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Author |
Emmanuelli, Julien |
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Title |
Politique de réduction des risques : programmes d'échange de seringues |
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Journal Article |
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Year |
2004 |
Publication |
M/S : médecine sciences : revue internationale des sciences biomédicales |
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Volume |
20 |
Issue |
5; 05/2004 |
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599-603 |
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Keywords |
harm reduction; harm reduction policy; health promotion; needle distribution and exchange; hepatitis C; hepatitis C virus; HIV infection; intravenous drug user; program planning, implementation, and evaluation; program evaluation |
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Dans de nombreux pays développés, les programmes d’échange de seringue (PES) sont un des éléments clefs de la politique de réduction des risques chez les usagers de drogues. La plupart des études sur les PES tendent à montrer qu’ils sont protecteurs vis-à-vis de la transmission du virus du sida (VIH) à condition d’être complétés par d’autres actions de réduction des risques. Leur efficacité sur la transmission du virus de l’hépatite C (VHC) semble beaucoup moins certaine. De plus, il apparaît que les jeunes usagers de drogues par injection (UDI), groupe à haut risque de contamination par le VIH et le VHC, ne fréquentent pas ou très peu les PES. En plus de maintenir un niveau d’accès suffisant aux seringues stériles, il est nécessaire de s’interroger sur la manière de toucher les jeunes usagers de drogues commençant à s’injecter des produits, en travaillant notamment sur leurs réseaux sociaux. Il faut également développer la prévention des pratiques sexuelles à risque, qui sont fortement associées aux pratiques à risque liées à l’injection. Enfin, il faut améliorer la qualité des évaluations de ces programmes. In several developed countries, needles exchange programs (NEPs) are a key preventive tool in harm reduction policy related to drug use. Many studies about NEP show it reduces HIV infections related to syringes sharing when part of others preventive actions. NEPs seem to have no impact on HCV transmission. Furthermore, young drug users, who are at high risk for HIV and HCV infections, are not attending NEPs very often. Trying to maintain high accessibility to sterile syringes, efforts must be stressed on hard-to-reach populations such as young injection drug users (IDU), focusing on their social network. Emphasis must also be put on prevention of unsafe sexual intercourse, often related to syringe sharing, which must be more prevented. Finally, design of assessment studies should be improved. |
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French |
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0767-0974 |
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50-at |
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59523 |
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Author |
Heimer, Robert; Clair, Scott; Teng, Wei; Grau, Lauretta E.; Khoshnood, Kaveh; Singer, Merrill |
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Title |
Effects of increasing syringe availability on syringe-exchange use and HIV risk : Connecticut, 1990-2001 |
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Journal Article |
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Year |
2002 |
Publication |
Journal of urban health : bulletin of the New York Academy of Medicine |
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Volume |
79 |
Issue |
4; 12/2002 |
Pages |
556-570 |
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Keywords |
HIV infection; needle sharing; needle distribution and exchange; intravenous injection; Connecticut; New Haven; Hartford |
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Abstract |
Syringe-exchange programs (SEPs) in Connecticut operate with caps on the number of syringes exchanged per visit. We investigated the effects of legislation increasing the cap on drug injectors’ access to clean syringes through the SEPs in New Haven and Hartford. The mixed design of this study included longitudinal and cross-sectional data from individuals and ecological data from program operations. Five parameters-syringe return rate, syringes per visit to the SEP, syringe reuse rate, syringe human immunodeficiency virus (HIV) prevalence, and syringe sharing-were monitored through syringe tracking and testing of SEP syringes and by interviewing injectors. Two increases in the cap-from 5 to 10 and then from 10 to 30-had little effect on the five parameters that measured injectors’ access to clean syringes. In contrast, access to clean syringes increased when the New Haven SEP first began operations, when syringes first became available at pharmacies in Hartford, and when the agency running the Hartford SEP changed. Legislation providing piecemeal increases in the cap may not, by themselves, be sufficient to increase injectors’ access to clean syringes and decrease the risk of human immunodeficiency virus transmission in this population. |
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1099-3460 |
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50-as |
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59522 |
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Author |
Linas, Benjamin P.; Coffin, Philipp O.; Backes, Glenn; Vlahov, David |
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Title |
New York State pharmacist's attitudes toward needle and syringe sales to injection drug users before implementation of syringe deregulation |
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Journal Article |
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Year |
2000 |
Publication |
Journal of urban health : bulletin of the New York Academy of Medicine |
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77 |
Issue |
4; 12/2000 |
Pages |
768-780 |
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Keywords |
harm reduction; needle distribution and exchange; pharmacist; minor offense; prevention; law; United States; New York |
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In May 2000, New York State passed legislation permitting the sale, purchase, and possession of up to 10 needles and syringes without a prescription. The law is intended to reduce the transmission of human immunodeficiency virus (HIV) and hepatitis among injection drug users (IDUs), their sexual partners, and their children. To obtain baseline information about the attitudes and likely practices of New York State pharmacists, we distributed a self-administered questionnaire to attendees of the state pharmacy association meeting in June 2000. Of 48 usable responses, 19% were from New York City and the rest from New York State. Of the 48, 42% were unaware of the new law before the day of the survey, and 60% were somewhat or very willing to sell needles and syringes to an IDU. Of those who were not willing to sell to an IDU, 82% cited familiarity of the customer as a very important consideration in their decision making. Those who were not willing to sell to an IDU were more concerned about the detrimental impact of syringe sales on the community, were less likely to be aware of the new law, and were more likely to be concerned about legal liability for syringe sales. Over 80% of all pharmacists believed that syringe sales to IDUs are an important preventive health measure. The majority also favored learning more about the law. Compared to other state surveys of pharmacists, these preliminary data show a similar level of interest in becoming involved with syringe availability programs. |
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1099-3460 |
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50-ar |
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59521 |
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Author |
Moeckli, Christian |
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Title |
Qualitätssicherung und Qualitätsstandards in der Überlebenshilfe : Material einer Tagung |
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Journal Article |
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Year |
1997 |
Publication |
Sozialarbeit : Fachblatt des Schweizerischen Berufsverbandes Dipl. SozialarbeiterInnen und SozialpädagogInnen (SBS) |
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29 |
Issue |
5; 03/1997 |
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19-24 |
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harm reduction; quality; quality control; program planning, implementation, and evaluation; Switzerland; conference; journal article |
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German |
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1015-4507 |
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50-ao |
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59518 |
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Author |
Lindenmeyer, Hannes; Wenger, Bernhard |
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Title |
Qualitätsentwicklung : ein Schritt nach vorne |
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Journal Article |
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Year |
2001 |
Publication |
Panorama |
Abbreviated Journal |
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2001 |
Issue |
4 |
Pages |
40-41 |
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Keywords |
quality; target group; political authority; unemployed; cooperation; labor market; Switzerland |
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Die Organisatoren von arbeitsmarktlichen Massnahmen (AMM) stehen im Spannungsfeld der stellensuchenden Menschen, der auftraggebenden Behörden und der eigenen Trägerschaften. Sie befinden sich ausserdem in einem Netz von Akteuren aus verschiedenen Institutionen wie RAV, Berufsberatung, Sozialbehörden, Bildungsinstituten usw. Trotz dieser komplexen Rahmenbedingungen hat sich der Schweizerische Verband der Organisatoren arbeitsmarktlicher Massnahmen (SVOAM) die «Förderung der Integration und Wiedereingliederung Stellensuchender durch eine stete Verbesserung der angebotenen arbeitsmarktlichen Massnahmen» zum Ziel gesetzt. Ob und wieweit dieser Anspruch erreicht werden kann, lässt sich nicht leicht beantworten. Les organisateurs de mesures concernant le marché du travail (MMT) se situent dans un champ de tension entre les personnes à la recherche d’emploi, les autorités donnant le mandat et les prestataires eux-mêmes. Ils se trouvent de plus dans un réseau d’acteurs appartenant à différentes institutions, telles que les ORP, l’orientation professionnelle, les services sociaux, les institutions de formation, etc. Malgré ces conditions cadres complexes, l’Association des organisateurs de mesures actives en Suisse (AOMAS) s’est donnée pour but «le développement de l’intégration et de la réinsertion des personnes à la recherche d’emploi par une amélioration constante des mesures du marché du travail offertes». Il n’est pas facile de savoir comment et dans quelle mesure cette exigence peut être atteinte. En prenant en compte la multiplicité des besoins, l’AOMAS a créé un modèle bien étayé et compréhensible, qui inclut aussi bien le contrat de prestation négocié avec les autorités que les accords avec les participants individuels. La base est un système de référence qui tient compte des caractéristiques particulières des différents groupes cibles, des procédures particulières et des ressources à disposition. Sur cette base, l’effectivité des MMT doit être évaluée selon des critères clairs et compréhensibles. Pour chaque critère ont été développés des indicateurs concrets, et des standards minimaux ont été fixés. De plus, le nouveau modèle contribue à optimiser la collaboration entre les institutions concernées, en montrant comment elles peuvent s’entendre sur les processus centraux de chacun des acteurs, sur les compétences et sur le déroulement du processus. Le système de référence doit pouvoir faire l’objet d’un développement continu sur la base des expériences. |
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German |
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1661-9552 |
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50-ap |
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59519 |
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Author |
Mosebach, Ursula |
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Title |
Die Qualität sozialer Dienstleistungen : Anmerkungen zum Diskussionsstand eines aktuellen Themas |
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Journal Article |
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1997 |
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Jugendwohl : Zeitschrift für Kinder- und Jugendhilfe |
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5 |
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218-226 |
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quality; quality control; social services; program planning, implementation, and evaluation; certification |
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German |
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0022-5975 |
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50-an |
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59517 |
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Author |
Stoop, Karin; Leber, Lukas |
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Title |
Organisationsentwicklung und regionales Management ambulanter Suchthilfe : Erfahrungen mit Case Management in der Perspektive Solothurn |
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Journal Article |
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2001 |
Publication |
Suchttherapie : Prävention, Behandlung, wissenschaftliche Grundlagen |
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2 |
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2 |
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84-89 |
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organizational structure; case management; collaboration; ambulatory care facility |
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Von sozialen Diensten und Einrichtungen wird erwartet, dass sie für das Gemeinwesen und für die Bürger soziale Probleme bewältigen helfen und lösen. Um diese Aufgabe zielwirksam und mit vertretbarem Aufwand wahrnehmen zu können, hat man für Humandienste die Arbeitsweise des Case Managements eingeführt. Es schafft Übersicht in der Versorgungslandschaft und Transparenz im Verfahren für alle Beteiligten und legt insbesondere für den Hilfebedürftigen Wegmarken für seine Unterstützung und sein eigenes Dazutun fest [1]. Die Perspektive Fachstellen für soziale Dienstleistungen Solothurn (Schweiz), nachstehend Perspektive genannt, ist ein Zusammenschluss verschiedener Trägerschaften in der Sozialarbeit mit Suchtmittelabhängigen. Die Fachstellen der Bereiche Beratung, Überlebenshilfe, Arbeit, Wohnen und Prävention arbeiten institutionenübergreifend nach Case Management. Organisational Development and Regional Management of Ambulatory Addict Assistance: Social services and institutions are expected to help solve social problems for the community and its citizens. In order to accomplish this task with justifiable expense in a straightforward manner, the working method of the so-called case management was introduced in the human services, improving control over social services and the perspicuity of the procedure for all the people involved by establishing milestones particularly for the persons seeking help with regard to the assistance received and their own contributions. Milestones were established for the help-seeking people with regard to their support and their own contributions. The Perspektive Fachstellen für soziale Dienstleistungen Solothurn (agencies for social services and institutions in Solothurn, Switzerland) are a pool of different organisations all working with addicts. Although the several agencies are responsible for a whole range of different social services, they collaborate by way of case management, crossing the borders of the separate institutions. |
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1439-9903 |
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50-am |
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59516 |
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Author |
Wittchen, Hans-Ulrich; Apelt, Sabine M. |
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Title |
Wann sind Substitutionsbehandlungen effektiv? : neue Resultate empirischer Forschung : Plenarvorträge 2 |
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Journal Article |
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Year |
2004 |
Publication |
Suchtmedizin in Forschung und Praxis |
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6 |
Issue |
2 |
Pages |
127-129 |
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treatment and maintenance; drug substitution therapy; cost-benefit analysis; drug dependent; demographic characteristics; comorbidity; HIV infection; viral hepatitis; hepatitis C; treatment outcome; methadone maintenance |
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1437-5567 |
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50-al |
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59515 |
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Author |
Williamson, Nancy; Archibald, Chris; Van Vliet, Jon S. |
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Title |
Unexplained deaths among injection drug users : a case of probable clostridium myonecrosis |
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Journal Article |
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2001 |
Publication |
Canadian Medical Association journal : CMAJ = Journal de l’Association médicale canadienne : JAMC |
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165 |
Issue |
5; 04.09.2001 |
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609-611 |
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intravenous drug user; AODR mortality; clostridium; gangrene; skin inflammation; primary health care; general practitioner; United Kingdom; Ireland |
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Abstract |
A series of unexplained deaths associated with soft-tissue inflammation and severe systemic sepsis was reported among injection drug users (IDUs) in the United Kingdom and the Republic of Ireland in 2000. Health Canada has identified one reported fatality in an IDU that matched the case definition. Although the cause of the epidemic in the UK and Ireland is not fully understood, contributing factors include injecting into muscle or beneath the skin, rather than directly into a vein, and the use of acid to dissolve the heroin. This single Canadian case is considered to be a sporadic event that occurs at a low background rate among IDUs. These cases serve to remind primary health care providers to be vigilant in cases of soft-tissue infection among IDUs and not to underestimate the potential severity of the situation. |
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0820-3946 |
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50-aj |
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59513 |
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Author |
Veale, Jacob |
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Title |
Harm reduction and the community |
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Journal Article |
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Year |
1994 |
Publication |
International journal of drug policy |
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5 |
Issue |
2 |
Pages |
115-119 |
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harm reduction; prevention; health promotion; HIV infection; Aids; intravenous drug user; crime; cooperation; drug market; United Kingdom; London |
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With the limited exception of HIV/AIDS prevention, harm minimisation in the UK has focused on the harm that drug users may do to themselves. This article explains how harm minimisation within Hammersmith and Fulham (part of inner London ) has now begun to address wider issues. Hammersmith and Fulham has the highest estimate HIV+ rate of any local authority area in the UK, and approximately 4000 injecting drug users. Spending on HIV prevention and services for people with HIV/AIDS is the highest in the UK . Police estimate that more than half of all acquisitive crime in the area is committed to fund drug purchases. Public services in the health, criminal justice, education, housing and social fields have formed an unusually close partnership to address these problems. This is generating rapid changes in service provision, including moves away from prosecution of people in possession of any drug for their own use, and moves to attract many more users into treatment by greatly extending prescribing practice. The overall aims of harm minimisation in the area now include reduction of crime and reduction of the illicit drug market alongside minimisation of harm to drug users themselves. |
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0955-3959 (Print); 1873-4758 (Electronic) |
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50-ai |
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59512 |
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