Among the piranhas: the troubling lifespan of ethnic tropes in “tribal” tourism to Vietnam

This article presents findings from mixed-method research into ethnic tourism in Vietnam. Drawing on critical discourse analysis and ethnographic research carried out in Sapa, northern Vietnam, the article examines how minority Indigenous groups are represented in ways that reproduce certain racial and gendered tropes that are drawn upon by tourists before, during and after actual tours. Findings from the study suggest that ethnic tourism is having a marginalising effect on minority ethnic women, who are becoming excluded from social, symbolic and economic space for behaviour that is deemed inauthentic. Tourists are drawing on a narrow range of Orientalist tropes throughout different stages of their participation in ethnic tourism and are carrying forward their pre-conceptions into tourism environments. Therefore, the ways in which indigeneity is packaged for tourists and the ways that tourists “authenticate” ethnicity inform their desires, which then shape their behaviour and interactions with locals. By bringing together ideas about authentication and gendered Orientalism and Othering, the analysis shows that the power play and its effects on Indigenous groups are considerable and troubling, with the whims and desires of tourists steering tourism organisation, including the surveillance and controlling of Indigenous women traders in and around the town

Daily Bread: Women’s Self-Help Microfinance and the Social Meanings of Money

In this article we explore the impacts and implications of ‘Rojiroti’, a women’s self-help group (SHG) microfinance scheme operating in poor communities in Bihar, India. We focus particularly on how improvements found in women’s circumstances and in children’s health might result from Rojiroti SHG membership. Through data from five focus groups and 19 individual interviews with women in communities where Rojiroti operates, we discover how the scheme is regarded and how it affects women’s management of household budgets. Moreover, we explore the relational aspects of SHG microfinance and the ways that it can alter family and social dynamics. Drawing on notions of ‘earmarked’ money (Zelizer, 1997) and ‘safeguarded’ money (Wilkis, 2017), we argue that the money itself has meaning and non-pecuniary value in the form of other currencies including power and agency, which can lead to improved wellbeing and health of families

‘You can never cross the same river twice’: climbers’ embodied quests for ‘original adventure’ in southern Thailand

This article presents ethnographic research into individual narratives of adventure in a small, undeveloped bay called Ton Sai in southern Thailand’s Krabi Province. Ton Sai is extremely popular with Western rock climbers and increasingly with other adventure seekers and backpackers questing for ‘authentic’ Thailand, yet is subject to almost no representation in the commercial sense. It is an example of a destination that is not on the corporate ‘radar’, yet, as will be seen, is famed, desired and produced by ‘niche’ tourists seeking very specifically valued tropical adventures. This research aims to interrogate how such a destination becomes, and remains, valued as adventurous by climbers and therefore shed some light on individual, subjective production of adventure in specific Developing World contexts. Drawing on original interview and other ethnographic data collected during winter 2012/2013, this article argues that even when third-party commercial mediators are absent, the powers of quest for authenticity and adventure are powerful enough to turn the wheels of mediation themselves. In the ‘elite circles’ in which this group manoeuvres, notions of ideal adventure space run deep and are reproduced discursively and through embodied performances in an exoticised environment that is valued for its ‘primitive timelessness’. The implications of this for locals are explored

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

Background: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. Methods: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. Findings: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96–1·28). Interpretation: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. Funding: National Institute for Health Research Health Services and Delivery Research Programme

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme

Gutters and Stars : The Young British in Tenerife; Mobility, Identity and Place

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

‘My dark heaven’: Hidden voices in orphanage tourism

Literature on orphanage tourism considers the motives of Western volunteers and the problematic nature of their compulsion to ‘help’ vulnerable children in the Global South. Orphanage tourism is also increasingly adopted into ‘rescue ideologies’ (Howard, 2016) and anti-trafficking/’modern slavery’ campaigns. The perspectives of children involved, however, are missing from these discourses. This article draws on original empirical data to explore the narratives of young Nepali adults who lived in Kathmandu orphanages as children. Through these narratives, the article explores the diverse complexities of the residents’ experiences of volunteer tourism and NGO ‘rescue’, and the shortcomings of recent ‘neo-abolitionist’ frameworks. The article argues that such framings are routinely oversimplified and that a more nuanced and contextualised empirical exploration is urgently needed