Le tourisme macabre à La Nouvelle-Orléans après Katrina : résilience et mémorialisation des espaces affectés par des catastrophes majeures

Le « tourisme macabre » renvoie à des pratiques de tourisme culturel, centrées sur la visite des sites de mort et de dévastation. Après avoir exposé l’histoire de ce concept et les multiples réalités qu’il recouvre, cette recherche s’attache à examiner comment cette forme de tourisme s’est rapidement développée à La Nouvelle-Orléans après le passage de l’ouragan Katrina, le 29 août 2005. Il s’agit ici d’analyser les enjeux multiples et parfois conflictuels de ces pratiques, à travers l’étude des motivations et des interactions entre les différents acteurs de ce tourisme macabre. Ce dernier participe en effet de la patrimonialisation des espaces affectés par la catastrophe, mais ce faisant, il met également en lumière les enjeux politiques, sociaux et culturels, liés à l’interprétation de l’événement et aux discours sur la reconstruction de la ville. Les nécessités économiques et l’horizon d’attente des touristes par rapport aux représentations de La Nouvelle-Orléans dans la conscience collective américaine conduisent ainsi à la construction d’une mémoire sélective de la catastrophe. Cela se traduit par une surreprésentation de certains lieux et, corrélativement, par un manque de visibilité d’autres espaces dont les besoins peinent à accéder à la sphère publique.“Dark tourism” is a form of cultural tourism that focuses on the visit of death and devastation sites. After describing the scientific background of this concept and the many situations it covers, this research will try to study how dark tourism practices quickly developed in post-Katrina New Orleans. The point here is to analyze the multiple, and sometime conflicting, issues at stake through these practices. We will do so by observing the motivations and relations between the participants, producers, and witnesses of these “Katrina tours”. These tours are part of a cultural capitalization on the disaster, but also highlight the political, social, and cultural issues regarding its interpretation and the discourses on the city recovery. Economic necessities as well as the tourists’expectations vis-à-vis certain representations of New Orleans in the American psyche led to the creation of a selective memory of the disaster. This translates into an overrepresentation of some neighborhoods and, conversely, into a lack of visibility of other places whose needs do not appear in the public sphere

Addressing Racial and Socioeconomic Disparities Through Patient Education and Increasing Healthcare Professionals’ Cultural Competency to Reduce Maternal Mortality in the United States

Pregnancy-related deaths in the United States continue to increase with a notable disparity for women of color and/or low socioeconomic status. Hundreds of women die each year due to pregnancy or delivery complications as researchers and healthcare providers remain unclear on the solution. The mortality rate is the result of pregnancy complications, the aggravation of preexisting comorbidities, methods of intervention, or events precipitated by the pregnancy.https://openworks.mdanderson.org/rmps/1002/thumbnail.jp

Radio 33 comparado con el patrón de oro para diagnóstico de osteoporosis

Introducción: la medición de la densidad mineral ósea en el fémur y columna lumbar es considerada la prueba de oro para el diagnóstico de osteoporosis en mujeres postmenopáusicas, sin tener suficiente evidencia de la utilidad al medir de manera individual o simultanea el radio 33 con este mismo propósito. Metodología Se realizó un estudio de pruebas diagnósticas, valorando concordancia anidada para determinar el valor diagnóstico del radio 33 comparado con los resultados por dual fémur y columna, actualmente patrón de oro el en diagnóstico. Se incluyeron mujeres mayores de 50 años entre el periodo de 2008 y 2011. Resultados Se incluyeron 3241 osteodensitometrias de pacientes femeninas con columna AP, dual fémur, radio ultradistal y radio 33. Tomando como estándar de oro la medición en columna y/o femur, el radio-33 obtuvo una sensibilidad de 95.5% y especificidad de 91% (p= 0,000) para osteoporosis, y una sensibilidad de 76.5% y especificidad de 54.9% p=0,000 para el diagnóstico de osteopenia. El radio 33 permite diagnosticar un 35% adicional de casos que no son captados con la medición en fémur y columna lumbar. Discusión La osteodensitometría en los sitios usados comúnmente, predice únicamente el 40% del riesgo de fractura (1). Si se incluye la medición de radio 33, la sensibilidad de la osteodensitometría sube en un 35.66% adicional, logrando detectar más pacientes con este riesgo y generando un impacto en la oportunidad del tratamiento y quizás reducción en la morbi-mortalidad secundaria a fracturas en esta población susceptible.Introduction The measurement of bone density in lumbar spine and hip is considered the gold standard for the diagnosis of osteoporosis in postmenopausal women. No one knows the impact of the simultaneous measurement on radio 33. Methods We performed a diagnostic test study with a nested concordance study to determine the diagnostic value of radius-33 compared to the diagnosis made by gold standar in osteoporosis. We included women over 50 years with menopause in the period between 2008 and 2011. Results A total of 3241 female patients who had a column osteodensitometry AP, dual femur and forearm ultradistal radius and 33 % were included. On the diagnostic gold standard for column and / or hip, radius -33 had a sensitivity of 95.5 % and specificity of 91 % ( p = 0.000) for osteoporosis and a sensitivity of 76.5 % and specificity of 54.9 % p = 0.000 for the diagnosis of osteopenia. The radius 33 diagnosed an additional 35% of cases that were not diagnosed with gold standar tests. Discussion Osteodensitometry commonly used sites predicts only 40 % of the risk of fracture(1) . If we include measuring radius 33 osteodensitometry sensitivity increase an additional 35.66 %, thereby detecting more patients at risk for fracture. Carrying an impact on the timeliness of care and perhaps reducing morbidity and mortality from fractures

Stable isotope metabolomics of pulmonary artery smooth muscle and endothelial cells in pulmonary hypertension and with TGF-beta treatment.

Altered metabolism in pulmonary artery smooth muscle cells (PASMCs) and endothelial cells (PAECs) contributes to the pathology of pulmonary hypertension (PH), but changes in substrate uptake and how substrates are utilized have not been fully characterized. We hypothesized stable isotope metabolomics would identify increased glucose, glutamine and fatty acid uptake and utilization in human PASMCs and PAECs from PH versus control specimens, and that TGF-β treatment would phenocopy these metabolic changes. We used 13C-labeled glucose, glutamine or a long-chain fatty acid mixture added to cell culture media, and mass spectrometry-based metabolomics to detect and quantify 13C-labeled metabolites. We found PH PASMCs had increased glucose uptake and utilization by glycolysis and the pentose shunt, but no changes in glutamine or fatty acid uptake or utilization. Diseased PAECs had increased proximate glycolysis pathway intermediates, less pentose shunt flux, increased anaplerosis from glutamine, and decreased fatty acid β-oxidation. TGF-β treatment increased glycolysis in PASMCs, but did not recapitulate the PAEC disease phenotype. In TGF-β-treated PASMCs, glucose, glutamine and fatty acids all contributed carbons to the TCA cycle. In conclusion, PASMCs and PAECs collected from PH subjects have significant changes in metabolite uptake and utilization, partially recapitulated by TGF-β treatment

Is the liver kinetic growth rate in ALPPS unprecedented when compared with PVE and living donor liver transplant? A multicentre analysis

AbstractBackgroundThe clinical perspective on hepatic growth is limited. The goal of the present study was to compare hepatic hypertrophy and the kinetic growth rate(KGR) in patients after the ALPPS (Associating Liver Partition with Portal Vein Ligation for Staged Hepatectomy) procedure, portal vein embolization (PVE) and living donor liver transplantation.MethodsVolumetry and KGR of the future liver remnant (FLR) were compared from (15) patients undergoing ALPPS, (53) patients undergoing PVE, (90) recipients of living donor liver grafts and (93) donors of living donor liver grafts.ResultsThe degree of hypertrophy was significantly greater after ALPPS (84.3 ± 7.8%) than after PVE (36.0 ± 27.2%) (P < 0.001). The KGR was also significantly greater for ALPPS [32.7 ± 13.6 cubic centimetres (cc)/day] (10.8 ± 4.5%/day) compared with PVE (4.4 ± 3.2 cc/day) (0.98 ± 0.75%/day) (P < 0.001). The FLR of living donor donors had the greatest degree of hypertrophy (107.5 ± 39.2%) and was greater than after ALPPS (P = 0.02), PVE (P < 0.001) and in living donor‐recipient grafts (P < 0.001). KGR (cc/day) was greater in FLR of living donor donors compared with both ALPPS (P < 0.001) and PVE (P < 0.001). The KGR in patients undergoing ALPPS and living donor liver transplantation had a linear relationship with the size of FLR.ConclusionFLR hypertrophy and KGR were greater after ALPPS than PVE. However, the degree of hypertrophy after ALPPS is not unprecedented, as KGR in the FLR from living donor donors is equal to or greater than after ALPPS. The KGR of the FLR in patients after ALPPS and living donor donors correlates directly with the size of the FLR

Exposure to Violence and Sleep Inadequacies among Men and Women Living in a Shelter Setting

Exposure to violence may explain sleep inadequacies reported by homeless adults, with women being potentially more susceptible to violence and sleep disturbances than men. This study examined the association between violence and sleep inadequacies among homeless adults and explored differences by sex. Adult participants were recruited from a shelter (n = 194; 71.1% men, Mage = 43.8+12.2). Participants self-reported victimization and/or witnessing violence (mugging, fight, and/or sexual assault) at the shelter, sleep duration (over an average 24 hours), insufficient sleep (days without sufficient rest/sleep), and unintentional daytime sleep (days with unintentional sleep) in the past month. Linear regressions were used to estimate associations between violence and sleep inadequacies, controlling for sex, age, race, months homeless, and depression. Moderation by sex was examined via an interaction term following mean-centering of variables. Overall, 20.6% of participants (n = 40) reported victimization since moving to the shelter. In the last month, participants reported witnessing an average of 2.9+5.1 acts of violence. Over the same timeframe, participants reported 6.9+2.0 hours of sleep nightly, 11.2+10.7 days of insufficient sleep, and 6.2+8.8 days with unintentional daytime sleep. In adjusted analyses, witnessing violence was associated with insufficient sleep (p = .001). Men and women differed only in age and race in unadjusted analyses; sex was not a significant moderator of any association between violence and sleep in adjusted analyses. Links between witnessing violence and sleep inadequacies should be considered in shelter health promotion efforts. Successful efforts to minimize violence may reduce insufficient sleep amongst both sexes