The language of post-apartheid urban development: the semiotic landscape of Marshalltown in Johannesburg

A dissertation submitted to the School of Language, Literature and Media, Faculty of Humanities for the degree of Doctor of Philosophy, March 2017Although the burgeoning fields of linguistic and semiotic landscapes (LL and SL) studies provide extensive coverage of urban settings around the globe, it lacks a focus on urban development and the associated phenomenons such as gentrification, with the notable exception of Lou (2016). This dissertation looks at the neighbourhood of Marshalltown, located in the inner city of Johannesburg. Marshalltown is known as the mining district because of its proximity to the original goldmines that sparked the growth of the city. The neighbourhood’s SL has radically shifted from a place of urban decay to a trendy neighbourhood since the late 1990s, after urban development efforts financed by the private sector made the area stand out from the rest of the inner city. The developers working in Marshalltown have purposefully filled it with signs indexing the mining heritage its businesses which tend to cater to the middle-to-upper-classes, thus excluding poorer residents which make up most of the inner city’s population. Against this backdrop, the dissertation aims to answer the following three research questions: 1) How is Marshalltown constructed as a space of heritage, both in its materiality and in its representation in a corpus of media texts? 2) Considering that heritage entails a selection process from a more general historic field, which sections of history are curated in Marshalltown’s SL, which are silenced, and what are the implications for the narratives displayed in the context of post-apartheid South Africa? 3) How is Marshalltown’s urban environment experienced by social actors in a context of globalized trends in urban design which rely on heritage and authenticity to market formerly ignored city centres? The data for this study consists of a corpus of 25 media articles from various outlets, 255 photographs of Marshalltown and its vicinity, ethnographic field notes written between 2012 and 2016, as well as interviews with developers, heritage architect, a deputy director of immovable heritage at the City of Johannesburg, shop owners and people who work in the area. This dissertation aims to contribute to the young field of SL studies, while bringing forth Scollon and Scollon’s (2003) methodological toolkit of geosemiotic which allows for an analysis of signs in place and how people interact with them to draw a pertinent analysis of the construction of place. Geosemiotics is coupled with specific themes for each analytical chapter which brings forth a new way of analysing a SL. Those themes are 1) the language of urban development which drawing on Markus and Cameron (2002) helps analyse the representation of city neighbourhoods; 2) heritage, which brings a temporal perspective to SL studies that I call a chronoscape; 3) authenticity, which brings a visual analysis addition to the recent debate on the topic within sociolinguistics scholarship (Coupland 2003, Bucholtz 2003 and Eckert 2003) and its focus on the discursive construction of what counts as authentic. This study argues that Marshalltown’s post-apartheid SL is carefully designed by a majority of (white) developers wanting to give the area a heritage feel, borrowing from the mining history of the city; thus anchoring a European influenced heritage within their own interpretation of what an African city should look like. The heritage feel of Marshalltown is part of a broader plan to reclaim the city, which means changing the image it acquired previously during an era of urban decay as a dangerous no-go area, into an attractive tourism-friendly urban space. Those changes are achieved by inserting development efforts into the market for authentic urban lifestyle which Marshalltown can provide thanks to its preserved history. The neighbourhood stands out from the rest of the inner city by being privately controlled and maintained thus distancing itself from the popular discourse of inner city Johannesburg and instead developers redesign it as an ideal space for consumption.XL201

Influence du sexe sur la présentation clinique et la sévérité de la polyarthrite rhumatoïde

MONTPELLIER-BU Médecine (341722104) / SudocMONTPELLIER-BU Médecine UPM (341722108) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Towards an improved access to psychiatric rehabilitation: availability and effectiveness at 1-year follow-up of psychoeducation, cognitive remediation therapy, cognitive behaviour therapy and social skills training in the FondaMental Advanced Centers of Expertise-Schizophrenia (FACE-SZ) national cohort. Running title: Psychosocial therapies in schizophrenia PhD and the FACE-SZ (FondaMental Academic Centers of Expertise for Schizophrenia) group*

International audiencePsychosocial Interventions (PIs) have shown positive effects on clinical and functional outcomes of schizophrenia (SZ) in randomized controlled trials. However their effectiveness and accessibility remain unclear to date in “real world” schizophrenia. The objectives of the present study were (i) to assess the proportion of SZ outpatients who benefited from PIs between 2010 and 2015 in France after an Expert Center Intervention in a national multicentric non-selected community-dwelling sample; (ii) to assess PIs’ effectiveness at 1-year follow-up. 183 SZ outpatients were recruited from FondaMental Advanced Centers of Expertise for Schizophrenia cohort. Baseline and 1-year evaluations included sociodemographic data, current treatments, illness characteristics and standardized scales for clinical severity, adherence to treatment, quality of life, a large cognitive battery, and daily functioning assessment. Only 7 (3.8%) received a PI before the evaluation, and 64 (35%) have received at least one PI during the 1-year follow-up. Having had at least one PI during the follow-up has been associated in multivariate analyses with significantly higher improvement in positive and negative symptoms (respectively p =0.031; p = 0.011), mental flexibility (TMT B, p = 0.029; C-VF, p = 0.02) and global functioning (p =0.042). CBT and SST were associated with higher cognitive improvements, while CRT was associated with clinical improvement. These results have not been demonstrated before and suggest that the effect of each PI is larger than its initial target. The present study has confirmed the PIs’ effectiveness in a large sample of community-dwelling SZ outpatients at 1 year follow-up. Efforts to improve access to PI should be reinforced in public health policies

Mechanical ventilation in patients with cardiogenic pulmonary edema: a sub-analysis of the LUNG SAFE study

International audienceBackground: Patients with acute respiratory failure caused by cardiogenic pulmonary edema (CPE) may require mechanical ventilation that can cause further lung damage. Our aim was to determine the impact of ventilatory settings on CPE mortality. Methods: Patients from the LUNG SAFE cohort, a multicenter prospective cohort study of patients undergoing mechanical ventilation, were studied. Relationships between ventilatory parameters and outcomes (ICU discharge/ hospital mortality) were assessed using latent mixture analysis and a marginal structural model. Results: From 4499 patients, 391 meeting CPE criteria (median age 70 [interquartile range 59-78], 40% female) were included. ICU and hospital mortality were 34% and 40%, respectively. ICU survivors were younger (67 [57-77] vs 74 [64-80] years, p < 0.001) and had lower driving (12 [8-16] vs 15 [11-17] cmH 2 O, p < 0.001), plateau (20 [15-23] vs 22 [19-26] cmH 2 O, p < 0.001) and peak (21 [17-27] vs 26 [20-32] cmH 2 O, p < 0.001) pressures. Latent mixture analysis of patients receiving invasive mechanical ventilation on ICU day 1 revealed a subgroup ventilated with high pressures with lower probability of being discharged alive from the ICU (hazard ratio [HR] 0.79 [95% confidence interval 0.60-1.05], p = 0.103) and increased hospital mortality (HR 1.65 [1.16-2.36], p = 0.005). In a marginal structural model, driving pressures in the first week (HR 1.12 [1.06-1.18], p < 0.001) and tidal volume after day 7 (HR 0.69 [0.52-0.93], p = 0.015) were related to survival. Conclusions: Higher airway pressures in invasively ventilated patients with CPE are related to mortality. These patients may be exposed to an increased risk of ventilator-induced lung injury

Outcome of acute hypoxaemic respiratory failure: insights from the LUNG SAFE Study

Background: Current incidence and outcome of patients with acute hypoxaemic respiratory failure requiring mechanical ventilation in the intensive care unit (ICU) are unknown, especially for patients not meeting criteria for acute respiratory distress syndrome (ARDS). Methods: An international, multicentre, prospective cohort study of patients presenting with hypoxaemia early in the course of mechanical ventilation, conducted during four consecutive weeks in the winter of 2014 in 459 ICUs from 50 countries (LUNG SAFE). Patients were enrolled with arterial oxygen tension/inspiratory oxygen fraction ratio ≤300 mmHg, new pulmonary infiltrates and need for mechanical ventilation with a positive end-expiratory pressure of ≥5 cmH2O. ICU prevalence, causes of hypoxaemia, hospital survival and factors associated with hospital mortality were measured. Patients with unilateral versus bilateral opacities were compared. Findings: 12 906 critically ill patients received mechanical ventilation and 34.9% with hypoxaemia and new infiltrates were enrolled, separated into ARDS (69.0%), unilateral infiltrate (22.7%) and congestive heart failure (CHF; 8.2%). The global hospital mortality was 38.6%. CHF patients had a mortality comparable to ARDS (44.1% versus 40.4%). Patients with unilateral-infiltrate had lower unadjusted mortality, but similar adjusted mortality compared to those with ARDS. The number of quadrants on chest imaging was associated with an increased risk of death. There was no difference in mortality comparing patients with unilateral-infiltrate and ARDS with only two quadrants involved. Interpretation: More than one-third of patients receiving mechanical ventilation have hypoxaemia and new infiltrates with a hospital mortality of 38.6%. Survival is dependent on the degree of pulmonary involvement whether or not ARDS criteria are reached