Prevalence and factors associated with alcohol and drug-related disorders in prison: a French national study

BACKGROUND: Most studies measuring substance-use disorders in prisons focus on incoming or on remand prisoners and are generally restricted to drugs. However, there is evidence that substance use initiation or continuation occurs in prison, and that alcohol use is common. The aim of this study is 1) to assess prevalence of both drug and alcohol abuse and dependence (DAD/AAD) in a national randomised cohort of French prisoners, short or long-term sentence 2) to assess the risk factors associated with DAD/AAD in prison. a stratified random strategy was used to select 1) 23 prisons among the different types of prison 2) 998 prisoners. Diagnoses were assessed according to a standardized procedure, each prisoner being assessed by two psychiatrists, one junior, using a structured interview (MINI 5 plus), and one senior, completing the procedure with an open clinical interview. At the end of the interview the clinicians met and agreed on a list of diagnoses. Cloninger's Temperament and Character Inventory (TCI) was also used. RESULTS: More than a third of prisoners presented either AAD or DAD in the last 12 months. Cannabis was the most frequent drug and just under a fifth of prisoners had AAD. AAD and DAD were clearly different for the following: socio-demographic variables, childhood history, imprisonment characteristics, psychiatric comorbidity and Cloninger's TCI. Profiles of AAD in prison are similar to type II alcoholism. CONCLUSION: Regular screening of AAD/DAD in prison, and specific treatment programmes taking into account differences between prisoners with an AAD and prisoners with a DAD should be a public health priority in priso

Addictions et doubles diagnostics dans les prisons françaises

PARIS-BIUSJ-Physique recherche (751052113) / SudocSudocFranceF

Etude de la survenue d un biais attentionnel, à l aide d un test de stroop addiction, chez des sujets alcoolo-dépendants sevrés, en comparaison à une population de témoins

PARIS7-Xavier Bichat (751182101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Community Obligations in Shared Responsibility: Policy Pathways for Resilience

Shared responsibility lies at the heart of the Australian National Strategy for Disaster Resilience; disasters are no longer solely a government responsibility as all societal actors are charged with some obligations for disaster mitigation, response and recovery. However, shared responsibility carries with it certain legal and policy ramifications: for responsibility to be shared across the community, it must be specified, accepted and complied with. The community is a central concept in the NSDR, as community resilience and empowerment are its stated goals. While research so far has focused on responsibility-sharing between different levels of the government and on the role of the individual, we focus on the much more problematic community. Communities can be place-based (as in a specific locality or region); or interest-based (a group of people within society sharing common characteristics such as ethnicity, religion, recreation or industry); or a combination of these. In disaster resilience the starting point for consideration is a community of place, within which lie multiple, diverse, competing and overlapping communities of interest. In this study, we break down a hypothetical place-based community into its component parts (households, businesses, government and various types of community organisations) to examine the responsibilities that are (or conceivably might be) placed on them by the NSDR and associated policies. We identify what types of policy instruments (regulation, price signals, moral suasion) are used to ensure, or at least promote compliance and cooperation with identified responsibilities. We then discuss what these policy instruments mean for the achievement of community resilience

Extension of the Relational Algebra to Probabilistic Complex Values

We present a probabilistic data model for complex values

A Data Model and Algebra for Probabilistic Complex Values

We present a probabilistic data model for complex values. More precisely, we introduce probabilistic complex value relations, which combine the concept of probabilistic relations with the idea of complex values in a uniform framework. We elaborate a modeltheoretic definition of probabilistic combination strategies, which has a rigorous foundation on probability theory. We then define an algebra for querying database instances, which comprises the operations of selection, projection, renaming, join, Cartesian product, union, intersection, and difference. We prove that our data model and algebra for probabilistic complex values generalizes the classical relational data model and algebra. Moreover, we show that under certain assumptions, all our algebraic operations are tractable. We finally show that most of the query equivalences of classical relational algebra carry over to our algebra on probabilistic complex value relations. Hence, query optimization techniques for classical relational algebra can easily be applied to optimize queries on probabilistic complex value relations. Keywords: Complex value databases, probabilistic databases, data model, relational algebra, query languages. AMS Subject classification: Primary 68P15, 68P20; Secondary 68T30, 68T37 1

Shared responsibility: the who, what and how

As natural disasters increase around the world and stretch the capacities of emergency services, national governments and international institutions have stressed the importance of shared responsibility; the idea that all actors within a society have some obligations in disaster management and must work collectively to reduce disaster risk. However, the exact balance between individual and government responsibility is not yet established and continually contested, especially after major events. In Australia, the National Strategy for Disaster Resilience (NSDR) is the overarching policy framework for disaster risk management and aims to create resilient communities through an emphasis on shared responsibility and empowerment. Through a literature review and document analysis of the NSDR and associated policy documents, we clarify, organise and operationalise the necessarily general policy goal of shared responsibility. We first analyse how the NSDR conceptualises communities to discover which community actors are mentioned. We then identify the responsibilities it prescribes or implies for these different actors and consider the types of policy instruments that are relevant to disaster risk management. Our analysis reveals a tension between the NSDR’s placement of government at the centre of disaster risk management, and its other, less well-explained emphasis on community empowermentThe authors acknowledge the support of the Commonwealth of Australia through the Bushfire and Natural Hazards Cooperative Research Centre that funded this research

: Suicide in bipolar disorders

International audienceBellivier F, Yon L, Luquiens A, Azorin J-M, Bertsch J, Gerard S, Reed C, Lukasiewicz M. Suicidal attempts in bipolar disorder: results from an observational study (EMBLEM). Bipolar Disord 2011: 13: 377-386. © 2011 The Authors. Journal compilation © 2011 John Wiley & Sons A/S. Objectives:  To compare patients with and without a history of suicidal attempts in a large cohort of patients with bipolar disorder and to identify variables that are associated with suicidal behavior. Methods:  European Mania in Bipolar Longitudinal Evaluation of Medication (EMBLEM) is a two-year, prospective, observational study that enrolled 3,684 adult patients with bipolar disorder and initiated or changed oral treatment for an acute manic/mixed episode. Of those, 2,416 patients were eligible for the two-year follow-up. Only baseline characteristics were studied in the present study, included sociodemographic data, psychiatric history and comorbidities, history of suicide attempts, history of substance use problems, compliance with treatment, inpatient admissions, and functional status. Symptom severity was assessed using the Clinical Global Impression-Bipolar Disorder (CGI-BP) scale, the Young Mania Rating Scale (YMRS), and the 5-item Hamilton Depression Rating Scale (HAMD-5). A logistic regression model identified baseline variables independently associated with a history of suicidal behavior. Results:  Of the 2,219 patients who provided data on their lifetime history of suicide attempts, 663 (29.9%) had a history of suicidal behavior (at least one attempt). Baseline factors associated with a history of suicidal behavior included female gender, a history of alcohol abuse, a history of substance abuse, young age at first treatment for a mood episode, longer disease duration, greater depressive symptom severity (HAMD-5 total score), current benzodiazepine use, higher overall symptom severity (CGI-BP: mania and overall score), and poor compliance. Conclusions:  These factors may be considered as potential characteristics to identify subjects at risk for suicidal behavior throughout the course of bipolar disorder