Elevated ratio of acylated to unacylated ghrelin in children and young adults with Prader–Willi syndrome

Prader–Willi syndrome (PWS) is characterized by a switch from failure to thrive to excessive weight gain and hyperphagia in early childhood. Hyperghrelinemia may be involved in the underlying mechanisms of the switch. The purpose of this study is to evaluate acylated ghrelin (AG) and unacylated ghrelin (UAG) levels in PWS and investigate their associations with hyperphagia. This is a cross-sectional clinical study conducted in three PWS expert centers in the Netherlands and France. Levels of AG and UAG and the AG/UAG ratio were determined in 138 patients with PWS (0.2–29.4 years) and compared with 50 age-matched obese subjects (4.3–16.9 years) and 39 healthy controls (0.8–28.6 years). AEBSF was used to inhibit deacylation of AG. As a group, PWS patients had higher AG but similar UAG levels as healthy controls (AG 129.1 vs 82.4 pg/ml, p = 0.016; UAG 135.3 vs 157.3 pg/ml, resp.), resulting in a significantly higher AG/UAG ratio (1.00 vs 0.61, p = 0.001, resp.). Obese subjects had significantly lower AG and UAG levels than PWS and controls (40.3 and 35.3 pg/ml, resp.), but also a high AG/UAG ratio (1.16). The reason for the higher AG/UAG ratio in PWS and obese was, however, completely different, as PWS had a high AG and obese a very low UAG. PWS patients without weight gain or hyperphagia had a similar AG/UAG ratio as age-matched controls, in contrast to those with weight gain and/or hyperphagia who had an elevated AG/UAG ratio. The switch to excessive weight gain in PWS seems to coincide with an increase in the AG/UAG ratio, even prior to the start of hyperphagia

Qualité de l'eau et santé en contexte urbain sahélien et semi-aride : approche géopraphique à Nouakchot (Mauritanie)

International audienceAccess to drinking water with sufficient quantity is a major public health issue in a semi-arid sahelian city like Nouakchottwhere the low household connection rate to the supply network led to a multitude of remedies and practices with a risk of watercontamination and propagation of water-borne diseases (diarrhea, cholera, typhoid, parasitic infections, skin diseases, etc.). Thus,this paper proposes to analyze the impact of water quality on health risks inequalities in urban areas. To do this, the methodologicalapproach combines a socio-environmental, microbiological and epidemiological demarche based on the use of various datasources (national surveys, bacteriological studies of water and diarrheal morbidity provided by health facilities). Overall, the resultsshow that only 25.6% of households have improved water source when a majority of the population recourse on precarious modeswith a daily supply less than the recommended standard of 20 liters per person. Bacteriological analyzes show that 93% of waterpoints supplying about 74% of households are contaminated with values between 10 and 80 fecal coliforms per 100 ml of water.This degree of contamination corroborates with the level of diarrhea prevalence (12.8%) whose morbidity appears so unequal thatthe variability of supply modes and water microbiological quality according to the municipalities. Therefore, exposure to diarrhealdiseases through water prism is a real public health problem. It is essential to develop a strategy focalized in the people awareness,the water sources management and water treatment before consumption to improve water quality at all levels of supply chain.L’accès à une eau potable en quantité suffisante représente un enjeu majeur de santé publique dans une ville sahéliennesemi-aride à l’instar de Nouakchott en Mauritanie où le faible taux de raccordement des ménages au réseau d’adduction conduità une multitude de recours et pratiques avec un risque de contamination de l’eau et de propagation de maladies hydriques(diarrhée, choléra, typhoïde, parasitoses, dermatoses, etc.). Ainsi, ce papier cherche à analyser l’impact de la qualité de l’eausur les inégalités de risques sanitaires en milieu urbain. Pour ce faire, l’approche méthodologique combine une démarche socioenvironnementale,microbiologique et épidémiologique basée sur l’utilisation de sources de données diverses (enquêtes nationales,études bactériologiques de l’eau et morbidité diarrhéique diagnostiquée). Dans l’ensemble, les résultats montrent que seuls 25,6%des ménages disposent de sources d’approvisionnement améliorées en eau potable au moment où une majeure partie de lapopulation a recours à des modes d’alimentation précaires avec une dotation journalière inférieure à la norme recommandée de20 litres par personne. Les analyses bactériologiques montrent que 93% des points d’eau qui alimentent environ 74% des ménagessont contaminés avec des valeurs comprises entre 10 et 80 coliformes fécaux par 100 ml d’eau. Ce degré de contaminationcorrobore avec le niveau de prévalence de la diarrhée (12,8%) dont la morbidité se révèle aussi inégale que la variabilité desmodes d’approvisionnement et de la qualité microbiologique de l’eau selon les communes. Dès lors, l’exposition aux maladiesdiarrhéiques à travers le prisme de l’eau pose un véritable problème de santé publique. Il s’avère indispensable de développerune stratégie axée sur la sensibilisation, l’aménagement des points d’eau et le traitement avant la consommation pour améliorer laqualité de l’eau à tous les niveaux de la chaîne d’approvisionnement

Spatial epidemiology of urban health risks in select West African cities

West African cities face critical societal challenges that are linked to environmental and health changes. These challenges are further exacerbated by urbanization dynamics, climate change, socio-economic mutation and lack of capacity for sustainable urban development, governance and basic services delivery. The deficiency of environmental sanitation and ecosystem services have led to high complexity of urban health risks inequalities, resulting in the need for more research on efficient urban health policies. The purpose of this contribution is to present the main findings on the spatial epidemiology of diarrhaea and malaria, and their associated risks factors in the following select West African cities. Spatial variability of exposure to diarrhaea and malaria transmission is linked to several health risks such as lack of access to water and sanitation, solid wastes management, urban flooding

Rethinking slavery heritage tourism

This paper argues that the investigation of slavery heritage within a ‘thana’- or ‘dark’ tourism framework invariably fails to appreciate the subtleties, power relationships and various contestations that are at play in both the presentation and consumption of former Transatlantic Slave Trade (TAST) sites. Instead, the authors argue that a combination of Halbwachs’ collective memory theory and Tunbridge and Ashworth’s concept of dissonant heritage can provide a deeper understanding of tourism linked to such sites. A study of TAST sites in Ghana identified six key groups of stakeholders involved in the interpretation of slavery heritage, each with its own agenda, desire to remember or forget slave memories and desire to compose different narratives. By analysing collective slave memories, the study proposes a framework that demonstrates that tourism to TAST-related sites is complex and nuanced because it relates to the nature of the historic event itself, intrinsic qualities of TAST-related sites in terms of current relevance and the closeness of the event or site to each stakeholder.School of Hotel and Tourism Managemen