Aim: The study investigates patterns of cocaine powder and crack cocaine use of different groups in nine European cities. Design, Setting, Participants: Multi-centre cross-sectional study conducted in Barcelona, Budapest, Dublin, Hamburg, London, Paris, Rome, Vienna, and Zurich. Data were collected by structured face-to-face interviews. The sample comprises 1,855 cocaine users out of three subgroups: 632 cocaine users in addiction treatment, mainly maintenance treatment; 615 socially marginalized cocaine users not in treatment, and 608 socially integrated cocaine users not in treatment. Measurements: Use of cocaine powder, crack cocaine and other substances in the last 30 days, routes of administration, and lifetime use of cocaine powder and crack cocaine. Findings: The marginalized group showed the highest intensity of cocaine use, the highest intensity of heroin use and of multiple substance use. 95% of the integrated group snorted cocaine powder, while in the two other groups, injecting was quite prevalent, but with huge differences between the cities. 96% of all participants had used at least one other substance in addition to cocaine in the last 30 days. Conclusions: The use of cocaine powder and crack cocaine varies widely between different groups and between cities. Nonetheless, multiple substance use is the predominating pattern of cocaine use, and the different routes of administration have to be taken into account.
Understanding the differences between contrasting groups is a fundamental task in data analysis. This realization has led to the development of a new special purpose data mining technique, contrast-set mining. We undertook a study with a retail collaborator to compare contrast-set mining with existing rule-discovery techniques. To our surprise we observed that straightforward application of an existing commercial rule-discovery system, Magnum Opus, could successfully perform the contrast-set-mining task. This led to the realization that contrast-set mining is a special case of the more general rule-discovery task. We present the results of our study together with a proof of this conclusion.
This article explores how proponents of a public health model of alcohol policy have, for more than a quarter of a century, argued consistently but unsuccessfully for an integrated national alcohol policy in the Republic of Ireland. It looks in particular at the past decade, a time when increases in alcohol consumption and related problems strengthened the case for such an integrated policy, and when managerial innovations in the sphere of cross-cutting management appeared to provide a template for its implementation. A number of explanations are offered for the refusal of successive governments to respond to what its advocates see as the only rational, evidence-based approach to the prevention of alcohol problems. It is argued that, unlike the Nordic countries, the political culture of independent Ireland has never been one in which the state could unilaterally impose strict alcohol control policies as a feature of its broader vision of the welfare state. It is also argued that during the recent period of economic prosperity (the so-called 'Celtic Tiger' era) the country was characterised by a neo-liberal policy climate, which was specifically antipathetic to the idea that the state should interfere directly in the alcohol market with a view to preventing related problems. It is suggested that the social partnership model of governance, to which many people attributed the country's economic success, created an atmosphere of consensualism within which the state as mediator between the two main protagonists (the public health lobby and the drinks industry) was unwilling to challenge the drinks industry. It is also concluded that this failure to create a national alcohol policy based on public health principles demonstrates the limitations of the cross-cutting, or 'joined-up', approach to public management in those areas of social policy characterised by clashing value systems or fundamental conflicts of economic interest. Finally, it is acknowledged that in Ireland, as elsewhere, neo-liberal certitudes have been effectively dethroned by the economic recession and banking crisis of late 2008; whether these more straitened economic circumstances will provide a better fit for the 'nanny state' ideals of the public health perspective on alcohol remains to be seen.
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