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Fortune Ncube - One of the best experts on this subject based on the ideXlab platform.
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Sex work amongst people who inject drugs in England, Wales and Northern Ireland: Findings from a National Survey of Health Harms and Behaviours
International Journal of Drug Policy, 2015Co-Authors: S Croxford, Vivian Hope, John V. Parry, Lucy Platt, Katelyn J. Cullen, Fortune NcubeAbstract:a b s t r a c t Background: We provide the first national prevalence estimate of sex work amongst people who inject drugs (PWID) in England, Wales and Northern Ireland and investigate to what extent sex work is associ- ated with blood-borne virus (BBV) Infection. Methods: PWID, recruited through drug services, provided a dried-blood spot and completed a ques- tionnaire. Demographics and risk behaviours were examined by gender and sex work status. Factors associated with BBV Infection were explored using logistic regression. Results: Amongst 2400 PWID (75% men), 14% had experience of sex work (men: 8%; women: 31%). Sex workers (SWs) had been injecting longer than non-SWs (men: 14 vs. 12 years; women: 11 vs. 6 years) and more frequently shared needles/syringes (men: 23% vs. 14%; women: 28% vs. 18%). Proportionally more male SWs were non UK-born (12% vs. 7%) and had more same-sex partners (19% vs. 3%) than non-SWs. Amongst women, more SWs had a recent Injection-Site Infection (46% vs. 31%), been imprisoned (58% vs. 48%) or homeless (57% vs. 40%). Sex work was not associated with BBV Infection. Conclusion: Services, including needle and syringe programmes, need to cater for the gendered differences in vulnerabilities amongst PWID, specifically addressing the complex needs of SWs.
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Factors associated with recent symptoms of an Injection Site Infection or injury among people who inject drugs in three English cities
International Journal of Drug Policy, 2014Co-Authors: Vivian Hope, Matthew Hickman, John V. Parry, Fortune NcubeAbstract:Abstract Background People who inject drugs (PWID) are at risk of Injection Site Infections and injuries. The factors associated with recent symptoms of these problems are examined. Method PWID recruited using respondent driven sampling, underwent a computer-assisted interview and provided a dried-blood spot sample. Weight data were examined using logistic regression. Results The mean age of the 855 participants was 32 years, and 25% were women. During the preceding 28 days, 94% had injected heroin and 50% crack-cocaine; with 41% injecting into their arms and 47% their groin. The passing on of used needles/syringes was reported by 9.7% and receiving by 8.0%. During the preceding 28 days, 21% reported having redness, swelling and tenderness, 6.1% an abscess, and 5.2% a sore/open wound at an Injection Site; with a quarter (24%) reporting one or more of these. A range of factors were associated with these symptoms; all three symptoms were associated with more frequent Injection and the use of multiple Injection Sites; two of the symptoms were also associated with having recently overdosed and the use of particular Injection Sites. Conclusions Injection Site Infections and injuries are common among PWID and targeted interventions are needed to reduce risk.
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The extent of Injection Site Infection in injecting drug users: findings from a national surveillance study.
Epidemiology and Infection, 2010Co-Authors: Vivian Hope, Andrea Marongiu, John V. Parry, Fortune NcubeAbstract:Injection Site Infections in injecting drug users (IDUs) are associated with serious morbidity and healthcare costs. Factors associated with symptoms of these were examined through annual (2006-2008) unlinked-anonymous survey of IDUs in England, Wales and Northern Ireland. Overall 36% (1863/5209) self-reported having a symptom with no trend over time (35% 2006, 37% 2007, 34% 2008). Symptoms were less common in the North East of England; increased with years injecting; and were higher in women, those recently homeless, those recently using a needle exchange, and those injecting both opiates and stimulants. Of those injecting during the previous 4 weeks (n=3733) symptoms were associated with: injecting daily; injecting >or=10 times a day; injecting into hands, groin, or legs; sharing filters; and reusing water to flush syringes. Symptoms of Injection Site Infections are common in IDUs. Better-targeted preventive interventions are needed, and continued surveillance should assist with assessing the impact of new initiatives.
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Frequency, factors and costs associated with Injection Site Infections: Findings from a national multi-Site survey of injecting drug users in England
BMC Infectious Diseases, 2008Co-Authors: Vivian Hope, Jo Kimber, Peter Vickerman, Matthew Hickman, Fortune NcubeAbstract:Background Injection Site Infections among injecting drug users (IDUs) have been associated with serious morbidity and health service costs in North America. This study explores the frequency, factors and costs associated with Injection Site Infections among IDUs in England. Methods Unlinked-anonymous survey during 2003/05 recruiting IDUs from community settings at seven locations across England. Self-reported injecting practice, symptoms of Injection Site Infections (abscess or open wound) and health service utilisation data were collected using a questionnaire, participants also provided dried blood spot samples (tested for markers blood borne virus Infections). Cost estimates were obtained by combining questionnaire data with information from national databases and the scientific literature. Results 36% of the 1,058 participants reported an Injection Site Infection in the last year. Those reporting an Injection Site Infection were more likely to be female and aged over 24, and to have: injected into legs, groin, and hands in last year; injected on 14 or more days during the last four weeks; cleaned needles/syringes for reuse; injected crack-cocaine; antibodies to hepatitis C; and previously received prescribed substitute drug. Two-thirds of those with an Injection Site Infection reported seeking medical advice; half attended an emergency department and three-quarters of these reported hospital admission. Simple conservative estimates of associated healthcare costs range from £15.5 million per year to as high as £30 million; though if less conservative unit costs assumptions are made the total may be much higher (£47 million). The vast majority of these costs are due to hospital admissions and the uncertainty is due to little data on length of hospital stays. Conclusion Symptoms of Injection Site Infections are common among IDUs in England. The potential costs to the health service are substantial, but these costs need more accurate determination. Better-targeted interventions to support safer Injection need to be developed and evaluated. The validity of self-reported symptoms, and the relationship between symptoms, Infection severity, and health seeking behaviour require further research.
Vivian Hope - One of the best experts on this subject based on the ideXlab platform.
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Sex work amongst people who inject drugs in England, Wales and Northern Ireland: Findings from a National Survey of Health Harms and Behaviours
International Journal of Drug Policy, 2015Co-Authors: S Croxford, Vivian Hope, John V. Parry, Lucy Platt, Katelyn J. Cullen, Fortune NcubeAbstract:a b s t r a c t Background: We provide the first national prevalence estimate of sex work amongst people who inject drugs (PWID) in England, Wales and Northern Ireland and investigate to what extent sex work is associ- ated with blood-borne virus (BBV) Infection. Methods: PWID, recruited through drug services, provided a dried-blood spot and completed a ques- tionnaire. Demographics and risk behaviours were examined by gender and sex work status. Factors associated with BBV Infection were explored using logistic regression. Results: Amongst 2400 PWID (75% men), 14% had experience of sex work (men: 8%; women: 31%). Sex workers (SWs) had been injecting longer than non-SWs (men: 14 vs. 12 years; women: 11 vs. 6 years) and more frequently shared needles/syringes (men: 23% vs. 14%; women: 28% vs. 18%). Proportionally more male SWs were non UK-born (12% vs. 7%) and had more same-sex partners (19% vs. 3%) than non-SWs. Amongst women, more SWs had a recent Injection-Site Infection (46% vs. 31%), been imprisoned (58% vs. 48%) or homeless (57% vs. 40%). Sex work was not associated with BBV Infection. Conclusion: Services, including needle and syringe programmes, need to cater for the gendered differences in vulnerabilities amongst PWID, specifically addressing the complex needs of SWs.
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Factors associated with recent symptoms of an Injection Site Infection or injury among people who inject drugs in three English cities
International Journal of Drug Policy, 2014Co-Authors: Vivian Hope, Matthew Hickman, John V. Parry, Fortune NcubeAbstract:Abstract Background People who inject drugs (PWID) are at risk of Injection Site Infections and injuries. The factors associated with recent symptoms of these problems are examined. Method PWID recruited using respondent driven sampling, underwent a computer-assisted interview and provided a dried-blood spot sample. Weight data were examined using logistic regression. Results The mean age of the 855 participants was 32 years, and 25% were women. During the preceding 28 days, 94% had injected heroin and 50% crack-cocaine; with 41% injecting into their arms and 47% their groin. The passing on of used needles/syringes was reported by 9.7% and receiving by 8.0%. During the preceding 28 days, 21% reported having redness, swelling and tenderness, 6.1% an abscess, and 5.2% a sore/open wound at an Injection Site; with a quarter (24%) reporting one or more of these. A range of factors were associated with these symptoms; all three symptoms were associated with more frequent Injection and the use of multiple Injection Sites; two of the symptoms were also associated with having recently overdosed and the use of particular Injection Sites. Conclusions Injection Site Infections and injuries are common among PWID and targeted interventions are needed to reduce risk.
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The extent of Injection Site Infection in injecting drug users: findings from a national surveillance study.
Epidemiology and Infection, 2010Co-Authors: Vivian Hope, Andrea Marongiu, John V. Parry, Fortune NcubeAbstract:Injection Site Infections in injecting drug users (IDUs) are associated with serious morbidity and healthcare costs. Factors associated with symptoms of these were examined through annual (2006-2008) unlinked-anonymous survey of IDUs in England, Wales and Northern Ireland. Overall 36% (1863/5209) self-reported having a symptom with no trend over time (35% 2006, 37% 2007, 34% 2008). Symptoms were less common in the North East of England; increased with years injecting; and were higher in women, those recently homeless, those recently using a needle exchange, and those injecting both opiates and stimulants. Of those injecting during the previous 4 weeks (n=3733) symptoms were associated with: injecting daily; injecting >or=10 times a day; injecting into hands, groin, or legs; sharing filters; and reusing water to flush syringes. Symptoms of Injection Site Infections are common in IDUs. Better-targeted preventive interventions are needed, and continued surveillance should assist with assessing the impact of new initiatives.
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Frequency, factors and costs associated with Injection Site Infections: Findings from a national multi-Site survey of injecting drug users in England
BMC Infectious Diseases, 2008Co-Authors: Vivian Hope, Jo Kimber, Peter Vickerman, Matthew Hickman, Fortune NcubeAbstract:Background Injection Site Infections among injecting drug users (IDUs) have been associated with serious morbidity and health service costs in North America. This study explores the frequency, factors and costs associated with Injection Site Infections among IDUs in England. Methods Unlinked-anonymous survey during 2003/05 recruiting IDUs from community settings at seven locations across England. Self-reported injecting practice, symptoms of Injection Site Infections (abscess or open wound) and health service utilisation data were collected using a questionnaire, participants also provided dried blood spot samples (tested for markers blood borne virus Infections). Cost estimates were obtained by combining questionnaire data with information from national databases and the scientific literature. Results 36% of the 1,058 participants reported an Injection Site Infection in the last year. Those reporting an Injection Site Infection were more likely to be female and aged over 24, and to have: injected into legs, groin, and hands in last year; injected on 14 or more days during the last four weeks; cleaned needles/syringes for reuse; injected crack-cocaine; antibodies to hepatitis C; and previously received prescribed substitute drug. Two-thirds of those with an Injection Site Infection reported seeking medical advice; half attended an emergency department and three-quarters of these reported hospital admission. Simple conservative estimates of associated healthcare costs range from £15.5 million per year to as high as £30 million; though if less conservative unit costs assumptions are made the total may be much higher (£47 million). The vast majority of these costs are due to hospital admissions and the uncertainty is due to little data on length of hospital stays. Conclusion Symptoms of Injection Site Infections are common among IDUs in England. The potential costs to the health service are substantial, but these costs need more accurate determination. Better-targeted interventions to support safer Injection need to be developed and evaluated. The validity of self-reported symptoms, and the relationship between symptoms, Infection severity, and health seeking behaviour require further research.
Jacob Henrichs - One of the best experts on this subject based on the ideXlab platform.
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Prevalence of insulin glargine vial use beyond 28 days in a Medicaid population.
Journal of the American Pharmacists Association : JAPhA, 2018Co-Authors: Judith M. Turner, Elizabeth J. Unni, Jennifer Strohecker, Jacob HenrichsAbstract:Insulin glargine, one of the most commonly prescribed drugs for diabetes, has a 28-day limit on the use of a 10-mL (1000 units) multiple-dose vial once the bottle is punctured. If patients who are using smaller doses or are not adherent continue to use insulin glargine beyond the 28-day window, it can result in questionable stability and sterility of the product. The aim of this study was to determine the proportion of patients who used each insulin glargine vial for more than 28 days, the mean number of days the vial was used after 28 days, the reason for the extended use, and whether that use had any association with diabetes control and Injection Site Infection. The study was conducted in 2 phases. Phase I was a retrospective database analysis of insulin glargine 10-mL vial use by the adult Medicaid population with type 2 diabetes served by Molina Healthcare to determine the proportion of patients who used each vial beyond 28 days. Phase II was a cross-sectional telephone interview to identify the reasons for the extended use. Of the 269 patients identified, 81% used it for more than 28 days, with a mean of 43 days. Of the interviewed patients, 60% did not discard the vials after 28 days because of a lack of awareness. Patients who were aware of the 28-day limit were informed by a pharmacist or diabetes educator. A large proportion of Medicaid patients were found to use insulin glargine past the recommended 28-day limit. More work is needed with a larger sample size to determine whether reasons besides lack of awareness affect the use of insulin glargine beyond its expiration and the role of pharmacists and diabetes educators in improving adherence to disposing of the drug after 28 days. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
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Prevalence of insulin glargine vial use beyond 28 days in a Medicaid population.
Journal of the American Pharmacists Association, 2018Co-Authors: Judith M. Turner, Elizabeth J. Unni, Jennifer Strohecker, Jacob HenrichsAbstract:Abstract Objectives Insulin glargine, one of the most commonly prescribed drugs for diabetes, has a 28-day limit on the use of a 10-mL (1000 units) multiple-dose vial once the bottle is punctured. If patients who are using smaller doses or are not adherent continue to use insulin glargine beyond the 28-day window, it can result in questionable stability and sterility of the product. The aim of this study was to determine the proportion of patients who used each insulin glargine vial for more than 28 days, the mean number of days the vial was used after 28 days, the reason for the extended use, and whether that use had any association with diabetes control and Injection Site Infection. Methods The study was conducted in 2 phases. Phase I was a retrospective database analysis of insulin glargine 10-mL vial use by the adult Medicaid population with type 2 diabetes served by Molina Healthcare to determine the proportion of patients who used each vial beyond 28 days. Phase II was a cross-sectional telephone interview to identify the reasons for the extended use. Results Of the 269 patients identified, 81% used it for more than 28 days, with a mean of 43 days. Of the interviewed patients, 60% did not discard the vials after 28 days because of a lack of awareness. Patients who were aware of the 28-day limit were informed by a pharmacist or diabetes educator. Conclusion A large proportion of Medicaid patients were found to use insulin glargine past the recommended 28-day limit. More work is needed with a larger sample size to determine whether reasons besides lack of awareness affect the use of insulin glargine beyond its expiration and the role of pharmacists and diabetes educators in improving adherence to disposing of the drug after 28 days.
Monika Hilbe - One of the best experts on this subject based on the ideXlab platform.
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Abscess of the cervical spine secondary to Injection Site Infection in a heifer
Acta Veterinaria Scandinavica, 2017Co-Authors: Ueli Braun, Christian Gerspach, Karolin Kühn, Julia Bünter, Monika HilbeAbstract:Background Abscesses in the neck region can result from Infection associated with Injection of drugs into the neck muscles. To our knowledge, there have been no reports of osteomyelitis of the cervical vertebra and spinal cord compression secondary to an abscess in the neck. This case report describes the findings in a 9.5-month-old heifer with an abscess of the cervical spine secondary to Injection Site Infection.
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Abscess of the cervical spine secondary to Injection Site Infection in a heifer
Acta Veterinaria Scandinavica, 2017Co-Authors: Ueli Braun, Christian Gerspach, Karolin Kühn, Julia Bünter, Monika HilbeAbstract:Background Abscesses in the neck region can result from Infection associated with Injection of drugs into the neck muscles. To our knowledge, there have been no reports of osteomyelitis of the cervical vertebra and spinal cord compression secondary to an abscess in the neck. This case report describes the findings in a 9.5-month-old heifer with an abscess of the cervical spine secondary to Injection Site Infection. Case presentation The main clinical findings were swelling on the left side of the neck, proprioceptive deficits in all limbs and generalised ataxia. The ultrasonographic examination of the swelling showed an abscess. Radiographs showed a well-defined lytic lesion in 5th cervical vertebra (C5). Postmortem examination revealed an intramuscular encapsulated abscess on the left side of the neck at the level of C5. The abscess had invaded the vertebral canal and caused marked compression of the spinal cord. Conclusions Injection technique is critical for the prevention of problems such as those described in this report. Sterile hypodermic needles must be used, and the volume of drug per Injection Site limited to 10–15 ml in young cattle.
Judith M. Turner - One of the best experts on this subject based on the ideXlab platform.
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Prevalence of insulin glargine vial use beyond 28 days in a Medicaid population.
Journal of the American Pharmacists Association : JAPhA, 2018Co-Authors: Judith M. Turner, Elizabeth J. Unni, Jennifer Strohecker, Jacob HenrichsAbstract:Insulin glargine, one of the most commonly prescribed drugs for diabetes, has a 28-day limit on the use of a 10-mL (1000 units) multiple-dose vial once the bottle is punctured. If patients who are using smaller doses or are not adherent continue to use insulin glargine beyond the 28-day window, it can result in questionable stability and sterility of the product. The aim of this study was to determine the proportion of patients who used each insulin glargine vial for more than 28 days, the mean number of days the vial was used after 28 days, the reason for the extended use, and whether that use had any association with diabetes control and Injection Site Infection. The study was conducted in 2 phases. Phase I was a retrospective database analysis of insulin glargine 10-mL vial use by the adult Medicaid population with type 2 diabetes served by Molina Healthcare to determine the proportion of patients who used each vial beyond 28 days. Phase II was a cross-sectional telephone interview to identify the reasons for the extended use. Of the 269 patients identified, 81% used it for more than 28 days, with a mean of 43 days. Of the interviewed patients, 60% did not discard the vials after 28 days because of a lack of awareness. Patients who were aware of the 28-day limit were informed by a pharmacist or diabetes educator. A large proportion of Medicaid patients were found to use insulin glargine past the recommended 28-day limit. More work is needed with a larger sample size to determine whether reasons besides lack of awareness affect the use of insulin glargine beyond its expiration and the role of pharmacists and diabetes educators in improving adherence to disposing of the drug after 28 days. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
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Prevalence of insulin glargine vial use beyond 28 days in a Medicaid population.
Journal of the American Pharmacists Association, 2018Co-Authors: Judith M. Turner, Elizabeth J. Unni, Jennifer Strohecker, Jacob HenrichsAbstract:Abstract Objectives Insulin glargine, one of the most commonly prescribed drugs for diabetes, has a 28-day limit on the use of a 10-mL (1000 units) multiple-dose vial once the bottle is punctured. If patients who are using smaller doses or are not adherent continue to use insulin glargine beyond the 28-day window, it can result in questionable stability and sterility of the product. The aim of this study was to determine the proportion of patients who used each insulin glargine vial for more than 28 days, the mean number of days the vial was used after 28 days, the reason for the extended use, and whether that use had any association with diabetes control and Injection Site Infection. Methods The study was conducted in 2 phases. Phase I was a retrospective database analysis of insulin glargine 10-mL vial use by the adult Medicaid population with type 2 diabetes served by Molina Healthcare to determine the proportion of patients who used each vial beyond 28 days. Phase II was a cross-sectional telephone interview to identify the reasons for the extended use. Results Of the 269 patients identified, 81% used it for more than 28 days, with a mean of 43 days. Of the interviewed patients, 60% did not discard the vials after 28 days because of a lack of awareness. Patients who were aware of the 28-day limit were informed by a pharmacist or diabetes educator. Conclusion A large proportion of Medicaid patients were found to use insulin glargine past the recommended 28-day limit. More work is needed with a larger sample size to determine whether reasons besides lack of awareness affect the use of insulin glargine beyond its expiration and the role of pharmacists and diabetes educators in improving adherence to disposing of the drug after 28 days.