Changing patterns of first injection across key periods of the French Harm Reduction Policy: PrimInject, a cross sectional analysis

Background: Monitoring of emerging modes of drug consumption in France has identified new patterns of injection among youths with diverse social backgrounds, which may explain the persistence of high rates of hepatitis C virus infection. The circumstances surrounding the first injection have been poorly documented in the group of heavy drug users and in the context of the French opioid substitution treatment (OST) policy that provides expanded access to high-dosage buprenorphine (BHD). Methods: An Internet survey (Priminject) was conducted from October 2010 to March 2011 with French drug users. Four time periods were compared based on critical dates throughout the implementation of the Harm Reduction Policy in France. Results: Compared with drug users who injected for the first time prior to 1995, the aspects of drug use for users who recently injected for the first time were as follows: (1) experimentation with miscellaneous drugs before the first injection; (2) an older age at the time of first injection; (3) heroin as the drug of choice for an individual’s first injection, notwithstanding the increased usage of stimulant drugs; (4) BHD did not appear to be a pathway to injection; and (5) an increased number of users who injected their first time alone, without the help or presence of another individual. Conclusion: The PrimInject study showed that there is a group of injection drug users that is larger than the group of injection drug users observed in previous studies; therefore, it is necessary to diversify programs to reach the entire spectrum of high-risk users.

Energy efficiency and greenhouse gas emissions of different supply chains: a comparison of French, UK and Belgian cases

Freight transportation system is critical to economic activity but it carries significant environmental costs, notably GHG emissions and climate change : energy use and corresponding CO2 emissions is increasing faster in freight transport than in other sectors and this increase is primarily the result of increased trade. This paper compares the transport activities, associated energy consumption and CO2 emissions of different supply chains for a range of products in three countries: Belgium, France and United Kingdom. Among the products considered are furniture and ‘fruits & vegetables’. For each of these products, different supply chains, involving more or less transport activity and associated energy consumption are analysed in each country. The comparison highlights some of the main factors that influence GHG emissions for different supply chains and illustrates how they vary according to product and country of final distribution. In more detail, the paper addresses the main differences between the supply chains of these products namely, the origin of their sourcing, the logistical organisation between production and retail and different types of retail outlet. The origin of the sourcing impact is mainly related to distance. The impact of the logistical organisation between raw material and retail on GHG emissions is linked to the mode and vehicle choice and to the load factor. As for retail, the consumer trip emissions, between his home and the retail outlet, are also an important part of the whole supply chain emissions. It is worthwhile to notice that our goal in this project is to consider the whole supply chain, from production to consumption. Therefore a particular focus is put on the mobility behaviours of consumers purchasing the studied products during their shopping and dropping back home activities related to these products. Especially a web based survey has been conducted and the gathered results offer an opportunity for drawing a more detailed picture of the associated CO2 emissions. This paper uses the results of an ongoing research on supply chain energy efficiency, funded by ADEME (the French Energy Agency) through the French program on transport research (PREDIT). This research is based on a comprehensive review of the various approaches to quantifying the environmental impacts of supply chains together with data collection from a range of organisations including manufacturers, retailers and transport companies. We will first present the developed methodologies, then the results corresponding to each studied product will be described. A discussion of the potential application of the research approach to the wider debate about the environmental impact of freight transport and the scope for GHG emissions reduction targets to be achieved will be included.

Energy efficiency and greenhouse gas emissions of different supply chains: a comparison of French, UK and Belgian cases

Freight transportation system is critical to economic activity but it carries significant environmental costs, notably GHG emissions and climate change : energy use and corresponding CO2 emissions is increasing faster in freight transport than in other sectors and this increase is primarily the result of increased trade. This paper compares the transport activities, associated energy consumption and CO2 emissions of different supply chains for a range of products in three countries: Belgium, France and United Kingdom. Among the products considered are furniture and fruits & vegetables. For each of these products, different supply chains, involving more or less transport activity and associated energy consumption are analysed in each country. The comparison highlights some of the main factors that influence GHG emissions for different supply chains and illustrates how they vary according to product and country of final distribution. In more detail, the paper addresses the main differences between the supply chains of these products namely, the origin of their sourcing, the logistical organisation between production and retail and different types of retail outlet. The origin of the sourcing impact is mainly related to distance. The impact of the logistical organisation between raw material and retail on GHG emissions is linked to the mode and vehicle choice and to the load factor. As for retail, the consumer trip emissions, between his home and the retail outlet, are also an important part of the whole supply chain emissions. It is worthwhile to notice that our goal in this project is to consider the whole supply chain, from production to consumption. Therefore a particular focus is put on the mobility behaviours of consumers purchasing the studied products during their shopping and dropping back home activities related to these products. Especially a web based survey has been conducted and the gathered results offer an opportunity for drawing a more detailed picture of the associated CO2 emissions. This paper uses the results of an ongoing research on supply chain energy efficiency, funded by ADEME (the French Energy Agency) through the French program on transport research (PREDIT). This research is based on a comprehensive review of the various approaches to quantifying the environmental impacts of supply chains together with data collection from a range of organisations including manufacturers, retailers and transport companies. We will first present the developed methodologies, then the results corresponding to each studied product will be described. A discussion of the potential application of the research approach to the wider debate about the environmental impact of freight transport and the scope for GHG emissions reduction targets to be achieved will be included.

A Migrant Culture on Display: The French Migrant and French Gastronomy in London (19th – 21st centuries)

The large contemporary French migrant population – estimated by the French Consulate at around 300,000–400,000 in the UK, the majority living in London and the South-East – remains ‘absent’ from studies on migration, and, in a study of migrant food history in Britain, is considered not to have left traces as a migrant community. Over the centuries, the presence of various French communities in London has varied significantly as far as numbers are concerned, but what does not change is their simultaneous ‘visibility’ and ‘invisibility’ in accounts of the history of the capital: even when relatively ‘visible’ at certain historical moments, they still often remain hidden in its histories. At times the French in London are described as a ‘sober, well-behaved […] and law-abiding community’; at other times they ‘appeared as a foreign body in the city’. This article reflects on the dynamics at play between a migrant culture associated with high cultural capital (so much so that is often emulated by those who are not French) and the host culture perception of and relationship to it, in order to consider what this may ‘mean’ for the French (and Francophone) migrant experience. French gastronomy and culinary knowledge is taken as an example of material culture and of cultural capital ‘on display’ specifically in the activity of dining out, especially in French restaurants, or in those influenced by French gastronomy. The social activity of dining out is replete with displays of knowledge (linguistic, culinary), of cultural literacy, of modes of behaviour, of public identity, and of rituals strictly codified in both migrant and host cultures. Dining out is also an emotional and politically-charged activity, fraught with feelings of suspicion (what is in the food? what does the chef get up to in the kitchen?) and of anxieties and tensions concerning status, class and gender distinctions. This article considers the ways in which the migrant French citizen of London may be considered as occupying an ambiguous position at different times in history, simultaneously possessing cultural capital and needing to negotiate complex cultural encounters in the connections between identity and the symbolic status of food in food production, food purveying and food consumption.

Orientalism and Imperialism in French West Africa. Considerations on travel literature, colonial tourism, and the desert as a “commodity” in Mauritania

In this article we intend to make a summary overview of the influence that literary production, originated under colonial mapping missions or later in travel writing, had in the construction and establishment of a discourse to advertise and promote tourism in Mauritania. To this end we will draw on travel narratives that are illustrative of different periods and that correspond in some way to discourses of otherness. In this specific case, such discourses relate to the “Moors” of the West African coast and were produced in various historical contexts. We will also consider the discourse present in the tourism promotion materials of the colonial period and we will demonstrate to what extent it can be engaged in a dialogue with 19th and 20th centuries’ Western colonial literature.

Validity, reliability and responsiveness of the French language translation of the Western Ontario Shoulder Instability Index (WOSI).

BACKGROUND: The WOSI (Western Ontario Shoulder Instability Index) is a self-administered quality of life questionnaire designed to be used as a primary outcome measure in clinical trials on shoulder instability, as well as to measure the effect of an intervention on any particular patient. It is validated and is reliable and sensitive. As it is designed to measure subjective outcome, it is important that translation should be methodologically rigorous, as it is subject to both linguistic and cultural interpretation. OBJECTIVE: To produce a French language version of the WOSI that is culturally adapted to both European and North American French-speaking populations. MATERIALS AND METHODS: A validated protocol was used to create a French language WOSI questionnaire (WOSI-Fr) that would be culturally acceptable for both European and North American French-speaking populations. Reliability and responsiveness analyses were carried out, and the WOSI-Fr was compared to the F-QuickDASH-D/S (Disability of the Arm, Shoulder and Hand-French translation), and Walch-Duplay scores. RESULTS: A French language version of the WOSI (WOSI-Fr) was accepted by a multinational committee. The WOSI-Fr was then validated using a total of 144 native French-speaking subjects from Canada and Switzerland. Comparison of results on two WOSI-Fr questionnaires completed at a mean interval of 16 days showed that the WOSI-Fr had strong reliability, with a Pearson and interclass correlation of r=0.85 (P=0.01) and ICC=0.84 [95% CI=0.78-0.88]. Responsiveness, at a mean 378.9 days after surgical intervention, showed strong correlation with that of the F-QuickDASH-D/S, with r=0.67 (P<0.01). Moreover, a standardized response means analysis to calculate effect size for both the WOSI-Fr and the F-QuickDASH-D/S showed that the WOSI-Fr had a significantly greater ability to detect change (SRM 1.55 versus 0.87 for the WOSI-Fr and F-QuickDASH-D/S respectively, P<0.01). The WOSI-Fr showed fair correlation with the Walch-Duplay. DISCUSSION: A French-language translation of the WOSI questionnaire was created and validated for use in both Canadian and Swiss French-speaking populations. This questionnaire will facilitate outcome assessment in French-speaking settings, collaboration in multinational studies and comparison between studies performed in different countries. TYPE OF STUDY: Multicenter cohort study. LEVEL OF EVIDENCE: II.

Substance use among sportive adolescents in the French-speaking part of Switzerland

[Contents] Introduction. Objectives. Methodology. Results. Characteristics of the sample. Substance use (Psychoactive substances, Performance-enhancing substances). Profile of sportive adolescents using substances. Mixed substance use. Other factors related to substance use. Inactivity. Conclusions. References. Annexes. Annex 1. Questionnaire. Annex 2. Sample weighting procedure. Annex 3. Sports type.

Primary localized rectal/pararectal gastrointestinal stromal tumors: results of surgical and multimodal therapy from the French Sarcoma group.

BACKGROUND: Rectal and pararectal gastrointestinal stromal tumors (GISTs) are rare. The optimal management strategy for primary localized GISTs remains poorly defined. METHODS: We conducted a retrospective analysis of 41 patients with localized rectal or pararectal GISTs treated between 1991 and 2011 in 13 French Sarcoma Group centers. RESULTS: Of 12 patients who received preoperative imatinib therapy for a median duration of 7 (2-12) months, 8 experienced a partial response, 3 had stable disease, and 1 had a complete response. Thirty and 11 patients underwent function-sparing conservative surgery and abdominoperineal resection, respectively. Tumor resections were mostly R0 and R1 in 35 patients. Tumor rupture occurred in 12 patients. Eleven patients received postoperative imatinib with a median follow-up of 59 (2.4-186) months. The median time to disease relapse was 36 (9.8-62) months. The 5-year overall survival rate was 86.5%. Twenty patients developed local recurrence after surgery alone, two developed recurrence after resection combined with preoperative and/or postoperative imatinib, and eight developed metastases. In univariate analysis, the mitotic index (≤5) and tumor size (≤5 cm) were associated with a significantly decreased risk of local relapse. Perioperative imatinib was associated with a significantly reduced risk of overall relapse and local relapse. CONCLUSIONS: Perioperative imatinib therapy was associated with improved disease-free survival. Preoperative imatinib was effective. Tumor shrinkage has a clear benefit for local excision in terms of feasibility and function preservation. Given the complexity of rectal GISTs, referral of patients with this rare disease to expert centers to undergo a multidisciplinary approach is recommended.

Validation de la version française du questionnaire I7 d'impulsivité. Influence de la personnalité, du sexe et de la religion = Validation of the french version of the eysenck's impulsiveness questionnaire (I7). Influence of personality, gender, and religion

L'objectif de cette étude est de vérifier la validité interne de la version française du questionnaire d'impulsivité d'Eysenck (I7), traduite par Dupont et al., sur un échantillon d'étudiants suisses (n = 220). Dans leur questionnaire, Eysenck et Eysenck proposent trois échelles : les deux premières évaluant deux composantes distinctes de l'impulsivité (l'Impulsivité caractérisant les individus qui agissent sans penser, sans être conscients des risques associés à leurs actions, et la Recherche d'aventure caractérisant les individus qui agissent en étant conscients, et en tenant compte des risques associés à leurs actions), et la troisième servant de « distracteur » (l'Empathie caractérisant les individus qui ont la faculté de s'identifier à l'autre). La structure à trois facteurs de l'instrument a été confirmée par notre analyse factorielle en composantes principales. La solution factorielle retenue n'explique toutefois qu'une faible proportion de la variance (21.9 %). L'homogénéité interne des échelles, mesurée à l'aide d'alphas de Cronbach, est acceptable pour l'échelle d'Impulsivité (.78) et de Recherche d'aventure (.71), mais elle est, en revanche, faible pour l'échelle d'Empathie (.62). Les échelles de l'I7 d'Eysenck entretiennent des corrélations cohérentes avec les cinq grandes dimensions de la personnalité mesurées par le NEO PI-R. L'Impulsivité est associée négativement à la dimension Conscience (r = - .32), alors que la Recherche d'aventures est associée positivement à la dimension Extraversion (r = .33). Le sexe a un impact sur les échelles Recherche d'aventure et Empathie. Les qualités métrologiques de la version française du questionnaire d'impulsivité d'Eysenck (I7) sont satisfaisantes, mais l'estimation d'autres indices de validité, comme la fidélité test-retest et la validité convergente, devrait être réalisée.

Neo/adjuvant chemotherapy does not improve outcome in resected primary synovial sarcoma: a study of the French Sarcoma Group.

BACKGROUND: There are only scarce data about the benefit of adjunctive chemotherapy in patients with localized synovial sarcoma (SS). PATIENTS AND METHODS: Data from 237 SS patients recorded in the database of the French Sarcoma Group were retrospectively analyzed. The respective impact of radiotherapy, neo-adjuvant chemotherapy and adjuvant chemotherapy on overall survival (OS), local recurrence-free survival (LRFS) and distant recurrence-free survival (DRFS) were assessed after adjustment to prognostic factors. RESULTS: The median follow-up was 58 months (range 1-321). Adjuvant, neo-adjuvant chemotherapy and postoperative radiotherapy were administered in 112, 45 and 181 cases, respectively. In all, 59% of patients treated with chemotherapy received an ifosfamide-containing regimen. The 5-year OS, LRFS and DRFS rates were 64.0%, 70% and 57%, respectively. On multivariate analysis, age >35 years old, grade 3 and not-R0 margins were highly significant independent predictors of worse OS. After adjustment to prognostic factors, radiotherapy significantly improved LRFS but not DRFS or OS. Neither neo-adjuvant nor adjuvant chemotherapy had significant impact on OS, LRFS or DRFS. CONCLUSION: As for other high-grade soft-tissue sarcomas, well-planned wide surgical excision with adjuvant radiotherapy remains the cornerstone of treatment for SS. Neo-adjuvant or adjuvant chemotherapy should not be delivered outside a clinical trial setting.