Abstract: Die Totalrevision des Alkoholgesetzes befindet sich aktuell in parlamentarischer Beratung. Die Autoren sind überzeugt, dass diese ihr gesundheitspolitisches Ziel nur erreicht, wenn den vorgeschlagenen Liberalisierungsmassnahmen kohärente Präventionsmassnahmen zur Seite gestellt werden.

Abstract: Marijuana is the most widely used illicit drug, however its effects on cognitive functions underling safe driving remain mostly unexplored. Our goal was to evaluate the impact of cannabis on the driving ability of occasional smokers, by investigating changes in the brain network involved in a tracking task. The subject characteristics, the percentage of D9-Tetrahydrocannabinol in the joint, and the inhaled dose were in accordance with real-life conditions. Thirty-one male volunteers were enrolled in this study that includes clinical and toxicological aspects together with functional magnetic resonance imaging of the brain and measurements of psychomotor skills. The fMRI paradigm was based on a visuo-motor tracking task, alternating active tracking blocks with passive tracking viewing and rest condition. We show that cannabis smoking, even at low D9-Tetrahydrocannabinol blood concentrations, decreases psychomotor skills and alters the activity of the brain networks involved in cognition. The relative decrease of Blood Oxygen Level Dependent response (BOLD) after cannabis smoking in the anterior insula, dorsomedial thalamus, and striatum compared to placebo smoking suggests an alteration of the network involved in saliency detection. In addition, the decrease of BOLD response in the right superior parietal cortex and in the dorsolateral prefrontal cortex indicates the involvement of the Control Executive network known to operate once the saliencies are identified. Furthermore, cannabis increases activity in the rostral anterior cingulate cortex and ventromedial prefrontal cortices, suggesting an increase in self-oriented mental activity. Subjects are more attracted by intrapersonal stimuli (“self”) and fail to attend to task performance, leading to an insufficient allocation of task-orientedre sources and to sub-optimal performance. These effects correlate with the subjective feeling of confusion rather than with the blood level of D9-Tetrahydrocannabinol. These findings bolster the zero-tolerance policy adopted in several countries that prohibits the presence of any amount of drugs in blood while driving.

Abstract: Memory deficits lead to distortion when long recall periods are used to assess alcohol consumption. We used the recently developed Internet-based cell phone-optimised assessment technique (ICAT) to describe the drinkingpatterns of youngpeopleover the course of Thursday, Friday and Saturday evenings and to compare the amounts reported during the drinking sessions in question with those in the retrospective baseline assessment. Methods Using hyperlinks in text messages sent to their cell phones over five weeks, 183 young adults in French-speaking Switzerland completed a total of 8646 questionnaires at 8 pm, 9 pm, 10 pm, 11 pm, midnight and 11 am the next morning over 1441 evenings. Findings Participants consumed an average of three drinks on Thursday evenings, four on Friday evenings and five and a half on Saturday evenings. The multi-group and multi-level latent growth curves showed that while the difference was minimal at the beginning of the evening, consumption decreased over the course of the evening on Thursdays, remained about stable on Fridays and increased on Saturdays between both genders. The amounts indicated in the evening assessments were up to twice as high as those indicated retrospectively. Conclusions Using participants’ cell phones, ICAT appears to be a convenient method for collecting alcohol-related data throughout the evening. Due to the significant impact of eveningdrinkingpatterns on the total amount consumed and related consequences, it is important to prevent the average increase of drinking that is likely to occur on Saturday evenings among youngpeople.

Abstract: Cet article discute de la pertinence d’un modèle d’intervention basé sur une approche communautaire, c’est-àdire citoyenne autant que professionnelle, qui vise à développer une posture de questionnement face aux jeunes en situation de vulnérabilité. Il souligne les caractéristiques et les risques du modèle et l’illustre par des exemples d’application en Valais