Skip to main content
SpringerLink
Log in

Suchtmittelgebrauch bei medizinischem Personal

  • Chapter
Suchtmittel in der AINS

  • 1410 Accesses

Zusammenfassung

Der Gebrauch von legalen und illegalen Suchtmitteln ist weit verbreitet (Die Drogenbeauftragte der Bundesregierung 2004, Office of Applied Studies 2005). Dabei wurden und werden die gleichen Substanzen von verschiedenen Gesellschaften durchaus unterschiedlich beurteilt, wobei die Einschätzung nicht unbedingt rationalen Gründen folgt (Hurrelmann 2004). Beispiele dafür sind die Prohibition in den USA in den 1920er-Jahren, die unterschiedliche Einschätzung von Cannabisprodukten in den Niederlanden und Deutschland oder der weit verbreitete Gebrauch von Kokablättern in Südamerika. Demzufolge spricht die World Health Organization (WHO) auch in einer sehr lesenswerten Monographie wertungsneutral von psychoaktiven Substanzen (World Health Organization 2004). Im allgemeinen Sprachgebrauch werden die gesellschaftlich akzeptierten legalen Suchtmittel Alkohol, Koffein und Nikotin meistens als Genussmittel bezeichnet.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 29.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  • Aasland OG, Ekeberg O, Schweder T: Suicide rates from 1960 to 1989 in Norwegian physicians compared with other educational groups. Soc Sci Med 2001; 52:259–265

    Article  CAS  PubMed  Google Scholar 

  • American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders — Fourth Edition (DSM-IV). American Psychiatric Publishing 2000

    Google Scholar 

  • American Society of Anesthesiologists: Model Curriculum on Drug Abuse and Addiction for Residents in Anesthesiology. www.asahq.org/clinical/curriculum.pdf. 2003

    Google Scholar 

  • Ärztekammer Hamburg: Ärzte und Sucht. www.aerztekammer-hamburg.de/aerzte/aerzte_sucht.htm

    Google Scholar 

  • Ärztekammer Schleswig-Holstein: Komission Sucht und Drogen. www.aeksh.de/9aktuell/htm/sucht_und_drogen.htm

    Google Scholar 

  • Baldwin DC, Hughes PH, Conard SE, Storr CL, Sheehan DV: Substance use among senior medical students. A survey of 23 medical schools. JAMA 1991; 265:2074–2078

    Article  PubMed  Google Scholar 

  • Barengo NC, Sandstrom PH, Jormanainen VJ, Myllikangas MT: Changes in smoking prevalence among Finnish physicians 1990–2001. Eur J Public Health 2004; 14(2):201–203

    Article  PubMed  Google Scholar 

  • Beelmann K: Widerwille gegen die Schnapsflasche — Interventionsprogramm der Ärztekammer Hamburg bei Suchtund Abhängigkeitserkrankungen. Hamburger Ärzteblatt 2003; 286–289

    Google Scholar 

  • Berde CB, Strichartz GR: Local Anesthetics. In Miller RD (ed): Anesthesia, 5th edition. Churchill Livingstone 2000; 491–521

    Google Scholar 

  • Berry CB, Crome IB, Plant M, Plant M: Substance misuse amongst anaesthetists in the United Kingdom and Ireland. Anaesthesia 2000; 55:946–952

    Article  CAS  PubMed  Google Scholar 

  • Bohigian GM, Croughan JL, Sanders K, Evans ML, Bondurant R, Platt C: Substance Abuse and Dependence in Physicians: The Missouri Physicians’ Health Program. South Med J 1996; 89(11):1078–1080

    Article  CAS  PubMed  Google Scholar 

  • Böllinger L: Gebräuch und Abhangigkeit von illegalen Drogen — Ansätze einer metapsychologischen Eingrenzung. Psyche — Z Psychoanal 2005; 59(6):491–533

    Google Scholar 

  • Booth JV, Grossman D, Moore J, Lineberger C, Reynolds JD, Reves JG, and Sheffield D: Substance Abuse Among Physicians: A Survey of Academic Anesthesiology Programs. Anesth Analg 2002; 95:1024–1030

    Article  PubMed  Google Scholar 

  • Brenner H, Scharrer S: Smoking habits of future physicians: a survey among medical students of a south German university. Soz Präventivmed 1996; 41(3):150–157

    Article  CAS  PubMed  Google Scholar 

  • Bundesärztekammer: Suchterkrankungen bei Ärzten. www.bundesaerztekammer.de/30/Praevention/20Sucht/75Suchtarzt/index.html

    Google Scholar 

  • Cadman M, Bell J.: Doctors detected self-administering opioids in New South Wales, 1985–1994: characteristics and outcome. MJA 1998; 169:419–421; www.mja.com.au/public/issues/oct19/cadman/cadman.html

    CAS  PubMed  Google Scholar 

  • Center C, Davis M, Detre T et al.: Confronting Depression and Suicide in Physicians. JAMA 2003; 289(23):3161–3166

    Article  PubMed  Google Scholar 

  • Collins GB, McAllister MS, Jensen M, Gooden TO: Chemical Dependence Treatment Outcomes of Residents in Anesthesiology: Results of a Survey. Anesth Analg 2005; 101:1457–1462

    Article  PubMed  Google Scholar 

  • Collins RL, Gollnisch G, Morsheimer ET: Substance use among a regional sample of female nurses. Drug Alcohol Depend 1999; 55:145–155

    Article  CAS  PubMed  Google Scholar 

  • Colliver JD, Hughes A: Data collection methodologies — Commentary. J Drug Issues 2001; 31:717–720

    Google Scholar 

  • Croen LG, Woesner M, Herman M, Reichgott M: A longitudinal study of substance use and abuse in a single class of medical students. Acad Med 1997; 72(5):376–381

    Article  CAS  PubMed  Google Scholar 

  • Davis RM: When doctors smoke. Tob Control 1993; 2:187–188

    Article  Google Scholar 

  • Dawson D, Reid K: Fatigue, alcohol impairment. Nature 1997; 388:235

    Article  CAS  PubMed  Google Scholar 

  • Deutsche Hauptstelle für Suchtfragen (DHS) e.V.: Substanzbezogene Störungen am Arbeitsplatz. Hamm 2001

    Google Scholar 

  • Deutsche Hauptstelle für Suchtfragen (DHS) e.V.: DHS-Jahrbuch Sucht. Hamm 2005

    Google Scholar 

  • Deutsche Referenzstelle der EBDD: Bericht 2005 des nationalen REITOX-Knotenpunktes an die EBDD — Deutschland. www.dbdd.de/Download/REITOX_D2005_DE_D_fin.pdf 2005

    Google Scholar 

  • Die Drogenbeauftragte der Bundesregierung. Drogen-und Suchtbericht. 2004

    Google Scholar 

  • Domenighetti G, Tomamichel M, Gutzwiller F, Berthoud S, Casablanca A: Psychoactive drug use among medical doctors is higher than in the general population. Soc Sci Med 1991; 33:269–274

    Article  CAS  PubMed  Google Scholar 

  • Domino KB, Hornbein TF, Polissar NI, Renner G, Johnson J, Alberti S, Hankes L: Risk Factors for Relapse in Health Care Professionals With Substance Use Disorders. JAMA 2005; 293(12):1453–1460

    Article  CAS  PubMed  Google Scholar 

  • Ermann M: Abhängigkeitsverhalten und Sucht. In: Psychosomatische Medizin und Psychotherapie, 4. Aufl. Kohlhammer 2004; 289–297

    Google Scholar 

  • Europäische Beobachtungsstelle für Drogen und Drogensucht: Jahresbericht 2005: Der Stand der Drogenproblematik in Europa. Amt für amtliche Veröffentlichungen der Europäischen Gemeinschaften. Luxemburg 2005; http://annualreport.emcdda.eu.int/de/home-de.html

    Google Scholar 

  • Farber NJ, Gilibert SG, Aboff BM, Collier VU, Weiner J, Boyer EJ: Physicians willingness to report impaired colleagues. Soc Sci Med 2005; 61:1772–1775

    Article  PubMed  Google Scholar 

  • Flaherty JA, Richmann JA: Substance Use and Addiction Among Medical Students, Residents and Physicians. Psychiatr Clin North Am 1993; 16(1):189–198

    CAS  PubMed  Google Scholar 

  • Frank E, Dingle AD: Self-Reported Depression and Suicide Attempts Among US Women Physicians. Am J Psychiatry 1999; 156:1887–1894

    CAS  PubMed  Google Scholar 

  • Freud S: Über Coca (1884). In: Hirschmüller A (Hrsg.): Schriften über Kokain, Sigmund Freud — Werke im Taschenbuch, 3. Aufl. Fischer Taschenbuch Verlag 2004

    Google Scholar 

  • Fry RA: Substance Abuse by Anaesthetists in Australia and New Zealand. Anaesth Intensive Care 2005, 33:248–255

    CAS  PubMed  Google Scholar 

  • Galambos G: Doctors Mental Health Literature Review. 2003; www.mbansw.org.au/dmh/literature_review.html

    Google Scholar 

  • Gastfriend DR: Physician Substance Abuse and Recovery. JAMA 2005; 293(12):1513–1515

    Article  CAS  PubMed  Google Scholar 

  • Ghodse AH, Howse K: Substance use of medical students: a nationwide survey. Health Trends 1994; 26(3):85–87

    CAS  PubMed  Google Scholar 

  • Hall J, Gold MS, Graham NA, Pomm R: The Effects of Alcohol Use During Medical School. Psychiatric Annals 2005; 35(6):505–508

    Google Scholar 

  • Hamadeh RR: Smoking habits of primary health care physicians in Bahrain. J R Soc Health 1999; 119(1):36–39

    Article  CAS  Google Scholar 

  • Hawton K, Clements A, Sakarovitch C, Simkin S, Deeks JJ: Suicide in doctors: a study of risk according to gender, seniority and specialty in medical practitioners in England and Wales, 1979–1995. J Epidemiol Community Health 2001; 55:296–300

    Article  CAS  PubMed  Google Scholar 

  • Heatherton TF, Koslowski LT, Frecker RC: The Fagerstrom Test for Nicotine Dependence. Br J Addict 1991, 86:119–127

    Article  Google Scholar 

  • Hughes PH, Brandenburg N, Baldwin DC, Storr CL, Williams KM, Anthony JC, Sheehan DV: Prevalence of substance use among US physicians. JAMA 1992; 267:2333–2339

    Article  CAS  PubMed  Google Scholar 

  • Hughes PH, Storr CL, Brandenburg NA, Baldwin DC, Anthony JC, Sheehan DV. Physician Substance Use by Medical Specialty. J Addict Dis 1999; 18(2):23–36

    Article  CAS  PubMed  Google Scholar 

  • Hulse G, Sim MG, Khong E: Management of the impaired doctor. Aust Fam Physician 2004; 33(9):703–708

    PubMed  Google Scholar 

  • Hurrelmann K: Legale und illegale Drogen — wie kann ihr Missbrauch verhindert werden? Sucht 2000; 46(6):452–456

    Google Scholar 

  • Irving J: The Cider House Rules. William Morrow, New York, 1985. dt. Gottes Werk und Teufels Beitrag, 1988

    Google Scholar 

  • Jacobs WS, Repetto M, Vinson S, Pomm R, Gold MS. Random Urin Testing as an Intervention for Drug Addiction. Psychiatric annals 2004; 34(10):781–785

    Google Scholar 

  • Josseran L, King G, Guilbert P, Davis J, Brücker G: Smoking by French general practitioners: behaviour, attitudes and practice. Eur J Public Health 2005; 15(1):33–38

    Article  PubMed  Google Scholar 

  • Josseran L, King G, Velter A, Dresssen C, Grizeau D: Smoking Behavior and Opinions of French General Practitioners. J Natl Med Assoc 2000; 92(8):382–390

    CAS  PubMed  Google Scholar 

  • Jurkat HB, Reimer C: Arbeitsbelastung und Lebenszufriedenheit bei berufstatigen Medizinern in Abhängigkeit von der Fachrichtung. Schweiz Arztez 2001; 82:1745–1750

    Google Scholar 

  • Kelly D: Burnout and alcohol problem. In: Health Risk to the Health Care Professional. Royal College of Physicians of London 1995; 63–76

    Google Scholar 

  • Kenna GA, Wood MD: Alcohol use by healthcare professionals. Drug Alcohol Depend 2004; 75:107–116

    Article  PubMed  Google Scholar 

  • Kenna GA, Wood MD: Family history of alcohol and drug use in healthcare professionals. J Subst Use 2005; 10(4):225–238

    Article  Google Scholar 

  • Kenna GA, Wood MD: The prevalence of alcohol, cigarette and illicit drug use and problems among dentists. J Am Dent Assoc 2005; 136:1023–1034

    PubMed  Google Scholar 

  • Khong E, Sim MG, Hulse G: The identification and mangament of the drug impaired doctor. Aust Fam Physician 2002; 31(12):1097–1100

    PubMed  Google Scholar 

  • Kumar P, Basu D: Substance Abuse by Medical Students and Doctors. J Indian Med Assoc 2000; 98(8):447–452

    CAS  PubMed  Google Scholar 

  • Levine MR, Rennie WP: Pre-employment urine drug testing of hospital employees: future questions and review of current literature. Occup Environ Med 2004; 61:318–324

    Article  CAS  PubMed  Google Scholar 

  • Lindeman S, Läärä E, Hirvonen J, Lönnqvist J: Suicide mortality among medical doctors in Finland: are females more prone to suicide than their male colleagues? Psychol Med 1997; 27:1219–1222

    Article  CAS  PubMed  Google Scholar 

  • Lutsky I, Hopwood M, Abram SE, Cerletty JM, Hoffman RG, Kampine JP: Use of psychoactive substances in three medical specialties: anaesthesia, medicine and surgery. Can J Anaesth 1994; 41(7):561–567

    Article  CAS  PubMed  Google Scholar 

  • Lutsky I, Hopwood M, Abram SE, Jacobson GR, Haddox JD, Kampine JP: Psychoactive substance use among American anesthesiologists: a 30-year retrospektive study. Can J Anaesth 1993; 40(10):915–921

    Article  CAS  PubMed  Google Scholar 

  • Mansky PA: Alcohol & Drug Abuse: Physician Health Programs and the Potentially Impaired Physician With a Substance Use Disorder. Psychiatr Serv 1996; 47(5):465–472

    CAS  PubMed  Google Scholar 

  • Martell BA, Mitchell E, Poling J, Gonsai K, Kosten TR: Vaccine Pharmacotherapy for the Treatment of Cocaine Dependence. Biol Psychiatry 2005; 58:158–164

    Article  CAS  PubMed  Google Scholar 

  • Mäulen B: Abhängigkeit bei Ärzten. In: Faust (Hrsg.): Psychiatrie: ein Lehrbuch für Klinik, Praxis und Beratung. 2. Aufl. Frankfurt: Gustav Fischer 1996

    Google Scholar 

  • Mäulen B: Suizide bei Ärzten. Münch Med Wochenschr 2002; www.aerztegesundheit.de/suizid4.htm

    Google Scholar 

  • McCabe SE, Knight JR, Teter CJ, Wechsler H: Non-medical use of prescription stimulants among US college students: prevalence an correlates from a national survey. Addiction 2005; 99:96–106

    Article  Google Scholar 

  • McGovern MP, Angres DH, Uziel-Miller ND, Leon S: Female Physicians and Substance Abuse: Comparisons with Male Physicians Presenting for Assessment. J Subst Abuse Treat 1998, 15(6):525–533

    Article  CAS  PubMed  Google Scholar 

  • Michaelsen A, Richarz B, Reichardt H, Spahn G, Konietzko N, Dobos GJ: Raucherentwohnung bei Krankenhausmitarbeitern. Dtsch Med Wochenschr 2002, 127:1742–1747

    Google Scholar 

  • Newbury-Birch D, White M, Kamali F: Factors influencing alcohol and illicit drug amongst medical students. Drug Alcohol Depend 2000; 59:125–130

    Article  CAS  PubMed  Google Scholar 

  • O’Connor PG, Spickard A: Physician Impairment By Substance Abuse. Vanderbilt University Medical Center 2001; www.mc.vanderbilt.edu/root/vumc.php?site=cph&doc=1088

    Google Scholar 

  • Office of Applied Studies: Drug Use Among U.S. Workers: Prevalence & Trends by Occupation and Industry. 1996; www.oas.samhsa.gov/work1996/toc.htm

    Google Scholar 

  • Office of Applied Studies: Tobacco Use, Income, and Educational Level. 2002; www.oas.samhsa.gov/2k2/tob/tob.cfm

    Google Scholar 

  • Office of Applied Studies: National Survey on Drug Use & Health. 2005; www.oas.samhsa.gov/nsduh/2k5nsduh/2k5results.htm

    Google Scholar 

  • Ohida T, Osaki Y, Kobayashi Y, Sekiyama M, Minowa M: Smoking prevalence of female nurses in the nationals hospitals of Japan. Tob Control 1999; 8(2):192–195

    Article  CAS  PubMed  Google Scholar 

  • Ohida T, Sakurai H, Mochizuki Y, Kamal AM, Takemura S, Minowa M, Kawahara K. Smoking prevalence and attitudes toward smoking among Japanese physicians. JAMA 2001; 285(20):2643–2648

    Article  CAS  PubMed  Google Scholar 

  • Paris RT, Canavan DI: Physician Substance Abuse Impairment: Anestesiologists vs. Other Specialties. J Addict Dis 1999; 18(1):1–7

    Article  CAS  PubMed  Google Scholar 

  • Pärna K, Rahu M, Rahu K: Smoking habits and attitudes towards smoking among Estonian physicians. Public Health 2005; 119(5):390–399

    Article  PubMed  Google Scholar 

  • Plasschaert AJM, Hoogstraten J, van Emmerik BJ, Webster DB, Clayton RR: Substance use among Dutch dental students. Community Dent Oral Epidemiol 2001; 29:48–54

    Article  CAS  PubMed  Google Scholar 

  • Prather E: The ultimative failure — Physician suicide is a growing concern. Tex Med 2005; 101(5):30–38

    Google Scholar 

  • Prignot J, Vermeire P, Jamart J, Uydebrouck M, Wanlin M, Thijs J for the Working Group of the Belgian Lung and Tuberculosis Association (BELTA): Time-trends (1983–1998) in smoking habits among Belgian physicians. Arch Public Health 2000; 58:111–129

    Google Scholar 

  • Rahn E, Mahnkopf A: Lehrbuch Psychiatrie für Studium und Praxis, 3. Aufl. Psychiatrieverlag, Bonn 2005

    Google Scholar 

  • Reimer C, Jurkat HB: Zur Problematik der Lebensqualität und Suchtgefährdung vom Ärztinnen und Ärzten. In: Stetter F (Hrsg.): Suchttherapie an der Schwelle zur Jahrtausendwende, Wege aus der Sucht. Neuland Verlag, Geesthacht 2000

    Google Scholar 

  • Reimer C, Jurkat HB: Lebensqualität von Psychiatern und Psychotherapeuten. Schweiz Ärztez 2001; 82:1733–1738

    Google Scholar 

  • Reimer C, Jurkat HB, Mäulen B, Stetter F: Zur Problematik der Suchtgefährdung von berufstätigen Medizinern. Psychotherapeut 2001; 46:376–385

    Article  Google Scholar 

  • Rosvold EO, Vaglum P, Moum T: Use of minor tranquilizers among Norwegian physicians. A nation-wide comparative study. Soc Sci Med 1998; 46:581–590

    Article  CAS  PubMed  Google Scholar 

  • Schulz M, Töpper M, Behrens J: Rauchverhalten von Mitarbeitern und Patienten der psychiatrischen ABteilung eines Allgemeinkrankenhauses. Gesundheitswesen 2004; 66:107–113

    Article  CAS  PubMed  Google Scholar 

  • Shaw MF, McGovern MP, Angres DH, Rawal P: Physicians and nurses with substance use disorders. J Adv Nurs 2004; 47(5):561–571

    Article  PubMed  Google Scholar 

  • Sonneck G, Wagner R: Suicide and Burnout of Physicians. Omega 1996; 33(3):255–263

    Google Scholar 

  • Storr CL, Trinkoff AM, Hughes P: Similarities of Substance Use between Medical and Nursing Specialties. Subst Use Misuse 2000; 35:1443–1469

    Article  CAS  PubMed  Google Scholar 

  • Swanson SP, Roberts LJ, Chapman MD: Are Anaesthetist Prone to Suicide? A Review of Rates and Risk Factors. Anaesth Intensive Care 2003, 31:434–445

    CAS  PubMed  Google Scholar 

  • Tapia-Conyer R, Craviato P, de la Rosa B, Galvan F, Garcia-de la Torre G, Kuri P: Cigarette smoking: knowledge and attitudes among Mexican physicians. Salud Publica Mex 1997, 39(6):507–512

    CAS  PubMed  Google Scholar 

  • Torre DM, Wang N, Meoni LA, Young JH, Klag MJ, Ford DE: Suicide Compared to Other Causes of Mortality in Physicians. Suicide Life Threat Behav 2005; 35(2):146–153

    Article  PubMed  Google Scholar 

  • Tory S, Rasanen K, Kujala S et al.: Self-reported Health, Illness, and Self-care Among Finnish Physicians. Arch Fam Med 2000; 9:1079–1085

    Article  Google Scholar 

  • Trinkoff AM; Storr CL: Substance Use among Nurses: Differences between Specialties. Am J Public Health 1998; 88:581–585

    Article  CAS  PubMed  Google Scholar 

  • Trinkoff AM, Zhou Q, Storr CL, Soeken KL: Workplace Access, Negative Proscriptions, Job Strain, and Substance Use in Registered Nurses. Nurs Res 2000; 49(2):83–90

    Article  CAS  PubMed  Google Scholar 

  • Tselebis A, Panaghiotou A, Theotoka I, Ilias I: Nursing staff anxiety versus smoking habits. Int J Nurs Pract 2001; 7(3):221–223

    Article  CAS  PubMed  Google Scholar 

  • Underwood B, Fox K, Nixon PJ: Alcohol and drug use among vocational dental practitioners. Br Dent J 2003; 195:265–268

    Article  CAS  PubMed  Google Scholar 

  • Wadsworth EJK, Moss SC, Simpson SA, Smith AP: Factors associated with recreational drug use. J Psychopharmacol 2004; 18(2):238–248

    Article  PubMed  Google Scholar 

  • Weir E: Substance abuse among physicians. CMAJ 2000; 162(12):1730

    CAS  PubMed  Google Scholar 

  • Westhorpe R: Horace Wells (1815–1848). Anaesth Intensive Care 1996; 24:415

    CAS  PubMed  Google Scholar 

  • World Health Organization: Neuroscience of psychoactive substance use and dependence. Genf: WHO 2004Symbole

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universität Rostock, Schillingallee 35, 18057, Rostock

    Dr. C. J. Kreienmeyer

Authors
  1. Dr. C. J. Kreienmeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universität Rostock, Schillingallee 35, 18057, Rostock

    Dierk A. Vagts DEAA, EDIC (MSc. Krankenhausmanagement Oberarzt, Leiter der Perioperativen Intensivtherapie (PIT) (MSc. Krankenhausmanagement Oberarzt, Leiter der Perioperativen Intensivtherapie (PIT)

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer Medizin Verlag Heidelberg

About this chapter

Cite this chapter

Kreienmeyer, C.J. (2007). Suchtmittelgebrauch bei medizinischem Personal. In: Vagts, D.A. (eds) Suchtmittel in der AINS. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-33734-8_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-33734-8_10

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-33733-1

  • Online ISBN: 978-3-540-33734-8

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation