Représentations sociales de la dangerosité psychiatrique chez les intervenants en santé mentale : une anthropologie du risque

Le présent mémoire porte sur les représentations sociales de la dangerosité en psychiatrie chez les intervenants de proximité (infirmières, préposés, et agent de sécurité), d’un milieu de soins psychiatriques. Nous cherchons à explorer comment ces intervenants perçoivent et interprètent les risques inhérents à leur métier et comment ils y réagissent en situation d’incertitude. Les concepts de dangerosité, d’ « individu dangereux » et de risque en psychiatrie sont abordés dans le présent mémoire, à travers un angle historique, social et anthropologique, suivant les lectures de Michel Foucault; de Robert Castel; de Ian Hacking; et de Mary Douglas. De l’observation participante dans une unité de soins psychiatriques aigus et des entrevues semi-structurées ont été réalisées auprès d’une dizaine d’intervenants en santé mentale. Une approche ethnographique et interprétative nous a permis de dégager les principales récurrences, divergences et contradictions intra et inter intervenants sur la question de la dangerosité et du risque en psychiatrie. Les résultats sont séparés en fonction de trois grands thèmes : 1) représentations sociales de la dangerosité 2) perceptions du risque au travail 3) réactions face au risque perçu. L’analyse de nos résultats montre que les connaissances qu’ont les intervenants sur la dangerosité ne se limitent pas à celles produites par le savoir expert, elles s’ouvrent aussi sur leur propre réalité clinique. De plus, contrairement aux prédictions du savoir expert, la différence observée entre les pratiques de contrôle des intervenants n’est pas la conséquence d’une surestimation du risque ni d’un manque d’information « objective » sur les facteurs de risque du comportement agressif, mais s’explique davantage en fonction de la présence ou de l’absence d’un lien thérapeutique et du degré de reconnaissance sociale dans les interactions entre les soignants et les soignés. Les éléments qui renforcent ou limitent l’établissement d’un lien de confiance sont explicités dans le présent mémoire.

Elemental analysis of New Zealand Nephrite Jade (pounamu) for forensic purposes

Pounamu (NZ jade), or nephrite, is a protected mineral in its natural form following the transfer of ownership back to Ngai Tahu under the Ngai Tahu (Pounamu Vesting) Act 1997. Any theft of nephrite is prosecutable under the Crimes Act 1961. Scientific evidence is essential in cases where origin is disputed. A robust method for discrimination of this material through the use of elemental analysis and compositional data analysis is required. Initial studies have characterised the variability within a given nephrite source. This has included investigation of both in situ outcrops and alluvial material. Methods for the discrimination of two geographically close nephrite sources are being developed. Key Words: forensic, jade, nephrite, laser ablation, inductively coupled plasma mass spectrometry, multivariate analysis, elemental analysis, compositional data analysis

Innovative practices in Psychiatry. Argentina, 1960-1970

The paper analyzes innovative psychiatric practices that took place in Argentina during the sixties and seventies at the Hospital Jose Esteves in the province of Buenos Aires. Objective: To present the coexistence of different paradigms related to mental health in the same institution and to analyze the complexities generated by this scenario. Methodology: This study uses primary sources in the form of medical records of patients admitted to the hospital between 1960 and 1979. The medical records were cross-referenced with publications of newspapers and magazines of the time. Results: The analysis shows that the political environment during the era of militarydictatorship —characterized by ideological persecution and the inhibition of political expression— influenced the development of innovative psychiatric practices. At the same time, instances ofanti-Semitism and ideological persecution among health workers affected therapeutic approaches. Conclusions: While the introduction of innovative practices in mental health led to someresistance among the more orthodox psychiatrists, the presence of different paradigms shows a plan, both political and professional, to transform psychiatry and admission policy in Argentina.

Polimorfismos del gen Butirilcolinesterasa responsables de reacciones adversas en pacientes consumidores de “cocaína”

La butirilcolinesterasa humana (BChE; EC 3.1.1.8) es una enzima polimórfica sintetizada en el hígado y en el tejido adiposo, ampliamente distribuida en el organismo y encargada de hidrolizar algunos ésteres de colina como la procaína, ésteres alifáticos como el ácido acetilsalicílico, fármacos como la metilprednisolona, el mivacurium y la succinilcolina y drogas de uso y/o abuso como la heroína y la cocaína. Es codificada por el gen BCHE (OMIM 177400), habiéndose identificado más de 100 variantes, algunas no estudiadas plenamente, además de la forma más frecuente, llamada usual o silvestre. Diferentes polimorfismos del gen BCHE se han relacionado con la síntesis de enzimas con niveles variados de actividad catalítica. Las bases moleculares de algunas de esas variantes genéticas han sido reportadas, entre las que se encuentra las variantes Atípica (A), fluoruro-resistente del tipo 1 y 2 (F-1 y F-2), silente (S), Kalow (K), James (J) y Hammersmith (H). En este estudio, en un grupo de pacientes se aplicó el instrumento validado Lifetime Severity Index for Cocaine Use Disorder (LSI-C) para evaluar la gravedad del consumo de “cocaína” a lo largo de la vida. Además, se determinaron Polimorfismos de Nucleótido Simple (SNPs) en el gen BCHE conocidos como responsables de reacciones adversas en pacientes consumidores de “cocaína” mediante secuenciación del gen y se predijo el efecto delos SNPs sobre la función y la estructura de la proteína, mediante el uso de herramientas bio-informáticas. El instrumento LSI-C ofreció resultados en cuatro dimensiones: consumo a lo largo de la vida, consumo reciente, dependencia psicológica e intento de abandono del consumo. Los estudios de análisis molecular permitieron observar dos SNPs codificantes (cSNPs) no sinónimos en el 27.3% de la muestra, c.293A>G (p.Asp98Gly) y c.1699G>A (p.Ala567Thr), localizados en los exones 2 y 4, que corresponden, desde el punto de vista funcional, a la variante Atípica (A) [dbSNP: rs1799807] y a la variante Kalow (K) [dbSNP: rs1803274] de la enzima BChE, respectivamente. Los estudios de predicción In silico establecieron para el SNP p.Asp98Gly un carácter patogénico, mientras que para el SNP p.Ala567Thr, mostraron un comportamiento neutro. El análisis de los resultados permite proponer la existencia de una relación entre polimorfismos o variantes genéticas responsables de una baja actividad catalítica y/o baja concentración plasmática de la enzima BChE y algunas de las reacciones adversas ocurridas en pacientes consumidores de cocaína.

Forensic acarology: an introduction

Mites can be found in all imaginable terrestrial habitats, in freshwater, and in salt water. Mites can be found in our houses and furnishings, on our clothes, and even in the pores of our skin-almost every single person carries mites. Most of the time, we are unaware of them because they are small and easily overlooked, and-most of the time-they do not cause trouble. In fact, they may even proof useful, for instance in forensics. The first arthropod scavengers colonising a dead body will be flies with phoretic mites. The flies will complete their life cycle in and around the corpse, while the mites may feed on the immature stages of the flies. The mites will reproduce much faster than their carriers, offering themselves as valuable timeline markers. There are environments where insects are absent or rare or the environmental conditions impede their access to the corpse. Here, mites that are already present and mites that arrive walking, through air currents or material transfer become important. At the end of the ninetieth century, the work of Jean Pierre M,gnin became the starting point of forensic acarology. M,gnin documented his observations in 'La Faune des Cadavres' [The Fauna of Carcasses]. He was the first to list eight distinct waves of arthropods colonising human carcasses. The first wave included flies and mites, the sixth wave was composed of mites exclusively. The scope of forensic acarology goes further than mites as indicators of time of death. Mites are micro-habitat specific and might provide evidential data on movement or relocation of bodies, or locating a suspect at the scene of a crime. Because of their high diversity, wide occurrence, and abundance, mites may be of great value in the analysis of trace evidence.

A two-locus forensic match probability for subdivided populations

A two-locus match probability is presented that incorporates the effects of within-subpopulation inbreeding (consanguinity) in addition to population subdivision. The usual practice of calculating multi-locus match probabilities as the product of single-locus probabilities assumes independence between loci. There are a number of population genetics phenomena that can violate this assumption: in addition to consanguinity, which increases homozygosity at all loci simultaneously, gametic disequilibrium will introduce dependence into DNA profiles. However, in forensics the latter problem is usually addressed in part by the careful choice of unlinked loci. Hence, as is conventional, we assume gametic equilibrium here, and focus instead on between-locus dependence due to consanguinity. The resulting match probability formulae are an extension of existing methods in the literature, and are shown to be more conservative than these methods in the case of double homozygote matches. For two-locus profiles involving one or more heterozygous genotypes, results are similar to, or smaller than, the existing approaches.

Implications for DNA identification arising from an analysis of Australian forensic databases

Previous analyses of Australian samples have suggested that populations of the same broad racial group (Caucasian, Asian, Aboriginal) tend to be genetically similar across states. This suggests that a single national Australian database for each such group may be feasible, which would greatly facilitate casework. We have investigated samples drawn from each of these groups in different Australian states, and have quantified the genetic homogeneity across states within each racial group in terms of the "coancestry coefficient" F(ST). In accord with earlier results, we find that F(ST) values, as estimated from these data, are very small for Caucasians and Asians, usually <0.5%. We find that "declared" Aborigines (which includes many with partly Aboriginal genetic heritage) are also genetically similar across states, although they display some differentiation from a "pure" Aboriginal population (almost entirely of Aboriginal genetic heritage).