The Swiss heroin trials: testing alternative approaches

Over half a million heroin misusers receive oral methadone maintenance treatment world-wide1 but the maintenance prescription of injectable opioid drugs, like heroin, remains controversial. In 1992 Switzerland began a large scale evaluation of heroin and other injectable opiate prescribing that eventually involved 1035 misusers. 2 3 The results of the evaluation have recently been reported.4 These show that it was feasible to provide heroin by intravenous injection at a clinic, up to three times a day, for seven days a week. This was done while maintaining good drug control, good order, client safety, and staff morale. Patients were stabilised on 500 to 600 mg heroin daily without evidence of increasing tolerance. Retention in treatment was 89% at six months and 69% at 18 months.4 The self reported use of non-prescribed heroin fell signifianctly, but other drug use was minimally affected. The death rate was 1% per year, and there were no deaths from overdose among participants . . . [Full text of this article]

Linking client and employee perceptions of the organization: A study of client satisfaction with health care services

Client satisfaction with health care sen ices has usually been researched in terms of socio-demographic and predispositional characteristics associated with the client. The present study included organizational characteristics as predictors of client satisfaction with health care services. Participants in the research were clients and employees of an Australian public-sector health care organization who responded to separate client and employee questionnaires. Hierarchical regression analyses indicated that, after controlling for a number of client characteristics, organizational characteristics, as perceived by employees, accounted for a significant proportion of additional variance in client satisfaction with health care services. Results of the present study provided some support for the proposition that employee perceptions of the working environment should be considered in a more comprehensive understanding of client satisfaction with health care services. Limitations of the study highlight practical difficulties in the assessment of client outcomes and methodological complexities in linking individual and organizational processes.

Moneyless business exchange - Practitioners' attitudes to business-to-business barter in Australia

In recent years, domestic business-to-business barter has become institutionalized as an alternative marketing exchange system in Australia, and elsewhere. This article reports the findings of a survey of 164 members of Australia's largest trade exchange, Bartercard There are few, if any, published empirical studies on this topic. This study is exploratory. Most firms surveyed are small firms in the services sectors. Although Bartercard has an extensive membership, trading within the system is limited with most members trading less than once per week and with barter transactions contributing less than 5% of their annual gross sales. The main benefits of membership include new customers and increased sales and networking opportunities. The main limitations include the limited functionality of the trade dollar limited trading opportunities, and practical trading difficulties. In selling, there appears to be no differential between the cash and trade prices, whereas trade dollars are discounted in purchasing. Participants acknowledge that business-to-business barter will remain and grow regardless of cyclical macroeconomic changes. (C) 1998 Elsevier Science Inc.