[New tools for preventing and evaluating risk practices for hepatitis C transmission among injection drug users: some reflections on injection rooms and the measurement of risk-taking behaviors]. / Quels nouveaux outils pour prévenir et évaluer les pratiques à risque chez les injecteurs de drogue face au VHC? Réflexions sur les salles d'injection et les outils de mesure des prises de risques.

Injection rooms should be able to contribute to the prevention of the risks of transmission of hepatitis C (HCV) among intravenous drug users (IDUs). However, these services have yet to be set up and tested in France. This article presents a literature review of injection rooms and explores possible ways of evaluating the effects of this type of service on risks for HCV. Given the difficulties of estimating the service's impact on the incidence of HCV, evaluations could target injection-related risk taking behaviors. The second part of the article addresses the issue of risk taking practices and presents a new research tool able to explore out-of-the-ordinary situations involving risk-taking. Tested on a population of IDUs in Marseille, this tool detects forms of risk-taking and contexts in which injection is performed, which are always missed by the usual measures of risk practices. It could therefore be added to these measures and be useful for evaluating injection rooms.

[Doctors' opinions on palliative care: results from a French survey on physicians attitudes and practices]. / Deux points de vue des médecins sur les soins palliatifs.

OBJECTIVE: To examine practitioners' opinions on palliative care. METHOD: Statistical analyses were carried out on data collected from 1000 physicians recruited to participate in a study on knowledge, attitudes and practices with respect to palliative care ("Palliative Care 2002"). A cluster analysis (CAH) was conducted based on responses to nine questions in order to identify homogeneous and contrasting profiles of opinions on palliative care. RESULTS: Two distinctly different categories of profiles emerged. The first one had a restrictive approach to palliative care (n = 387; 38.7%), while the second one supported its expansion (n = 613; 61.3%). CONCLUSION: A newly revised communication campaign which favoured and recognised palliative care could assist in the dissemination of related practices among physicians.

[Terminal care of patients by the general practitioner and the specialist. Results of a French survey "Attitudes and practices in palliative treatment--2002"]. / Prise en charge des malades en fin de vie en médecine générale et spécialisée. Résultats de l'enquête française "Attitudes et pratiques face aux soins palliatifs-2002".

OBJECTIVE: Assess the attitude of the practitioners with regard to the management of patients at the end of their lives, depending on the physician/patient communication and treatment of pain. Method Statistical analysis of the data collected among 1,000 practitioners recruited for a survey on knowledge, attitudes and practices regarding palliative care in 2002. RESULTS: The practitioners who felt "ill at ease" in the management of patients at the end of their life often had a poor opinion regarding morphine and did not systematically their patients of the therapeutic aims. CONCLUSION: Greater awareness by the practitioners of palliative care would help to improve the quality of care supplied to terminally ill patients.

[Chief health risks associated with intravenous heroin and cocaine abuse]. / Les principaux risques sanitaires associés à l'usage d'héroïne ou de cocaïne par voie intraveineuse.

THREE CATEGORIES OF COMPLICATIONS: Heroine and cocaine are the main drugs used by injecting drug-users (IDU) in France. There are three categories of complications associated with intravenous drug abuse: effects related to drug toxicity, effects associated with the administration route, and effects associated with social implications of drug-dependence. OTHER HEALTH PROBLEMS: The impact of HIV infection among IDU, particularly in southern Europe, has led to renewed interest in the other health problems raised by this population. A review of recent literature shows that cocaine toxicity is better understood than heroine toxicity. In addition, intravenous drug abuse can lead to a whole series of disease states related to trauma or infection.