De l’incertitude de la naissance au risque obstetrical : les enjeux d’une définition

La réforme de la périnatalité française, mise en place à la fin des années 1990, repose sur une catégorisation du risque obstétrical (bas, moyen, haut). Selon le niveau de risque estimé, la femme enceinte doit être adressée à une maternité de niveau I, II ou III. À partir d’une enquête effectuée par des observations et des entretiens auprès d’obstétriciens et de sages-femmes, il s’agit, dans cet article, de montrer que la définition de ces catégories du risque est en elle-même un enjeu. En effet, leur contestation ou leur acceptation traduisent deux conceptions sensiblement différentes : l’une induit une accentuation de l’hypermédicalisation de l’accouchement, l’autre tend vers la « dé-technicisation » de la naissance et l’ouverture de Maisons de Naissance, encore à l’état de projet en France.The reform of perinatal care in France, implanted in the late ’90s, is based on a classification of obstetrical risk (low, medium, high). According to her estimated risk level, the pregnant woman will be referred to a I, II or III-level maternity unit. Based on a survey carried out by means of observations and interviews with obstetricians and midwives, the paper sets out to show that the definition of these risk categories is an issue in itself. Indeed, the contestation or acceptance of this classification reveals two very different concepts : the first introduces an accentuation of the hypermedicalization of delivery, the second tends towards its « de-technicalizing » and the opening of Birthing Homes, still at the project stage in France.La reforma de la perinatalidad francesa establecida a finales de los años 90, se basa en una clasificación del riesgo obstétrico (bajo, medio, alto). Según el nivel de riesgo considerado, la mujer embarazada debe ser dirigida a una maternidad de nivel I, II o III. A partir de una investigación efectuada por observaciones y conversaciones acerca de obstetras y comadronas, se trata, en este artículo, de poner de manifiesto que la definición de estas categorías del riesgo es en sí mismo lo que está en juego. En efecto, su conflicto o su aceptación traducen dos concepciones sensiblemente diferentes : una induce un énfasis a dar muchos medicamentos en el momento del parto, y la otra tiende hacia « destecnificar »el nacimiento y la apertura de Casas de Nacimiento, aún, en Francia, en proyecto

Electroretinography and circadian rhythm in Lycosa tarentula (Araneae, Lycosidae)

Electroretinography reveals the existence of a well marked circadian rhythm. Anterior eyes have a high nocturnal sensitivity, whereas posterior eyes have a high diurnal sensitivit

The Punto Cubano as Cultural Practice. Keys to Understanding in the Western Region of Cuba

The Punto cubano is a musical genre from Cuba, declared Intangible Heritage of Humanity by UNESCO in 2017. Over the past century, numerous investigations have focused on its musical characteristics itself, leaving aside its dimension as a cultural practice, which has led to various preservation and transmission processes. This article proposes precisely its assessment as a cultural practice, based on the importance and role that various artistic expressions have within this musical genre and the community character of their parties. It takes as a reference the previous work El punto cubano en Mayabeque. Tendencias de desarrollo (2013-2016) (Carricaburu, 2019), based on an analysis of studies on gender, addresses aspects of its relationship with the Cuban cultural identity and focuses its gaze on the proposal of validation of the cultural practice concept for this case, by analyzing the practices carried out in the western province of Mayabeque. In short, starting from an intense field research work and the comparative analysis of numerous peasant tunes recorded on the field, we propose to demonstrate the stable and continuous practice of the punto cubano in this province.El punto cubano es un género musical oriundo de Cuba, declarado por la UNESCO Patrimonio Inmaterial de la Humanidad en 2017. En el transcurso del pasado siglo, numerosas investigaciones han puesto el foco en sus características musicales propiamente, dejando a un lado su dimensión de práctica cultural, la cual ha propiciado diversos procesos de preservación y transmisión. Este artículo propone precisamente su valoración como práctica cultural, a partir de la importancia y el papel que diversas expresiones artísticas tienen dentro de este género musical y el carácter comunitario de sus fiestas. Toma como referencia el trabajo previo El punto cubano en Mayabeque. Tendencias de desarrollo (2013-2016) (Carricaburu, 2019). Partiendo de un análisis de los estudios sobre el género, aborda aspectos de su relación con la identidad cultural del cubano y centra su mirada en la propuesta de validación del concepto práctica cultural para este caso, mediante el análisis de las prácticas realizadas en la occidental provincia de Mayabeque. En definitiva, nos planteamos, a partir de un intenso trabajo de investigación de campo y el análisis comparativo de numerosas tonadas campesinas grabadas in situ, evidenciar la práctica estable y continuada del punto cubano en esta provincia

Un estudio situado sobre la enseñanza de la composición musical desde una perspectiva praxial

En el presente trabajo nos proponemos realizar un estudio situado sobre la enseñanza y el aprendizaje musical desde una perspectiva praxial tal como se presentan en el Nivel Superior de Collegium CEIM. Esto se hará en una primera instancia de forma general para luego profundizar en la enseñanza específica de la composición musical. Para dichos objetivos tomaremos como punto de partida el lema de la institución, el cual reza “Aprender música haciendo música”. A través de entrevistas, indagaremos en los significados que pueda haber tenido en el momento de la creación de dicho establecimiento educativo y en los significados dados por los actuales actores del mismo, es decir, el valor que tiene en la cultura institucional de Collegium CEIM.Fil: Carricaburu, Leo. Universidad Nacional de Córdoba. Facultad de Artes. Departamento Académico de Música; Argentina.Fil: Gentile, Mariano. Universidad Nacional de Córdoba. Facultad de Artes. Departamento Académico de Música; Argentina

Pupil Size in Spider Eyes Is Linked to Post-Ecdysal Lens Growth

In this study we describe a distinctive pigment ring that appears in spider eyes after ecdysis and successively decreases in size in the days thereafter. Although pigment stops in spider eyes are well known, size variability is, to our knowledge, reported here for the first time. Representative species from three families (Ctenidae, Sparassidae and Lycosidae) are investigated and, for one of these species (Cupiennius salei, Ctenidae), the progressive increase in pupil diameter is monitored. In this species the pupil occupies only a fourth of the total projected lens surface after ecdysis and reaches its final size after approximately ten days. MicroCT images suggest that the decrease of the pigment ring is linked to the growth of the corneal lens after ecdysis. The pigment rings might improve vision in the immature eye by shielding light rays that would otherwise enter the eye via peripheral regions of the cornea, beside the growing crystalline lens

Reflective Practice About Retroperitoneal Laparoscopy in Comparison to Open Surgery for Ureteropelvic Junction Obstruction Repair in Children Less Than 1 Year of Age

Introduction: The interest in laparoscopy in the treatment of ureteropelvic junction obstruction (UPJO) in children under 12 months of age remains controversial. The aim of this study is to evaluate feasibility and benefits of retroperitoneal laparoscopy (RL) compared to open surgery in this age group.Materials and Methods: Between January 2012 and May 2017, we performed 222 pyeloplasties: 144 by laparoscopy and 78 by open surgery. From 2012, the choice of operative technique was decided according to the laparoscopic experience of the surgeon; two surgeons operated laparoscopically on all children <12 months of age, while others operated using posterior lumbotomy (PL). The RL is standardized and performed by 3 trocars (5, 3, 3). Pre, per and postoperative parameters were analyzed retrospectively. Statistical tests: Pearson, Fisher, Student and Mann-Whitney.Results: During this 5-year period, 24 RL and 53 PL were included with a median follow-up of 27 months (5–63). In the LR group, postoperative drainage was performed by JJ (13 cases) and external stent (11 cases). No conversion has been listed in this group. In each group there was one failure that needed redo pyeloplasty. Duration of hospitalization and intravenous acetaminophen use were significantly lower in the RL group (2.8 vs. 2.3 days, p = 0.02, respectively) while operating time was significantly longer (163 vs. 85.8 min, p = 0.001). The postoperative complication rate was statistically identical in each group (urinary tract infection, wall hematoma, hematuria…).Conclusion: RL is feasible in children under 1 year of age in the hands of well-experienced surgeons with longer operative time but without added morbidity. Subject to the retrospective nature of our study, the RL seems to offer a benefit regarding duration of hospitalization and analgesics consumption

'When you have children, you're obliged to live': Motherhood, Chronic Illness and Biographical Disruption

Recent work on biographical disruption has emphasised the critical importance of timing and context to the understanding of the effects of illness on identity. This paper takes a different approach by examining the inter-relationship between illness and key sources of identity, in this instance HIV infection and motherhood. It is argued that, viewed in this light, biographical disruption remains a powerful analytic framework with which to explore the intense threat which may be posed to key identities by chronic, potentially fatal illnesses, and the fundamental re-working of such identities occasioned by such threats. With reference to the empirical study on which this paper draws, it is shown that, the respondents’ emphasis on their need to survive and to protect their children, represented a fundamental re-formulation of their identities as mothers and, therefore, a type of biographical disruption while paradoxically also containing elements of biographical reinforcement. It is further argued that the incorporation of such key identities into the analysis problematises work that suggests that biographical disruption is less relevant to those who have experienced difficult lives, while also highlighting the need to take greater account of gender and caring responsibilities in further work in this field

Genomic tagging reveals a random association of endogenous PtdIns5P 4-kinases IIα and IIβ and a partial nuclear localization of the IIα isoform

PtdIns5P 4-kinases IIα and IIβ are cytosolic and nuclear respectively when transfected into cells, including DT40 cells [Richardson, Wang, Clarke, Patel and Irvine (2007) Cell. Signalling 19, 1309–1314]. In the present study we have genomically tagged both type II PtdIns5P 4-kinase isoforms in DT40 cells. Immunoprecipitation of either isoform from tagged cells, followed by MS, revealed that they are associated directly with each other, probably by heterodimerization. We quantified the cellular levels of the type II PtdIns5P 4-kinase mRNAs by real-time quantitative PCR and the absolute amount of each isoform in immunoprecipitates by MS using selective reaction monitoring with 14N,13C-labelled internal standard peptides. The results suggest that the dimerization is complete and random, governed solely by the relative concentrations of the two isoforms. Whereas PtdIns5P 4-kinase IIβ is >95% nuclear, as expected, the distribution of PtdIns4P 4-kinase IIα is 60% cytoplasmic (all bound to membranes) and 40% nuclear. In vitro, PtdIns5P 4-kinase IIα was 2000-fold more active as a PtdIns5P 4-kinase than the IIβ isoform. Overall the results suggest a function of PtdIns5P 4-kinase IIβ may be to target the more active IIα isoform into the nucleus

From activism to secrecy: contemporary experiences of living with HIV in London in people diagnosed from 1986 to 2014

Background Successes in biomedicine have transformed HIV from a debilitating and frequently fatal infection to a chronic, manageable condition. Objective To explore how the contemporary metanarrative of HIV as a chronic condition is understood by patients and how it varies depending on when they were diagnosed. Design Qualitative interviews with fifty-two people living with HIV who were diagnosed during different phases in the history of the epidemic. Setting and participants Participants were recruited from two HIV clinics in London to include four “HIV generations”: generation 1 were those who had been diagnosed pre-1997 (pre-ART), generation 2 from 1997-2005 (complex ART), generation 3 from 2006-2012 (simpler ART) and generation 4 were diagnosed in the year before the study (2013-2014). Results Participants in all HIV generations took their medication as prescribed, attended clinic appointments and were well-informed about their immunological biomarkers. While the pre-treatment generation had been engaged in community endeavours such as activism, public education and use of support groups, those more recently diagnosed had little experience of collective activities and their HIV was essentially a private matter, separate from their social identity. These strategies worked for some however those experiencing clinical or social problems related to HIV or wider issues often relied exclusively on their HIV clinic for wider support. Conclusion The loss of public conversation around HIV, the imperative for patients to take on greater individual responsibility for HIV management and the streamlining of HIV services alongside reductions in ancillary support services may expose some people to suboptimal health outcomes

Impacts of long-standing illness and chronic illness on working hours and household income in a longitudinal UK study.

Individuals within households encounter a variety of events including development of a disability or chronic illness. We used data from the Understanding Society, 2009-2016, to determine whether there are changes to working hours or household income as a result of an individual developing an illness. After adjusting for a variety of sociodemographic characteristics, there were few associations observed between one's own individual illness status and household income. There was a clear trend of reduction of weekly working hours with increasing severity and chronicity of the individuals' illness or disease. Individuals who were not ill, but lived in an household with an ill person worked about 30-min less per week, b = -0.69, 95% confidence interval (CI)=(-1.09, -0.30), while those with a limiting long-standing illness and a chronic disease worked 3.5 h less per week, b = -3.64, 95% CI=(-4.21, -3.08), compared to individuals with no illness in their household. Individuals with a limiting illness only had lower incomes, b = -0.04, 95% CI=(-0.07, -0.004) compared to individuals with no household illness. These associations were not greatly changed with the inclusion of reception of benefits or being cared for. Interactions were observed by gender, age being cared for and reception of benefits. Additionally, there were differences were observed by working age groups and between those who lived alone and those who did not. The findings suggest that while there is a reduction of working hours among individuals with an illness or who have an ill person in their home, household income is resilient to the experience of an illness, in the United Kingdom. However, this appeared to differ by household composition, i.e. whether individuals were of working age or whether they lived alone. Identification of households at highest risk of income reduction may serve to inform policy and appropriate distribution of services and support