Ethical reflections emerging during the activity of a low threshold facility with supervised drug consumption room in Geneva, Switzerland

A drug consumption room (DCR), 'Quai 9', opened in Geneva, Switzerland in 2001. As part of its evaluation, a study of situations which presented staff with ethical conflicts in their day to day work was undertaken in 2003. Problem situations were identified via an open ended questionnaire and non-participatory observations. The nature of the ethical conflicts encountered in the identified situations was discussed in a staff focus group and analysed using an ethical framework based on three levels of norms (personal, professional, institutional) adapted from a clinical setting. In a second focus group, an applied analysis, using the same level of norms from the first focus group, was presented to the staff to assist them dealing with ethical conflicts. Situations associated with ethical conflicts for staff were assisting clients to inject, client refusal to seek treatment in spite of poor health, new injectors, prohibition of access to minors, pregnant clients, client self mutilation, and non-participation in proposed activities. The study showed that despite Quai 9's clear objectives, expressed philosophy, and operational rules, the staff were frequently exposed to ethically conflicting situations. However, open and structured discussion of these situations using an ethical framework which allowed the identification of different norms and discussion of their respective importance in order to reach a common decision was feasible and useful in a DCR setting. [Authors]]]> Substance Abuse, Intravenous ; Substance Abuse Treatment Centers oai:serval.unil.ch:BIB_8D3C1A76E1EC 2022-05-07T01:22:30Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_8D3C1A76E1EC Reponse immunitaire: aspects nouveaux. [Immune response: current aspects] info:eu-repo/semantics/altIdentifier/pmid/2785702 Cerottini, J. C. info:eu-repo/semantics/article article 1989-03 Revue Médicale de la Suisse Romande, vol. 109, no. 3, pp. 201-3 info:eu-repo/semantics/altIdentifier/pissn/0035-3655 Antibody Formation Antigen-Antibody Reactions B-Lymphocytes/*immunology Humans Immunity, Cellular T-Lymphocytes/*immunology oai:serval.unil.ch:BIB_8D3C480D64EF 2022-05-07T01:22:30Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_8D3C480D64EF PKA antagonizes CLASP-dependent microtubule stabilization to re-localize Pom1 and buffer cell size upon glucose limitation. info:doi:10.1038/ncomms9445 info:eu-repo/semantics/altIdentifier/doi/10.1038/ncomms9445 info:eu-repo/semantics/altIdentifier/pmid/26443240 Kelkar, M. Martin, S.G. info:eu-repo/semantics/article article 2015 Nature Communications, vol. 6, pp. 8445 info:eu-repo/semantics/altIdentifier/eissn/2041-1723 urn:issn:2041-1723 <![CDATA[Cells couple growth with division and regulate size in response to nutrient availability. In rod-shaped fission yeast, cell-size control occurs at mitotic commitment. An important regulator is the DYRK-family kinase Pom1, which forms gradients from cell poles and inhibits the mitotic activator Cdr2, itself localized at the medial cortex. Where and when Pom1 modulates Cdr2 activity is unclear as Pom1 medial cortical levels remain constant during cell elongation. Here we show that Pom1 re-localizes to cell sides upon environmental glucose limitation, where it strongly delays mitosis. This re-localization is caused by severe microtubule destabilization upon glucose starvation, with microtubules undergoing catastrophe and depositing the Pom1 gradient nucleator Tea4 at cell sides. Microtubule destabilization requires PKA/Pka1 activity, which negatively regulates the microtubule rescue factor CLASP/Cls1/Peg1, reducing CLASP's ability to stabilize microtubules. Thus, PKA signalling tunes CLASP's activity to promote Pom1 cell side localization and buffer cell size upon glucose starvation

Evaluation de l'espace d'accueil et d'injection "Quai 9" : deuxième phase 2003

[Table des matières] Résumé. 1. Introduction. 2. Méthodologie. 3. Monitoring des activités du Quai 9. 4. Salle d'injection : typologie d'usagers et substances utilisées (analyse des données de 2002). 5. Qu'est-ce qui influence les usagers à changer ou à ne pas changer de comportement ? Qui sont les usagers qui changent leur comportement ? 6. Quelles sont les limites, c'est-à-dire les situations posant problème pour les membres de l'équipe ? 7. Conclusions et recommandations générales. 8. Annexes

Osteitis condensans Ilii as differential diagnosis of sacroiliitis: learning in order not to fail / Osteíte Condensante do Íleo como diagnóstico diferencial de sacroileíte: aprendendo para não errar

Osteitis Condensans Ilii (OCI) is a rare benign condition of unknown etiology. The prevalence in overall population ranges from 0.9 to 2.5%, and it is more frequent in multiparous women before the fourth decade of life1. It can be asymptomatic and discovered by accidental radiologic diagnosis or it may present as inflammatory low back pain 1,2. The symptomatic form is an important mimicking factor of sacroiliitis, and it should always be considered as differential diagnosis1. Given the rareness of the disease and the importance of differential diagnosis, we report an OCI case that mimics sacroiliitis

Evaluation du projet UniSET

En mai 2003, la Direction de la sécurité sociale et de l'environnement a confié à l'IUMSP le mandat d'évaluer le projet de l'Unité d'intervention socio-éducative de terrain (UniSET) mis en place en novembre 2002 dans le but d'améliorer la situation sur la place St-Laurent. Ce rapport présente les résultats d'évaluation

Evaluation de Quai 9, "Espace d'accueil et d'injection" à Genève: période 12/2001 - 12/2002

Sur mandat du Conseil d'Etat, le Groupe Sida Genève gère, depuis décembre 2001, un espace d'accueil et d'injection appelé Quai 9, dans lequel les usagers de drogues peuvent consommer le produit de la rue dans des conditions sanitaires à moindres risques. La salle d'accueil est le coeur de la structure, un espace de transition entre la rue et l'infection. Y sont dispensés des soins de santé primaires qui, outre l'avantage de mettre plus vite en évidence des lésions potientiellement graves, permettent une parole autour du corps, de la santé, du soin de soi, des maladies transmissibles. Le rapport d'évaluation à un an démontre le bon fonctionnement du lieu et son intégration dans le réseau genevois. De nombreux relais vers le réseau social et médical sont effectués

Development of a competence scale for brief psychodynamic investigation: a pilot study

Studied the development and psychometric characteristics of the Investigation Competence Scale (M. Tadic et al, 2003), an instrument designed to assess a therapist's skill in delivering brief psychodynamic investigation (BPI) therapy. In this pilot study, 4 BPI experienced therapists, 3 junior therapists, and 2 blind raters evaluated 16 BPI video- or audio-recorded BPI interviews. These interviews represented 8 patients who had been treated by experienced therapists and 8 patients who had been treated by junior therapists. Therapists' general and psychoanalytic attitudes, competence in investigation and interpretation, and global competence were assessed. Independent and consensus scoring methods were used. Inter-rater reliability, internal consistency, content validity, and construct validity were determined. The results show that the Investigation Competence Scale is a reliable instrument that has promise for evaluating the competence of therapists using BPI methods. Further investigation using a larger sample size is suggested. (PsycINFO Database Record (c) 2004 APA, all rights reserved