices instead of
the conventional device. It was not possible to identify a favourite
between these two devices. Some devices were considered to be unfavourable.

The main disadvantages that users experienced included slow flashback
(where venepuncture is confirmed by blood visibly entering the device),
blood leakage from the back of the device and resistance when withdrawing
the needle from the cannula.
__________________________________________________________________
________________________________*_________________________________

23. No Abstract: Risk factor analysis of sharp medical instrument injuries
__________________________________________________________________
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2008 Sep;26(9):575-6.

[Risk factor analysis of sharp medical instrument injuries].

[Article in Chinese]

Li L.
__________________________________________________________________
________________________________*_________________________________

24. Martket Report: Global Special Purpose Needles Market to Reach $4.0
Billion by 2017, According to New Report by Global Industry Analysts,
Inc.
__________________________________________________________________
Global Special Purpose Needles Market to Reach $4.0 Billion by 2017,
According to New Report by Global Industry Analysts, Inc.

GIA announces the release of a comprehensive global report on Special
Purpose Needles markets. Global market for Special Purpose Needles is
projected to reach $4.0 billion by 2017.

Continued growth in the market is buoyed by increasing number of outpatient
procedures, growing awareness of diseases such as HIV/AIDS, HCV, gonorrhea,
and tuberculosis. New product developments and legislations dealing with
worker safety are further boosting the demand for safety needles.

Special Purpose Needles: A Global Strategic Business Report
San Jose, California (PRWEB) March 06, 2012

Follow us on LinkedIn – Market for specialty needles is highly influenced
by growing demand for user safety and cost effective solutions. Needle
stick injuries and worker safety remain a prime area of concern in the
market. The medical disposables segment in the healthcare industry was
among the least affected by economic ups and downs owing to the high focus
on patient as well as employee safety. Consequently, syringes and surgical
masks and gloves were among the segments that maintained their growth tempo
despite cutbacks in hospital expenditures. Further, the resultant squeeze
in average income levels brought down by recession has reinforced the
growing trend towards home and alternate healthcare, which is a major
factor driving growth of disposable products. In addition, growing
healthcare focus and expenditure by governments in the developing
countries, particularly the BRIC nations, is also providing a major thrust
to the special purpose needles market.

As stated by the new market research report on Special Purpose Needles, the
US continues to remain the largest regional market, while Latin America and
Asia-Pacific represent the fastest growing markets.

Product-wise,
hypodermic needles account for the largest market share, while intravenous
needles constitute the fastest growing segment. Innovations in disposable
drug injection market, including the single-use needleless injectors and
pre-filled injectors are poised to take considerable market share from
syringes.

Rise in popularity of self-injection devices for patients with
allergic asthma, migraine, and rhinitis diseases is further boosting the
use of needles for self-administration of hypodermal medications. The trend
is driving demand for pen needles.

Moreover growing hygiene consciousness
among patients propels them to change their self-medication needles
frequently, leading to further rise in demand for medication needles.
Major players in the marketplace include Angiotech Pharmaceuticals, Argon
Medical Devices, C.R. Bard, Becton, Dickinson and Company, B. Braun
Medical, Cadence Science, Carefusion Corporation, Covidien Ltd., Ethicon,
Inrad, Medline Industries, MIFAM S.A., Smiths Medical, TERUMO Corporation,
and World Wide Medical Technologies.

The research report titled “Special Purpose Needles: A Global Strategic
Business Report” announced by Global Industry Analysts, Inc., provides a
comprehensive review of trends, issues, strategic industry activities, and
profiles of major companies worldwide.

Segments analyzed in the report
include Acupuncture Needles, Aspirating Needles, Biopsy Needles, Blood
Collection Needles, Blunt Needles, Bone Marrow Needles, Cardiology Needles,
Catheter Needles, Dental Needles, Dialysis Needles, Electrode Needles,
Endoscopy Needles, Epidural Needles, Fistula Needles, Hypodermic Needles,
Intra-arterial Needles, Intravenous Needles, Ophthalmic Needles,
Pneumoperitoneum Needles, Radiology Needles, Spinal Needles, and Suture
Needles.

The study reviews recent past, current and future market
projections over the period 2009-2017.Analysis is presented for established
and emerging markets including the US, Canada, Japan, France, Germany, the
UK, Italy, Spain, Russia, Asia-Pacific, Latin America, and Rest of World.

For more details about this comprehensive market research report, please
visit – http://www.strategyr.com/Special_Purpose_Needles_Market_Report.asp

About Global Industry Analysts, Inc.

Global Industry Analysts, Inc., (GIA) is a leading publisher of off-the-
shelf market research. Founded in 1987, the company currently employs over
800 people worldwide. Annually, GIA publishes more than 1300 full-scale
research reports and analyzes 40,000+ market and technology trends while
monitoring more than 126,000 Companies worldwide. Serving over 9500 clients
in 27 countries, GIA is recognized today, as one of the world’s largest and
reputed market research firms.

Follow us on LinkedIn
Global Industry Analysts, Inc.
Telephone: 408-528-9966
Fax: 408-528-9977
Email: press(at)StrategyR(dot)com
Web Site: http://www.StrategyR.com/
__________________________________________________________________
________________________________*_________________________________

25. Funding: Engaging Local Indigenous Organizations in Developing HIV/AIDS
Monitoring and Evaluation Capacity in Ukraine under the President’s
Emergency Plan for AIDS Relief (PEPFAR)

Crossposted from the US CDC National Prevention Information Network’s
(NPIN) Funding Database www.cdcnpin.org/scripts/locates/LocateFund.asp
__________________________________________________________________

Fund Number: 4494

Fund Title: Engaging Local Indigenous Organizations in Developing HIV/AIDS
Monitoring and Evaluation Capacity in Ukraine under the President’s
Emergency Plan for AIDS Relief (PEPFAR)

Fund Category:
HIV/AIDS

Description:
Grant Amount: Approximate Current Fiscal Year Funding: $800,000;
Approximate Total Project Period Funding: $4,800,000.

Under the leadership of the U.S. Global AIDS Coordinator, as part of the
President’s Emergency Plan, the U.S. Department of Health and Human
Services’ Centers for Disease Control and Prevention (HHS/CDC) works with
host countries and other key partners to assess the needs of each country
and design a customized program of assistance that fits within the host
nation’s strategic plan and partnership framework.

This cooperative agreement will facilitate collaboration among regional and
national level organizations to strengthen strategic information
activities, improve data collection, quality control, and management, and
to conduct epidemiologic and behavioral surveys and use their results to
inform programmatic decisions in HIV. It will also complement research
activity to be conducted using Round 10 Global Fund monies to generate
specific knowledge on various aspects of HIV epidemiology and intervention
effectiveness, and thus contribute to the achievement of all three of the
goals of Ukraine’s Partnership Framework, e.g. to improve the quality and
cost effectiveness of HIV prevention, care, and treatment services for Most
At Risk Populations (MARPs), to strengthen national and local ability to
achieve National AIDS Program objectives and to reduce HIV transmission
among MARPs. Partners receiving HHS/CDC funding must place a clear emphasis
on developing local indigenous capacity to deliver HIV/AIDS related
services to the Ukraine population and must also coordinate with activities
supported by Ukraine, international or USG agencies to avoid duplication.

Sponsor(s):
US Department of Health and Human Services
Public Health Service
Centers for Disease Control and Prevention

Funder’s Fund ID: CDC-RFA-GH12-1228
Application Due Date: 04/26/2012
Award Date: 09/30/2012
Fund Duration: 5 years.

Application Process:
Applicants must download the SF424 application package associated with this
funding opportunity from Grants.gov. If access to the Internet is not
available or if the applicant encounters difficulty in accessing the forms
on-line, contact the HHS/CDC Procurement and Grant Office Technical
Information Management Section (PGO TIMS) staff at (770) 488-2700 email:
pgotim@cdc.gov, Monday-Friday 7:00am – 4:30pm U.S. Eastern Standard Time
for further instruction. CDC Telecommunications for the hearing impaired or
disabled is available at: TTY 1-888-232-6348.

Number of Awards: 1 award

Award Notes:
Approximate Current Fiscal Year Funding: $800,000. Approximate Total
Project Period Funding: $4,800,000 (This amount is an estimate, and is
subject to availability of funds and includes direct costs for
international organizations or direct and indirect costs for domestic
grantees for all years.)

Eligible Locations: – National – International

Fund Notes:
For program synopsis and guidance, visit the website:
http://www.grants.gov/search/search.do;jsessionid=
4s0RPQGMDcWgGw5DJRgS0G50DMLXrD0mHvWK3Y9mpjj9T52XlCWZ!545677704?oppId=
146833&mode=VIEW.

or: http://tinyurl.com/7bjz2lk

Application Contact Address: Grants.gov

Technical Contact Name:
Charles Vitek
Title: Project Officer
Technical Contact Address:
DHHS/CDC
19 Nyzhniy Val Street
04071 Kyiv,
Ukraine
Email: cvitek@usaid.gov
Charles Vitek’s Phone: 38-044-537-4692.

Support Types: – Cooperative Agreements

Subject Areas:
– Cost Management
– Health Care Programs/Services
– HIV/AIDS Prevention
– Information Dissemination
– International Cooperation
– Medical Treatments and Therapies
– Program Management

Audiences:
– At Risk Persons
– Developing Nations

Eligibility:
– City Agencies
– Colleges/Universities
– Commercial Organizations
– Community Based Organizations
– County Agencies
– Hospitals
– IRS 501 (c)(3) Organizations
– Minority Owned Organizations
– Nonprofit Organizations
– Religious Organizations
– Research Institutions
– State Agencies
– Tribal Organizations
– Woman Owned Organizations

Eligibility Notes:
Eligible applicants include: Nonprofit with 501C3 IRS status (other than
institution of higher education); Nonprofit without 501C3 IRS status (other
than institution of higher education); For-profit organizations (other than
small business); Small, minority, and women-owned businesses; Universities;
Colleges; Research institutions; Hospitals; Community-based organizations;
Faith-based organizations; Federally recognized or state-recognized
American Indian/Alaska Native tribal governments; American Indian/Alaska
native tribally designated organizations; Alaska Native health
corporations; Urban Indian health organizations; Tribal epidemiology
centers; State and local governments or their Bona Fide Agents (this
includes the District of Columbia, the Commonwealth of Puerto Rico, the
Virgin Islands, the Commonwealth of the Northern Marianna Islands, American
Samoa, Guam, the Federated States of Micronesia, the Republic of the
Marshall Islands, and the Republic of Palau); Political subdivisions of
States (in consultation with States); Non-domestic (non-U.S.) entity; Other
(specify). A Bona Fide Agent is an agency/organization identified by the
state as eligible to submit an application under the state eligibility in
lieu of a state application. If applying as a bona fide agent of a state or
local government, a legal, binding agreement from the state or local
government as documentation of the status is required. Attach with “Other
Attachment Forms” when submitting via www.grants.gov.
__________________________________________________________________
________________________________*_________________________________

26. Patient Safety Research: Introductory Course (On-Line)

Crossposted with thanks from the WHO/PAHO EQUIDAD listserve
__________________________________________________________________
Patient safety research: introductory course (on-line)

Patient Safety Research Team -WHO – World Health Organization

Available online at: http://bit.ly/xLShap

“…..How familiar are you with the concept of patient safety? Hundreds of
thousands of patients are harmed or die each year due to unsafe care, or
get injured inadvertently when seeking health care. Understanding the
magnitude of the problem in hospitals and primary care facilities is the
first step towards improving patient safety.

A series of free on-line courses were broadcast (in April and May 2010) to
introduce the basic elements of patient safety research. There were eight
sessions for health-care professionals and researchers interested in
learning how to identify patient safety problems. Through these sessions,
participants were informed of the core principles of patient safety
research.

The sessions were provided by internationally renowned specialists in
patient safety, namely

Dr David Bates, External Programme Lead for Research, WHO Patient Safety,
and the Director of the Center of Excellence in Patient Safety and
Research, USA,
Dr Albert Wu, a professor in the Department of Health Policy and Management
at Johns Hopkins University, USA.

Online Course

Session 1 This first session introduces the concept of “Patient Safety”.

Starting from the definition of patient safety, topical global issues are
explained, supported by practical examples.

Session 2 In this session, we focus on “research” in patient safety.

Five important aspects of the research cycle will be explained: “measuring
harm”, “understanding causes”, “identifying solutions”, “evaluating impact”
and “translating evidence into safer health care”.

Session 3 Measuring what goes wrong in health care includes counting how
many patients are harmed or killed each year, and from what types of
adverse events. This session introduces methods for measuring harm.

Session 4 Once priority areas have been identified, the next step is to
understand the underlying causes of adverse events that lead to patient
harm.
This session explains several methods, using practical examples.

Session 5 To improve patient safety, solutions are needed that tackle the
underlying causes of unsafe care.
In this session we explain how we can design solutions andimplement them.
Session 6 It is crucial to evaluate the effectiveness of solutions in real-
life settings in terms of their impact, acceptability and affordability.

In this session, several methods for evaluation are introduced.

Session 7 The final step in the research cycle is to understand how
research findings can be translated into practice.

Session 8 In this last session, we review the previous sessions, reflecting
on questions and comments from the participants. ….”
__________________________________________________________________
________________________________*_________________________________

27. News

– China: Wrong treatment leads to Hepatitis C cases
– China: AIDS fight set to get new boost
– USA: HIV rate among US intravenous drug users falls: CDC
– USA: HIV among injection drug users declines

Selected news items reprinted under the fair use doctrine of international
copyright law: http://www4.law.cornell.edu/uscode/17/107.html
__________________________________________________________________
China: Wrong treatment leads to Hepatitis C cases
IANS, Zee News (03.03.12)

Beijing: Improper diagnosis and treatment in clinics in a Chinese province
have lead to over 100 Hepatitis C cases, the health department said.

The cases have been reported in Zijin county of southern Guangdong
province, the China Daily reported Saturday.

Till late February, a total of 123 people were infected with Hepatitis C,
and residents suspect that medical malpractice could have been the reason.

The cases were linked to improper diagnosis and treatment, patients who
received intravenous medicine, infection from mother to child and through
sexual transmission, according to the provincial health department.

Local residents allege that all of the infected people had received
injections with reused needles.

Hepatitis C is a viral disease mainly transmitted through contact with
contaminated blood, through sexual contact and from mother to child during
delivery. Infection can also lead to liver cancer.

Tags: Wrong treatment, Hepatitis C, China
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China: AIDS fight set to get new boost
By Shan Juan, China Daily (02.03.12)

” Greater cooperation with public also vital”, health official says

BEIJING – Organizations involved in the fight against HIV/AIDS will get
greater government support, a health official said.

“The government will beef up investment and support for social groups” and
cooperate with reliable ones, Yu Jingjin, director of the disease
prevention and control bureau under the Ministry of Health, said.

Each province this year will support three to five civil societies tackling
HIV/AIDS and help them with operational costs and training, he said.

His comments came amid concern over the withdrawal of money from the Global
Fund to Fight AIDS, Tuberculosis and Malaria next year.

The fund has been hit by the failure of international donors to meet their
commitments.

Yu urged health authorities to work more with society in general to fight
AIDS. Cooperation in this sphere has not always worked fully to its
potential, he said.

Meanwhile, the ministry and the Ministry of Civil Affairs have carried out
research to broaden cooperation with civil societies, he noted.
Under current regulations community-based organizations have difficulty
registering at the Ministry of Civil Affairs.

This hinders their operations such as raising funds and claiming tax
exemption.

The number of infected people should be below 1.2 million by 2015 according
to targets publicized on Wednesday that were incorporated into the 12th
Five-Year Plan (2011-15).

Official estimates put current infections at 780,000.

The targets envisage new HIV cases in 2015 dropping by 25 percent compared
with 2010 and the AIDS death rate dropping by 30 percent.

“These are tough targets and it will take hard work for us to meet them,”
Yu said.

Yu urged local governments not to be complacent about what has been
achieved as the country was still facing huge challenges to curb HIV/AIDS.
A surge in deaths has occurred in recent years as those infected gradually
developed full-blown AIDS, he said.

China reported 21,234 AIDS deaths last year, up 11.8 percent over 2010. It
is the leading fatal infectious disease in China since 2008, official
statistics showed.

Tracking sufferers can be difficult and there have been cases where full-
blown AIDS was evident even before HIV testing had taken place, he said.
And intervention is difficult because most transmissions occur during
intimate moments. This is why education about the virus and AIDS is so
important, he said.

Of the new reported HIV/AIDS cases in 2011, nearly 79 percent were due to
unsafe sex, both heterosexual and homosexual.

“The epidemic and its transmission is more complex now,” said Wu Zunyou,
director of the National Center for AIDS/STD Control and Prevention.
Wu said that the percentage of young students and old people becoming
infected has increased.

Last year, national health departments recorded more than 84 million HIV
antibody tests, up 30 percent over 2010.

Intervention and prevention has targeted more susceptible groups, such as
sex workers and homosexuals, Yu said.

To better reach these groups, “community organizations play an
indispensable role”, he said.
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USA: HIV rate among US intravenous drug users falls: CDC
By Julie Steenhuysen, Reuters, (02.03.12)

HIV infections among intravenous drug users in the United States have
fallen by half in the past decade, but HIV testing is also down and risky
behaviors such as needle-sharing persist, U.S. health experts said on
Thursday.

A study by researchers at the U.S. Centers for Disease Control (CDC) and
Prevention based on a 2009 survey of 10,000 people from 20 urban areas
found that 9 percent of IV drug users were infected with the human
immunodeficiency virus or HIV, the virus that causes AIDS.

That compares with a rate of 18 percent in the 1990s.

“Despite the fact that we’ve seen declines in new HIV infections, a
substantial number of IDUs (injection drug users) in major US cities are
HIV-infected and their risk behavior remains fairly high,” said Dr. Cyprian
Wejnert, an epidemiologist at the CDC, whose study appears in the CDC’s
weekly report on death and disease.

“We found 9 percent of IDUs were HIV-positive and nearly half of those were
unaware of their infection,” Wejnert said in a telephone interview.

After falling significantly since the peak of the epidemic, HIV rates in
the United States have been leveling out, but pockets of infection persist,
especially in high-risk groups such as young people and men who have sex
with men.

The survey tested individuals for HIV and asked questions about their risk
behaviors and use of HIV prevention services.

It found about a third of intravenous drug users in the survey said they
shared syringes, most said they had unprotected sex in the past year and
more than half said they had more than one sexual partner.

The study also found that rates of HIV testing in this at-risk population
were falling.

“While CDC recommends that individuals are tested for HIV at least
annually, only 49 percent … reported being tested in the last 12 months,”
Wejnert said. That represents a significant drop from a survey done in
2005-2006, he said.

Dr. Amy Lansky, deputy director in the Division of HIV/AIDS Prevention at
CDC, said the findings will be used as CDC focuses on prevention efforts on
high-risk populations.

“It’s a really important part of understanding the leading edge of the
epidemic,” she said.

“What the data from this report shows is we really do need to continue our
efforts to expand HIV testing and improve testing,” she said, adding that
the CDC also needs to focus prevention efforts on reaching more drug users.

Effective prevention efforts include offering condoms and substance abuse
treatment. But the CDC cannot distribute clean needles because U.S.
lawmakers in December reinstated a ban on the use of federal funds for such
programs.

According to the CDC, 1.2 million Americans have HIV, and 1 in 5 U.S.
adults with HIV do not know they are infected.

(Editing by Mohammad Zargham and Todd Eastham)
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http://tinyurl.com/6owgvyk

USA: HIV among injection drug users declines
By Dr Ananya Mandal ,MD, News-Medical.net (02.03.12)

According to latest figures the number of needle drug users testing
positive for HIV is on the decline.

U.S. health officials say the rate has dropped by half since the 1990s. The
decline may be related to a growth in needle exchange programs. For the
report more than 10,000 drug users in 20 metropolitan areas were surveyed
and tested for HIV in 2009. About 1 in 10 tested positive for the virus. In
the ’90s, roughly 1 in 5 did. Addicts who inject heroin, cocaine or other
drugs have been one of the groups hit hardest by AIDS.

“Despite the fact that we’ve seen declines in new HIV infections, a
substantial number of IDUs (injection drug users) in major US cities are
HIV-infected and their risk behavior remains fairly high,” said Dr. Cyprian
Wejnert, an epidemiologist at the CDC. “We found 9 percent of IDUs
[injection drug users] were HIV-positive and nearly half of those were
unaware of their infection,” Wejnert said in a telephone interview.

The study also found that only about half of infected drug users know they
carry the AIDS virus. The Centers for Disease Control and Prevention
released the study Thursday. HIV rates have been falling in the United
States, but pockets of infection continue to persist, especially in high-
risk groups such as young people and men who have sex with men.

From the study about one third of injection drug users in the survey said
they shared syringes, most said they had unprotected sex in the past year
and more than half said they had more than one sexual partner.

The researchers found that rates of HIV testing in this at-risk population
are decreasing. “While CDC recommends that individuals are tested for HIV
at least annually, only 49 percent, less than half of those interviewed,
reported being tested in the last 12 months,” Wejnert said. This represents
a significant drop from a survey done in 2005-2006, he said.

Dr. Amy Lansky, deputy director in the Division of HIV/AIDS Prevention at
CDC said the findings will be used as CDC focuses on high risk populations.
“It’s a really important part of understanding the leading edge of the
epidemic.” She said.

“What the data from this report shows is we really do need to continue our
efforts to expand HIV testing and improve testing,” she said, adding that
the CDC also needs to focus its prevention efforts on reaching more drug
users. Such efforts include offering new sterile syringes, condoms, and
substance abuse treatment.

The CDC reports that there are 1.2 million Americans with HIV and 1 in 5
U.S. adults with HIV do not know they are infected.

In another related story the Senate approved a proposal that lawmakers say
will provide greater access to HIV tests and bring Massachusetts into
compliance with federal recommendations aimed at promoting more testing.
The measure reduces barriers to testing for the virus that causes AIDS by
eliminating the need for doctors to obtain written consent from patients,
and instead requires only verbal consent.

“This will increase testing for HIV because it makes it normal, it will be
like getting your cholesterol checked when you get your annual physical,”
said Senate President Therese Murray.

Only Massachusetts and Nebraska still require specific written consent for
HIV testing, according to the National HIV/AIDS Clinicians’ Consultation
Center at the University of California, San Francisco.

State law still requires written informed consent from a patient each time
information is released from a patient’s file pertaining to HIV. Physicians
say that creates barriers to treatment because if, for instance, a patient
is being referred to another specialist, the physician must still obtain
written consent from the patient before telling the specialist about any
HIV-related medications that patient is taking.

The medical society, which sent a letter to lawmakers Wednesday about its
remaining concerns, said the current law hampers the growing use of
electronic health records, which allow physicians to share patient files
more efficiently and accurately.

The AIDS Action Committee released a statement applauding the Senate’s
approval of the bill, saying it will expand HIV testing. “There are an
estimated 25,000 to 27,000 people living with HIV/AIDS in Massachusetts,
but approximately 21% of them are unaware that they are HIV positive,” the
statement said. “We cannot end the AIDS epidemic in Massachusetts if those
who are HIV positive are unaware of their status.”

But Fenway Health, which specializes in AIDS care, released a statement
from its chief executive, Dr. Stephen Boswell, that said the Senate bill
has “significant” problems because it still requires written consent before
physicians can share information with each other about patients HIV status.
“In urgent situations,” Boswell said, “timely communication among
clinicians can mean the difference between life and death.”
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The 2010 annual Safe Injection Global Network meeting was held from 9
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The SIGN 2010 meeting report pdf, 1.36Mb is available on line at:
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