Sample records for programmes syringe vending

  1. The effectiveness and safety of syringe vending machines as a component of needle syringe programmes in community settings.

    PubMed

    Islam, Mofizul; Wodak, Alex; Conigrave, Katherine M

    2008-12-01

    Syringe vending machines (SVMs) have been introduced in Europe and Australasia as part of the effort to increase the availability of sterile needles and syringes to injecting drug users (IDUs). This qualitative review of 14 published and grey literature studies examines whether community-based SVMs as a component of a comprehensive needle syringe programme (NSP) assist to reduce the spread of HIV and other blood-borne viruses amongst IDUs. The available evidence suggests that SVMs increase access to sterile injecting equipment, reduce needle and syringe sharing, and are likely to be cost efficient. SVMs also complement other modes of NSP delivery as they are used by IDUs who are less likely to attend staffed NSPs or pharmacies. If installed and properly maintained in a well-chosen location and with the local community well prepared, SVMs can enhance the temporal and geographical availability of sterile injecting equipment.

  2. Syringe vending machines for injection drug users: an experiment in Marseille, France.

    PubMed Central

    Obadia, Y; Feroni, I; Perrin, V; Vlahov, D; Moatti, J P

    1999-01-01

    OBJECTIVES: This study evaluated the usefulness of vending machines in providing injection drug users with access to sterile syringes in Marseille, France. METHODS: Self-administered questionnaires were offered to 485 injection drug users obtaining syringes from 32 pharmacies, 4 needle exchange programs, and 3 vending machines. RESULTS: Of the 343 respondents (response rate = 70.7%), 21.3% used the vending machines as their primary source of syringes. Primary users of vending machines were more likely than primary users of other sources to be younger than 30 years, to report no history of drug maintenance treatment, and to report no sharing of needles or injection paraphernalia. CONCLUSIONS: Vending machines may be an appropriate strategy for providing access to syringes for younger injection drug users, who have typically avoided needle exchange programs and pharmacies. PMID:10589315

  3. Multiple access to sterile syringes for injection drug users: vending machines, needle exchange programs and legal pharmacy sales in Marseille, France.

    PubMed

    Moatti, J P; Vlahov, D; Feroni, I; Perrin, V; Obadia, Y

    2001-03-01

    In Marseille, southeastern France, HIV prevention programs for injection drug users (IDUs) simultaneously include access to sterile syringes through needle exchange programs (NEPs), legal pharmacy sales and, since 1996, vending machines that mechanically exchange new syringes for used ones. The purpose of this study was to compare the characteristics of IDUs according to the site where they last obtained new syringes. During 3 days in September 1997, all IDUs who obtained syringes from 32 pharmacies, four NEPs and three vending machines were offered the opportunity to complete a self-administered questionnaire on demographics, drug use characteristics and program utilization. Of 485 individuals approached, the number who completed the questionnaire was 141 in pharmacies, 114 in NEPs and 88 at vending machines (response rate = 70.7%). Compared to NEP users, vending machine users were younger and less likely to be enrolled in a methadone program or to report being HIV infected, but more likely to misuse buprenorphine. They also had lower financial resources and were less likely to be heroin injectors than both pharmacy and NEP users. Our results suggest that vending machines attract a very different group of IDUs than NEPs, and that both programs are useful adjuncts to legal pharmacy sales for covering the needs of IDUs for sterile syringes in a single city. Assessment of the effectiveness and cost-effectiveness of combining such programs for the prevention of HIV and other infectious diseases among IDUs requires further comparative research. Copyright 2001 S. Karger AG, Basel

  4. Exploring stakeholder perceptions of acceptability and feasibility of needle exchange programmes, syringe vending machines and safer injection facilities in Tijuana, Mexico.

    PubMed

    Philbin, Morgan M; Mantsios, Andrea; Lozada, Remedios; Case, Patricia; Pollini, Robin A; Alvelais, Jorge; Latkin, Carl A; Magis-Rodriguez, Carlos; Strathdee, Steffanie A

    2009-07-01

    Injection drug use is a growing public health crisis along the U.S.-Mexican border and rising rates of blood-borne infections highlight the pressing need for harm reduction interventions. We explored the acceptability and feasibility of such interventions in Tijuana, a city adjacent to San Diego, California. Using in-depth qualitative interviews conducted from August 2006-March 2007 with 40 key stakeholders - pharmacists, legal professionals, health officials, religious officials, drug treatment providers, and law enforcement personnel - we explored the acceptability and feasibility of interventions to reduce drug-related harm in Tijuana, Mexico. Interviews were taped with consent, transcribed verbatim, and translated. Content analysis was conducted to identify themes which included barriers, structural limitations, and suggestions for implementation. Topics included acceptance and feasibility of needle exchange programmes (NEPs), syringe vending machines, and safer injection facilities (SIFs), structural barriers and suggestions for implementation. Of these interventions, NEPs were deemed the most acceptable (75%); however, only half believed these could be feasibly implemented, citing barriers involving religion, police, and lack of political will, public awareness, and funding. Increasing HIV infection rates among injection drug users in Tijuana have prompted interest in public health responses. Our results may assist policy strategists in implementing social-structural interventions that will help create enabling environments that facilitate the scale-up and implementation of harm reduction in Tijuana.

  5. Exploring stakeholder perceptions of acceptability and feasibility of needle exchange programmes, syringe vending machines and safer injection facilities in Tijuana, Mexico

    PubMed Central

    Philbin, Morgan M.; Mantsios, Andrea; Lozada, Remedios; Case, Patricia; Pollini, Robin A.; Alvelais, Jorge; Latkin, Carl A.; Magis-Rodriguez, Carlos; Strathdee, Steffanie A.

    2009-01-01

    Background Injection drug use is a growing public health crisis along the U.S.–Mexican border and rising rates of blood-borne infections highlight the pressing need for harm reduction interventions. We explored the acceptability and feasibility of such interventions in Tijuana, a city adjacent to San Diego, California. Methods Using in-depth qualitative interviews conducted from August 2006–March 2007 with 40 key stakeholders – pharmacists, legal professionals, health officials, religious officials, drug treatment providers, and law enforcement personnel – we explored the acceptability and feasibility of interventions to reduce drug-related harm in Tijuana, Mexico. Interviews were taped with consent, transcribed verbatim, and translated. Content analysis was conducted to identify themes which included barriers, structural limitations, and suggestions for implementation. Results Topics included acceptance and feasibility of needle exchange programmes (NEPs), syringe vending machines, and safer injection facilities (SIFs), structural barriers and suggestions for implementation. Of these interventions, NEPs were deemed the most acceptable (75%); however, only half believed these could be feasibly implemented, citing barriers involving religion, police, and lack of political will, public awareness, and funding. Conclusions Increasing HIV infection rates among injection drug users in Tijuana have prompted interest in public health responses. Our results may assist policy strategists in implementing social-structural interventions that will help create enabling environments that facilitate the scale-up and implementation of harm reduction in Tijuana. PMID:18963906

  6. The evaluation of a trial of syringe vending machines in Canberra, Australia.

    PubMed

    McDonald, David

    2009-07-01

    Syringe vending machines (SVMs) have been trialled in Canberra, Australian Capital Territory, Australia, as an intervention aiming to increase the availability of sterile injecting equipment for use by IDUs. This study evaluated the 12-month trial. A utilisation-focused evaluation model, with both formative and summative components, was employed. Four SVMs were installed, each dispensing packs containing four 1 mL syringes and associated injecting paraphernalia. The trial participants were the clients of the SVMs and other key informants. The core measurements used were the number of syringes dispensed in Canberra by SVMs and other outlets, SVM clients' demographics and experiences of and attitudes towards SVMs, perceived impacts of SVMs on needle sharing, unsafe disposal of used syringes in the vicinity of SVMs, and community and stakeholder attitudes. The trial was implemented successfully, with no adverse consequences identified. The SVMs appear to be serving both the usual clients of the other outlets for sterile injecting equipment (community pharmacies and the Needle Syringe Program outlets) and others who are reluctant to use such outlets or find them inconvenient. The out-of-business-hours provision of syringes through the SVMs was particularly welcomed by both SVM clients and other stakeholders. The continuing operation of the initial four SVMs is widely supported, and additional machines are requested by clients and others. Owing to the success of the trial in terms of feasibility and outcomes for both IDUs and for the broader community, it is desirable that providing sterile injecting equipment through SVMs continues and be expanded as an integral component of harm reduction strategies.

  7. Assessing the role of syringe dispensing machines and mobile van outlets in reaching hard-to-reach and high-risk groups of injecting drug users (IDUs): a review

    PubMed Central

    Islam, Md Mofizul; Conigrave, Katherine M

    2007-01-01

    Reaching hard-to-reach and high-risk injecting drug users (IDUs) is one of the most important challenges for contemporary needle syringe programs (NSPs). The aim of this review is to examine, based upon the available international experience, the effectiveness of syringe vending machines and mobile van/bus based NSPs in making services more accessible to these hard-to-reach and high-risk groups of IDUs. A literature search revealed 40 papers/reports, of which 18 were on dispensing machines (including vending and exchange machines) and 22 on mobile vans. The findings demonstrate that syringe dispensing machines and mobile vans are promising modalities of NSPs, which can make services more accessible to the target group and in particular to the harder-to-reach and higher-risk groups of IDUs. Their anonymous and confidential approaches make services attractive, accessible and acceptable to these groups. These two outlets were found to be complementary to each other and to other modes of NSPs. Services through dispensing machines and mobile vans in strategically important sites are crucial elements in continuing efforts in reducing the spread of HIV and other blood borne viruses among IDUs. PMID:17958894

  8. Introducing auto-disable syringes to the national immunization programme in Madagascar.

    PubMed Central

    Drain, Paul K.; Ralaivao, Josoa S.; Rakotonandrasana, Alexander; Carnell, Mary A.

    2003-01-01

    OBJECTIVE: To evaluate the safety and coverage benefits of auto-disable (AD) syringes, weighed against the financial and logis- tical costs, and to create appropriate health policies in Madagascar. METHODS: Fifteen clinics in Madagascar, trained to use AD syringes, were randomized to implement an AD syringe only, mixed (AD syringes used only on non-routine immunization days), or sterilizable syringe only (control) programme. During a five-week period, data on administered vaccinations were collected, interviews were conducted, and observations were recorded. FINDINGS: The use of AD syringes improved coverage rates by significantly increasing the percentage of vaccines administered on non-routine immunization days (AD-only 4.3%, mixed 5.7%, control 1.1% (P<0.05)). AD-only clinics eliminated sterilization sessions for vaccinations, whereas mixed clinics reduced the number of sterilization sessions by 64%. AD syringes were five times more expensive than sterilizable syringes, which increased AD-only and mixed clinics' projected annual injection costs by 365% and 22%, respectively. However, introducing AD syringes for all vaccinations would only increase the national immunization budget by 2%. CONCLUSION: The use of AD syringes improved vaccination coverage rates by providing ready-to-use sterile syringes on non-routine immunization days and decreasing the number of sterilization sessions, thereby improving injection safety. The mixed programme was the most beneficial approach to phasing in AD syringes and diminishing logistical complications, and it had minimal costs. AD syringes, although more expensive, can feasibly be introduced into a developing country's immunization programme to improve vaccination safety and coverage. PMID:14576886

  9. Sharing of Needles and Syringes among Men Who Inject Drugs: HIV Risk in Northwest Bangladesh.

    PubMed

    Pasa, M Kamal; Alom, Kazi Robiul; Bashri, Zubaida; Vermund, Sten H

    2016-01-01

    Injection drug use is prevalent in northwestern Bangladesh. We sought to explore the context of needle/syringe sharing among persons who inject drugs (PWID), examining risk exposures to blood-borne infections like the human immunodeficiency virus (HIV) and hepatitis in a region where these dual epidemics are likely to expand. We used a qualitative research approach to learn about injection practices, conducting 60 in-depth interviews among PWID. We then conducted 12 focus group discussions (FGDs) that generated a checklist of salient issues, and followed up with personal observations of typical days at the drug-use venues. Content and interpretative frameworks were used to analyze qualitative information and socio-demographic information, using SPSS software. We found that needle/syringe-sharing behaviours were integrated into the overall social and cultural lives of drug users. Sharing behaviours were an central component of PWID social organization. Sharing was perceived as an inherent element within reciprocal relationships, and sharing was tied to beliefs about drug effects, economic adversity, and harassment due to their drug user status. Carrying used needles/syringes to drug-use venues was deemed essential since user-unfriendly needle-syringe distribution schedules of harm reduction programmes made it difficult to access clean needles/syringes in off-hours. PWID had low self-esteem. Unequal power relationships were reported between the field workers of harm reduction programmes and PWID. Field workers expressed anti-PWID bias and judgmental attitudes, and also had had misconceptions about HIV and hepatitis transmission. PWID were especially disturbed that no assistance was forthcoming from risk reduction programme staff when drug users manifested withdrawal symptoms. Interventions must take social context into account when scaling up programmes in diverse settings. The social organization of PWID include values that foster needle-syringe sharing. Utilization and impact of risk reduction programmes might be improved with expanded clean needle/syringe distribution at times and venues convenient for PWID, better trained and non-judgmental staff, and medical assistance for health problems, including drug withdrawal symptoms.

  10. Correlates of syringe coverage for heroin injection in 35 large metropolitan areas in the US in which heroin is the dominant injected drug

    PubMed Central

    Tempalski, Barbara; Cooper, Hannah L.; Friedman, Samuel R.; Des Jarlais, Don C.; Brady, Joanne; Gostnell, Karla

    2009-01-01

    Background Scientific consensus holds that if, at the outset of the HIV/AIDS epidemic, injection drug users (IDUs) had had better access to sterile syringes, much of the epidemic among IDUs in the U.S. could have been prevented. In the context of preventing infectious diseases, 100% syringe coverage—that is, one sterile syringe per injector for each injection—is a public health goal. Notably, we know little about variations in syringe coverage within the U.S. and elsewhere, or about the social and political factors that might determine this coverage. Methods Using data from Holmberg (AJPH, 1996), the 1990 United States Census, the 2000 Beth Israel National Syringe Exchange Survey (n=72), and estimates of IDUs in metropolitan areas (MSAs); (Friedman et al., 2004), we explore the impact of (1) political factors (ACT UP, outreach, early syringe exchange programme (SEP) presence, men who have sex with men (MSM) per capita, drug arrests, and police per capita); (2) local resources for SEPs; and (3) indicators of socioeconomic inequality on SEP coverage. We define “syringe coverage” as the ratio of syringes distributed at SEPs to the number of syringes heroin injectors need in a year. We calculated the number of syringes heroin injectors need in a year by multiplying an estimate of the number of IDUs in each MSA by an estimate of the average number of times heroin injectors inject heroin per year (2.8 times per day times 365 days). In this analysis, the sample was limited to 35 MSAs in which the primary drug of choice among injectors was heroin. Results SEP coverage varies greatly across MSAs, with an average of 3 syringes distributed per 100 injection events (std dev = 0.045; range: 2 syringes per 10 injection events, to 3 syringes per 10,000 injection events). In bivariate regression analyses, a 1 unit difference in the proportion of the population that was MSM per 1,000 was associated with a difference of 0.002 in SEP coverage (p=0.052); early SEP presence was associated with a difference of 0.038 in coverage (p=0.012); and having government funding was associated with a 0.040 difference in SEP coverage (p=0.021). Conclusions This analysis suggests that longer duration of SEP presence may increase syringe distribution and enhance successful programme utilization. Furthermore, MSAs with greater proportions of MSM tend to have better SEP coverage, perhaps providing further evidence that grassroots activism plays an important role in programme implementation and successful SEP coverage. This research provides evidence that government funding for SEPs contributes to better syringe coverage. PMID:18295468

  11. The effect of social demographic factors, snack consumption and vending machine use on oral health of children living in London.

    PubMed

    Maliderou, M; Reeves, S; Noble, C

    2006-10-07

    To investigate the effect of socio-economic status, sugar, snack consumption and vending machine use on the prevalence and severity of caries (DMF) in children. An observational study was carried out in a dental practice in inner city London. Sixty children were asked to complete a questionnaire and a three day food and drink diary. After a dental examination the number of decayed (D), missing (M) or filled (F) teeth provided a DMF score. Anova and Pearsons correlations were used to analyse the data statistically. Children from social groups I and II consumed significantly less (P < 0.05) sugar, confectionery, crisps and used a vending machine less often than children from other social groups. Children from Social groups I, II and III had significantly lower DMF scores. The average DMF from social group I children was 0.5 +/- 0.6, whilst group IV children had the greatest incidence and a DMF of 4.6 +/- 0.8. Significant correlations were identified between DMF and sugar, confectionery and crisp consumption and vending machine use, and a negative correlation between DMF and vegetable consumption. Socio-economic status and access to vending machines were found to have a significant effect on sugar intakes, foods choices, and dental health. The removal of vending machines from schools or at least installing 'healthy' vending machines is recommended. Health promotion programmes that account for social groups and snacking habits that are cost effective are required.

  12. Integrating multiple programme and policy approaches to hepatitis C prevention and care for injection drug users: a comprehensive approach.

    PubMed

    Birkhead, Guthrie S; Klein, Susan J; Candelas, Alma R; O'Connell, Daniel A; Rothman, Jeffrey R; Feldman, Ira S; Tsui, Dennis S; Cotroneo, Richard A; Flanigan, Colleen A

    2007-10-01

    New York State is home to an estimated 230,000 individuals chronically infected with hepatitis C virus (HCV) and roughly 171,500 active injection drug users (IDUs). HCV/HIV co-infection is common and models of service delivery that effectively meet IDUs' needs are required. A HCV strategic plan has stressed integration. HCV prevention and care are integrated within health and human service settings, including HIV/AIDS organisations and drug treatment programmes. Other measures that support comprehensive HCV services for IDUs include reimbursement, clinical guidelines, training and HCV prevention education. Community and provider collaborations inform programme and policy development. IDUs access 5 million syringes annually through harm reduction/syringe exchange programmes (SEPs) and a statewide syringe access programme. Declines in HCV prevalence amongst IDUs in New York City coincided with improved syringe availability. New models of care successfully link IDUs at SEPs and in drug treatment to health care. Over 7000 Medicaid recipients with HCV/HIV co-infection had health care encounters related to their HCV in a 12-month period and 10,547 claims for HCV-related medications were paid. The success rate of transitional case management referrals to drug treatment is over 90%. Training and clinical guidelines promote provider knowledge about HCV and contribute to quality HCV care for IDUs. Chart reviews of 2570 patients with HIV in 2004 documented HCV status 97.4% of the time, overall, in various settings. New HCV surveillance systems are operational. Despite this progress, significant challenges remain. A comprehensive, public health approach, using multiple strategies across systems and mobilizing multiple sectors, can enhance IDUs access to HCV prevention and care. A holisitic approach with integrated services, including for HCV-HIV co-infected IDUs is needed. Leadership, collaboration and resources are essential.

  13. Auto-disable syringes for immunization: issues in technology transfer.

    PubMed Central

    Lloyd, J. S.; Milstien, J. B.

    1999-01-01

    WHO and its partners recommend the use of auto-disable syringes, "bundled" with the supply of vaccines when donor dollars are used, in all mass immunization campaigns, and also strongly advocate their use in routine immunization programmes. Because of the relatively high price of auto-disable syringes, WHO's Technical Network for Logistics in Health recommends that activities be initiated to encourage the transfer of production technology for these syringes as a means of promoting their use and enhancing access to the technology. The present article examines factors influencing technology transfer, including feasibility, corporate interest, cost, quality assurance, intellectual property considerations, and probable time frames for implementation. Technology transfer activities are likely to be complex and difficult, and may not result in lower prices for syringes. Guidelines are offered on technology transfer initiatives for auto-disable syringes to ensure the quality of the product, the reliability of the supply, and the feasibility of the technology transfer activity itself. PMID:10680248

  14. Tuberculosis knowledge among injecting drug users visiting syringe exchange programme in Tallinn, Estonia.

    PubMed

    Rüütel, Kristi; Parker, R David; Sobolev, Igor; Loit, Helle-Mai

    2012-12-01

    The purpose of the current study was to describe tuberculosis (TB) knowledge, beliefs, and experience with TB services among injecting drug users. Participants for this anonymous, cross-sectional study were recruited from a community based syringe exchange programme in Tallinn, Estonia. A structured questionnaire was completed and included information on socio-demographics, health history, drug use, and knowledge about TB and HIV. The study included 407 people (79% male, mean age 27.9 years, mean injection drug use 9.4 years). 32.9% of participants reported HIV infection and 1.7% lifetime history of TB. 26.4% participants (n=106) reported symptoms suggestive of TB. 93% of participants recognized correctly that TB is air-borne infection and 91% that HIV is a risk factor for TB. Only 40% of the participants knew that TB diagnostics and treatment in Estonia are free of charge for everybody and 58% reported they knew where to get health care services in case they suspected that they had TB. TB transmission and treatment adherence knowledge was better among those in contact with either health care or harm reduction services, e.g the community based syringe exchange programme. Similar to HIV services, TB prevention and education should be integrated into harm reduction and drug treatment programmes to facilitate early diagnosis and treatment of TB among injecting drug users.

  15. The development of peer educator-based harm reduction programmes in Northern Vietnam.

    PubMed

    Walsh, Nick; Gibbie, Tania M; Higgs, Peter

    2008-03-01

    Injecting drug use remains an important risk factor for transmission in Vietnam, with an estimated 50% of the 290 000 people living with HIV/AIDS reporting injecting drug use as a risk factor. Despite this, effective harm reduction interventions are generally lacking. This paper describes the implementation of peer-based harm reduction programmes in two rural provinces of Vietnam. Peer educators were trained in basic HIV prevention, including harm reduction. After significant preparation work with the Provincial AIDS Committees of Bac Giang and Thanh Hoa and other relevant national, provincial and local authorities, the interventions were commenced. Harm reduction interventions were delivered through outreach as well as on-site. This included needle and syringe distribution and collection. Community advocacy occurred throughout the life of the project. Local authorities and peers believed that while there was a general reduction in stigma and discrimination, legal barriers associated particularly with the carrying of injecting equipment remained. This impacted upon the ability of peer educators to work with their clients. Peer-based delivery of harm reduction intervention is acceptable. Harm reduction interventions, including needle and syringe programmes, are feasible and acceptable in these two rural Vietnamese provinces. Community acceptance and uptake of these interventions is key to successful expansion across the region. Active participation by families of drug users seems crucial. This initiative demonstrates that despite a difficult policy environment, peer-delivered needle and syringe programmes are feasible within a rural Asian environment as long as there is adequate local political and community support.

  16. [Limits of self regulation of the private food sector: the case of removing of vending machines from schools].

    PubMed

    Michaud, Claude; Baudier, François

    2007-01-01

    Conflicts of interest between the food industry and public decision makers have increasingly multiplied over the last few years, especially within the context of implementing the French National Nutrition Programme. This paper describes the rhetoric and the strategies developed by the private sector in order to counter the law's implementation and enforcement based on a concrete example, namely, the removal of vending machines from schools. After having evoked possibilities of developing new partnerships as suggested by national and international health authorities, it reaffirms the right and the duty of the State to regulate within the framework of a health promotion policy, an approach which integrates the necessary open democratic public debate between the different sectors.

  17. Programme Note: Realities and Opportunities in Ho Chi Minh City.

    ERIC Educational Resources Information Center

    Franchet, Chi Nguyen

    1996-01-01

    The current status of street children in Ho Chi Minh City, Vietnam, is characterized by marginalization from society through street vending, begging, theft, and prostitution. Evaluation of a drop-in center serving children without family linkages indicates need for needs assessments, follow-up activities, measurement of individual child progress,…

  18. Home medication injection among Latina women in Los Angeles: implications for health education and prevention.

    PubMed

    Flaskerud, J H; Nyamathi, A M

    1996-02-01

    Reuse of needles and syringes after home injection of medications and vitamins may be a risk for transmission of HIV. An exploratory study was done to determine (1) how commonly injectable medications were used in the home; (2) whether needles and syringes were reused; and (3) common practices for cleaning needles and syringes. A survey was conducted of low income Latina women (n = 216) who were attending a Public Health Foundation nutrition programme for women, infants and children (WIC) in Los Angeles. To clarify and expand on the survey findings, focus group interviews were done with an additional 55 women attending WIC. Quantitative data were analysed using descriptive and comparative statistics. Qualitative data were subjected to content analysis. The use of injectable medications purchased in Mexico was fairly common (43.5%); reuse of disposable needles and syringes (48%) and sharing (36%) among injectors were also common. Methods of cleaning needles and syringes were inadequate to CDC recommended guidelines. Injectors and non-injectors differed significantly in ethnicity, religion, and marital status. The only significant predictor of medication injection was educational level. Analysis of qualitative data revealed the reasons that Latina subjects were injecting medication; how they were transporting medicines from Mexico; and how they were cleaning their equipment. The practical implications for health education and prevention programmes should include an awareness that home use and reuse of needles for injection of medications may be common in some social groups and that knowledge of the potential dangers in reuse and sharing of needles may not extend to home medication injection.

  19. Drug residues in used syringes in Switzerland: A comparative study.

    PubMed

    Lefrançois, Elodie; Augsburger, Marc; Esseiva, Pierre

    2018-05-01

    Harm reduction services, including needle-exchange programmes, have been implemented in Switzerland for over 20 years. Their main aim is to lessen the negative social and/or physical consequences associated with illicit drug consumption and, therefore, improve prevention messages. To this end, knowledge of illicit drug consumption practices is necessary. Periodic self-report surveys are the primary source of data for monitoring drug users' behaviour. Analysis of residual content of used syringes can bring further and objective knowledge about consumed products through analytically confirmed data. Used syringes were sampled in 2 syringe-exchange facilities in Lausanne. These structures are a bus where the users bring back their syringes (ABS) and an automatic injecting kit dispenser (AIKD). Once syringes were collected, a validated gas chromatography-mass spectrometry (GC-MS) method was implemented in order to detect drugs (licit or illicit) contained in the residual content of used syringes. Cocaine was the most common drug detected alone (39% in ABS and 31% in AIKD), followed by the simultaneous detection of heroin and cocaine (12% and 17%) and heroin and midazolam (12% and 17%). The differences between the illicit drugs distribution of used syringes collected in AIKD and ABS were not statistically significant. Analysis of residual content of used syringes as a monitoring tool is an original approach that has already led to a better understanding of the habits of drug-injection users. Over the long term, this approach is a powerful tool to track and detect new consumption practices in a quasi-real-time. Copyright © 2017 John Wiley & Sons, Ltd.

  20. Portable system of programmable syringe pump with potentiometer for determination of promethazine in pharmaceutical applications.

    PubMed

    Saleh, Tawfik A; Abulkibash, A M; Ibrahim, Atta E

    2012-04-01

    A simple and fast-automated method was developed and validated for the assay of promethazine hydrochloride in pharmaceutical formulations, based on the oxidation of promethazine by cerium in an acidic medium. A portable system, consisting of a programmable syringe pump connected to a potentiometer, was constructed. The developed change in potential during promethazine oxidation was monitored. The related optimum working conditions, such as supporting electrolyte concentration, cerium(IV) concentration and flow rate were optimized. The proposed method was successfully applied to pharmaceutical samples as well as synthetic ones. The obtained results were realized by the official British pharmacopoeia (BP) method and comparable results were obtained. The obtained t-value indicates no significant differences between the results of the proposed and BP methods, with the advantages of the proposed method being simple, sensitive and cost effective.

  1. A sophisticated programmable miniaturised pump for insulin delivery.

    PubMed

    Klein, J C; Slama, G

    1980-09-01

    We have conceived a truly pre-programmable infusion system usable for intravenous administration of insulin in diabetic subjects. The original system has been built into a small, commercially available, syringe-pump of which only the case and the mechanical parts have been kept. The computing until has a timer, a programmable memory of 512 words by 8 bits and a digital-to-frequency converter to run the motor which drives the syringe. The memory contains 8 profiles of insulin injections stored in digital form over 64 words. Each profile is selected by the patient before eating according to the carbohydrate content of the planned meal and last about two hours, starting from and returning to the basal rate of insulin, at which it remains until next profile selection. Amount, profiles and duration of insulin injection are either mean values deduced from previous studies with a closed-loop artificial pancreas or personally fitted values; they are stored in an instantly replaceable memory cell. This device allows the patient to choose the time, nature and amount of his food intake.

  2. Portable system of programmable syringe pump with potentiometer for determination of promethazine in pharmaceutical applications

    PubMed Central

    Saleh, Tawfik A.; Abulkibash, A.M.; Ibrahim, Atta E.

    2011-01-01

    A simple and fast-automated method was developed and validated for the assay of promethazine hydrochloride in pharmaceutical formulations, based on the oxidation of promethazine by cerium in an acidic medium. A portable system, consisting of a programmable syringe pump connected to a potentiometer, was constructed. The developed change in potential during promethazine oxidation was monitored. The related optimum working conditions, such as supporting electrolyte concentration, cerium(IV) concentration and flow rate were optimized. The proposed method was successfully applied to pharmaceutical samples as well as synthetic ones. The obtained results were realized by the official British pharmacopoeia (BP) method and comparable results were obtained. The obtained t-value indicates no significant differences between the results of the proposed and BP methods, with the advantages of the proposed method being simple, sensitive and cost effective. PMID:23960787

  3. 34 CFR 395.1 - Terms.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... machine or a vending facility on the same premises as a vending facility operated by a blind vendor, except that vending machines or vending facilities operated in areas serving employees the majority of... time required to patronize the vending facility) to the vending facility operated by a blind vendor...

  4. 34 CFR 395.1 - Terms.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... machine or a vending facility on the same premises as a vending facility operated by a blind vendor, except that vending machines or vending facilities operated in areas serving employees the majority of... time required to patronize the vending facility) to the vending facility operated by a blind vendor...

  5. 34 CFR 395.1 - Terms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... machine or a vending facility on the same premises as a vending facility operated by a blind vendor, except that vending machines or vending facilities operated in areas serving employees the majority of... time required to patronize the vending facility) to the vending facility operated by a blind vendor...

  6. 10 CFR 431.292 - Definitions concerning refrigerated bottled or canned beverage vending machines.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... cooled, and is not a combination vending machine. Class B means any refrigerated bottled or canned beverage vending machine not considered to be Class A, and is not a combination vending machine. Combination vending machine means a refrigerated bottled or canned beverage vending machine that also has non...

  7. 34 CFR 395.32 - Collection and distribution of vending machine income from vending machines on Federal property.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true Collection and distribution of vending machine income from vending machines on Federal property. 395.32 Section 395.32 Education Regulations of the Offices... Management § 395.32 Collection and distribution of vending machine income from vending machines on Federal...

  8. 34 CFR 395.32 - Collection and distribution of vending machine income from vending machines on Federal property.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false Collection and distribution of vending machine income from vending machines on Federal property. 395.32 Section 395.32 Education Regulations of the Offices... Management § 395.32 Collection and distribution of vending machine income from vending machines on Federal...

  9. 34 CFR 395.32 - Collection and distribution of vending machine income from vending machines on Federal property.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true Collection and distribution of vending machine income from vending machines on Federal property. 395.32 Section 395.32 Education Regulations of the Offices... Management § 395.32 Collection and distribution of vending machine income from vending machines on Federal...

  10. 34 CFR 395.32 - Collection and distribution of vending machine income from vending machines on Federal property.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false Collection and distribution of vending machine income from vending machines on Federal property. 395.32 Section 395.32 Education Regulations of the Offices... Management § 395.32 Collection and distribution of vending machine income from vending machines on Federal...

  11. Impact of Healthy Vending Machine Options in a Large Community Health Organization.

    PubMed

    Grivois-Shah, Ravi; Gonzalez, Juan R; Khandekar, Shashank P; Howerter, Amy L; O'Connor, Patrick A; Edwards, Barbara A

    2017-01-01

    To determine whether increasing the proportion of healthier options in vending machines decreases the amount of calories, fat, sugar, and sodium vended, while maintaining total sales revenue. This study evaluated the impact of altering nutritious options to vending machines throughout the Banner Health organization by comparing vended items' sales and nutrition information over 6 months compared to the same 6 months of the previous year. Twenty-three locations including corporate and patient-care centers. Changing vending machine composition toward more nutritious options. Comparisons of monthly aggregates of sales, units vended, calories, fat, sodium, and sugar vended by site. A pre-post analysis using paired t tests comparing 6 months before implementation to the equivalent 6 months postimplementation. Significant average monthly decreases were seen for calories (16.7%, P = .002), fat (27.4%, P ≤ .0001), sodium (25.9%, P ≤ .0001), and sugar (11.8%, P = .045) vended from 2014 to 2015. Changes in revenue and units vended did not change from 2014 to 2015 ( P = .58 and P = .45, respectively). Increasing the proportion of healthier options in vending machines from 20% to 80% significantly lowered the amount of calories, sodium, fat, and sugar vended, while not reducing units vended or having a negative financial impact.

  12. Vending Assessment and Program Implementation in Four Iowa Worksites.

    PubMed

    Lillehoj, Catherine J; Nothwehr, Faryle; Shipley, Kala; Voss, Carol

    2015-11-01

    The worksite food environment, including vending options, has been explored as an important contributor to dietary decisions made every day. The current study describes the vending environment, and efforts to change it, in four Iowa worksites using a series of case studies. Data were gathered by local coordinators as part of the Iowa Community Transformation Grant project. Data were collected from three sources. First, the Nutrition Environment Measures Survey-Vending was used to assess healthy vending options in worksite machines before and after the intervention. Second, employee vending behavior was evaluated with a pre-, post-intervention survey. Items assessed attitudes and behaviors regarding vending, plus awareness and reaction to intervention activities. Third, program coordinators documented vending machine intervention strategies used, such as social marketing materials and product labels. The Nutrition Environment Measures Survey-Vending documented that the majority of vending options did not meet criteria for healthfulness. The vending survey found that employees were generally satisfied with the healthier items offered. Some differences were noted over time at the four worksites related to employee behavior and attitudes concerning healthy options. There were also differences in intervention implementation and the extent of changes made by vending companies. Overall, findings demonstrate that a large percentage of employees are constrained in their ability to access healthy foods due to limited worksite vending options. There also remain challenges to making changes in this environment. Findings have implications for public health practitioners to consider when designing healthy vending interventions in worksites. © 2015 Society for Public Health Education.

  13. Development of a programmable piggyback syringe pump and four-times-a-day injection regimen for superovulation in non-lactating Holstein cows

    PubMed Central

    IRSHAD, Abdul Razaq; SASAKI, Taihei; KUBO, Tomoaki; ODASHIMA, Naoyuki; KATANO, Keiji; OSAWA, Takeshi; TAKAHASHI, Toru; IZAIKE, Yoshiaki

    2015-01-01

    The objectives of the present study were to develop a programmable piggyback syringe pump for bovine superovulation and to evaluate the effects of a four-times-a-day injection regimen using the pump. Non-lactating Holstein cows were treated with a total of 30 armour units of porcine FSH by injection four times a day with the pump (study, n = 9) or injection twice a day manually (control, n = 9) for four consecutive days from D10 of the estrous cycle. The pump-driven program successfully induced superovulation in all cows tested. The numbers of small (3– < 5 mm in diameter) and large (≥ 10 mm in diameter) follicles were greater in the study group on D11-13 and D14, respectively. There were fewer unovulated follicles detected on D21 (7 days after estrus) in the study group than in the control group (1.2 ± 0.4 and 3.2 ± 0.6, respectively). PMID:26052155

  14. Development of a programmable piggyback syringe pump and four-times-a-day injection regimen for superovulation in non-lactating Holstein cows.

    PubMed

    Irshad, Abdul Razaq; Sasaki, Taihei; Kubo, Tomoaki; Odashima, Naoyuki; Katano, Keiji; Osawa, Takeshi; Takahashi, Toru; Izaike, Yoshiaki

    2015-01-01

    The objectives of the present study were to develop a programmable piggyback syringe pump for bovine superovulation and to evaluate the effects of a four-times-a-day injection regimen using the pump. Non-lactating Holstein cows were treated with a total of 30 armour units of porcine FSH by injection four times a day with the pump (study, n = 9) or injection twice a day manually (control, n = 9) for four consecutive days from D10 of the estrous cycle. The pump-driven program successfully induced superovulation in all cows tested. The numbers of small (3- < 5 mm in diameter) and large (≥ 10 mm in diameter) follicles were greater in the study group on D11-13 and D14, respectively. There were fewer unovulated follicles detected on D21 (7 days after estrus) in the study group than in the control group (1.2 ± 0.4 and 3.2 ± 0.6, respectively).

  15. Behavioural change in injecting drug users: evaluation of an HIV/AIDS education programme.

    PubMed

    Martin, G S; Serpelloni, G; Galvan, U; Rizzetto, A; Gomma, M; Morgante, S; Rezza, G

    1990-01-01

    The results obtained from the training and follow-up of 189 IDUs who participated in a programme consisting of an audiovisual presentation, pre-/post-testing and individual counselling are presented. Syringe sharing decreased from 35% at initial contact to 12% after 6 months. Sexual behaviour proved more resistant to change. However, condom use in at-risk situations increased from 49% to 70%. IDUs under continuous methadone treatment were less likely to engage high risk drug injecting practices than the other IDUs. Results indicate that an educational programme addressed toward risk reduction may determine relevant behavioural change among IDUs.

  16. Campus-based snack food vending consumption.

    PubMed

    Caruso, Michelle L; Klein, Elizabeth G; Kaye, Gail

    2014-01-01

    To evaluate the purchases of university vending machine clientele and to understand what consumers purchase, purchase motivations, and purchase frequency after implementation of a vending policy designed to promote access to healthier snack options. Cross-sectional data collection from consumers at 8 campus vending machines purposefully selected from a list of highest-grossing machines. Vending machines were stocked with 28.5% green (choose most often), 43% yellow (occasionally), and 28.5% red (least often) food items. Consumers were predominately students (86%) and persons aged 18-24 years (71%). Red vending choices were overwhelmingly selected over healthier vending options (59%). Vended snack food selections were most influenced by hunger (42%) and convenience (41%). Most consumers (51%) frequented vending machines at least 1 time per week. Despite decreased access to less healthful red snack food choices, consumers chose these snacks more frequently than healthier options in campus vending machines. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  17. 10 CFR 431.292 - Definitions concerning refrigerated bottled or canned beverage vending machines.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... beverage vending machines. 431.292 Section 431.292 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY... Vending Machines § 431.292 Definitions concerning refrigerated bottled or canned beverage vending machines. Basic model means, with respect to refrigerated bottled or canned beverage vending machines, all units...

  18. Low-cost feedback-controlled syringe pressure pumps for microfluidics applications.

    PubMed

    Lake, John R; Heyde, Keith C; Ruder, Warren C

    2017-01-01

    Microfluidics are widely used in research ranging from bioengineering and biomedical disciplines to chemistry and nanotechnology. As such, there are a large number of options for the devices used to drive and control flow through microfluidic channels. Commercially available syringe pumps are probably the most commonly used instruments for this purpose, but are relatively high-cost and have inherent limitations due to their flow profiles when they are run open-loop. Here, we present a low-cost ($110) syringe pressure pump that uses feedback control to regulate the pressure into microfluidic chips. Using an open-source microcontroller board (Arduino), we demonstrate an easily operated and programmable syringe pump that can be run using either a PID or bang-bang control method. Through feedback control of the pressure at the inlets of two microfluidic geometries, we have shown stability of our device to within ±1% of the set point using a PID control method and within ±5% of the set point using a bang-bang control method with response times of less than 1 second. This device offers a low-cost option to drive and control well-regulated pressure-driven flow through microfluidic chips.

  19. Low-cost feedback-controlled syringe pressure pumps for microfluidics applications

    PubMed Central

    Lake, John R.; Heyde, Keith C.

    2017-01-01

    Microfluidics are widely used in research ranging from bioengineering and biomedical disciplines to chemistry and nanotechnology. As such, there are a large number of options for the devices used to drive and control flow through microfluidic channels. Commercially available syringe pumps are probably the most commonly used instruments for this purpose, but are relatively high-cost and have inherent limitations due to their flow profiles when they are run open-loop. Here, we present a low-cost ($110) syringe pressure pump that uses feedback control to regulate the pressure into microfluidic chips. Using an open-source microcontroller board (Arduino), we demonstrate an easily operated and programmable syringe pump that can be run using either a PID or bang-bang control method. Through feedback control of the pressure at the inlets of two microfluidic geometries, we have shown stability of our device to within ±1% of the set point using a PID control method and within ±5% of the set point using a bang-bang control method with response times of less than 1 second. This device offers a low-cost option to drive and control well-regulated pressure-driven flow through microfluidic chips. PMID:28369134

  20. 15 CFR 5.5 - Vending machines.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 1 2011-01-01 2011-01-01 false Vending machines. 5.5 Section 5.5... machines. (a) The income from any vending machines which are located within reasonable proximity to and are... shall be assigned to the operator of such stand. (b) If a vending machine vends articles of a type...

  1. 15 CFR 5.5 - Vending machines.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Vending machines. 5.5 Section 5.5... machines. (a) The income from any vending machines which are located within reasonable proximity to and are... shall be assigned to the operator of such stand. (b) If a vending machine vends articles of a type...

  2. 34 CFR 395.8 - Distribution and use of income from vending machines on Federal property.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false Distribution and use of income from vending machines on... use of income from vending machines on Federal property. (a) Vending machine income from vending machines on Federal property which has been disbursed to the State licensing agency by a property managing...

  3. 34 CFR 395.8 - Distribution and use of income from vending machines on Federal property.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false Distribution and use of income from vending machines on... use of income from vending machines on Federal property. (a) Vending machine income from vending machines on Federal property which has been disbursed to the State licensing agency by a property managing...

  4. 34 CFR 395.8 - Distribution and use of income from vending machines on Federal property.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true Distribution and use of income from vending machines on... use of income from vending machines on Federal property. (a) Vending machine income from vending machines on Federal property which has been disbursed to the State licensing agency by a property managing...

  5. 34 CFR 395.8 - Distribution and use of income from vending machines on Federal property.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... blind vendor in any amount exceeding the average net income of the total number of blind vendors in the... 34 Education 2 2010-07-01 2010-07-01 false Distribution and use of income from vending machines on... use of income from vending machines on Federal property. (a) Vending machine income from vending...

  6. 34 CFR 395.8 - Distribution and use of income from vending machines on Federal property.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... blind vendor in any amount exceeding the average net income of the total number of blind vendors in the... 34 Education 2 2011-07-01 2010-07-01 true Distribution and use of income from vending machines on... use of income from vending machines on Federal property. (a) Vending machine income from vending...

  7. Healthier vending machines in workplaces: both possible and effective.

    PubMed

    Gorton, Delvina; Carter, Julie; Cvjetan, Branko; Ni Mhurchu, Cliona

    2010-03-19

    To develop healthier vending guidelines and assess their effect on the nutrient content and sales of snack products sold through hospital vending machines, and on staff satisfaction. Nutrition guidelines for healthier vending machine products were developed and implemented in 14 snack vending machines at two hospital sites in Auckland, New Zealand. The guidelines comprised threshold criteria for energy, saturated fat, sugar, and sodium content of vended foods. Sales data were collected prior to introduction of the guidelines (March-May 2007), and again post-introduction (March-May 2008). A food composition database was used to assess impact of the intervention on nutrient content of purchases. A staff survey was also conducted pre- and post-intervention to assess acceptability. Pre-intervention, 16% of staff used vending machines once a week or more, with little change post-intervention (15%). The guidelines resulted in a substantial reduction in the amount of energy (-24%), total fat (-32%), saturated fat (-41%), and total sugars (-30%) per 100 g product sold. Sales volumes were not affected, and the proportion of staff satisfied with vending machine products increased. Implementation of nutrition guidelines in hospital vending machines led to substantial improvements in nutrient content of vending products sold. Wider implementation of these guidelines is recommended.

  8. Vending machine policies and practices in Delaware.

    PubMed

    Gemmill, Erin; Cotugna, Nancy

    2005-04-01

    Overweight has reached alarming proportions among America's youth. Although the cause of the rise in overweight rates in children and adolescents is certainly the result of the interaction of a variety of factors, the presence of vending machines in schools is one issue that has recently come to the forefront. Many states have passed or proposed legislation that limits student access to vending machines in schools or require that vending machines in schools offer healthier choices. The purposes of this study were (a) to assess the food and beverage vending machine offerings in the public school districts in the state of Delaware and (b) to determine whether there are any district vending policies in place other than the current U.S. Department of Agriculture regulations. The results of this study indicate the most commonly sold food and drink items in school vending machines are of minimal nutritional value. School administrators are most frequently in charge of the vending contract, as well as setting and enforcing vending machine policies. Suggestions are offered to assist school nurses, often the only health professional in the school, in becoming advocates for changes in school vending practices and policies that promote the health and well-being of children and adolescents.

  9. The food and beverage vending environment in health care facilities participating in the healthy eating, active communities program.

    PubMed

    Lawrence, Sally; Boyle, Maria; Craypo, Lisa; Samuels, Sarah

    2009-06-01

    Little has been done to ensure that the foods sold within health care facilities promote healthy lifestyles. Policies to improve school nutrition environments can serve as models for health care organizations. This study was designed to assess the healthfulness of foods sold in health care facility vending machines as well as how health care organizations are using policies to create healthy food environments. Food and beverage assessments were conducted in 19 California health care facilities that serve children in the Healthy Eating, Active Communities sites. Items sold in vending machines were inventoried at each facility and interviews conducted for information on vending policies. Analyses examined the types of products sold and the healthfulness of these products. Ninety-six vending machines were observed in 15 (79%) of the facilities. Hospitals averaged 9.3 vending machines per facility compared with 3 vending machines per health department and 1.4 per clinic. Sodas comprised the greatest percentage of all beverages offered for sale: 30% in hospital vending machines and 38% in clinic vending machines. Water (20%) was the most prevalent in health departments. Candy comprised the greatest percentage of all foods offered in vending machines: 31% in clinics, 24% in hospitals, and 20% in health department facilities. Across all facilities, 75% of beverages and 81% of foods sold in vending machines did not adhere to the California school nutrition standards (Senate Bill 12). Nine (47%) of the health care facilities had adopted, or were in the process of adopting, policies that set nutrition standards for vending machines. According to the California school nutrition standards, the majority of items found in the vending machines in participating health care facilities were unhealthy. Consumption of sweetened beverages and high-energy-density foods has been linked to increased prevalence of obesity. Some health care facilities are developing policies that set nutrition standards for vending machines. These policies could be effective in increasing access to healthy foods and beverages in institutional settings.

  10. Nutritional value of foods sold in vending machines in a UK University: Formative, cross-sectional research to inform an environmental intervention.

    PubMed

    Park, Hanla; Papadaki, Angeliki

    2016-01-01

    Vending machine use has been associated with low dietary quality among children but there is limited evidence on its role in food habits of University students. We aimed to examine the nutritional value of foods sold in vending machines in a UK University and conduct formative research to investigate differences in food intake and body weight by vending machine use among 137 University students. The nutrient content of snacks and beverages available at nine campus vending machines was assessed by direct observation in May 2014. Participants (mean age 22.5 years; 54% males) subsequently completed a self-administered questionnaire to assess vending machine behaviours and food intake. Self-reported weight and height were collected. Vending machine snacks were generally high in sugar, fat and saturated fat, whereas most beverages were high in sugar. Seventy three participants (53.3%) used vending machines more than once per week and 82.2% (n 60) of vending machine users used them to snack between meals. Vending machine accessibility was positively correlated with vending machine use (r = 0.209, P = 0.015). Vending machine users, compared to non-users, reported a significantly higher weekly consumption of savoury snacks (5.2 vs. 2.8, P = 0.014), fruit juice (6.5 vs. 4.3, P = 0.035), soft drinks (5.1 vs. 1.9, P = 0.006), meat products (8.3 vs. 5.6, P = 0.029) and microwave meals (2.0 vs. 1.3, P = 0.020). No between-group differences were found in body weight. Most foods available from vending machines in this UK University were of low nutritional quality. In this sample of University students, vending machine users displayed several unfavourable dietary behaviours, compared to non-users. Findings can be used to inform the development of an environmental intervention that will focus on vending machines to improve dietary behaviours in University students in the UK. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Preconditioning of mesenchymal stromal cells toward nucleus pulposus-like cells by microcryogels-based 3D cell culture and syringe-based pressure loading system.

    PubMed

    Zeng, Yang; Feng, Siyu; Liu, Wei; Fu, Qinyouen; Li, Yaqian; Li, Xiaokang; Chen, Chun; Huang, Chenyu; Ge, Zigang; Du, Yanan

    2017-04-01

    To precondition mesenchymal stromal/stem cells (MSCs) with mechanical stimulation may enhance cell survival and functions following implantation in load bearing environment such as nucleus pulposus (NP) in intervertebral disc (IVD). In this study, preconditioning of MSCs toward NP-like cells was achieved in previously developed poly (ethylene glycol) diacrylate (PEGDA) microcryogels (PMs) within a syringe-based three-dimensional (3D) culture system which provided a facile and cost-effective pressure loading approach. PMs loaded with alginate and MSCs could be incubated in a sealable syringe which could be air-compressed to apply pressure loading through a programmable syringe pump. Expression levels of chondrogenic marker genes SOX9, COL II, and ACAN were significantly upregulated in MSCs when pressure loading of 0.2 MPa or 0.8 MPa was implemented. Expression levels of COL I and COL X were downregulated when pressure loading was applied. In a nude mouse model, MSCs loaded in PMs mechanically stimulated for three days were subcutaneously injected using the same culture syringe. Three weeks postinjection, more proteoglycans (PGs) were deposited and more SOX9 and COL II but less COL I and COL X were stained in 0.2 MPa group. Furthermore, injectable MSCs-loaded PMs were utilized in an ex vivo rabbit IVD organ culture model that demonstrated the leak-proof function and enhanced cell retention of PMs assisted cell delivery to a load bearing environment for potential NP regeneration. This microcryogels-based 3D cell culture and syringe-based pressure loading system represents a novel method for 3D cell culture with mechanical stimulation for better function. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 507-520, 2017. © 2015 Wiley Periodicals, Inc.

  12. 32 CFR 260.1 - Purpose.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... blind to operate vending facilities; (2) Requirements for satisfactory vending facility sites on DoD-controlled property; and (3) Vending machine income-sharing requirements on DoD-controlled property (b... Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS VENDING...

  13. Healthier snacks in school vending machines: a pilot project in four Ontario high schools.

    PubMed

    Callaghan, Christine; Mandich, Gillian; He, Meizi

    2010-01-01

    The Healthy Vending Machine Pilot Project (HVMPP) was a public health initiative intended to create a healthier school nutrition environment by making healthier snacks available in vending machines, while maintaining a profit margin. The HVMPP was evaluated using quantitative and qualitative measures. Vending machines were stocked with healthier choices and conventional vending products at a 50:50 ratio. The HVMPP was implemented from February to May 2007 in four Ontario secondary schools in Middlesex-London, Elgin, and Oxford counties. Product sales were tracked, and focus groups were conducted to obtain students' opinions about healthy eating and vending choices. "Healthier choice" sales ranged from 14% to 17%. In all schools, vending revenues declined from 0.7% to 66%. A majority of participants had substantial knowledge of healthy eating and were in favour of healthier choices in vending machines; however, price, value, and taste were barriers that led them to purchase these products rarely. Students preferred to have "real" healthy snacks, such as yogurt, fruit, and vegetables, available in schools. Replacing 50% of vending stock with healthier snacks resulted in a decline in vending revenues. Future health programs in schools need to provide "real" healthy snacks, such as low-fat dairy products, fruits, and vegetables.

  14. 31 CFR 11.2 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... vending facilities, including vending machines, on property controlled by the Department of the Treasury... States. Treasury bureaus shall ensure that the collection and distribution of vending machine income from vending machines on Treasury-controlled property shall be in compliance with the regulations set forth in...

  15. Where has all the chocolate gone? A national survey assesses the effects of recent legislation to improve the nutritional quality of English secondary-school vending.

    PubMed

    Matthews, Anne; Nelson, Michael; Kaur, Asha; Rayner, Mike; Kelly, Paul; Cowburn, Gill

    2011-08-01

    Obesity levels are rising in almost all parts of the world, including the UK. School food offers children in Great Britain between 25 % and 33 % of their total daily energy, with vending typically offering products high in fat, salt or sugar. Government legislation of 2007 to improve the quality of school food now restricts what English schools can vend. In assessing the effect of this legislation on the quality of English secondary-school vending provision, the response of schools to these effects is explored through qualitative data. A longitudinal postal and visit-based inventory survey of schools collected vending data during the academic year 2006-2007 (pre-legislation), 2007-2008 and 2008-2009 (both post-legislation). Interviews with school staff explored issues of compliance. Product categorisation and analysis were carried out by product type, nutrient profiling and by categories of foods allowed or prohibited by the legislation. English secondary schools. A representative sample of 279 schools including sixty-two researcher-visited inventory schools participated in the research. School vending seems to have moved towards compliance with the new standards - now drinks vending predominates and is largely compliant, whereas food vending is significantly reduced and is mostly non-compliant. Sixth form vending takes a disproportionate share of non-compliance. Vending has declined overall, as some schools now perceive food vending as uneconomic. Schools adopting a 'whole-school' approach appeared the most successful in implementing the new standards. Government legislation has achieved significant change towards improving the quality of English school vending, with the unintended consequence of reducing provision.

  16. Parental attitudes towards soft drink vending machines in high schools.

    PubMed

    Hendel-Paterson, Maia; French, Simone A; Story, Mary

    2004-10-01

    Soft drink vending machines are available in 98% of US high schools. However, few data are available about parents' opinions regarding the availability of soft drink vending machines in schools. Six focus groups with 33 parents at three suburban high schools were conducted to describe the perspectives of parents regarding soft drink vending machines in their children's high school. Parents viewed the issue of soft drink vending machines as a matter of their children's personal choice more than as an issue of a healthful school environment. However, parents were unaware of many important details about the soft drink vending machines in their children's school, such as the number and location of machines, hours of operation, types of beverages available, or whether the school had contracts with soft drink companies. Parents need more information about the number of soft drink vending machines at their children's school, the beverages available, the revenue generated by soft drink vending machine sales, and the terms of any contracts between the school and soft drink companies.

  17. An Analysis of Public Health Policy and Legal Issues Relevant to Mobile Food Vending

    PubMed Central

    Stevens, Stephanie A.; Yen, Irene H.; Laraia, Barbara L.

    2010-01-01

    Mobile food vending is a component of the food environment that has received little attention in the public health literature beyond concerns about food sanitation and hygiene issues. However, several features of mobile food vending make it an intriguing venue for food access. We present key components of mobile vending regulation and provide examples from 12 US cities to illustrate the variation that can exist surrounding these regulations. Using these regulatory features as a framework, we highlight existing examples of “healthy vending policies” to describe how mobile food vending can be used to increase access to nutritious food for vulnerable populations. PMID:20864711

  18. 20 CFR 368.3 - Vending machines.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Vending machines. 368.3 Section 368.3 Employees' Benefits RAILROAD RETIREMENT BOARD INTERNAL ADMINISTRATION, POLICY AND PROCEDURES PROHIBITION OF CIGARETTE SALES TO MINORS § 368.3 Vending machines. The sale of tobacco products in vending machines is...

  19. 20 CFR 368.3 - Vending machines.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Vending machines. 368.3 Section 368.3 Employees' Benefits RAILROAD RETIREMENT BOARD INTERNAL ADMINISTRATION, POLICY AND PROCEDURES PROHIBITION OF CIGARETTE SALES TO MINORS § 368.3 Vending machines. The sale of tobacco products in vending machines is...

  20. 20 CFR 368.3 - Vending machines.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Vending machines. 368.3 Section 368.3 Employees' Benefits RAILROAD RETIREMENT BOARD INTERNAL ADMINISTRATION, POLICY AND PROCEDURES PROHIBITION OF CIGARETTE SALES TO MINORS § 368.3 Vending machines. The sale of tobacco products in vending machines is...

  1. 20 CFR 368.3 - Vending machines.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Vending machines. 368.3 Section 368.3 Employees' Benefits RAILROAD RETIREMENT BOARD INTERNAL ADMINISTRATION, POLICY AND PROCEDURES PROHIBITION OF CIGARETTE SALES TO MINORS § 368.3 Vending machines. The sale of tobacco products in vending machines is...

  2. 20 CFR 368.3 - Vending machines.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Vending machines. 368.3 Section 368.3 Employees' Benefits RAILROAD RETIREMENT BOARD INTERNAL ADMINISTRATION, POLICY AND PROCEDURES PROHIBITION OF CIGARETTE SALES TO MINORS § 368.3 Vending machines. The sale of tobacco products in vending machines is...

  3. Development of a microbial population within a hot-drinks vending machine and the microbial load of vended hot chocolate drink.

    PubMed

    Hall, A; Short, K; Saltmarsh, M; Fielding, L; Peters, A

    2007-09-01

    In order to understand the development of the microbial population within a hot-drinks vending machine a new machine was placed in a staff area of a university campus vending only hot chocolate. The machine was cleaned weekly using a detergent based protocol. Samples from the mixing bowl, dispense area, and drink were taken over a 19-wk period and enumerated using plate count agar. Bacillus cereus was identified using biochemical methods. Vended drinks were sampled at 0, 3, 6, and 9 min after vending; the hot chocolate powder was also sampled. Over the 1st 8 wk, a significant increase in the microbial load of the machine components was observed. By the end of the study, levels within the vended drink had also increased significantly. Inactivation of the automatic flush over a subsequent 5-wk period led to a statistically but not operationally significant increase in the microbial load of the dispense area and vended drink. The simple weekly clean had a significant impact on the microbial load of the machine components and the vended drink. This study demonstrated that a weekly, detergent-based cleaning protocol was sufficient to maintain the microbial population of the mixing bowl and dispense point in a quasi-steady state below 3.5 log CFU/cm2 ensuring that the microbial load of the vended drinks was maintained below 3.4 log CFU/mL. The microbial load of the drinks showed no significant changes over 9 min after vending, suggesting only spores are present in the final product.

  4. 34 CFR 395.16 - Permit for the establishment of vending facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., the number, location and type of vending machines and other terms and conditions desired to be... 34 Education 2 2010-07-01 2010-07-01 false Permit for the establishment of vending facilities. 395...) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION VENDING FACILITY PROGRAM...

  5. A comparison of the vending environment among three rural subtypes of secondary schools.

    PubMed

    Kehm, Rebecca; Davey, Cynthia S; Kubik, Martha Y; Nanney, Marilyn S

    2018-01-01

    The purpose of this study was to further explore the rural school food environment. This study assessed trends in prevalence of vending machines and vending items within and between Minnesota schools located in 3 rural subtypes: town/rural fringe, town/rural distant, and remote rural. Generalized estimating equation models were employed to analyze data from the 2006 through 2012 School Health Profiles Principal's Surveys (Profiles). All 3 rural subtypes had a statistically significant decrease in the prevalence of low nutrient energy dense (LNED) vending items between 2006 and 2012, with the exception of sports drinks. However, different vending practices were observed between rural subtypes, with town/rural fringe schools providing more LNED vending options and experiencing less positive change over time compared to town/rural distant and remote rural schools. Differences in vending machine practices emerge when rural schools are subtyped.

  6. 27 CFR 46.209 - Articles in vending machines.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Articles in vending... Cigarette Tubes Held for Sale on April 1, 2009 Inventories § 46.209 Articles in vending machines. There is no exemption for articles in vending machines. They are subject to the floor stocks tax and must be...

  7. 27 CFR 46.209 - Articles in vending machines.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Articles in vending... Cigarette Tubes Held for Sale on April 1, 2009 Inventories § 46.209 Articles in vending machines. There is no exemption for articles in vending machines. They are subject to the floor stocks tax and must be...

  8. 27 CFR 46.209 - Articles in vending machines.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Articles in vending... Cigarette Tubes Held for Sale on April 1, 2009 Inventories § 46.209 Articles in vending machines. There is no exemption for articles in vending machines. They are subject to the floor stocks tax and must be...

  9. 27 CFR 46.209 - Articles in vending machines.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Articles in vending... Cigarette Tubes Held for Sale on April 1, 2009 Inventories § 46.209 Articles in vending machines. There is no exemption for articles in vending machines. They are subject to the floor stocks tax and must be...

  10. 27 CFR 46.209 - Articles in vending machines.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Articles in vending... Cigarette Tubes Held for Sale on April 1, 2009 Inventories § 46.209 Articles in vending machines. There is no exemption for articles in vending machines. They are subject to the floor stocks tax and must be...

  11. Food labeling; calorie labeling of articles of food in vending machines. Final rule.

    PubMed

    2014-12-01

    To implement the vending machine food labeling provisions of the Patient Protection and Affordable Care Act of 2010 (ACA), the Food and Drug Administration (FDA or we) is establishing requirements for providing calorie declarations for food sold from certain vending machines. This final rule will ensure that calorie information is available for certain food sold from a vending machine that does not permit a prospective purchaser to examine the Nutrition Facts Panel before purchasing the article, or does not otherwise provide visible nutrition information at the point of purchase. The declaration of accurate and clear calorie information for food sold from vending machines will make calorie information available to consumers in a direct and accessible manner to enable consumers to make informed and healthful dietary choices. This final rule applies to certain food from vending machines operated by a person engaged in the business of owning or operating 20 or more vending machines. Vending machine operators not subject to the rules may elect to be subject to the Federal requirements by registering with FDA.

  12. Evaluating the Potential Health and Revenue Outcomes of a 100% Healthy Vending Machine Nutrition Policy at a Large Agency in Los Angeles County, 2013-2015.

    PubMed

    Wickramasekaran, Ranjana N; Robles, Brenda; Dewey, George; Kuo, Tony

    Healthy vending machine policies are viewed as a promising strategy for combating the growing obesity epidemic in the United States. Few studies have evaluated the short- and intermediate-term outcomes of healthy vending policies, especially for interventions that require 100% healthy products to be stocked. To evaluate the potential impact of a 100% healthy vending machine nutrition policy. The vendor's quarterly revenue, product sales records, and nutritional information data from 359 unique vending machines were used to conduct a baseline and follow-up policy analysis. County of Los Angeles facilities, 2013-2015. Vending machines in facilities located across Los Angeles County. A healthy vending machine policy executed in 2013 that required 100% of all products sold in contracted machines meet specified nutrition standards. Policy adherence; average number of calories, sugar, and sodium in food products sold; revenue change. Policy adherence increased for snacks and beverages sold by the vending machines by 89% and 98%, respectively. Average snack and beverage revenues decreased by 37% and 34%, respectively, during the sampled period. Although a 100% healthy vending policy represents a promising strategy for encouraging purchases of healthier foods, steps should be taken to counteract potential revenue changes when planning its implementation.

  13. Associations between the perceived presence of vending machines and food and beverage logos in schools and adolescents' diet and weight status.

    PubMed

    Minaker, Leia M; Storey, Kate E; Raine, Kim D; Spence, John C; Forbes, Laura E; Plotnikoff, Ronald C; McCargar, Linda J

    2011-08-01

    The increasing prevalence of obesity among youth has elicited calls for schools to become more active in promoting healthy weight. The present study examined associations between various aspects of school food environments (specifically the availability of snack- and beverage-vending machines and the presence of snack and beverage logos) and students' weight status, as well as potential influences of indices of diet and food behaviours. A cross-sectional, self-administered web-based survey. A series of multinomial logistic regressions with generalized estimating equations (GEE) were constructed to examine associations between school environment variables (i.e. the reported presence of beverage- and snack-vending machines and logos) and self-reported weight- and diet-related behaviours. Secondary schools in Alberta, Canada. A total of 4936 students from grades 7 to 10. The presence of beverage-vending machines in schools was associated with the weight status of students. The presence of snack-vending machines and logos was associated with students' frequency of consuming vended goods. The presence of snack-vending machines and logos was associated with the frequency of salty snack consumption. The reported presence of snack- and beverage-vending machines and logos in schools is related to some indices of weight status, diet and meal behaviours but not to others. The present study supported the general hypothesis that the presence of vending machines in schools may affect students' weight through increased consumption of vended goods, but notes that the frequency of 'junk' food consumption does not seem to be related to the presence of vending machines, perhaps reflecting the ubiquity of these foods in the daily lives of students.

  14. 31 CFR 12.3 - Sale of tobacco products in vending machines prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... RESTRICTION OF SALE AND DISTRIBUTION OF TOBACCO PRODUCTS § 12.3 Sale of tobacco products in vending machines prohibited. The sale of tobacco products in vending machines located in or around any Federal building under... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Sale of tobacco products in vending...

  15. The impact of the availability of school vending machines on eating behavior during lunch: the Youth Physical Activity and Nutrition Survey.

    PubMed

    Park, Sohyun; Sappenfield, William M; Huang, Youjie; Sherry, Bettylou; Bensyl, Diana M

    2010-10-01

    Childhood obesity is a major public health concern and is associated with substantial morbidities. Access to less-healthy foods might facilitate dietary behaviors that contribute to obesity. However, less-healthy foods are usually available in school vending machines. This cross-sectional study examined the prevalence of students buying snacks or beverages from school vending machines instead of buying school lunch and predictors of this behavior. Analyses were based on the 2003 Florida Youth Physical Activity and Nutrition Survey using a representative sample of 4,322 students in grades six through eight in 73 Florida public middle schools. Analyses included χ2 tests and logistic regression. The outcome measure was buying a snack or beverage from vending machines 2 or more days during the previous 5 days instead of buying lunch. The survey response rate was 72%. Eighteen percent of respondents reported purchasing a snack or beverage from a vending machine 2 or more days during the previous 5 school days instead of buying school lunch. Although healthier options were available, the most commonly purchased vending machine items were chips, pretzels/crackers, candy bars, soda, and sport drinks. More students chose snacks or beverages instead of lunch in schools where beverage vending machines were also available than did students in schools where beverage vending machines were unavailable: 19% and 7%, respectively (P≤0.05). The strongest risk factor for buying snacks or beverages from vending machines instead of buying school lunch was availability of beverage vending machines in schools (adjusted odds ratio=3.5; 95% confidence interval, 2.2 to 5.7). Other statistically significant risk factors were smoking, non-Hispanic black race/ethnicity, Hispanic ethnicity, and older age. Although healthier choices were available, the most common choices were the less-healthy foods. Schools should consider developing policies to reduce the availability of less-healthy choices in vending machines and to reduce access to beverage vending machines. Copyright © 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

  16. Working with community partners to implement and evaluate the Chicago Park District's 100% Healthier Snack Vending Initiative.

    PubMed

    Mason, Maryann; Zaganjor, Hatidza; Bozlak, Christine T; Lammel-Harmon, Colleen; Gomez-Feliciano, Lucy; Becker, Adam B

    2014-08-07

    The objective of this case study was to evaluate the acceptability, sales impact, and implementation barriers for the Chicago Park District's 100% Healthier Snack Vending Initiative to strengthen and support future healthful vending efforts. The Chicago Park District is the largest municipal park system in the United States, serving almost 200,000 children annually through after-school and summer programs. Chicago is one of the first US cities to improve park food environments through more healthful snack vending. A community-based participatory evaluation engaged community and academic partners, who shared in all aspects of the research. From spring 2011 to fall 2012, we collected data through observation, surveys, and interviews on staff and patron acceptance of snack vending items, purchasing behaviors, and machine operations at a sample of 10 Chicago parks. A new snack vending contract included nutrition standards for serving sizes, calories, sugar, fat, and sodium for all items. Fifteen months of snack vending sales data were collected from all 98 snack vending machines in park field houses. Staff (100%) and patrons (88%) reacted positively to the initiative. Average monthly per-machine sales increased during 15 months ($84 to $371). Vendor compliance issues included stocking noncompliant items and delayed restocking. The initiative resulted in improved park food environments. Diverse partner engagement, participatory evaluation, and early attention to compliance can be important supports for healthful vending initiatives. Consumer acceptance and increasing revenues can help to counter fears of revenue loss that can pose barriers to adoption.

  17. Analysis of NREL Cold-Drink Vending Machines for Energy Savings

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Deru, M.; Torcellini, P.; Bottom, K.

    NREL Staff, as part of Sustainable NREL, an initiative to improve the overall energy and environmental performance of the lab, decided to control how its vending machines used energy. The cold-drink vending machines across the lab were analyzed for potential energy savings opportunities. This report gives the monitoring and the analysis of two energy conservation measures applied to the cold-drink vending machines at NREL.

  18. Locking devices on cigarette vending machines: evaluation of a city ordinance.

    PubMed Central

    Forster, J L; Hourigan, M E; Kelder, S

    1992-01-01

    OBJECTIVES. Policymakers, researchers, and citizens are beginning to recognize the need to limit minors' access to tobacco by restricting the sale of cigarettes through vending machines. One policy alternative that has been proposed by the tobacco industry is a requirement that vending machines be fitted with electronic locking devices. This study evaluates such a policy as enacted in St. Paul, Minn. METHODS. A random sample of vending machine locations was selected for cigarette purchase attempts conducted before implementation and at 3 and 12 months postimplementation. RESULTS. The rate of noncompliance by merchants was 34% after 3 months and 30% after 1 year. The effect of the law was to reduce the ability of a minor to purchase cigarettes from locations originally selling cigarettes through vending machines from 86% at baseline to 36% at 3 months. The purchase rate at these locations rose to 48% at 1 year. CONCLUSIONS. Our results suggest that cigarette vending machine locking devices may not be as effective as vending machine bans and require additional enforcement to ensure compliance with the law. PMID:1503160

  19. 34 CFR 395.9 - The setting aside of funds by the State licensing agency.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... operation of the vending facilities and, to the extent applicable, from vending machine income under § 395.8... (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION VENDING FACILITY...

  20. 15 CFR 5.1 - Purpose.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... includes vending machines). ... Foreign Trade Office of the Secretary of Commerce OPERATION OF VENDING STANDS § 5.1 Purpose. This part... the Randolph-Sheppard Vending Stand Act (49 Stat. 1559, as amended by the act of August 3, 1954, 68...

  1. Profits, commercial food supplier involvement, and school vending machine snack food availability: implications for implementing the new competitive foods rule.

    PubMed

    Terry-McElrath, Yvonne M; Hood, Nancy E; Colabianchi, Natalie; O'Malley, Patrick M; Johnston, Lloyd D

    2014-07-01

    The 2013-2014 school year involved preparation for implementing the new US Department of Agriculture (USDA) competitive foods nutrition standards. An awareness of associations between commercial supplier involvement, food vending practices, and food vending item availability may assist schools in preparing for the new standards. Analyses used 2007-2012 questionnaire data from administrators of 814 middle and 801 high schools in the nationally representative Youth, Education, and Society study to examine prevalence of profit from and commercial involvement with vending machine food sales, and associations between such measures and food availability. Profits for the school district were associated with decreased low-nutrient, energy-dense (LNED) food availability and increased fruit/vegetable availability. Profits for the school and use of company suppliers were associated with increased LNED availability; company suppliers also were associated with decreased fruit/vegetable availability. Supplier "say" in vending food selection was associated with increased LNED availability and decreased fruit/vegetable availability. Results support (1) increased district involvement with school vending policies and practices, and (2) limited supplier "say" as to what items are made available in student-accessed vending machines. Schools and districts should pay close attention to which food items replace vending machine LNED foods following implementation of the new nutrition standards. © 2014, American School Health Association.

  2. Consumer support for healthy food and drink vending machines in public places.

    PubMed

    Carrad, Amy M; Louie, Jimmy Chun-Yu; Milosavljevic, Marianna; Kelly, Bridget; Flood, Victoria M

    2015-08-01

    To investigate the feasibility of introducing vending machines for healthier food into public places, and to examine the effectiveness of two front-of-pack labelling systems in the vending machine context. A survey was conducted with 120 students from a university and 120 employees, patients and visitors of a hospital in regional NSW, Australia. Questions explored vending machine use, attitudes towards healthier snack products and price, and the performance of front-of-pack labelling formats for vending machine products. Most participants viewed the current range of snacks and drinks as "too unhealthy" (snacks 87.5%; drinks 56.7%). Nuts and muesli bars were the most liked healthier vending machine snack. Higher proportions of participants were able to identify the healthier snack in three of the five product comparisons when products were accompanied with any type of front-of-pack label (all p<0.01); however, participants were less likely to be able to identify the healthier product in the drinks comparison when a front-of-pack guide was present. Respondents were interested in a range of healthier snacks for vending machines. Front-of-pack label formats on vending machines may assist consumers to identify healthier products. Public settings, such as universities and hospitals, should support consumers to make healthy dietary choices by improving food environments. © 2015 Public Health Association of Australia.

  3. Health-promoting vending machines: evaluation of a pediatric hospital intervention.

    PubMed

    Van Hulst, Andraea; Barnett, Tracie A; Déry, Véronique; Côté, Geneviève; Colin, Christine

    2013-01-01

    Taking advantage of a natural experiment made possible by the placement of health-promoting vending machines (HPVMs), we evaluated the impact of the intervention on consumers' attitudes toward and practices with vending machines in a pediatric hospital. Vending machines offering healthy snacks, meals, and beverages were developed to replace four vending machines offering the usual high-energy, low-nutrition fare. A pre- and post-intervention evaluation design was used; data were collected through exit surveys and six-week follow-up telephone surveys among potential vending machine users before (n=293) and after (n=226) placement of HPVMs. Chi-2 statistics were used to compare pre- and post-intervention participants' responses. More than 90% of pre- and post-intervention participants were satisfied with their purchase. Post-intervention participants were more likely to state that nutritional content and appropriateness of portion size were elements that influenced their purchase. Overall, post-intervention participants were more likely than pre-intervention participants to perceive as healthy the options offered by the hospital vending machines. Thirty-three percent of post-intervention participants recalled two or more sources of information integrated in the HPVM concept. No differences were found between pre- and post-intervention participants' readiness to adopt healthy diets. While the HPVM project had challenges as well as strengths, vending machines offering healthy snacks are feasible in hospital settings.

  4. Impact of Total Vending Machine Restrictions on US Young Adult Smoking

    PubMed Central

    Kelly, Brian C.; Kadowaki, Joy

    2016-01-01

    Introduction: In an analysis of smoking using a longitudinal sample of US young adults, we extend research on tobacco vending machine restrictions beyond its prior focus on minors by examining the influence of total vending machine restrictions, which apply to adult-only facilities and represents the only remaining vending machine exemption since the enactment of the Family Smoking Prevention and Tobacco Control Act. We identify whether the passage of a restriction influences an individual’s smoking on repeated observations, and if the propensity is lower among those who live in locations with a restriction. Methods: Combining a repository of US tobacco policies at all geographic levels with the nationally-representative geocoded National Longitudinal Survey of Youth 1997 and Census data, we use multilevel logistic regression to examine the impact of total vending machine restrictions on any past 30-day smoking and past 30-day smoking of one pack per day among young adults (ages 19–31), while accounting for other tobacco control policy, community, and individual covariates. Results: We find that total vending machine restrictions decrease any recent smoking (OR = 0.451; p < .01), net of other covariates. Though the passage of a restriction does not alter an individual’s smoking over time, living longer in an area that has a restriction lowers the propensity that an individual will smoke at all (OR = 0.442; p < .05). We find no effect of total vending machine restrictions on smoking a pack daily. Conclusions: Total vending machine restrictions appear to be an effective, yet highly underutilized, means of tobacco control. Implications: Past scientific inquiries examining vending machine restrictions have focused upon minor access, adolescent perceptions of availability, and subsequent smoking. The potential for total vending machine restrictions, which extend to adult-only facilities, to influence patterns of smoking among those of legal age, remains significant. Those who are subject to total vending machine restrictions for longer periods are less likely to have recently smoked, but individuals do not change their smoking behavior in response to the passage of a restriction. These restrictions do not affect heavy smokers. Such policies are an effective but underutilized policy mechanism to prevent smoking among young adults. PMID:27281606

  5. Integrated lab-in-syringe platform incorporating a membraneless gas-liquid separator for automatic cold vapor atomic absorption spectrometry.

    PubMed

    Giakisikli, Georgia; Miró, Manuel; Anthemidis, Aristidis

    2013-10-01

    This manuscript reports the proof-of-concept of a novel integrated lab-in-syringe/gas-liquid separation (LIS/GLS) batch-flow system based on a programmable flow for automatic cold vapor atomic absorption spectrometric assays. Homogeneous mixing of metered volumes of sample and reagent solutions drawn up in a sandwich-type mode along with in situ vapor generation are accomplished inside the microsyringe in a closed manner, while the separation of vapor species is achieved via the membraneless GLS located at the top of the syringe's valve in the upright position. The potentials of the proposed manifold were demonstrated for trace inorganic mercury determination in drinking waters and seawater. For a 3.0 mL sample, the limit of detection and repeatability (RSD) were found to be 0.03 μg L(-1) Hg(II) and 3.1% (at the 2.0 μg L(-1) concentration level), respectively, with a dynamic range extending up to 10.0 μg L(-1). The proposed system fulfills the requirements of US-EPA, WHO, and EU Council Directives for measurements of the maximum allowed concentrations of inorganic mercury in drinking water.

  6. 32 CFR 260.6 - Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... period of time subject to suspension or termination upon failure to comply with agreed-upon terms. It... sanitation and the maintenance of vending facilities and vending machines in an orderly condition at all times, and the installation, maintenance, repair, replacement, servicing, and removal of vending...

  7. 32 CFR 260.6 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... period of time subject to suspension or termination upon failure to comply with agreed-upon terms. It... sanitation and the maintenance of vending facilities and vending machines in an orderly condition at all times, and the installation, maintenance, repair, replacement, servicing, and removal of vending...

  8. Simulation and Community-Based Instruction of Vending Machines with Time Delay.

    ERIC Educational Resources Information Center

    Browder, Diane M.; And Others

    1988-01-01

    The study evaluated the use of simulated instruction on vending machine use as an adjunct to community-based instruction with two moderately retarded children. Results showed concurrent acquisition of the vending machine skills across trained and untrained sites. (Author/DB)

  9. Sales of healthy snacks and beverages following the implementation of healthy vending standards in City of Philadelphia vending machines.

    PubMed

    Pharis, Meagan L; Colby, Lisa; Wagner, Amanda; Mallya, Giridhar

    2018-02-01

    We examined outcomes following the implementation of employer-wide vending standards, designed to increase healthy snack and beverage options, on the proportion of healthy v. less healthy sales, sales volume and revenue for snack and beverage vending machines. A single-arm evaluation of a policy utilizing monthly sales volume and revenue data provided by the contracted vendor during baseline, machine conversion and post-conversion time periods. Study time periods are full calendar years unless otherwise noted. Property owned or leased by the City of Philadelphia, USA. Approximately 250 vending machines over a 4-year period (2010-2013). At post-conversion, the proportion of sales attributable to healthy items was 40 % for snacks and 46 % for beverages. Healthy snack sales were 323 % higher (38·4 to 162·5 items sold per machine per month) and total snack sales were 17 % lower (486·8 to 402·1 items sold per machine per month). Healthy beverage sales were 33 % higher (68·2 to 90·6 items sold per machine per month) and there was no significant change in total beverage sales (213·2 to 209·6 items sold per machine per month). Revenue was 11 % lower for snacks ($US 468·30 to $US 415·70 per machine per month) and 21 % lower for beverages ($US 344·00 to $US 270·70 per machine per month). Sales of healthy vending items were significantly higher following the implementation of employer-wide vending standards for snack and beverage vending machines. Entities receiving revenue-based commission payments from vending machines should employ strategies to minimize potential revenue losses.

  10. Drinking Water Quality of Water Vending Machines in Parit Raja, Batu Pahat, Johor

    NASA Astrophysics Data System (ADS)

    Hashim, N. H.; Yusop, H. M.

    2016-07-01

    An increased in demand from the consumer due to their perceptions on tap water quality is identified as one of the major factor on why they are mentally prepared to pay for the price of the better quality drinking water. The thought that filtered water quality including that are commercially available in the market such as mineral and bottled drinking water and from the drinking water vending machine makes they highly confident on the level of hygiene, safety and the mineral content of this type of drinking water. This study was investigated the vended water quality from the drinking water vending machine in eight locations in Parit Raja are in terms of pH, total dissolve solids (TDS), turbidity, mineral content (chromium, arsenic, cadmium, lead and nickel), total organic carbon (TOC), pH, total colony-forming units (CFU) and total coliform. All experiments were conducted in one month duration in triplicate samples for each sampling event. The results indicated the TDS and all heavy metals in eight vended water machines in Parit Raja area were found to be below the Food Act 1983, Regulation 360C (Standard for Packaged Drinking Water and Vended water, 2012) and Malaysian Drinking Water Quality, Ministry of Health 1983. No coliform was presence in any of the vended water samples. pH was found to be slightly excess the limit provided while turbidity was found to be 45 to 95 times more higher than 0.1 NTU as required by the Malaysian Food Act Regulation. The data obtained in this study would suggest the important of routine maintenance and inspection of vended water provider in order to maintain a good quality, hygienic and safety level of vended water.

  11. Foods Sold in School Vending Machines are Associated with Overall Student Dietary Intake

    PubMed Central

    Rovner, Alisha J.; Nansel, Tonja R.; Wang, Jing; Iannotti, Ronald J.

    2010-01-01

    Purpose To examine the association between foods sold in school vending machines and students’ dietary behaviors. Methods The 2005-2006 US Health Behavior in School Aged Children (HBSC) survey was administered to 6th to 10th graders and school administrators. Students’ dietary intake was estimated with a brief food frequency measure. Administrators completed questions about foods sold in vending machines. For each food intake behavior, a multilevel regression analysis modeled students (level 1) nested within schools (level 2), with the corresponding food sold in vending machines as the main predictor. Control variables included gender, grade, family affluence and school poverty. Analyses were conducted separately for 6th to 8th and 9th to 10th grades. Results Eighty-three percent of schools (152 schools, 5,930 students) had vending machines which primarily sold foods of minimal nutritional values (soft drinks, chips and sweets). In younger grades, availability of fruits/vegetables and chocolate/sweets was positively related to the corresponding food intake, with vending machine content and school poverty explaining 70.6% of between-school variation in fruit/vegetable consumption, and 71.7% in sweets consumption. In older grades, there was no significant effect of foods available in vending machines on reported consumption of those foods. Conclusions Vending machines are widely available in US public schools. In younger grades, school vending machines were related to students’ diets positively or negatively, depending on what was sold in them. Schools are in a powerful position to influence children’s diets; therefore attention to foods sold in them is necessary in order to try to improve children’s diets. PMID:21185519

  12. Impact of the HEALTHY Study on Vending Machine Offerings in Middle Schools.

    PubMed

    Hartstein, Jill; Cullen, Karen W; Virus, Amy; El Ghormli, Laure; Volpe, Stella L; Staten, Myrlene A; Bridgman, Jessica C; Stadler, Diane D; Gillis, Bonnie; McCormick, Sarah B; Mobley, Connie C

    2011-01-01

    The purpose of this study is to report the impact of the three-year middle school-based HEALTHY study on intervention school vending machine offerings. There were two goals for the vending machines: serve only dessert/snack foods with 200 kilocalories or less per single serving package, and eliminate 100% fruit juice and beverages with added sugar. Six schools in each of seven cities (Houston, TX, San Antonio, TX, Irvine, CA, Portland, OR, Pittsburg, PA, Philadelphia, PA, and Chapel Hill, NC) were randomized into intervention (n=21 schools) or control (n=21 schools) groups, with three intervention and three control schools per city. All items in vending machine slots were tallied twice in the fall of 2006 for baseline data and twice at the end of the study, in 2009. The percentage of total slots for each food/beverage category was calculated and compared between intervention and control schools at the end of study, using the Pearson chi-square test statistic. At baseline, 15 intervention and 15 control schools had beverage and/or snack vending machines, compared with 11 intervention and 11 control schools at the end of the study. At the end of study, all of the intervention schools with beverage vending machines, but only one out of the nine control schools, met the beverage goal. The snack goal was met by all of the intervention schools and only one of the four control schools with snack vending machines. The HEALTHY study's vending machine beverage and snack goals were successfully achieved in intervention schools, reducing access to less healthy food items outside the school meals program. Although the effect of these changes on student diet, energy balance and growth is unknown, these results suggest that healthier options for snacks can successfully be offered in school vending machines.

  13. Food sold in school vending machines is associated with overall student dietary intake.

    PubMed

    Rovner, Alisha J; Nansel, Tonja R; Wang, Jing; Iannotti, Ronald J

    2011-01-01

    To examine the association between food sold in school vending machines and the dietary behaviors of students. The 2005-2006 U.S. Health Behavior in School-aged Children survey was administered to 6th to 10th graders and school administrators. Dietary intake in students was estimated with a brief food frequency measure. School administrators completed questions regarding food sold in vending machines. For each food intake behavior, a multilevel regression analysis modeled students (level 1) nested within schools (level 2), with the corresponding food sold in vending machines as the main predictor. Control variables included gender, grade, family affluence, and school poverty index. Analyses were conducted separately for 6th to 8th and 9th-10th grades. In all, 83% of the schools (152 schools; 5,930 students) had vending machines that primarily sold food of minimal nutritional values (soft drinks, chips, and sweets). In younger grades, availability of fruit and/or vegetables and chocolate and/or sweets was positively related to the corresponding food intake, with vending machine content and school poverty index providing an explanation for 70.6% of between-school variation in fruit and/or vegetable consumption and 71.7% in sweets consumption. Among the older grades, there was no significant effect of food available in vending machines on reported consumption of those food. Vending machines are widely available in public schools in the United States. In younger grades, school vending machines were either positively or negatively related to the diets of the students, depending on what was sold in them. Schools are in a powerful position to influence the diets of children; therefore, attention to the food sold at school is necessary to try to improve their diets. Copyright © 2011 Society for Adolescent Health and Medicine. All rights reserved.

  14. Pricing and Availability Intervention in Vending Machines at Four Bus Garages

    PubMed Central

    Hannan, Peter J; Harnack, Lisa J; Mitchell, Nathan R; Toomey, Traci L; Gerlach, Anne

    2009-01-01

    Objective To evaluate the effects of lowering prices and increasing availability on sales of healthy foods and beverages from 33 vending machines in four bus garages as part of a multi-component worksite obesity prevention intervention. Methods Availability of healthy items was increased to 50% and prices were lowered at least 10% in the vending machines in two metropolitan bus garages for an 18-month period. Two control garages offered vending choices at usual availability and prices. Sales data were collected monthly from each of the vending machines at the four garages. Results Increases in availability to 50% and price reductions of an average of 31% resulted in 10-42% higher sales of the healthy items. Employees were most price-responsive for snack purchases. Conclusions Greater availability and lower prices on targeted food and beverage items from vending machines was associated with greater purchases of these items over an eighteen-month period. Efforts to promote healthful food purchases in worksite settings should incorporate these two strategies. PMID:20061884

  15. Pricing and promotion effects on low-fat vending snack purchases: the CHIPS Study.

    PubMed

    French, S A; Jeffery, R W; Story, M; Breitlow, K K; Baxter, J S; Hannan, P; Snyder, M P

    2001-01-01

    This study examined the effects of pricing and promotion strategies on purchases of low-fat snacks from vending machines. Low-fat snacks were added to 55 vending machines in a convenience sample of 12 secondary schools and 12 worksites. Four pricing levels (equal price, 10% reduction, 25% reduction, 50% reduction) and 3 promotional conditions (none, low-fat label, low-fat label plus promotional sign) were crossed in a Latin square design. Sales of low-fat vending snacks were measured continuously for the 12-month intervention. Price reductions of 10%, 25%, and 50% on low-fat snacks were associated with significant increases in low-fat snack sales; percentages of low-fat snack sales increased by 9%, 39%, and 93%, respectively. Promotional signage was independently but weakly associated with increases in low-fat snack sales. Average profits per machine were not affected by the vending interventions. Reducing relative prices on low-fat snacks was effective in promoting lower-fat snack purchases from vending machines in both adult and adolescent populations.

  16. Pricing and availability intervention in vending machines at four bus garages.

    PubMed

    French, Simone A; Hannan, Peter J; Harnack, Lisa J; Mitchell, Nathan R; Toomey, Traci L; Gerlach, Anne

    2010-01-01

    To evaluate the effects of lowering prices and increasing availability on sales of healthy foods and beverages from 33 vending machines in 4 bus garages as part of a multicomponent worksite obesity prevention intervention. Availability of healthy items was increased to 50% and prices were lowered at least 10% in the vending machines in two metropolitan bus garages for an 18-month period. Two control garages offered vending choices at usual availability and prices. Sales data were collected monthly from each of the vending machines at the four garages. Increases in availability to 50% and price reductions of an average of 31% resulted in 10% to 42% higher sales of the healthy items. Employees were mostly price responsive for snack purchases. Greater availability and lower prices on targeted food and beverage items from vending machines was associated with greater purchases of these items over an 18-month period. Efforts to promote healthful food purchases in worksite settings should incorporate these two strategies.

  17. 32 CFR 260.3 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... operations. Direct competition. The presence and operation of a DoD Component vending machine or a vending... machines or vending facilities operated in areas serving employees, the majority of whom normally do not have access (in terms of uninterrupted ease of approach and the amount of time required to patronize...

  18. 32 CFR 260.3 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... operations. Direct competition. The presence and operation of a DoD Component vending machine or a vending... machines or vending facilities operated in areas serving employees, the majority of whom normally do not have access (in terms of uninterrupted ease of approach and the amount of time required to patronize...

  19. 32 CFR 260.3 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... operations. Direct competition. The presence and operation of a DoD Component vending machine or a vending... machines or vending facilities operated in areas serving employees, the majority of whom normally do not have access (in terms of uninterrupted ease of approach and the amount of time required to patronize...

  20. 32 CFR 260.7 - Information requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... sharing requirements by § 260.6(d)(3) of this part), and the amount of such vending machine income...) MISCELLANEOUS VENDING FACILITY PROGRAM FOR THE BLIND ON DOD-CONTROLLED FEDERAL PROPERTY § 260.7 Information...&R) the total number of applications for vending facility locations received from State licensing...

  1. 75 FR 48955 - Arbitration Panel Decision Under the Randolph-Sheppard Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-12

    ... vending machine facility operated by a blind vendor at the USPS's Chicago Processing and Distribution... cafeteria operations are exempt from the Act and whether the vending machines operated by a private vendor at the Chicago Processing and Distribution Center are in direct competition with the vending machines...

  2. Vending Reimbursable Lunches to High School Students: A Study of Two Successes

    ERIC Educational Resources Information Center

    Carr, Deborah H.; Cross, Evelina W.

    2008-01-01

    Objectives: The objectives were to investigate the operational requirements for offering healthful vended reimbursable lunches to students and to identify barriers to implementation. Methods: A descriptive case study method was utilized to explore the operations of two school nutrition programs offering vended reimbursable lunches. Two school…

  3. 43 CFR 13.1 - Authority and purpose.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... practicable, preference shall be given to blind persons in the operation of vending stands and machines on any... Public Lands: Interior Office of the Secretary of the Interior VENDING FACILITIES OPERATED BY BLIND PERSONS § 13.1 Authority and purpose. The Randolph-Sheppard Vending Stand Act of June 20, 1936, as amended...

  4. 77 FR 4288 - Arbitration Panel Decision Under the Randolph-Sheppard Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-27

    ... February 5, 2009, permit application to operate vending machines at the Southern Oregon Rehabilitation... Blind for a permit to operate the Clinic vending machines.'' Arbitration Panel Decision After reviewing... vending machines are part and parcel of that facility. The panel noted that the parties' differing...

  5. 43 CFR 13.2 - Application for permit.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Application for permit. 13.2 Section 13.2 Public Lands: Interior Office of the Secretary of the Interior VENDING FACILITIES OPERATED BY BLIND... maintain vending facilities, including both vending stands and machines, to be operated by blind persons...

  6. 43 CFR 13.2 - Application for permit.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Application for permit. 13.2 Section 13.2 Public Lands: Interior Office of the Secretary of the Interior VENDING FACILITIES OPERATED BY BLIND... maintain vending facilities, including both vending stands and machines, to be operated by blind persons...

  7. 43 CFR 13.2 - Application for permit.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Application for permit. 13.2 Section 13.2 Public Lands: Interior Office of the Secretary of the Interior VENDING FACILITIES OPERATED BY BLIND... maintain vending facilities, including both vending stands and machines, to be operated by blind persons...

  8. Sweet and salty. An assessment of the snacks and beverages sold in vending machines on US post-secondary institution campuses.

    PubMed

    Byrd-Bredbenner, Carol; Johnson, Michelle; Quick, Virginia M; Walsh, Jennifer; Greene, Geoffrey W; Hoerr, Sharon; Colby, Sarah M; Kattelmann, Kendra K; Phillips, Beatrice W; Kidd, Tandalayo; Horacek, Tanya M

    2012-06-01

    This study assessed the nutritional quality of snacks and beverages sold in vending machines. The contents of snack and beverage vending machines in 78 buildings on 11 US post-secondary education campuses were surveyed. Of the 2607 snack machine slots surveyed, the most common snacks vended were salty snacks (e.g., chips, pretzels) and sweets (i.e., candy and candy bars). The 1650 beverage machine slots assessed contained twice as many sugar-sweetened beverages as non-calorie-containing beverages. Only two institutions sold both milk and 100% juice in vending machines. The portion of snacks and beverages sold averaged more than 200 cal. Neither snacks nor beverages were nutrient dense. The majority of snacks were low in fiber and high in calories and fat and almost half were high in sugar. Most beverages were high in calories and sugar. This study's findings suggest that vending machines provide limited healthful choices. Findings from benchmark assessments of components of the food environment, like the vending options reported here, can provide valuable input to campus administrators, health services, food service, and students who want to establish campus policies to promote healthful eating. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Impact of Total Vending Machine Restrictions on US Young Adult Smoking.

    PubMed

    Vuolo, Mike; Kelly, Brian C; Kadowaki, Joy

    2016-11-01

    In an analysis of smoking using a longitudinal sample of US young adults, we extend research on tobacco vending machine restrictions beyond its prior focus on minors by examining the influence of total vending machine restrictions, which apply to adult-only facilities and represents the only remaining vending machine exemption since the enactment of the Family Smoking Prevention and Tobacco Control Act. We identify whether the passage of a restriction influences an individual's smoking on repeated observations, and if the propensity is lower among those who live in locations with a restriction. Combining a repository of US tobacco policies at all geographic levels with the nationally-representative geocoded National Longitudinal Survey of Youth 1997 and Census data, we use multilevel logistic regression to examine the impact of total vending machine restrictions on any past 30-day smoking and past 30-day smoking of one pack per day among young adults (ages 19-31), while accounting for other tobacco control policy, community, and individual covariates. We find that total vending machine restrictions decrease any recent smoking (OR = 0.451; p < .01), net of other covariates. Though the passage of a restriction does not alter an individual's smoking over time, living longer in an area that has a restriction lowers the propensity that an individual will smoke at all (OR = 0.442; p < .05). We find no effect of total vending machine restrictions on smoking a pack daily. Total vending machine restrictions appear to be an effective, yet highly underutilized, means of tobacco control. Past scientific inquiries examining vending machine restrictions have focused upon minor access, adolescent perceptions of availability, and subsequent smoking. The potential for total vending machine restrictions, which extend to adult-only facilities, to influence patterns of smoking among those of legal age, remains significant. Those who are subject to total vending machine restrictions for longer periods are less likely to have recently smoked, but individuals do not change their smoking behavior in response to the passage of a restriction. These restrictions do not affect heavy smokers. Such policies are an effective but underutilized policy mechanism to prevent smoking among young adults. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Does opioid substitution treatment in prisons reduce injecting-related HIV risk behaviours? A systematic review.

    PubMed

    Larney, Sarah

    2010-02-01

    To review systematically the evidence on opioid substitution treatment (OST) in prisons in reducing injecting-related human immunodeficiency virus (HIV) risk behaviours. Systematic review in accordance with guidelines of the Cochrane Collaboration. Electronic databases were searched to identify studies of prison-based opioid substitution treatment programmes that included assessment of effects of prison OST on injecting drug use, sharing of needles and syringes and HIV incidence. Published data were used to calculate risk ratios for outcomes of interest. Risk ratios were not pooled due to the low number of studies and differences in study designs. Five studies were included in the review. Poor follow-up rates were reported in two studies, and representativeness of the sample was uncertain in the remaining three studies. Compared to inmates in control conditions, for treated inmates the risk of injecting drug use was reduced by 55-75% and risk of needle and syringe sharing was reduced by 47-73%. No study reported a direct effect of prison OST on HIV incidence. There may be a role for OST in preventing HIV transmission in prisons, but methodologically rigorous research addressing this question specifically is required. OST should be implemented in prisons as part of comprehensive HIV prevention programmes that also provide condoms and sterile injecting and tattooing equipment.

  11. Vending Machines: A Narrative Review of Factors Influencing Items Purchased.

    PubMed

    Hua, Sophia V; Ickovics, Jeannette R

    2016-10-01

    Vending machines are a ubiquitous part of our food environments. Unfortunately, items found in vending machines tend to be processed foods and beverages high in salt, sugar, and/or fat. The purpose of this review is to describe intervention and case studies designed to promote healthier vending purchases by consumers and identify which manipulations are most effective. All studies analyzed were intervention or case studies that manipulated vending machines and analyzed sales or revenue data. This literature review is limited to studies conducted in the United States within the past 2 decades (ie, 1994 to 2015), regardless of study population or setting. Ten articles met these criteria based on a search conducted using PubMed. Study manipulations included price changes, increase in healthier items, changes to the advertisements wrapped around vending machines, and promotional signs such as a stoplight system to indicate healthfulness of items and to remind consumers to make healthy choices. Overall, seven studies had manipulations that resulted in statistically significant positive changes in purchasing behavior. Two studies used manipulations that did not influence consumer behavior, and one study was equivocal. Although there was no intervention pattern that ensured changes in purchasing, price reductions were most effective overall. Revenue from vending sales did not change substantially regardless of intervention, which will be important to foster initiation and sustainability of healthier vending. Future research should identify price changes that would balance healthier choices and revenue as well as better marketing to promote purchase of healthier items. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  12. School Vending Machine Purchasing Behavior: Results from the 2005 YouthStyles Survey

    ERIC Educational Resources Information Center

    Thompson, Olivia M.; Yaroch, Amy L.; Moser, Richard P.; Rutten, Lila J. Finney; Agurs-Collins, Tanya

    2010-01-01

    Background: Competitive foods are often available in school vending machines. Providing youth with access to school vending machines, and thus competitive foods, is of concern, considering the continued high prevalence of childhood obesity: competitive foods tend to be energy dense and nutrient poor and can contribute to increased energy intake in…

  13. 76 FR 37291 - Food Labeling; Calorie Labeling of Articles of Food in Vending Machines; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-27

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 101 [Docket No. FDA-2011-F-0171] Food Labeling; Calorie Labeling of Articles of Food in Vending Machines; Correction... certain articles of food sold from vending machines. The document published with several errors including...

  14. 75 FR 79352 - Arbitration Panel Decision Under the Randolph-Sheppard Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-20

    ... manage vending machines at the Chemeketa Community College in addition to those he was already operating... 2005, while operating his vending location at the Lottery Building, Complainant learned from another... permitting it to be combined with the proposed espresso cart, in return for a vending machine location at the...

  15. 76 FR 48831 - Arbitration Panel Decision Under the Randolph-Sheppard Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-09

    ... to manage the Marion County vending route comprised of vending machines at the Oregon Department of... which trainees were allowed to go home on weekends. At the same time, the SLA learned that the DPSST cafeteria was selling items in competition with Complainant's vending machines. On October 4, 2006...

  16. 15 CFR 5.2 - Policy.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 1 2011-01-01 2011-01-01 false Policy. 5.2 Section 5.2 Commerce and Foreign Trade Office of the Secretary of Commerce OPERATION OF VENDING STANDS § 5.2 Policy. (a) The... Randolph-Sheppard Vending Stand Act, as amended to operate vending stands without any charge for space or...

  17. 15 CFR 5.2 - Policy.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 1 2014-01-01 2014-01-01 false Policy. 5.2 Section 5.2 Commerce and Foreign Trade Office of the Secretary of Commerce OPERATION OF VENDING STANDS § 5.2 Policy. (a) The... Randolph-Sheppard Vending Stand Act, as amended to operate vending stands without any charge for space or...

  18. 15 CFR 5.2 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Policy. 5.2 Section 5.2 Commerce and Foreign Trade Office of the Secretary of Commerce OPERATION OF VENDING STANDS § 5.2 Policy. (a) The... Randolph-Sheppard Vending Stand Act, as amended to operate vending stands without any charge for space or...

  19. 15 CFR 5.2 - Policy.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 15 Commerce and Foreign Trade 1 2012-01-01 2012-01-01 false Policy. 5.2 Section 5.2 Commerce and Foreign Trade Office of the Secretary of Commerce OPERATION OF VENDING STANDS § 5.2 Policy. (a) The... Randolph-Sheppard Vending Stand Act, as amended to operate vending stands without any charge for space or...

  20. 15 CFR 5.2 - Policy.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 15 Commerce and Foreign Trade 1 2013-01-01 2013-01-01 false Policy. 5.2 Section 5.2 Commerce and Foreign Trade Office of the Secretary of Commerce OPERATION OF VENDING STANDS § 5.2 Policy. (a) The... Randolph-Sheppard Vending Stand Act, as amended to operate vending stands without any charge for space or...

  1. 34 CFR 395.17 - Suspension of designation as State licensing agency.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... lapse of a reasonable time, the Secretary is of the opinion that such failure to comply still continues... protection of Federal property on which vending machines subject to the requirements of § 395.32 are located in the State. Upon the suspension of such designation, vending machine income from vending machines...

  2. 34 CFR 395.17 - Suspension of designation as State licensing agency.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... lapse of a reasonable time, the Secretary is of the opinion that such failure to comply still continues... protection of Federal property on which vending machines subject to the requirements of § 395.32 are located in the State. Upon the suspension of such designation, vending machine income from vending machines...

  3. 34 CFR 395.17 - Suspension of designation as State licensing agency.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... lapse of a reasonable time, the Secretary is of the opinion that such failure to comply still continues... protection of Federal property on which vending machines subject to the requirements of § 395.32 are located in the State. Upon the suspension of such designation, vending machine income from vending machines...

  4. 34 CFR 395.17 - Suspension of designation as State licensing agency.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... lapse of a reasonable time, the Secretary is of the opinion that such failure to comply still continues... protection of Federal property on which vending machines subject to the requirements of § 395.32 are located in the State. Upon the suspension of such designation, vending machine income from vending machines...

  5. 34 CFR 395.17 - Suspension of designation as State licensing agency.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... lapse of a reasonable time, the Secretary is of the opinion that such failure to comply still continues... protection of Federal property on which vending machines subject to the requirements of § 395.32 are located in the State. Upon the suspension of such designation, vending machine income from vending machines...

  6. 3 CFR - Federal Support for the Randolph-Sheppard Vending Facility Program

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Federal Support for the Randolph-Sheppard Vending Facility Program Presidential Documents Other Presidential Documents Memorandum of January 20, 2012 Federal Support for the Randolph-Sheppard Vending Facility Program Memorandum for the Heads of Executive Departments and Agencies Thousands of American...

  7. 10 CFR 431.294 - Uniform test method for the measurement of energy consumption of refrigerated bottled or canned...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... consumption of refrigerated bottled or canned beverage vending machines. 431.294 Section 431.294 Energy... method for the measurement of energy consumption of refrigerated bottled or canned beverage vending... test procedure for energy consumption of refrigerated bottled or canned beverage vending machines shall...

  8. Impact of the HEALTHY study on vending machine offerings in middle schools

    USDA-ARS?s Scientific Manuscript database

    The purpose of this study is to report the impact of the three-year middle school-based HEALTHY study on intervention school vending machine offerings. There were two goals for the vending machines: serve only dessert/snack foods with 200 kilocalories or less per single serving package, and eliminat...

  9. 76 FR 21872 - Arbitration Panel Decision Under the Randolph-Sheppard Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-19

    ...'s bid to manage a snack bar vending facility at the Nesbett Courthouse (Nesbett), a State court..., challenged the SLA's selection of a nonblind severely disabled vendor to operate the snack bar vending... for the Nesbett snack bar vending facility. At that time, the nonblind vendor had been operating the...

  10. 41 CFR 102-74.50 - Are Federal agencies required to give blind vendors priority in operating vending facilities?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... required to give blind vendors priority in operating vending facilities? 102-74.50 Section 102-74.50 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL....50 Are Federal agencies required to give blind vendors priority in operating vending facilities? With...

  11. Pricing and promotion effects on low-fat vending snack purchases: the CHIPS Study.

    PubMed Central

    French, S A; Jeffery, R W; Story, M; Breitlow, K K; Baxter, J S; Hannan, P; Snyder, M P

    2001-01-01

    OBJECTIVES: This study examined the effects of pricing and promotion strategies on purchases of low-fat snacks from vending machines. METHODS: Low-fat snacks were added to 55 vending machines in a convenience sample of 12 secondary schools and 12 worksites. Four pricing levels (equal price, 10% reduction, 25% reduction, 50% reduction) and 3 promotional conditions (none, low-fat label, low-fat label plus promotional sign) were crossed in a Latin square design. Sales of low-fat vending snacks were measured continuously for the 12-month intervention. RESULTS: Price reductions of 10%, 25%, and 50% on low-fat snacks were associated with significant increases in low-fat snack sales; percentages of low-fat snack sales increased by 9%, 39%, and 93%, respectively. Promotional signage was independently but weakly associated with increases in low-fat snack sales. Average profits per machine were not affected by the vending interventions. CONCLUSIONS: Reducing relative prices on low-fat snacks was effective in promoting lower-fat snack purchases from vending machines in both adult and adolescent populations. PMID:11189801

  12. Harm reduction programmes in the Asia--Pacific Region.

    PubMed

    Reid, Gary; Devaney, Madonna L; Baldwin, Simon

    2008-01-01

    This paper reports on the public health intervention of harm reduction to address drug use issues in the Asia-Pacific region. It is based on the report 'Situational analysis of illicit drug issues and responses in Asia and the Pacific', commissioned by the Australian National Council on Drugs Asia Pacific Drug Issues Committee. A comprehensive desk-based review based on published and unpublished literature and key informant data. Drug use in the Asia--Pacific region is widespread, resulting in serious adverse health consequences. Needle and syringe programmes are found in some parts of Asia, but not in the six Pacific Island countries reviewed. Outreach and peer education programmes are implemented, but overall appear minor in size and scope. Substitution therapy programmes appear to be entering a new era of acceptance in some parts of Asia. Primary health care specifically for drug users overall is limited. Harm reduction programmes in the Asia--Pacific region are either small in scale or do not exist. Most programmes lack the technical capacity, human resources and a limited scope of operations to respond effectively to the needs of drug users. Governments in this region should be encouraged to endorse evidence-based harm reduction programmes.

  13. Impact of the HEALTHY Study on Vending Machine Offerings in Middle Schools

    PubMed Central

    Hartstein, Jill; Cullen, Karen W.; Virus, Amy; El Ghormli, Laure; Volpe, Stella L.; Staten, Myrlene A; Bridgman, Jessica C.; Stadler, Diane D.; Gillis, Bonnie; McCormick, Sarah B.; Mobley, Connie C.

    2013-01-01

    Purpose/Objectives The purpose of this study is to report the impact of the three-year middle school-based HEALTHY study on intervention school vending machine offerings. There were two goals for the vending machines: serve only dessert/snack foods with 200 kilocalories or less per single serving package, and eliminate 100% fruit juice and beverages with added sugar. Methods Six schools in each of seven cities (Houston, TX, San Antonio, TX, Irvine, CA, Portland, OR, Pittsburg, PA, Philadelphia, PA, and Chapel Hill, NC) were randomized into intervention (n=21 schools) or control (n=21 schools) groups, with three intervention and three control schools per city. All items in vending machine slots were tallied twice in the fall of 2006 for baseline data and twice at the end of the study, in 2009. The percentage of total slots for each food/beverage category was calculated and compared between intervention and control schools at the end of study, using the Pearson chi-square test statistic. Results At baseline, 15 intervention and 15 control schools had beverage and/or snack vending machines, compared with 11 intervention and 11 control schools at the end of the study. At the end of study, all of the intervention schools with beverage vending machines, but only one out of the nine control schools, met the beverage goal. The snack goal was met by all of the intervention schools and only one of the four control schools with snack vending machines. Applications to Child Nutrition Professionals The HEALTHY study’s vending machine beverage and snack goals were successfully achieved in intervention schools, reducing access to less healthy food items outside the school meals program. Although the effect of these changes on student diet, energy balance and growth is unknown, these results suggest that healthier options for snacks can successfully be offered in school vending machines. PMID:23687471

  14. Variation in access to sugar-sweetened beverages in vending machines across rural, town and urban high schools

    PubMed Central

    Adachi-Mejia, A.M.; Longacre, M.R.; Skatrud-Mickelson, M.; Li, Z.; Purvis, L.A.; Titus, L.J.; Beach, M.L.; Dalton, M.A.

    2013-01-01

    SUMMARY Objectives The 2010 Dietary Guidelines for Americans include reducing consumption of sugar-sweetened beverages. Among the many possible routes of access for youth, school vending machines provide ready availability of sugar-sweetened beverages. The purpose of this study was to determine variation in high school student access to sugar-sweetened beverages through vending machines by geographic location – urban, town or rural – and to offer an approach for analysing school vending machine content. Study design Cross-sectional observational study. Methods Between October 2007 and May 2008, trained coders recorded beverage vending machine content and machine-front advertising in 113 machines across 26 schools in New Hampshire and Vermont, USA. Results Compared with town schools, urban schools were significantly less likely to offer sugar-sweetened beverages (P=0.002). Rural schools also offered more sugar-sweetened beverages than urban schools, but this difference was not significant. Advertisements for sugar-sweetened beverages were highly prevalent in town schools. Conclusions High school students have ready access to sugar-sweetened beverages through their school vending machines. Town schools offer the highest risk of exposure; school vending machines located in towns offer up to twice as much access to sugar-sweetened beverages in both content and advertising compared with urban locations. Variation by geographic region suggests that healthier environments are possible and some schools can lead as inspirational role models. PMID:23498924

  15. Vending Machines of Food and Beverages and Nutritional Profile of their Products at Schools in Madrid, Spain, 2014-2015.

    PubMed

    Monroy-Parada, Doris Xiomara; Ángeles Moya, María; José Bosqued, María; López, Lázaro; Rodríguez-Artalejo, Fernando; Royo-Bordonada, Miguel Ángel

    2016-06-09

    Policies restricting access to sugary drinks and unhealthy foods in the school environment are associated with healthier consumption patterns. In 2010, Spain approved a Consensus Document regarding Food at Schools with nutritional criteria to improve the nutritional profile of foods and drinks served at schools. The objective of this study was to describe the frequency of food and drink vending machines at secondary schools in Madrid, the products offered at them and their nutritional profile. Cross-sectional study of a random sample of 330 secondary schools in Madrid in 2014-2015. The characteristics of the schools and the existence of vending machines were recorded through the internet and by telephone interview. The products offered in a representative sample of 6 vending machines were identified by in situ inspection, and its nutritional composition was taken from its labeling. Finally, the nutritional profile of each product was analyzed with the United Kingdom profile model, which classifies products as healthy and less healthy. The prevalence of vending machines was 17.3%. Among the products offered, 80.5% were less healthy food and drinks (high in energy, fat or sugar and poor in nutrients) and 10.5% were healthy products. Vending machines are common at secondary schools in Madrid. Most products are vending machines are still less healthy.

  16. [Hygienic assessment of student's nutrition through vending machines (fast food)].

    PubMed

    Karelin, A O; Pavlova, D V; Babalyan, A V

    2015-01-01

    The article presents the results of a research work on studying the nutrition of students through vending machines (fast food), taking into account consumer priorities of students of medical University, the features and possible consequences of their use by students. The object of study was assortment of products sold through vending machines on the territory of the First Saint-Petersburg Medical University. Net calories, content of proteins, fats and carbohydrates, glycemic index, glycemic load were determined for each product. Information about the use of vending machines was obtained by questionnaires of students 2 and 4 courses of medical and dental faculties by standardized interview method. As was found, most sold through vending machines products has a high energy value, mainly due to refined carbohydrates, and was characterized by medium and high glycemic load. They have got low protein content. Most of the students (87.3%) take some products from the vending machines, mainly because of lack of time for canteen and buffets visiting. Only 4.2% students like assortment of vending machines. More than 50% students have got gastrointestinal complaints. Statistically significant relationship between time of study at the University and morbidity of gastrointestinal tract, as well as the number of students needing medical diet nutrition was found. The students who need the medical diet use fast food significantly more often (46.6% who need the medical diet and 37.7% who don't need it).

  17. 34 CFR 395.30 - The location and operation of vending facilities for blind vendors on Federal property.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... blind vendors on Federal property. 395.30 Section 395.30 Education Regulations of the Offices of the... EDUCATION VENDING FACILITY PROGRAM FOR THE BLIND ON FEDERAL AND OTHER PROPERTY Federal Property Management § 395.30 The location and operation of vending facilities for blind vendors on Federal property. (a...

  18. 31 CFR 12.3 - Sale of tobacco products in vending machines prohibited.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... machines prohibited. 12.3 Section 12.3 Money and Finance: Treasury Office of the Secretary of the Treasury RESTRICTION OF SALE AND DISTRIBUTION OF TOBACCO PRODUCTS § 12.3 Sale of tobacco products in vending machines prohibited. The sale of tobacco products in vending machines located in or around any Federal building under...

  19. 34 CFR 395.30 - The location and operation of vending facilities for blind vendors on Federal property.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... EDUCATION VENDING FACILITY PROGRAM FOR THE BLIND ON FEDERAL AND OTHER PROPERTY Federal Property Management... 34 Education 2 2011-07-01 2010-07-01 true The location and operation of vending facilities for blind vendors on Federal property. 395.30 Section 395.30 Education Regulations of the Offices of the...

  20. Impact of the HEALTHY Study on Vending Machine Offerings in Middle Schools

    ERIC Educational Resources Information Center

    Hartstein, Jill; Cullen, Karen W.; Virus, Amy; El Ghormli, Laure; Volpe, Stella L.; Staten, Myrlene A.; Bridgman, Jessica C.; Stadler, Diane D.; Gillis, Bonnie; McCormick, Sarah B.; Mobley, Connie C.

    2011-01-01

    Purpose/Objectives: The purpose of this study is to report the impact of the three-year middle school-based HEALTHY study on intervention school vending machine offerings. There were two goals for the vending machines: serve only dessert/snack foods with 200 kilocalories or less per single serving package, and eliminate 100% fruit juice and…

  1. Acquisition, Maintenance and Generalization of Vending Machine Purchasing Skills by Moderately Handicapped Students.

    ERIC Educational Resources Information Center

    Nietupski, John; And Others

    1984-01-01

    Four elementary age moderately disabled students were taught to use a picture-prompt prosthetic to make vending machine purchases. All students reached criterion on the vending machine use task, demonstrated partial generalization to untrained machines, and three Ss exhibited maintenance as much as six weeks beyond the termination of instruction.…

  2. Profits, Commercial Food Supplier Involvement, and School Vending Machine Snack Food Availability: Implications for Implementing the New Competitive Foods Rule

    ERIC Educational Resources Information Center

    Terry-McElrath, Yvonne M.; Hood, Nancy E.; Colabianchi, Natalie; O'Malley, Patrick M.; Johnston, Lloyd D.

    2014-01-01

    Background: The 2013-2014 school year involved preparation for implementing the new US Department of Agriculture (USDA) competitive foods nutrition standards. An awareness of associations between commercial supplier involvement, food vending practices, and food vending item availability may assist schools in preparing for the new standards.…

  3. 34 CFR 395.30 - The location and operation of vending facilities for blind vendors on Federal property.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... blind vendors on Federal property. 395.30 Section 395.30 Education Regulations of the Offices of the... EDUCATION VENDING FACILITY PROGRAM FOR THE BLIND ON FEDERAL AND OTHER PROPERTY Federal Property Management § 395.30 The location and operation of vending facilities for blind vendors on Federal property. (a...

  4. 34 CFR 395.30 - The location and operation of vending facilities for blind vendors on Federal property.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... blind vendors on Federal property. 395.30 Section 395.30 Education Regulations of the Offices of the... EDUCATION VENDING FACILITY PROGRAM FOR THE BLIND ON FEDERAL AND OTHER PROPERTY Federal Property Management § 395.30 The location and operation of vending facilities for blind vendors on Federal property. (a...

  5. 34 CFR 395.30 - The location and operation of vending facilities for blind vendors on Federal property.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... blind vendors on Federal property. 395.30 Section 395.30 Education Regulations of the Offices of the... EDUCATION VENDING FACILITY PROGRAM FOR THE BLIND ON FEDERAL AND OTHER PROPERTY Federal Property Management § 395.30 The location and operation of vending facilities for blind vendors on Federal property. (a...

  6. Compliance with school nutrition policies in Ontario and Alberta: An assessment of secondary school vending machine data from the COMPASS study.

    PubMed

    Vine, Michelle M; Harrington, Daniel W; Butler, Alexandra; Patte, Karen; Godin, Katelyn; Leatherdale, Scott T

    2017-04-20

    We investigated the extent to which a sample of Ontario and Alberta secondary schools are being compliant with their respective provincial nutrition policies, in terms of the food and beverages sold in vending machines. This observational study used objective data on drinks and snacks from vending machines, collected over three years of the COMPASS study (2012/2013-2014/2015 school years). Drink (e.g., sugar-containing carbonated/non-carbonated soft drinks, sports drinks, etc.) and snack (e.g., chips, crackers, etc.) data were coded by number of units available, price, and location of vending machine(s) in the school. Univariate and bivariate analyses were undertaken using R version 3.2.3. In order to assess policy compliancy over time, nutritional information of products in vending machines was compared to nutrition standards set out in P/PM 150 in Ontario, and those set out in the Alberta Nutrition Guidelines for Children and Youth (2012) in Alberta. Results reveal a decline over time in the proportion of schools selling sugar-containing carbonated soft drinks (9% in 2012/2013 vs. 3% in 2014/2015), crackers (26% vs. 17%) and cake products (12% vs. 5%) in vending machines, and inconsistent changes in the proportion selling chips (53%, 67% and 65% over the three school years). Conversely, results highlight increases in the proportion of vending machines selling chocolate bars (7% vs. 13%) and cookies (21% vs. 40%) between the 2012/2013 and 2014/2015 school years. Nutritional standard policies were not adhered to in the majority of schools with respect to vending machines. There is a need for investment in formal monitoring and evaluation of school policies, and the provision of information and tools to support nutrition policy implementation.

  7. [Card-based age control mechanisms at tobacco vending machines. Effect and consequences].

    PubMed

    Schneider, S; Meyer, C; Löber, S; Röhrig, S; Solle, D

    2010-02-01

    Until recently, 700,000 tobacco vending machines provided uncontrolled access to cigarettes for children and adolescents in Germany. On January 1, 2007, a card-based electronic locking device was attached to all tobacco vending machines to prevent the purchase of cigarettes by children and adolescents under 16. Starting in 2009, only persons older than 18 are able to buy cigarettes from tobacco vending machines. The aim of the present investigation (SToP Study: "Sources of Tobacco for Pupils" Study) was to assess changes in the number of tobacco vending machines after the introduction of these new technical devices (supplier's reaction). In addition, the ways smoking adolescents make purchases were assessed (consumer's reaction). We registered and mapped the total number of tobacco points of sale (tobacco POS) before and after the introduction of the card-based electronic locking device in two selected districts of the city of Cologne. Furthermore, pupils from local schools (response rate: 83%) were asked about their tobacco consumption and ways of purchase using a questionnaire. Results indicated that in the area investigated the total number of tobacco POSs decreased from 315 in 2005 to 277 in 2007. The rates of decrease were 48% for outdoor vending machines and 8% for indoor vending machines. Adolescents reported circumventing the card-based electronic locking devices (e.g., by using cards from older friends) and using other tobacco POSs (especially newspaper kiosks) or relying on their social network (mainly friends). The decreasing number of tobacco vending machines has not had a significant impact on cigarette acquisition by adolescent smokers as they tend to circumvent the newly introduced security measures.

  8. School vending machine purchasing behavior: results from the 2005 YouthStyles survey.

    PubMed

    Thompson, Olivia M; Yaroch, Amy L; Moser, Richard P; Finney Rutten, Lila J; Agurs-Collins, Tanya

    2010-05-01

    Competitive foods are often available in school vending machines. Providing youth with access to school vending machines, and thus competitive foods, is of concern, considering the continued high prevalence of childhood obesity: competitive foods tend to be energy dense and nutrient poor and can contribute to increased energy intake in children and adolescents. To evaluate the relationship between school vending machine purchasing behavior and school vending machine access and individual-level dietary characteristics, we used population-level YouthStyles 2005 survey data to compare nutrition-related policy and behavioral characteristics by the number of weekly vending machine purchases made by public school children and adolescents (N = 869). Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were computed using age- and race/ethnicity-adjusted logistic regression models that were weighted on age and sex of child, annual household income, head of household age, and race/ethnicity of the adult in study. Data were collected in 2005 and analyzed in 2008. Compared to participants who did not purchase from a vending machine, participants who purchased >or=3 days/week were more likely to (1) have unrestricted access to a school vending machine (OR = 1.71; 95% CI = 1.13-2.59); (2) consume regular soda and chocolate candy >or=1 time/day (OR = 3.21; 95% CI = 1.87-5.51 and OR = 2.71; 95% CI = 1.34-5.46, respectively); and (3) purchase pizza or fried foods from a school cafeteria >or=1 day/week (OR = 5.05; 95% CI = 3.10-8.22). Future studies are needed to establish the contribution that the school-nutrition environment makes on overall youth dietary intake behavior, paying special attention to health disparities between whites and nonwhites.

  9. School vending machine use and fast-food restaurant use are associated with sugar-sweetened beverage intake in youth.

    PubMed

    Wiecha, Jean L; Finkelstein, Daniel; Troped, Philip J; Fragala, Maren; Peterson, Karen E

    2006-10-01

    To examine associations between use of school vending machines and fast-food restaurants and youth intake of sugar-sweetened beverages. A cross-sectional observational study. From a group randomized obesity intervention, we analyzed baseline data from 1,474 students in 10 Massachusetts middle schools with vending machines that sold soda and/or other sweetened drinks. Daily sugar-sweetened beverage consumption (regular soda, fruit drinks, and iced tea), purchases from school vending machines, and visits to fast-food restaurants in the preceding 7 days were estimated by self-report. Chi(2) and nonparametric tests were performed on unadjusted data; multivariable models adjusted for sex, grade, body mass index, and race/ethnicity, and accounted for clustering within schools. Among 646 students who reported using school vending machines, 456 (71%) reported purchasing sugar-sweetened beverages. Overall, 977 students (66%) reported eating at a fast-food restaurant. Sugar-sweetened beverage intakes averaged 1.2 servings per day. In adjusted models, relative to no vending machine purchases, servings per day increased by 0.21 for one to three purchases per week (P=0.0057), and 0.71 with four or more purchases (P<0.0001). Relative to no fast-food restaurant visits, sugar-sweetened beverage servings per day increased by 0.13 with one visit per week (P=0.07), 0.49 with two to three visits (P=0.0013), and by 1.64 with four or more visits (P=0.0016). Among students who use school vending machines, more report buying sugar-sweetened beverages than any other product category examined. Both school vending machine and fast-food restaurant use are associated with overall sugar-sweetened beverage intake. Reduction in added dietary sugars may be attainable by reducing use of these sources or changing product availability.

  10. The role of remote community stores in reducing the harm resulting from tobacco to Aboriginal people.

    PubMed

    Ivers, Rowena G; Castro, Anthony; Parfitt, David; Bailie, Ross S; Richmond, Robyn L; D'Abbs, Peter H

    2006-05-01

    The objective of this study was to assess the potential for reducing the harm resulting from tobacco use through health promotion programmes run in community stores in remote Aboriginal communities. The Tobacco Project utilised data from 111 stakeholder interviews (72 at baseline and 71 at follow-up after 12 months) assessing presence of sales to minors, tobacco advertising, labelling and pricing. It also involved the assessment of observational data from community stores and comments obtained from 29 tobacco vendors derived from community surveys. Sales of tobacco to minors were not reported in community stores and all stores complied with requirements to display the legislated signage. However, tobacco was accessible to minors through a vending machine and through independent vendors. Only one store displayed tobacco advertising; all stores had displayed anti-tobacco health promotion posters or pamphlets. Pricing policies in two stores may have meant that food items effectively subsidised the cost of tobacco. All stores had unofficial no-smoking policies in accessible parts of the store. Remote community stores complied with existing legislation, aside from allowing access of minors to vending machines. There may still be potential for proactive tobacco education campaigns run through community stores and for a trial assessing the effect of changes in tobacco prices on tobacco consumption.

  11. Electronic vending machines for dispensing rapid HIV self-testing kits: a case study.

    PubMed

    Young, Sean D; Klausner, Jeffrey; Fynn, Risa; Bolan, Robert

    2014-02-01

    This short report evaluates the feasibility of using electronic vending machines for dispensing oral, fluid, rapid HIV self-testing kits in Los Angeles County. Feasibility criteria that needed to be addressed were defined as: (1) ability to find a manufacturer who would allow dispensing of HIV testing kits and could fit them to the dimensions of a vending machine, (2) ability to identify and address potential initial obstacles, trade-offs in choosing a machine location, and (3) ability to gain community approval for implementing this approach in a community setting. To address these issues, we contracted a vending machine company who could supply a customized, Internet-enabled machine that could dispense HIV kits and partnered with a local health center available to host the machine onsite and provide counseling to participants, if needed. Vending machines appear to be feasible technologies that can be used to distribute HIV testing kits.

  12. State sales tax rates for soft drinks and snacks sold through grocery stores and vending machines, 2007.

    PubMed

    Chriqui, Jamie F; Eidson, Shelby S; Bates, Hannalori; Kowalczyk, Shelly; Chaloupka, Frank J

    2008-07-01

    Junk food consumption is associated with rising obesity rates in the United States. While a "junk food" specific tax is a potential public health intervention, a majority of states already impose sales taxes on certain junk food and soft drinks. This study reviews the state sales tax variance for soft drinks and selected snack products sold through grocery stores and vending machines as of January 2007. Sales taxes vary by state, intended retail location (grocery store vs. vending machine), and product. Vended snacks and soft drinks are taxed at a higher rate than grocery items and other food products, generally, indicative of a "disfavored" tax status attributed to vended items. Soft drinks, candy, and gum are taxed at higher rates than are other items examined. Similar tax schemes in other countries and the potential implications of these findings relative to the relationship between price and consumption are discussed.

  13. Nutrition environment measures survey-vending: development, dissemination, and reliability.

    PubMed

    Voss, Carol; Klein, Susan; Glanz, Karen; Clawson, Margaret

    2012-07-01

    Researchers determined a need to develop an instrument to assess the vending machine environment that was comparably reliable and valid to other Nutrition Environment Measures Survey tools and that would provide consistent and comparable data for businesses, schools, and communities. Tool development, reliability testing, and dissemination of the Nutrition Environment Measures Survey-Vending (NEMS-V) involved a collaboration of students, professionals, and community leaders. Interrater reliability testing showed high levels of agreement among trained raters on the products and evaluations of products. NEMS-V can benefit public health partners implementing policy and environmental change initiatives as a part of their community wellness activities. The vending machine project will support a policy calling for state facilities to provide a minimum of 30% of foods and beverages in vending machines as healthy options, based on NEMS-V criteria, which will be used as a model for other businesses.

  14. Electronic vending machines for dispensing rapid HIV self-testing kits: A case study

    PubMed Central

    Young, Sean D.; Klausner, Jeffrey; Fynn, Risa; Bolan, Robert

    2014-01-01

    This short report evaluates the feasibility of using electronic vending machines for dispensing oral, fluid, rapid HIV-self testing kits in Los Angeles County. Feasibility criteria that needed to be addressed were defined as: 1) ability to find a manufacturer who would allow dispensing of HIV testing kits and could fit them to the dimensions of a vending machine, 2) ability to identify and address potential initial obstacles, trade-offs in choosing a machine location, and 3) ability to gain community approval for implementing this approach in a community setting. To address these issues, we contracted a vending machine company who could supply a customized, Internet-enabled machine that could dispense HIV kits and partnered with a local health center available to host the machine onsite and provide counseling to participants, if needed. Vending machines appear to be feasible technologies that can be used to distribute HIV testing kits. PMID:23777528

  15. Promoting the Purchase of Low-Calorie Foods from School Vending Machines: A Cluster-Randomized Controlled Study

    ERIC Educational Resources Information Center

    Kocken, Paul L.; Eeuwijk, Jennifer; van Kesteren, Nicole M.C.; Dusseldorp, Elise; Buijs, Goof; Bassa-Dafesh, Zeina; Snel, Jeltje

    2012-01-01

    Background: Vending machines account for food sales and revenue in schools. We examined 3 strategies for promoting the sale of lower-calorie food products from vending machines in high schools in the Netherlands. Methods: A school-based randomized controlled trial was conducted in 13 experimental schools and 15 control schools. Three strategies…

  16. Pricing and Promotion Effects on Low-Fat Vending Snack Purchases: The CHIPS Study.

    ERIC Educational Resources Information Center

    French, Simone A.; Jeffery, Robert W.; Story, Mary; Breitlow, Kyle K.; Baxter, Judith S.; Hannan, Peter; Snyder, M. Patricia

    2001-01-01

    Examined the effects of pricing and promotion strategies on purchases of low-fat snacks from vending machines set up at secondary schools and worksites in Minnesota. Analysis of sales data indicated that reducing relative prices on low-fat snacks was very effective in promoting lower-fat snack purchases from vending machines in both settings. (SM)

  17. 41 CFR 102-74.50 - Are Federal agencies required to give blind vendors priority in operating vending facilities?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... required to give blind vendors priority in operating vending facilities? 102-74.50 Section 102-74.50 Public....50 Are Federal agencies required to give blind vendors priority in operating vending facilities? With certain exceptions, the Randolph-Sheppard Act (20 U.S.C. 107 et seq.) requires that blind persons licensed...

  18. 41 CFR 102-74.50 - Are Federal agencies required to give blind vendors priority in operating vending facilities?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... required to give blind vendors priority in operating vending facilities? 102-74.50 Section 102-74.50 Public....50 Are Federal agencies required to give blind vendors priority in operating vending facilities? With certain exceptions, the Randolph-Sheppard Act (20 U.S.C. 107 et seq.) requires that blind persons licensed...

  19. 41 CFR 102-74.50 - Are Federal agencies required to give blind vendors priority in operating vending facilities?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... required to give blind vendors priority in operating vending facilities? 102-74.50 Section 102-74.50 Public....50 Are Federal agencies required to give blind vendors priority in operating vending facilities? With certain exceptions, the Randolph-Sheppard Act (20 U.S.C. 107 et seq.) requires that blind persons licensed...

  20. 41 CFR 102-74.50 - Are Federal agencies required to give blind vendors priority in operating vending facilities?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... required to give blind vendors priority in operating vending facilities? 102-74.50 Section 102-74.50 Public....50 Are Federal agencies required to give blind vendors priority in operating vending facilities? With certain exceptions, the Randolph-Sheppard Act (20 U.S.C. 107 et seq.) requires that blind persons licensed...

  1. Students' perspectives on promoting healthful food choices from campus vending machines: a qualitative interview study.

    PubMed

    Ali, Habiba I; Jarrar, Amjad H; Abo-El-Enen, Mostafa; Al Shamsi, Mariam; Al Ashqar, Huda

    2015-05-28

    Increasing the healthfulness of campus food environments is an important step in promoting healthful food choices among college students. This study explored university students' suggestions on promoting healthful food choices from campus vending machines. It also examined factors influencing students' food choices from vending machines. Peer-led semi-structured individual interviews were conducted with 43 undergraduate students (33 females and 10 males) recruited from students enrolled in an introductory nutrition course in a large national university in the United Arab Emirates. Interviews were audiotaped, transcribed, and coded to generate themes using N-Vivo software. Accessibility, peer influence, and busy schedules were the main factors influencing students' food choices from campus vending machines. Participants expressed the need to improve the nutritional quality of the food items sold in the campus vending machines. Recommendations for students' nutrition educational activities included placing nutrition tips on or beside the vending machines and using active learning methods, such as competitions on nutrition knowledge. The results of this study have useful applications in improving the campus food environment and nutrition education opportunities at the university to assist students in making healthful food choices.

  2. Time to B. cereus about hot chocolate.

    PubMed Central

    Nelms, P K; Larson, O; Barnes-Josiah, D

    1997-01-01

    OBJECTIVE: To determine the cause of illnesses experienced by employees of a Minneapolis manufacturing plant after drinking hot chocolate bought from a vending machine and to explore the prevalence of similar vending machine-related illnesses. METHODS: The authors inspected the vending machines at the manufacturing plant where employees reported illnesses and at other locations in the city where hot chocolate beverages were sold in machines. Tests were performed on dry mix, water, and beverage samples and on machine parts. RESULTS: Laboratory analyses confirmed the presence of B. cereus in dispensed beverages at a concentration capable of causing illness (170,000 count/gm). In citywide testing of vending machines dispensing hot chocolate, 7 of the 39 licensed machines were found to be contaminated, with two contaminated machines having B. cereus levels capable of causing illness. CONCLUSIONS: Hot chocolate sold in vending machines may contain organisms capable of producing toxins that under favorable conditions, can induce illness. Such illnesses are likely to be underreported. Even low concentrations of B. cereus may be dangerous for vulnerable populations such as the aged or immunosuppressed. Periodic testing of vending machines is thus warranted. The relationship between cleaning practices and B. cereus contamination is an issue for further study. PMID:9160059

  3. Time to B. cereus about hot chocolate.

    PubMed

    Nelms, P K; Larson, O; Barnes-Josiah, D

    1997-01-01

    To determine the cause of illnesses experienced by employees of a Minneapolis manufacturing plant after drinking hot chocolate bought from a vending machine and to explore the prevalence of similar vending machine-related illnesses. The authors inspected the vending machines at the manufacturing plant where employees reported illnesses and at other locations in the city where hot chocolate beverages were sold in machines. Tests were performed on dry mix, water, and beverage samples and on machine parts. Laboratory analyses confirmed the presence of B. cereus in dispensed beverages at a concentration capable of causing illness (170,000 count/gm). In citywide testing of vending machines dispensing hot chocolate, 7 of the 39 licensed machines were found to be contaminated, with two contaminated machines having B. cereus levels capable of causing illness. Hot chocolate sold in vending machines may contain organisms capable of producing toxins that under favorable conditions, can induce illness. Such illnesses are likely to be underreported. Even low concentrations of B. cereus may be dangerous for vulnerable populations such as the aged or immunosuppressed. Periodic testing of vending machines is thus warranted. The relationship between cleaning practices and B. cereus contamination is an issue for further study.

  4. Milk Vending Does Not Improve College Students' Milk and Calcium Intakes.

    PubMed

    Rose, Angela M; Williams, Rachel A; Hanks, Andrew S; Kennel, Julie A; Gunther, Carolyn

    2018-03-01

    In the transition from adolescence to young adulthood, overall diet quality decreases, including a reduction in both dairy and calcium consumption. The objective of this pilot study was to determine the impact of milk vending on milk and calcium intakes in college students. Participants were 124 college students living in dorms at a large public university (Fall 2012). Milk vending machines were installed in two campus dorms. Before and 2 months after installation, students were surveyed about milk and calcium intakes, as well as attitudes regarding milk vending. Sales data for the newly installed machines were also collected between the pre- and posttest surveys. Students reported similar milk and calcium consumption before and after the intervention. Mean calcium intakes were lower than the recommended dietary allowance for students in either life stage group (18 years old or 19 years and older). Milk vending sales data showed that during the study period, approximately nine bottles of milk were bought each day from the two dorms combined. Results from this study suggest that milk vending alone may not be an effective strategy for preventing the commonly observed decrease in milk and calcium intakes among college students.

  5. Variation in access to sugar-sweetened beverages in vending machines across rural, town and urban high schools.

    PubMed

    Adachi-Mejia, A M; Longacre, M R; Skatrud-Mickelson, M; Li, Z; Purvis, L A; Titus, L J; Beach, M L; Dalton, M A

    2013-05-01

    The 2010 Dietary Guidelines for Americans include reducing consumption of sugar-sweetened beverages. Among the many possible routes of access for youth, school vending machines provide ready availability of sugar-sweetened beverages. The purpose of this study was to determine variation in high school student access to sugar-sweetened beverages through vending machines by geographic location - urban, town or rural - and to offer an approach for analysing school vending machine content. Cross-sectional observational study. Between October 2007 and May 2008, trained coders recorded beverage vending machine content and machine-front advertising in 113 machines across 26 schools in New Hampshire and Vermont, USA. Compared with town schools, urban schools were significantly less likely to offer sugar-sweetened beverages (P = 0.002). Rural schools also offered more sugar-sweetened beverages than urban schools, but this difference was not significant. Advertisements for sugar-sweetened beverages were highly prevalent in town schools. High school students have ready access to sugar-sweetened beverages through their school vending machines. Town schools offer the highest risk of exposure; school vending machines located in towns offer up to twice as much access to sugar-sweetened beverages in both content and advertising compared with urban locations. Variation by geographic region suggests that healthier environments are possible and some schools can lead as inspirational role models. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  6. Vending machine assessment methodology. A systematic review.

    PubMed

    Matthews, Melissa A; Horacek, Tanya M

    2015-07-01

    The nutritional quality of food and beverage products sold in vending machines has been implicated as a contributing factor to the development of an obesogenic food environment. How comprehensive, reliable, and valid are the current assessment tools for vending machines to support or refute these claims? A systematic review was conducted to summarize, compare, and evaluate the current methodologies and available tools for vending machine assessment. A total of 24 relevant research studies published between 1981 and 2013 met inclusion criteria for this review. The methodological variables reviewed in this study include assessment tool type, study location, machine accessibility, product availability, healthfulness criteria, portion size, price, product promotion, and quality of scientific practice. There were wide variations in the depth of the assessment methodologies and product healthfulness criteria utilized among the reviewed studies. Of the reviewed studies, 39% evaluated machine accessibility, 91% evaluated product availability, 96% established healthfulness criteria, 70% evaluated portion size, 48% evaluated price, 52% evaluated product promotion, and 22% evaluated the quality of scientific practice. Of all reviewed articles, 87% reached conclusions that provided insight into the healthfulness of vended products and/or vending environment. Product healthfulness criteria and complexity for snack and beverage products was also found to be variable between the reviewed studies. These findings make it difficult to compare results between studies. A universal, valid, and reliable vending machine assessment tool that is comprehensive yet user-friendly is recommended. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. 41 CFR 102-74.75 - May Federal agencies sell tobacco products in vending machines in Government-owned and leased space?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... sell tobacco products in vending machines in Government-owned and leased space? 102-74.75 Section 102... Services § 102-74.75 May Federal agencies sell tobacco products in vending machines in Government-owned and... machines in Government-owned and leased space. The Administrator of GSA or the head of an Agency may...

  8. Energy Savings and Persistence from an Energy Services Performance Contract at an Army Base

    DTIC Science & Technology

    2011-10-01

    control system upgrades, lighting retrofits, vending machine controls, and cooling tower variable frequency drivers (VFDs). To accomplish the...controls were installed in the vending machines , and for the 87018 thermal plant, cooling tower VFDs were implemented. To develop baseline models...identify the reasons of improved or deteriorated energy performance of the buildings. For example, periodic submetering of the vending machines

  9. Basic and Special Criteria for the Evaluation of Manually Activated and/or Coin Activated Vending Machines for Foods and/or Beverages. Revised February 1963.

    ERIC Educational Resources Information Center

    National Sanitation Foundation, Ann Arbor, MI.

    Appraisal of various types of manually activated and/or coin activated vending machines is discussed in this standard. The following are included--(1) introduction and definitions and discussion of various types of food and beverage vending machines, (2) general provisions including minimum requirements, alternate materials, and a classification…

  10. Itinerant vending of medicines inside buses in Nigeria: vending strategies, dominant themes and medicine-related information provided.

    PubMed

    Yusuff, Kazeem B; Wassi Sanni, Abd'

    2011-07-01

    To determine vending strategies and marketing themes employed by itinerant bus vendors, and assess the accuracy and completeness of information provided on medicines being sold in an urban setting in Nigeria. Cross-sectional study and content analysis of itinerant vending of medicines inside buses recorded with a mobile telephone on purposively selected routes in a mega city with an estimated 18 million residents in southwestern Nigeria over a 2-month period. Two coders independently assessed 192 vending episodes by 56 vendors for 147 OTC and prescription medicines. Inter-rater reliability (Gwet AC1 =0.924; p<0.0001). Fourteen thousands and four hundred potential consumers encountered 192 recorded episodes of vending of medicines inside 192 buses within the study periods. Forty-four (78•5%) of the 56 vendors were females in the 30-45 years age bracket, were mostly (75%) attired in the local 'Iro and Buba' Ankara fabric and showed laminated identity cards (97.5%) issued by the local association for 'marketers' of medicines inside buses, markets, and motor parks. Of the 14400 consumers encountered inside buses during the study period, between 6.7% and 48.3% purchased the medicines promoted. Prayers against death from road traffic accidents and diseases of physical and / or meta-physical origins were the most frequently used (76•8%) ice-breaking opening statement / strategy to gain consumers' attention. Hematinics, multi-vitamins, simple analgesic, NSAIDs and corticosteroids were the most frequently vended medicines. Consumers' enquiries were related to dosing for children (51.8%), elderly (28.6%), and pregnancy (52.7%); and contra-indications during pregnancy (8.9%). Factual medicines information such as dose, frequency, potential side effects and contra-indications were not provided in majority of vending episodes. Itinerant vending of medicines and the use of misleading and melodramatic themes to secure high consumer patronage appear considerable in Nigeria. Majority of the vendors did not correctly respond to consumers medicine-related enquiries, or provide detailed factual medicines information to guide appropriate use. These misleading promotional activities could potentially encourage inappropriate purchase and probable self-medication by consumers.

  11. Itinerant vending of medicines inside buses in Nigeria: vending strategies, dominant themes and medicine-related information provided

    PubMed Central

    Yusuff, Kazeem B.; Wassi Sanni, Abd’

    Objective To determine vending strategies and marketing themes employed by itinerant bus vendors, and assess the accuracy and completeness of information provided on medicines being sold in an urban setting in Nigeria. Methods Cross-sectional study and content analysis of itinerant vending of medicines inside buses recorded with a mobile telephone on purposively selected routes in a mega city with an estimated 18 million residents in southwestern Nigeria over a 2-month period. Two coders independently assessed 192 vending episodes by 56 vendors for 147 OTC and prescription medicines. Inter-rater reliability (Gwet AC1 =0.924; p<0.0001). Results Fourteen thousands and four hundred potential consumers encountered 192 recorded episodes of vending of medicines inside 192 buses within the study periods. Forty-four (78•5%) of the 56 vendors were females in the 30-45 years age bracket, were mostly (75%) attired in the local ‘Iro and Buba’ Ankara fabric and showed laminated identity cards (97.5%) issued by the local association for ‘marketers’ of medicines inside buses, markets, and motor parks. Of the 14400 consumers encountered inside buses during the study period, between 6.7% and 48.3% purchased the medicines promoted. Prayers against death from road traffic accidents and diseases of physical and / or meta-physical origins were the most frequently used (76•8%) ice-breaking opening statement / strategy to gain consumers’ attention. Hematinics, multi-vitamins, simple analgesic, NSAIDs and corticosteroids were the most frequently vended medicines. Consumers’ enquiries were related to dosing for children (51.8%), elderly (28.6%), and pregnancy (52.7%); and contra-indications during pregnancy (8.9%). Factual medicines information such as dose, frequency, potential side effects and contra-indications were not provided in majority of vending episodes. Conclusions Itinerant vending of medicines and the use of misleading and melodramatic themes to secure high consumer patronage appear considerable in Nigeria. Majority of the vendors did not correctly respond to consumers medicine-related enquiries, or provide detailed factual medicines information to guide appropriate use. These misleading promotional activities could potentially encourage inappropriate purchase and probable self-medication by consumers. PMID:24367466

  12. Scoping out the literature on mobile needle and syringe programs-review of service delivery and client characteristics, operation, utilization, referrals, and impact.

    PubMed

    Strike, Carol; Miskovic, Miroslav

    2018-02-08

    Needle and syringe program (NSP) service delivery models encompass fixed sites, mobile services, vending machines, pharmacies, peer NSPs, street outreach, and inter-organizational agreements to add NSP services to other programs. For programs seeking to implement or improve mobile services, access to a synthesis of the evidence related to mobile services is beneficial, but lacking. We used a scoping study method to search MEDLINE, PSYCHInfo, Embase, Scopus, and Sociological for relevant literature. We identified 39 relevant manuscripts published between 1975 and November 2017 after removing duplicates and non-relevant manuscripts from the 1313 identified by the search. Charting of the data showed that these publications reported findings related to the service delivery model characteristics, client characteristics, service utilization, specialized interventions offered on mobile NSPs, linking clients to other services, and impact on injection risk behaviors. Mobile NSPs are implemented in high-, medium-, and low-income countries; provide equipment distribution and many other harm reduction services; face limitations to service complement, confidentiality, and duration of interactions imposed by physical space; adapt to changes in locations and types of drug use; attract people who engage in high-risk/intensity injection behavior and who are often not reached by other service models; and may lead to reduced injection-related risks. It is not clear from the literature reviewed, what are, or if there are, a "core and essential" complement of services that mobile NSPs should offer. Decisions about service complement for mobile NSPs need to be made in relation to the context and also other available services. Reports of client visits to mobile NSP provide a picture of the volume and frequency of utilization but are difficult to compare given varied measures and reference periods. Mobile NSPs have an important role to play in improving HIV and HCV prevention efforts across the world. However, more work is needed to create clearer assessment metrics and to improve access to NSP services across the world.

  13. Does providing nutrition information at vending machines reduce calories per item sold?

    PubMed

    Dingman, Deirdre A; Schulz, Mark R; Wyrick, David L; Bibeau, Daniel L; Gupta, Sat N

    2015-02-01

    In 2010, the United States (US) enacted a restaurant menu labeling law. The law also applied to vending machine companies selling food. Research suggested that providing nutrition information on menus in restaurants might reduce the number of calories purchased. We tested the effect of providing nutrition information and 'healthy' designations to consumers where vending machines were located in college residence halls. We conducted our study at one university in Southeast US (October-November 2012). We randomly assigned 18 vending machines locations (residence halls) to an intervention or control group. For the intervention we posted nutrition information, interpretive signage, and sent a promotional email to residents of the hall. For the control group we did nothing. We tracked sales over 4 weeks before and 4 weeks after we introduced the intervention. Our intervention did not change what the residents bought. We recommend additional research about providing nutrition information where vending machines are located, including testing formats used to present information.

  14. Paediatric HUS Cases Related to the Consumption of Raw Milk Sold by Vending Machines in Italy: Quantitative Risk Assessment Based on Escherichia coli O157 Official Controls over 7 years.

    PubMed

    Giacometti, F; Bonilauri, P; Piva, S; Scavia, G; Amatiste, S; Bianchi, D M; Losio, M N; Bilei, S; Cascone, G; Comin, D; Daminelli, P; Decastelli, L; Merialdi, G; Mioni, R; Peli, A; Petruzzelli, A; Tonucci, F; Liuzzo, G; Serraino, A

    2017-11-01

    A quantitative risk assessment (RA) was developed to estimate haemolytic-uremic syndrome (HUS) cases in paediatric population associated with the consumption of raw milk sold in vending machines in Italy. The historical national evolution of raw milk consumption phenomenon since 2008, when consumer interest started to grow, and after 7 years of marketing adjustment, is outlined. Exposure assessment was based on the official Shiga toxin-producing Escherichia coli O157:H7 (STEC) microbiological records of raw milk samples from vending machines monitored by the regional Veterinary Authorities from 2008 to 2014, microbial growth during storage, consumption frequency of raw milk, serving size, consumption preference and age of consumers. The differential risk considered milk handled under regulation conditions (4°C throughout all phases) and the worst time-temperature field handling conditions detected. In case of boiling milk before consumption, we assumed that the risk of HUS is fixed at zero. The model estimates clearly show that the public health significance of HUS cases due to raw milk STEC contamination depends on the current variability surrounding the risk profile of the food and the consumer behaviour has more impact than milk storage scenario. The estimated HUS cases predicted by our model are roughly in line with the effective STEC O157-associated HUS cases notified in Italy only when the proportion of consumers not boiling milk before consumption is assumed to be 1%. Raw milk consumption remains a source of E. coli O157:H7 for humans, but its overall relevance is likely to have subsided and significant caution should be exerted for temporal, geographical and consumers behaviour analysis. Health education programmes and regulatory actions are required to educate people, primarily children, on other STEC sources. © 2016 Blackwell Verlag GmbH.

  15. Youth access to tobacco: the effects of age, gender, vending machine locks, and "it's the law" programs.

    PubMed Central

    DiFranza, J R; Savageau, J A; Aisquith, B F

    1996-01-01

    OBJECTIVES. This study evaluated the influence of age, gender, vending machine lockout devices, and tobacco industry-sponsored voluntary compliance programs ("It's the Law" programs) on underage youths' ability to purchase tobacco. METHODS. Twelve youths made 480 attempts to purchase tobacco in Massachusetts from over-the-counter retailers and vending machines with and without remote control lockout devices. Half the vendors were participating in It's the Law programs. RESULTS. In communities with no requirements for lockout devices, illegal sales were far more likely from vending machines than from over-the-counter sources (odds ratio [OR] = 5.9, 95% confidence interval [CI] = 3.3, 10.3). Locks on vending machines made them equivalent to over-the-counter sources in terms of illegal sales to youths. Vendors participating in It's the Law programs were as likely to make illegal sales as nonparticipants (OR = 0.87, 95% CI = 0.57, 1.35). Girls and youths 16 years of age and older were more successful at purchasing tobacco. CONCLUSIONS. The It's the Law programs are ineffective in preventing illegal sales. While locks made vending machines equivalent to over-the-counter sources in their compliance with the law, they are not a substitute for law enforcement. PMID:8633739

  16. Sanitary conditions of food vending sites and food handling practices of street food vendors in Benin City, Nigeria: implication for food hygiene and safety.

    PubMed

    Okojie, P W; Isah, E C

    2014-01-01

    To determine the sanitary conditions of vending sites as well as food handling practices of street food vendors in Benin City, Nigeria. A descriptive cross-sectional study was done using an observational checklist and researcher-administered questionnaire. 286 randomly selected vending units were surveyed, and their operators interviewed on their food handling practices. A higher proportion, 259 (90.5%), of the observed vending sites appeared clean. The following sanitary facilities were observed in and around the respective food premises of the respondents: waste bin, 124 (43.4%), refuse dumpsite, 41 (14.3%), wash hand basin, 201 (71.2%), hand towel, 210 (73.4%), and soap, 220 (76.9%). There were also the presence of flies 118, (41.3%), and the presence of rats/cockroaches, 7 (2.4%). Respondents with tertiary education, 5 (38.5%), vended foods in environment with good hygiene status compared to those with secondary, 45 (31.7%), and primary education, 33 (27.3%). There was no statistically significant association between educational status and the hygiene status of food premise (P = 0.362). This study showed that street food vending sites in Benin City were sanitary and that food vendors had good food handling practices.

  17. Implementation of electronic locking devices for adolescents at German tobacco vending machines: intended and unintended changes of supply and demand.

    PubMed

    Schneider, S; Meyer, C; Yamamoto, S; Solle, D

    2009-08-01

    Starting from 1 January 2007, electronic locking devices based on proof-of-age (via electronic cash cards or a European driving licence) were installed in approximately 500,000 vending machines across Germany to restrict the purchase of cigarettes to those over the age of 16. To examine changes in the number of tobacco vending machines before and after the introduction of these new measures. The total number of commercial tobacco sources in 2 selected districts (70,000 inhabitants) in Cologne were recorded and mapped. This major German city was the ideal setting for this study as investigators were able to use existing sociogeographical data from the area. A complete inventory was compiled in autumn 2005 and 2007. A total of 780 students aged 12 to 15 were also interviewed in the study areas. The main outcome measures were quantities and locations of commercial tobacco sources. Between 2005 and 2007 the total number of tobacco sources decreased from 315 to 277 within the study area. Although the most obvious reduction was detected in the number of outdoor vending machines (-48%), the number of indoor vending machines also decreased by 8%. Adolescents changed from vending machines to other sources for cigarettes, particularly kiosks or friends (+31% points usage rate, p<0.001; +35% points usage rate, p<0.001, respectively). Although the number of tobacco vending machines decreased, this has not had a significant impact on cigarette acquisition by underage smokers as they were able to circumvent this new security measure in several different ways.

  18. Safer injections following a new national medicine policy in the public sector, Burkina Faso 1995 – 2000

    PubMed Central

    Logez, Sophie; Hutin, Yvan; Somda, Paul; Thuault, Jérôme; Holloway, Kathleen

    2005-01-01

    Background The common failure of health systems to ensure adequate and sufficient supplies of injection devices may have a negative impact on injection safety. We conducted an assessment in April 2001 to determine to which extent an increase in safe injection practices between 1995 and 2000 was related to the increased access to injection devices because of a new essential medicine policy in Burkina Faso. Methods We reviewed outcomes of the new medicine policy implemented in1995. In April 2001, a retrospective programme review assessed the situation between 1995 and 2000. We visited 52 health care facilities where injections had been observed during a 2000 injection safety assessment and their adjacent operational public pharmaceutical depots. Data collection included structured observations of available injection devices and an estimation of the proportion of prescriptions including at least one injection. We interviewed wholesaler managers at national and regional levels on supply of injection devices to public health facilities. Results Fifty of 52 (96%) health care facilities were equipped with a pharmaceutical depot selling syringes and needles, 37 (74%) of which had been established between 1995 and 2000. Of 50 pharmaceutical depots, 96% had single-use 5 ml syringes available. At all facilities, patients were buying syringes and needles out of the depot for their injections prescribed at the dispensary. While injection devices were available in greater quantities, the proportion of prescriptions including at least one injection remained stable between 1995 (26.5 %) and 2000 (23.8 %). Conclusion The implementation of pharmaceutical depots next to public health care facilities increased geographical access to essential medicines and basic supplies, among which syringes and needles, contributing substantially to safer injection practices in the absence of increased use of therapeutic injections. PMID:16364178

  19. Health Promotion and Healthier Products Increase Vending Purchases: A Randomized Factorial Trial.

    PubMed

    Hua, Sophia V; Kimmel, Lisa; Van Emmenes, Michael; Taherian, Rafi; Remer, Geraldine; Millman, Adam; Ickovics, Jeannette R

    2017-07-01

    The current food environment has a high prevalence of nutrient-sparse foods and beverages, most starkly seen in vending machine offerings. There are currently few studies that explore different interventions that might lead to healthier vending machine purchases. To examine how healthier product availability, price reductions, and/or promotional signs affect sales and revenue of snack and beverage vending machines. A 2×2×2 factorial randomized controlled trial was conducted. Students, staff, and employees on a university campus. All co-located snack and beverage vending machines (n=56, 28 snack and 28 beverage) were randomized into one of eight conditions: availability of healthier products and/or 25% price reduction for healthier items and/or promotional signs on machines. Aggregate sales and revenue data for the 5-month study period (February to June 2015) were compared with data from the same months 1 year prior. Analyses were conducted July 2015. The change in units sold and revenue between February through June 2014 and 2015. Linear regression models (main effects and interaction effects) and t test analyses were performed. The interaction between healthier product guidelines and promotional signs in snack vending machines documented increased revenue (P<0.05). Beverage machines randomized to meet healthier product guidelines documented increased units sold (P<0.05) with no revenue change. Price reductions alone had no effect, nor were there any effects for the three-way interaction of the factors. Examining top-selling products for all vending machines combined, pre- to postintervention, we found an overall shift to healthier purchasing. When healthier vending snacks are available, promotional signs are also important to ensure consumers purchase those items in greater amounts. Mitigating potential loss in profits is essential for sustainability of a healthier food environment. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  20. Needle syringe programmes and opioid substitution therapy for preventing hepatitis C transmission in people who inject drugs

    PubMed Central

    Platt, Lucy; Minozzi, Silvia; Reed, Jennifer; Vickerman, Peter; Hagan, Holly; French, Clare; Jordan, Ashly; Degenhardt, Louisa; Hope, Vivian; Hutchinson, Sharon; Maher, Lisa; Palmateer, Norah; Taylor, Avril; Bruneau, Julie; Hickman, Matthew

    2017-01-01

    Background Needle syringe programmes and opioid substitution therapy for preventing hepatitis C transmission in people who inject drugs Needle syringe programmes (NSP) and opioid substitution therapy (OST) are the primary interventions to reduce hepatitis C (HCV) transmission in people who inject drugs. There is good evidence for the effectiveness of NSP and OST in reducing injecting risk behaviour and increasing evidence for the effectiveness of OST and NSP in reducing HIV acquisition risk, but the evidence on the effectiveness of NSP and OST for preventing HCV acquisition is weak. Objectives To assess the effects of needle syringe programmes and opioid substitution therapy, alone or in combination, for preventing acquisition of HCV in people who inject drugs. Search methods We searched the Cochrane Drug and Alcohol Register, CENTRAL, the Cochrane Database of Systematic Reviews (CDSR), the Database of Abstracts of Reviews of Effects (DARE), the Health Technology Assessment Database (HTA), the NHS Economic Evaluation Database (NHSEED), MEDLINE, Embase, PsycINFO, Global Health, CINAHL, and the Web of Science up to 16 November 2015. We updated this search in March 2017, but we have not incorporated these results into the review yet. Where observational studies did not report any outcome measure, we asked authors to provide unpublished data. We searched publications of key international agencies and conference abstracts. We reviewed reference lists of all included articles and topic-related systematic reviews for eligible papers. Selection criteria We included prospective and retrospective cohort studies, cross-sectional surveys, case-control studies and randomised controlled trials that measured exposure to NSP and/or OST against no intervention or a reduced exposure and reported HCV incidence as an outcome in people who inject drugs. We defined interventions as current OST (within previous 6 months), lifetime use of OST and high NSP coverage (regular attendance at an NSP or all injections covered by a new needle/syringe) or low NSP coverage (irregular attendance at an NSP or less than 100% of injections covered by a new needle/syringe) compared with no intervention or reduced exposure. Data collection and analysis We followed the standard Cochrane methodological procedures incorporating new methods for classifying risk of bias for observational studies. We described study methods against the following 'Risk of bias' domains: confounding, selection bias, measurement of interventions, departures from intervention, missing data, measurement of outcomes, selection of reported results; and we assigned a judgment (low, moderate, serious, critical, unclear) for each criterion. Main results We identified 28 studies (21 published, 7 unpublished): 13 from North America, 5 from the UK, 4 from continental Europe, 5 from Australia and 1 from China, comprising 1817 incident HCV infections and 8806.95 person-years of follow-up. HCV incidence ranged from 0.09 cases to 42 cases per 100 person-years across the studies. We judged only two studies to be at moderate overall risk of bias, while 17 were at serious risk and 7 were at critical risk; for two unpublished datasets there was insufficient information to assess bias. As none of the intervention effects were generated from RCT evidence, we typically categorised quality as low. We found evidence that current OST reduces the risk of HCV acquisition by 50% (risk ratio (RR) 0.50, 95% confidence interval (CI) 0.40 to 0.63, I2 = 0%, 12 studies across all regions, N = 6361), but the quality of the evidence was low. The intervention effect remained significant in sensitivity analyses that excluded unpublished datasets and papers judged to be at critical risk of bias. We found evidence of differential impact by proportion of female participants in the sample, but not geographical region of study, the main drug used, or history of homelessness or imprisonment among study samples. Overall, we found very low-quality evidence that high NSP coverage did not reduce risk of HCV acquisition (RR 0.79, 95% CI 0.39 to 1.61) with high heterogeneity (I2 = 77%) based on five studies from North America and Europe involving 3530 participants. After stratification by region, high NSP coverage in Europe was associated with a 76% reduction in HCV acquisition risk (RR 0.24, 95% CI 0.09 to 0.62) with less heterogeneity (I2 =0%). We found low-quality evidence of the impact of combined high coverage of NSP and OST, from three studies involving 3241 participants, resulting in a 74% reduction in the risk of HCV acquisition (RR 0.26 95% CI 0.07 to 0.89). Authors' conclusions OST is associated with a reduction in the risk of HCV acquisition, which is strengthened in studies that assess the combination of OST and NSP. There was greater heterogeneity between studies and weaker evidence for the impact of NSP on HCV acquisition. High NSP coverage was associated with a reduction in the risk of HCV acquisition in studies in Europe. Interventions for reducing hepatitis C infection in people who inject drugs Review question We examine research on the effect of needle syringe programmes (NSP) and opioid substitution treatment (OST) in reducing the risk of becoming infected with the hepatitis C virus. Background There are around 114.9 million people living with hepatitis C and 3 to 4 million people newly infected each year. The main risk for becoming infected is sharing used needles/syringes. Almost half the people who inject drugs have hepatitis C. The provision of sterile injecting equipment through NSPs reduces the need for sharing equipment when preparing and injecting drugs. OST is taken orally and reduces frequency of injection and unsafe injecting practices. We examined whether NSP and OST, provided alone or together, are effective in reducing the chances of becoming infected with hepatitis C in people who inject drugs. Search date The evidence is current to November 2015. Study characteristics We identified 28 research studies across Europe, Australia, North America and China. On average across the studies, the rate of new hepatitis C infections per year was 19.0 for every 100 people. Data from 11,070 people who inject drugs who were not infected with hepatitis C at the start of the study were combined in the analysis. Of the sample, 32% were female, 50% injected opioids, 51% injected daily, and 40% had been homeless. Our study was funded by the National Institute of Health Research's (NIHR) Public Health Research Programme, the Health Protection Research Unit in Evaluation of Interventions, and the European Commission Drug Prevention and Information Programme (DIPP), Treatment as Prevention in Europe: Model Projections. Key results Current use of OST (defined as use at the time of survey or within the previous six months) may reduce risk of acquiring hepatitis C by 50%. We are uncertain whether high coverage NSP (defined as regular attendance at an NSP or all injections being covered by a new needle/syringe) reduces the risk of becoming infected with hepatitis C across all studies globally, but there was some evidence from studies in Europe that high NSP coverage may reduce the risk of hepatitis C infection by 76%. The combined use of high coverage NSP with OST may reduce risk of hepatitis C infection by 74%. Quality of the evidence Quality of evidence ranged from moderate to very low because none of the studies used the gold standard design of randomised controlled trials. PMID:28922449

  1. 10 CFR 431.291 - Scope.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Refrigerated Bottled or Canned Beverage Vending Machines § 431.291 Scope. This subpart specifies test procedures for certain commercial refrigerated bottled or canned beverage vending machines, pursuant to part...

  2. 10 CFR 431.291 - Scope.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Refrigerated Bottled or Canned Beverage Vending Machines § 431.291 Scope. This subpart specifies test procedures for certain commercial refrigerated bottled or canned beverage vending machines, pursuant to part...

  3. Leveraging delay discounting for health: Can time delays influence food choice?

    PubMed

    Appelhans, Bradley M; French, Simone A; Olinger, Tamara; Bogucki, Michael; Janssen, Imke; Avery-Mamer, Elizabeth F; Powell, Lisa M

    2018-07-01

    Delay discounting, the tendency to choose smaller immediate rewards over larger delayed rewards, is theorized to promote consumption of immediately rewarding but unhealthy foods at the expense of long-term weight maintenance and nutritional health. An untested implication of delay discounting models of decision-making is that selectively delaying access to less healthy foods may promote selection of healthier (immediately available) alternatives, even if they may be less desirable. The current study tested this hypothesis by measuring healthy versus regular vending machine snack purchasing before and during the implementation of a 25-s time delay on the delivery of regular snacks. Purchasing was also examined under a $0.25 discount on healthy snacks, a $0.25 tax on regular snacks, and the combination of both pricing interventions with the 25-s time delay. Across 32,019 vending sales from three separate vending locations, the 25-s time delay increased healthy snack purchasing from 40.1% to 42.5%, which was comparable to the impact of a $0.25 discount (43.0%). Combining the delay and the discount had a roughly additive effect (46.0%). However, the strongest effects were seen under the $0.25 tax on regular snacks (53.7%) and the combination of the delay and the tax (50.2%). Intervention effects varied substantially between vending locations. Importantly, time delays did not harm overall vending sales or revenue, which is relevant to the real-world feasibility of this intervention. More investigation is needed to better understand how the impact of time delays on food choice varies across populations, evaluate the effects of time delays on beverage vending choices, and extend this approach to food choices in contexts other than vending machines. ClinicalTrials.gov, NCT02359916. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Promoting the purchase of low-calorie foods from school vending machines: a cluster-randomized controlled study.

    PubMed

    Kocken, Paul L; Eeuwijk, Jennifer; Van Kesteren, Nicole M C; Dusseldorp, Elise; Buijs, Goof; Bassa-Dafesh, Zeina; Snel, Jeltje

    2012-03-01

    Vending machines account for food sales and revenue in schools. We examined 3 strategies for promoting the sale of lower-calorie food products from vending machines in high schools in the Netherlands. A school-based randomized controlled trial was conducted in 13 experimental schools and 15 control schools. Three strategies were tested within each experimental school: increasing the availability of lower-calorie products in vending machines, labeling products, and reducing the price of lower-calorie products. The experimental schools introduced the strategies in 3 consecutive phases, with phase 3 incorporating all 3 strategies. The control schools remained the same. The sales volumes from the vending machines were registered. Products were grouped into (1) extra foods containing empty calories, for example, candies and potato chips, (2) nutrient-rich basic foods, and (3) beverages. They were also divided into favorable, moderately unfavorable, and unfavorable products. Total sales volumes for experimental and control schools did not differ significantly for the extra and beverage products. Proportionally, the higher availability of lower-calorie extra products in the experimental schools led to higher sales of moderately unfavorable extra products than in the control schools, and to higher sales of favorable extra products in experimental schools where students have to stay during breaks. Together, availability, labeling, and price reduction raised the proportional sales of favorable beverages. Results indicate that when the availability of lower-calorie foods is increased and is also combined with labeling and reduced prices, students make healthier choices without buying more or fewer products from school vending machines. Changes to school vending machines help to create a healthy school environment. © 2012, American School Health Association.

  5. A public school district's vending machine policy and changes over a 4-year period: implementation of a national wellness policy.

    PubMed

    Han-Markey, T L; Wang, L; Schlotterbeck, S; Jackson, E A; Gurm, R; Leidal, A; Eagle, K

    2012-04-01

    The school environment has been the focus of many health initiatives over the years as a means to address the childhood obesity crisis. The availability of low-nutrient, high-calorie foods and beverages to students via vending machines further exacerbates the issue of childhood obesity. However, a healthy overhaul of vending machines may also affect revenue on which schools have come to depend. This article describes the experience of one school district in changing the school environment, and the resulting impact on food and beverage vending machines. Observational study in Ann Arbor public schools. The contents and locations of vending machines were identified in 2003 and surveyed repeatedly in 2007. Overall revenues were also documented during this time period. Changes were observed in the contents of both food and beverage vending machines. Revenue in the form of commissions to the contracted companies and the school district decreased. Local and national wellness policy changes may have financial ramifications for school districts. In order to facilitate and sustain school environment change, all stakeholders, including teachers, administrators, students and healthcare providers, should collaborate and communicate on policy implementation, recognizing that change can have negative financial consequences as well as positive, healthier outcomes. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  6. Evaluation of compliance with the self-regulation agreement of the food and drink vending machine sector in primary schools in Madrid, Spain, in 2008.

    PubMed

    Royo-Bordonada, Miguel A; Martínez-Huedo, María A

    2014-01-01

    To evaluate compliance with the self-regulation agreement of the food and drink vending machine sector in primary schools in Madrid, Spain. Cross-sectional study of the prevalence of vending machines in 558 primary schools in 2008. Using the directory of all registered primary schools in Madrid, we identified the presence of machines by telephone interviews and evaluated compliance with the agreement by visiting the schools and assessing accessibility, type of publicity, the products offered and knowledge of the agreement. The prevalence of schools with vending machines was 5.8%. None of the schools reported knowledge of the agreement or of its nutritional guidelines, and most machines were accessible to primary school pupils (79.3%) and packed with high-calorie, low-nutrient-dense foods (58.6%). Compliance with the self-regulation agreement of the vending machines sector was low. Stricter regulation should receive priority in the battle against the obesity epidemic. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  7. [The effect of colored syringes and a colored sheet on the incidence of syringe swaps during anesthetic management].

    PubMed

    Hirabayashi, Yoshihiro; Kawakami, Takayuki; Suzuki, Hideo; Igarashi, Takashi; Saitoh, Kazuhiko; Seo, Norimasa

    2005-09-01

    Syringe swap is an important problem in anesthetic care, causing harm to patients. We examined the effect of colored syringe and a colored sheet on the incidence of syringe swaps during anesthetic management. We determined the color code. The blue-syringe contains local anesthetics; yellow-syringe, sympathomimetic drugs; and white-syringe with a red label fixed opposite the scale, muscle relaxants. The colored sheet displays the photographs of the syringe with drug name, dose and volume. The colored syringe and colored sheet were supplied for use from February 2004. We compared the incidence of syringe swaps during the period from February 2004 to January 2005 with that from February 2003 to January 2004. Although five syringe swaps were recorded from February 2003 to January 2004, in 5901 procedures, we encountered no syringe swaps from February 2004 to January 2005, in 6078 procedures. The colored syringe and colored sheet significantly decreased the incidence of syringe swaps during anesthetic management (P <0.05). The use of the sheet together with colored syringes can prevent syringe swaps during anesthesia.

  8. 31 CFR 11.6 - Terms of permit.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... vending facilities shall be operated in compliance with applicable health, sanitation, and building codes... normal cleaning, maintenance, and repair of the building structure in and adjacent to the vending...

  9. 31 CFR 11.6 - Terms of permit.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... vending facilities shall be operated in compliance with applicable health, sanitation, and building codes... normal cleaning, maintenance, and repair of the building structure in and adjacent to the vending...

  10. 31 CFR 11.6 - Terms of permit.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... vending facilities shall be operated in compliance with applicable health, sanitation, and building codes... normal cleaning, maintenance, and repair of the building structure in and adjacent to the vending...

  11. A qualitative assessment of stakeholder perceptions and socio-cultural influences on the acceptability of harm reduction programs in Tijuana, Mexico

    PubMed Central

    Philbin, Morgan M; Lozada, Remedios; Zúñiga, María Luisa; Mantsios, Andrea; Case, Patricia; Magis-Rodriguez, Carlos; Latkin, Carl A; Strathdee, Steffanie A

    2008-01-01

    Background The Mexico-U.S. border region is experiencing rising rates of blood-borne infections among injection drug users (IDUs), emphasizing the need for harm reduction interventions. Methods We assessed the religious and cultural factors affecting the acceptability and feasibility of three harm reduction interventions – Needle exchange programs (NEPs), syringe vending machines, and safer injection facilities (SIFs) – in Tijuana, Mexico. In-depth qualitative interviews were conducted with 40 community stakeholders to explore cultural and societal-related themes. Results Themes that emerged included Tijuana's location as a border city, family values, and culture as a mediator of social stigma and empathy towards IDUs. Perception of low levels of both awareness and socio-cultural readiness for harm reduction interventions was noted. Religious culture emerged as a theme, highlighting the important role religious leaders play in determining community responses to harm reduction and rehabilitation strategies for IDUs. The influence of religious culture on stakeholders' opinions concerning harm reduction interventions was evidenced by discussions of family and social values, stigma, and resulting policies. Conclusion Religion and politics were described as both a perceived benefit and deterrent, highlighting the need to further explore the overall influences of culture on the acceptability and implementation of harm reduction programs for drug users. PMID:19021899

  12. 76 FR 41265 - Agency Information Collection Activities; Announcement of Office of Management and Budget...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-13

    ...; Restaurant Menu and Vending Machine Labeling: Recordkeeping and Mandatory Third Party Disclosure Under... collection of information entitled ``Restaurant Menu and Vending Machine Labeling: Recordkeeping and...

  13. 10 CFR 431.295 - Units to be tested.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... EQUIPMENT Refrigerated Bottled or Canned Beverage Vending Machines Test Procedures § 431.295 Units to be tested. For each basic model of refrigerated bottled or canned beverage vending machine selected for...

  14. The effect on syringe performance of fluid storage and repeated use: implications for syringe pumps.

    PubMed

    Capes, D F; Herring, D; Sunderland, V B; McMillan, D; McDonald, C

    1996-01-01

    Syringe stiction has been reported to cause syringe pump malfunction, hence the effect on syringe performance of syringe use and the formulations used in the syringe were investigated. The force required for syringe plunger motion (at 2.5 mm min-1), when filled with soybean oil emulsion (SBOE) and with water, and the extraction of silicone oil from syringes by these fluids, were measured for Primo, Talus and Terumo 10 mL, and Terumo 50 mL syringes. The breakloose, average extrusion and maximum force required to maintain plunger motion increased after storage of SBOE for 7 days in all syringes tested (p < 0.05). The storage of water increased the breakloose force of all syringes, but only increased the maximum force of Talus syringes, and both the average extrusion and maximum forces of Terumo 10 mL syringes. The mechanism for this is most likely swelling of the elastomer of the piston due to sorption of fluid. The force was found to increase logarithmically with repeated syringe use. Electrothermal atomization atomic absorption spectroscopy was used to measure the silicone oil content of syringe extractions. Three extractions were performed: repeated flushing, vigorous washing, and storage for 7 days with occasional agitation. Up to 69.4% of the silicone oil present in the syringes was extracted with both water and SBOE when they were stored or washed. In contrast to water, SBOE also extracted the lubricant when the syringe was filled and flushed immediately. If syringes are refilled, stored filled before use, or used over a prolonged period, particularly with a SBOE formulation, syringe striction may occur during infusion with a syringe pump.

  15. The effects of a nutrition education intervention on vending machine sales on a university campus.

    PubMed

    Brown, Mary V; Flint, Matthew; Fuqua, James

    2014-01-01

    To determine the effects of a nutrition information intervention on the vending machine purchases on a college campus. Five high-use vending machines were selected for the intervention, which was conducted in the fall of 2011. Baseline sales data were collected in the 5 machines prior to the intervention. At the time of the intervention, color-coded stickers were placed near each item selection to identify less healthy (red), moderately healthy (yellow), and more healthy (green) snack items. Sales data were collected during the 2-week intervention. Purchases of red- and yellow-stickered foods were reduced in most of the machines; moreover, sales of the green-stickered items increased in all of the machines. The increased purchases of healthier snack options demonstrate encouraging patterns that support more nutritious and healthy alternatives in vending machines.

  16. Predicting pharmacy syringe sales to people who inject drugs: Policy, practice and perceptions.

    PubMed

    Meyerson, Beth E; Davis, Alissa; Agley, Jon D; Shannon, David J; Lawrence, Carrie A; Ryder, Priscilla T; Ritchie, Karleen; Gassman, Ruth

    2018-06-01

    Pharmacies have much to contribute to the health of people who inject drugs (PWID) and to community efforts in HIV and hepatitis C (HCV) prevention through syringe access. However, little is known about what predicts pharmacy syringe sales without a prescription. To identify factors predicting pharmacy syringes sales to PWID. A hybrid staggered online survey of 298 Indiana community pharmacists occurred from July-September 2016 measuring pharmacy policy, practice, and pharmacist perceptions about syringe sales to PWID. Separate bivariate logistical regressions were followed by multivariable logistic regression to predict pharmacy syringe sales and pharmacist comfort dispensing syringes to PWID. Half (50.5%) of Indiana pharmacies sold syringes without a prescription to PWID. Pharmacy syringe sales was strongly associated with pharmacist supportive beliefs about syringe access by PWID and their comfort level selling syringes to PWID. Notably, pharmacies located in communities with high rates of opioid overdose mortality were 56% less likely to sell syringes without a prescription than those in communities with lower rates. Pharmacist comfort dispensing syringes was associated with being male, working at a pharmacy that sold syringes to PWID and one that stocked naloxone, having been asked about syringe access by medical providers, and agreement that PWID should be able to buy syringes without a prescription. As communities with high rates of opioid overdose mortality were less likely to have pharmacies that dispensed syringes to PWID, a concerted effort with these communities and their pharmacies should be made to understand opportunities to increase syringe access. Future studies should explore nuances between theoretical support for syringe access by PWID without a prescription and actual dispensing behaviors. Addressing potential policy conflicts and offering continuing education on non-prescription syringe distribution for pharmacists may improve comfort distributing syringes to PWID, and therefore increase pharmacy syringe sales. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  17. Availability of Vending Machines and School Stores in California Schools.

    PubMed

    Cisse-Egbuonye, Nafissatou; Liles, Sandy; Schmitz, Katharine E; Kassem, Nada; Irvin, Veronica L; Hovell, Melbourne F

    2016-01-01

    This study examined the availability of foods sold in vending machines and school stores in United States public and private schools, and associations of availability with students' food purchases and consumption. Descriptive analyses, chi-square tests, and Spearman product-moment correlations were conducted on data collected from 521 students aged 8 to 15 years recruited from orthodontic offices in California. Vending machines were more common in private schools than in public schools, whereas school stores were common in both private and public schools. The food items most commonly available in both vending machines and school stores in all schools were predominately foods of minimal nutritional value (FMNV). Participant report of availability of food items in vending machines and/or school stores was significantly correlated with (1) participant purchase of each item from those sources, except for energy drinks, milk, fruits, and vegetables; and (2) participants' friends' consumption of items at lunch, for 2 categories of FMNV (candy, cookies, or cake; soda or sports drinks). Despite the Child Nutrition and Women, Infants, and Children (WIC) Reauthorization Act of 2004, FMNV were still available in schools, and may be contributing to unhealthy dietary choices and ultimately to health risks. © 2015, American School Health Association.

  18. Availability of vending machines and school stores in California schools

    PubMed Central

    Liles, Sandy; Schmitz, Katharine E.; Kassem, Nada O.F; Irvin, Veronica L; Hovell, Melbourne F.

    2015-01-01

    Background This study examined the availability of foods sold in vending machines and school stores in US public and private schools, and associations of availability with students' food purchases and consumption. Methods Descriptive analyses, chi-square tests, and Spearman product-moment correlations were conducted on data collected from 521 students aged 8 to15 years recruited from orthodontic offices in California. Results Vending machines were more common in private schools than in public schools, while school stores were common in both private and public schools. The food items most commonly available in both vending machines and school stores in all schools were predominately foods of minimal nutritional value (FMNV). Participant report of availability of food items in vending machines and/or school stores was significantly correlated with: (1) participant purchase of each item from those sources, except for energy drinks, milk, fruits, and vegetables; and (2) participants' friends' consumption of items at lunch, for two categories of FMNV (candy, cookies, or cake; soda or sports drinks). Conclusions Despite the Child Nutrition and WIC reauthorization Act of 2004, FMNV were still available in schools, and may be contributing to unhealthy dietary choices and ultimately to health risks. PMID:26645420

  19. Are products sold in university vending machines nutritionally poor? A food environment audit.

    PubMed

    Grech, Amanda; Hebden, Lana; Roy, Rajshri; Allman-Farinelli, Margaret

    2017-04-01

    (i) To audit the nutritional composition, promotion and cost of products available from vending machines available to young adults; and (ii) to examine the relationship between product availability and sales. A cross-sectional analysis of snacks and beverages available and purchased at a large urban university was conducted between March and September 2014. Sales were electronically tracked for nine months. A total of 61 vending machines were identified; 95% (n = 864) of the available snacks and 49% of beverages (n = 455) were less-healthy items. The mean (SD) nutrient value of snacks sold was: energy 1173 kJ (437.5), saturated fat 5.36 g (3.6), sodium 251 mg (219), fibre 1.56 g (1.29) and energy density 20.16 kJ/g (2.34) per portion vended. There was a strong correlation between the availability of food and beverages and purchases (R 2 = 0.98, P < 0.001). Vending machines market and sell less-healthy food and beverages to university students. Efforts to improve the nutritional quality are indicated and afford an opportunity to improve the diet quality of young adults, a group at risk of obesity. © 2016 Dietitians Association of Australia.

  20. Factors associated with buying and selling syringes among injection drug users in a setting of one of North America's largest syringe exchange programs.

    PubMed

    Kuyper, Laura M; Kerr, Thomas; Li, Kathy; Hogg, Robert S; Tyndall, Mark W; Montaner, Julio S G; Wood, Evan

    2006-01-01

    We performed analyses of syringe buying and syringe selling among Vancouver injection drug users, recruited from May 1996 and followed up between November 2002 and August 2003, in the context of one of North America's largest syringe exchange programs (SEPs). An interviewer-administered questionnaire, approximately 45 minutes in duration, was used to collect information regarding risk factors for HIV infection and sources of sterile syringes. Seventy participants (15%) reported syringe selling and 122 (26%) reported syringe buying. Syringe sellers were more likely to be female, reside in unstable housing, need help injecting, and have visited the SEP at least once weekly. Syringe buyers were more likely to need help injecting, have difficulty finding new syringes, have binged on drugs, and have visited the SEP at least once weekly. Syringe buying most frequently occurred when the SEP was closed.

  1. Not sold here: limited access to legally available syringes at pharmacies in Tijuana, Mexico

    PubMed Central

    2011-01-01

    Background Sterile syringe access is a critical component of HIV prevention programs. Although retail pharmacies provide convenient outlets for syringe access, injection drug users (IDUs) may encounter barriers to syringe purchase even where purchase without a prescription is legal. We sought to obtain an objective measure of syringe access in Tijuana, Mexico, where IDUs report being denied or overcharged for syringes at pharmacies. Methods Trained "mystery shoppers" attempted to buy a 1 cc insulin syringe according to a predetermined script at all retail pharmacies in three Tijuana neighborhoods. The same pharmacies were surveyed by telephone regarding their syringe sales policies. Data on purchase attempts were analyzed using basic statistics to obtain an objective measure of syringe access and compared with data on stated sales policies to ascertain consistency. Results Only 46 (28.4%) of 162 syringe purchase attempts were successful. Leading reasons for unsuccessful attempts were being told that the pharmacy didn't sell syringes (35.3%), there were no syringes in stock (31.0%), or a prescription was required (20.7%). Of 136 pharmacies also surveyed by telephone, a majority (88.2%) reported selling syringes but only one-third (32.5%) had a successful mystery shopper purchase; the majority of unsuccessful purchases were attributed to being told the pharmacy didn't sell syringes. There was similar discordance regarding prescription policies: 74 pharmacies said in the telephone survey that they did not require a prescription for syringes, yet 10 of these pharmacies asked the mystery shopper for a prescription. Conclusions IDUs in Tijuana have limited access to syringes through retail pharmacies and policies and practices regarding syringe sales are inconsistent. Reasons for these restrictive and inconsistent practices must be identified and addressed to expand syringe access, reduce syringe sharing and prevent HIV transmission. PMID:21609471

  2. Not sold here: limited access to legally available syringes at pharmacies in Tijuana, Mexico.

    PubMed

    Pollini, Robin A; Rosen, Perth C; Gallardo, Manuel; Robles, Brenda; Brouwer, Kimberly C; Macalino, Grace E; Lozada, Remedios

    2011-05-24

    Sterile syringe access is a critical component of HIV prevention programs. Although retail pharmacies provide convenient outlets for syringe access, injection drug users (IDUs) may encounter barriers to syringe purchase even where purchase without a prescription is legal. We sought to obtain an objective measure of syringe access in Tijuana, Mexico, where IDUs report being denied or overcharged for syringes at pharmacies. Trained "mystery shoppers" attempted to buy a 1 cc insulin syringe according to a predetermined script at all retail pharmacies in three Tijuana neighborhoods. The same pharmacies were surveyed by telephone regarding their syringe sales policies. Data on purchase attempts were analyzed using basic statistics to obtain an objective measure of syringe access and compared with data on stated sales policies to ascertain consistency. Only 46 (28.4%) of 162 syringe purchase attempts were successful. Leading reasons for unsuccessful attempts were being told that the pharmacy didn't sell syringes (35.3%), there were no syringes in stock (31.0%), or a prescription was required (20.7%). Of 136 pharmacies also surveyed by telephone, a majority (88.2%) reported selling syringes but only one-third (32.5%) had a successful mystery shopper purchase; the majority of unsuccessful purchases were attributed to being told the pharmacy didn't sell syringes. There was similar discordance regarding prescription policies: 74 pharmacies said in the telephone survey that they did not require a prescription for syringes, yet 10 of these pharmacies asked the mystery shopper for a prescription. IDUs in Tijuana have limited access to syringes through retail pharmacies and policies and practices regarding syringe sales are inconsistent. Reasons for these restrictive and inconsistent practices must be identified and addressed to expand syringe access, reduce syringe sharing and prevent HIV transmission.

  3. The syringe gap: an assessment of sterile syringe need and acquisition among syringe exchange program participants in New York City

    PubMed Central

    Heller, Daliah I; Paone, Denise; Siegler, Anne; Karpati, Adam

    2009-01-01

    Background Programmatic data from New York City syringe exchange programs suggest that many clients visit the programs infrequently and take few syringes per transaction, while separate survey data from individuals using these programs indicate that frequent injecting – at least daily – is common. Together, these data suggest a possible "syringe gap" between the number of injections performed by users and the number of syringes they are receiving from programs for those injections. Methods We surveyed a convenience sample of 478 injecting drug users in New York City at syringe exchange programs to determine whether program syringe coverage was adequate to support safer injecting practices in this group. Results Respondents reported injecting a median of 60 times per month, visiting the syringe exchange program a median of 4 times per month, and obtaining a median of 10 syringes per transaction; more than one in four reported reusing syringes. Fifty-four percent of participants reported receiving fewer syringes than their number of injections per month. Receiving an inadequate number of syringes was more frequently reported by younger and homeless injectors, and by those who reported public injecting in the past month. Conclusion To improve syringe coverage and reduce syringe sharing, programs should target younger and homeless drug users, adopt non-restrictive syringe uptake policies, and establish better relationships with law enforcement and homeless services. The potential for safe injecting facilities should be explored, to address the prevalence of public injecting and resolve the 'syringe gap' for injecting drug users. PMID:19138414

  4. 7 CFR 503.9 - Soliciting, vending, debt collection, and distribution of handbills.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.9..., commercial soliciting and vending of all kinds, the display or distribution of commercial advertising, or the...

  5. Effects of promotional materials on vending sales of low-fat items in teachers' lounges.

    PubMed

    Fiske, Amy; Cullen, Karen Weber

    2004-01-01

    This study examined the impact of an environmental intervention in the form of promotional materials and increased availability of low-fat items on vending machine sales. Ten vending machines were selected and randomly assigned to one of three conditions: control, or one of two experimental conditions. Vending machines in the two intervention conditions received three additional low-fat selections. Low-fat items were promoted at two levels: labels (intervention I), and labels plus signs (intervention II). The number of individual items sold and the total revenue generated was recorded weekly for each machine for 4 weeks. Use of promotional materials resulted in a small, but not significant, increase in the number of low-fat items sold, although machine sales were not significantly impacted by the change in product selection. Results of this study, although not statistically significant, suggest that environmental change may be a realistic means of positively influencing consumer behavior.

  6. The Availability of Competitive Foods and Beverages to Middle School Students in Appalachian Virginia Before Implementation of the 2014 Smart Snacks in School Standards.

    PubMed

    Mann, Georgianna; Kraak, Vivica; Serrano, Elena

    2015-09-17

    The study objective was to examine the nutritional quality of competitive foods and beverages (foods and beverages from vending machines and à la carte foods) available to rural middle school students, before implementation of the US Department of Agriculture's Smart Snacks in School standards in July 2014. In spring 2014, we audited vending machines and à la carte cafeteria foods and beverages in 8 rural Appalachian middle schools in Virginia. Few schools had vending machines. Few à la carte and vending machine foods met Smart Snacks in School standards (36.5%); however, most beverages did (78.2%). The major challenges to meeting standards were fat and sodium content of foods. Most competitive foods (62.2%) did not meet new standards, and rural schools with limited resources will likely require assistance to fully comply.

  7. Barriers to Pharmacy-Based Syringe Purchase Among Injection Drug Users in Tijuana, Mexico: A Mixed Methods Study

    PubMed Central

    Lozada, Remedios; Gallardo, Manuel; Rosen, Perth; Vera, Alicia; Macias, Armando; Palinkas, Lawrence A.; Strathdee, Steffanie A.

    2010-01-01

    Injection drug users (IDUs) may be denied purchase of sterile syringes even where purchase without a prescription is legal. This study examined barriers to over-the-counter (OTC) syringe purchase among IDUs in Tijuana, Mexico. A quantitative survey and subsequent focus groups were used to quantify barriers to purchase, identify their correlates and provide in-depth exploration of syringe purchase experiences. Of 627 IDUs, 81% purchased a syringe in the past 6 months and 16% were refused or overcharged. Factors independently associated with refusal/overcharging were homelessness, receptive syringe sharing, >5 uses per syringe, and number of lifetime abscesses. Few pharmacies sold syringes to IDUs, who adapted by limiting purchase attempts to pharmacies known to sell syringes consistently. Failed purchases occurred when drug withdrawal required purchase at unusual times or locations, often following release from jail. IDUs reported syringe sharing, syringe reuse, and searching through unsecured medical waste for syringes in response to failed purchase attempts. Interventions to expand OTC syringe sales to IDUs, particularly near detention facilities, will facilitate safer injection practices. PMID:20300820

  8. 76 FR 32215 - Agency Information Collection Activities; Announcement of Office of Management and Budget...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-03

    ...; Restaurant Menu and Vending Machine Labeling; Registration for Small Chains Under Section 4205 of the Patient... ``Restaurant Menu and Vending Machine Labeling: Registration for Small Chains Under Section 4205 of the Patient...

  9. ENERGY STAR Certified Vending Machines

    EPA Pesticide Factsheets

    Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Refrigerated Beverage Vending Machines that are effective as of March 1, 2013. A detailed listing of key efficiency criteria are available at

  10. Syringe Disposal Among Injection Drug Users in San Francisco

    PubMed Central

    Martinez, Alexis N.; Carpenter, Lisa; Geckeler, Dara; Colfax, Grant; Kral, Alex H.

    2011-01-01

    To assess the prevalence of improperly discarded syringes and to examine syringe disposal practices of injection drug users (IDUs) in San Francisco, we visually inspected 1000 random city blocks and conducted a survey of 602 IDUs. We found 20 syringes on the streets we inspected. IDUs reported disposing of 13% of syringes improperly. In multivariate analysis, obtaining syringes from syringe exchange programs was found to be protective against improper disposal, and injecting in public places was predictive of improper disposal. Few syringes posed a public health threat. PMID:20466956

  11. Warming of infusion syringes caused by electronic syringe pumps.

    PubMed

    Cornelius, A; Frey, B; Neff, T A; Gerber, A C; Weiss, M

    2003-05-01

    To evaluate inadvertent warming of the infusion syringe in four different types of electronic syringe pumps. Ambient temperature and syringe surface temperature were simultaneously measured by two electronic temperature probes in four different models of commercially available syringe pumps. Experiments were performed at an infusion rate of 1 ml h(-1) using both battery-operated and main power-operated pumps. Measurements were repeated four times with two pumps from each of the four syringe pump types at a room temperature of approximately 23 degrees C. Differences among the four syringe pump brands regarding ambient to syringe temperature gradient were compared using ANOVA. A P-value of less than 0.05 was considered statistically significant. Syringe warming differed significantly between the four syringe brands for both the battery-operated and main power-operated mode (ANOVA, P< 0.001 for both modes). Individual differences between syringe surface and ambient temperature ranged from 0.3 to 1.9 degrees C for battery operation and from 0.5 to 11.2 degrees C during main-power operation. Infusion solutions can be significantly warmed by syringe pumps. This has potential impact on bacterial growth and the stability of drug solutions and blood products infused, as well as on the susceptibility to hydrostatic pressure changes within the infusion syringe.

  12. 31 CFR 11.7 - Enforcement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... management official in an attempt to resolve the issue. ... 11.7 Money and Finance: Treasury Office of the Secretary of the Treasury OPERATION OF VENDING... to the operation of the vending facility in an informal manner with the participation of the blind...

  13. Fundamental Study about the Landscape Estimation and Analysis by CG

    NASA Astrophysics Data System (ADS)

    Nakashima, Yoshio; Miyagoshi, Takashi; Takamatsu, Mamoru; Sassa, Kazuhiro

    In recent years, the color of advertising signboards or vending machines on the streets should be harmonized with the surrounding landscape. In this study, we investigated how the colors (red and white) of the vending machines virtually installed by CG would affect the traditional landscape. 20 subjects estimated landscape samples in Hida-Furukawa by the SD technique. The result of our experiment shows that the vending machines have great influence on the surrounding landscape. On the other hand, we have confirmed that they can harmonize with the circumference landscape by the color to use.

  14. Bacteriological quality of drinks from vending machines.

    PubMed Central

    Hunter, P. R.; Burge, S. H.

    1986-01-01

    A survey on the bacteriological quality of both drinking water and flavoured drinks from coin-operated vending machines is reported. Forty-four per cent of 25 drinking water samples examined contained coliforms and 84% had viable counts of greater than 1000 organisms ml at 30 degrees C. Thirty-one flavoured drinks were examined; 6% contained coliforms and 39% had total counts greater than 1000 organisms ml. It is suggested that the D.H.S.S. code of practice on coin-operated vending machines is not being followed. It is also suggested that drinking water alone should not be dispensed from such machines. PMID:3794325

  15. Associations between parental limits, school vending machine purchases, and soft drink consumption among Kentucky middle school students.

    PubMed

    Nickelson, Jen; Roseman, Mary G; Forthofer, Melinda S

    2010-01-01

    To examine associations between parental limits on soft drinks and purchasing soft drinks from school vending machines and consuming soft drinks among middle school students. Secondary analysis of cross-sectional data from the middle school Youth Risk Behavior Survey. Eight public middle schools in central Kentucky. All sixth- through eighth-grade students in 7 schools and all eighth-grade students in 1 school (n = 4,049). Self-reported parental limits on soft drink intake, school vending machine soft drink purchases, soft drink consumption, and control variables. Chi-square and binary logistic regression analyses. Compared to students with no parental limits on soft drink consumption, students with the strictest limits were less likely to purchase soft drinks from school vending machines and consume soft drinks; conversely, students with minor parental limitations were more likely to consume soft drinks. The odds of consuming soft drinks were nearly 4 times greater when students purchased soft drinks from school vending machines than when they did not. Further research may enhance understanding of the influence of varying degrees of parental limitations. Efforts to reduce children's soft drink consumption may be augmented by policies limiting soft drink purchases in schools. Copyright 2010 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

  16. Spatio-temporal outbreaks of campylobacteriosis and the role of fresh-milk vending machines in the Czech Republic: A methodological study.

    PubMed

    Marek, Lukáš; Pászto, Vít

    2017-11-08

    Inspired by local outbreaks of campylobacteriosis in the Czech Republic in 2010 linked to the debate about alleged health risks of the raw milk consumption, a detailed study was carried out. Firstly, scanning was utilised to identify spatio-temporal clusters of the disease from 2008 to 2012. Then a spatial method (geographical profiling originally developed for criminology) served as assessment in selecting fresh-milk vending machines that could have contributed to some of the local campylobacteriosis outbreaks. Even though an area of increased relative risk of the disease was identified in the affected city of České Budějovice during January and February 2010, geoprofiling did not identify any vending machines in the area as the potential source. However, possible sources in some nearby cities were suggested. Overall, 14 high-rate clusters including the localisation of 9% of the vending machines installed in the Czech Republic were found in the period 2008-2012. Although the vending machines are subject to strict hygiene standards and regular testing, a potential link between a small number of them and the spatial distribution of campylobacteriosis has been detected in the Czech Republic. This should be taken into account in public health research of the disease.

  17. A systematic literature review of nutrition interventions in vending machines that encourage consumers to make healthier choices.

    PubMed

    Grech, A; Allman-Farinelli, M

    2015-12-01

    Internationally, vending machines are scrutinized for selling energy-dense nutrient-poor foods and beverages, and the contribution to overconsumption and subsequent risk of obesity. The aim of this review is to determine the efficacy of nutrition interventions in vending machine in eliciting behaviour change to improve diet quality or weight status of consumers. Electronic databases Cochrane, EMBASE, CINAHL, Science Direct and PubMed were searched from inception. (i) populations that have access to vending machines; (ii) nutrition interventions; (iii) measured outcomes of behaviour change (e.g. sales data, dietary intake or weight change); and (iv) experimental trials where controls were not exposed to the intervention. Risk of bias was assessed independently by two researchers, and higher quality research formed the basis of this qualitative review. Twelve articles from 136 searched were included for synthesis. Intervention settings included schools, universities and workplaces. Reducing price or increasing the availability increased sales of healthier choices. The results of point-of-purchase nutrition information interventions were heterogeneous and when measured changes to purchases were small. This review offers evidence that pricing and availability strategies are effective at improving the nutritional quality foods and beverages purchased from vending machines. Evidence on how these interventions alter consumer's overall diet or body mass index is needed. © 2015 World Obesity.

  18. Recovering Infectious HIV from Novel Syringe-Needle Combinations with Low Dead Space Volumes.

    PubMed

    Abdala, Nadia; Patel, Amisha; Heimer, Robert

    This study determines if detachable syringe-needle combinations redesigned to reduce their dead space volume may substantially reduce the burden of exposure to infectious HIV among people who inject drugs. Two novel, low dead space (LDS) syringe-needle designs-one added a piston to the plunger (LDS syringe) and the other added a filler to the needle (LDS needle) to reduce their dead space-were compared to standard detachable needle-syringe combinations and to syringes with fixed needles. LDS and standard syringes attached to LDS and standard needles of 23-, 25-, and 27-gauge size were contaminated with HIV-infected blood in the laboratory. The proportion of syringe-needle combinations containing infectious HIV was analyzed after syringes were (1) stored up to 7 days at 22°C or (2) rinsed with water. Detachable syringes attached to 25-gauge needles yielded comparable proportions of syringes with infectious HIV, whether the needle was standard or LDS. Among needles of greater diameter (23 gauge), LDS needles tended to reduce recoverable HIV to a greater extent than standard needles. Syringes with fixed needles showed superior results to LDS syringes attached to needles of equivalent diameter and were less likely to get clogged by blood. Detachable LDS syringe-needle designs must be recommended with caution since they still pose potential risk for HIV transmission. Distribution of LDS syringes and needles must be accompanied by recommendations and instructions for their proper rinsing and disinfection in order to reduce viral burden and chances of needle clogging.

  19. Safety syringes and anti-needlestick devices in orthopaedic surgery.

    PubMed

    Sibbitt, Wilmer L; Band, Philip A; Kettwich, Lawrence G; Sibbitt, Cristina R; Sibbitt, Lori J; Bankhurst, Arthur D

    2011-09-07

    The American Academy of Orthopaedic Surgery (AAOS), The Joint Commission, the Occupational Safety and Health Administration (OSHA), and the Needlestick Safety and Prevention Act encourage the integration of safety-engineered devices to prevent needlestick injuries to health-care workers and patients. We hypothesized that safety syringes and needles could be used in outpatient orthopaedic injection and aspiration procedures. The study investigated the orthopaedic uses and procedural idiosyncrasies of safety-engineered devices, including (1) four safety needles (Eclipse, SafetyGlide, SurGuard, and Magellan), (2) a mechanical safety syringe (RPD), (3) two automatic retractable syringes (Integra, VanishPoint), (4) three manual retractable syringes (Procedur-SF, Baksnap, Invirosnap), and (5) three shielded syringes (Safety-Lok, Monoject, and Digitally Activated Shielded [DAS] Syringe). The devices were first tested ex vivo, and then 1300 devices were used for 425 subjects undergoing outpatient arthrocentesis, intra-articular injections, local anesthesia, aspiration biopsy, and ultrasound-guided procedures. During the clinical observation, there were no accidental needlesticks (0 needlesticks per 1300 devices). Safety needles could be successfully used on a Luer syringe but were limited to ≤1.5 in (≤3.81 cm) in length and the shield could interfere with sonography. The mechanical safety syringes functioned well in all orthopaedic procedures. Automatic retractable syringes were too small for arthrocentesis of the knee, and the plunger blew out and prematurely collapsed with high-pressure injections. The manual retractable syringes and shielded syringes could be used with conventional needles for most orthopaedic procedures. The most effective and reliable safety devices for orthopaedic syringe procedures are shielded safety needles, mechanical syringes, manual retractable syringes, and shielded syringes, but not automatic retractable syringes. Even when adopting safety-engineered devices for an orthopaedic clinic, conventional syringes larger than 20 mL and conventional needles longer than 1.5 in (3.8 cm) are necessary.

  20. Defense Logistics: Space-Available Travel Challenges May Be Exacerbated If Eligibility Expands

    DTIC Science & Technology

    2012-09-10

    space-available travelers’ use of terminal facilities results in additional maintenance costs for waiting areas, restrooms, and vending machines ...additional required maintenance. For example, additional travelers’ use of waiting areas, restrooms, and vending machines in the terminals could require

  1. Over-the-counter but out of reach: a pharmacy-based survey of OTC syringe sales in Tijuana, Mexico.

    PubMed

    Pollini, Robin A; Gallardo, Manuel; Ruiz, Serena; Case, Patricia; Zaller, Nickolas; Lozada, Remedios

    2014-05-01

    Sterile syringe access is critical to HIV prevention efforts targeting injection drug users (IDUs) but some pharmacies do not sell syringes over-the-counter (OTC) even where such sales are legal. We conducted a pharmacy survey in Tijuana, Mexico (where OTC sales are legal) to characterize attitudes toward syringe sales and to explore support for expanding pharmacy-based HIV prevention efforts. Of 203 respondents, 28% supported OTC syringe sales to IDUs and 74% said their pharmacy required a prescription for at least some syringe sales. Support for OTC syringe sales was independently associated with selling OTC syringes, understanding the role of sterile syringes in HIV prevention, and recognizing pharmacies as an important health resource for IDUs. Most respondents supported an expanded role for pharmacies in HIV prevention, exclusive of OTC syringe sales. Our study provides information for developing interventions to promote OTC syringe sales and expanding pharmacy-based distribution of HIV-related information and resources.

  2. Options for reducing HIV transmission related to the dead space in needles and syringes.

    PubMed

    Zule, William A; Pande, Poonam G; Otiashvili, David; Bobashev, Georgiy V; Friedman, Samuel R; Gyarmathy, V Anna; Des Jarlais, Don C

    2018-01-15

    When shared by people who inject drugs, needles and syringes with different dead space may affect the probability of HIV and hepatitis C virus (HCV) transmission differently. We measured dead space in 56 needle and syringe combinations obtained from needle and syringe programs across 17 countries in Europe and Asia. We also calculated the amounts of blood and HIV that would remain in different combinations following injection and rinsing. Syringe barrel capacities ranged from 0.5 to 20 mL. Needles ranged in length from 8 to 38 mm. The average dead space was 3 μL in low dead space syringes with permanently attached needles, 13 μL in high dead space syringes with low dead space needles, 45 μL in low dead space syringes with high dead space needles, and 99 μL in high dead space syringes with high dead space needles. Among low dead space designs, calculated volumes of blood and HIV viral burden were lowest for low dead space syringes with permanently attached needles and highest for low dead space syringes with high dead space needles. The dead space in different low dead space needle and syringe combinations varied substantially. To reduce HIV transmission related to syringe sharing, needle and syringe programs need to combine this knowledge with the needs of their clients.

  3. Logistics management in Universal Immunisation Programme.

    PubMed

    Bachani, D; Bansal, R D

    1990-01-01

    The review of the National Immunization Programme of India in 1989 focused attention to the issue of storage and distribution of vaccines. Cold-chain equipment such as walk-in-coolers (WICs), deep freezers, ice-lined refrigerators (ILRs), and vaccine carriers proliferated after the introduction of the universal immunization program (UIP) but the available units fell short of the official targets in 1988, especially ILRs (7500 proposed and 2876 available) and vaccine carriers (250,000 proposed and 35,500 available). Some states had over 6 months of supplies of vaccines whose management posed problems of losing potency: oral polio virus (OPV) potency was acceptable in 63% of stock in 1988. Syringes, needles, stoves, pressure-cooker sterilizers, dial thermometers, and refrigerator repair kits were in short supply especially at the primary health care (PHC) level. Only 1/3 of subcenters had sterilizers and 58% had vaccines carriers. Logistics management on the state level required provision of vaccines based on previous use and eligible population with even distribution throughout the year. On the district level WICs were needed for every district with 1.5 million inhabitants. Recording of vaccine requirement, utilization, and storage would aid target allocations and avoid wastage. On the institutional and PHC level an ILR and a transporting vehicle was needed. The number of women and children eligible for immunization had to be calculated based on real population figures. Cold-chain capacity of 30,000-40,000 vials was required for a district as well as about 500 reusable syringes and needles a year along with vaccination cards exceeding the number of women and children by 10% for recordkeeping at the PHC center.

  4. Feasibility of reaching world health organization targets for hepatitis C and the cost-effectiveness of alternative strategies.

    PubMed

    Wisløff, T; White, R; Dalgard, O; Amundsen, E J; Meijerink, H; Kløvstad, H

    2018-04-06

    New drugs for treating hepatitis C have considerably increased the probability of being cured. Treatment uptake, however, is still low. The objectives of this study were to analyse the impact of initiatives that may increase the proportion of infected people on treatment and interventions aimed at reducing the incidence of new infection among people who inject drugs. A compartmental model for Norway was used to simulate hepatitis C and related complications. We analysed 2 different screening initiatives aimed to increase the proportion of infected people on treatment. Interventions aiming at reducing the hepatitis C incidence analysed were opioid substitution therapy (OST), a clean needle and syringe programme and a combination of both. The most cost-effective strategy for increasing hepatitis C treatment uptake was screening by general practitioners while simultaneously allowing for all infected people to be treated. We estimated that this intervention reduces the incidence of hepatitis C by 2030 by 63% compared with the current incidence. The 2 harm reduction strategies both reduced the incidence of hepatitis C by about 70%. Combining an increase in the current clean needles and syringe programme with OST was clearly the most cost-effective option. This strategy would reduce the incidence of hepatitis C by 80% compared with the current incidence by 2030. Thus, interventions to reduce the burden and spread of hepatitis C are cost-effective. Reaching the WHO target of a 90% reduction in hepatitis C incidence by 2030 may be difficult without combining different initiatives. © 2018 The Authors. Journal of Viral Hepatitis Published by John Wiley & Sons Ltd.

  5. What happens after the implementation of electronic locking devices for adolescents at cigarette vending machines? A natural longitudinal experiment from 2005 to 2009 in Germany.

    PubMed

    Schneider, Sven; Gruber, Johannes; Yamamoto, Shelby; Weidmann, Christian

    2011-08-01

    As of January 01, 2007, electronic locking devices based on proof of age (electronic cash cards or European driving licenses) were installed on 500,000 cigarette vending machines across Germany to restrict the purchase of cigarettes to those over the age of 16 years. In 2009, the age limit was raised to 18 years. The aim of this study was to compare the number of cigarette vending machines and other commercial sources before and after the enactment of the new law and to examine the association between commercial cigarette sources and area socioeconomic status (SES). We recorded and mapped using Geographical Information System software the total number of commercial cigarette sources in 4 selected districts in the major German city of Cologne. The city was the ideal setting for this study as we were able to use existing sociogeographical data from this area. We compiled a complete inventory of commercial cigarette sources in autumn 2005 and 2009. An interim inventory was also completed in 2007. Between 2005 and 2009, the total number of cigarette sources decreased from 369 to 325 within the study area. Although the most obvious reduction was detected in the number of outdoor vending machines (-44%), the number of indoor vending machines also decreased by 5%. In 2005 as well as in 2009, we found significantly fewer commercial cigarette sources in districts with above-average SES than in districts with below-average SES. Although the number of overall cigarette vending machines decreased, the disparity in distribution of cigarette sources between socially advantaged and disadvantaged areas increased.

  6. Disinfection of syringes contaminated with hepatitis C virus by rinsing with household products.

    PubMed

    Binka, Mawuena; Paintsil, Elijah; Patel, Amisha; Lindenbach, Brett D; Heimer, Robert

    2015-01-01

    Background.  Hepatitis C virus (HCV) transmission among people who inject drugs (PWID) is associated with the sharing of injection paraphernalia. People who inject drugs often "disinfect" used syringes with household products when new syringes are unavailable. We assessed the effectiveness of these products in disinfecting HCV-contaminated syringes. Methods.  A genotype-2a reporter virus assay was used to assess HCV infectivity in syringes postrinsing. Hepatitis C virus-contaminated 1 mL insulin syringes with fixed needles and 1 mL tuberculin syringes with detachable needles were rinsed with water, Clorox bleach, hydrogen peroxide, ethanol, isopropanol, Lysol, or Dawn Ultra at different concentrations. Syringes were either immediately tested for viable virus or stored at 4°C, 22°C, and 37°C for up to 21 days before viral infectivity was determined. Results.  Most products tested reduced HCV infectivity to undetectable levels in insulin syringes. Bleach eliminated HCV infectivity in both syringes. Other disinfectants produced virus recovery ranging from high (5% ethanol, 77% ± 12% HCV-positive syringes) to low (1:800 Dawn Ultra, 7% ± 7% positive syringes) in tuberculin syringes. Conclusions.  Household disinfectants tested were more effective in fixed-needle syringes (low residual volume) than in syringes with detachable needles (high residual volume). Bleach was the most effective disinfectant after 1 rinse, whereas other diluted household products required multiple rinses to eliminate HCV. Rinsing with water, 5% ethanol (as in beer), and 20% ethanol (as in fortified wine) was ineffective and should be avoided. Our data suggest that rinsing of syringes with household disinfectants may be an effective tool in preventing HCV transmission in PWID when done properly.

  7. Disinfection of Syringes Contaminated With Hepatitis C Virus by Rinsing With Household Products

    PubMed Central

    Binka, Mawuena; Paintsil, Elijah; Patel, Amisha; Lindenbach, Brett D.; Heimer, Robert

    2015-01-01

    Background. Hepatitis C virus (HCV) transmission among people who inject drugs (PWID) is associated with the sharing of injection paraphernalia. People who inject drugs often “disinfect” used syringes with household products when new syringes are unavailable. We assessed the effectiveness of these products in disinfecting HCV-contaminated syringes. Methods. A genotype-2a reporter virus assay was used to assess HCV infectivity in syringes postrinsing. Hepatitis C virus-contaminated 1 mL insulin syringes with fixed needles and 1 mL tuberculin syringes with detachable needles were rinsed with water, Clorox bleach, hydrogen peroxide, ethanol, isopropanol, Lysol, or Dawn Ultra at different concentrations. Syringes were either immediately tested for viable virus or stored at 4°C, 22°C, and 37°C for up to 21 days before viral infectivity was determined. Results. Most products tested reduced HCV infectivity to undetectable levels in insulin syringes. Bleach eliminated HCV infectivity in both syringes. Other disinfectants produced virus recovery ranging from high (5% ethanol, 77% ± 12% HCV-positive syringes) to low (1:800 Dawn Ultra, 7% ± 7% positive syringes) in tuberculin syringes. Conclusions. Household disinfectants tested were more effective in fixed-needle syringes (low residual volume) than in syringes with detachable needles (high residual volume). Bleach was the most effective disinfectant after 1 rinse, whereas other diluted household products required multiple rinses to eliminate HCV. Rinsing with water, 5% ethanol (as in beer), and 20% ethanol (as in fortified wine) was ineffective and should be avoided. Our data suggest that rinsing of syringes with household disinfectants may be an effective tool in preventing HCV transmission in PWID when done properly. PMID:26034767

  8. Highly controlled vascular syringes for pericardiocentesis.

    PubMed

    Ricciardi, Mark; Roldan, Carlos; Sibbitt, Randy; Sibbitt, Wilmer; Michael, Adrian; Palmer, Dennis

    2010-12-01

    The present study determined the utility and needle control characteristics of highly controlled vascular syringes for image-guided pericardiocentesis. Vascular syringes have been integrated into invasive cardiovascular procedures with improved patient safety, but to date have not been used in pericardiocentesis. To address this issue, we determined the method of use of vascular syringes for pericardiocentesis. A vascular syringe with reciprocating plungers, the reciprocating procedure device (RPD syringe), replaced the corresponding 10 ml and 20 ml conventional syringes in a standard pericardiocentesis tray. The vascular syringe is controlled with one hand, and can either aspirate or inject by pushing the corresponding aspiration or injection plunger. Four hundred and thirty seven subjects underwent vascular syringe procedures. The linear displacement method was used to precisely measure control of the needle tip in millimeters (mm) in vascular syringes compared to conventional syringes in 20 individual operators. Relative to the corresponding 10 ml and 20 ml conventional syringes, vascular syringes significantly reduced unintended forward penetration of the needle tip by 44% (7.0 ± 4.3 mm; p < 0.0001) and 53% (10.1 ± 5.5 mm; p < 0.0001), respectively, and reduced unintended retraction of the needle by 56% (2.7 ± 2.2 mm; p < 0.001) and 60% (3.5 ± 2.5 mm; p < 0.001), respectively. During pericardiocentesis, the mechanical syringe permitted facile one-handed aspiration and maintained the operator's ability to clear the needle. In the 437 vascular syringe procedures, there were no complications, with an estimated cost savings of $10-65 per procedure. Vascular syringes improve needle control in pericardiocentesis, promote patient safety and permit one-handed aspiration and injection.

  9. Who purchases nonprescription syringes? Characterizing customers of the Expanded Syringe Access Program (ESAP).

    PubMed

    Battles, Haven B; Rowe, Kirsten A; Ortega-Peluso, Christina; Klein, Susan J; Tesoriero, James M

    2009-11-01

    This study represents the first attempt in the USA to survey pharmacy nonprescription syringe customers at their point of purchase. We surveyed 62 individuals purchasing nonprescription syringes in seven pharmacies located in NYC and Albany, NY, USA. Three quarters of respondents purchased for illicit use, and 36% purchased for medical use, with differences found by race and gender. Half got their syringes from pharmacies "most of the time." Half had ever been refused a syringe purchase in a NYS pharmacy, with men, Blacks, and Hispanics reporting higher levels of refusals than women or whites. Two thirds reported syringe reuse but very few reported sharing. While approximately one quarter safely obtained and disposed of syringes "most of the time," two thirds used both safe and unsafe methods. Pharmacy-based syringe access programs are essential in areas not served by syringe exchanges.

  10. 46 CFR 386.13 - Soliciting, vending, and debt collection.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Soliciting, vending, and debt collection. 386.13 Section 386.13 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION MISCELLANEOUS REGULATIONS GOVERNING PUBLIC BUILDINGS AND GROUNDS AT THE UNITED STATES MERCHANT MARINE ACADEMY § 386.13 Soliciting...

  11. Insert Coins in Slot.

    ERIC Educational Resources Information Center

    Vail, Kathleen

    1999-01-01

    Despite federal and state regulations prohibiting the sale of nonnutritious foods in competition with school lunch programs, powerful market forces are keeping vending machines in schools. In 1997, schools generated $750 million for the vending machine market. Soft-drink companies are offering million-dollar contracts to some schools. Student…

  12. 34 CFR 395.35 - Terms of permit.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION VENDING FACILITY PROGRAM FOR THE BLIND ON FEDERAL AND OTHER... because of sex, race, age, creed, color, national origin, physical or mental disability, or political... property; and (3) Articles sold at vending facilities operated by blind licensees may consist of newspapers...

  13. Antibiotic Residues in Milk from Three Popular Kenyan Milk Vending Machines.

    PubMed

    Kosgey, Amos; Shitandi, Anakalo; Marion, Jason W

    2018-05-01

    Milk vending machines (MVMs) are growing in popularity in Kenya and worldwide. Milk vending machines dispense varying quantities of locally sourced, pasteurized milk. The Kenya Dairy Board has a regulatory framework, but surveillance is weak because of several factors. Milk vending machines' milk is not routinely screened for antibiotics, thereby increasing potential for antibiotic misuse. To investigate, a total of 80 milk samples from four commercial providers ( N = 25), street vendors ( N = 21), and three MVMs ( N = 34) were collected and screened in Eldoret, Kenya. Antibiotic residue surveillance occurred during December 2016 and January 2017 using Idexx SNAP ® tests for tetracyclines, sulfamethazine, beta-lactams, and gentamicin. Overall, 24% of MVM samples and 24% of street vendor samples were presumably positive for at least one antibiotic. No commercial samples were positive. Research into cost-effective screening methods and increased monitoring by food safety agencies are needed to uphold hazard analysis and critical control point for improving antibiotic stewardship throughout the Kenyan private dairy industry.

  14. The association between the availability of sugar-sweetened beverage in school vending machines and its consumption among adolescents in California: a propensity score matching approach.

    PubMed

    Shi, Lu

    2010-01-01

    There is controversy over to what degree banning sugar-sweetened beverage (SSB) sales at schools could decrease the SSB intake. This paper uses the adolescent sample of 2005 California Health Interview Survey to estimate the association between the availability of SSB from school vending machines and the amount of SSB consumption. Propensity score stratification and kernel-based propensity score matching are used to address the selection bias issue in cross-sectional data. Propensity score stratification shows that adolescents who had access to SSB through their school vending machines consumed 0.170 more drinks of SSB than those who did not (P < .05). Kernel-based propensity score matching shows the SSB consumption difference to be 0.158 on the prior day (P < .05). This paper strengthens the evidence for the association between SSB availability via school vending machines and the actual SSB consumption, while future studies are needed to explore changes in other beverages after SSB becomes less available.

  15. Physician control of needle and syringe during aspiration-injection procedures with the new reciprocating syringe.

    PubMed

    Sibbitt, Wilmer; Sibbitt, Randy R; Michael, Adrian A; Fu, Druce I; Draeger, Hilda T; Twining, Jon M; Bankhurst, Arthur D

    2006-04-01

    To evaluate physician control of needle and syringe during aspiration-injection syringe procedures by comparing the new reciprocating procedure syringe to a traditional conventional syringe. Twenty-six physicians were tested for their individual ability to control the reciprocating and conventional syringes in typical aspiration-injection procedures using a novel quantitative needle-based displacement procedure model. Subsequently, the physicians performed 48 clinical aspiration-injection (arthrocentesis) procedures on 32 subjects randomized to the reciprocating or conventional syringes. Clinical outcomes included procedure time, patient pain, and operator satisfaction. Multivariate modeling methods were used to determine the experimental variables in the syringe control model most predictive of clinical outcome measures. In the model system, the reciprocating syringe significantly improved physician control of the syringe and needle, with a 66% reduction in unintended forward penetration (p < 0.001) and a 68% reduction in unintended retraction (p < 0.001). In clinical arthrocentesis, improvements were also noted: 30% reduction in procedure time (p < 0.03), 57% reduction in patient pain (p < 0.001), and a 79% increase in physician satisfaction (p < 0.001). The variables in the experimental system--unintended forward penetration, unintended retraction, and operator satisfaction--independently predicted the outcomes of procedure time, patient pain, and physician satisfaction in the clinical study (p < or = 0.001). The reciprocating syringe reduces procedure time and patient pain and improves operator satisfaction with the procedure syringe. The reciprocating syringe improves physician performance in both the validated quantitative needle-based displacement model and in real aspiration-injection syringe procedures, including arthrocentesis.

  16. Street vending and informal economy: Survey data from Cali, Colombia.

    PubMed

    Martinez, Lina M; Estrada, Daniela

    2017-10-01

    This data brief describes data collected in Cali, Colombia about the economic dynamic and socioeconomic conditions of street vendors in the city. The study was conducted between 2014 and 2016 in two populated sites in terms of formal and informal commerce in the city. We present the methodology followed in the study, location of street vending sites and type of data collected to approximate to the economic dimension of street vending. Data collected contains information about sociodemographic characteristics, life satisfaction, business operation and characteristics, income and expenses, official license for operation. This information is linked to the publication (Martinez et al., 2017) [1].

  17. Evaluation of Community-Based Policy, Systems, and Environment Interventions Targeting the Vending Machines.

    PubMed

    Garcia, Kristen M; Garney, Whitney R; Primm, Kristin M; McLeroy, Kenneth R

    The American Heart Association conducted policy, systems, and environmental (PSE) focused interventions to increase healthy vending in 8 communities. PSE interventions were assessed using the Nutrition Environment Measures Survey Vending Assessment to see changes in the food environment. Baseline and follow-up assessments were conducted with 3 settings and a total of 19 machines. PSE changes resulted in increased availability of healthy options and decreased unhealthy options. Implementation of PSE interventions targeting the food environment can be an effective method of providing increased access to healthy foods and beverages with the goal of increasing consumption to decrease chronic diseases.

  18. 32 CFR 1903.17 - Soliciting, vending, and debt collection.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.17 Soliciting, vending, and debt collection... 5 CFR parts 110 and 950 as amended and sponsored or approved by the Director of Central Intelligence... compliance with Central Intelligence Agency rules governing the use of such authorized bulletin boards...

  19. 32 CFR 1903.17 - Soliciting, vending, and debt collection.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.17 Soliciting, vending, and debt collection... 5 CFR parts 110 and 950 as amended and sponsored or approved by the Director of Central Intelligence... compliance with Central Intelligence Agency rules governing the use of such authorized bulletin boards...

  20. 32 CFR 1903.17 - Soliciting, vending, and debt collection.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.17 Soliciting, vending, and debt collection... 5 CFR parts 110 and 950 as amended and sponsored or approved by the Director of Central Intelligence... compliance with Central Intelligence Agency rules governing the use of such authorized bulletin boards...

  1. 32 CFR 1903.17 - Soliciting, vending, and debt collection.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.17 Soliciting, vending, and debt collection... 5 CFR parts 110 and 950 as amended and sponsored or approved by the Director of Central Intelligence... compliance with Central Intelligence Agency rules governing the use of such authorized bulletin boards...

  2. 32 CFR 1903.17 - Soliciting, vending, and debt collection.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.17 Soliciting, vending, and debt collection... 5 CFR parts 110 and 950 as amended and sponsored or approved by the Director of Central Intelligence... compliance with Central Intelligence Agency rules governing the use of such authorized bulletin boards...

  3. 31 CFR 700.8 - Soliciting, vending, debt collection and distribution of handbills.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Money and Finance (Continued) FEDERAL LAW ENFORCEMENT TRAINING CENTER, DEPARTMENT OF THE TREASURY REGULATIONS GOVERNING CONDUCT IN OR ON THE FEDERAL LAW ENFORCEMENT TRAINING CENTER (FLETC) BUILDINGS AND... soliciting for charity and contributions, commercial soliciting and vending of all kinds, the display or...

  4. 76 FR 50267 - Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-12

    ... Engineering, Rockwell Engineering, Excel Logistics, and American Food and Vending, Calhoun Spotting Services... Corporation, Conestoga Rovers and Associates, Phillips Engineering, Rockwell Engineering, Excel Logistics, and..., Excel Logistics, and American Food and Vending, Calhoun Spotting Service, and Job World, Inc. working on...

  5. Syringe Disposal among Injection Drug Users in Harlem and the Bronx during the New York State Expanded Syringe Access Demonstration Program

    ERIC Educational Resources Information Center

    Cleland, Charles M.; Deren, Sherry; Fuller, Crystal M.; Blaney, Shannon; McMahon, James M.; Tortu, Stephanie; Des Jarlais, Don C.; Vlahov, David

    2007-01-01

    Effective January 1, 2001, New York State enacted the Expanded Syringe Access Demonstration Program (ESAP), allowing syringes to be sold in pharmacies without a prescription or dispensed through doctors, hospitals, and clinics to adults. A concern in the assessment of ESAP is its effects on syringe disposal practices. Syringe use data regarding…

  6. Pharmacy access to sterile syringes for injection drug users: attitudes of participants in a syringe exchange program.

    PubMed

    Junge, B; Vlahov, D; Riley, E; Huettner, S; Brown, M; Beilenson, P

    1999-01-01

    To examine attitudes of participants of a van-based syringe exchange program (SEP) toward the hypothetical prospect of pharmacy-based syringe access. One-time, cross-sectional survey. Baltimore, Maryland. 206 injection drug users who participate in the Baltimore SEP. Face-to-face interviews. Location preferred for obtaining syringes, drug and syringe use, past experience with pharmacies, and willingness to pay. The sample was 67% men, 95% African American, and 95% unemployed; mean age was 39.8 years. A total of 19% of respondents had bought syringes at a pharmacy during the prior six months. Some 37% reported having been turned down when asking for syringes at a pharmacy, most commonly due to lack of identification to prove diabetic status (50%). If legal restrictions were lifted, 92% of respondents would obtain syringes from pharmacies, and would be willing to pay a mean price of $0.80 (median = $1.00) per syringe. Women were more likely than men to report the intention to switch from van-based SEP to pharmacy (57% versus 38%, p = .045). If current legal restrictions were lifted, pharmacies would be a viable syringe source appealing particularly to women, suggesting gender-specific access issues that should be addressed. The per-syringe price that study participants would be willing to pay exceeds typical retail prices, suggesting that pharmacists could charge enough per syringe to recoup operational costs.

  7. Access to Sterile Syringes through San Francisco Pharmacies and the Association with HIV Risk Behavior among Injection Drug Users

    PubMed Central

    Kral, Alex H.; Stopka, Thomas J.; Garfein, Richard S.; Reuckhaus, Paul; Bluthenthal, Ricky N.

    2010-01-01

    Increased options for syringe acquisition and disposal have been associated with reductions in high-risk behaviors. This study determined the extent of pharmacy uptake in accessing syringes among injection drug users (IDUs) and estimated associations between pharmacy uptake and safer injection/disposal practices. Two years after the implementation of California’s Disease Prevention Demonstration Project, which removed restrictions to non-prescription syringe sales through pharmacies with local authorization, IDUs were recruited through street outreach in San Francisco and interviewed regarding recent syringe acquisition, use, and disposal. The sample of 105 persons included a high proportion of men (67%), people of color (49%), and homeless persons (71%). The most common syringe source was a syringe exchange program (SEP) (80%), with pharmacies being accessed by 39% of respondents. The most commonly cited source of disposal was a SEP (65%), with very few reports of pharmacy disposal (2%). Adjusted analysis showed that unsuccessful attempts to purchase syringes at a pharmacy increased the odds of both injecting with a used syringe and giving away a used syringe. Using a SEP decreased the odds of unsafe injection and disposal practices. Thus, 2 years after the initiation of the California Disease Prevention Demonstration Project, results from this small study suggest that SEPs still provide the majority of syringe distribution and disposal services to San Francisco IDUs; however, pharmacies now augment syringe access. In addition, unsafe injection behavior is reported more often among those who do not use these syringe sources. These results are consistent with prior studies in suggesting that increasing the availability of syringes through SEPs and pharmacies, and developing bridges between them, may further reduce syringe-related risk. PMID:20526690

  8. Comparison of injection drug users accessing syringes from pharmacies, syringe exchange programs, and other syringe sources to inform targeted HIV prevention and intervention strategies

    PubMed Central

    Rudolph, Abby E.; Crawford, Natalie D.; Ompad, Danielle C.; Benjamin, Ebele O.; Stern, Rachel J.; Fuller, Crystal M.

    2011-01-01

    Objective In New York, syringe exchange programs (SEPs) and pharmacies provide syringe access for IDUs but may be unable to meet the needs of all IDUs. This analysis aims to describe IDUs who access syringes through different outlets to help inform the prevention needs of IDUs who under-utilize safe syringe sources in a city where syringe availability is high relative to other U.S. cities. Design Cross-sectional study Setting New York City (2005–2007) Participants 285 IDUs recruited using street-intercept sampling Intervention(s) Not Applicable Main outcome measure(s) IDUs using SEPs, pharmacies, or other outlets as a primary syringe source were compared by sociodemographic characteristics, injection practices and medical service utilization. Results Chi-square tests and polytomous logistic regression were used to compare IDUs with different self-reported primary syringe sources used 6 months prior to study entry. Compared with IDUs using other syringe sources, those using primarily SEPs were less likely to be Black (AOR:0.26 95%CI:0.11–0.57), more likely to inject daily (AOR:3.32; 95%CI:1.58–6.98), and more likely to inject with a new syringe (AOR:2.68; 95%CI:1.30–5.54). Compared with IDUs using other syringe sources, those using primarily pharmacies were less likely to be Black (AOR:0.39; 95%CI0.17–0.90). Conclusion These data suggest that pharmacies and SEPs may be reaching different populations of IDUs and highlight a sub-population of highly marginalized IDUs (Black and infrequent injectors) who are under-utilizing safe syringe sources in New York City. Targeted interventions are needed to reduce racial disparities and increase utilization of safe syringe outlets. PMID:20199954

  9. How does the use of multiple needles/syringes per injecting episode impact on the measurement of individual level needle and syringe program coverage?

    PubMed

    O'Keefe, Daniel; McCormack, Angus; Cogger, Shelley; Aitken, Campbell; Burns, Lucinda; Bruno, Raimondo; Stafford, Jenny; Butler, Kerryn; Breen, Courtney; Dietze, Paul

    2017-08-01

    Recent work by McCormack et al. (2016) showed that the inclusion of syringe stockpiling improves the measurement of individual-level syringe coverage. We explored whether including the use of a new parameter, multiple sterile syringes per injecting episode, further improves coverage measures. Data comes from 838 people who inject drugs, interviewed as part of the 2015 Illicit Drug Reporting System. Along with syringe coverage questions, the survey recorded the number of sterile syringes used on average per injecting episode. We constructed three measures of coverage: one adapted from Bluthenthal et al. (2007), the McCormack et al. measure, and a new coverage measure that included use of multiple syringes. Predictors of multiple syringe use and insufficient coverage (<100% of injecting episodes using a sterile syringe) using the new measure, were tested in logistic regression and the ability of the measures to discriminate key risk behaviours was compared using ROC curve analysis. 134 (16%) participants reported needing multiple syringes per injecting episode. Women showed significantly increased odds of multiple syringe use, as did those reporting injection related injuries/diseases and injecting of opioid substitution drugs or pharmaceutical opioids. Levels of insufficient coverage across the three measures were substantial (20%-28%). ROC curve analysis suggested that our new measure was no better at discriminating injecting risk behaviours than the existing measures. Based on our findings, there appears to be little need for adding a multiple syringe use parameter to existing coverage formulae. Hence, we recommend that multiple syringe use is not included in the measurement of individual-level syringe coverage. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Syringe disposal among injection drug users in Harlem and the Bronx during the New York State Expanded Syringe Access Demonstration Program.

    PubMed

    Cleland, Charles M; Deren, Sherry; Fuller, Crystal M; Blaney, Shannon; McMahon, James M; Tortu, Stephanie; Des Jarlais, Don C; Vlahov, David

    2007-04-01

    Effective January 1, 2001, New York State enacted the Expanded Syringe Access Demonstration Program (ESAP), allowing syringes to be sold in pharmacies without a prescription or dispensed through doctors, hospitals, and clinics to adults. A concern in the assessment of ESAP is its effects on syringe disposal practices. Syringe use data regarding the last injection episode were combined from three projects (N = 1,030) recruiting injection drug users. Disposal of syringes by methods known to be safe decreased significantly over time after the implementation of ESAP. Syringes obtained either from syringe exchange programs or ESAP sources were more likely to be disposed of safely than syringes obtained from other sources. Efforts to enlist pharmacists and others involved in ESAP implementation to encourage safe disposal are needed. More detailed information on disposal practices is needed to capture the continuum from least to most safe practices and variation within individuals.

  11. Comparative evaluation of endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe in obturation of primary teeth: An in vitro study.

    PubMed

    Hiremath, Mallayya C; Srivastava, Pooja

    2016-01-01

    The purpose of this in vitro study was to compare four methods of root canal obturation in primary teeth using conventional radiography. A total of 96 root canals of primary molars were prepared and obturated with zinc oxide eugenol. Obturation methods compared were endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe. The root canal obturations were evaluated by conventional radiography for the length of obturation and presence of voids. The obtained data were analyzed using Chi-square test. The results showed significant differences between the four groups for the length of obturation (P < 0.05). The endodontic pressure syringe showed the best results (98.5% optimal fillings) and jiffy tube showed the poor results (37.5% optimal fillings) for the length of obturation. The insulin syringe (79.2% optimal fillings) and local anesthetic syringe (66.7% optimal fillings) showed acceptable results for the length of root canal obturation. However, minor voids were present in all the four techniques used. Endodontic pressure syringe produced the best results in terms of length of obturation and controlling paste extrusion from the apical foramen. However, insulin syringe and local anesthetic syringe can be used as effective alternative methods.

  12. Nonprescription Syringe Sales: A Missed Opportunity for HIV Prevention in California

    PubMed Central

    Pollini, Robin A.; Rudolph, Abby E.; Case, Patricia

    2014-01-01

    Background California Senate Bill 41 (SB41), effective January 2012, is an HIV prevention measure designed to expand syringe access among injection drug users (IDUs) by allowing pharmacists to sell up to 30 syringes without a prescription. Objective We assessed SB41 implementation in two inland California counties where prevalence of injection drug use is among the highest in the nation. Design Syringe purchase trial. Setting Fresno and Kern counties, California. Participants All retail pharmacies (N=248). Main outcome measure Successful or unsuccessful syringe purchase attempt. Results Only 52 (21.0%) syringe purchase attempts were successful. The proportion of successful attempts did not vary by county or by data collector ethnicity. The most common reasons for unsuccessful syringe purchase attempts were prescription requirements (45.7%), the requested syringe size was not available (10.7%), and the pharmacy did not sell syringes (9.7%). In addition, some syringe purchase attempts (4.1%) were unsuccessful because the data collector was asked to purchase more syringes than allowed by law. Although 80% and 78% of Fresno and Kern residents, respectively, live within a 5-minute drive of a retail pharmacy, less than half live within a 5-minute drive of a pharmacy that sold syringes. Conclusion SB41 has not resulted in broad pharmacy-based syringe access in California's inland counties, where a disproportionate number of HIV/AIDS cases are associated with injection drug use. Additional steps by legislative bodies, regulatory agencies, and professional organizations are needed to actively engage pharmacies in expanding nonprescription syringe sales to reduce HIV transmission among IDUs. PMID:25575149

  13. Access to syringes for HIV prevention for injection drug users in St. Petersburg, Russia: syringe purchase test study

    PubMed Central

    2013-01-01

    Background The HIV epidemic in Russia is concentrated among injection drug users (IDUs). This is especially true for St. Petersburg where high HIV incidence persists among the city’s estimated 80,000 IDUs. Although sterile syringes are legally available, access for IDUs may be hampered. To explore the feasibility of using pharmacies to expand syringe access and provide other prevention services to IDUs, we investigated the current access to sterile syringes at the pharmacies and the correlation between pharmacy density and HIV prevalence in St. Petersburg. Methods 965 pharmacies citywide were mapped, classified by ownership type, and the association between pharmacy density and HIV prevalence at the district level was tested. We selected two districts among the 18 districts – one central and one peripheral – that represented two major types of city districts and contacted all operating pharmacies by phone to inquire if they stocked syringes and obtained details about their stock. Qualitative interviews with 26 IDUs provided data regarding syringe access in pharmacies and were used to formulate hypotheses for the pharmacy syringe purchase test wherein research staff attempted to purchase syringes in all pharmacies in the two districts. Results No correlation was found between the density of pharmacies and HIV prevalence at the district level. Of 108 operating pharmacies, 38 (35%) did not sell syringes of the types used by IDUs; of these, half stocked but refused to sell syringes to research staff, and the other half did not stock syringes at all. Overall 70 (65%) of the pharmacies did sell syringes; of these, 49 pharmacies sold single syringes without any restrictions and 21 offered packages of ten. Conclusions Trainings for pharmacists need to be conducted to reduce negative attitudes towards IDUs and increase pharmacists’ willingness to sell syringes. At a structural level, access to safe injection supplies for IDUs could be increased by including syringes in the federal list of mandatory medical products sold by pharmacies. PMID:23452390

  14. 10 CFR 431.292 - Definitions concerning refrigerated bottled or canned beverage vending machines.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., and functional (or hydraulic) characteristics that affect energy consumption, energy efficiency, water... 10 Energy 3 2012-01-01 2012-01-01 false Definitions concerning refrigerated bottled or canned beverage vending machines. 431.292 Section 431.292 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY...

  15. 10 CFR 431.292 - Definitions concerning refrigerated bottled or canned beverage vending machines.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., and functional (or hydraulic) characteristics that affect energy consumption, energy efficiency, water... 10 Energy 3 2013-01-01 2013-01-01 false Definitions concerning refrigerated bottled or canned beverage vending machines. 431.292 Section 431.292 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY...

  16. 10 CFR 431.292 - Definitions concerning refrigerated bottled or canned beverage vending machines.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., and functional (or hydraulic) characteristics that affect energy consumption, energy efficiency, water... 10 Energy 3 2014-01-01 2014-01-01 false Definitions concerning refrigerated bottled or canned beverage vending machines. 431.292 Section 431.292 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY...

  17. 7 CFR 503.9 - Soliciting, vending, debt collection, and distribution of handbills.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false Soliciting, vending, debt collection, and distribution of handbills. 503.9 Section 503.9 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.9...

  18. 7 CFR 503.9 - Soliciting, vending, debt collection, and distribution of handbills.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false Soliciting, vending, debt collection, and distribution of handbills. 503.9 Section 503.9 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.9...

  19. 7 CFR 503.9 - Soliciting, vending, debt collection, and distribution of handbills.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 false Soliciting, vending, debt collection, and distribution of handbills. 503.9 Section 503.9 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.9...

  20. 7 CFR 503.9 - Soliciting, vending, debt collection, and distribution of handbills.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false Soliciting, vending, debt collection, and distribution of handbills. 503.9 Section 503.9 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.9...

  1. 41 CFR 102-74.70 - Are commercial vendors and nonprofit organizations required to operate vending facilities by...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Are commercial vendors and nonprofit organizations required to operate vending facilities by permit or contractual...

  2. Inclusion of Women in the Randolph-Sheppard Program.

    ERIC Educational Resources Information Center

    Tucker, Angula; Moore, J. Elton

    The Randolph-Sheppard Act of 1936 established the Randolph-Sheppard Vending Facility Program, more commonly known in most states as the Business Enterprise Program (BEP). The BEP is described as a program that provides persons with blindness with remunerative employment and self-support through the operation of vending facilities on federal…

  3. 31 CFR 700.8 - Soliciting, vending, debt collection and distribution of handbills.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Soliciting, vending, debt collection and distribution of handbills. 700.8 Section 700.8 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FEDERAL LAW ENFORCEMENT TRAINING CENTER, DEPARTMENT OF THE TREASURY...

  4. 31 CFR 700.8 - Soliciting, vending, debt collection and distribution of handbills.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Soliciting, vending, debt collection and distribution of handbills. 700.8 Section 700.8 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FEDERAL LAW ENFORCEMENT TRAINING CENTER, DEPARTMENT OF THE TREASURY...

  5. 31 CFR 700.8 - Soliciting, vending, debt collection and distribution of handbills.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Soliciting, vending, debt collection and distribution of handbills. 700.8 Section 700.8 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FEDERAL LAW ENFORCEMENT TRAINING CENTER, DEPARTMENT OF THE TREASURY...

  6. 31 CFR 700.8 - Soliciting, vending, debt collection and distribution of handbills.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Soliciting, vending, debt collection and distribution of handbills. 700.8 Section 700.8 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FEDERAL LAW ENFORCEMENT TRAINING CENTER, DEPARTMENT OF THE TREASURY...

  7. 34 CFR 395.1 - Terms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., DEPARTMENT OF EDUCATION VENDING FACILITY PROGRAM FOR THE BLIND ON FEDERAL AND OTHER PROPERTY Definitions... licensing agency to operate a vending facility on Federal or other property. (c) Blind person means a person... evidenced by a limitation to the field of vision in the better eye to such a degree that its widest diameter...

  8. Availability of Vending Machines and School Stores in California Schools

    ERIC Educational Resources Information Center

    Cisse-Egbuonye, Nafissatou; Liles, Sandy; Schmitz, Katharine E.; Kassem, Nada; Irvin, Veronica L.; Hovell, Melbourne F.

    2016-01-01

    Background: This study examined the availability of foods sold in vending machines and school stores in United States public and private schools, and associations of availability with students' food purchases and consumption. Methods: Descriptive analyses, chi-square tests, and Spearman product-moment correlations were conducted on data collected…

  9. 31 CFR 407.9 - Soliciting, vending, debt collection, and distribution of handbills.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 2 2013-07-01 2013-07-01 false Soliciting, vending, debt collection, and distribution of handbills. 407.9 Section 407.9 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) SECRET SERVICE, DEPARTMENT OF THE TREASURY REGULATIONS GOVERNING CONDUCT...

  10. 31 CFR 407.9 - Soliciting, vending, debt collection, and distribution of handbills.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Soliciting, vending, debt collection, and distribution of handbills. 407.9 Section 407.9 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) SECRET SERVICE, DEPARTMENT OF THE TREASURY REGULATIONS GOVERNING CONDUCT...

  11. 31 CFR 407.9 - Soliciting, vending, debt collection, and distribution of handbills.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Soliciting, vending, debt collection, and distribution of handbills. 407.9 Section 407.9 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) SECRET SERVICE, DEPARTMENT OF THE TREASURY REGULATIONS GOVERNING CONDUCT...

  12. 31 CFR 407.9 - Soliciting, vending, debt collection, and distribution of handbills.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 2 2014-07-01 2014-07-01 false Soliciting, vending, debt collection, and distribution of handbills. 407.9 Section 407.9 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) SECRET SERVICE, DEPARTMENT OF THE TREASURY REGULATIONS GOVERNING CONDUCT...

  13. 31 CFR 407.9 - Soliciting, vending, debt collection, and distribution of handbills.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false Soliciting, vending, debt collection, and distribution of handbills. 407.9 Section 407.9 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) SECRET SERVICE, DEPARTMENT OF THE TREASURY REGULATIONS GOVERNING CONDUCT...

  14. 75 FR 28302 - American Food and Vending Spring Hill, TN; Notice of Negative Determination Regarding Application...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-20

    ... Spring Hill, TN; Notice of Negative Determination Regarding Application for Reconsideration By... negative determination applicable to workers and former workers at American Food and Vending, Spring Hill... eligible for TAA because they are service workers who provided services to General Motors, Spring Hill...

  15. 36 CFR 504.8 - Soliciting, vending, debt collection, and distribution of handbills

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Soliciting, vending, debt collection, and distribution of handbills 504.8 Section 504.8 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND REGULATIONS GOVERNING SMITHSONIAN INSTITUTION BUILDINGS AND GROUNDS § 504.8 Soliciting...

  16. National Apprenticeship and Training Standards for Vending Machine Mechanics.

    ERIC Educational Resources Information Center

    Employment and Training Administration (DOL), Washington, DC.

    This booklet contains national standards for apprentices in vending machine mechanics. The main topic of the booklet, Provisions of Standards, includes the following: definitions of terms used in the booklet, apprenticeship qualifications, a statement on equal opportunity employment, explanation of probation, hours of work, credit for previous…

  17. Can Nutrition Information Increase Sales of Healthful Vended Snacks?

    ERIC Educational Resources Information Center

    Hoerr, Sharon Marshall; Louden, Victoria Ann

    1993-01-01

    A study was made of snack selections from unrefrigerated vending machines in relation to increased availabilty of nutrient-dense snack options and provision of nutrient information at four college sites. When snack options included more nutrient-dense choices, sales dropped. When nutrition information was posted on the machines, sales increased…

  18. 27 CFR 46.166 - Dealing in tobacco products.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... packages, provided the products remain in the packages until removed by the customer or in the presence of the customer. Where a vending machine is used, tobacco products must similarly be vended in proper... consumption in the United States unless such articles are removed from their export packaging and repackaged...

  19. 75 FR 48954 - Arbitration Panel Decision Under the Randolph-Sheppard Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-12

    ... and its implementing regulations concerning the food services at Wright-Patterson Air Force Base in... permit to operate snack and beverage vending machines throughout the Wright-Patterson Air Force Base, and... income from the vending machines at the Wright-Patterson Air Force Base pursuant to the Act and...

  20. Effects of naloxone distribution alone or in combination with addiction treatment with or without pre-exposure prophylaxis for HIV prevention in people who inject drugs: a cost-effectiveness modelling study.

    PubMed

    Uyei, Jennifer; Fiellin, David A; Buchelli, Marianne; Rodriguez-Santana, Ramon; Braithwaite, R Scott

    2017-03-01

    In the USA, an epidemic of opioid overdose deaths is occurring, many of which are from heroin. Combining naloxone distribution with linkage to addiction treatment or pre-exposure prophylaxis (PrEP) for HIV prevention through syringe service programmes has the potential to save lives and be cost-effective. We estimated the outcomes and cost-effectiveness of five alternative strategies: no additional intervention, naloxone distribution, naloxone distribution plus linkage to addiction treatment, naloxone distribution plus PrEP, and naloxone distribution plus linkage to addiction treatment and PrEP. We developed a decision analytical Markov model to simulate opioid overdose, HIV incidence, overdose-related deaths, and HIV-related deaths in people who inject drugs in Connecticut, USA. Model input parameters were derived from published sources. We compared each strategy with no intervention, as well as simultaneously considering all strategies. Sensitivity analysis was done for all variables. Linkage to addiction treatment was referral to an opioid treatment programme for methadone. Endpoints were survival, life expectancy, quality-adjusted life-years (QALYs), number and percentage of overdose deaths averted, number of HIV-related deaths averted, total costs (in 2015 US$) associated with each strategy, and incremental cost per QALY gained. In the base-case analysis, compared with no additional intervention, the naloxone distribution strategy yielded an incremental cost-effectiveness ratio (ICER) of $323 per QALY, and naloxone distribution plus linkage to addiction treatment was cost saving compared with no additional intervention (greater effectiveness and less expensive). The most efficient strategies (ie, those conferring the greatest health benefit for a particular budget) were naloxone distribution combined with linkage to addiction treatment (cost saving), and naloxone distribution combined with PrEP and linkage to addiction treatment (ICER $95 337 per QALY) at a willingness-to-pay threshold of $100 000. In probabilistic sensitivity analysis, the combination of naloxone distribution, PrEP, and linkage to addiction treatment was the optimal strategy in 37% of iterations and the combination of naloxone distribution and linkage to addiction treatment was the optimal strategy in 34% of iterations. Naloxone distribution through syringe service programmes is cost-effective compared with syringe distribution alone, but when combined with linkage to addiction treatment is cost saving compared with no additional services. A strategy that combines naloxone distribution, PrEP, and linkage to addiction treatment results in greater health benefits in people who inject drugs and is also cost-effective. State of Connecticut Department of Public Health and the National Institute of Mental Health. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND license. Published by Elsevier Ltd.. All rights reserved.

  1. Safe syringe disposal is related to safe syringe access among HIV-positive injection drug users.

    PubMed

    Coffin, Phillip O; Latka, Mary H; Latkin, Carl; Wu, Yingfeng; Purcell, David W; Metsch, Lisa; Gomez, Cynthia; Gourevitch, Marc N

    2007-09-01

    We evaluated the effect of syringe acquisition on syringe disposal among HIV-positive injection drug users (IDUs) in Baltimore, New York City, and San Francisco (N = 680; mean age 42 years, 62% male, 59% African-American, 21% Hispanic, 12% White). Independent predictors of safe disposal were acquiring syringes through a safe source and ever visiting a syringe exchange program. Weaker predictors included living in San Francisco, living in the area longer, less frequent binge drinking, injecting with an HIV+ partner, peer norms supporting safe injection, and self-empowerment. Independent predictors of safe "handling"-both acquiring and disposing of syringes safely-also included being from New York and being older. HIV-positive IDUs who obtain syringes from a safe source are more likely to safely dispose; peer norms contribute to both acquisition and disposal. Interventions to improve disposal should include expanding sites of safe syringe acquisition while enhancing disposal messages, alternatives, and convenience.

  2. New York City pharmacists' attitudes toward sale of needles/syringes to injection drug users before implementation of law expanding syringe access.

    PubMed

    Coffin, P O; Linas, B P; Factor, S H; Vlahov, D

    2000-12-01

    In May 2000, New York State passed legislation permitting the sale, purchase, and possession of up to 10 needles and syringes (hereafter "syringes") without a prescription, intended to reduce blood-borne pathogen transmission among injection drug users (IDUs). To obtain baseline data on pharmacists' attitudes and practices related to human immunodeficiency virus (HIV) prevention and IDUs, a telephone survey was administered to 130 pharmacists systematically selected in New York City. Less than half of pharmacists were aware of the new law; 49.6% were willing to or supported providing nonprescription sales of syringes to IDUs. Pharmacists in support tended to be less likely to consider customer appearance "very important." Managing and supervising pharmacists were more likely than staff pharmacists to support syringe sales to IDUs. Managing and supervising pharmacists who stocked packs of 10 syringes and personal sharps disposal containers, pharmacists who supported syringe exchange in the pharmacy, and pharmacists who were willing to sell syringes to diabetics without a prescription were more likely to support syringe sales to IDUs. Syringe disposal was a prominent concern among all pharmacists. Those not in support of syringe sales to IDUs tended to be more likely to believe the practice would increase drug use. These data suggest the need for initiatives to address concerns about syringe disposal and tailored continuing education classes for pharmacists on HIV and viral hepatitis prevention among IDUs.

  3. Barriers to Access to Sterile Syringes as Perceived by Pharmacists and Injecting Drug Users: Implications for Harm Reduction in Lebanon.

    PubMed

    Ghaddar, Ali; Nassar, Karine; Elsoury, Ghadier

    2017-09-19

    Access to sterile syringes to injecting drug users (IDU) reduces sharing behavior and prevents the transmission of HIV. To describe the barriers to access to sterile syringes for IDUs in Lebanon from the perspectives of pharmacists and IDUs. in this qualitative study conducted in Lebanon, data were collected from 72 syringe purchase tests at pharmacies, 64 interviewees with pharmacists and 2 focus groups with injecting drug users. Two independent researchers analyzed the verbatim transcripts. Results revealed that pharmacists often deny access to sterile syringes to IDUs who are frequently stigmatized and intimidated at pharmacies. While no large gender differences in pharmacists' attitudes and practices were observed, inequalities in syringe access were noticed with men IDUs more often denied purchase. Pharmacists had several barriers to sell syringes to IDUs including fear of disease spread, increased drug use, inappropriately discarded syringes, staff and customer safety, and business concerns. IDUs had several challenges to purchase syringes including stigmatization, intimidation, physical harassment, concern to reveal identity, fear of arrest and syringe price abuse. Identifying the barriers to and facilitators of access to sterile syringes to IDUs is important to guide the development of efficient policies. Findings implicate the importance of empowering IDUs to purchase syringes at pharmacies through reducing the negative attitude towards IDUs and strengthening pharmacists' role in the promotion of health of IDUs. Findings also suggest that the habit of syringe sharing would decrease if the legal and cultural barriers to access are reduced.

  4. Nonprescription syringe sales: a missed opportunity for HIV prevention in California.

    PubMed

    Pollini, Robin A; Rudolph, Abby E; Case, Patricia

    2015-01-01

    To assess implementation of California Senate Bill SB41 in two inland California counties where prevalence of injection drug use is among the highest in the nation. Syringe purchase trial. Fresno and Kern counties, California. All 248 community pharmacies in the counties. Successful or unsuccessful syringe purchase attempt. Only 52 (21.0%) syringe purchase attempts were successful. The proportion of successful attempts did not vary by county or by data collector ethnicity. The most common reasons for unsuccessful syringe purchase attempts were prescription requirements (45.7%), the requested syringe size was not available (10.7%), and the pharmacy did not sell syringes (9.7%). In addition, some syringe purchase attempts (4.1%) were unsuccessful because the data collector was asked to purchase more syringes than allowed by law. Although 80% and 78% of Fresno and Kern residents, respectively, live within a 5-minute drive of a community pharmacy, less than one-half live within a 5-minute drive of a community pharmacy that sold syringes. SB41 has not resulted in broad pharmacy-based syringe access in California's inland counties, where a disproportionate number of cases of human immunodeficiency virus (HIV) infections are associated with injection drug use. Additional steps by legislative bodies, regulatory agencies, and professional organizations are needed to actively engage pharmacies in expanding nonprescription syringe sales to reduce HIV transmission among injection drug users.

  5. Efficacy of air/water syringe tip sterilization.

    PubMed

    Inger, M; Bennani, V; Farella, M; Bennani, F; Cannon, R D

    2014-03-01

    Dental procedures involve contact between instruments and the patient's tissues, blood or saliva. This study evaluated the efficacy of the standardized sterilization of non-disposable air/water syringe tips and corrosion and contaminant build-up in these tips. The bacterial contamination of single-use and multiple-use non-disposable air/water syringe tips after routine use and sterilization was compared to that of single-use disposable tips by microbial culturing on PCA and blood agar plates. The effect of flushing the syringe tips prior to sterilization was also measured. The amount of corrosion in single-use and multiple-use non-disposable syringes was measured by SEM and EDS analyses. Non-disposable syringe tips had significantly (p < 0.05) greater bacterial contamination than single-use disposable tips. There were no statistically different levels of contamination between flushed and non-flushed non-disposable syringes or between single-use and multiple-use non-disposable syringes. SEM and EDS analyses showed greater evidence of corrosion and contaminant build-up in multiple-use syringes compared to single-use non-disposable syringes. Sterilization of non-disposable air/water syringes is not completely effective and rinsing, or the number of uses, does not affect the effectiveness of sterilization. There may be a lower risk of cross-infection from the use of disposable air/water syringe tips, instead of non-disposable ones. © 2014 Australian Dental Association.

  6. Syringe possession arrests are associated with receptive syringe sharing in two Mexico-US border cities

    PubMed Central

    Pollini, Robin A.; Brouwer, Kimberly C.; Lozada, Remedios M.; Ramos, Rebeca; Cruz, Michelle F.; Magis-Rodriguez, Carlos; Case, Patricia; Burris, Scott; Pu, Minya; Frost, Simon D. W.; Palinkas, Lawrence A.; Miller, Cari; Strathdee, Steffanie A.

    2008-01-01

    Aims To identify factors associated with receptive syringe sharing among injection drug users (IDUs) and elucidate the association between syringe possession arrests and syringe sharing. Design Cross-sectional study. Setting Mexican border cities of Tijuana, Baja California and Ciudad Juarez, Chihuahua. Participants IDUs in Tijuana (n = 222) and Ciudad Juarez (n = 206) were recruited using respondent-driven sampling (RDS). IDUs were ≥18 years and had injected illicit drugs in the past month. Measurements An interviewer-administered survey was used to collect quantitative data on socio-demographic, behavioral and contextual characteristics, including self-reported syringe sharing and arrests for syringe possession. Associations with receptive syringe sharing were investigated using logistic regression with RDS adjustment. Findings Overall, 48% of participants reported ever being arrested for carrying an unused/sterile syringe, even though syringe purchase and possession is legal in Mexico. Arrest for possessing unused/sterile syringes was associated independently with receptive syringe sharing [adjusted odds ratio (AOR) = 2.05; 95% confidence interval (CI): 1.26, 3.35], as was injecting in a shooting gallery (AOR = 3.60; 95% CI: 2.21, 5.87), injecting in the street (AOR = 2.05; 95% CI: 1.18, 3.54) and injecting methamphetamine (AOR = 2.77; 95% CI: 1.41, 5.47) or cocaine (AOR = 1.96; 95% CI: 1.15, 3.36). More than half of participants (57%) had been arrested for possessing a used syringe; in a second model, arrest for used syringe possession was also associated independently with receptive sharing (AOR = 2.87; 95% CI: 1.76, 4.69). Conclusions We documented high levels of syringe-related arrests in two Mexican–US border cities and an independent association between these arrests and risky injection practices. Public health collaborations with law enforcement to modify the risk environment in which drug use occurs are essential to facilitate safer injection practices. PMID:18028520

  7. Syringe size: does it matter in physician-performed procedures?

    PubMed

    Michael, Adrian A; Moorjani, Gautam R; Peisajovich, Andres; Park, Kye S; Sibbitt, Wilmer L; Bankhurst, Arthur D

    2009-03-01

    We hypothesized that the size of syringe influenced needle control in physician-performed procedures. Operators were tested for their ability to control a 1-, 3-, 5-, 10-, and 20-mL syringe and equivalent sizes of the new safety device, the reciprocating procedure device (RPD), using the quantitative needle-based displacement method. Three hundred twenty clinical syringe procedures were then randomized to either a 3- or 10-mL conventional syringe or to a 3- or 10-mL RPD. Patient pain was measured with the Visual Analog Pain Scale (VAPS). Increasing syringe size was associated with the undesirable characteristic of unintended forward penetration (loss of control of the needle in the forward direction) (r(2) = 0.97, slope = 2.14, 95% CI: 1.54-2.76, P < 0.002), and unintended retraction (loss of control of the needle in the reverse direction) (r(2) = 0.97, slope 2.15, 95% CI: 1.54-2.76, P < 0.002). In addition, 2-handed operation of a syringe resulted in greater control than 1-handed operation of a syringe (P < 0.001). When 1-handed operation was required, the RPD control syringe reduced unintended penetration by 52.3% (P >or= 0.001), unintended retraction by 56.8% (P >or= 0.001), and patient pain by 54.7% (P >or= 0.001) at each device size. For greater safety and control when operating the conventional syringe, smaller syringe sizes and 2 hands instead of 1 hand should be used whenever possible. If 1-handed operation of a syringe is necessary, a safety technology like the RPD control syringe should be used.

  8. Changing Household Dynamics: Children's American Generational Resources in Street Vending Markets

    ERIC Educational Resources Information Center

    Estrada, Emir

    2013-01-01

    This article prompts a re-visioning of segmented assimilation theory by examining the household dynamics and consequences that occur when Latino immigrant children and youth become active contributors to family street vending businesses. Based on participant observation and 20 in-depth interviews with Latino children who work with their immigrant…

  9. 41 CFR 102-74.55 - Are vending facilities authorized under the Randolph-Sheppard Act operated by permit or contract?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Are vending facilities... Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Concession Services § 102-74...

  10. Developing Preservice Teachers' Understanding of Function Using a Vending Machine Metaphor Applet

    ERIC Educational Resources Information Center

    McCulloch, Allison; Lovett, Jennifer; Edgington, Cyndi

    2017-01-01

    The purpose of this study is to examine the use of a Vending Machine applet as a cognitive root for the development of preservice teachers understanding of function. The applet was designed to purposefully problematize common misconceptions associated with the algebraic nature of typical function machines. Findings indicated affordances and…

  11. Mending Vending: Administrators Face a Dilemma

    ERIC Educational Resources Information Center

    Sternberg, Ruth E.

    2005-01-01

    Phil Gainous is in a sticky spot. The board of education in Montgomery County, Md., decided this was the year when sugary sodas and non-nutritious snacks must disappear from high school vending machines, replaced by healthier options. Gainous isn't against promoting healthy habits. But as the veteran principal of Montgomery Blair High School, the…

  12. 78 FR 14564 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-06

    ... due to the fact that the Family Smoking Prevention and Tobacco Control Act, which gives the Food and... actively enforcing the vending machine requirements of the Family Smoking Prevention and Tobacco Control Act''). This new option is included because federal law bans vending machines in youth accessible...

  13. 36 CFR 702.13 - Soliciting, vending, debt collection, and distribution of handbills.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... collection, and distribution of handbills. 702.13 Section 702.13 Parks, Forests, and Public Property LIBRARY OF CONGRESS CONDUCT ON LIBRARY PREMISES § 702.13 Soliciting, vending, debt collection, and... article for sale, or the collecting of private debts on the grounds or within the buildings of the Library...

  14. 36 CFR 702.13 - Soliciting, vending, debt collection, and distribution of handbills.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... collection, and distribution of handbills. 702.13 Section 702.13 Parks, Forests, and Public Property LIBRARY OF CONGRESS CONDUCT ON LIBRARY PREMISES § 702.13 Soliciting, vending, debt collection, and... article for sale, or the collecting of private debts on the grounds or within the buildings of the Library...

  15. 36 CFR 702.13 - Soliciting, vending, debt collection, and distribution of handbills.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... collection, and distribution of handbills. 702.13 Section 702.13 Parks, Forests, and Public Property LIBRARY OF CONGRESS CONDUCT ON LIBRARY PREMISES § 702.13 Soliciting, vending, debt collection, and... article for sale, or the collecting of private debts on the grounds or within the buildings of the Library...

  16. 36 CFR 702.13 - Soliciting, vending, debt collection, and distribution of handbills.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... collection, and distribution of handbills. 702.13 Section 702.13 Parks, Forests, and Public Property LIBRARY OF CONGRESS CONDUCT ON LIBRARY PREMISES § 702.13 Soliciting, vending, debt collection, and... article for sale, or the collecting of private debts on the grounds or within the buildings of the Library...

  17. 10 CFR 431.294 - Uniform test method for the measurement of energy consumption of refrigerated bottled or canned...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... consumption of refrigerated bottled or canned beverage vending machines. 431.294 Section 431.294 Energy... EQUIPMENT Refrigerated Bottled or Canned Beverage Vending Machines Test Procedures § 431.294 Uniform test... machines. (a) Scope. This section provides test procedures for measuring, pursuant to EPCA, the energy...

  18. 31 CFR 91.9 - Soliciting, vending, debt collection, and distribution of handbills.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Soliciting, vending, debt collection, and distribution of handbills. 91.9 Section 91.9 Money and Finance: Treasury Regulations Relating to Money and Finance REGULATIONS GOVERNING CONDUCT IN OR ON THE BUREAU OF THE MINT BUILDINGS AND GROUNDS...

  19. Vending Machine Policies and Practices in Delaware

    ERIC Educational Resources Information Center

    Gemmill, Erin; Cotugna, Nancy

    2005-01-01

    Overweight has reached alarming proportions among America's youth. Although the cause of the rise in overweight rates in children and adolescents is certainly the result of the interaction of a variety of factors, the presence of vending machines in schools is one issue that has recently come to the forefront. Many states have passed or proposed…

  20. 10 CFR 431.296 - Energy conservation standards and their effective dates.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... CERTAIN COMMERCIAL AND INDUSTRIAL EQUIPMENT Refrigerated Bottled or Canned Beverage Vending Machines... refrigerated bottled or canned beverage vending machine manufactured on or after August 31, 2012 shall have a... (kilowatt hours per day) Class A MDEC = 0.055 × V + 2.56. Class B MDEC = 0.073 × V + 3.16. Combination...

  1. VENDING PERMITS FOOD SERVICE TO GROW WITH COLLEGE.

    ERIC Educational Resources Information Center

    RUSHING, JOE B.

    WHEN FUNDS WERE NOT AVAILABLE FOR BUILDING A CAFETERIA AT THE JUNIOR COLLEGE OF BROWARD COUNTY, FLORIDA, USE OF VENDING MACHINES PROVED TO BE AN EFFECTIVE MEANS OF PROVIDING FOOD SERVICE TO THE STUDENTS OF THE GROWING COLLEGE. SANDWICH SERVICE HAD ALREADY BEEN FOUND UNSATISFACTORY, AND LACK OF KITCHEN FACILITIES PRECLUDED PREPARATION OF FOOD ON…

  2. A Mixed Message: The School Vending Machine.

    ERIC Educational Resources Information Center

    Hinkle, Margaret Murray

    1982-01-01

    Dental disease, especially tooth decay, is reaching epidemic proportions among children of school age. Since sugar is a major cause of tooth decay and since many confections are sold in schools, it is recommended that schools remove confections and other nonnutritional food items from vending machines, fund-raising activities, and food services.…

  3. 34 CFR 395.32 - Collection and distribution of vending machine income from vending machines on Federal property.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... department, agency, or instrumentality of the United States, in accordance with established procedures of... each property managing department, agency or instrumentality of the United States, subject to the..., agencies, or instrumentalities of the United States, under which blind vendors or State licensing agencies...

  4. 43 CFR 13.4 - Terms of permit.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Terms of permit. 13.4 Section 13.4 Public Lands: Interior Office of the Secretary of the Interior VENDING FACILITIES OPERATED BY BLIND PERSONS § 13.4 Terms of permit. Every permit shall describe the location of the vending facilities and shall be...

  5. 43 CFR 13.4 - Terms of permit.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Terms of permit. 13.4 Section 13.4 Public Lands: Interior Office of the Secretary of the Interior VENDING FACILITIES OPERATED BY BLIND PERSONS § 13.4 Terms of permit. Every permit shall describe the location of the vending facilities and shall be...

  6. 43 CFR 13.1 - Authority and purpose.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Authority and purpose. 13.1 Section 13.1 Public Lands: Interior Office of the Secretary of the Interior VENDING FACILITIES OPERATED BY BLIND... practicable, preference shall be given to blind persons in the operation of vending stands and machines on any...

  7. 43 CFR 13.1 - Authority and purpose.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Authority and purpose. 13.1 Section 13.1 Public Lands: Interior Office of the Secretary of the Interior VENDING FACILITIES OPERATED BY BLIND... practicable, preference shall be given to blind persons in the operation of vending stands and machines on any...

  8. 43 CFR 13.4 - Terms of permit.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Terms of permit. 13.4 Section 13.4 Public Lands: Interior Office of the Secretary of the Interior VENDING FACILITIES OPERATED BY BLIND PERSONS § 13.4 Terms of permit. Every permit shall describe the location of the vending facilities and shall be...

  9. 43 CFR 13.1 - Authority and purpose.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Authority and purpose. 13.1 Section 13.1 Public Lands: Interior Office of the Secretary of the Interior VENDING FACILITIES OPERATED BY BLIND... practicable, preference shall be given to blind persons in the operation of vending stands and machines on any...

  10. The Association between the Availability of Sugar-Sweetened Beverage in School Vending Machines and Its Consumption among Adolescents in California: A Propensity Score Matching Approach

    PubMed Central

    Shi, Lu

    2010-01-01

    There is controversy over to what degree banning sugar-sweetened beverage (SSB) sales at schools could decrease the SSB intake. This paper uses the adolescent sample of 2005 California Health Interview Survey to estimate the association between the availability of SSB from school vending machines and the amount of SSB consumption. Propensity score stratification and kernel-based propensity score matching are used to address the selection bias issue in cross-sectional data. Propensity score stratification shows that adolescents who had access to SSB through their school vending machines consumed 0.170 more drinks of SSB than those who did not (P < .05). Kernel-based propensity score matching shows the SSB consumption difference to be 0.158 on the prior day (P < .05). This paper strengthens the evidence for the association between SSB availability via school vending machines and the actual SSB consumption, while future studies are needed to explore changes in other beverages after SSB becomes less available. PMID:20976298

  11. Surveying vendors of street-vended food: a new methodology applied in two Guatemalan cities.

    PubMed Central

    Mahon, B. E.; Sobel, J.; Townes, J. M.; Mendoza, C.; Gudiel Lemus, M.; Cano, F.; Tauxe, R. V.

    1999-01-01

    Lack of reliable data about street vendors, who are difficult to survey, has hampered efforts to improve the safety of street-vended food. A two-phase method for sampling vendors, surveying first in areas of concentrated vending activity identified by local authorities and second in randomly selected areas, was developed and implemented in two Guatemalan cities where street-vended food had been implicated in cholera transmission. In a 4-day survey in Escuintla, 59 vendors (42 from phase 1, 17 from phase 2) were interviewed. They demonstrated good knowledge of food safety and cholera but unsafe practices, implying that more effective, practical training was needed. In a 6-day survey in Guatemala City, 78 vendors (77 from phase 1, 1 from phase 2) were interviewed. Sixty-eight (87 %) vendors stored water, usually in wide-mouthed vessels prone to contamination; this led to a field test of a new system for safe water storage. Useful information for public health planning and intervention can be gathered rapidly with this new method for surveying street vendors. PMID:10459643

  12. Quality evaluation of radiographic contrast media in large-volume prefilled syringes and vials.

    PubMed

    Sendo, T; Hirakawa, M; Yaginuma, M; Aoyama, T; Oishi, R

    1998-06-01

    The authors compared the particle contaminations of radiographic contrast media packaged in large-volume prefilled syringes and vials. Particle counting was performed for four contrast media packaged in large-volume prefilled syringes (iohexol, ioversol, ioversol for angiography, and ioxaglate) and three contrast media packaged in vials (iohexol, ioversol, and ioxaglate). X-ray emission spectrometry was performed to characterize the individual particles. The amount of silicone oil in the syringe was quantified with infrared spectrophotometry. The particle contamination in syringes containing ioversol was higher than that in syringes containing iohexol or ioxaglate. Particle contamination in the vials was relatively low, except with ioxaglate. X-ray emission spectrometry of the components of the syringe and vial showed that the source of particles was internal material released from the rubber stopper or inner surface. The particle counts for contrast media packaged in syringes and vials varied considerably among the different contrast media and were related to the amount of silicone oil on the inner surface and rubber piston of the syringe.

  13. Structure of the syringeal muscles in jungle crow (Corvus macrorhynchos).

    PubMed

    Tsukahara, Naoki; Yang, Qian; Sugita, Shoei

    2008-09-01

    Birds' vocalizations are produced by the syrinx, which is located between the trachea and the two primary bronchi. Oscine birds have multiple pairs of syringeal muscles in the syrinx. To determine the detailed structure of the syringeal muscle in jungle crows, an oscine bird, a histological study and gross examination of the syrinx were performed. In the histological study, sections of the syrinxes from four jungle crows were stained with Azan and observed. Each syringeal muscle was classified by the limit of the fascia from neighbor fascicules. From the gross examination a 3-D image of the structure of the syringeal muscles was generated. The combined histological and anatomical results show that there are seven pairs of syringeal muscles in jungle crows. Muscle fusions were observed in some of the syringeal muscles. It is likely that each syringeal muscle has a specific role. Jungle crows may be able to generate various calls because they have several pairs of syringeal muscles.

  14. How state taxes and policies targeting soda consumption modify the association between school vending machines and student dietary behaviors: a cross-sectional analysis.

    PubMed

    Taber, Daniel R; Chriqui, Jamie F; Vuillaume, Renee; Chaloupka, Frank J

    2014-01-01

    Sodas are widely sold in vending machines and other school venues in the United States, particularly in high school. Research suggests that policy changes have reduced soda access, but the impact of reduced access on consumption is unclear. This study was designed to identify student, environmental, or policy characteristics that modify the associations between school vending machines and student dietary behaviors. Data on school vending machine access and student diet were obtained as part of the National Youth Physical Activity and Nutrition Study (NYPANS) and linked to state-level data on soda taxes, restaurant taxes, and state laws governing the sale of soda in schools. Regression models were used to: 1) estimate associations between vending machine access and soda consumption, fast food consumption, and lunch source, and 2) determine if associations were modified by state soda taxes, restaurant taxes, laws banning in-school soda sales, or student characteristics (race/ethnicity, sex, home food access, weight loss behaviors.). Contrary to the hypothesis, students tended to consume 0.53 fewer servings of soda/week (95% CI: -1.17, 0.11) and consume fast food on 0.24 fewer days/week (95% CI: -0.44, -0.05) if they had in-school access to vending machines. They were also less likely to consume soda daily (23.9% vs. 27.9%, average difference  =  -4.02, 95% CI: -7.28, -0.76). However, these inverse associations were observed primarily among states with lower soda and restaurant tax rates (relative to general food tax rates) and states that did not ban in-school soda sales. Associations did not vary by any student characteristics except for weight loss behaviors. Isolated changes to the school food environment may have unintended consequences unless policymakers incorporate other initiatives designed to discourage overall soda consumption.

  15. How State Taxes and Policies Targeting Soda Consumption Modify the Association between School Vending Machines and Student Dietary Behaviors: A Cross-Sectional Analysis

    PubMed Central

    Taber, Daniel R.; Chriqui, Jamie F.; Vuillaume, Renee; Chaloupka, Frank J.

    2014-01-01

    Background Sodas are widely sold in vending machines and other school venues in the United States, particularly in high school. Research suggests that policy changes have reduced soda access, but the impact of reduced access on consumption is unclear. This study was designed to identify student, environmental, or policy characteristics that modify the associations between school vending machines and student dietary behaviors. Methods Data on school vending machine access and student diet were obtained as part of the National Youth Physical Activity and Nutrition Study (NYPANS) and linked to state-level data on soda taxes, restaurant taxes, and state laws governing the sale of soda in schools. Regression models were used to: 1) estimate associations between vending machine access and soda consumption, fast food consumption, and lunch source, and 2) determine if associations were modified by state soda taxes, restaurant taxes, laws banning in-school soda sales, or student characteristics (race/ethnicity, sex, home food access, weight loss behaviors.) Results Contrary to the hypothesis, students tended to consume 0.53 fewer servings of soda/week (95% CI: -1.17, 0.11) and consume fast food on 0.24 fewer days/week (95% CI: -0.44, -0.05) if they had in-school access to vending machines. They were also less likely to consume soda daily (23.9% vs. 27.9%, average difference = -4.02, 95% CI: -7.28, -0.76). However, these inverse associations were observed primarily among states with lower soda and restaurant tax rates (relative to general food tax rates) and states that did not ban in-school soda sales. Associations did not vary by any student characteristics except for weight loss behaviors. Conclusion Isolated changes to the school food environment may have unintended consequences unless policymakers incorporate other initiatives designed to discourage overall soda consumption. PMID:25083906

  16. Extractables and leachables considerations for prefilled syringes.

    PubMed

    Jenke, Dennis R

    2014-10-01

    Use of pre-filled syringes as both a packaging and delivery system for pharmaceutical drug products is accelerating. Pre-filled syringes must meet the quality and suitability for use requirements for both systems, including compatibility with the drug product. Relevant incompatibilities between pre-filled syringes and drug products include the safety of syringe-based leachables that accumulate in drug products and the ability of leachables to interact with the drug product's ingredients as such interactions can affect safety, efficacy, stability and physical viability. Relevant suitability considerations for pre-filled syringes are discussed herein and specific examples of suitability for use issues for pre-filled syringes are cited, focusing on extractables associated with pre-filled syringes and leachables derived from such syringes. Aspects considered include the toxicological impact of leachables, their ability to alter the efficacy of drug products and to produce other undesirable outcomes such as aggregation and immunogenic responses. Materials used in pre-filled syringes and the conditions of use minimize the traditional safety risk associated with leachables. However, drug products that use pre-filled syringes are prone to non-traditional interactions such as disruption of protein conformation, leading to potential efficacy, safety and quality issues. In order to qualify pre-filled syringes for use, the traditional approach of measuring extractables and leachables and inferring their effect must be augmented by rigorous compatibility testing. Research into the fundamental relationship between leachables and drug substances will be necessary so the more time- and cost-efficient 'measure and infer' approach can be widely implemented.

  17. State but not district nutrition policies are associated with less junk food in vending machines and school stores in US public schools.

    PubMed

    Kubik, Martha Y; Wall, Melanie; Shen, Lijuan; Nanney, Marilyn S; Nelson, Toben F; Laska, Melissa N; Story, Mary

    2010-07-01

    Policy that targets the school food environment has been advanced as one way to increase the availability of healthy food at schools and healthy food choice by students. Although both state- and district-level policy initiatives have focused on school nutrition standards, it remains to be seen whether these policies translate into healthy food practices at the school level, where student behavior will be impacted. To examine whether state- and district-level nutrition policies addressing junk food in school vending machines and school stores were associated with less junk food in school vending machines and school stores. Junk food was defined as foods and beverages with low nutrient density that provide calories primarily through fats and added sugars. A cross-sectional study design was used to assess self-report data collected by computer-assisted telephone interviews or self-administered mail questionnaires from state-, district-, and school-level respondents participating in the School Health Policies and Programs Study 2006. The School Health Policies and Programs Study, administered every 6 years since 1994 by the Centers for Disease Control and Prevention, is considered the largest, most comprehensive assessment of school health policies and programs in the United States. A nationally representative sample (n=563) of public elementary, middle, and high schools was studied. Logistic regression adjusted for school characteristics, sampling weights, and clustering was used to analyze data. Policies were assessed for strength (required, recommended, neither required nor recommended prohibiting junk food) and whether strength was similar for school vending machines and school stores. School vending machines and school stores were more prevalent in high schools (93%) than middle (84%) and elementary (30%) schools. For state policies, elementary schools that required prohibiting junk food in school vending machines and school stores offered less junk food than elementary schools that neither required nor recommended prohibiting junk food (13% vs 37%; P=0.006). Middle schools that required prohibiting junk food in vending machines and school stores offered less junk food than middle schools that recommended prohibiting junk food (71% vs 87%; P=0.07). Similar associations were not evident for district-level polices or high schools. Policy may be an effective tool to decrease junk food in schools, particularly in elementary and middle schools. Copyright 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

  18. State but not District Nutrition Policies Are Associated with Less Junk Food in Vending Machines and School Stores in US Public Schools

    PubMed Central

    KUBIK, MARTHA Y.; WALL, MELANIE; SHEN, LIJUAN; NANNEY, MARILYN S.; NELSON, TOBEN F.; LASKA, MELISSA N.; STORY, MARY

    2012-01-01

    Background Policy that targets the school food environment has been advanced as one way to increase the availability of healthy food at schools and healthy food choice by students. Although both state- and district-level policy initiatives have focused on school nutrition standards, it remains to be seen whether these policies translate into healthy food practices at the school level, where student behavior will be impacted. Objective To examine whether state- and district-level nutrition policies addressing junk food in school vending machines and school stores were associated with less junk food in school vending machines and school stores. Junk food was defined as foods and beverages with low nutrient density that provide calories primarily through fats and added sugars. Design A cross-sectional study design was used to assess self-report data collected by computer-assisted telephone interviews or self-administered mail questionnaires from state-, district-, and school-level respondents participating in the School Health Policies and Programs Study 2006. The School Health Policies and Programs Study, administered every 6 years since 1994 by the Centers for Disease Control and Prevention, is considered the largest, most comprehensive assessment of school health policies and programs in the United States. Subjects/setting A nationally representative sample (n = 563) of public elementary, middle, and high schools was studied. Statistical analysis Logistic regression adjusted for school characteristics, sampling weights, and clustering was used to analyze data. Policies were assessed for strength (required, recommended, neither required nor recommended prohibiting junk food) and whether strength was similar for school vending machines and school stores. Results School vending machines and school stores were more prevalent in high schools (93%) than middle (84%) and elementary (30%) schools. For state policies, elementary schools that required prohibiting junk food in school vending machines and school stores offered less junk food than elementary schools that neither required nor recommended prohibiting junk food (13% vs 37%; P = 0.006). Middle schools that required prohibiting junk food in vending machines and school stores offered less junk food than middle schools that recommended prohibiting junk food (71% vs 87%; P = 0.07). Similar associations were not evident for district-level polices or high schools. Conclusions Policy may be an effective tool to decrease junk food in schools, particularly in elementary and middle schools. PMID:20630161

  19. Volumetric Lattice Boltzmann Simulation for Fluid dynamics and Turbulence in Practical Syringes

    NASA Astrophysics Data System (ADS)

    Lima, Everton; Deep, Debanjan; Yu, Huidan (Whitney)

    2012-11-01

    We conduct numerical experiments to study fluid dynamics and turbulence in syringes using volumetric lattice Boltzmann method (VLBM) that is developed for dealing with arbitrary moving boundaries. Several common used medical syringes are used to predict the efficiency and safety of syringes experiencing low flow infusion rates. It is found that smaller size syringes reach a steady flow rate much sooner than larger ones, which are in quantitative agreement with experimental results. The relation between the syringe size and its steady flow rate is revealed. At low flow rates, corner vortices are observed. We explore conditions that lead to turbulent flow aiming to aid safer syringe application in nursing practices.

  20. Patients' Reactions to Local Anaesthetic Application Devices in Paediatric Dentistry.

    PubMed

    Bajrić, Elmedin; Kobasglija, Sedin; Jurić, Hrvoje

    2015-09-01

    Local anaesthesia is the most common medium for pain control in most dental treatments. Physical appearance of syringe itself can be considered as a provoking factor for the emergence of dental fear and anxiety (DFA). In this research the patient reactions to local anaesthesia application devices, as one of the main causes for DFA emergence, were inquired. The sample comprised of 120 patients, divided in three age groups, formed of 40 patients aged 8, 12 and 15 years. DFA prevalence was quantified by Children Fear Survey Schedule-Dental Subscale (CFSS-DS). Three different syringes were offered to the patients. Reasons for choosing one of the syringes were detected. Patients assigned statistically highest rank to plastic syringe. Boys chose metal and intraligamental syringe statistically more often than girls. Patients with higher CFSS-DS scores chose metal syringe as last option. None of the reasons for selection was dominant, except pain that could be caused by usage of any of the three syringes. A large number of patients did not mention any of the reasons for choosing particular syringes. Plastic syringe represented the most acceptable device for local anaesthetic application to our patients. Patients often linked pain with dental syringes.

  1. Impact of increased syringe access: preliminary findings on injection drug user syringe source, disposal, and pharmacy sales in Harlem, New York.

    PubMed

    Fuller, Crystal M; Ahern, Jennifer; Vadnai, Liza; Coffin, Phillip O; Galea, Sandro; Factor, Stephanie H; Vlahov, David

    2002-01-01

    To evaluate the New York State Expanded Syringe Access Demonstration Program (ESAP) through injection drug user (IDU) surveys, discarded needles and syringes studies, and pharmacy sales and experiences surveys. Pre-post comparison. In Harlem, New York City, risk surveys among street-recruited IDUs, needle/syringe street counts on 27 systematically sampled city blocks, and Harlem pharmacist reports of sales and experiences. Number and types of IDU syringe sources, block mean counts of discarded needles and syringes, level of pharmacy nonprescription syringe sales (NPSS), and pharmacists' experiences. Comparing 209 pre-ESAP with 396 post-ESAP IDUs, pharmacies as a primary syringe source increased: 3.4% to 5.3% (P < .001, and ever pharmacy use increased: 4.9% to 12.5% (P < .001), respectively. Compared with pre-ESAP IDUs, post-ESAP IDUs tended to be younger and more often black. Harlem pharmacy participation in ESAP increased considerably from March 1, 2001, to March 1, 2002, 49% to 79%, respectively. Among three Harlem pharmacies, there was a modest increase in NPSS; pharmacists reported no problems, and no discarded needles and syringes were observed in pharmacy areas. In the three pharmacies, the proportion of syringe sales that were NPSS was 46% (110 to 240 NPSS/month), 3% (25 to 90 NPSS/month), and 0%. The mean ratios of needles/syringes to background trash have not increased in Harlem since ESAP began. To date, no evidence of harmful effects discarded needles/syringes, pharmacy altercations) resulting from ESAP were observed. While NPSS have increased in Harlem, pharmacy use among IDUs remains low. In Harlem, efforts are underway to increase ESAP awareness and reduce socioenvironmental barriers to ESAP.

  2. Racial differences in acquisition of syringes from pharmacies under conditions of legal but restricted sales.

    PubMed

    Costenbader, Elizabeth C; Zule, William A; Coomes, Curtis C

    2010-09-01

    Injecting drug users (IDUs) are at increased risk of acquiring and transmitting HIV and other bloodborne pathogens through the multi-person use of syringes. Although research has shown that increased access to syringes through syringe exchange programs (SEPs) is an effective strategy to reduce risky injection practices many areas of the United States still do not have SEPs. In the absence of SEPs, legislation allowing pharmacies over-the-counter sales of syringes has also been shown to reduce syringe sharing. The success of pharmacy sales however is limited by other legal stipulations, such as drug paraphernalia laws, which in turn may contribute to fear among IDUs about being caught purchasing and carrying syringes. Between 2003 and 2006, 851 out-of-treatment IDUs were recruited using street outreach in the Raleigh-Durham (North Carolina) area. Data were collected using audio-computer assisted interview (ACASI) technology. Multiple logistic regression analyses were performed to assess factors associated with purchasing syringes from pharmacies. In our study sample, African-American IDUs were one-fifth as likely as white IDUs to report pharmacies as their primary source of syringes. Given the absence of syringe exchange programs and the relatively high prevalence of HCV and HIV among IDUs in the Raleigh-Durham area, the limited use of pharmacies as a source of syringes among African-American IDUs in this study sample is problematic. The study findings support the need for effective multilevel interventions to increase access to clean needles in this population, as well as for policy interventions, such as legalization of SEPs and elimination of penalties for carrying syringes, to reduce harm and eliminate the health threats posed by receptive syringe sharing. Copyright 2010 Elsevier B.V. All rights reserved.

  3. Characterization of the initial level and migration of silicone oil lubricant in empty prefilled syringes for biologics using infrared spectroscopy.

    PubMed

    Bee, Jared S; Frey, Vadim V; Javed, Urooj; Chung, Jonathan; Corcoran, Marta L; Roussel, Paul S; Krause, Stephan O; Cash, Patricia W; Bishop, Steven M; Dimitrova, Mariana N

    2014-01-01

    Glass prefillable syringes are lubricated with silicone oil to ensure functionality and a consistent injection for the end user. If excessive silicone is applied, droplets could potentially result in aggregation of sensitive biopharmaceuticals or clouding of the solution. Therefore, monitoring and optimization of the applied silicone layer is critical for prefilled syringe development. The hydrophobic properties of silicone oil, the potential for assay interference, and the very small quantities applied to prefilled syringes present a challenge for the development of a suitable assay. In this work we present a rapid and simple Fourier transform infrared (FTIR) spectroscopy method for quantitation of total silicone levels applied to prefilled syringes. Level-dependent silicone oil migration occurred over time for empty prefilled syringes stored tip-up. However, migration from all prefilled syringes with between 0.25 and 0.8 mg of initial silicone oil resulted in a stable limiting minimum level of between 0.15 and 0.26 mg of silicone in the syringe reached after 1 to 4 years of empty tip-up storage. The results of the FTIR assay correlated well with non-destructive reflectometry characterization of the syringes. This assay can provide valuable data for selection of a robust initial silicone oil target and quality control of prefilled syringes intended for biopharmaceuticals. Glass prefillable syringes are lubricated with silicone oil to ensure functionality and a consistent injection for the end user. If excessive silicone is applied, droplets could potentially result in aggregation of sensitive biopharmaceuticals or clouding of the solution. Therefore, monitoring and optimization of the applied silicone layer is critical for prefilled syringe development. The hydrophobic properties of silicone oil, the potential for assay interference, and the very small quantities applied to prefilled syringes present a challenge for the development of a suitable assay. In this work we present a rapid and simple Fourier transform infrared (FTIR) spectroscopy method for quantitation of total silicone levels applied to prefilled syringes. Level-dependent silicone oil migration occurred over time for empty prefilled syringes stored tip-up. However, migration from all prefilled syringes with between 0.25 and 0.8 mg of initial silicone oil resulted in a stable limiting minimum level of between 0.15 and 0.26 mg of silicone in the syringe reached after 1 to 4 years of empty tip-up storage. The results of the FTIR assay correlated well with non-destructive reflectometry characterization of the syringes. This assay can provide valuable data for selection of a robust initial silicone oil target and quality control of prefilled syringes intended for biopharmaceuticals. © PDA, Inc. 2014.

  4. SCORE Study Report 7: incidence of intravitreal silicone oil droplets associated with staked-on vs luer cone syringe design.

    PubMed

    Scott, Ingrid U; Oden, Neal L; VanVeldhuisen, Paul C; Ip, Michael S; Blodi, Barbara A; Antoszyk, Andrew N

    2009-11-01

    To evaluate the incidence of intravitreal silicone oil (SO) droplets associated with intravitreal injections using a staked-on vs luer cone syringe design in the SCORE (Standard Care vs COrticosteroid in REtinal Vein Occlusion) Study. Prospective, randomized, phase III clinical trial. The incidence of intravitreal SO was compared among participants exposed to the staked-on syringe design, the luer cone syringe design, or both of the syringe designs in the SCORE Study, which evaluated intravitreal triamcinolone acetonide injection(s) for vision loss secondary to macular edema associated with central or branch retinal vein occlusion. Injections were given at baseline and 4-month intervals, based on treatment assignment and study-defined retreatment criteria. Because intravitreal SO was observed following injections in some participants, investigators were instructed, on September 22, 2006, to look for intravitreal SO at all study visits. On November 1, 2007, the luer cone syringe design replaced the staked-on syringe design. A total of 464 participants received a total of 1,205 injections between November 4, 2004 and February 28, 2009. Intravitreal SO was noted in 141 of 319 participants (44%) exposed only to staked-on syringes, 11 of 87 (13%) exposed to both syringe designs, and 0 of 58 exposed only to luer cone syringes (P < .0001). Among participants with first injections after September 22, 2006, intravitreal SO was noted in 65 of 114 (57%) injected only with staked-on syringes compared with 0 of 58 injected only with luer cone syringes. Differential follow-up is unlikely to explain these results. In the SCORE Study, luer cone syringe design is associated with a lower frequency of intravitreal SO droplet occurrence compared with the staked-on syringe design, likely attributable to increased residual space in the needle hub with the luer cone design.

  5. [Embolic complications by ink clots removed from syringes during cerebral angiography].

    PubMed

    Kohyama, Shinya; Ishihara, Shoichiro; Yamane, Fumitaka; Ishihara, Hideaki; Kanazawa, Ryuzaburo; Suzuki, Masanori; Neki, Hiroaki; Ohkawara, Mai

    2009-01-01

    We noted, during cerebral angiography, that the contrast medium was contaminated with numerous small black ink clots from gradation marks on syringes. In this report, we show that ink can be removed from syringes in solid form, and that they may result in embolic complications during cerebral angiography. To demonstrate that the ink from gradation marks on syringes can come off in a solid form and attach itself to the gloves during cerebral angiography, syringes were gripped many times (just as in an angiographic procedure) after immersion in contrast medium or 0.9% saline for 10 minutes. To see if difference of contrast medium and syringes could affect the removing of ink, five types of nonangiographic syringes and one type of angiographic syringe were rubbed with gauze after certain time periods after immersing them in four kinds of contrast medium or 0.9% saline. Ink attached itself to the gloves in a solid form by repeated gripping due to adherence of contrast medium. Ink was removed from all nonangiographic syringes by rubbing after immersion in any type of contrast medium for two hours. Gradation marks on angiographic syringes were stable with all types of contrast medium. Thus, ink for gradation marks on nonangiographic syringes, which is easily removed in a solid form due to contrast medium, can be the source of embolic complication during cerebral angiography.

  6. Demographic, Risk, and Spatial Factors Associated With Over-the-Counter Syringe Purchase Among Injection Drug Users

    PubMed Central

    Stopka, Thomas J.; Lutnick, Alexandra; Wenger, Lynn D.; DeRiemer, Kathryn; Geraghty, Estella M.; Kral, Alex H.

    2012-01-01

    Since 2005, California law allowed over-the-counter (OTC) syringe sales pending local authorization. Although pharmacy sales of OTC syringes are associated with reduced injection-mediated risks and decreases in human immunodeficiency virus infection rates, little is known about the factors associated with syringe purchase among injection drug users (IDUs). Using a cross-sectional design, the authors applied targeted sampling to collect quantitative survey data from IDUs (n = 563) recruited in San Francisco, California, during 2008. They also compiled a comprehensive list of retail pharmacies, their location, and whether they sell OTC syringes. They used a novel combination of geographic information system and statistical analyses to determine the demographic, behavioral, and spatial factors associated with OTC syringe purchase by IDUs. In multivariate analyses, age, race, injection frequency, the type of drug injected, and the source of syringe supply were independently associated with OTC syringe purchases. Notably, the prevalence of OTC syringe purchase was 53% lower among African-American IDUs (adjusted prevalence ratio = 0.47, 95% confidence interval: 0.33, 0.67) and higher among injectors of methamphetamine (adjusted prevalence ratio = 1.35, 95% confidence interval: 1.07, 1.70). Two neighborhoods with high densities of IDUs had limited access to OTC syringes. Increased access to OTC syringes would potentially prevent blood-borne infectious diseases among IDUs. PMID:22562660

  7. Food in the Schools, Part I. Options in Education, Program #75.

    ERIC Educational Resources Information Center

    George Washington Univ., Washington, DC. Inst. for Educational Leadership.

    This document presents the program transcripts of a weekly series broadcast by member stations of National Public Radio. The program focuses on food in the schools. It addresses the following issues: plate waste in Chicago and Dallas; banning junk food and vending machines; the results of a vending machine junk food ban in West Virginia;…

  8. Intelligent Hybrid Vehicle Power Control - Part 1: Machine Learning of Optimal Vehicle Power

    DTIC Science & Technology

    2012-06-30

    time window ),[ tWt DT : vave, vmax, vmin, ac, vst and vend, where the first four parameters are, respectively, the average speed, maximum speed...minimum speed and average acceleration, during the time period ),[ tWt DT , vst is the vehicle speed at )( DTWt  , and vend is the vehicle

  9. 36 CFR § 702.13 - Soliciting, vending, debt collection, and distribution of handbills.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... LIBRARY OF CONGRESS CONDUCT ON LIBRARY PREMISES § 702.13 Soliciting, vending, debt collection, and... article for sale, or the collecting of private debts on the grounds or within the buildings of the Library...) Peddlers and solicitors will not be permitted to enter Library buildings unless they have a specific...

  10. Associations between Parental Limits, School Vending Machine Purchases, and Soft Drink Consumption among Kentucky Middle School Students

    ERIC Educational Resources Information Center

    Nickelson, Jen; Roseman, Mary G.; Forthofer, Melinda S.

    2010-01-01

    Objective: To examine associations between parental limits on soft drinks and purchasing soft drinks from school vending machines and consuming soft drinks among middle school students. Design: Secondary analysis of cross-sectional data from the middle school Youth Risk Behavior Survey. Setting: Eight public middle schools in central Kentucky.…

  11. Probing transplant and living donor candidates about their participation in organ vending.

    PubMed

    Bramstedt, Katrina A

    2010-09-01

    The selling of human organs for transplant is illegal in the United States and in most countries; however, such transactions still occur. Transplant hospitals and their personnel have multiple ethical duties, including (1) protecting the safety of their living donors and transplant recipients and (2) protecting the integrity of living donation and transplantation as clinical practices. To date, few psychosocial screening tools exist that pertain specifically to a person's risk or intent of pursuing organ vending (buying or selling). This article presents a series of transplant ethics case consultations that spawned the creation of a set of behavioral prompts for teams to probe with regard to organ vending when screening candidates about their suitability for participation as living donors or transplant recipients.

  12. A Method To Determine the Kinetics of Solute Mixing in Liquid/Liquid Formulation Dual-Chamber Syringes.

    PubMed

    Werk, Tobias; Mahler, Hanns-Christian; Ludwig, Imke Sonja; Luemkemann, Joerg; Huwyler, Joerg; Hafner, Mathias

    Dual-chamber syringes were originally designed to separate a solid substance and its diluent. However, they can also be used to separate liquid formulations of two individual drug products, which cannot be co-formulated due to technical or regulatory issues. A liquid/liquid dual-chamber syringe can be designed to achieve homogenization and mixing of both solutions prior to administration, or it can be used to sequentially inject both solutions. While sequential injection can be easily achieved by a dual-chamber syringe with a bypass located at the needle end of the syringe barrel, mixing of the two fluids may provide more challenges. Within this study, the mixing behavior of surrogate solutions in different dual-chamber syringes is assessed. Furthermore, the influence of parameters such as injection angle, injection speed, agitation, and sample viscosity were studied. It was noted that mixing was poor for the commercial dual-chamber syringes (with a bypass designed as a longitudinal ridge) when the two liquids significantly differ in their physical properties (viscosity, density). However, an optimized dual-chamber syringe design with multiple bypass channels resulted in improved mixing of liquids. Dual-chamber syringes were originally designed to separate a solid substance and its diluent. However, they can also be used to separate liquid formulations of two individual drug products. A liquid/liquid dual-chamber syringe can be designed to achieve homogenization and mixing of both solutions prior to administration, or it can be used to sequentially inject both solutions. While sequential injection can be easily achieved by a dual-chamber syringe with a bypass located at the needle end of the syringe barrel, mixing of the two fluids may provide more challenges. Within this study, the mixing behavior of surrogate solutions in different dual-chamber syringes is assessed. Furthermore, the influence of parameters such as injection angle, injection speed, agitation, and sample viscosity were studied. It was noted that mixing was poor for the commercially available dual-chamber syringes when the two liquids significantly differ in viscosity and density. However, an optimized dual-chamber syringe design resulted in improved mixing of liquids. © PDA, Inc. 2017.

  13. [2000-year history of the ear syringe and its relationship to the enema. Images from the history of otorhinolaryngology, represented by instruments from the collection of the Ingolstadt Medical History Museum].

    PubMed

    Feldmann, H

    1999-08-01

    SYRINGES WITH A PISTON AND THEIR USE AS "CLYSTER ORICULARIUS" IN THE ANCIENT ROME: Syringes with a piston were already known in ancient times and have been mentioned as a device for spraying rose water (Philon of Byzantium, about 230 BC), and for fighting fires (Heron of Alexandria about 110 AD). Celsus mentions it several times in his grand opus "De Medicina" (1st century AD) in the treatment of purulent discharge from the ear and for removing foreign bodies from the external ear canal. He always calls it "clyster oricularius", i.e. ear syringe, even when he describes its use in applications other than otological, such as in urology. Later the ear syringe fell from favor for a very long time and was reinvented only at the beginning of the 19th century. IRRIGATION OF THE BOWELS, FROM THE BAG SYRINGE TO THE PISTON SYRINGE: Irrigations of the bowels, clysters, were performed from ancient times to the 18th century with a baglike syringe using the bladder of animals as a pouch. Syringes with a piston were used by barbers and surgeons only for cleansing wounds or irrigating natural cavities of the body. Irrigation of the external ear canal had completely fallen from favor. In France in the 18th century large syringes with a piston made of tin oder brass came into use for enemas and replaced the old baglike devices. THE REINVENTION OF THE EAR SYRINGE AFTER THE PROTOTYPE OF THE ENEMA SYRINGE: Itard, an otologist in France in 1821, was the first to describe irrigating the ear with a syringe to remove hard wax. He recommended using an enema syringe ("seringue à lavement") for the procedure. Soon after his publication special ear syringes of appropriate size were developed and described by Beck in Freiburg, Germany, in 1827; by Fabrizi in Modena, Italy, 1839; and Schmalz in Dresden, Germany, 1846, who also introduced the kidney-shaped bowel for catching the water. Apart from that, small baglike syringes made of rubber were devised especially for use by the patient himself (Kramer, Berlin, 1860). This historical development is described in detail and illustrated by numerous figures.

  14. Botulinum Toxin Therapy: Is Syringe Type Related to Cost-Effectiveness?

    PubMed

    Foglietti, Mark Anthony; Wright, Lauren; Foglietti-Fostyk, Alanna

    2018-03-01

    Clostridium botulinum toxin is effective through cleaving presynaptic proteins at the neuromuscular junction, which prevents the release of acetylcholine and inhibits muscle contraction. Several serotypes of botulinum toxin (BT) exist; however, only 2 types have been approved by the US Food and Drug Administration for commercial and medical use, A and B. Both types of BT must be administered intramuscularly with a syringe, but the type of syringe is the injector's preference. Which syringe type is most efficient in minimizing product waste and most cost-effective for the patient and provider? We performed a single-center, open-label, analytical study using BT therapy and 2 types of syringes for analytics of cost-effectiveness. OnabotulinumtoxinA was the neuromodulator used in this report. Vials (100 U) of BT A were each reconstituted with 2.5 mL of 0.9% sodium chloride, for a final concentration of 4 U/0.1 mL. High-dead-space syringes are compared with low-dead-space syringes: 1-mL tuberculin (TB) luer slip syringe with detachable 25-gauge needle and 1-mL ultrafine insulin syringe with an attached 31-gauge needle, respectively. After each syringe was evacuated, the TB syringe was noted to contain 0.05 mL of the remaining product in the hub. Providers are discarding approximately 2 U of BT per TB syringe product injection. If the physician uses 30 syringes per day, 3 days a week, for 1 year, it equals to a lost revenue of approximately $155,500 per year. To individualize the cost-effective analysis, average quantity of syringes used per patient and overall patient volume must be considered, with corresponding adjustment of cost and units discarded. The American Society of Plastic Surgeons reported that the use of neuromodulators has increased by approximately 797% from 2000 to 2016. During that period, the price of neuromodulators has also increased by approximately 85%. Considering these statistics, the type of syringe used for BT neuromodular injection is a thought-provoking concept but surrounded by a paucity of data. Overall, our data suggest that the use of ultrafine insulin syringes for injection of BT reduces product waste and is cost-effective for the patient and the provider.

  15. Ongoing incident hepatitis C virus infection among people with a history of injecting drug use in an Australian prison setting, 2005-2014: The HITS-p study.

    PubMed

    Cunningham, E B; Hajarizadeh, B; Bretana, N A; Amin, J; Betz-Stablein, B; Dore, G J; Luciani, F; Teutsch, S; Dolan, K; Lloyd, A R; Grebely, J

    2017-09-01

    Hepatitis C virus (HCV) transmission is high in prisons. This study investigated trends in HCV incidence and associated factors among a cohort of prisoners with a history of injecting drug use in New South Wales, Australia. Data were available from the Hepatitis C Incidence and Transmission Study-prisons (HITS-p) from 2005 to 2014. Temporal trends in HCV incidence were evaluated. Factors associated with time to HCV seroconversion among people with ongoing injecting was assessed using Cox proportional hazards. Among 320 antibody-negative participants with a history of injecting drug use (mean age 26; 72% male), 62% (n=197) reported injecting drug use during follow-up. Overall, 93 infections were observed. HCV incidence was 11.4/100 person-years in the overall population and 6.3/100 person-years among the continually imprisoned population. A stable trend in HCV incidence was observed. Among the overall population with ongoing injecting during follow-up, ≥weekly injecting drug use frequency was independently associated with time to HCV seroconversion. Among continuously imprisoned injectors with ongoing injecting during follow-up, needle/syringe sharing was independently associated with time to HCV seroconversion. This study demonstrates that prison is a high-risk environment for acquisition of HCV infection. Needle and syringe sharing was associated with HCV infection among continually imprisoned participants, irrespective of frequency of injecting or the type of drug injected. These findings highlight the need for the evaluation of improved HCV prevention strategies in prison, including needle/syringe programmes and HCV treatment. © 2017 John Wiley & Sons Ltd.

  16. Human campylobacteriosis related to the consumption of raw milk sold by vending machines in Italy: Quantitative risk assessment based on official controls over four years.

    PubMed

    Giacometti, Federica; Bonilauri, Paolo; Amatiste, Simonetta; Arrigoni, Norma; Bianchi, Manila; Losio, Marina Nadia; Bilei, Stefano; Cascone, Giuseppe; Comin, Damiano; Daminelli, Paolo; Decastelli, Lucia; Merialdi, Giuseppe; Mioni, Renzo; Peli, Angelo; Petruzzelli, Annalisa; Tonucci, Franco; Piva, Silvia; Serraino, Andrea

    2015-09-01

    A quantitative risk assessment (RA) model was developed to describe the risk of campylobacteriosis linked to consumption of raw milk sold in vending machines in Italy. Exposure assessment was based on the official microbiological records of raw milk samples from vending machines monitored by the regional Veterinary Authorities from 2008 to 2011, microbial growth during storage, destruction experiments, consumption frequency of raw milk, serving size, consumption preference and age of consumers. The differential risk considered milk handled under regulation conditions (4°C throughout all phases) and the worst time-temperature field handling conditions detected. Two separate RA models were developed, one for the consumption of boiled milk and the other for the consumption of raw milk, and two different dose-response (D-R) relationships were considered. The RA model predicted no human campylobacteriosis cases per year either in the best (4°C) storage conditions or in the case of thermal abuse in case of boiling raw milk, whereas in case of raw milk consumption the annual estimated campylobacteriosis cases depend on the dose-response relationships used in the model (D-R I or D-R II), the milk time-temperature storage conditions, consumer behaviour and age of consumers, namely young (with two cut-off values of ≤5 or ≤6 years old for the sensitive population) versus adult consumers. The annual estimated cases for young consumers using D-R II for the sensitive population (≤5 years old) ranged between 1013.7/100,000 population and 8110.3/100,000 population and for adult consumers using D-R I between 79.4/100,000 population and 333.1/100,000 population. Quantification of the risks associated with raw milk consumption is necessary from a public health perspective and the proposed RA model represents a useful and flexible tool to perform future RAs based on local consumer habits to support decision-making on safety policies. Further educational programmes for raw milk consumers or potential raw milk consumers are required to encourage consumers to boil milk to reduce the associated risk of illness. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Policy outcomes of applying different nutrient profiling systems in recreational sports settings: the case for national harmonization in Canada.

    PubMed

    Olstad, Dana Lee; Poirier, Kelly; Naylor, Patti-Jean; Shearer, Cindy; Kirk, Sara F L

    2015-08-01

    To assess agreement among three nutrient profiling systems used to evaluate the healthfulness of vending machine products in recreation and sport settings in three Canadian provinces. We also assessed whether the nutritional profile of vending machine items in recreation and sport facilities that were adhering to nutrition guidelines (implementers) was superior to that of facilities that were not (non-implementers). Trained research assistants audited the contents of vending machines. Three provincial nutrient profiling systems were used to classify items into each province's most, moderately and least healthy categories. Agreement among systems was assessed using weighted κ statistics. ANOVA assessed whether the average nutritional profile of vending machine items differed according to province and guideline implementation status. Eighteen recreation and sport facilities in three Canadian provinces. One-half of facilities were implementing nutrition guidelines. Snacks (n 531) and beverages (n 618) within thirty-six vending machines were audited. Overall, the systems agreed that the majority of items belonged within their respective least healthy categories (66-69 %) and that few belonged within their most healthy categories (14-22 %). Agreement among profiling systems was moderate to good, with κ w values ranging from 0·49 to 0·69. Implementers offered fewer of the least healthy items (P<0·05) and these items had a better nutritional profile compared with items in non-implementing facilities. The policy outcomes of the three systems are likely to be similar, suggesting there may be scope to harmonize nutrient profiling systems at a national level to avoid unnecessary duplication and support food reformulation by industry.

  18. Are school vending machines loaded with calories and fat: an assessment of 106 middle and high schools.

    PubMed

    Pasch, Keryn E; Lytle, Leslie A; Samuelson, Anne C; Farbakhsh, Kian; Kubik, Martha Y; Patnode, Carrie D

    2011-04-01

    The purpose of this study was to describe the extent to which vending offerings in 106 schools in the St. Paul-Minneapolis, Minnesota metropolitan area, met criteria for types of beverages, fat, and calories based on selected criteria offered by the Institute of Medicine. Schools where youth participants were attending for the 2006-2007 school year were identified and invited to participate in the study (n = 143); 81% of schools (n = 116) agreed to participate. Of the 116 schools, 106 had vending machines. Across schools with vending machines (n = 106), 5085 food and 8442 beverage items were offered. Overall, only 18% of beverage items met criteria for calories and type of beverage; significantly more items in public schools met the criteria as compared to private schools (19% vs 12%; p < .01). This difference was also significant for high schools as compared to middle schools (18% vs 22%; p < .01). For food items, 41% met calorie criteria, 45% met fat criteria, and 22% met both fat and calorie criteria. Significantly more food items met both criteria in public than private schools (22% vs 18%; p = .01), while high schools (22%) and middle schools (21%) were similar. A very small proportion of foods (< 5%) would have met the full criteria suggested by the Institute of Medicine for competitive foods. Overall, foods and beverages offered in vending machines continue to be high in fat and calories. Public schools are doing a slightly better job of providing healthy foods as compared to private schools. © 2011, American School Health Association.

  19. Are School Vending Machines Loaded with Calories and Fat: An Assessment of 106 Middle and High Schools

    PubMed Central

    PASCH, KERYN E.; LYTLE, LESLIE A.; SAMUELSON, ANNE C.; FARBAKHSH, KIAN; KUBIK, MARTHA Y.; PATNODE, CARRIE D.

    2013-01-01

    Background The purpose of this study was to describe the extent to which vending offerings in 106 schools in the St. Paul-Minneapolis, Minnesota metropolitan area met criteria for types of beverages, fat and calories based on selected criteria offered by the Institute of Medicine. Methods Schools where youth participants were attending for the 2006-2007 school year were identified and invited to participate in the study (n=143); 81% of schools (n=116) agreed to participate. Results Of the 116 schools, 106 had vending machines. Across schools with vending machines (n=106), 5085 food and 8442 beverage items were offered. Overall, only 18% of beverage items met criteria for calories and type of beverage; significantly more items in public schools met the criteria as compared to private schools (19% vs. 12%; p<0.01). This difference was also significant for high schools as compared to middle schools (18% vs. 22%; p<0.01). For food items, 41% met calorie criteria, 45% met fat criteria, and 22% met both fat and calorie criteria. Significantly more food items met both criteria in public than private schools (22% vs. 18%; p=0.01), while high schools (22%) and middle schools (21%) were similar. A very small proportion of foods (<5%) would have met the full criteria suggested by the Institute of Medicine for competitive foods.. Conclusion Overall, foods and beverages offered in vending machines continue to be high in fat and calories. Public schools are doing a slightly better job of providing healthy foods as compared to private schools. PMID:21392013

  20. Increased Access to Unrestricted Pharmacy Sales of Syringes in Seattle–King County, Washington: Structural and Individual-Level Changes, 1996 Versus 2003

    PubMed Central

    Deibert, Ryan J.; Goldbaum, Gary; Parker, Theodore R.; Hagan, Holly; Marks, Robert; Hanrahan, Michael; Thiede, Hanne

    2006-01-01

    We examined pharmacists’ attitudes and practices related to syringe sales to injection drug users before and after legal reform and local programming to enhance sterile syringe access. We replicated a 1996 study by conducting pharmacist phone surveys and syringe test-buys in randomly selected pharmacies. Test-buy success increased from 48% in 1996 to 65% in 2003 (P=.04). Pharmacists agreeing that syringes should be available to injection drug users through pharmacy purchase increased from 49% to 71% (P<.01). Pharmacy policies and pharmacist attitudes were strongly associated with syringe access. Structural changes, including policy reform and pharmacy outreach, appear to increase syringe access. Interventions should address pharmacy policies and pharmacist attitudes and policies. PMID:16809607

  1. Consequences of a restrictive syringe exchange policy on utilization patterns of a syringe exchange program in Baltimore, Maryland: Implications for HIV risk

    PubMed Central

    Sherman, Susan G.; Patel, Shivani A.; Ramachandran, Daesha V.; Galai, Noya; Chaulk, Patrick; Serio-Chapman, Chris; Gindi, Renee M.

    2016-01-01

    Background Syringe distribution policies continue to be debated in many jurisdictions throughout the U.S. The Baltimore Needle and Syringe Exchange Program (NSP) operated under a 1-for-1 syringe exchange policy from its inception in 1994 through 1999, when it implemented a restrictive policy (2000–2004) that dictated less than 1-for-1 exchange for non-program syringes. Methods Data were derived from the Baltimore NSP, which prospectively collected data on all client visits. We examined the impact of this restrictive policy on program-level output measures (i.e., distributed:returned syringe ratio, client volume) before, during, and after the restrictive exchange policy. Through multiple logistic regression, we examined correlates of less than 1-for-1 exchange ratios at the client-level before and during the restrictive exchange policy periods. Results During the restrictive policy period, the average annual program-level ratio of total syringes distributed:returned dropped from 0.99 to 0.88, with a low point of 0.85 in 2000. There were substantial decreases in the average number of syringes distributed, syringes returned, the total number of clients, and new clients enrolling during the restrictive compared to the preceding period. During the restrictive period, 33,508 more syringes were returned to the needle exchange than were distributed. In the presence of other variables, correlates of less than 1-for-1 exchange ratio were being white, female, and less than 30 years old. Discussion With fewer clean syringes in circulation, restrictive policies could increase the risk of exposure to HIV among IDUs and the broader community. The study provides evidence to the potentially harmful effects of such policies. PMID:25919590

  2. 77 FR 3915 - Federal Support for the Randolph-Sheppard Vending Facility Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... Vol. 77 Wednesday, No. 16 January 25, 2012 Part IV The President Memorandum of January 20, 2012--Federal Support for the Randolph- Sheppard Vending Facility Program #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol. 77, No. 16 / Wednesday, January 25, 2012 / Presidential Documents#0;#0; #0; #0;Title 3-- #0;The President [[Page 3917

  3. Are School Vending Machines Loaded with Calories and Fat: An Assessment of 106 Middle and High Schools

    ERIC Educational Resources Information Center

    Pasch, Keryn E.; Lytle, Leslie A.; Samuelson, Anne C.; Farbakhsh, Kian; Kubik, Martha Y.; Patnode, Carrie D.

    2011-01-01

    Background: The purpose of this study was to describe the extent to which vending offerings in 106 schools in the St. Paul-Minneapolis, Minnesota metropolitan area, met criteria for types of beverages, fat, and calories based on selected criteria offered by the Institute of Medicine. Methods: Schools where youth participants were attending for the…

  4. Breaking Habits: The Effect of The French Vending Machine Ban on School Snacking and Sugar Intakes

    ERIC Educational Resources Information Center

    Capacci, Sara; Mazzocchi, Mario; Shankar, Bhavani

    2018-01-01

    This paper estimates the effect of the 2005 vending machine ban in French secondary schools on nutrient intakes and on the frequency of morning snacking at school. Using data before and after the ban, and exploiting the discontinuity associated with the age-dependent exposure to the ban, we specify a difference-in-differences regression…

  5. Profiling online recreational/prescription drugs' customers and overview of drug vending virtual marketplaces.

    PubMed

    Orsolini, Laura; Francesconi, Giulia; Papanti, Duccio; Giorgetti, Arianna; Schifano, Fabrizio

    2015-07-01

    Internet and social networking sites play a significant role in the marketing and distribution of recreational/prescription drugs without restrictions. We aimed here at reviewing data relating to the profile of the online drug customer and at describing drug vending websites. The PubMed, Google Scholar, and Scopus databases were searched here in order to elicit data on the socio-demographic characteristics of the recreational marketplaces/online pharmacies' customers and the determinants relating to online drug purchasing activities. Typical online recreational drugs' customers seem to be Caucasian, men, in their 20s, highly educated, and using the web to impact as minimally as possible on their existing work/professional status. Conversely, people without any health insurance seemed to look at the web as a source of more affordable prescription medicines. Drug vending websites are typically presented here with a "no prescription required" approach, together with aggressive marketing strategies. The online availability of recreational/prescriptions drugs remains a public health concern. A more precise understanding of online vending sites' customers may well facilitate the drafting and implementation of proper prevention campaigns aimed at counteracting the increasing levels of online drug acquisition and hence intake activities. Copyright © 2015 John Wiley & Sons, Ltd.

  6. Misplaced Paternalism and other Mistakes in the Debate over Kidney Sales.

    PubMed

    Semrau, Luke

    2017-03-01

    Erik Malmqvist defends the prohibition on kidney sales as a justifiable measure to protect individuals from harms they have not autonomously chosen. This appeal to 'group soft paternalism' requires that three conditions be met. It must be shown that some vendors will be harmed, that some will be subject to undue pressure to vend, and that we cannot feasibly distinguish between the autonomous and the non-autonomous. I argue that Malmqvist fails to demonstrate that any of these conditions are likely to obtain. His argument involves two common errors. First, he, like many, proceeds on a mistaken understanding of how to assess harm. What matters is not the balance of costs and benefits of vending, but a comparison of potential vendors' welfare across two possible courses of action. Second, Malmqvist's concerns about third-party pressure are predicated on an empirically unrealistic understanding of the operation of a regulated market. A widely underappreciated fact is that kidney sales will be relatively rare, and most who try to vend will be unable to. Because pressure on another to vend will not result in the desired outcome, few will exert it. © 2016 John Wiley & Sons Ltd.

  7. Sterile syringe access and disposal among injection drug users newly enrolled in methadone maintenance treatment: a cross-sectional survey

    PubMed Central

    McNeely, Jennifer; Arnsten, Julia H; Gourevitch, Marc N

    2006-01-01

    Background We sought to assess injection practices, means of acquiring and disposing of syringes, and utilization and knowledge of harm reduction resources among injection drug users (IDUs) entering methadone maintenance treatment (MMT). Methods Interviews with 100 consecutive patients, including 35 IDUs, entering a MMT program in the Bronx, NY. Results Utilization of unsafe syringe sources was reported by 69% of IDUs in our sample. Most (80%) IDUs reused syringes, and syringe sharing was also common. Fewer than half knew that non-prescription pharmacy purchase of syringes was possible. The most common means of disposing of injecting equipment were the trash (63%) and syringe exchange programs (49%). Conclusions These findings indicate that drug users entering treatment under-utilize sanctioned venues to obtain sterile syringes or safely dispose of used injection equipment. Programs providing services to drug users should adopt a proactive stance to address the safety and health issues faced by injectors. PMID:16503997

  8. Reuse prevention syringes for reconstitution of lyophilized vaccines: Operational study and UNICEF plans for expanding introduction.

    PubMed

    Fleming, Jessica A; Hoekstra, Edward John; Moniaga, Vanda; Widjaya, Anton; Soepardi, Jane; Supartha, Nyoman; Salovaara, Annika; Khamassi, Selma; Nelson, Carib

    2009-01-01

    Since the 1990s, the United Nation's Children's Fund has encouraged injection safety for immunizations through bundling vaccines with appropriate amounts of supporting equipment and by supplying autodisable (AD) syringes for injections. However, poor vaccine reconstitution practices continue to be reported worldwide. By 2009, UNICEF will begin to phase out the distribution of standard disposable syringes for vaccine reconstitution and replace them with reuse prevention (RUP) syringes, with a full transition expected by the end of 2010. A field evaluation in Indonesia was conducted to identify introduction requirements, issues with healthcare worker training and acceptance, and RUP syringe performance and safety. Managers and health workers felt that RUP syringes improved injection safety and fit easily into country logistical systems. Healthcare workers felt they were intuitive to use, but recommended special training. The integration of RUP reconstitution syringes by UNICEF could increase injection safety by preventing the reuse of syringes and reducing vaccine contamination.

  9. Greater Drug Injecting Risk for HIV, HBV, and HCV Infection in a City Where Syringe Exchange and Pharmacy Syringe Distribution are Illegal

    PubMed Central

    Zhao, Mingfang; Gyarmathy, V. Anna; Cisek, Linda; Friedman, Samuel R.; Baxter, Robert C.

    2008-01-01

    Comparing drug-injecting risk between cities that differ in the legality of sterile syringe distribution for injection drug use provides a natural experiment to assess the efficacy of legalizing sterile syringe distribution as a structural intervention to prevent human immunodeficiency virus (HIV) and other parenterally transmitted infections among injection drug users (IDUs). This study compares the parenteral risk for HIV and hepatitis B (HBV) and C (HCV) infection among IDUs in Newark, NJ, USA, where syringe distribution programs were illegal during the period when data were collected, and New York City (NYC) where they were legal. IDUs were nontreatment recruited, 2004–2006, serotested, and interviewed about syringe sources and injecting risk behaviors (prior 30 days). In multivariate logistic regression, adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) for city differences are estimated controlling for potential city confounders. IDUs in Newark (n = 214) vs. NYC (n = 312) were more likely to test seropositive for HIV (26% vs. 5%; AOR = 3.2; 95% CI = 1.6, 6.1), antibody to the HBV core antigen (70% vs. 27%; AOR = 4.4; 95% CI = 2.8, 6.9), and antibody to HCV (82% vs. 53%; AOR = 3.0; 95% CI = 1.8, 4.9), were less likely to obtain syringes from syringe exchange programs or pharmacies (AOR = 0.004; 95% CI = 0.001, 0.01), and were more likely to obtain syringes from street sellers (AOR = 74.0; 95% CI = 29.9, 183.2), to inject with another IDU’s used syringe (AOR = 2.3; 95% CI = 1.1, 5.0), to reuse syringes (AOR = 2.99; 95% CI = 1.63, 5.50), and to not always inject once only with a new, sterile syringe that had been sealed in a wrapper (AOR = 5.4; 95% CI = 2.9, 10.3). In localities where sterile syringe distribution is illegal, IDUs are more likely to obtain syringes from unsafe sources and to engage in injecting risk behaviors. Legalizing and rapidly implementing sterile syringe distribution programs are critical for reducing parenterally transmitted HIV, HBV, and HCV among IDUs. PMID:18340537

  10. Cost and acceptability of three syringe-pump infusion systems.

    PubMed

    Johnson, M S; Pesko, L J; Wood, C F; Reinders, T P

    1990-08-01

    The fiscal impact and acceptability of implementing a syringe-pump infusion system at a 900-bed university teaching hospital where the minibag system has been in use is reported. Researchers selected three models of syringe pumps for evaluation: the Bard Harvard Mini-Infuser 150XL, the Becton Dickinson 360 Infuser, and the Strato Stratofuse System. Each pump was evaluated for three weeks on a medical-surgical unit and a hematology-oncology unit. Drugs to be infused were chosen after a literature review to determine which drugs had been successfully infused via syringe pump; 22 formulary medications were selected. Syringes were prepared as singly packaged doses or as doses prepared in bulk and packaged frozen. Control of the syringe pumps and microbore tubing was assigned to the inpatient pharmacy staff. Nurses and pharmacy personnel were apprised of the study and taught how to use the syringe pumps. Time-and-motion studies were performed in the sterile products preparation area, and a cost analysis was done. Nurses preferred syringe pumps over the minibag system because the pumps reduced the nursing time needed to infuse a drug, administered less fluid, provided consistent infusion rates, had alarms, and were relatively easy to use. The time required to prepare syringes did not differ substantially among syringe-pump models. It was estimated that using any of the evaluated pumps in place of the minibag system would save $126,500 during the three-year period 1988-91, primarily because of differences in the cost of disposable items. The syringe-pump infusion system is an acceptable and cost-effective alternative to the minibag system.

  11. The association between state bans on soda only and adolescent substitution with other sugar-sweetened beverages: a cross-sectional study.

    PubMed

    Taber, Daniel R; Chriqui, Jamie F; Vuillaume, Renee; Kelder, Steven H; Chaloupka, Frank J

    2015-07-27

    Across the United States, many states have actively banned the sale of soda in high schools, and evidence suggests that students' in-school access to soda has declined as a result. However, schools may be substituting soda with other sugar-sweetened beverages (SSBs), and national trends indicate that adolescents are consuming more sports drinks and energy drinks. This study examined whether students consumed more non-soda SSBs in states that banned the sale of soda in school. Student data on consumption of various SSBs and in-school access to vending machines that sold SSBs were obtained from the National Youth Physical Activity and Nutrition Study (NYPANS), conducted in 2010. Student data were linked to state laws regarding the sale of soda in school in 2010. Students were cross-classified based on their access to vending machines and whether their state banned soda in school, creating 4 comparison groups. Zero-inflated negative binomial models were used to compare these 4 groups with respect to students’ self-reported consumption of diet soda, sports drinks, energy drinks, coffee/tea, or other SSBs. Students who had access to vending machines in a state that did not ban soda were the reference group. Models were adjusted for race/ethnicity, sex, grade, home food access, state median income, and U.S. Census region. Students consumed more servings of sports drinks, energy drinks, coffee/tea, and other SSBs if they resided in a state that banned soda in school but attended a school with vending machines that sold other SSBs. Similar results were observed where schools did not have vending machines but the state allowed soda to be sold in school. Intake was generally not elevated where both states and schools limited SSB availability – i.e., states banned soda and schools did not have SSB vending machines. State laws that ban soda but allow other SSBs may lead students to substitute other non-soda SSBs. Additional longitudinal research is needed to confirm this. Elevated SSB intake was not observed when both states and schools took steps to remove SSBs from school.

  12. Healthier choices in an Australian health service: a pre-post audit of an intervention to improve the nutritional value of foods and drinks in vending machines and food outlets

    PubMed Central

    2013-01-01

    Background Vending machines and shops located within health care facilities are a source of food and drinks for staff, visitors and outpatients and they have the potential to promote healthy food and drink choices. This paper describes perceptions of parents and managers of health-service located food outlets towards the availability and labelling of healthier food options and the food and drinks offered for sale in health care facilities in Australia. It also describes the impact of an intervention to improve availability and labelling of healthier foods and drinks for sale. Methods Parents (n = 168) and food outlet managers (n = 17) were surveyed. Food and drinks for sale in health-service operated food outlets (n = 5) and vending machines (n = 90) in health care facilities in the Hunter New England region of NSW were audited pre (2007) and post (2010/11) the introduction of policy and associated support to increase the availability of healthier choices. A traffic light system was used to classify foods from least (red) to most healthy choices (green). Results Almost all (95%) parents and most (65%) food outlet managers thought food outlets on health service sites should have signs clearly showing healthy choices. Parents (90%) also thought all food outlets on health service sites should provide mostly healthy items compared to 47% of managers. The proportion of healthier beverage slots in vending machines increased from 29% to 51% at follow-up and the proportion of machines that labelled healthier drinks increased from 0 to 26%. No outlets labelled healthier items at baseline compared to 4 out of 5 after the intervention. No changes were observed in the availability or labelling of healthier food in vending machines or the availability of healthier food or drinks in food outlets. Conclusions Baseline availability and labelling of healthier food and beverage choices for sale in health care facilities was poor in spite of the support of parents and outlet managers for such initiatives. The intervention encouraged improvements in the availability and labelling of healthier drinks but not foods in vending machines. PMID:24274916

  13. The association between state bans on soda only and adolescent substitution with other sugar-sweetened beverages: a cross-sectional study

    PubMed Central

    2015-01-01

    Background Across the United States, many states have actively banned the sale of soda in high schools, and evidence suggests that students’ in-school access to soda has declined as a result. However, schools may be substituting soda with other sugar-sweetened beverages (SSBs), and national trends indicate that adolescents are consuming more sports drinks and energy drinks. This study examined whether students consumed more non-soda SSBs in states that banned the sale of soda in school. Methods Student data on consumption of various SSBs and in-school access to vending machines that sold SSBs were obtained from the National Youth Physical Activity and Nutrition Study (NYPANS), conducted in 2010. Student data were linked to state laws regarding the sale of soda in school in 2010. Students were cross-classified based on their access to vending machines and whether their state banned soda in school, creating 4 comparison groups. Zero-inflated negative binomial models were used to compare these 4 groups with respect to students’ self-reported consumption of diet soda, sports drinks, energy drinks, coffee/tea, or other SSBs. Students who had access to vending machines in a state that did not ban soda were the reference group. Models were adjusted for race/ethnicity, sex, grade, home food access, state median income, and U.S. Census region. Results Students consumed more servings of sports drinks, energy drinks, coffee/tea, and other SSBs if they resided in a state that banned soda in school but attended a school with vending machines that sold other SSBs. Similar results were observed where schools did not have vending machines but the state allowed soda to be sold in school. Intake was generally not elevated where both states and schools limited SSB availability – i.e., states banned soda and schools did not have SSB vending machines. Conclusion State laws that ban soda but allow other SSBs may lead students to substitute other non-soda SSBs. Additional longitudinal research is needed to confirm this. Elevated SSB intake was not observed when both states and schools took steps to remove SSBs from school. PMID:26221969

  14. Healthier choices in an Australian health service: a pre-post audit of an intervention to improve the nutritional value of foods and drinks in vending machines and food outlets.

    PubMed

    Bell, Colin; Pond, Nicole; Davies, Lynda; Francis, Jeryl Lynn; Campbell, Elizabeth; Wiggers, John

    2013-11-25

    Vending machines and shops located within health care facilities are a source of food and drinks for staff, visitors and outpatients and they have the potential to promote healthy food and drink choices. This paper describes perceptions of parents and managers of health-service located food outlets towards the availability and labelling of healthier food options and the food and drinks offered for sale in health care facilities in Australia. It also describes the impact of an intervention to improve availability and labelling of healthier foods and drinks for sale. Parents (n = 168) and food outlet managers (n = 17) were surveyed. Food and drinks for sale in health-service operated food outlets (n = 5) and vending machines (n = 90) in health care facilities in the Hunter New England region of NSW were audited pre (2007) and post (2010/11) the introduction of policy and associated support to increase the availability of healthier choices. A traffic light system was used to classify foods from least (red) to most healthy choices (green). Almost all (95%) parents and most (65%) food outlet managers thought food outlets on health service sites should have signs clearly showing healthy choices. Parents (90%) also thought all food outlets on health service sites should provide mostly healthy items compared to 47% of managers. The proportion of healthier beverage slots in vending machines increased from 29% to 51% at follow-up and the proportion of machines that labelled healthier drinks increased from 0 to 26%. No outlets labelled healthier items at baseline compared to 4 out of 5 after the intervention. No changes were observed in the availability or labelling of healthier food in vending machines or the availability of healthier food or drinks in food outlets. Baseline availability and labelling of healthier food and beverage choices for sale in health care facilities was poor in spite of the support of parents and outlet managers for such initiatives. The intervention encouraged improvements in the availability and labelling of healthier drinks but not foods in vending machines.

  15. Time to act: a call for comprehensive responses to HIV in people who use drugs

    PubMed Central

    Beyrer, Chris; Malinowska-Sempruch, Kasia; Kamarulzaman, Adeeba; Kazatchkine, Michel; Sidibe, Michel; Strathdee, Steffanie A

    2013-01-01

    The published work on HIV in people who use drugs shows that the global burden of HIV infection in this group can be reduced. Concerted action by governments, multilateral organisations, health systems, and individuals could lead to enormous benefits for families, communities, and societies. We review the evidence and identify synergies between biomedical science, public health, and human rights. Cost-effective interventions, including needle and syringe exchange programmes, opioid substitution therapy, and expanded access to HIV treatment and care, are supported on public health and human rights grounds; however, only around 10% of people who use drugs worldwide are being reached, and far too many are imprisoned for minor offences or detained without trial. To change this situation will take commitment, advocacy, and political courage to advance the action agenda. Failure to do so will exacerbate the spread of HIV infection, undermine treatment programmes, and continue to expand prison populations with patients in need of care. PMID:20650515

  16. Wrap spring clutch syringe ram and frit mixer

    DOEpatents

    Simpson, Frank B.

    2006-07-25

    A wrap spring clutch syringe ram pushes at least one syringe with virtually instantaneous starting and stopping, and with constant motion at a defined velocity during the intervening push. The wrap spring clutch syringe ram includes an electric motor, a computer, a flywheel, a wrap spring clutch, a precision lead screw, a slide platform, and syringe reservoirs, a mixing chamber, and a reaction incubation tube. The electric motor drives a flywheel and the wrap spring clutch couples the precision lead screw to the flywheel when a computer enables a solenoid of the wrap spring clutch. The precision lead screw drives a precision slide which causes syringes to supply a portion of solution into the mixing chamber and the incubation tube. The wrap spring clutch syringe ram is designed to enable the quantitative study of solution phase chemical and biochemical reactions, particularly those reactions that occur on the subsecond time scale.

  17. Oral syringe use survey.

    PubMed

    Baldwin, J N; Wedemeyer, H F

    1980-09-01

    Use of oral syringes at children's and ASHP-accredited residency hospitals in the United States was surveyed. Questionnaires were mailed to 131 hospitals; 117 (89.3%) were returned. Of the responding hospitals, 54.5% of children's hospitals and 67.1% of residency hospitals used oral syringes. There was no definite preference for a particular brand or type (glass vs. plastic) of syringe. Patients who often required liquid dosage forms, including pediatric and geriatric patients and patients with nasogastric tubes, were most frequently included in oral syringe distribution systems. Twenty-six of the 73 hospitals utilizing oral syringes used them for most unit dose liquids in all drug distribution systems. The remainder reported use for specific medications or circumstances. Expiration dating policies varied from 24 hours to one year to the manufacturer's expiration dating. The survey indicates widespread use of oral syringes and identifies a need for evaluation of medication stability in these devices.

  18. The cleaning of instruments and syringes

    PubMed Central

    Darmady, E. M.; Hughes, K. E. A.; Drewett, S. E.; Prince, D.; Tuke, Winifred; Verdon, Patricia

    1965-01-01

    The dangers to the handler of syringes used for routine injections were found to be negligible, but known infected syringes and those contaminated with antibiotics should be autoclaved before handling as a high proportion of these carry pathogenic organisms. Mechanical methods of cleaning syringes and instruments are assessed. The use of an artificial soil for testing purposes is described. Using this soil, ultrasonics by themselves are inadequate for cleaning syringes and instruments. Agitation with ultrasonics is essential for syringes, but is insufficient for instruments. Detergents are therefore an essential adjunct to the cleaning process. For syringes Pyroneg proved to be the most satisfactory, particularly if they had been previously siliconized. The best detergent for instruments contaminated with these types of soil was Penesolve 814 at a temperature of 95°C. but the instruments must be adequately rinsed after this treatment. A number of other detergents and cleaning agents are discussed. PMID:14247708

  19. Bilateral innervation of syringeal muscles by the hypoglossal nucleus in the jungle crow (Corvus macrorhynchos).

    PubMed

    Tsukahara, Naoki; Kamata, Naoki; Nagasawa, Miyuki; Sugita, Shoei

    2009-08-01

    Bird vocalizations are produced by contractions of syringeal muscles, which are controlled by the hypoglossal nucleus. In oscines, syringeal muscles are controlled by the hypoglossal nucleus ipsilaterally, whereas syringeal innervation is bilateral in non-oscines. We have determined the course of hypoglossal nerves in the jungle crow Corvus macrorhynchos. Our results indicate a cross-over of the hypoglossal nerve from the left side to the right side on the trachea 7 mm rostral to the Musculus sternotrachealis. We also investigated the innervation of the syringeal muscles of jungle crows from the hypoglossal nucleus using the horseradish peroxidase (HRP) method. After HRP was injected into the syringeal muscles on each side, HRP-labeled cells were found bilaterally in the hypoglossal nerve. These results suggest that the syringeal muscles of jungle crows are innervated bilaterally from the hypoglossal nucleus, although these birds are categorized as oscines.

  20. Bilateral innervation of syringeal muscles by the hypoglossal nucleus in the jungle crow (Corvus macrorhynchos)

    PubMed Central

    Tsukahara, Naoki; Kamata, Naoki; Nagasawa, Miyuki; Sugita, Shoei

    2009-01-01

    Bird vocalizations are produced by contractions of syringeal muscles, which are controlled by the hypoglossal nucleus. In oscines, syringeal muscles are controlled by the hypoglossal nucleus ipsilaterally, whereas syringeal innervation is bilateral in non-oscines. We have determined the course of hypoglossal nerves in the jungle crow Corvus macrorhynchos. Our results indicate a cross-over of the hypoglossal nerve from the left side to the right side on the trachea 7 mm rostral to theMusculus sternotrachealis. We also investigated the innervation of the syringeal muscles of jungle crows from the hypoglossal nucleus using the horseradish peroxidase (HRP) method. After HRP was injected into the syringeal muscles on each side, HRP-labeled cells were found bilaterally in the hypoglossal nerve. These results suggest that the syringeal muscles of jungle crows are innervated bilaterally from the hypoglossal nucleus, although these birds are categorized as oscines. PMID:19490396

  1. Syringe Exchange, Injecting and Intranasal Drug Use

    PubMed Central

    Arasteh, Kamyar; McKnight, Courtney; Ringer, Martin; Friedman, Samuel R.

    2016-01-01

    Objective To assess trends in injecting and non-injecting drug use after implementation of large-scale syringe exchange in New York City. The belief that implementation of syringe exchange will lead to increased drug injecting has been a persistent argument against syringe exchange. Methods Administrative data on route of administration for primary drug of abuse among patients entering the Beth Israel methadone maintenance program from 1995 – 2007. Approximately 2000 patients enter the program each year. Results During and after the period of large scale implementation of syringe exchange, the numbers of methadone program entrants reporting injecting drug use decreased while the numbers of entrants reporting intranasal drug use increased (p < .001). Conclusion While assessing possible effects of syringe exchange on trends in injecting drug use is inherently difficult, this may be the strongest data collected to date showing a lack of increase in drug injecting following implementation of syringe exchange. PMID:19891668

  2. The Washington Needle Depot: fitting healthcare to injection drug users rather than injection drug users to healthcare: moving from a syringe exchange to syringe distribution model

    PubMed Central

    2010-01-01

    Needle exchange programs chase political as well as epidemiological dragons, carrying within them both implicit moral and political goals. In the exchange model of syringe distribution, injection drug users (IDUs) must provide used needles in order to receive new needles. Distribution and retrieval are co-existent in the exchange model. Likewise, limitations on how many needles can be received at a time compel addicts to have multiple points of contact with professionals where the virtues of treatment and detox are impressed upon them. The centre of gravity for syringe distribution programs needs to shift from needle exchange to needle distribution, which provides unlimited access to syringes. This paper provides a case study of the Washington Needle Depot, a program operating under the syringe distribution model, showing that the distribution and retrieval of syringes can be separated with effective results. Further, the experience of IDUs is utilized, through paid employment, to provide a vulnerable population of people with clean syringes to prevent HIV and HCV. PMID:20047690

  3. Syringe Sharing Among a Prospective Cohort of Street-Involved Youth: Implications for Needle Distribution Programs.

    PubMed

    Bozinoff, Nikki; Wood, Evan; Dong, Huiru; Richardson, Lindsey; Kerr, Thomas; DeBeck, Kora

    2017-09-01

    The sharing of previously used syringes is associated with the transmission of Hepatitis C and HIV. This longitudinal study examines syringe borrowing and syringe lending within a prospective cohort of street-involved youth in Vancouver, Canada. From September 2005 to May 2014, data were collected from the At-Risk Youth Study, a cohort of street-involved youth age 14-26 at enrollment, and analyzed using generalized estimating equations. Among 505 participants, 142 (28.1%) reported syringe borrowing and 132 (26.1%) reported syringe lending during the study period. In separate multivariable analyses, having difficulty finding clean needles and homelessness were significantly associated with syringe borrowing (Adjusted Odds Ratio (AOR) = 2.28, 95% CI 1.66-3.12 and AOR = 1.52, CI 1.05-2.21, respectively) and syringe lending (AOR = 1.89, 95% CI 1.32-2.71 and AOR = 1.65, 95% CI 1.11-2.44, respectively) (all p values < 0.05). Findings highlight gaps in syringe access for vulnerable young injectors and suggest that service delivery for youth may be suboptimal. Further examination of how needle distribution efforts might be improved to better meet the needs of young people is warranted.

  4. Evaluation of child preference for dentist attire and usage of camouflage syringe in reduction of anxiety.

    PubMed

    Babaji, Prashant; Chauhan, Pavni P; Rathod, Vikram; Mhatre, Swapnil; Paul, Uttam; Guram, Guneet

    2017-01-01

    The aim of this study is to evaluate the child preference for dentist attire and camouflage versus conventional syringe in reduction of anxiety. A total of 600 children aged 6-14 years were made to look at a set of six photos of an individual dressed with different colored apron of pink, green, blue, white colors, formal dress, and cartoon character along with conventional syringe and camouflage syringe with a toy-like appearance to permit injection of local anesthesia. Children's anxiety level during injections and with colored coat was assessed and recorded using the Modified Child Dental Anxiety Scale faces version. SPSS statistical software version 21 and using Chi-square test. Among age group of 6-8 years, 65.33% selected colorful apron, while other age groups 9-10, 11-12 years, and 13-14 years selected 47.34%, 57.34%, and 50.67% white coat, respectively ( P < 0.05). For syringe, 78% of younger age group (6-10 years) preferred camouflage syringe, whereas 71% of older age group (11-14 years) preferred conventional syringe. Anxiety level of all children for syringe was more compared to that of white coat. Younger children prefer colorful attire of dentist and camouflage syringe over conventional compared to older one.

  5. School and district wellness councils and availability of low-nutrient, energy-dense vending fare in Minnesota middle and high schools.

    PubMed

    Kubik, Martha Y; Lytle, Leslie A; Farbakhsh, Kian

    2011-01-01

    The Child Nutrition and WIC Reauthorization Act of 2004 required school districts participating in the federal school meals program to establish by the start of the 2006-2007 school year policies that included nutrition guidelines for all foods sold on school campus during the school day and policy development involving key stakeholders. For many schools, policy development was done by wellness councils. This study examined the association between having a wellness council and availability of low-nutrient, energy-dense foods/beverages in school vending machines following enactment of the federal legislation. In 2006-2007, Minnesota middle (n=35) and high (n=54) school principals reported whether their school and district had a wellness council. Trained research staff observed foods/beverages in vending machines accessible to students. Low-nutrient, energy-dense foods/beverages (snacks >3 g fat or >200 calories/serving, and soda, fruit/sport drinks and reduced-fat/whole milk) were grouped into seven categories (eg, high-fat baked goods) and a food score was calculated. Higher scores indicated more low-nutrient, energy-dense vending fare. Multivariate linear regression, adjusted for school characteristics, was used to examine associations between scores and a three-category council variable (district-only; district and school; no council). Among schools, 53% had district-only councils, 38% district and school councils, and 9% had no council. Schools with both a district and school council had a significantly lower mean food score than schools without councils (P=0.03). The potential of wellness councils to impact availability of low-nutrient, energy-dense vending fare is promising. There may be an added benefit to having both a school and district council. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

  6. Potency and stability of frozen urokinase solutions in syringes.

    PubMed

    Dedrick, Stephen C; Ramirez-Rico, José

    2004-08-01

    The stability and potency of frozen urokinase solutions in syringes were studied. To determine the stability and potency of compounded urokinase dilutions after multiple freeze-thaw cycles, a total of 160 syringes containing five urokinase concentrations (2,500, 5,000, 7,500, 12,500, and 25,000 IU/mL) were prepared. For each of the five concentrations tested, two syringes per concentration were reserved for baseline testing. The remaining 150 syringes were frozen at -30 degrees C. After 7 days, half of the syringes (group 1) were thawed at room temperature, tested, and left at room temperature for 12 hours before refreezing. The other half of the syringes (group 2) were kept frozen for 30 days. Thirty days after initial compounding, all syringes were thawed, and the samples' urokinase potency, pH, and physical appearance were evaluated. Syringes were visually inspected for color, clarity, and precipitation. Descriptive statistics were computed for each concentration group and testing day. The compounded dilutions were stable under each experimental condition, with no physical deterioration or loss of in vitro potency after two freeze-thaw cycles. The reduced waste associated with the ability to refreeze unused urokinase could substantially lower the cost of procedures such as thrombolysis after intraventricular hemorrhage and catheter clearance by as much as 95%. Dilutions of urokinase 2,500-25,000 IU/mL were stable in single-use syringes after being frozen for 7 days, thawed, and refrozen for another 23 days.

  7. Expanding access to sterile syringes through pharmacies: assessment of New York's Expanded Syringe Access Program.

    PubMed

    Tesoriero, James M; Battles, Haven B; Klein, Susan J; Kaufman, Erin; Birkhead, Guthrie S

    2009-01-01

    To investigate the evolution of pharmacist practices, attitudes, and experiences with the Expanded Syringe Access Program (ESAP), which permits over-the-counter sale of syringes by registered pharmacies in New York State. Longitudinal study. New York State in 2002 and 2006. 506 (2002) and 682 (2006) managing pharmacists (response rates approximately 70%) at ESAP-registered pharmacies (n = 346 in both years). Mailed surveys (2002 and 2006). Pharmacist practices, attitudes, and experiences with ESAP over time. Approximately 75% of pharmacists reported that ESAP had facilitated timely/emergency access to syringes, and more than 90% in each year reported no problems or very few problems administering ESAP. The practice of placing additional requirements on the sale of syringes decreased from 2002 (51.4%) to 2006 (45.1%), while a 55% increase in syringe sales was reported between 2002 (43.3/month) and 2006 (67.1/month). The sale of sharps containers also increased between 2002 (85.2%) and 2006 (92.8%). Community independent pharmacies and those located outside New York City generally expressed more favorable attitudes and experiences with ESAP, although these differences decreased over time. Pharmacy-based syringe access is a viable harm-reduction alternative in the fight against blood-borne diseases, with ESAP now equaling the number of syringes being distributed by syringe exchange programs in New York State. Continued education/training is necessary to increase participation in ESAP and to further reduce barriers to ESAP use.

  8. Decreased Odds of Injection Risk Behavior Associated With Direct Versus Indirect Use of Syringe Exchange: Evidence From Two California Cities.

    PubMed

    Behrends, Czarina N; Li, Chin-Shang; Gibson, David R

    2017-07-29

    While there is substantial evidence that syringe exchange programs (SEPs) are effective in preventing HIV among people who inject drugs (PWID), nearly all the evidence comes from PWID who obtain syringes from an SEP directly. Much less is known about the benefits of secondary exchange to PWID who get syringes indirectly from friends or acquaintances who visit an SEP for them. We evaluated the effectiveness of direct versus indirect syringe exchange in reducing HIV-related high-risk injecting behavior among PWID in two separate studies conducted in Sacramento and San Jose, California, cities with quite different syringe exchange models. In both studies associations between direct and indirect syringe exchange and self-reported risk behavior were examined with multivariable logistic regression models. Study 1 assessed effects of a "satellite" home-delivery syringe exchange in Sacramento, while Study 2 evaluated a conventional fixed-site exchange in San Jose. Multivariable analyses revealed 95% and 69% reductions, respectively, in high-risk injection associated with direct use of the SEPs in Sacramento and San Jose, and a 46% reduction associated with indirect use of the SEP in Sacramento. Conclusions/Importance: The very large effect of direct SEP use in Sacramento was likely due in part to home delivery of sterile syringes. While more modest effects were associated with indirect use, such use nevertheless is valuable in reducing the risk of HIV transmission of PWID who are unable or unwilling to visit a syringe exchange.

  9. Nonprescription syringe sales: Resistant pharmacists' attitudes and practices.

    PubMed

    Chiarello, Elizabeth

    2016-09-01

    To examine barriers to nonprescription syringe sales (NPSS) in pharmacies by examining resistant pharmacists' willingness to provide syringes to people who inject drugs (PWID) and their current practices for provision or refusal. Qualitative, semi-structured, in-depth interviews with community pharmacists in California, Kansas, Mississippi, and New Jersey. Participants include seventeen community pharmacists who expressed ethical concerns about providing syringes drawn from a larger sample of 71 community pharmacists participating in a study of ethical decision-making. Analysis captures pharmacists' descriptions of their experiences providing syringes to suspected PWID. Pharmacists who identified syringes as a key ethical issue exhibited significant ambivalence about providing syringes to PWID. Most of these pharmacists were aware of harm reduction logics, but endorsed them to varying degrees. Moral concerns about supplying PWID with syringes were mediated by law and organizational policy. Many pharmacists who considered syringes an ethical challenge allayed their concerns by creating informal policy and engaging in deterrence practices designed to dissuade PWID from coming to the pharmacy. As heroin abuse rates continue to rise, pharmacists are undoubtedly integral allies in the fight to prevent the spread of communicable diseases like HIV/AIDS and Hepatitis C. Education should be aimed at identifying barriers to NPSS resulting from resistant pharmacists' attitudes and practices. Increased education paired with favorable law and organizational policy and decentralization of syringe provision could increase access to clean needles and decrease public health risks. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. [Trial manufacture of a plunger shield for a disposable plastic syringe].

    PubMed

    Murakami, Shigeki; Emoto, Takashi; Mori, Hiroshige; Fujita, Katsuhisa; Kubo, Naoki

    2008-08-20

    A syringe-type radiopharmaceutical being supplied by a manufacturer has a syringe shield and a plunger shield, whereas an in-hospital labeling radiopharmaceutical is administered by a disposable plastic syringe without the plunger shield. In cooperation with Nihon Medi-Physics Co. Ltd., we have produced a new experimental plunger shield for the disposable plastic syringe. In order to evaluate this shielding effect, we compared the leaked radiation doses of our plunger shield with those of the syringe-type radiopharmaceutical (Medi shield type). Our plunger shield has a lead plate of 21 mm in diameter and 3 mm thick. This shield is equipped with the plunger-end of a disposal plastic syringe. We sealed 99mTc solution into a plastic syringe (Terumo Co.) of 5 ml with our plunger shield and Medi shield type of 2 ml. We measured leaked radiation doses around syringes using fluorescent glass dosimeters (Dose Ace). The number of measure points was 18. The measured doses were converted to 70 microm dose equivalent at 740 MBq of radioactivity. The results of our plunger shield and the Medi shield type were as follows: 4-13 microSv/h and 3-14 microSv/h at shielding areas, 3-545 microSv/h and 6-97 microSv/h at non-shielding areas, 42-116 microSv/h and 88-165 microSv/h in the vicinity of the syringe shield, and 1071 microSv/h and 1243 microSv/h at the front of the needle. For dose rates of shielding areas around the syringe, the shielding effects were approximately the same as those of the Medi shield type. In conclusion, our plunger shield may be useful for reducing finger exposure during the injection of an in-hospital labeled radiopharmaceutical.

  11. A System for Anesthesia Drug Administration Using Barcode Technology: The Codonics Safe Label System and Smart Anesthesia Manager.

    PubMed

    Jelacic, Srdjan; Bowdle, Andrew; Nair, Bala G; Kusulos, Dolly; Bower, Lynnette; Togashi, Kei

    2015-08-01

    Many anesthetic drug errors result from vial or syringe swaps. Scanning the barcodes on vials before drug preparation, creating syringe labels that include barcodes, and scanning the syringe label barcodes before drug administration may help to prevent errors. In contrast, making syringe labels by hand that comply with the recommendations of regulatory agencies and standards-setting bodies is tedious and time consuming. A computerized system that uses vial barcodes and generates barcoded syringe labels could address both safety issues and labeling recommendations. We measured compliance of syringe labels in multiple operating rooms (ORs) with the recommendations of regulatory agencies and standards-setting bodies before and after the introduction of the Codonics Safe Label System (SLS). The Codonics SLS was then combined with Smart Anesthesia Manager software to create an anesthesia barcode drug administration system, which allowed us to measure the rate of scanning syringe label barcodes at the time of drug administration in 2 cardiothoracic ORs before and after introducing a coffee card incentive. Twelve attending cardiothoracic anesthesiologists and the OR satellite pharmacy participated. The use of the Codonics SLS drug labeling system resulted in >75% compliant syringe labels (95% confidence interval, 75%-98%). All syringe labels made using the Codonics SLS system were compliant. The average rate of scanning barcodes on syringe labels using Smart Anesthesia Manager was 25% (730 of 2976) over 13 weeks but increased to 58% (956 of 1645) over 8 weeks after introduction of a simple (coffee card) incentive (P < 0.001). An anesthesia barcode drug administration system resulted in a moderate rate of scanning syringe label barcodes at the time of drug administration. Further, adaptation of the system will be required to achieve a higher utilization rate.

  12. [Economic impact of strategies using ephedrine prefilled syringes].

    PubMed

    Crégut-Corbaton, J; Malbranche, C; Guignard, M-H; Fagnoni, P

    2013-11-01

    Ephedrine is an emergency drug available in ampules and syringes need to be prepared in advance according to one of two strategies in our establishment: strategy 1 (S1: 1 ampule per patient) and strategy 2 (S2: 1 ampule per operating room). There are also prefilled syringes. Because of their high cost and conflicting results in the literature, we assessed the economic interest of using prefilled syringes compared with strategies S1 and S2. This was a prospective observational study. The consumption of ephedrine was recorded over two periods of 14 days: P1 with syringes prepared in advance according to S1 or S2 and P2 with the on-demand use of prefilled syringes. The cost of a syringe of ephedrine prepared in advance (nurse time preparation included) was evaluated at €1.65 vs. €3.57 for a prefilled syringe. In operating rooms using S1, the use of prefilled syringes reduced overall the cost per patient about €1.22 and global annual costs by 72% (€2830), while the decrease was about €0.32 for the cost per patient and about 47% (€2760) for global annual costs for operating rooms using S2. The interest of our study is that we investigated different supply strategies for ephedrine within a large number of operating rooms. In our establishment, it was decided to use prefilled syringes in operating rooms that used S1. As well as the economic interest, prefilled syringes contributed to improved safety and saved nursing time. Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  13. Adverse event associated with a change in nonprescription syringe sale policy.

    PubMed

    Zaller, Nickolas D; Yokell, Michael A; Jeronimo, Alexandra; Bratberg, Jeffrey P; Case, Patricia; Rich, Josiah D

    2010-01-01

    To report and describe the possible correlation of a change in syringe sale policy at a community pharmacy with an adverse clinical outcome. Providence, RI, in summer 2009. 27-year-old white woman with a long-standing history of chronic relapsing opiate addiction and human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfection. The patient presented to the hospital emergency department with 5 days of severe diffuse pain, swelling in her hands and feet, and several days of rigors with fevers, sweats, and chills. She was diagnosed with sepsis resulting from a disseminated methicillin-resistant Staphylococcus aureus (MRSA) infection. The patient was treated with intravenous antibiotics, neurosurgical drainage of an epidural abscess, intensive care unit care for 1 week, and acute hospitalization for 8 weeks. Not applicable. A few weeks before the patient was hospitalized, pharmacists at her local neighborhood pharmacy decided to stop selling syringes in packages of 10. Instead, syringes were sold at a minimum quantity of 100. The patient did not know where to obtain sterile syringes and began reusing syringes. The patient introduced pathogenic bacteria from her skin into her bloodstream through unsafe injection practices. The change in syringe sale policy at her local pharmacy likely inadvertently contributed to this severe and life-threatening situation. Consideration of the implications of syringe sale policy must include an understanding of the barriers that influence individual pharmacist's decisions regarding particular store policies that affect over-the-counter syringe sales. Legalized sale of nonprescription syringes in community pharmacies alone is not enough to curb the epidemic of unsafe injection practices in the United States. All medical risks that are inherent in the use of unsafe syringes, including blood-borne viral pathogens (e.g., HIV, HCV) and bacterial infections (e.g., MRSA), should be considered.

  14. Investigation of Two Prototypes of Novel Noncontact Technologies for Automated Real-Time Capture of Incremental Drug Administration Data From Syringes.

    PubMed

    Eagle, Benjamin; Williams, David J; Dingley, John

    2017-08-01

    An ideal electronic anesthesia recording system would be capable of not only recording physiological data but also injectable drug doses given, including those given incrementally from one syringe, without recourse to manual data entry. We compared 2 prototype devices which wirelessly recognized individual syringes and measured changes in their plunger positions via 2 different optical noncontact means, allowing calculation of incremental drug doses given. Both devices incorporated a radio-frequency identification reader, which wirelessly read a unique code from a radio-frequency identification tag within syringe drug labels. A custom-designed cradle oriented any inserted 1-mL to 20-mL syringe in a repeatable position. The "laser" device had a moving laser beam broken by the end of the syringe plunger. The infrared (IR) device measured time of travel of IR light from a sender to a syringe plunger and back to a receiver. Both devices could therefore determine the drug and volume administered since the previous occasion when any syringe had been used. For each syringe size of 1, 2, 5, 10, and 20 mL, 121 plunger-length measurements were made over their full range, with each machine against a reference method of water filling and weighing using a randomized de Bruijn sequence. For every syringe size, the laser device showed greater accuracy and precision, lower bias, and narrower limits of agreement (95% confidence intervals = bias ± 1.96 SD) than the IR device when compared to the reference method. For all syringe sizes, the range of bias was -0.05 to 0.32 mL for the laser and -2.42 to 1.38 mL for the IR. Lin concordance correlation coefficient values for the IR versus reference methods ranged from 0.6259 to 0.9255, with the lowest coefficients seen in syringes with the shortest distance of plunger travel (2 and 5 mL), while in laser versus reference comparisons, these coefficients were similar (0.9641-0.9981) over all syringe lengths. Both devices measured syringe volume changes, demonstrating potential for measuring incremental drug doses, recording these, and also the time of each measurement. The IR device had no moving parts, which would be advantageous in a clinical situation. However, the current embodiment was not deemed accurate enough for clinical use, potentially remediable through improvements in hardware and software design. The laser device showed high accuracy and precision over all syringe sizes and contained volumes, and was considered potentially accurate enough for clinical use with suitable development.

  15. The best argument against kidney sales fails.

    PubMed

    Semrau, Luke

    2015-06-01

    Simon Rippon has recently argued against kidney markets on the grounds that introducing the option to vend will result in many people, especially the poor, being subject to harmful pressure to vend. Though compelling, Rippon's argument fails. What he takes to be a single phenomenon-social and legal pressure to vend-is actually two. Only one of these forms of pressure is, by Rippon's own account, harmful. Further, an empirically informed view of the regulated market suggests that this harmful pressure is easily avoided. Thus, the harm that is the lynchpin of Rippon's opposition is neither a necessary feature of the market nor is it likely to play a significant role in its operation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Methods To Determine the Silicone Oil Layer Thickness in Sprayed-On Siliconized Syringes.

    PubMed

    Loosli, Viviane; Germershaus, Oliver; Steinberg, Henrik; Dreher, Sascha; Grauschopf, Ulla; Funke, Stefanie

    2018-01-01

    The silicone lubricant layer in prefilled syringes has been investigated with regards to siliconization process performance, prefilled syringe functionality, and drug product attributes, such as subvisible particle levels, in several studies in the past. However, adequate methods to characterize the silicone oil layer thickness and distribution are limited, and systematic evaluation is missing. In this study, white light interferometry was evaluated to close this gap in method understanding. White light interferometry demonstrated a good accuracy of 93-99% for MgF 2 coated, curved standards covering a thickness range of 115-473 nm. Thickness measurements for sprayed-on siliconized prefilled syringes with different representative silicone oil distribution patterns (homogeneous, pronounced siliconization at flange or needle side, respectively) showed high instrument (0.5%) and analyst precision (4.1%). Different white light interferometry instrument parameters (autofocus, protective shield, syringe barrel dimensions input, type of non-siliconized syringe used as base reference) had no significant impact on the measured average layer thickness. The obtained values from white light interferometry applying a fully developed method (12 radial lines, 50 mm measurement distance, 50 measurements points) were in agreement with orthogonal results from combined white and laser interferometry and 3D-laser scanning microscopy. The investigated syringe batches (lot A and B) exhibited comparable longitudinal silicone oil layer thicknesses ranging from 170-190 nm to 90-100 nm from flange to tip and homogeneously distributed silicone layers over the syringe barrel circumference (110- 135 nm). Empty break-loose (4-4.5 N) and gliding forces (2-2.5 N) were comparably low for both analyzed syringe lots. A silicone oil layer thickness of 100-200 nm was thus sufficient for adequate functionality in this particular study. Filling the syringe with a surrogate solution including short-term exposure and emptying did not significantly influence the silicone oil layer at the investigated silicone level. It thus appears reasonable to use this approach to characterize silicone oil layers in filled syringes over time. The developed method characterizes non-destructively the layer thickness and distribution of silicone oil in empty syringes and provides fast access to reliable results. The gained information can be further used to support optimization of siliconization processes and increase the understanding of syringe functionality. LAY ABSTRACT: Silicone oil layers as lubricant are required to ensure functionality of prefilled syringes. Methods evaluating these layers are limited, and systematic evaluation is missing. The aim of this study was to develop and assess white light interferometry as an analytical method to characterize sprayed-on silicone oil layers in 1 mL prefilled syringes. White light interferometry showed a good accuracy (93-99%) as well as instrument and analyst precision (0.5% and 4.1%, respectively). Different applied instrument parameters had no significant impact on the measured layer thickness. The obtained values from white light interferometry applying a fully developed method concurred with orthogonal results from 3D-laser scanning microscopy and combined white light and laser interferometry. The average layer thicknesses in two investigated syringe lots gradually decreased from 170-190 nm at the flange to 100-90 nm at the needle side. The silicone layers were homogeneously distributed over the syringe barrel circumference (110-135 nm) for both lots. Empty break-loose (4-4.5 N) and gliding forces (2-2.5 N) were comparably low for both analyzed syringe lots. Syringe filling with a surrogate solution, including short-term exposure and emptying, did not significantly affect the silicone oil layer. The developed, non-destructive method provided reliable results to characterize the silicone oil layer thickness and distribution in empty siliconized syringes. This information can be further used to support optimization of siliconization processes and increase understanding of syringe functionality. © PDA, Inc. 2018.

  17. 78 FR 20116 - Draft Guidance for Industry and Food and Drug Administration Staff; Glass Syringes for Delivering...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-03

    ...] Draft Guidance for Industry and Food and Drug Administration Staff; Glass Syringes for Delivering Drug... and FDA staff entitled ``Glass Syringes for Delivering Drug and Biological Products: Technical... supplemental data are necessary for FDA to ensure the safe and effective use of glass syringes that comply with...

  18. Buyer Beware: Negotiating Legal and Fair Contracts between Schools and Food and Beverage Companies. A Legal Memorandum: Quarterly Law Topics for School Leaders, Fall 2004

    ERIC Educational Resources Information Center

    Underwood, Julie

    2004-01-01

    Exclusive vending contracts with food and beverage companies can produce much-needed revenue for school districts. However, these pouring and vending contracts as well as other forms of exclusive vendor contracts are often the subject of contentious public debate and legal challenges. Even the language used to refer to such agreements varies:…

  19. HullBUG Technology Development for Underwater Hull Cleaning

    DTIC Science & Technology

    2015-05-14

    drawings would be vended out to approved vendors for quoting. Quotes would be obtained for different levels of production in order to better understand...the savings associated with buying more. Once a good pricing model was developed and quantity purchased determined, parts would be vended out and...detailed, dimensioned and tolerances added to enable quoting by commercial machine shops. A top assembly drawing was created that identified all

  20. Acceptability of using electronic vending machines to deliver oral rapid HIV self-testing kits: a qualitative study.

    PubMed

    Young, Sean D; Daniels, Joseph; Chiu, ChingChe J; Bolan, Robert K; Flynn, Risa P; Kwok, Justin; Klausner, Jeffrey D

    2014-01-01

    Rates of unrecognized HIV infection are significantly higher among Latino and Black men who have sex with men (MSM). Policy makers have proposed that HIV self-testing kits and new methods for delivering self-testing could improve testing uptake among minority MSM. This study sought to conduct qualitative assessments with MSM of color to determine the acceptability of using electronic vending machines to dispense HIV self-testing kits. African American and Latino MSM were recruited using a participant pool from an existing HIV prevention trial on Facebook. If participants expressed interest in using a vending machine to receive an HIV self-testing kit, they were emailed a 4-digit personal identification number (PIN) code to retrieve the test from the machine. We followed up with those who had tested to assess their willingness to participate in an interview about their experience. Twelve kits were dispensed and 8 interviews were conducted. In general, participants expressed that the vending machine was an acceptable HIV test delivery method due to its novelty and convenience. Acceptability of this delivery model for HIV testing kits was closely associated with three main factors: credibility, confidentiality, and convenience. Future research is needed to address issues, such as user-induced errors and costs, before scaling up the dispensing method.

  1. Council-supported condom vending machines: are they acceptable to rural communities?

    PubMed

    Tomnay, Jane E; Hatch, Beth

    2013-11-01

    Twenty-four hour access to condoms for young people living in rural Victoria is problematic for many reasons, including the fact that condom vending machines are often located in venues and places they cannot access. We partnered with three rural councils to install condom vending machines in locations that provided improved access to condoms for local young people. Councils regularly checked the machines, refilled the condoms and retrieved the money. They also managed the maintenance of the machine and provided monthly data. In total, 1153 condoms were purchased over 12 months, with 924 (80%) obtained from male toilets and 69% (801 out of 1153) purchased in the second half of the study. Revenue of $2626.10 (AUD) was generated and no negative feedback from residents was received by any council nor was there any negative reporting by local media. Vandalism, tampering or damage occurred at all sites; however, only two significant episodes of damage required a machine to be sent away for repairs. Condom vending machines installed in rural towns in north-east Victoria are accessible to young people after business hours, are cost-effective for councils and have not generated any complaints from residents. The machines have not suffered unrepairable damage and were used more frequently as the study progressed.

  2. Micro-engineered remote palpation device for assessing tissue compliance.

    PubMed

    Hien, M; Yang, T H J; Leung, S K W; Reuben, R L; Habib, F K; McNeill, S A; Schneider, A; McBride, G; Stevens, R; Else, R W

    2008-01-01

    This paper concerns the operation of the actuator for a prototype micro-engineered mechanical palpation device for deployment via a cystoscope to measure the dynamic mechanical properties of the prostate gland in vivo. The subassembly consists of a 400x200 microm silicon (Si) piston manufactured using deep reactive ion etching (DRIE) housed within an anodically bonded glass-Si-glass sandwiched housing. The micro-channel on the Si layer was formed by powder blasting and contains the micro-piston with one end pointing to the side of the housing and the other facing a via hole leading to a capillary tube. The opening on the side of the housing was sealed by a 5 microm thick silicone membrane which acts to retain the micro-piston and act as a return spring. A 320 microm diameter capillary forms the connection between the micro-channel and a micro-syringe which is operated by a programmable syringe pump to produce a reciprocating action. A pressure sensor is connected along the capillary tube to measure the dynamic pressure within the system. The micro-piston has already been used, separately actuated to measure the dynamic mechanical properties of known viscoelastic materials and prostate tissue. The purpose of the present work is to assess the functionality of the actuator assembly.

  3. Food insecurity among people who inject drugs in Los Angeles and San Francisco.

    PubMed

    Schmitz, Jane; Kral, Alex H; Chu, Daniel; Wenger, Lynn D; Bluthenthal, Ricky N

    2016-08-01

    We estimated the prevalence of food insecurity among people who inject drugs (PWID) in Los Angeles and San Francisco and explored correlates of food insecurity. A cross-sectional study that measured 30 d food insecurity using the US Adult Food Security Survey ten-item Module developed by the US Department of Agriculture. Food insecurity was defined as including low and very low food security. Two cities in the state of California, USA. Male and female active PWID (n 777). Among participants, 58 % reported food insecurity and 41 % reported very low food security. Food-insecure PWID were more likely to report being homeless (prevalence ratio (PR)=1·20; 95 % CI 1·05, 1·37), chest pain in the past 12 months (PR=1·19; CI 1·06, 1·35), acquiring syringes from someone who goes to a syringe exchange programme (PR=1·27; 95 % CI 1·13, 1·43) and feeling at risk for arrest for possession of drug paraphernalia (PR=1·30; 95 % CI 1·15, 1·46). Current food insecurity was common among PWID in these two cities, yet few factors were independently associated with food insecurity. These data suggest that broad strategies to improve food access for this high-risk population are urgently needed.

  4. Automated dynamic liquid-liquid-liquid microextraction followed by high-performance liquid chromatography-ultraviolet detection for the determination of phenoxy acid herbicides in environmental waters.

    PubMed

    Wu, Jingming; Ee, Kim Huey; Lee, Hian Kee

    2005-08-05

    Automated dynamic liquid-liquid-liquid microextraction (D-LLLME) controlled by a programmable syringe pump and combined with HPLC-UV was investigated for the extraction and determination of 5 phenoxy acid herbicides in aqueous samples. In the extraction procedure, the acceptor phase was repeatedly withdrawn into and discharged from the hollow fiber by the syringe pump. The repetitive movement of acceptor phase into and out of the hollow fiber channel facilitated the transfer of analytes into donor phase, from the organic phase held in the pore of the fiber. Parameters such as the organic solvent, concentrations of the donor and acceptor phases, plunger movement pattern, speed of agitation and ionic strength of donor phase were evaluated. Good linearity of analytes was achieved in the range of 0.5-500 ng/ml with coefficients of determination, r2 > 0.9994. Good repeatabilities of extraction performance were obtained with relative standard deviations lower than 7.5%. The method provided up-to 490-fold enrichment within 13 min. In addition, the limits of detection (LODs) ranged from 0.1 to 0.4 ng/mL (S/N = 3). D-LLLME was successfully applied for the analysis of phenoxy acid herbicides from real environmental water samples.

  5. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Haseler, Luke J., E-mail: l.haseler@griffith.edu.au; Sibbitt, Randy R., E-mail: THESIBB2@aol.com; Sibbitt, Wilmer L., E-mail: wsibbitt@salud.unm.edu

    Purpose: Syringes are used for diagnostic fluid aspiration and fine-needle aspiration biopsy in interventional procedures. We determined the benefits, disadvantages, and patient safety implications of syringe and needle size on vacuum generation, hand force requirements, biopsy/fluid yield, and needle control during aspiration procedures. Materials and Methods: Different sizes (1, 3, 5, 10, and 20 ml) of the conventional syringe and aspirating mechanical safety syringe, the reciprocating procedure device, were studied. Twenty operators performed aspiration procedures with the following outcomes measured: (1) vacuum (torr), (2) time to vacuum (s), (3) hand force to generate vacuum (torr-cm{sup 2}), (4) operator difficulty duringmore » aspiration, (5) biopsy yield (mg), and (6) operator control of the needle tip position (mm). Results: Vacuum increased tissue biopsy yield at all needle diameters (P < 0.002). Twenty-milliliter syringes achieved a vacuum of -517 torr but required far more strength to aspirate, and resulted in significant loss of needle control (P < 0.002). The 10-ml syringe generated only 15% less vacuum (-435 torr) than the 20-ml device and required much less hand strength. The mechanical syringe generated identical vacuum at all syringe sizes with less hand force (P < 0.002) and provided significantly enhanced needle control (P < 0.002). Conclusions: To optimize patient safety and control of the needle, and to maximize fluid and tissue yield during aspiration procedures, a two-handed technique and the smallest syringe size adequate for the procedure should be used. If precise needle control or one-handed operation is required, a mechanical safety syringe should be considered.« less

  6. Stability of acetylcysteine solution repackaged in oral syringes and associated cost savings.

    PubMed

    Kiser, Tyree H; Oldland, Alan R; Fish, Douglas N

    2007-04-01

    The physical and chemical stability of repackaged acetylcysteine 600 mg/3 mL solution in oral syringes stored under refrigeration or at room temperature was studied for six months; a cost analysis was also conducted. Acetylcysteine 20% solution for inhalation was repackaged undiluted as 600 mg/3 mL in capped oral syringes and stored either under refrigeration or at room temperature exposed to fluorescent light. Four samples for each storage condition were analyzed in duplicate on day zero, weekly for the first month, and then every two weeks during months 2-6. Physical stability was assessed, and the chemical stability of acetylcysteine was evaluated by high-performance liquid chromatography. Acetylcysteine solution in syringes was physically stable during the entire six-month study period. When stored at room temperature, acetylcysteine retained 99% of the original concentration at three months and 95% at six months after preparation of the syringes. Loss of acetylcysteine was <2% at six months when stored under refrigeration. Packaging acetylcysteine in batches of 100 syringes instead of preparing individual syringes reduced wastage to zero syringes, saving an estimated $247 in drug costs. The estimated pharmacy time savings was 30 hours ($702). Acetylcysteine 20% solution repackaged as 600 mg/3 mL in oral syringes is both physically and chemically stable under refrigeration or at room temperature under normal fluorescent lighting for six months. The total loss of acetylcysteine was approximately 5% at room temperature under fluorescent lighting and <2% under refrigeration. Repackaging the solution in syringes in bulk rather than in single doses demonstrated a measurable cost saving.

  7. Pharmacy syringe purchase test of nonprescription syringe sales in San Francisco and Los Angeles in 2010.

    PubMed

    Lutnick, Alexandra; Cooper, Erin; Dodson, Chaka; Bluthenthal, Ricky; Kral, Alex H

    2013-04-01

    The two main legal sources of clean needles for illicit injection drug users (IDUs) in California are syringe exchange programs (SEPs) and nonprescription syringe sales (NPSS) at pharmacies. In 2004, California became one of the last states to allow NPSS. To evaluate the implementation of NPSS and the California Disease Prevention Demonstration Project (DPDP), we conducted syringe purchase tests in San Francisco (SF) and Los Angeles (LA) between March and July of 2010. Large differences in implementation were observed in the two cities. In LA, less than one-quarter of the enrolled pharmacies sold syringes to our research assistant (RA), and none sold a single syringe. The rate of successful purchase in LA is the lowest reported in any syringe purchase test. In both sites, there was notable variation among the gauge size available, and price and quantity of syringes required for a purchase. None of the DPDP pharmacies in LA or SF provided the requisite health information. The findings suggest that more outreach needs to be conducted with pharmacists and pharmacy staff. The pharmacies' failure to disseminate the educational materials may result in missed opportunities to provide needed harm reduction information to IDUs. The varied prices and required quantities may serve as a barrier to syringe access among IDUs. Future research needs to examine reasons why pharmacies do not provide the mandated information, whether the omission of disposal options is indicative of pharmacies' reluctance to serve as disposal sites, and if the dual opt-in approach of NPSS/DPDP is a barrier to pharmacy enrollment.

  8. Local anesthetic syringe ergonomics and student preferences.

    PubMed

    Wiener, R Constance; Crout, Richard J; Sandell, Joan; Howard, Brandi; Ouassa, Lydia; Wearden, Stanley; Wiener, Michael A

    2009-04-01

    With a diverse population of dentists, dental hygienists, and dental assistants, there is a wide range of sizes and shapes of individuals. Ergonomic considerations have resulted in the design of many adjustable delivery systems, chairs, and pieces of equipment. Companies have marketed instrumentation specifically for people with small hands, yet little research has been done regarding the advertising claims. The objective of this study was to compare the perceptions of dental and dental hygiene students after they used a conventional syringe and a petite syringe that has been marketed as advantageous for individuals with smaller hands. The two syringes were compared for aspiration, injection, and sense of control. A total of 181 students were invited to serve as subjects in the study, and ninety participated. The study involved two phases. During phase I, students used conventional and petite syringes to give a simulated inferior alveolar nerve block injection. In phase II, students gave a simulated palatal injection using both sizes of syringes. After performing the simulations, the students responded to a questionnaire. The students reported that the petite syringe gave them control, and 62.2 percent of them preferred it to the conventional syringe. There were differences in preferences between female and male students and also differences in preferences based on students' glove sizes. The female students preferred the petite syringe when aspiration was required. Overall, the students who wore small and extra small gloves had a preference for the petite syringe and felt it provided a sense of control, a key component when learning to provide injections.

  9. Pharmacy student knowledge, attitudes, and beliefs about selling syringes to injection drug users.

    PubMed

    Blumenthal, Wendy J; Springer, Kristen W; Jones, T Stephen; Sterk, Claire E

    2002-01-01

    To explore pharmacy school education and pharmacy students' knowledge, attitudes, and beliefs about human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), drug use, and syringe sales to injection drug users (IDUs). Qualitative study of a convenience sample of pharmacy school students. A pharmacy school in the southeastern United States. Two focus groups and nine in-depth interviews were conducted about HIV/AIDS education and counseling, syringe sales to possible IDUs, and related pharmacy school education. 19 Doctor of Pharmacy students, including 88 students in their third professional year and 11 in their fourth professional year. Most participants believed that they would benefit from more class time on HIV/AIDS topics, including AIDS treatment medications and HIV prevention. Most participants believed that the laws and regulations governing syringe sales in their state were vague, leaving syringe sale decisions to pharmacists' discretion. Nine study participants supported selling syringes to possible IDUs, five opposed it, and five were undecided or ambivalent. Classroom education focused on addiction to prescription drugs, with limited attention to illicit drug use. Pharmacy students have divided opinions about selling syringes to IDUs. To prepare students for helping their patients with drug-use problems, pharmacy schools should increase training about HIV/AIDS and addiction. Policy makers should consider changing laws and regulations of syringe sales to recognize prevention of blood-borne infections as a legitimate medical purpose for selling syringes to IDUs.

  10. Syringe access for the prevention of blood borne infections among injection drug users

    PubMed Central

    Stancliff, Sharon; Agins, Bruce; Rich, Josiah D; Burris, Scott

    2003-01-01

    Background Approximately one-third of acquired immunodeficiency syndrome cases in the United States are associated with the practice of sharing of injection equipment and are preventable through the once-only use of syringes, needles and other injection equipment. Discussion Sterile syringes may be obtained legally by 4 methods depending on the state. They may be purchased over the counter, prescribed, obtained at syringe exchange programs or furnished by authorized agencies. Each of these avenues has advantages and disadvantages; therefore, legal access through all means is the most likely way to promote the use of sterile syringes. Summary By assisting illicit drug injectors to obtain sterile syringes the primary care provider is able to reduce the incidence of blood borne infections, and educate patients about safe syringe disposal. The provider is also able to initiate discussion about drug use in a nonjudgmental manner and to offer care to patients who are not yet ready to consider drug treatment. PMID:14633286

  11. [Morphine self-administration by rats using a pneumatic syringe].

    PubMed

    Akiyama, Y; Takayama, S

    1988-06-01

    An apparatus for drug self-administration by rats using a pneumatic syringe was developed by Weeks. A microliter syringe operated by a pneumatic cylinder supplies an accurate volume of drug solution within one second. When coefficient of variation of infusion volume was compared among pneumatic syringe, infusion pump, and peristaltic pump, pneumatic syringe showed higher accuracy in infusion volume than the other two pumps. Since the infusion speed by a pneumatic syringe is very rapid (less than one second per infusion), the effect of infusion speed on reinforcing property of morphine was investigated. When rats self-administered 0.1, 0.3, 1.0, and 3.0 mg/kg/infusion of morphine by pneumatic syringes, the patterns of self-infusion were more stable, the number of self-infusions and the amount self-administered were larger, and a dose-response relationship was clearer in comparison with those self-infused the same doses of morphine for 5.6 seconds by infusion pumps or peristaltic pumps.

  12. 21 CFR 872.6770 - Cartridge syringe.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... syringe is a device intended to inject anesthetic agents subcutaneously or intramuscularly. The device... cartridge) containing anesthetic is placed. After attaching a needle to the syringe body and activating the...

  13. 21 CFR 872.6770 - Cartridge syringe.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... syringe is a device intended to inject anesthetic agents subcutaneously or intramuscularly. The device... cartridge) containing anesthetic is placed. After attaching a needle to the syringe body and activating the...

  14. 21 CFR 872.6770 - Cartridge syringe.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... syringe is a device intended to inject anesthetic agents subcutaneously or intramuscularly. The device... cartridge) containing anesthetic is placed. After attaching a needle to the syringe body and activating the...

  15. 21 CFR 872.6770 - Cartridge syringe.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... syringe is a device intended to inject anesthetic agents subcutaneously or intramuscularly. The device... cartridge) containing anesthetic is placed. After attaching a needle to the syringe body and activating the...

  16. 21 CFR 872.6770 - Cartridge syringe.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... syringe is a device intended to inject anesthetic agents subcutaneously or intramuscularly. The device... cartridge) containing anesthetic is placed. After attaching a needle to the syringe body and activating the...

  17. Using Pharmacies in a Structural Intervention to Distribute Low Dead Space Syringes to Reduce HIV and HCV Transmission in People Who Inject Drugs

    PubMed Central

    Johnson, Terence L.; Zule, William A.; Carda-Auten, Jessica; Golin, Carol E.

    2015-01-01

    Ongoing injection drug use contributes to the HIV and HCV epidemics in people who inject drugs. In many places, pharmacies are the primary source of sterile syringes for people who inject drugs; thus, pharmacies provide a viable public health service that reduces blood-borne disease transmission. Replacing the supply of high dead space syringes with low dead space syringes could have far-reaching benefits that include further prevention of disease transmission in people who inject drugs and reductions in dosing inaccuracies, medication errors, and medication waste in patients who use syringes. We explored using pharmacies in a structural intervention to increase the uptake of low dead space syringes as part of a comprehensive strategy to reverse these epidemics. PMID:25880955

  18. Using Pharmacies in a Structural Intervention to Distribute Low Dead Space Syringes to Reduce HIV and HCV Transmission in People Who Inject Drugs.

    PubMed

    Oramasionwu, Christine U; Johnson, Terence L; Zule, William A; Carda-Auten, Jessica; Golin, Carol E

    2015-06-01

    Ongoing injection drug use contributes to the HIV and HCV epidemics in people who inject drugs. In many places, pharmacies are the primary source of sterile syringes for people who inject drugs; thus, pharmacies provide a viable public health service that reduces blood-borne disease transmission. Replacing the supply of high dead space syringes with low dead space syringes could have far-reaching benefits that include further prevention of disease transmission in people who inject drugs and reductions in dosing inaccuracies, medication errors, and medication waste in patients who use syringes. We explored using pharmacies in a structural intervention to increase the uptake of low dead space syringes as part of a comprehensive strategy to reverse these epidemics.

  19. Scale-up of a comprehensive harm reduction programme for people injecting opioids: lessons from north-eastern India

    PubMed Central

    Lalmuanpuii, Melody; Biangtung, Langkham; Mishra, Ritu Kumar; Reeve, Matthew J; Tzudier, Sentimoa; Singh, Angom L; Sinate, Rebecca

    2013-01-01

    Abstract Problem Harm reduction packages for people who inject illicit drugs, including those infected with human immunodeficiency virus (HIV), are cost-effective but have not been scaled up globally. In the north-eastern Indian states of Manipur and Nagaland, the epidemic of HIV infection is driven by the injection of illicit drugs, especially opioids. These states needed to scale up harm reduction programmes but faced difficulty doing so. Approach In 2004, the Bill & Melinda Gates Foundation funded Project ORCHID to scale up a harm reduction programme in Manipur and Nagaland. Local setting In 2003, an estimated 10 000 and 16 000 people were injecting drugs in Manipur and Nagaland, respectively. The prevalence of HIV infection among people injecting drugs was 24.5% in Manipur and 8.4% in Nagaland. Relevant changes By 2012, the harm reduction programme had been scaled up to an average of 9011 monthly contacts outside clinics (80% of target); an average of 1709 monthly clinic visits (15% of target, well above the 5% monthly goal) and an average monthly distribution of needles and syringes of 16 each per programme participant. Opioid agonist maintenance treatment coverage was 13.7% and retention 6 months after enrolment was 63%. Antiretroviral treatment coverage for HIV-positive participants was 81%. Lessons learnt A harm reduction model consisting of community-owned, locally relevant innovations and business approaches can result in good harm reduction programme scale-up and influence harm reduction policy. Project ORCHID has influenced national harm reduction policy in India and contributed to the development of harm reduction guidelines. PMID:23599555

  20. HullBUG Technology Development for Underwater Hull Cleaning

    DTIC Science & Technology

    2014-01-15

    Grooming Tool would be generated. These drawings would be vended out to approved vendors for quoting. Quotes would be obtained for different levels...determined, parts would be vended out and manufactured. These parts would then be assembled at SRC. A test program would then follow to fully...identified all machined parts as well as all purchased hardware Top Assembly Based on total cost, a decision was made to make 1 grooming tool and 1

  1. HullBUG Technology Development for Underwater Hull Cleaning

    DTIC Science & Technology

    2013-08-23

    drawings of the Grooming Tool would be generated. These drawings would be vended out to approved vendors for quoting. Quotes would be obtained for...quantity purchased determined, parts would be vended out and manufactured. These parts would then be assembled at SRC. A test program would then follow...tolerances added to enable quoting by commercial machine shops. A top assembly drawing was created that identified all machined parts as well as all

  2. Listeria spp. in Street-Vended Ready-to-Eat Foods

    PubMed Central

    El-Shenawy, Moustafa; El-Shenawy, Mohamed; Mañes, Jordi; Soriano, Jose M.

    2011-01-01

    Street-vended ready-to-eat food sold in Egypt, including sandwiches and dishes of traditional food, was examined for the presence of Listeria species. Out of 576 samples, 24% were found to contain Listeria species. L. monocytogenes and L. innocua were isolated from 57% and 39% of the contaminated samples, respectively. Other Listeria spp. were detected with lower frequency. L. monocytogenes of ≥103 CFU/g were detected in 7% of the total examined samples, which represent 49% of the contaminated food samples (meat, poultry, seafood, dairy products, and products of plant origin). Most of the samples contaminated by L. monocytogenes had high levels of total viable bacterial counts. The results obtained may help to clarify the epidemiology of listeriosis in the country and draw the attention of the decision makers to issue hygienic regulations for food processing industries as well as street vendors in order to ensure safe street-vended ready-to-eat food. PMID:22194742

  3. Reducing the illegal sale of cigarettes to minors.

    PubMed

    Altman, D G; Foster, V; Rasenick-Douss, L; Tye, J B

    1989-01-06

    This study reports on an effort to stop the illegal sale of cigarettes to minors. In Santa Clara County, Calif, 412 stores and 30 vending machines were visited by 18 minors aged 14 through 16 years with the intent to purchase cigarettes; they were successful at 74% of the stores and 100% of the vending machines. After an aggressive six-month campaign using communitywide media, direct merchant education, contact with the chief executive officers of chain stores and franchise operations owned by major companies, and grassroots work with community organizations, the percentage of stores with illegal over-the-counter sale of cigarettes to minors was reduced to 39%. Sales from vending machines were not reduced. While much remains to be accomplished in stopping the illegal sale of tobacco to minors, data from this study illustrate that a well-designed community and merchant education campaign can significantly reduce such sales.

  4. Nonprescription naloxone and syringe sales in the midst of opioid overdose and hepatitis C virus epidemics: Massachusetts, 2015.

    PubMed

    Stopka, Thomas J; Donahue, Ashley; Hutcheson, Marguerite; Green, Traci C

    To determine the prevalence of nonprescription naloxone and sterile syringe sales, factors associated with nonprescription sales, geospatial access to nonprescription naloxone and syringe-selling pharmacies, and targets for potential interventions. Cross-sectional study. Massachusetts has experienced steep increases in reported opioid overdoses and hepatitis C virus cases in the past decade. Pharmacists have the potential to play a substantial role in increasing access to nonprescription naloxone and sterile syringes, which can reverse opioid overdoses and decrease hepatitis C virus transmission, respectively. We completed brief telephone surveys with 809 of 1042 retail pharmacies across Massachusetts (response rate = 77.6%) during 2015 to assess experience with nonprescription sales of naloxone and sterile syringes. Our primary outcomes were the stocking and selling of naloxone in the pharmacy (yes or no) for nonprescription sales and nonprescription syringe sales (yes or no). We conducted multivariable regression analyses and created maps using a geographic information system to identify factors associated with nonprescription sales of naloxone and sterile syringes, and to improve our understanding of geospatial access to pharmacy-based naloxone and syringe sales. More than 97% of pharmacies reported selling sterile syringes without requiring a prescription, and 45% of pharmacies reported stocking and selling naloxone. Factors associated with nonprescription sales included hours of operation, experience with and interest in harm reduction activities, and presence in an opioid overdose hotspot. Geographic access to nonprescription sale of sterile syringes is widespread, whereas geospatial access to naloxone is limited. Training to understand the benefits, applications, and distribution needs of naloxone is of interest to surveyed pharmacists. Access to sterile syringes through nonprescription sales is strong across Massachusetts, and although more than 350 pharmacies (45%) reported stocking and selling naloxone to prevent opioid overdose deaths, there is much room for improvement in access and training among pharmacy staff members. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  5. Non-Prescription Naloxone and Syringe Sales in the Midst of Opioid Overdose and Hepatitis C Virus Epidemics: Massachusetts, 2015

    PubMed Central

    Stopka, Thomas J.; Donahue, Ashley; Hutcheson, Marguerite; Green, Traci C.

    2017-01-01

    Objectives To determine the prevalence of non-prescription naloxone and sterile syringe sales, factors associated with non-prescription sales, geospatial access to non-prescription naloxone and syringe selling pharmacies, and targets for potential interventions. Design Cross-sectional study. Setting and Participants Massachusetts has experienced steep increases in reported opioid overdoses and hepatitis C virus (HCV) cases in the past decade. Pharmacists have the potential to play a substantial role in increasing access to non-prescription naloxone and sterile syringes, which can reverse opioid overdoses and decrease HCV transmission, respectively. We completed brief telephone surveys with 809 of 1,042 retail pharmacies across Massachusetts (response rate=77.6%) during 2015 to assess experience with non-prescription sales of naloxone and sterile syringes. Outcome Measures Our primary outcomes were the stocking and selling of naloxone in the pharmacy (yes/no) for non-prescription sales, and non-prescription syringe sales (yes/no). We conducted multivariable regression analyses and created maps using a geographic information system (GIS) to identify factors associated with non-prescription sales of naloxone and sterile syringes, and to improve our understanding geospatial access to pharmacy-based naloxone and syringe sales. Results Over 97% of pharmacies reported selling sterile syringes without requiring a prescription and 45% of pharmacies reported stocking and selling naloxone. Factors associated with non-prescription sales included: hours of operation, experience with and interest in harm reduction activities, and presence in an opioid overdose hotspot. Geographic access to non-prescription sale of sterile syringes is wide-spread, while geospatial access to naloxone is more limited. Training to better understand the benefits, applications, and distribution needs of naloxone is of interest to surveyed pharmacists. Conclusion Access to sterile syringes through non-prescription sales is strong across Massachusetts and, while over 350 pharmacies (45%) reported stocking and selling naloxone to prevent opioid overdose deaths, there is much room for improvement in access, and training among pharmacy staff. PMID:28189540

  6. Microbial contamination of syringes during preparation: the direct influence of environmental cleanliness and risk manipulations on end-product quality.

    PubMed

    Stucki, Cyril; Sautter, Anna-Maria; Favet, Jocelyne; Bonnabry, Pascal

    2009-11-15

    The direct influence of environmental cleanliness and risk manipulations on prepared syringes was evaluated. Media-fill testing was used to estimate potential microbial contamination. Syringes were prepared in three different environments using four different uncontrolled high-risk manipulations. The three environments included an International Organization for Standardization (ISO) class 5 horizontal laminar-airflow hood in an ISO class 6 cleanroom (in accordance with United States Pharmacopeia [USP] chapter 797), an ISO class 7 drug preparation area of an operating room, and an uncontrolled decentralized pharmacy in a ward. For each combination of environment and manipulation, 100 syringes were filled by a single operator. The four high-risk manipulations used included simple filling of syringes with trypticase soy broth, three-second contact by the ungloved fingers of the operator with the hub of the syringe, three-second contact between an object and the hub of the syringe, and exposure of the filled syringes to ambient air for 10 minutes. Of the 1500 syringes prepared in three different environments, none produced within the cleanroom contained microorganisms, 6% were contaminated in the operating room, and 16% were contaminated in the ward (p < 0.0001). Certain high-risk manipulations were associated with a significant increase in the contamination of the surrogate syringes, including exposure to nonsterile ambient air and nonsterile objects or fingers (p < 0.0001). High contamination rates were measured when the hub of syringes touched nonsterile environmental surfaces and fingers, whereas the drawn-air manipulation was associated with a lower risk of contamination. Working within a properly operating unidirectional airflow primary engineering control in an ISO class 5 cleanroom in accordance with USP chapter 797 requirements was demonstrated to be the best way to avoid bacterial or fungal contamination of injectable drugs directly resulting in patient infections.

  7. Is crime associated with over-the-counter pharmacy syringe sales? Findings from Los Angeles, California.

    PubMed

    Stopka, Thomas J; Geraghty, Estella M; Azari, Rahman; Gold, Ellen B; DeRiemer, Kathryn

    2014-03-01

    More than 50,000 new HIV infections occur annually in the United States. Injection drug users represent twelve percent of incident HIV infections each year. Pharmacy sales of over-the-counter (OTC) syringes have helped prevent HIV transmission among injection drug users in many states throughout the United States. However, concerns exist among some law enforcement officials, policymakers, pharmacists, and community members about potential links between OTC syringe sales and crime. We used a geographic information system and novel spatial and longitudinal analyses to determine whether implementation of pharmacy-based OTC syringe sales were associated with reported crime between January 2006 and December 2008 in Los Angeles Police Department Reporting Districts. We assessed reported crime pre- and post-OTC syringe sales initiation as well as longitudinal associations between crime and OTC syringe-selling pharmacies. By December 2008, 9.3% (94/1010) of Los Angeles Police Department Reporting Districts had at least one OTC syringe-selling pharmacy. Overall reported crime counts and reported crime rates decreased between 2006 and 2008 in all 1010 Reporting Districts. Using generalized estimating equations and adjusting for potential confounders, reported crime rates were negatively associated with OTC syringe sales (adjusted rate ratio: 0.89; 95% confidence interval: 0.81, 0.99). Our findings demonstrate that OTC pharmacy syringe sales were not associated with increases in reported crime in local communities in Los Angeles during 2006-2008. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Sterile Basics of Compounding: Relationship Between Syringe Size and Dosing Accuracy.

    PubMed

    Kosinski, Tracy M; Brown, Michael C; Zavala, Pedro J

    2018-01-01

    The purpose of this study was to investigate the accuracy and reproducibility of a 2-mL volume injection using a 3-mL and 10-mL syringe with pharmacy student compounders. An exercise was designed to assess each student's accuracy in compounding a sterile preparation with the correct 4-mg strength using a 3-mL and 10-mL syringe. The average ondansetron dose when compounded with the 3-mL syringe was 4.03 mg (standard deviation ± 0.45 mg), which was not statistically significantly different than the intended 4-mg desired dose (P=0.497). The average ondansetron dose when compounded with the 10-mL syringe was 4.18 mg (standard deviation + 0.68 mg), which was statistically significantly different than the intended 4-mg desired dose (P=0.002). Additionally, there also was a statistically significant difference in the average ondansetron dose compounded using a 3-mL syringe (4.03 mg) and a 10-mL syringe (4.18 mg) (P=0.027). The accuracy and reproducibility of the 2-mL desired dose volume decreased as the compounding syringe size increased from 3 mL to 10 mL. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

  9. Efficacy trial of Camouflage Syringe to reduce dental fear and anxiety.

    PubMed

    Ujaoney, S; Mamtani, M; Thakre, T; Tote, J; Hazarey, V; Hazarey, P; Kulkarni, H

    2013-12-01

    Dental fear and anxiety in early childhood are widely prevalent and contribute to dental problems and behaviour in adulthood. Novel ways to reduce dental fear and anxiety in children are needed. Our aim was to conduct an efficacy trial of a novel Camouflage Syringe to reduce dental fear and anxiety in children. randomised controlled trial of efficacy of the Camouflage Syringe. We designed a Camouflage Syringe with a toy-like appearance that veils the conventional syringe to permit topical application and injection of local anaesthesia and ensure more involvement of the patient in the treatment process. We conducted a concurrent parallel, randomised controlled trial (NCT01398007) on the efficacy of this Camouflage Syringe to reduce the dental fear and anxiety in children seeking dental treatment who required the use of local anaesthesia. Using Venham's clinical rating scale, Venham's picture test, parental stress questionnaire and recall questionnaire, the efficacy of the Camouflage Syringe to reduce dental fear and anxiety ranged from 82% to 97% for various outcomes and from 60% to 100% for prevention of related adverse outcomes. For all outcomes, the number needed to treat was close to unity. Our results strongly favour the use of Camouflage Syringe to reduce dental fear and anxiety in children.

  10. Safety and immunogenicity of inactivated poliovirus vaccine when given with measles-rubella combined vaccine and yellow fever vaccine and when given via different administration routes: a phase 4, randomised, non-inferiority trial in The Gambia.

    PubMed

    Clarke, Ed; Saidu, Yauba; Adetifa, Jane U; Adigweme, Ikechukwu; Hydara, Mariama Badjie; Bashorun, Adedapo O; Moneke-Anyanwoke, Ngozi; Umesi, Ama; Roberts, Elishia; Cham, Pa Modou; Okoye, Michael E; Brown, Kevin E; Niedrig, Matthias; Chowdhury, Panchali Roy; Clemens, Ralf; Bandyopadhyay, Ananda S; Mueller, Jenny; Jeffries, David J; Kampmann, Beate

    2016-08-01

    The introduction of the inactivated poliovirus vaccine (IPV) represents a crucial step in the polio eradication endgame. This trial examined the safety and immunogenicity of IPV given alongside the measles-rubella and yellow fever vaccines at 9 months and when given as a full or fractional dose using needle and syringe or disposable-syringe jet injector. We did a phase 4, randomised, non-inferiority trial at three periurban government clinics in west Gambia. Infants aged 9-10 months who had already received oral poliovirus vaccine were randomly assigned to receive the IPV, measles-rubella, and yellow fever vaccines, singularly or in combination. Separately, IPV was given as a full intramuscular or fractional intradermal dose by needle and syringe or disposable-syringe jet injector at a second visit. The primary outcomes were seroprevalence rates for poliovirus 4-6 weeks post-vaccination and the rate of seroconversion between baseline and post-vaccination serum samples for measles, rubella, and yellow fever; and the post-vaccination antibody titres generated against each component of the vaccines. We did a per-protocol analysis with a non-inferiority margin of 10% for poliovirus seroprevalence and measles, rubella, and yellow fever seroconversion, and (1/3) log2 for log2-transformed antibody titres. This trial is registered with ClinicalTrials.gov, number NCT01847872. Between July 10, 2013, and May 8, 2014, we assessed 1662 infants for eligibility, of whom 1504 were enrolled into one of seven groups for vaccine interference and one of four groups for fractional dosing and alternative route of administration. The rubella and yellow fever antibody titres were reduced by co-administration but the seroconversion rates achieved non-inferiority in both cases (rubella, -4·5% [95% CI -9·5 to -0·1]; yellow fever, 1·2% [-2·9 to 5·5]). Measles and poliovirus responses were unaffected (measles, 6·8% [95% CI -1·4 to 14·9]; poliovirus serotype 1, 1·6% [-6·7 to 4·7]; serotype 2, 0·0% [-2·1 to 2·1]; serotype 3, 0·0% [-3·8 to 3·9]). Poliovirus seroprevalence was universally high (>97%) after vaccination, but the antibody titres generated by fractional intradermal doses of IPV did not achieve non-inferiority compared with full dose. The number of infants who seroconverted or had a four-fold rise in titres was also lower by the intradermal route. There were no safety concerns. The data support the future co-administration of IPV, measles-rubella, and yellow fever vaccines within the Expanded Programme on Immunization schedule at 9 months. The administration of single fractional intradermal doses of IPV by needle and syringe or disposable-syringe jet injector compromises the immunity generated, although it results in a high post-vaccination poliovirus seroprevalence. Bill & Melinda Gates Foundation. Copyright © 2016 Clarke et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd.. All rights reserved.

  11. Making Nasopalatine Blocks Comfortable: A Randomised Prospective Clinical Comparison of Pain Associated with the Injection Using an Insulin Syringe and a Standard Disposable 3 mL Syringe.

    PubMed

    Prabhu, Sundararaman; Faizel, Syed; Pahlajani, Vedant; Prabhu, Shweta Jha

    2013-12-01

    This study was conducted to compare and evaluate the pain associated with administration of Nasopalatine blocks using a disposable insulin syringe and the conventional disposable 3 mL syringe. Forty patients requiring intraalveolar extractions of maxillary central incisors were randomly assigned to two groups of 20 patients each; one (Group A) received the nasopalatine block with a standard 3mL syringe and the other (Group B) received the block with an insulin syringe. Patients were asked to rate the pain associated with the injection on a visual analog scale (VAS) and the results were analysed using a Chi Square Test. The mean VAS score for Group A and B was 1.55 and 1 respectively. Chi Square value was calculated to be 8.603 (degree of freedom= 3, P value= 0.0351). There were no differences in the effectiveness of anesthesia between the groups. Pain associated with administration of the nasopalatine blocks may be significantly mitigated by using the Insulin syringe.

  12. A community based approach to linking injection drug users with needed services through pharmacies: An evaluation of a pilot intervention in New York City

    PubMed Central

    Rudolph, AE; Standish, K; Amesty, S; Crawford, ND; Stern, RJ; Badillo, WE; Boyer, A; Brown, D; Ranger, N; Orduna, JM Garcia; Lasenburg, L; Lippek, Sarah; Fuller, CM

    2010-01-01

    Studies suggest that community-based approaches could help pharmacies expand their public health role, particularly pertaining to HIV prevention. Thirteen pharmacies participating in New York’s Expanded Syringe Access Program, which permits non-prescription syringe sales to reduce syringe-sharing among injection drug users (IDUs), were enrolled in an intervention to link IDU syringe customers to medical/social services. Sociodemographics, injection practices, beliefs about and experiences with pharmacy use, and medical/social service utilization were compared among 29 IDUs purchasing syringes from intervention pharmacies and 66 IDUs purchasing syringes from control pharmacies using chi-square tests. Intervention IDUs reported more positive experiences in pharmacies than controls; both groups were receptive to a greater public health pharmacist role. These data provide evidence that CBPR aided in the implementation of a pilot structural intervention to promote understanding of drug use and HIV prevention among pharmacy staff, and facilitated expansion of pharmacy services beyond syringe sales in marginalized, drug-using communities. PMID:20528131

  13. Retraction of the Plunger on a Syringe of Hyaluronic Acid Before Injection: Are We Safe?

    PubMed

    Carey, Wayne; Weinkle, Susan

    2015-12-01

    Controversy exists concerning the need for aspiration before injection with hyaluronic acid (HA) fillers. The authors undertook a study of HA products to determine if blood could be aspirated back into a syringe of HA when the needle has been primed or filled with HA. Two studies were set up to determine if or when blood could be withdrawn from a heparinized fresh tube of blood into the HA syringe. Two different techniques were tested; one using a slow-pull retraction of the plunger and up to a 5-second waiting time before release versus a rapid pullback and quick release. Review of these data demonstrates that the usual clinical method, which involves quick withdrawal and instant release of the syringe plunger does not allow for sufficient removal of the filler found intraluminal in the needle and may give rise to false negative results in vitro and likely in vivo with the exception being the Galderma/Medicis products. In summary, withdrawal of the syringe plunger with no visible blood in the syringe does not eliminate the possibility of intravascular placement of the syringe needle.

  14. Development of a Mechatronic Syringe Pump to Control Fluid Flow in a Microfluidic Device Based on Polyimide Film

    NASA Astrophysics Data System (ADS)

    Sek Tee, Kian; Sharil Saripan, Muhammad; Yap, Hiung Yin; Fhong Soon, Chin

    2017-08-01

    With the advancement in microfluidic technology, fluid flow control for syringe pump is always essential. In this paper, a mechatronic syringe pump will be developed and customized to control the fluid flow in a poly-dimethylsiloxane (PDMS) microfluidic device based on a polyimide laminating film. The syringe pump is designed to drive fluid with flow rates of 100 and 1000 μl/min which intended to drive continuous fluid in a polyimide based microfluidic device. The electronic system consists of an Arduino microcontroller board and a uni-polar stepper motor. In the system, the uni-polar stepper motor was coupled to a linear slider attached to the plunger of a syringe pump. As the motor rotates, the plunger pumps the liquid out of the syringe. The accuracy of the fluid flow rate was determined by adjusting the number of micro-step/revolution to drive the stepper motor to infuse fluid into the microfluidic device. With the precise control of the electronic system, the syringe pump could accurately inject fluid volume at 100 and 1000 μl/min into a microfluidic device.

  15. Antimicrobial resistance and typing of Salmonella isolated from street vended foods and associated environment.

    PubMed

    Anukampa; Shagufta, Bi; Sivakumar, M; Kumar, Surender; Agarwal, Rajesh Kumar; Bhilegaonkar, Kiran Narayan; Kumar, Ashok; Dubal, Zunjar Baburao

    2017-07-01

    The present study was carried out to find out the occurrence and types of Salmonella present in street vended foods and associated environment, and their resistance pattern against various antibiotics. About 1075 street vended food and associated environment samples were processed for isolation and confirmation of different Salmonella spp. by targeting gene specific inv A gene and serotype specific Sdf I, Via B and Spy genes by PCR. Selected Salmonella isolates were screened for antibiotic resistance by using Baeur-Kirby disk diffusion test. Out of 1075 samples, only 31 (2.88%) isolates could be amplified the inv A gene of which 19 could be recovered from meat vendors; 8 from egg vendors while remaining 4 from milk vendors. Though, majority of Salmonella recovered from raw foods the ready-to-eat food like chicken gravy and rasmalai also showed its presence which pose a serious public health threat. Overall, 19, 6 and 1 isolates of S. Typhimurium, S. Enteritidis and S. Typhi could be detected by PCR while remaining 5 isolates could not be amplified suggesting other type of Salmonella. Selected Salmonella isolates were completely resistance to Oxacillin (100%) followed by Cefoxitin (30.43%) and Ampicillin (26.10%). Thus, it is observed that the street vended foods of animal origin and associated environment play an important role in transmission of food borne pathogens including Salmonella .

  16. Acceptability of Using Electronic Vending Machines to Deliver Oral Rapid HIV Self-Testing Kits: A Qualitative Study

    PubMed Central

    Young, Sean D.; Daniels, Joseph; Chiu, ChingChe J.; Bolan, Robert K.; Flynn, Risa P.; Kwok, Justin; Klausner, Jeffrey D.

    2014-01-01

    Introduction Rates of unrecognized HIV infection are significantly higher among Latino and Black men who have sex with men (MSM). Policy makers have proposed that HIV self-testing kits and new methods for delivering self-testing could improve testing uptake among minority MSM. This study sought to conduct qualitative assessments with MSM of color to determine the acceptability of using electronic vending machines to dispense HIV self-testing kits. Materials and Methods African American and Latino MSM were recruited using a participant pool from an existing HIV prevention trial on Facebook. If participants expressed interest in using a vending machine to receive an HIV self-testing kit, they were emailed a 4-digit personal identification number (PIN) code to retrieve the test from the machine. We followed up with those who had tested to assess their willingness to participate in an interview about their experience. Results Twelve kits were dispensed and 8 interviews were conducted. In general, participants expressed that the vending machine was an acceptable HIV test delivery method due to its novelty and convenience. Discussion Acceptability of this delivery model for HIV testing kits was closely associated with three main factors: credibility, confidentiality, and convenience. Future research is needed to address issues, such as user-induced errors and costs, before scaling up the dispensing method. PMID:25076208

  17. Moving from a project to programmatic response: scaling up harm reduction in Asia.

    PubMed

    Chatterjee, Anindya; Sharma, Mukta

    2010-03-01

    The response to the HIV epidemics among people who inject drugs in Asia began to emerge in the early to mid 1990s, with the rather hesitant implementation of small-scale needle syringe programmes and community care initiatives aiming to support those who were already living with the virus. Since then Asia has seen a significant scaling up of harm reduction, despite very limited resources and difficult policy and legislative environments. One of the major reasons this has happened, is the utilisation of programme based approaches and the firm entrenchment of harm reduction thinking within national HIV/AIDS programmes and strategic plans--in most cases aided by multilateral and bilateral donors. Several models of scale up have been noted in Asia. The transition away from project based approaches, while on the whole positive, can also have a negative impact if the involvement of civil society and a client focussed approach is not protected. Also there are implications for which models of capacity building can be systematised for ongoing scale up. Most crucially, the tensions between drug policy, human rights and public health policies need to be resolved if harm reduction services are to be made available to the millions in Asia who are still unable to access these services. Copyright (c) 2010 Elsevier B.V. All rights reserved.

  18. Syringe sociology.

    PubMed

    Vitellone, Nicole

    2015-06-01

    In this article I consider the impact of social epistemologies for understanding the object of the syringe. My aim is to examine the process through which the syringe transforms from an injecting device to a tool of social and political inquiry. Paying particular attention to the uses of Foucault, Becker, Bourdieu, Freud and Latour in empirical studies of injecting heroin use, I examine the sociology of the syringe through the lens of habit and habitus, discourse and deviance, mourning and melancholia, attachment and agencement. In pursuing the theory behind the object my goal is to address a sociological object in the making. In so doing I show how the syringe has been significant for social research, social theory, and sociology. It is the difference the object makes that this article seeks to describe. In tracing the epistemology of the syringe I show how the object is important not just for knowledge of addiction but sociology itself. © London School of Economics and Political Science 2015.

  19. Pharmacy-randomized intervention delivering HIV prevention services during the syringe sale to people who inject drugs in New York City.

    PubMed

    Lewis, Crystal Fuller; Rivera, Alexis V; Crawford, Natalie D; DeCuir, Jennifer; Amesty, Silvia

    2015-08-01

    Pharmacy syringe access may be an opportunity to provide HIV prevention resources to persons who inject drugs (PWID). We examined the impact of a pharmacy-randomized intervention to reduce injection risk among PWID in New York City. Pharmacies (n=88) were randomized into intervention, primary control, and secondary control arms. Intervention pharmacies received in-depth harm reduction training, recruited syringe customers who inject drugs into the study, and provided additional services (i.e., HIV prevention/medical/social service referrals, syringe disposal containers, and harm reduction print materials). Primary control pharmacies recruited syringe customers who inject drugs and did not offer additional services, and secondary control pharmacies did not recruit syringe customers (and are not included in this analysis) but participated in a pharmacy staff survey to evaluate intervention impact on pharmacy staff. Recruited syringe customers underwent a baseline and 3-month follow-up ACASI. The intervention effect on injection risk/protective behavior of PWID was examined. A total of 482 PWID completed baseline and follow-up surveys. PWID were mostly Hispanic/Latino, male, and mean age of 43.6 years. After adjustment, PWID in the intervention arm were more likely to report always using a sterile syringe vs. not (PR=1.24; 95% CI: 1.04-1.48) at 3-month follow-up. These findings present evidence that expanded pharmacy services for PWID can encourage sterile syringe use which may decrease injection risk in high HIV burdened Black and Latino communities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Epinephrine syringe exchange events in a paediatric cardiovascular ICU: analysing the storm.

    PubMed

    Achuff, Barbara-Jo; Achuff, Jameson C; Park, Hwan H; Moffett, Brady; Acosta, Sebastian; Rusin, Craig G; Checchia, Paul A

    2018-03-01

    Introduction Haemodynamically unstable patients can experience potentially hazardous changes in vital signs related to the exchange of depleted syringes of epinephrine to full syringes. The purpose was to determine the measured effects of epinephrine syringe exchanges on the magnitude, duration, and frequency of haemodynamic disturbances in the hour after an exchange event (study) relative to the hours before (control). Materials and methods Beat-to-beat vital signs recorded every 2 seconds from bedside monitors for patients admitted to the paediatric cardiovascular ICU of Texas Children's Hospital were collected between 1 January, 2013 and 30 June, 2015. Epinephrine syringe exchanges without dose/flow change were obtained from electronic records. Time, magnitude, and duration of changes in systolic blood pressure and heart rate were characterised using Matlab. Significant haemodynamic events were identified and compared with control data. In all, 1042 syringe exchange events were found and 850 (81.6%) had uncorrupted data for analysis. A total of 744 (87.5%) exchanges had at least 1 associated haemodynamic perturbation including 2958 systolic blood pressure and 1747 heart-rate changes. Heart-rate perturbations occurred 37% before exchange and 63% after exchange, and 37% of systolic blood pressure perturbations happened before syringe exchange, whereas 63% occurred after syringe exchange with significant differences found in systolic blood pressure frequency (p<0.001), duration (p<0.001), and amplitude (p<0.001) compared with control data. This novel data collection and signal processing analysis showed a significant increase in frequency, duration, and magnitude of systolic blood pressure perturbations surrounding epinephrine syringe exchange events.

  1. Family influences on breakfast frequency and quality among primary school pupils in Warsaw and its surrounding areas.

    PubMed

    Zielińska, Monika; Hamułka, Jadwiga; Gajda, Karolina

    2015-01-01

    Regular consumption of a well balanced breakfast is a pre-requisite for normal growth and child development, along with the acquisition of proper eating habits. The family environment is crucial place where children learn such patterns of behaviour that form the basis for their development. To determine how family factors affect the regular eating of breakfast and types of foodstuffs consumed in primary school pupils, including food purchases made from vending machines and school tuck shops. Subjects were 836 pupils (435 girls and 401 boys, aged 6 - 13) from Warsaw and the surrounding areas. Appropriate socio-demographic data and relevant eating habits were obtained from direct interviewing of the subjects by means of a custom designed questionnaire. Statistical analyses were performed by the Kohonen type cluster analysis model and Chi-square test (Chi(2)); (p≤0.05). Three clusters of pupils were identified by their differing socio-demographics and eating habits (eg. rates of breakfast consumption, buying from vending machines or school tuck shops). The first and third clusters were mainly pupils from two-parent families with parents proportionally spending similar times at work, where respective breakfast (87% and 91%) and second breakfast (77% and 72%) consumption rates were also similar together with food shopping rates during school time (respectively 69% and 63%). Pupils with single-parents, multi-generation families or if both parents were profession- ally active, predominated in the second cluster. These ate breakfast (73%) and second breakfast (67%) more rarely, but more frequently shopped for food at school (84%). A small number of pupils had a packed second breakfast from home, rarely ate sandwiches, fruit and/or vegetables and dairy products but ate more sweets, sweet rolls and savoury snacks. However, a large number of subjects bought sandwiches, fresh fruit and/or vegetables and fast-food at school. Family factors were found to affect eating habits in children and adolescents regarding how often breakfast was eaten and the type of foodstuffs consumed. High consumptions of unhealthy food items for second breakfast were also observed. Single-parent pupils, those in multi-generation families or if both parents are employed rarely brought second breakfasts from home but frequently bought food from vending machines and school tuck shops. The results of the presented findings are significant towards planning an appropriate educational campaigns and health programmes targeted at children, adolescents and their families.

  2. High risk behaviors of injection drug users registered with harm reduction programme in Karachi, Pakistan

    PubMed Central

    Altaf, Arshad; Shah, Sharaf Ali; Zaidi, Najam A; Memon, Ashraf; Nadeem-ur-Rehman; Wray, Norman

    2007-01-01

    Background Surveillance data of Sindh AIDS Control Programme, Pakistan suggest that HIV infection is rapidly increasing among IDUs in Karachi and has reached 9% in 2004–5 indicating that the country has progressed from nascent to concentrated level of HIV epidemic. Findings of 2nd generation surveillance in 2004–5 also indicate 104/395 (26.3%) IDUs HIV positive in the city. Methods We conducted a cross sectional study among registered IDUs of a needle exchange and harm reduction programme in Karachi, Pakistan. A total of 161 IDUs were included in the study between October–November 2003. A detailed questionnaire was implemented and blood samples were collected for HIV, hepatitis B & C and syphilis. HIV, hepatitis B and C antibody tests were performed using Enzyme Linked Immunosorbent Assay (ELISA) method. Syphilis tests (RPR & TPHA) were performed on Randox kit. Besides calculating frequencies univariate analysis was performed using t tests for continuous variables as age, age at first intercourse and average age of initiation of addiction and chi square for categorical variables like paid for sex or not to identify risk factors for hepatitis B and C and syphilis. Results Average age of IDU was 35.9 years and average age of initiation of drugs was 15.9 years. Number of drug injections per day was 2.3. Shooting drugs in group sharing syringes was reported by 128 (79.5%) IDUs. Over half 94 (58.3%) reported paying for sex and 64% reported never using a condom. Commercial selling of blood was reported by 44 (28%). 1 of 161 was HIV positive (0.6%). The prevalence of hepatitis B was 12 (7.5%), hepatitis C 151 (94.3%) and syphilis 21 (13.1%). IDUs who were hepatitis C positive were more likely to start sexual activity at an earlier age and had never used condoms. Similarly IDUs who were hepatitis B positive were more likely to belong to a younger age group. Syphilis positive IDUs were more likely to have paid for sex and had never used a condom. Conclusion Prudent measures such as access to sterile syringes, rehabilitation and opiate substitution therapies are required to reduce high risk behaviors of IDUs in Pakistan. PMID:17291354

  3. Survey of physicochemical characteristics and microbial contamination in selected food locally vended in Morogoro Municipality, Tanzania.

    PubMed

    Nonga, Hezron Emmanuel; Ngowi, Helena Aminiel; Mdegela, Robinson Hammerthon; Mutakyawa, Eliud; Nyahinga, Gabriel Busungu; William, Robert; Mwadini, Mtumwa Mohd

    2015-11-26

    Raw milk, raw fruit juice and raw fish are enriched with essential nutrients for human diet but are prone to microbial contamination along the value chain. This cross sectional study was conducted to assess physicochemical characteristics and microbial quality of raw milk, fruit juice and fish from food vendors in Morogoro Municipality, Tanzania. The physicochemical assessment of food samples was done by smell, colour, presence of debris, turbidity, consistence, pH and clot on alcohol test. Hygiene of food containers, personnel and the vending environment was also assessed. Qualitative and quantitative microbial assessment of food was done using standard laboratory protocols as described by Tanzania Bureau of Standards and International Systems of Standards. Raw milk sold in Morogoro was of poor quality since was adulterated with water, contained sediments and clotted on alcohol test. Up to 63 % of the milk samples were contaminated with Escherichia coli and 60 % had higher total viable count (TVC) than the recommended values. Raw fruit juice was stored in dirty containers and sold under unhygienic environment. Seventy-three percent of juice samples had TVC beyond the recommendations while E. coli contamination rate was 63.3 %. The raw fish samples had started spoiling as depicted through sensory evaluation. E. coli contamination rate was 55 % and that of Campylobacter jejuni was 0.5 %. The mean TVC of raw fish was 8.1 (Log cfu/g) and 96.2 % of the fish samples had TVC beyond the recommended limits of 5.0 Log cfu/g. The physicochemical characteristics of food vended in Morogoro Municipality were of poor quality. The food had high bacterial contaminations. This situation poses health risks to the public and losses to food vendors due to spoilage. Stakeholders in food value chain should be educated on safe production and good hygienic practices. Routine quality and safety assessment of locally vended food, inspection of selling premises and regular health check-up of the personnel involved in food vending industry should be instituted.

  4. An investigation of the association between vending machine confectionery purchase frequency by schoolchildren in the UK and other dietary and lifestyle factors.

    PubMed

    New, Susan A; Livingstone, M Barbara E

    2003-08-01

    Availability of confectionery from vending machines in secondary schools provides a convenient point of purchase. There is concern that this may lead to 'over-indulgence' and hence an increase in susceptibility to obesity and poor 'dietary quality'. The study objective was to investigate the association between the frequency of consumption of confectionery purchased from vending machines and other sources and related lifestyle factors in adolescent boys and girls. A secondary school-based, cross-sectional study. A total of 504 subjects were investigated (age range 12-15 years), from three schools in southern and northern England. Using a lifestyle questionnaire, frequency of confectionery consumption (CC) from all sources (AS) and vending machines (VM) was recorded for a typical school week. Subjects were categorised into non-consumers, low, medium and high consumers using the following criteria: none, 0 times per week; low, 1-5 times per week; medium, 6-9 times per week; high, 10 times per week or greater. No differences were found in the frequency of CC from AS or VM between those who consumed breakfast and lunch and those who did not. No differences were found in the frequency of fruit and vegetable intake in high VM CC vs. none VM CC groups, or in any of the VM CC groups. Confectionery consumption from AS (but not VM) was found to be higher in subjects who were physically active on the journey to school (P<0.01) but also higher in those who spent more time watching television and playing computer games (P<0.01). No associations were found between smoking habits or alcohol consumption and frequency of CC. These results do not show a link between consumption of confectionery purchased from vending machines and 'poor' dietary practice or 'undesirable' lifestyle habits. Findings for total confectionery consumption showed some interesting trends, but the results were not consistent, either for a negative or positive effect.

  5. Competitive foods in schools: Availability and purchasing in predominately rural small and large high schools

    PubMed Central

    Nollen, Nicole L.; Befort, Christie; Davis, Ann McGrath; Snow, Tricia; Mahnken, Jonathan; Hou, Qingjiang; Story, Mary; Ahluwalia, Jasjit S.

    2013-01-01

    OBJECTIVES Schools have an important role to play in obesity prevention, but little is known about the food environment in small, predominately rural schools. The primary purpose of this study was to compare the availability and student purchasing of foods sold outside of the reimbursable meals program through a la carte (ALC) or vending (i.e., competitive foods) in small (n = 7) and large (n = 6) Kansas high schools. METHODS A cross-sectional observational study design was used to capture the number of ALC and vending items available and purchased, and the fat and caloric content of all available and purchased items on a single school day between January and May 2005. RESULTS Small schools had significantly fewer vending machines than large schools [median=3.0 (range=2.0–5.0) versus 6.5 (range=4.0–8.0), p<0.01]. Vending and ALC items at small schools contained a median of 2.3 fewer fat grams per item (p≤0.05), while vending products contained a median of 25.0 fewer calories per item (p≤0.05) than at large schools. Significantly less fat (median= −15.4 grams/student) and fewer calories (median= −306.8 kcal/student) were purchased per student from all competitive food sources and from ALC (median= −12.9 fat grams and −323.3 kcal/student) by students in small schools compared to students in large schools (p≤0.05). CONCLUSIONS The findings, which highlight less availability and lower energy content from competitive foods at small compared to large schools, have implications for understanding how small schools support their food service programs with limited dependence on competitive foods and the impact that food and nutrition professionals can have on the school environment by providing more oversight into the nutritional quality of foods available. PMID:19394472

  6. Hypertensive Crisis During Norepinephrine Syringe Exchange: A Case Report.

    PubMed

    Snijder, Roland A; Knape, Johannes T A; Egberts, Toine C G; Timmerman, Annemoon M D E

    2017-04-01

    A 67-year critically ill patient suffered from a hypertensive crisis (200 mm Hg) because of a norepinephrine overdose. The overdose occurred when the clinician exchanged an almost-empty syringe and the syringe pump repeatedly reported an error. We hypothesized that an object between the plunger and the syringe driver may have caused the exertion of too much force on the syringe. Testing this hypothesis in vitro showed significant peak dosing errors (up to +572%) but moderate overdose (0.07 mL, +225%) if a clamp was used on the intravenous infusion line and a large overdose (0.8 mL, +2700%) if no clamp was used. Clamping and awareness are advised.

  7. HIV and incarceration: prisons and detention

    PubMed Central

    2011-01-01

    The high prevalence of HIV infection among prisoners and pre-trial detainees, combined with overcrowding and sub-standard living conditions sometimes amounting to inhuman or degrading treatment in violation of international law, make prisons and other detention centres a high risk environment for the transmission of HIV. Ultimately, this contributes to HIV epidemics in the communities to which prisoners return upon their release. We reviewed the evidence regarding HIV prevalence, risk behaviours and transmission in prisons. We also reviewed evidence of the effectiveness of interventions and approaches to reduce the risk behaviours and, consequently, HIV transmission in prisons. A large number of studies report high levels of risk behaviour in prisons, and HIV transmission has been documented. There is a large body of evidence from countries around the world of what prison systems can do to prevent HIV transmission. In particular, condom distribution programmes, accompanied by measures to prevent the occurrence of rape and other forms of non-consensual sex, needle and syringe programmes and opioid substitution therapies, have proven effective at reducing HIV risk behaviours in a wide range of prison environments without resulting in negative consequences for the health of prison staff or prisoners. The introduction of these programmes in prisons is therefore warranted as part of comprehensive programmes to address HIV in prisons, including HIV education, voluntary HIV testing and counselling, and provision of antiretroviral treatment for HIV-positive prisoners. In addition, however, action to reduce overcrowding and improve conditions in detention is urgently needed. PMID:21595957

  8. HIV and incarceration: prisons and detention.

    PubMed

    Jürgens, Ralf; Nowak, Manfred; Day, Marcus

    2011-05-19

    The high prevalence of HIV infection among prisoners and pre-trial detainees, combined with overcrowding and sub-standard living conditions sometimes amounting to inhuman or degrading treatment in violation of international law, make prisons and other detention centres a high risk environment for the transmission of HIV. Ultimately, this contributes to HIV epidemics in the communities to which prisoners return upon their release. We reviewed the evidence regarding HIV prevalence, risk behaviours and transmission in prisons. We also reviewed evidence of the effectiveness of interventions and approaches to reduce the risk behaviours and, consequently, HIV transmission in prisons. A large number of studies report high levels of risk behaviour in prisons, and HIV transmission has been documented. There is a large body of evidence from countries around the world of what prison systems can do to prevent HIV transmission. In particular, condom distribution programmes, accompanied by measures to prevent the occurrence of rape and other forms of non-consensual sex, needle and syringe programmes and opioid substitution therapies, have proven effective at reducing HIV risk behaviours in a wide range of prison environments without resulting in negative consequences for the health of prison staff or prisoners.The introduction of these programmes in prisons is therefore warranted as part of comprehensive programmes to address HIV in prisons, including HIV education, voluntary HIV testing and counselling, and provision of antiretroviral treatment for HIV-positive prisoners. In addition, however, action to reduce overcrowding and improve conditions in detention is urgently needed.

  9. A clinical comparative study between conventional and camouflaged syringes to evaluate behavior and anxiety in 6-11-year-old children during local anesthesia administration-a novel approach.

    PubMed

    Melwani, Anjana M; Srinivasan, Ila; Setty, Jyothsna V; D R, Murali Krishna; Pamnani, Sunaina S; Lalitya, Dandamudi

    2018-02-01

    The sight of dental injection can bring about severe anxiety in children. Therefore, an alternative method that is convenient, effective, and keeps the needle hidden making it child friendly is necessary. The objective of the study was to compare the efficacy of a camouflaged syringe and conventional syringe on behavior and anxiety in 6-11-year-old children during local anesthesia administration. The study was a randomized, crossover clinical study including 30 children. Children were separated into two groups. Group 1 consisted of 15 children aged 6-8 years while group 2 consisted of 15 children aged 9-11 years. This study involved two sessions wherein all the children were injected using conventional and camouflaged syringes in separate sessions. Their behavior was assessed using the Faces, Legs, Activity, Cry, Consolability (FLACC) behavior pain scale and anxiety was assessed by measuring changes in pulse rate. Patient and operator preferences were compared. The results showed a lower mean change in pulse rate and FLACC scores in the camouflaged group, suggesting a positive behavior and lesser anxiety with camouflaged syringes than with conventional syringes. The use of camouflaged syringes for anesthesia was demonstrated to be effective in improving the behavior of children and decreasing their anxiety, and is therefore recommended as an alternative to the use of conventional syringes for local anesthesia.

  10. Dump the pump: manual aspiration thrombectomy (MAT) with a syringe is technically effective, expeditious, and cost-efficient.

    PubMed

    Gross, Bradley A; Jadhav, Ashutosh P; Jovin, Tudor G; Jankowitz, Brian Thomas

    2018-04-01

    Syringe aspiration for manual aspiration thrombectomy (MAT) is a cost- and time-efficient alternative to an aspiration pump with likely similar efficacy. It is counterintuitive to expect the pump to perform better than direct vacuum with a syringe, as the pump must deliver vacuum additionally through a canister and meters of tubing. To present in vitro and clinical results of MAT with a syringe. An in vitro analysis was performed comparing vacuum pressures generated by syringe aspiration and with pump aspiration. This was then complemented with prospective clinical data providing details of angiographic and clinical outcomes for syringe MAT. The in vitro analysis demonstrated that equal to slightly greater vacuum pressures were generated by a 60 cc syringe as compared with the pump in both static and partial flow conditions. In our clinical series, 106/113 acute stroke thrombectomies over a 6-month period were performed with syringe MAT on the first pass. Syringe usage instead of pump tubing and a canister led to a total savings of $58 300. The rate of Thrombolysis in Cerebral Infarction 2b/3 recanalization was 93%. Adjunctive stentriever usage was performed in 23% of cases. Median puncture to reperfusion time was 25 min; mean change in National Institute of Health Stroke Scale score at 24 hours was an improvement of 5.1 (median 6). The in-hospital mortality rate was 10%. Seventy percent of patients were discharged to home (modified Rankin Scale (mRS) score 0-2) or a rehabilitation facility (mRS score 2-4). MAT using a syringe is a safe, fast, and more cost-effective approach than using an aspiration pump. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Evaluation of a new syringe presentation of reduced-antigen content diphtheria, tetanus, and acellular pertussis vaccine in healthy adolescents - A single blind randomized trial

    PubMed Central

    Pavia-Ruz, Noris; Abarca, Katia; Lepetic, Alejandro; Cervantes-Apolinar, Maria Yolanda; Hardt, Karin; Jayadeva, Girish; Kuriyakose, Sherine; Han, Htay Htay; de la O, Manuel

    2015-01-01

    Reduced-antigen-content diphtheria-tetanus-acellular pertussis (dTpa) vaccine, Boostrix™, is indicated for booster vaccination of children, adolescents and adults. The original prefilled disposable dTpa syringe presentation was recently replaced by another prefilled-syringe presentation with latex-free tip-caps and plunger-stoppers. 671 healthy adolescents aged 10–15 years who had previously received 5 or 6 previous DT(P)/dT(pa) vaccine doses, were randomized (1:1) to receive dTpa booster, injected using the new (dTpa-new) or previous syringe (dTpa-previous) presentations. Immunogenicity was assessed before and 1-month post-booster vaccination; safety/reactogenicity were assessed during 31-days post-vaccination. Non-inferiority of dTpa-new versus dTpa-previous was demonstrated for all antigens (ULs 95% CIs for GMC ratios ranged between 1.03-1.13). 1-month post-booster, immune responses were in similar ranges for all antigens with both syringe presentations. dTpa delivered using either syringe presentation was well-tolerated. These clinical results complement the technical data and support the use of the new syringe presentation to deliver the dTpa vaccine. PMID:26075317

  12. Compact Apparatus Grows Protein Crystals

    NASA Technical Reports Server (NTRS)

    Bugg, Charles E.; Delucas, Lawrence J.; Suddath, Fred L.; Snyder, Robert S.; Herren, Blair J.; Carter, Daniel C.; Yost, Vaughn H.

    1989-01-01

    Laboratory apparatus provides delicately balanced combination of materials and chemical conditions for growth of protein crystals. Apparatus and technique for growth based on hanging-drop method for crystallization of macromolecules. Includes pair of syringes with ganged plungers. One syringe contains protein solution; other contains precipitating-agent solution. Syringes intrude into cavity lined with porous reservoir material saturated with 1 mL or more of similar precipitating-agent solution. Prior to activation, ends of syringes plugged to prevent transport of water vapor among three solutions.

  13. Malaysia and harm reduction: the challenges and responses.

    PubMed

    Reid, Gary; Kamarulzaman, Adeeba; Sran, Sangeeta Kaur

    2007-03-01

    In Malaysia the response to illicit drug use has been largely punitive with the current goal of the Malaysian government being to achieve a drug-free society by 2015. This paper outlines the results of a desk-based situation assessment conducted over a 3-week period in 2004. Additional events, examined in 2005, were also included to describe more recent policy developments and examine how these came about. Despite punitive drug policy there has been a substantial rise in the number of drug users in the country. Over two-thirds of HIV/AIDS cases are among injecting drug users (IDUs) and there has been an exponential rise in the number of cases reported. Further, data suggest high risk drug use practices are widespread. Harm reduction initiatives have only recently been introduced in Malaysia. The successful piloting of substitution therapies, in particular methadone and buprenorphine, is cause for genuine hope for the rapid development of such interventions. In 2005 the government announced it will allow methadone maintenance programmes to operate beyond the pilot phase and needle and syringe exchange programmes will be established to serve the needs of IDUs.

  14. Design and Synthesis of Network-Forming Triblock Copolymers Using Tapered Block Interfaces

    PubMed Central

    Kuan, Wei-Fan; Roy, Raghunath; Rong, Lixia; Hsiao, Benjamin S.; Epps, Thomas H.

    2012-01-01

    We report a strategy for generating novel dual-tapered poly(isoprene-b-isoprene/styrene-b-styrene-b-styrene/methyl methacrylate-b-methyl methacrylate) [P(I-IS-S-SM-M)] triblock copolymers that combines anionic polymerization, atom transfer radical polymerization (ATRP), and Huisgen 1,3-dipolar cycloaddition click chemistry. The tapered interfaces between blocks were synthesized via a semi-batch feed using programmable syringe pumps. This strategy allows us to manipulate the transition region between copolymer blocks in triblock copolymers providing control over the interfacial interactions in our nanoscale phase-separated materials independent of molecular weight and block constituents. Additionally, we show the ability to retain a desirous and complex multiply-continuous network structure (alternating gyroid) in our dual-tapered triblock material. PMID:23066522

  15. Salmonella, Shigella and growth potential of other food-borne pathogens in Ethiopian street vended foods.

    PubMed

    Muleta, D; Ashenafi, M

    2001-11-01

    To evaluate the bacteriological safety of food items sold by street vendors with regard to Salmonella and Shigella and to assess the growth potential of some foodborne pathogens in some street foods. Collection of street-vended foods and laboratory based microbiological analysis. Microbiology Laboratory, Department of Biology, Addis Ababa University, Addis Ababa, Ethiopia. Most of the street food samples had aerobic mesophilic counts >10(7) cfu/g. Nine "kitfo" and one "egg sandwich" samples yielded Salmonella. Shigella was isolated from three "macaroni" samples. The Salmonella isolates were sensitive to all ten drugs tested but the Shigella isolates had multiple resistance against five drugs. In a challenge study, Salmonella typhimurium, Shigella flexneri and Staphylococcus aureus grew in street-vended food samples to hazardous levels within eight to twelve hours. Street foods are heavily contaminated with micro-organisms and are potential sources of food borne infections. Health hazards from street foods may be significantly minimised by consumption within four hours of preparation.

  16. Prevalence of pathogenic bacteria in street vended ready-to-eat meats in Windhoek, Namibia.

    PubMed

    Shiningeni, Daphney; Chimwamurombe, Percy; Shilangale, Renatus; Misihairabgwi, Jane

    2018-05-31

    To determine the prevalence of pathogenic bacteria in street vended ready-to-eat meats in Windhoek, Namibia, a total of 96 street vended ready to eat meat samples were evaluated. Prevalences of 42%, 52%, 15%, 6% and 83% were observed for Escherichia coli, Staphylococcus aureus, Listeria monocytogenes, Shigella and Enterobacteriaceae respectively, while the highest aerobic plate counts were 7.74 Log 10 cfu/g, 5.67 Log 10 cfu/g, 5.12 Log 10 cfu/g , 4.56 Log 10 cfu/g, 3.3 Log 10 cfu/g, 5.75 Log 10 cfu/g respectively. Unsatisfactory microbial levels were 32% for aerobic plate count, 26% for Enterobacteriaceae, 35% for Escherichia coli, 11% for Listeria monocytogenes, 7% for Staphylococcus aureus and 6% for Shigella. Salmonella was detected in 11% and 40% of samples from two suburbs. The unsatisfactory microbiological quality of some ready-to-eat meats necessitates the provision of training on food safety and hygiene to street vendors for consumer protection. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Impact of water-vending kiosks and hygiene education on household drinking water quality in rural Ghana.

    PubMed

    Opryszko, Melissa C; Guo, Yayi; MacDonald, Luke; MacDonald, Laura; Kiihl, Samara; Schwab, Kellogg J

    2013-04-01

    Innovative solutions are essential to improving global access to potable water for nearly 1 billion people. This study presents an independent investigation of one alternative by examining for-profit water-vending kiosks, WaterHealth Centers (WHCs), in rural Ghana to determine their association with household drinking water quality. WHCs' design includes surface water treatment using filtration and ultraviolet light disinfection along with community-based hygiene education. Analyses of water samples for Escherichia coli and household surveys from 49 households across five villages collected one time per year for 3 years indicate that households using WHCs had improved water quality compared with households using untreated surface water (adjusted incidence rate ratio = 0.07, 95% confidence interval = 0.02, 0.21). However, only 38% of households used WHCs by the third year, and 60% of those households had E. coli in their water. Recontamination during water transport and storage is an obstacle to maintaining WHC-vended water quality.

  18. Developing Local Board of Health Guidelines to Promote Healthy Food Access — King County, Washington, 2010–2012

    PubMed Central

    Johnson, Donna B.; Krieger, James; MacDougall, Erin; Payne, Elizabeth; Chan, Nadine L.

    2015-01-01

    Policies that change environments are important tools for preventing chronic diseases, including obesity. Boards of health often have authority to adopt such policies, but few do so. This study assesses 1) how one local board of health developed a policy approach for healthy food access through vending machine guidelines (rather than regulations) and 2) the impact of the approach. Using a case study design guided by “three streams” policy theory and RE-AIM, we analyzed data from a focus group, interviews, and policy documents. The guidelines effectively supported institutional policy development in several settings. Recognition of the problem of chronic disease and the policy solution of vending machine guidelines created an opening for the board to influence nutrition environments. Institutions identified a need for support in adopting vending machine policies. Communities could benefit from the study board’s approach to using nonregulatory evidence-based guidelines as a policy tool. PMID:25927606

  19. Impact of Water-Vending Kiosks and Hygiene Education on Household Drinking Water Quality in Rural Ghana

    PubMed Central

    Opryszko, Melissa C.; Guo, Yayi; MacDonald, Luke; MacDonald, Laura; Kiihl, Samara; Schwab, Kellogg J.

    2013-01-01

    Innovative solutions are essential to improving global access to potable water for nearly 1 billion people. This study presents an independent investigation of one alternative by examining for-profit water-vending kiosks, WaterHealth Centers (WHCs), in rural Ghana to determine their association with household drinking water quality. WHCs' design includes surface water treatment using filtration and ultraviolet light disinfection along with community-based hygiene education. Analyses of water samples for Escherichia coli and household surveys from 49 households across five villages collected one time per year for 3 years indicate that households using WHCs had improved water quality compared with households using untreated surface water (adjusted incidence rate ratio = 0.07, 95% confidence interval = 0.02, 0.21). However, only 38% of households used WHCs by the third year, and 60% of those households had E. coli in their water. Recontamination during water transport and storage is an obstacle to maintaining WHC-vended water quality. PMID:23382168

  20. Vacuum aspiration with the IPAS Modified Gynecologic Syringe.

    PubMed

    Balogh, S A

    1983-01-01

    The IPAS Modified Gynecologic Syringe was compared with the electric pump and standard hand pump in a clinical trial of 1227 women undergoing vacuum aspiration. This modified double-valve syringe was designed to fit larger 8 mm, 10 mm and 12 mm cannulae, which are more suitable for late first trimester procedures. The study was conducted at four centers in which the double-valve syringe was used alternately with the vacuum source normally used at each clinic. Although there were notable inter-center differences with respect to certain outcome variables, results were similar for procedures performed at the same center. The only significant finding was the lower proportion of women requiring D & C to complete uterine evacuation among double-valve syringe patients than among hand pump cases at one center. The data indicate that the double-valve syringe is safe and effective for uterine aspiration in women up to 14 weeks' gestation and may be preferable for use in clinics with limited facilities.

  1. Plausible authentication of manuka honey and related products by measuring leptosperin with methyl syringate.

    PubMed

    Kato, Yoji; Fujinaka, Rie; Ishisaka, Akari; Nitta, Yoko; Kitamoto, Noritoshi; Takimoto, Yosuke

    2014-07-09

    Manuka honey, obtained from Leptospermum scoparium flowers in New Zealand, has strong antibacterial properties. In this study, plausible authentication of the manuka honey was inspected by measuring leptosperin, methyl syringate 4-O-β-D-gentiobiose, along with methyl syringate. Despite a gradual decrease in methyl syringate content over 30 days at 50 °C, even at moderate 37 °C, leptosperin remained stable. A considerable correlation between nonperoxide antibacterial activity and leptosperin content was observed in 20 certified manuka honey samples. Leptosperin and methyl syringate in manuka honey and related products were analyzed using HPLC connected with mass spectrometry. One noncertified brand displayed significant variations in the leptosperin and methyl syringate contents between two samples obtained from different regions. Therefore, certification is clearly required to protect consumers from disguised and/or low-quality honey. Because leptosperin is stable during storage and specific to manuka honey, its measurement may be applicable for manuka honey authentication.

  2. Needle and syringe sharing among Iranian drug injectors

    PubMed Central

    Rafiey, Hassan; Narenjiha, Hooman; Shirinbayan, Peymaneh; Noori, Roya; Javadipour, Morteza; Roshanpajouh, Mohsen; Samiei, Mercedeh; Assari, Shervin

    2009-01-01

    Objective The role of needle and syringe sharing behavior of injection drug users (IDUs) in spreading of blood-borne infections – specially HIV/AIDS – is well known. However, very little is known in this regard from Iran. The aim of our study was to determine the prevalence and associates of needle and syringe sharing among Iranian IDUs. Methods In a secondary analysis of a sample of drug dependents who were sampled from medical centers, prisons and streets of the capitals of 29 provinces in the Iran in 2007, 2091 male IDUs entered. Socio-demographic data, drug use data and high risk behaviors entered to a logistic regression to determine independent predictors of lifetime needle and syringe sharing. Results 749(35.8%) reported lifetime experience of needle and syringe sharing. The likelihood of lifetime needle and syringe sharing was increased by female gender, being jobless, having illegal income, drug use by family members, pleasure/enjoyment as causes of first injection, first injection in roofless and roofed public places, usual injection at groin, usual injection at scrotum, lifetime experience of nonfatal overdose, and history of arrest in past year and was decreased by being alone at most injections. Conclusion However this data has been extracted from cross-sectional design and we can not conclude causation, some of the introduced variables with association with needle and syringe sharing may be used in HIV prevention programs which target reducing syringe sharing among IDUs. PMID:19643014

  3. High dead-space syringe use among people who inject drugs in Tijuana, Mexico.

    PubMed

    Rafful, Claudia; Zule, William; González-Zúñiga, Patricia E; Werb, Dan; Medina-Mora, María Elena; Magis-Rodriguez, Carlos; Strathdee, Steffanie A

    2015-05-01

    High dead-space syringes (HDSS) are believed to confer an elevated risk of acquiring HIV and other blood-borne infections. We identified prevalence and correlates of HDSS use among injection drug users (IDU) in Tijuana, Mexico, where syringe purchase and possession is legal without a prescription. Beginning in 2011, IDU who reported being 18 years or older and injected drugs within the last month were recruited into a prospective study. At baseline and semi-annually, 557 IDU underwent HIV-testing and interviewer-administered surveys. Logistic regression was used to identify correlates of using HDSS. Of 557 IDU, 40% had ever used HDSS, mostly because no other syringe type was available (72%), or because they were easier to get (20%). Controlling for sex and age at first injection, use of HDSS was associated with cocaine as the first drug injected (Adjusted Odds Ratio [AOR]: 2.68; Confidence Interval 95% [CI]: 1.15-6.22), having been stopped or arrested by police (AOR: 1.84; 95% CI: 1.11-3.07), being deported from the US (AOR: 1.64; 95% CI:1.06-2.53), and believing it is illegal to carry syringes (AOR:1.78; 95% CI: 1.01-3.15). Use of HDSS is surprisingly common among IDU in Tijuana. Efforts are needed to expand coverage of low-dead space syringes through existing syringe exchange programs. Education is required to increase awareness of the harms associated with HDSS, and to inform IDU that syringe possession is legal across Mexico.

  4. CHANGES IN LIPID-ENCAPSULATED MICROBUBBLE POPULATION DURING CONTINUOUS INFUSION AND METHODS TO MAINTAIN CONSISTENCY

    PubMed Central

    KAYA, MEHMET; GREGORY, THOMAS S.; DAYTON, PAUL A.

    2009-01-01

    Stabilized microbubbles are utilized as ultrasound contrast agents. These micron-sized gas capsules are injected into the bloodstream to provide contrast enhancement during ultrasound imaging. Some contrast imaging strategies, such as destruction-reperfusion, require a continuous injection of microbubbles over several minutes. Most quantitative imaging strategies rely on the ability to administer a consistent dose of contrast agent. Because of the buoyancy of these gas-filled agents, their spatial distribution within a syringe changes over time. The population of microbubbles that is pumped from a horizontal syringe outlet differs from initial population as the microbubbles float to the syringe top. In this manuscript, we study the changes in the population of a contrast agent that is pumped from a syringe due to microbubble floatation. Results are presented in terms of change in concentration and change in mean diameter, as a function of time, suspension medium, and syringe diameter. Data illustrate that the distribution of contrast agents injected from a syringe changes in both concentration and mean diameter over several minutes without mixing. We discuss the application of a mixing system and viscosity agents to keep the contrast solution more evenly distributed in a syringe. These results are significant for researchers utilizing microbubble contrast agents in continuous-infusion applications where it is important to maintain consistent contrast agent delivery rate, or in situations where the injection syringe cannot be mixed immediately prior to administration. PMID:19632760

  5. Giving an insulin injection

    MedlinePlus

    ... of Insulin To fill a syringe with one type of insulin: Wash your hands with soap and water. Dry them well. Check ... hand, and tap the syringe with your other hand. The bubbles will float to the top. Push the bubbles back into the ... To fill a syringe with two ...

  6. Variability in syringe components and its impact on functionality of delivery systems.

    PubMed

    Rathore, Nitin; Pranay, Pratik; Eu, Bruce; Ji, Wenchang; Walls, Ed

    2011-01-01

    Prefilled syringes and autoinjectors are becoming increasingly common for parenteral drug administration primarily due to the convenience they offer to the patients. Successful commercialization of such delivery systems requires thorough characterization of individual components. Complete understanding of various sources of variability and their ranking is essential for robust device design. In this work, we studied the impact of variability in various primary container and device components on the delivery forces associated with syringe injection. More specifically, the effects of barrel size, needle size, autoinjector spring force, and frictional forces have been evaluated. An analytical model based on underlying physics is developed that can be used to fully characterize the design space for a product delivery system. Use of prefilled syringes (syringes prefilled with active drug) is becoming increasingly common for injectable drugs. Compared to vials, prefilled syringes offer higher dose accuracy and ease of use due to fewer steps required for dosage. Convenience to end users can be further enhanced through the use of prefilled syringes in combination with delivery devices such as autoinjectors. These devices allow patients to self-administer the drug by following simple steps such as pressing a button. These autoinjectors are often spring-loaded and are designed to keep the needle tip shielded prior to injection. Because the needle is not visible to the user, such autoinjectors are perceived to be less invasive than syringes and help the patient overcome the hesitation associated with self-administration. In order to successfully develop and market such delivery devices, we need to perform an in-depth analysis of the components that come into play during the activation of the device and dose delivery. Typically, an autoinjector is activated by the press of a button that releases a compressed spring; the spring relaxes and provides the driving force to push the drug out of the syringe and into the site of administration. Complete understanding of the spring force, syringe barrel dimensions, needle size, and drug product properties is essential for robust device design. It is equally important to estimate the extent of variability that exists in these components and the resulting impact it could have on the performance of the device. In this work, we studied the impact of variability in syringe and device components on the delivery forces associated with syringe injection. More specifically, the effect of barrel size, needle size, autoinjector spring force, and frictional forces has been evaluated. An analytical model based on underlying physics is developed that can be used to predict the functionality of the autoinjector.

  7. Solute-Filled Syringe For Formulating Intravenous Solution

    NASA Technical Reports Server (NTRS)

    Owens, Jim; Bindokas, AL; Dudar, Tom; Finley, Mike; Scharf, Mike

    1993-01-01

    Prefilled syringe contains premeasured amount of solute in powder or concentrate form used to deliver solute to sterile interior of large-volume parenteral (LVP) bag. Predetermined amount of sterile water also added to LVP bag through sterilizing filter, and mixed with contents of syringe, yielding sterile intravenous solution of specified concentration.

  8. 21 CFR 870.1670 - Syringe actuator for an injector.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Syringe actuator for an injector. 870.1670 Section 870.1670 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1670 Syringe...

  9. Designing, Constructing, and Using an Inexpensive Electronic Buret

    ERIC Educational Resources Information Center

    Cao, Tingting; Zhang, Qing; Thompson, Jonathan E.

    2015-01-01

    A syringe-based, electronic fluid dispenser is described. The device mechanically connects a syringe plunger to a linear slide potentiometer. As the syringe plunger moves, the electrical resistance between terminals of the potentiometer varies. Application and subsequent measurement of a DC voltage between the potentiometer pins is used to track…

  10. 21 CFR 870.1670 - Syringe actuator for an injector.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Syringe actuator for an injector. 870.1670 Section 870.1670 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1670 Syringe...

  11. A Self-Contained Pole Syringe Array for Closed-Interval Water Sampling.

    DTIC Science & Technology

    1982-10-19

    L AD-R12l 265 R SELF-CONTAINED POLE SYRINGE ARRAY FOR CLOSDITRR Va WATER SANPLING4U) NAVAL RESEARCH LAB WASHINGTON DC I R E PELLENBARG ET AL. 19 OCT...PERIOD COVERED A SELF-CONTAINED POLE SYRINGE ARRAY FOR Interim report on one phase of CLOSED-INTERVAL WATER SAMPLING an NRL problem. 6. PERFORMING ORG...1473 EDITION OF I NOv ,, IS OMSOLCT S/N 0102-014- 6601 SECURITY CLASSIFICATION OF THIS PAGE (Wm Dle Et ere d A SELF-CONTAINED POLE SYRINGE ARRAY FOR

  12. Police training to align law enforcement and HIV prevention: preliminary evidence from the field.

    PubMed

    Beletsky, Leo; Agrawal, Alpna; Moreau, Bruce; Kumar, Pratima; Weiss-Laxer, Nomi; Heimer, Robert

    2011-11-01

    Having identified gaps in implementation of Rhode Island's syringe access law and police occupational safety education, public health and police professionals developed police training to boost legal knowledge, improve syringe access attitudes, and address needlestick injuries. Baseline data (94 officers) confirmed anxiety about needlestick injuries, poor legal knowledge, and occupational risk overestimation. Before training, respondents believed that syringe access promotes drug use (51%), increases likelihood of police needlestick injuries (58%), and fails to reduce epidemics (38%). Pretraining to posttraining evaluation suggested significant shifts in legal and occupational safety knowledge; changes in attitudes toward syringe access were promising. Training that combines occupational safety with syringe access content can help align law enforcement with public health goals. Additional research is needed to assess street-level effect and to inform intervention tailoring.

  13. Hydrodynamic comparison of the Penumbra system and commonly available syringes in forced-suction thrombectomy.

    PubMed

    Simon, Scott Douglas; Grey, Casey Paul

    2014-04-01

    The Penumbra system uses a coaxial separator and continuous extracorporeal suction to remove a clot from a cerebral artery. Forced-suction thrombectomy (FST) involves aspirating clots through the same reperfusion catheter using only a syringe, decreasing the procedure time and supplies needed. To evaluate multiple combinations of catheters and syringes to determine the optimal pairing for use in FST. Tests were performed using both the Penumbra system and syringes to aspirate water through Penumbra 0.041 inch (041), 4Max, 0.054 inch (054) and 5Max reperfusion catheters and a shuttle sheath. Dynamic pressure and flow at the catheter tip were calculated from the fill times for each system. Static pressure and force for each aspiration source were determined with a vacuum gauge. All syringes provided significantly higher dynamic pressure at the catheter tip than the Penumbra system (p<0.001). Increasing syringe volume significantly increased static pressure (p<0.001). Both flow and aspiration force significantly increased with catheter size (p<0.001). Cases are presented to demonstrate the clinical value of the laboratory principles. Maximizing static and dynamic pressure when performing FST is achieved by aspirating with a syringe possessing both the largest volume and the largest inlet diameter available. Maximizing aspiration force and flow rate is achieved by using the largest catheter possible.

  14. Liquid drugs and high dead space syringes may keep HIV and HCV prevalence high - a comparison of Hungary and Lithuania.

    PubMed

    Gyarmathy, V Anna; Neaigus, Alan; Li, Nan; Ujhelyi, Eszter; Caplinskiene, Irma; Caplinskas, Saulius; Latkin, Carl A

    2010-01-01

    Despitevery similar political, drug policy and HIV prevention backgrounds, HIV and HCV prevalence is considerably different in Hungary (low HIV and moderate HCV prevalence) and Lithuania (high HCV and moderate HIV prevalence). Wecompared the drug use profile of Hungarian (n = 215) and Lithuanian (n = 300) injecting drug users (IDUs). Overall, compared with IDUs in Hungary, IDUs in Lithuania often injected opiates purchased in liquid form ('shirka'), used and shared 2-piece syringes (vs. 1-piece syringes) disproportionately more often, were less likely to acquire their syringes from legal sources and had significantly more experience with injected and less experience with non-injected drugs. It may not be liquid drugs per se that contribute to a higher prevalence of HCV and/or HIV, but it is probably factors associated with the injecting of liquid drugs, such as the wide-spread use and sharing of potentially contaminated 2-piece syringes acquired often from non-legal sources, and syringe-mediated drug sharing with 2-piece syringes. Scaling up substitution therapy, especially heroin replacement, combined with reducing the supply of liquid drugs may decrease the prevalence of high-risk injecting behaviours related to the injecting of liquid drugs and drug injecting-related infections among IDUs in Lithuania. Copyright © 2010 S. Karger AG, Basel.

  15. Evaluation of nonprescription syringe sales in San Francisco.

    PubMed

    Rose, Valerie J; Raymond, H Fisher

    2010-01-01

    To determine the experiences, practices, and challenges associated with nonprescription syringe sales (NPSS) among pharmacists whose pharmacies were enrolled in the Disease Prevention Demonstration Project in San Francisco, CA. Self-administered survey mailed to 69 pharmacies and interviews with pharmacists and technicians. A total of 55 of 69 pharmacies (80%) returned the survey, and eight pharmacy managers and three pharmacy technicians were interviewed in person. Of pharmacists, 72% reported none or very few problems with NPSS in the previous year, although surveys and interviews illustrated challenges associated with NPSS in terms of time management, educating patients about syringe disposal, and understanding patient preferences for syringes. Of pharmacists, 62% reported NPSS to no more than 10 to 20 patients per week and 67% collected more than 400 syringes in the previous year. One-third of pharmacists perceived that their pharmacies were located in areas where drug activity was high and that the majority of NPSS patients injected illegal drugs. Access to sterile syringes is a prominent public health issue, and pharmacists can play an important role in injection drug user (IDU) education and disease prevention. This evaluation suggests that pharmacies are selling nonprescription syringes to individuals perceived to be IDUs with no major problems. Additional evaluations from health department programs are needed to demonstrate the efficacy of NPSS in California.

  16. Investigating Liquid Leak from Pre-Filled Syringes upon Needle Shield Removal: Effect of Air Bubble Pressure.

    PubMed

    Chan, Edwin; Maa, Yuh-Fun; Overcashier, David; Hsu, Chung C

    2011-01-01

    This study is to investigate the effect of headspace air pressure in pre-filled syringes on liquid leak (dripping) from the syringe needle upon needle shield removal. Drip tests to measure drip quantity were performed on syringes manually filled with 0.5 or 1.0 mL of various aqueous solutions. Parameters assessed included temperature (filling and test), bulk storage conditions (tank pressure and the type of the pressurized gas), solution composition (pure water, 0.9% sodium chloride, and a monoclonal antibody formulation), and testing procedures. A headspace pressure analyzer was used to verify the drip test method. Results suggested that leakage is indeed caused by headspace pressure increase, and the temperature effect (ideal gas expansion) is a major, but not the only, factor. The dissolved gases in the liquid bulk prior to or during filling may contribute to leakage, as these gases could be released into the headspace due to solubility changes (in response to test temperature and pressure conditions) and cause pressure increase. Needle shield removal procedures were found to cause dripping, but liquid composition played little role. Overall, paying attention to the processing history (pressure and temperature) of the liquid bulk is the key to minimize leakage. The headspace pressure could be reduced by decreasing liquid bulk storage pressure, filling at a higher temperature, or employing lower solubility gas (e.g., helium) for bulk transfer and storage. Leakage could also be mitigated by simply holding the syringe needle pointing upward during needle shield removal. Substantial advances in pre-filled syringe technology development, particularly in syringe filling accuracy, have been made. However, there are factors, as subtle as how the needle shield (or tip cap) is removed, that may affect dosing accuracy. We recently found that upon removal of the tip cap from a syringe held vertically with needle pointed downwards, a small amount of solution, up to 3-4% of the 1 mL filled volume or higher for filled volume of <1 mL, leaked out from the needle. This paper identified the root causes of this problem and offered solutions from the perspectives of the syringe fill process and the end user procedure. The readers will benefit from this paper by understanding how each process step prior to and during syringe filling may affect delivery performance of the pre-filled syringe device.

  17. Stability of stabilized 99mTc-D,L-HMPAO stored in vials and syringes.

    PubMed

    Del Carmen Plancha-Mansanet, Maria; Caballero-Calabuig, Elisa; Félix-Fontestad, Jesús; Reyes-Ojeda, María Dolores; Sopena-Novales, Pablo; Abreu-Sánchez, Pedro; Del Carmen Cano-Terol, Maria; Sopena-Monforte, Ramón

    2008-12-01

    Our objective was to determine the stability of stabilized (99m)Tc-hexamethylpropylene amine oxime ((99m)Tc-d,l-HMPAO) dispensed by vial and syringe, with the storage time and labeling activity varied. (99m)Tc-d,l-HMPAO was labeled according to the manufacturer's instructions, but with modification of the (99m)TcO(4)Na activity. Two groups were prepared: 1,110 MBq (30 mCi) and 2,600-3,700 MBq (70.3-100 mCi). Five minutes after labeling, the radiochemical purity (RCP) of the vial content was determined. Afterward, the same activity was distributed into two 2-mL syringes and into the manufacturer's vial. In one of the syringes, the radiopharmaceutical stayed in contact with the needle for 4 h. At 2 and 4 h after labeling, the RCP of the vial and syringe content was checked and compared. The mean RCP of stabilized (99m)Tc-d,l-HMPAO labeled with 1,110 MBq (30 mCi) and stored in a vial decreased from 93.1% at 5 min to 92.1% at 2 h and to 91.1% at 4 h. With storage in a syringe, the RCP decreased from 89.8% at 2 h to 88.7% at 4 h. This diminution increased for labeling with higher activities (2,600-3,700 MBq [70.3-100 mCi]), ranging from 91.4% at 5 min, 89.0% at 2 h, and 85.3% at 4 h in a vial and from 85.9% at 2 h to 80.2% in a syringe. (99m)TcO(2) and secondary (99m)Tc-HMPAO were the main impurities at t = 0. (99m)TcO(4)(-) was an impurity that increased with time in both vials and syringes but significantly so in syringes. All these impurities were higher with labeling activities in the range of 2,600-3,700 MBq (70.3-100 mCi). Contact of the needle with (99m)Tc-d,l-HMPAO sharply decreased the RCP to 57.1% at 4 h. The RCP of stabilized (99m)Tc-d,l-HMPAO decreases significantly in both vials and syringes with high labeling activities. The product is less stable when stored in a syringe than in a vial. The fraction of dose in contact with the needle affects the RCP results.

  18. Vial usage, device dead space, vaccine wastage, and dose accuracy of intradermal delivery devices for inactivated poliovirus vaccine (IPV).

    PubMed

    Jarrahian, Courtney; Rein-Weston, Annie; Saxon, Gene; Creelman, Ben; Kachmarik, Greg; Anand, Abhijeet; Zehrung, Darin

    2017-03-27

    Intradermal delivery of a fractional dose of inactivated poliovirus vaccine (IPV) offers potential benefits compared to intramuscular (IM) delivery, including possible cost reductions and easing of IPV supply shortages. Objectives of this study were to assess intradermal delivery devices for dead space, wastage generated by the filling process, dose accuracy, and total number of doses that can be delivered per vial. Devices tested included syringes with staked (fixed) needles (autodisable syringes and syringes used with intradermal adapters), a luer-slip needle and syringe, a mini-needle syringe, a hollow microneedle device, and disposable-syringe jet injectors with their associated filling adapters. Each device was used to withdraw 0.1-mL fractional doses from single-dose IM glass vials which were then ejected into a beaker. Both vial and device were weighed before and after filling and again after expulsion of liquid to record change in volume at each stage of the process. Data were used to calculate the number of doses that could potentially be obtained from multidose vials. Results show wide variability in dead space, dose accuracy, overall wastage, and total number of doses that can be obtained per vial among intradermal delivery devices. Syringes with staked needles had relatively low dead space and low overall wastage, and could achieve a greater number of doses per vial compared to syringes with a detachable luer-slip needle. Of the disposable-syringe jet injectors tested, one was comparable to syringes with staked needles. If intradermal delivery of IPV is introduced, selection of an intradermal delivery device can have a substantial impact on vaccine wasted during administration, and thus on the required quantity of vaccine that needs to be purchased. An ideal intradermal delivery device should be not only safe, reliable, accurate, and acceptable to users and vaccine recipients, but should also have low dead space, high dose accuracy, and low overall wastage to maximize the potential number of doses that can be withdrawn and delivered. Copyright © 2017 PATH. Published by Elsevier Ltd.. All rights reserved.

  19. Syringe confiscation as an HIV risk factor: the public health implications of arbitrary policing in Tijuana and Ciudad Juarez, Mexico.

    PubMed

    Beletsky, Leo; Lozada, Remedios; Gaines, Tommi; Abramovitz, Daniela; Staines, Hugo; Vera, Alicia; Rangel, Gudelia; Arredondo, Jaime; Strathdee, Steffanie A

    2013-04-01

    Female sex workers who inject drugs (FSW-IDUs) face elevated risk for HIV/STIs and constitute a key population for public health prevention. Through direct and indirect pathways including human rights violations, policing practices like syringe confiscation can compound FSW-IDU health risk and facilitate the spread of disease. We studied correlates of experiencing syringe confiscation among FSW-IDUs in northern Mexico, where formal policy allows for syringes to be available over the counter without a prescription, but police practices are often at odds with the law. FSW-IDUs reporting recent syringe sharing and unprotected sex with clients in Tijuana and Ciudad Juarez were administered surveys and HIV/STI testing. Logistic regression was used to identify correlates of syringe confiscation. Among 624 respondent FSW-IDUs, prevalence of syringe confiscation in the last 6 months was 48%. The following factors were positively associated with syringe confiscation: testing positive for HIV (adjusted odds ratio [aOR] = 2.54, 95% confidence interval [CI] = 1.11-5.80), reporting sexual abuse by police (aOR = 12.76, 95% CI = 6.58-24.72), engaging in groin injection (aOR = 1.84, 95% CI = 1.15-2.93), injecting in public (aOR = 1.64; 95% CI = 1.14-2.36), and obtaining syringes from pharmacies (aOR = 1.54; 95% CI = 1.06-2.23). Higher education level was negatively associated with syringe confiscation (aOR = 0.92, 95% CI = 0.87-0.98) as was frequent injection with clients within the last month (aOR = 0.64, 95% CI = 0.44-0.94). This analysis adds to the body of evidence linking unauthorized law enforcement actions targeting high-risk groups with HIV and other adverse health outcomes. Using a public health lens to conceptualize abuse as a structural risk factor, we advocate for multi-prong prevention, systematic monitoring, and evidence-based intervention response to deleterious police practices.

  20. Prevalence and predictors of transitions to and away from syringe exchange use over time in 3 US cities with varied syringe dispensing policies

    PubMed Central

    Green, Traci C.; Bluthenthal, Ricky N.; Singer, Merrill; Beletsky, Leo; Grau, Lauretta E.; Marshall, Patricia; Heimer, Robert

    2010-01-01

    Syringe exchange programs (SEPs) can reduce HIV risk among injecting drug users (IDUs) but their use may depend heavily on contextual factors such as local syringe policies. The frequency and predictors of transitioning over time to and from direct, indirect, and non-use of SEPs are unknown. We sought, over one year, to: (1) quantify and characterize transition probabilities of SEP attendance typologies; (2) identify factors associated with (a) change in typology, and (b) becoming and maintaining direct SEP use; and (3) quantify and characterize transition probabilities of SEP attendance before and after changes in policy designed to increase access. Using data collected from 583 IDUs participating in a three-city cohort study of SEPs, we conducted a latent transition analysis and multinomial regressions. Three typologies were detected: Direct SEP users, Indirect SEP users and Isolated IDUs. Transitions to direct SEP use were most prevalent. Factors associated with becoming or maintaining direct SEP use were female sex, Latino ethnicity, fewer injections per syringe, homelessness, recruitment city, injecting speedballs (cocaine and heroin), and police contact involving drug paraphernalia possession. Similar factors influenced transitions in the syringe policy change analysis. Policy change cities experienced an increase in Indirect SEP users (43% to 51%) with little increased direct use (29% to 31%). We found that, over time, IDUs tended to become Direct SEP users. Policies improving syringe availability influenced SEP use by increasing secondary syringe exchange. Interactions with police around drug paraphernalia may encourage SEP use for some IDUs and may provide opportunities for other health interventions. PMID:20537814

  1. Effect of Legal Status of Pharmacy Syringe Sales on Syringe Purchases by Persons Who Inject Drugs in San Francisco and San Diego, CA

    PubMed Central

    Siddiqui, Saira S.; Armenta, Richard; Evans, Jennifer L.; Yu, Michelle; Cuevas-Mota, Jazmine; Page, Kimberly; Davidson, Peter; Garfein, Richard S.

    2015-01-01

    Sharing blood-contaminated syringes is the main risk factor for acquiring and transmitting blood-borne infections among persons who inject drugs (PWID). To reduce this risk, in 2005, California enacted legislation allowing local health jurisdictions to legalize non-prescription syringe sales after approving a disease prevention demonstration project (DPDP). With San Francisco approving a DPDP immediately and San Diego never approving one, we compared PWID across cities for their use of pharmacies PWID to obtain syringes. PWID age 18–30 years old were recruited into separate studies in San Francisco (n=243) and San Diego (n=338) between 2008 and 2011. We used multivariable logistic regression to compare the proportions of PWID who obtained syringes from pharmacies by city while controlling for socio-demographics, injection practices and other risk behaviors. Overall, most PWID were white (71%), male (63%), and between the ages of 18–25 years (55%). Compared to San Francisco, a smaller proportion of PWID in San Diego had bought syringes from pharmacies in the prior three months (16.9% vs. 49.8%; p<0.001), which remained statistically significant after adjusting for socio-demographic and behavioral factors (adjusted odds ratio=4.45, 95% confidence interval: 2.98, 6.65). Use of pharmacies to obtain syringes was greater where it was legal to do so. Public health policy can influence HIV and hepatitis C associated risk among PWID; however, implementation of these policies is crucial for the benefits to be realized. PMID:26252980

  2. Making a difference? Applying Vitellone's Social Science of the Syringe to performance and image enhancing drug injecting.

    PubMed

    Hart, Aaron

    2018-04-18

    Vitellone's Social Science of the Syringe investigates epistemologies of injecting drug use. She argues for a methodology that can be simultaneously sensitive to biopolitical power regimes; the trajectories of social stratification; and the resistance, creativity and dignity of human agency. She proposes a methodological focus on the syringe-in-use as an active participant in these dynamics. Harm reduction policy and service provision frameworks have paid little attention to the phenomena of performance and image enhancing drug (PIEDs) injection. One way of assessing the merit of Vitellone's proposal is to use it to investigate these phenomena. I argue that Vitellone's method can be used to articulate a range of significant differences between people who inject PIEDs and other people who inject drugs, and that these differences can inform harm reduction initiatives. When compared to the heroin syringe, the PIED syringe participates in different socio-economic and material contexts, gendered identities, and biopolitical governance regimes. These differences materialise in different rates of syringe sharing and blood-borne virus transmission; and different experiences of needle exchange services. I offer a thought experiment demonstrating how a different syringe might alter the structural dynamics, biopolitical governance, and the agentic choices of people who inject PIEDs. Judging by the productive effects of diffracting Vitellone's analysis through an empirical concern with PIED injecting, I concur with Vitellone's proposition that 'something objective may be gained from an empirical investigation of the syringe-in-use' (p. 33). Copyright © 2018 Elsevier B.V. All rights reserved.

  3. High dead-space syringe use among people who inject drugs in Tijuana, Mexico

    PubMed Central

    Rafful, Claudia; Zule, William; González-Zúñiga, Patricia E.; Werb, Dan; Elena Medina-Mora, María; Magis-Rodriguez, Carlos; Strathdee, Steffanie A.

    2015-01-01

    Background High dead-space syringes (HDSS) are believed to confer an elevated risk of acquiring HIV and other blood-borne infections. Objectives We identified prevalence and correlates of HDSS use among injection drug users (IDU) in Tijuana, Mexico, where syringe purchase and possession is legal without a prescription. Methods Beginning in 2011, IDU who reported being 18 years or older, who injected drugs within the last month were recruited into a prospective study. At baseline and semi-annually, 557 IDU underwent HIV-testing and interviewer-administered surveys. Logistic regression was used to identify correlates of using HDSS. Results Of 557 IDU, 40% had ever used HDSS, mostly because no other syringe type was available (72%), or because they were easier to get (20%). Controlling for sex and age at first injection, use of HDSS was associated with cocaine as the first drug injected (Adjusted Odds Ratio [AOR]:2.68; Confidence Interval 95% [CI]:1.15-6.22), having been stopped or arrested by police (AOR:1.84; 95% CI:1.11-3.07), being deported from the US (AOR:1.64; 95%CI:1.06-2.53), and believing it is illegal to carry syringes (AOR:1.78; 95%CI:1.01-3.15). Conclusion Use of HDSS is surprisingly common among IDU in Tijuana. Efforts are needed to expand coverage of low-dead space syringes through existing syringe exchange programs. Education is required to increase awareness of the harms associated with HDSS, and to inform IDU that syringe possession is legal across Mexico. PMID:25695145

  4. Attitudes of North Carolina law enforcement officers toward syringe decriminalization

    PubMed Central

    Davis, Corey S.; Johnston, Jill; Zerden, Lisa de Saxe; Clark, Katie; Castillo, Tessie; Childs, Robert

    2015-01-01

    Background North Carolina, like much of the U.S. South, is disproportionately affected by HIV and hepatitis. This persistently high disease burden may be driven in part by laws that criminalize the possession and distribution of syringes for illicit drug use. Legal change to decriminalize syringes may reduce infection rates in the state, but is unlikely absent support from law enforcement actors. Methods We analyzed the responses of 350 North Carolina law enforcement officers to a confidential, anonymous survey. The survey instrument collected data regarding self-reported needle-stick injury (NSI), blood borne disease risk perception and attitudes toward syringe decriminalization. Results 82% of respondents reported that contracting HIV was a “big concern” for them. 3.8% of respondents reported ever receiving a job-related NSI, a rate of 36 NSI per 10,000 officer-years. Majorities of respondents reported positive views regarding syringe decriminalization, with approximately 63% agreeing that it would be “good for the community” and 60% agreeing that it would be “good for law enforcement.” Black and female officers were significantly less likely to agree that on-the-job NSI was a “big concern” and significantly more likely to agree that it would be good for law enforcement. Conclusions These findings suggest that many North Carolina LEOs understand the public health benefits of syringe access programs and may be inclined to support syringe decriminalization legislation. Further research is indicated to determine the causes of observed differences in perceptions of bloodborne disease risk and attitudes toward syringe decriminalization by race and sex. PMID:25193720

  5. Attitudes of North Carolina law enforcement officers toward syringe decriminalization.

    PubMed

    Davis, Corey S; Johnston, Jill; de Saxe Zerden, Lisa; Clark, Katie; Castillo, Tessie; Childs, Robert

    2014-11-01

    North Carolina, like much of the U.S. South, is disproportionately affected by HIV and hepatitis. This persistently high disease burden may be driven in part by laws that criminalize the possession and distribution of syringes for illicit drug use. Legal change to decriminalize syringes may reduce infection rates in the state, but is unlikely absent support from law enforcement actors. We analyzed the responses of 350 North Carolina law enforcement officers to a confidential, anonymous survey. The survey instrument collected data regarding self-reported needle-stick injury (NSI), blood borne disease risk perception and attitudes toward syringe decriminalization. 82% of respondents reported that contracting HIV was a "big concern" for them. 3.8% of respondents reported ever receiving a job-related NSI, a rate of 36 NSI per 10,000 officer-years. Majorities of respondents reported positive views regarding syringe decriminalization, with approximately 63% agreeing that it would be "good for the community" and 60% agreeing that it would be "good for law enforcement." Black and female officers were significantly less likely to agree that on-the-job NSI was a "big concern" and significantly more likely to agree that it would be good for law enforcement. These findings suggest that many North Carolina LEOs understand the public health benefits of syringe access programs and may be inclined to support syringe decriminalization legislation. Further research is indicated to determine the causes of observed differences in perceptions of bloodborne disease risk and attitudes toward syringe decriminalization by race and sex. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Effect of legal status of pharmacy syringe sales on syringe purchases by persons who inject drugs in San Francisco and San Diego, CA.

    PubMed

    Siddiqui, Saira S; Armenta, Richard F; Evans, Jennifer L; Yu, Michelle; Cuevas-Mota, Jazmine; Page, Kimberly; Davidson, Peter; Garfein, Richard S

    2015-11-01

    Sharing blood-contaminated syringes is the main risk factor for acquiring and transmitting blood-borne infections among persons who inject drugs (PWID). To reduce this risk, in 2005, California enacted legislation allowing local health jurisdictions to legalize non-prescription syringe sales after approving a disease prevention demonstration project (DPDP). With San Francisco approving a DPDP immediately and San Diego never approving one, we compared PWID across cities for their use of pharmacies PWID to obtain syringes. PWID age 18-30 years old were recruited into separate studies in San Francisco (n=243) and San Diego (n=338) between 2008 and 2011. We used multivariable logistic regression to compare the proportions of PWID who obtained syringes from pharmacies by city while controlling for sociodemographics, injection practices and other risk behaviors. Overall, most PWID were White (71%), male (63%), and between the ages of 18-25 years (55%). Compared to San Francisco, a smaller proportion of PWID in San Diego had bought syringes from pharmacies in the prior three months (16.9% vs. 49.8%; p<0.001), which remained statistically significant after adjusting for sociodemographic and behavioral factors (adjusted odds ratio=4.45, 95% confidence interval: 2.98, 6.65). Use of pharmacies to obtain syringes was greater where it was legal to do so. Public health policy can influence HIV and hepatitis C associated risk among PWID; however, implementation of these policies is crucial for the benefits to be realized. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Are major reductions in new HIV infections possible with people who inject drugs? The case for low dead-space syringes in highly affected countries.

    PubMed

    Zule, William A; Cross, Harry E; Stover, John; Pretorius, Carel

    2013-01-01

    Circumstantial evidence from laboratory studies, mathematical models, ecological studies and bio behavioural surveys, suggests that injection-related HIV epidemics may be averted or reversed if people who inject drugs (PWID) switch from using high dead-space to using low dead-space syringes. In laboratory experiments that simulated the injection process and rinsing with water, low dead space syringes retained 1000 times less blood than high dead space syringes. In mathematical models, switching PWID from high dead space to low dead space syringes prevents or reverses injection-related HIV epidemics. No one knows if such an intervention is feasible or what effect it would have on HIV transmission among PWID. Feasibility studies and randomized controlled trials (RCTs) will be needed to answer these questions definitively, but these studies will be very expensive and take years to complete. Rather than waiting for them to be completed, we argue for an approach similar to that used with needle and syringe programs (NSP), which were promoted and implemented before being tested more rigorously. Before implementation, rapid assessments that involve PWID will need to be conducted to ensure buy-in from PWID and other local stakeholders. This commentary summarizes the existing evidence regarding the protective effects of low dead space syringes and estimates potential impacts on HIV transmission; it describes potential barriers to transitioning PWID from high dead space to low dead space needles and syringes; and it presents strategies for overcoming these barriers. Copyright © 2012 Elsevier B.V. All rights reserved.

  8. Influence of Syringe Volume on Foam Stability in Sclerotherapy for Varicose Vein Treatment.

    PubMed

    Bai, Taoping; Jiang, Wentao; Fan, Yubo

    2018-05-01

    Despite the popularity of sclerotherapy for treating varicose veins, it still exhibits various problems, such as pulmonary embolism, deep-vein thrombosis, phlebitis, and visual disorders. To investigate syringe volume influence on foam stability, obtain the foam decay rule, and provide a reference for clinics. Five types of syringes are used to prepare foam at room temperature with various liquid-gas ratios. Foam decay process experiments were performed 5 times and recorded by video. The stability indices used include drainage time, half-life, bubble diameter, bubble surface density, and drainage rate. The 30 and 2-mL syringes, respectively, recorded the highest and lowest drainage speeds. Foam drainage time and half-life, differences varied between 15 and 70 seconds, and 20 and 100 seconds, respectively. Foam bubble diameters were distributed over 0.1 to 2.0 mm with roughly 200 to 700 bubbles per square centimeter. Increased syringe volume causes the bubble diameter to increase. Thus, foam dispersion increases and foam half-life decreases; hence, foam becomes unstable. It is, thus, better to use a small syringe several times to prepare foam in clinics using segmented injections.

  9. Police Training to Align Law Enforcement and HIV Prevention: Preliminary Evidence From the Field

    PubMed Central

    Agrawal, Alpna; Moreau, Bruce; Kumar, Pratima; Weiss-Laxer, Nomi; Heimer, Robert

    2011-01-01

    Having identified gaps in implementation of Rhode Island's syringe access law and police occupational safety education, public health and police professionals developed police training to boost legal knowledge, improve syringe access attitudes, and address needlestick injuries. Baseline data (94 officers) confirmed anxiety about needlestick injuries, poor legal knowledge, and occupational risk overestimation. Before training, respondents believed that syringe access promotes drug use (51%), increases likelihood of police needlestick injuries (58%), and fails to reduce epidemics (38%). Pretraining to posttraining evaluation suggested significant shifts in legal and occupational safety knowledge; changes in attitudes toward syringe access were promising. Training that combines occupational safety with syringe access content can help align law enforcement with public health goals. Additional research is needed to assess street-level effect and to inform intervention tailoring. PMID:21940924

  10. A simple device to convert a small-animal PET scanner into a multi-sample tissue and injection syringe counter.

    PubMed

    Green, Michael V; Seidel, Jurgen; Choyke, Peter L; Jagoda, Elaine M

    2017-10-01

    We describe a simple fixture that can be added to the imaging bed of a small-animal PET scanner that allows for automated counting of multiple organ or tissue samples from mouse-sized animals and counting of injection syringes prior to administration of the radiotracer. The combination of imaging and counting capabilities in the same machine offers advantages in certain experimental settings. A polyethylene block of plastic, sculpted to mate with the animal imaging bed of a small-animal PET scanner, is machined to receive twelve 5-ml containers, each capable of holding an entire organ from a mouse-sized animal. In addition, a triangular cross-section slot is machined down the centerline of the block to secure injection syringes from 1-ml to 3-ml in size. The sample holder is scanned in PET whole-body mode to image all samples or in one bed position to image a filled injection syringe. Total radioactivity in each sample or syringe is determined from the reconstructed images of these objects using volume re-projection of the coronal images and a single region-of-interest for each. We tested the accuracy of this method by comparing PET estimates of sample and syringe activity with well counter and dose calibrator estimates of these same activities. PET and well counting of the same samples gave near identical results (in MBq, R 2 =0.99, slope=0.99, intercept=0.00-MBq). PET syringe and dose calibrator measurements of syringe activity in MBq were also similar (R 2 =0.99, slope=0.99, intercept=- 0.22-MBq). A small-animal PET scanner can be easily converted into a multi-sample and syringe counting device by the addition of a sample block constructed for that purpose. This capability, combined with live animal imaging, can improve efficiency and flexibility in certain experimental settings. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Freeze-drying in novel container system: Characterization of heat and mass transfer in glass syringes.

    PubMed

    Patel, Sajal M; Pikal, Michael J

    2010-07-01

    This study is aimed at characterizing and understanding different modes of heat and mass transfer in glass syringes to develop a robust freeze-drying process. Two different holder systems were used to freeze-dry in syringes: an aluminum (Al) block and a plexiglass holder. The syringe heat transfer coefficient was characterized by a sublimation test using pure water. Mannitol and sucrose (5% w/v) were also freeze-dried, as model systems, in both the assemblies. Dry layer resistance was determined from manometric temperature measurement (MTM) and product temperature was measured using thermocouples, and was also determined from MTM. Further, freeze-drying process was also designed using Smart freeze-dryer to assess its application for freeze-drying in novel container systems. Heat and mass transfer in syringes were compared against the traditional container system (i.e., glass tubing vial). In the Al block, the heat transfer was via three modes: contact conduction, gas conduction, and radiation with gas conduction being the dominant mode of heat transfer. In the plexiglass holder, the heat transfer was mostly via radiation; convection was not involved. Also, MTM/Smart freeze-drying did work reasonably well for freeze-drying in syringes. When compared to tubing vials, product temperature decreases and hence drying time increases in syringes. (c) 2010 Wiley-Liss, Inc. and the American Pharmacists Association

  12. Potential air contamination during CO2 angiography using a hand-held syringe: theoretical considerations and gas chromatography.

    PubMed

    Cho, David R; Cho, Kyung J; Hawkins, Irvin F

    2006-01-01

    To assess air contamination in the hand-held syringes currently used for CO2 delivery and to determine whether there is an association between their position and the rate of air contamination. Assessment of air contamination in the syringe (20 ml) included theoretical modeling, mathematical calculation, and gas chromatography (GC). The model was used with Fick's first law to calculate the diffusion of CO2 and the amount of air contamination. For GC studies, the syringes were placed in the upright, horizontal, and inverted positions and gas samples were obtained after 5, 10, 20, 30, and 60 min. All trials with each position for each sampling time were performed five times. The amounts of air contamination with time calculated mathematically were 5-10% less than those of GC. With the diffusivity of air-CO2 at 0.1599 cm2/sec (9.594 cm2/min), air contamination was calculated to be 60% at 60 min. With GC air contamination was 13% at 5 min, 31% at 20 min, 43% at 30 min, and 68% at 60 min. There was no difference in air contamination between the different syringe positions. Air contamination occurs in hand-held syringes filled with CO2 when they are open to the ambient air. The amounts of air contamination over time are similar among syringes placed in the upright, horizontal, and inverted positions.

  13. Comparative evaluation of the amount of debris extruded apically using conventional syringe, passive ultrasonic irrigation and EndoIrrigator Plus system: An in vitro study

    PubMed Central

    Shetty, Vidhi Prabhakar; Naik, Balaram Damodar; Pachlag, Amit Kashinath; Yeli, Mahantesh Mrityunjay

    2017-01-01

    Aim: The aim of this study is to compare the effects of conventional syringe, passive ultrasonic irrigation (PUI), and EndoIrrigator Plus on the amount of apically extruded debris. Materials and Methods: Thirty extracted human mandibular premolars were selected and randomly assigned to three groups (n = 10). The root canals were irrigated with conventional syringe, PUI, and EndoIrrigator Plus. Sodium hypochlorite was used as an irrigant, and debris was collected in a previously described experimental model (Myers and Montgomery 1991). It was then stored in an incubator at 37°C for 10 days to evaporate the irrigant before weighing the dry debris. The mean weight of debris was assessed, one-way analysis of variance was used for comparison of values, and post hoc Tukey's test was used between groups (P = 0.05). Results: The EndoIrrigator Plus group extruded significantly less debris than PUI and conventional syringe groups (P < 0.05). Furthermore, PUI group extruded significantly less debris than conventional syringe irrigation group (P < 0.05). Conclusions: 1. All the three irrigation systems were associated with apical extrusion of debris, 2. EndoIrrigator Plus system extruded significantly less debris than the PUI system and the conventional syringe irrigation system, 3. PUI system extruded significantly less debris than the conventional syringe irrigation system. PMID:29430092

  14. Adherence to nutritional recommendations in vending machines at secondary schools in Madrid (Spain), 2014-2015.

    PubMed

    Monroy-Parada, Doris Xiomara; Jácome-González, María Luisa; Moya-Geromini, María Ángeles; Rodríguez-Artalejo, Fernando; Royo-Bordonada, Miguel Ángel

    2017-07-13

    To describe the nutritional content of products offered in food and drink vending machines at secondary schools in the Madrid Autonomous Community (Spain), and to evaluate these items' adherence to the nutritional recommendations of the National Health System Consensus Document on School Food. Cross-sectional study of a sample of 330 secondary schools in Madrid across the period 2014-2015. Secondary school vending machines were identified by telephone interview. The products offered in a representative sample of six machines were identified by inspection in situ, and their nutritional composition was obtained from the labelling. A total of 94.5% of the 55 products on offer failed to comply with at least one nutritional criterion of the Consensus Document on School Food. The recommendation relating to sugar content registered the highest level of non-compliance, with 52.7% of products, followed by the recommendations relating to energy (47.3%) and fats (45.5%). The mean number of unmet criteria was 2.2, with this figure being higher in foods than in drinks (2.8 versus 1; p <0.01). Almost all the products on display in secondary school vending machines in Madrid were in breach of the Consensus Document on School Food, mainly due to an excess of calories, sugars and fats. Compulsory nutritional criteria and a procedure for monitoring adherence should be established, specifying those responsible for performing this task and the corrective measures to be applied in the event of non-compliance. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Community Impact of Pharmacy-Randomized Intervention to Improve Access to Syringes and Services for Injection Drug Users

    ERIC Educational Resources Information Center

    Crawford, Natalie D.; Amesty, Silvia; Rivera, Alexis V.; Harripersaud, Katherine; Turner, Alezandria; Fuller, Crystal M.

    2014-01-01

    Objectives: In an effort to reduce HIV transmission among injection drug users (IDUs), New York State deregulated pharmacy syringe sales in 2001 through the Expanded Syringe Access Program by removing the requirement of a prescription. With evidence suggesting pharmacists' ability to expand their public health role, a structural, pharmacy-based…

  16. Stability of cyclosporine solutions stored in polypropylene-polyolefin bags and polypropylene syringes.

    PubMed

    Li, Mengqing; Forest, Jean-Marc; Coursol, Christian; Leclair, Grégoire

    2011-09-01

    The stability of cyclosporine diluted to 0.2 or 2.5 mg/mL with 0.9% sodium chloride injection or 5% dextrose injection and stored in polypropylene-polyolefin containers or polypropylene syringes was evaluated. Intravenous cyclosporine solutions (0.2 and 2.5 mg/mL) were aseptically prepared and transferred to 250-mL polypropylene-polyolefin bags or 60-mL polypropylene syringes. Chemical stability was measured using a stability-indicating high-performance liquid chromatography (HPLC) assay. Physical stability was assessed by visual inspection and a dynamic light scattering (DLS) method. After 14 days, HPLC assay showed that the samples of i.v. cyclosporine stored in polypropylene-polyolefin bags remained chemically stable (>98% of initial amount remaining); the physical stability of the samples was confirmed by DLS and visual inspection. The samples stored in polypropylene syringes were found to contain an impurity (attributed to leaching of a syringe component by the solution) that could be detected by HPLC after 1 day; on further investigation, no leaching was detected when the syringes were exposed to undiluted i.v. cyclosporine 50 mg/mL for 10 minutes. Samples of i.v. cyclosporine solutions of 0.2 and 2.5 mg/mL diluted in 0.9% sodium chloride injection or 5% dextrose injection and stored at 25 °C in polypropylene-polyolefin bags were physically and chemically stable for at least 14 days. When stored in polypropylene syringes, the samples were contaminated by an impurity within 1 day; however, the short-term (i.e., ≤10 minutes) use of the syringes for the preparation and transfer of i.v. cyclosporine solution is considered safe.

  17. Movement control during aspiration with different injection systems via video monitoring-an in vitro model.

    PubMed

    Kämmerer, P W; Schneider, D; Pacyna, A A; Daubländer, M

    2017-01-01

    The aim of the present study was an evaluation of movement during double aspiration by different manual syringes and one computer-controlled local anesthesia delivery system (C-CLAD). With five different devices (two disposable syringes (2, 5 ml), two aspirating syringes (active, passive), one C-CLAD), simulation of double aspiration in a phantom model was conducted. Two experienced and two inexperienced test persons carried out double aspiration with the injection systems at the right and left phantom mandibles in three different inclination angles (n = 24 × 5 × 2 for each system). 3D divergences of the needle between aspiration procedures (mm) were measured with two video cameras. An average movement for the 2-ml disposal syringe of 2.85 mm (SD 1.63), for the 5 ml syringe of 2.36 mm (SD 0.86), for the active-aspirating syringe of 2.45 mm (SD 0.9), for the passive-aspirating syringe of 2.01 mm (SD 0.7), and for the C-CLAD, an average movement of 0.91 mm (SD 0.63) was seen. The movement was significantly less for the C-CLAD compared to the other systems (p < 0.001). The movement of the needle in the soft tissue was significantly less for the C-CLAD compared to the other systems (p < 0.001). A difference in involuntary movement of the syringe could be seen in comparison between manual and C-CLAD systems. Launching the aspiration by a foot pedal in computer-assisted anesthesia leads to a minor movement. To solve the problem of movement during aspiration with possibly increased false-negative results, a C-CLAD seems to be favorable.

  18. Lab-In-Syringe automation of stirring-assisted room-temperature headspace extraction coupled online to gas chromatography with flame ionization detection for determination of benzene, toluene, ethylbenzene, and xylenes in surface waters.

    PubMed

    Horstkotte, Burkhard; Lopez de Los Mozos Atochero, Natalia; Solich, Petr

    2018-06-22

    Online coupling of Lab-In-Syringe automated headspace extraction to gas chromatography has been studied. The developed methodology was successfully applied to surface water analysis using benzene, toluene, ethylbenzene, and xylenes as model analytes. The extraction system consisted of an automatic syringe pump with a 5 mL syringe into which all solutions and air for headspace formation were aspirated. The syringe piston featured a longitudinal channel, which allowed connecting the syringe void directly to a gas chromatograph with flame ionization detector via a transfer capillary. Gas injection was achieved via opening a computer-controlled pinch valve and compressing the headspace, upon which separation was initialized. Extractions were performed at room temperature; yet sensitivity comparable to previous work was obtained by high headspace to sample ratio V HS /V Sample of 1.6:1 and injection of about 77% of the headspace. Assistance by in-syringe magnetic stirring yielded an about threefold increase in extraction efficiency. Interferences were compensated by using chlorobenzene as an internal standard. Syringe cleaning and extraction lasting over 10 min was carried out in parallel to the chromatographic run enabling a time of analysis of <19 min. Excellent peak area repeatabilities with RSD of <4% when omitting and <2% RSD when using internal standard corrections on 100 μg L -1 level were achieved. An average recovery of 97.7% and limit of detection of 1-2 μg L -1 were obtained in analyses of surface water. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Longitudinal analysis of change in individual-level needle and syringe coverage amongst a cohort of people who inject drugs in Melbourne, Australia.

    PubMed

    O'Keefe, Daniel; Scott, Nick; Aitken, Campbell; Dietze, Paul

    2017-07-01

    Needle and syringe program (NSP) coverage is often calculated at the individual level. This method relates sterile needle and syringe acquisition to injecting frequency, resulting in a percentage of injecting episodes that utilise a sterile syringe. Most previous research using this method was restricted by their cross-sectional design, calling for longitudinal exploration of coverage. We used the data of 518 participants from an ongoing cohort of people who inject drugs in Melbourne, Australia. We calculated individual-level syringe coverage for the two weeks prior to each interview, then dichotomised the outcome as either "sufficient" (≥100% of injecting episodes covered by at least one reported sterile syringe) or "insufficient" (<100%). Time-variant predictors of change in recent coverage (from sufficient to insufficient coverage) were estimated longitudinally using logistic regression with fixed effects for each participant. Transitioning to methamphetamine injection (AOR:2.16, p=0.004) and a newly positive HCV RNA test result (AOR:4.93, p=0.001) were both associated with increased odds of change to insufficient coverage, whilst change to utilising NSPs as the primary source of syringe acquisition (AOR: 0.41, p=0.003) and opioid substitution therapy (OST) enrolment (AOR:0.51, p=0.013) were protective against a change to insufficient coverage. We statistically tested the transitions between time-variant exposure sub-groups and transitions in individual-level syringe coverage. Our results give important insights into means of improving coverage at the individual level, suggesting that methamphetamine injectors should be targeted, whilst both OST prescription and NSP should be expanded. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Derailing healthy choices: an audit of vending machines at train stations in NSW.

    PubMed

    Kelly, Bridget; Flood, Victoria M; Bicego, Cecilia; Yeatman, Heather

    2012-04-01

    Train stations provide opportunities for food purchases and many consumers are exposed to these venues daily, on their commute to and from work. This study aimed to describe the food environment that commuters are exposed to at train stations in NSW. One hundred train stations were randomly sampled from the Greater Sydney Metropolitan region, representing a range of demographic areas. A purpose-designed instrument was developed to collect information on the availability, promotion and cost of food and beverages in vending machines. Items were classified as high/low in energy according to NSW school canteen criteria. Of the 206 vending machines identified, 84% of slots were stocked with high-energy food and beverages. The most frequently available items were chips and extruded snacks (33%), sugar-sweetened soft drinks (18%), chocolate (12%) and confectionery (10%). High energy foods were consistently cheaper than lower-energy alternatives. Transport sites may cumulatively contribute to excess energy consumption as the items offered are energy dense. Interventions are required to improve train commuters' access to healthy food and beverages.

  1. Healthy hospital food initiatives in the United States: time to ban sugar sweetened beverages to reduce childhood obesity

    PubMed Central

    Wojcicki, Janet M

    2014-01-01

    While childhood obesity is a global problem, the extent and severity of the problem in United States, has resulted in a number of new initiatives, including recent hospital initiatives to limit the sale of sweetened beverages and other high calorie drinks in hospital vending machines and cafeterias. These proposed policy changes are not unique to United States, but are more comprehensive in the number of proposed hospitals that they will impact. Meanwhile, however, it is advised, that these initiatives should focus on banning sugar sweetened beverages, including sodas, 100% fruit juice and sports drinks, from hospital cafeterias and vending machines instead of limiting their presence, so as to ensure the success of these programs in reducing the prevalence of childhood obesity. If US hospitals comprehensively remove sugar sweetened beverages from their cafeterias and vending machines, these programs could subsequently become a model for efforts to address childhood obesity in other areas of the world. Conclusion Hospitals should be a model for health care reform in their communities and removing sugar sweetened beverages is a necessary first step. PMID:23445326

  2. Examining the Association Between School Vending Machines and Children's Body Mass Index by Socioeconomic Status.

    PubMed

    O'Hara, Jeffrey K; Haynes-Maslow, Lindsey

    2015-01-01

    To examine the association between vending machine availability in schools and body mass index (BMI) among subgroups of children based on gender, race/ethnicity, and socioeconomic status classifications. First-difference multivariate regressions were estimated using longitudinal fifth- and eighth-grade data from the Early Childhood Longitudinal Study. The specifications were disaggregated by gender, race/ethnicity, and family socioeconomic status classifications. Vending machine availability had a positive association (P < .10) with BMI among Hispanic male children and low-income Hispanic children. Living in an urban location (P < .05) and hours watching television (P < .05) were also positively associated with BMI for these subgroups. Supplemental Nutrition Assistance Program enrollment was negatively associated with BMI for low-income Hispanic students (P < .05). These findings were not statistically significant when using Bonferroni adjusted critical values. The results suggest that the school food environment could reinforce health disparities that exist for Hispanic male children and low-income Hispanic children. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  3. [Development of Biliary Contrast Agents Remote Pushing Device].

    PubMed

    Zhu, Haoyang; Dong, Dinghui; Luo, Yu; Ren, Fenggang; Zhang, Jing; Tan, Wenjun; Shi, Aihua; Hu, Liangshuo; Wu, Rongqian; Lyu, Yi

    2018-01-30

    A biliary contrast agents pushing device, including a syringe pushing system and a remote controller is introduced. The syringe pushing system comprises an injector card slot, a support platform and an injection bolus fader. A 20 mL syringe can be fitted on the syringe pushing system and kept with the ground about 30 degree. This system can perform air bubble pumping back and contrast agents bolus injection as well as speed adjustment. Remote controller is an infrared remote control which can start and stop the syringe pushing system. With this device, the remote controlled cholangiography technology can be achieved, which can not only protect doctors from X-ray radiation but also improve the traditional T-tube cholangiography and the contrast effect, reduce postoperative complications in patients as well. The application of this device will improve the current diagnosis and treatment system, the device will benefit the majority of doctors and patients.

  4. Drugs given by a syringe driver: a prospective multicentre survey of palliative care services in the UK.

    PubMed

    Wilcock, Andrew; Jacob, Jayin K; Charlesworth, Sarah; Harris, Elayne; Gibbs, Margaret; Allsop, Helen

    2006-10-01

    The use of a syringe driver to administer drugs by continuous subcutaneous infusion is common practice in the UK. Over time, drug combinations used in a syringe driver are likely to change and the aim of this survey was to obtain a more recent snapshot of practice. On four separate days, at two-week intervals, a questionnaire was completed for every syringe driver in use by 15 palliative care services. Of 336 syringe drivers, the majority contained either two or three drugs, but one-fifth contained only one drug. The median (range) volume of the infusions was 15 (9.5-48) mL, and duration of infusion was generally 24 hours. Only one combination was reported as visually incompatible, and there were 13 site reactions (4% of total). Laboratory physical and chemical compatibility data are available for less than half of the most frequently used combinations.

  5. Plastic-Syringe Induced Silicone Contamination in Organic Photvoltaic Fabrication: Implications for Small-Volume Additives

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Carr, John A.; Nalwa, Kanwar S.; Mahadevapuram, Rakesh

    Herein, the implications of silicone contamination found in solution-processed conjugated polymer solar cells are explored. Similar to a previous work based on molecular cells, we find this contamination as a result of the use of plastic syringes during fabrication. However, in contrast to the molecular case, we find that glass-syringe fabricated devices give superior performance than plastic-syringe fabricated devices in poly(3-hexylthiophene)-based cells. We find that the unintentional silicone addition alters the solution’s wettability, which translates to a thinner, less absorbent film on spinning. With many groups studying the effects of small-volume additives, this work should be closely considered as manymore » of these additives may also directly alter the solutions’ wettability, or the amount of silicone dissolved off the plastic syringes, or both. Thereby, film thickness, which generally is not reported in detail, can vary significantly from device to device.« less

  6. Syringe Decriminalization Advocacy in Red States: Lessons from the North Carolina Harm Reduction Coalition.

    PubMed

    Cloud, David H; Castillo, Tessie; Brinkley-Rubinstein, Lauren; Dubey, Manisha; Childs, Robert

    2018-05-08

    Syringe access programs (SAPs) are cornerstone harm reduction interventions for combatting the national opioid epidemic. The goal of this paper is to describe effective advocacy strategies for enacting syringe decriminalization legislation to foster the expansion of SAPs in high-need areas amidst political opposition. Decades or research shows that SAPs prevent the transmission of HIV among people who inject drugs (PWID) and are a cost-effective tool for linking PWID to medical care, health education, and social services. In the USA, state laws criminalizing distribution and possession of syringes impede the expansion of SAPs into areas where they are sorely needed. In 2016, North Carolina became the first state to legalize SAPs with a Republican super majority. This paper distills strategies for community organizations seeking to advance syringe decriminalization legislation in politically conservative states with histories of prioritizing punitive sanctions over public health responses to drug use.

  7. Subcutaneous morphine infusion by syringe driver for terminally ill patients.

    PubMed

    Cools, H J; Berkhout, A M; De Bock, G H

    1996-05-01

    The study aimed to find whether subcutaneous morphine administration by syringe driver for terminally ill patients in a Dutch nursing home led to higher morphine doses and earlier death than routine morphine administration. The data comprised the files of all patients dying over a 2 year period in a 355-bed nursing home in Delft in the Netherlands. Thirty-eight per cent of the patients had been given morphine, 29% by continuous subcutaneous syringe driver. In comparing the patients given morphine with and without a syringe driver no differences emerged in mean age, sex, length of admission, type of ward, diagnosis, duration of morphine administration and mean dose. The data indicate that subcutaneous morphine administration by syringe driver decreases dose frequency problems and improves the control of pain and other symptoms in the last week before death. There was no evidence that administration of morphine in this way shortens survival.

  8. [Critical infusion incident caused by incorrect use of a patient-controlled analgesia pump].

    PubMed

    Steffen, M; von Hintzenstern, U; Obermayer, A

    2002-01-01

    We report on the case of a 17-year-old male patient who received a PCA pump after nephrectomy for postoperative analgesia. The syringe of the PCA pump was filled with 50 mg morphine and positioned about 25 cm above the heart. Since the piston of the syringe was not bolted while the pump was switched off, an unnoticed accidental evacuation of the whole content of the syringe into the intravenous line of the patient occurred because of gravity. This problem exists not only with PCA pumps, but can happen with syringe pumps in general. The incident, which can only be explained by strongly reduced venous pressure, was detected by chance. No harm resulted for the patient, but under different conditions it could have been lethal. This critical incident was caused by various factors: incorrect application in combination with insufficient experience or training, stress, inadequate handing-over of the patient and a lack of arrangements and instructions for procedures in routine situations. Suggestions for preventing such dangerous critical incidents are made and discussed. In particular, an algorithm for the correct procedure when inserting or changing the syringe of a syringe pump is presented.

  9. Sterilizable syringes: excessive risk or cost-effective option?

    PubMed Central

    Battersby, A.; Feilden, R.; Nelson, C.

    1999-01-01

    In recent years, many poorer countries have chosen to use disposable instead of sterilizable syringes. Unfortunately, the infrastructure and management systems that are vital if disposables are to be used safely do not exist. WHO estimates that up to 30% of injections administered are unsafe. The traditional sterilizable syringe had many disadvantages, some of which have been minimized through better design and the use of modern materials; others have been overcome because staff are able to demonstrate that they have performed safely. For example, the time-steam saturation-temperature (TST) indicator has enabled staff to demonstrate that a sterilizing cycle has been successfully completed. Health facility staff must be able to sterilize equipment, and the sterilizable syringe remains the least costly means of administering an injection. Data from countries that have acceptable systems for processing clinical waste indicate that safe and environmentally acceptable disposal, destruction and final containment cost nearly as much as the original cost of a disposable syringe. By careful supervision of staff behaviour and good management, some countries have demonstrated that they are able to administer safe injections with sterilizable syringes at a price they can afford. PMID:10593029

  10. Syringe Port: A Convenient, Safe, and Cost-Effective Tubular Retractor for Transportal Removal of Deep-Seated Lesions of the Brain.

    PubMed

    Singh, Harnarayan; Patir, Rana; Vaishya, Sandeep; Miglani, Rahul; Kaur, Amandeep

    2018-06-01

    Minimally invasive transportal resection of deep intracranial lesions has become a widely accepted surgical technique. Many disposable, mountable port systems are available in the market for this purpose, like the ViewSite Brain Access System. The objective of this study was to find a cost-effective substitute for these systems. Deep-seated brain lesions were treated with a port system made from disposable syringes. The syringe port could be inserted through minicraniotomies placed and planned with navigation. All deep-seated lesions like ventricular tumours, colloid cysts, deep-seated gliomas, and basal ganglia hemorrhages were treated with this syringe port system and evaluated for safety, operative site hematomas, and blood loss. 62 patients were operated on during the study period from January 2015 to July 2017, using this innovative syringe port system for deep-seated lesions of the brain. No operative site hematoma or contusions were seen along the port entry site and tract. Syringe port is a cost-effective and safe alternative to the costly disposable brain port systems, especially for neurosurgical setups in developing countries for minimally invasive transportal resection of deep brain lesions. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Syringe Sharing in Drug Injecting Dyads: A Cross-Classified Multilevel Analysis of Social Networks.

    PubMed

    Shahesmaeili, Armita; Mirzazadeh, Ali; McFarland, Willi; Sharifi, Hamid; Haghdoost, Ali Akbar; Soori, Hamid

    2018-05-15

    We examined the association of dyadic-level factors with syringe sharing among people who inject drugs (PWID) in Kerman, Iran. In a cross-sectional study, we collected data on 329 drug-injecting dyads by individual face-to-face interviews. An injecting dyad was defined as 2 PWID who knew each other and injected drugs together during the last 6 months. If they reported at least 1 occasion of syringe sharing, the dyad was considered high-risk. Dyadic-level factors associated with syringe sharing were assessed using cross-classified multilevel logistic regression. The rate of syringe sharing was significantly higher for dyads who were more intimate (adjusted odds ratio [AOR] 4.5, CI 95%, 2.3-8.6), who had instrumental support (AOR 2.1, 95% CI 1.1-4.5), and who pooled money for drugs (AOR 4.1, 95% CI 2.0-8.3). The rate was lower in same-sex dyads (AOR 0.4, 95% CI 0.2-0.9) and in dyads who shared health information (AOR 0.5, 95% CI 0.2-0.9). Findings highlight close-peer influences on syringe-sharing behavior.

  12. Primary and secondary analysis of local elected officials' decisions to support or oppose pharmacy sale of syringes in California.

    PubMed

    Backes, Glenn; Rose, Valerie J

    2010-07-01

    Under California law, local governments may authorize pharmacies within their jurisdictions to sell ten or fewer syringes to an adult without prescription, proof of identity, or proof of medical need. Local governments may simultaneously exempt adults from prosecution for violation of state drug paraphernalia codes for possession of ten or fewer syringes for personal use. Both of these provisions are temporary and sunset on December 31, 2010, unless subsequent state legislation amends that date. The objective of our study was to ascertain how and why local policymakers made their decisions regarding non-prescription syringe sale (NPSS). We examined influences on their decisions, including specific messengers and the arguments that were most salient to their decision making. We selected jurisdictions that were geographically representative of California counties; those with and without syringe exchange programs, and those that had passed or rejected NPSS. We conducted nine semi-structured interviews in five jurisdictions. To enrich primary data collection, we analyzed secondary data by reviewing audio, video, and written transcripts of public hearings and newspaper coverage in five jurisdictions, including three jurisdictions without primary interview data. Among proponents of NPSS, we identified common themes, including: (1) public health research provided conclusive evidence for reduction in HIV and hepatitis transmission without problems of crime, drug use, or unsafe discard of syringes; (2) the local health officer was the key to influencing local policymakers; (3) recall of prior debates over syringe exchange served to inform their decision making; and (4) a lack of local opposition or controversy. Common concerns among opponents of NPSS included: (1) that there would be an increase in unsafe discard of syringes; (2) loss of an important law enforcement tool; (3) that drug users were incapable of desired behavior change; and (4) that research was inconclusive, or proved that syringe access would not work in reducing rates of disease. Themes held in common by proponents and opponents of NPSS were identified as well. Syringe access through NPSS is in fact supported by a robust body of public health research and is considered an important component of a comprehensive strategy to reduce HIV and hepatitis transmission. Our study highlights the importance of understanding the perspectives of elected officials in order to ameliorate their concerns without undermining the public health goal of reducing death, disease, and suffering in at-risk communities.

  13. Officer Candidates Education and Training in the Albanian Armed Forces

    DTIC Science & Technology

    2008-12-12

    16-03-1999) 2 Note: The AAF manpower will be 14 500 ( Source: Ms Zana Xhuka Deputy Minister of Defense, “Metropol” Newspaper, Tirana 26/04/2007...Shtesa në pension vetëm për pjesën e mbetur pas miratimit të ligjit” Interviste me Zëvendësministren e Mbrojtjes Zj. Zana Xhuka 25 “Shtesa në pension...vetëm për pjesën e mbetur pas miratimit të ligjit” Interviste me Zëvendësministren e Mbrojtjes Zj. Zana Xhuka 59 26 Les Brownlee and Peter J

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

    PubMed

    Noroozi, Mehdi; Mirzazadeh, Ali; Noroozi, Alireza; Mehrabi, Yadoallah; Hajebi, Ahmad; Zamani, Saman; Sharifi, Hamid; Higgs, Peter; Soori, Hamid

    2015-01-01

    Needle-syringe programs (NSP) have been running in Iran since 2002. However, the coverage of such program among the NSP clients at the individual level was not studies yet. This study aimed to determine the client coverage of NSP and its correlation with high injection-related risk behaviors. A cross-sectional survey was conducted in Kermanshah province, Iran, in 2014. 230 people who inject drugs (PWID) recruited from two drop-in centers (DICs) from April to September 2014, participated in a face-to-face interview to provide information related individual coverage of NSP, demographic characteristics, and injecting behaviors 30 days prior to the interview. Overall, the average of syringe coverage was 158% [95% confidence interval (CI) = 65.7-205.5], while 56% (95% CI = 40-97) have individual converge less than 100%. Needle/syringe sharing was significantly higher among individual with low NSP coverage [adjusted odds ratio (AOR) = 2.6, 95% CI = 1.3-6.2]. About 85% participants with coverage of less than 100% reported reuse of syringe within the last 30 days (AOR = 3.2, 95% CI = 1.4-7.7). PWID are different regarding their NSP individual-level converges. There are certain clusters of PWID, who do not receive sufficient number of syringes. Given that insufficient individual syringe coverage level is highly associated with injection risk behaviors, reasons for such low converge need to be assessed and addressed carefully.

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

    PubMed Central

    Noroozi, Mehdi; Mirzazadeh, Ali; Noroozi, Alireza; Mehrabi, Yadoallah; Hajebi, Ahmad; Zamani, Saman; Sharifi, Hamid; Higgs, Peter; Soori, Hamid

    2015-01-01

    Background Needle-syringe programs (NSP) have been running in Iran since 2002. However, the coverage of such program among the NSP clients at the individual level was not studies yet. This study aimed to determine the client coverage of NSP and its correlation with high injection-related risk behaviors. Methods A cross-sectional survey was conducted in Kermanshah province, Iran, in 2014. 230 people who inject drugs (PWID) recruited from two drop-in centers (DICs) from April to September 2014, participated in a face-to-face interview to provide information related individual coverage of NSP, demographic characteristics, and injecting behaviors 30 days prior to the interview. Findings Overall, the average of syringe coverage was 158% [95% confidence interval (CI) = 65.7-205.5], while 56% (95% CI = 40-97) have individual converge less than 100%. Needle/syringe sharing was significantly higher among individual with low NSP coverage [adjusted odds ratio (AOR) = 2.6, 95% CI = 1.3-6.2]. About 85% participants with coverage of less than 100% reported reuse of syringe within the last 30 days (AOR = 3.2, 95% CI = 1.4-7.7). Conclusion PWID are different regarding their NSP individual-level converges. There are certain clusters of PWID, who do not receive sufficient number of syringes. Given that insufficient individual syringe coverage level is highly associated with injection risk behaviors, reasons for such low converge need to be assessed and addressed carefully. PMID:26885353

  16. Novel Technique for Rebubbling DMEK Grafts at the Slit Lamp Using Intravenous Extension Tubing.

    PubMed

    Sáles, Christopher S; Straiko, Michael D; Terry, Mark A

    2016-04-01

    To describe a novel technique for rebubbling DMEK grafts at the slit lamp using a cannula coupled to a syringe with intravenous (IV) extension tubing. We present a retrospective case series of eyes that underwent rebubbling using a novel technique at the slit lamp. The rebubbling apparatus is assembled using a standard 43-inch IV extension tube, a 5-cc luer lock syringe, and a 27-gauge cannula. The cannula is screwed onto one end of the extension tubing, and a 5-cc syringe that has been filled with air is screwed onto the opposite end. With the patient seated at the slit lamp, the cannula is positioned in the anterior chamber by the surgeon with one hand while the other hand operates the syringe and the joystick. We performed 5 rebubbling procedures at the slit lamp using a standard syringe and cannula. Despite suboptimal ergonomics with this approach, all of these cases achieved sufficient air fills without any complications. Four rebubbling procedures were subsequently performed at the slit lamp using our novel rebubbling technique. All of these cases also attained sufficient air fills without complications, but they were noted to be much easier to perform by the surgeon. Using IV extension tubing to couple a syringe to a cannula for rebubbling DMEK grafts at the slit lamp is ergonomically superior to the conventional alternative of using a standard cannula on a syringe. The technique is also simple and inexpensive to adopt.

  17. Factors associated with HIV testing among male injecting drug users: findings from a cross-sectional behavioural and biological survey in Manipur and Nagaland, India.

    PubMed

    Ganju, Deepika; Ramesh, Sowmya; Saggurti, Niranjan

    2016-06-21

    Although targeted interventions in India require all high-risk groups, including injecting drug users (IDUs), to test for HIV every 6 months, testing uptake among IDUs remains far from universal. Our study estimates the proportion of IDUs who have taken an HIV test and identifies the factors associated with HIV testing uptake in Nagaland and Manipur, two high HIV prevalence states in India where the epidemic is driven by injecting drug use. Data are drawn from the cross-sectional Integrated Behavioural and Biological Assessment (2009) of 1650 male IDUs from two districts each of Manipur and Nagaland. Participants were recruited using respondent-driven sampling (RDS). Descriptive data were analysed using RDSAT 7.1. Multivariate logistic regression analysis was undertaken using STATA 11 to examine the association between HIV testing and socio-demographic, behavioural and programme exposure variables. One third of IDUs reported prior HIV testing, of whom 8 % had tested HIV-positive. Among those without prior testing, 6.2 % tested HIV-positive in the current survey. IDUs aged 25-34 years (adjusted odds ratio (OR) = 1.41; 95 % confidence interval (CI) = 1.03-1.93), married (Adjusted OR = 1.56; 95 % CI = 1.15-2.12), had a paid sexual partner (Adjusted OR = 1.64; 95 % CI = 1.24-2.18), injected drugs for more than 36 months (Adjusted OR = 1.38; 95 % CI = 1.06-1.81), injected frequently (Adjusted OR = 1.49; 95 % CI = 1.12-1.98) and had high-risk perception (Adjusted OR = 1.68; 95 % CI = 1.32-2.14) were more likely than others to test for HIV. Compared to those with no programme exposure, IDUs who received counselling, or counselling and needle/syringe services, were more likely to test for HIV. HIV testing uptake among IDUs is low in Manipur and Nagaland, and a critical group of HIV-positive IDUs who have never tested for HIV are being missed by current programmes. This study identifies key sub-groups-including early initiators, short duration and less frequent injectors, perceived to be at low risk-for promoting HIV testing. Providing needles/syringes alone is not adequate to increase HIV testing; additionally, interventions must provide counselling services to inform all IDUs about HIV testing benefits, facilitate visits to testing centres and link those testing positive to timely treatment and care.

  18. [Evaluation of the prevalence of HIV infection in prison inmates at the time of their imprisonment during the period 1991-1995].

    PubMed

    Martín Sánchez, V; Caylá Buqueras, J A; González Morís, M L; Herrero Alonso, L E; Vicente Pérez, R

    1997-01-01

    Inmates of Spanish prisons include a high number of intravenous drug users (IVDUs) and other people whose practices entail the risk of infection with the human immunodeficiency virus (HIV). The aim of this work is to find out the evolution of the prevalence of HIV infection at the time of admission to prison and the factors associated with it in this population group. This may enable us to form an idea of the effectiveness of risk reduction strategies and help to improve them. All those people who were placed in a provincial penal institution in the northwest of Spain between 1991 and 1995. Socio-demographic, penal and HIV risk factor variables were gathered. The HIV infection test (ELISA and Western-blot) was carried out with the consent of the subjects. Of the 1,663 people studied, 19.4% were HIV-positive. The prevalence HIV infection was particularly marked statistically in: women (26.0%), the 25-34 age group (29.1%), whites (20.9%), single people (22.8%), those people with a tattoo (29.9%), those people with a background in self-inflicted injuries (42.2%), IVDUs (46.3%), those who admitted sharing syringes (61.5%) and those with a prison record of one or more years (37.3%). Logistical regression analysis showed the following as predictors of HIV infection: IVDUs, those who went to prison in 1992, women, the 25-34 and 35-44 age group, tattooed men, those with a background in self-inflicted injuries and those with a prison record, of more than one year. The gypsy ethnic group revealed a lower probability of HIV infection. The HIV infection time trend, stratified according to the prison record showed an almost significant drop (P = 0.064). The infection trend per IVDU did not show any modification (P = 0.16). A high prevalence of HIV infection was detected in a prison located in a region which has not been particularly affected by AIDS. IVDUs and some characteristics that may be related to this population group have an enormous influence on this phenomenon. The time trend for this infection in this population group has decreased through the lower number of IVDUs that are admitted to prison although very high levels of prevalence of the infection were maintained in this group over the five years of the study. It is recommended that risk-reduction programmes in prisons be fostered (methadone maintenance programmes, syringe exchange pilot programmes).

  19. Injecting drug users' experiences of policing practices in two Mexican-U.S. border cities: public health perspectives.

    PubMed

    Miller, Cari L; Firestone, Michelle; Ramos, Rebeca; Burris, Scott; Ramos, Maria Elena; Case, Patricia; Brouwer, Kimberly C; Fraga, Miguel Angel; Strathdee, Steffanie A

    2008-08-01

    Previous research has identified the impact of law enforcement practices on the behaviours and health of injection drug users (IDUs). We undertook a qualitative study of IDUs' experiences of policing practices in two Mexican cities on the U.S. border. In 2004, two teams of Mexican interviewers conducted in-depth interviews with IDUs residing in Tijuana and Ciudad Juarez (Cd. Juarez), Mexico, who had injected drugs at least once in the prior month. Topics included types of drug used, injection settings, access to sterile needles and experiences with police. Field notes and transcribed interviews were analysed to identify emergent themes. Amongst the 43 participants, most reported that it is common for IDUs to be arrested and detained for 36h for carrying sterile or used syringes. Most reported that they or someone they knew had been beaten by police. Interviews suggested five key themes relating to police influence on the risk environment: (1) impact of policing practices on accessibility of sterile syringes, (2) influence of police on choice of places to inject drugs (e.g., shooting galleries), (3) police violence, (4) police corruption and (5) perceived changes in policing practices. Findings suggest that some behaviour of police officers in Tijuana and Cd. Juarez is inconsistent with legal norms and may be negatively influencing the risk of acquiring blood-borne infections amongst IDUs. Implementing a comprehensive and successful HIV prevention programme amongst IDUs requires interventions to influence the knowledge, attitudes and practices of law enforcement officers.

  20. The pneumatic syringe: a simple apparatus for self-administration of drugs by rats.

    PubMed

    Weeks, J R

    1977-12-01

    Drug solution is delivered by a syringe operated by a pneumatic cylinder. Recommended delivery volumes are from 10 to 200 microliter. A solid-state control unit is described which can operate two syringes (drug injection and flush), has outputs for recording responses and injections, and can be programmed to provide several schedules of reinforcement. All components are readily commercially available.

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