Urban Popular Economies

What is a life worth living and how is it concretely actualized by an urban majority making often unanticipated, unformatted uses of the urban to engender livelihoods in a dynamic and open-ended process? This is the key question undertaken in this collectively written piece. This means thinking about work, paid and unpaid, in ways that highlight the everyday practices of urban inhabitants as they put together territories in which to operate, which sustain their imaginations of well-being as part of a process of being with others—in households, neighborhoods, communities, and institutions. What is it that different kinds of workers have in common; what links them; where does the household begin and end; what is the difference between productive and reproductive work

O uso da Indocianina Verde (ICG) em hepatectomias robóticas: uma revisão não sistemática / The Use of Indocyanine green (ICG) in robotic hepatectomies: a non-systematic review

Objetivo: O artigo tem como objetivo realizar uma revisão da literatura sobre o uso da Indocianina Verde nas hepatectomias robóticas. O intuito do trabalho é apresentar como essa recente técnica é executada, assim como estabelecer as vantagens que ela trás diante dos métodos convencionais e suas limitações vigentes. Introdução: A hepatectomia é um procedimento cirúrgico que tem se tornado cada vez mais seguro. Visando aprimorar a navegação intraoperatória pelas estruturas tridimensionais, os procedimentos robóticos podem ser realizados de forma guiada por fluorescência, a partir da aplicação de Indocianina verde (ICG). Metodologia: Essa é uma revisão não sistemática que tem como base artigos científicos publicados sobre o uso de Indocianina Verde em hepatectomias robóticas, utilizando-se os bancos de dados LILACS, Pubmed, Scielo, com seleção de artigos publicados nos últimos 14 anos. Resultado: A aplicação da técnica intraoperatória da ICG permite a identificação e o melhor entendimento de marcos anatômicos na cirurgia hepatobiliar: anatomia das artérias, veia porta e ductos biliares. O uso da ICG é indicado como método de alta sensibilidade na identificação de tumores malignos, o que aumenta a precisão da ressecção hepática e o estadiamento cirúrgico do câncer. Conclusão: A abordagem de tumores hepáticos é complexa e envolve inúmeras variáveis. É inegável que essa é uma técnica extremamente útil para as cirurgias oncológicas hepáticas, sendo necessário maiores estudos e aplicabilidades para a ICG

Support for UNRWA's survival

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides life-saving humanitarian aid for 5·4 million Palestine refugees now entering their eighth decade of statelessness and conflict. About a third of Palestine refugees still live in 58 recognised camps. UNRWA operates 702 schools and 144 health centres, some of which are affected by the ongoing humanitarian disasters in Syria and the Gaza Strip. It has dramatically reduced the prevalence of infectious diseases, mortality, and illiteracy. Its social services include rebuilding infrastructure and homes that have been destroyed by conflict and providing cash assistance and micro-finance loans for Palestinians whose rights are curtailed and who are denied the right of return to their homeland

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

What we talk about when we talk about decentralization? Insights from post-revolution Tunisia

Ce papier examine le langage de la décentralisation en Tunisie postrévolutionnaire. Il présente l’hypothèse que les institutions financières internationales mobilisent un langage de décentralisation qui leur permet d’attirer de nouveaux clients et de se réinventer dans un paysage politique en mutation. La montée en popularité des politiques de décentralisation dans un moment postrévolutionnaire dans les pays du Moyen Orient et de l’Afrique du Nord est partiellement due à ce langage. Dans une région où les expériences en terme de décentralisation restent limitées, il ne suffit pas d’examiner les incitations des décideurs à décentraliser ou bien l’effet des politiques de décentralisation une fois mise en œuvre. En fait, il s’avère nécessaire d’examiner la convergence de pressions locales pour pluraliser un champ politique restreint et des agendas de développement conçus par des institutions financières internationales qui présente les politiques de décentralisation comme modèle de développement approprié dans un contexte postrévolutionnaire. Pour défendre cette hypothèse, j’analyse le langage utilisé dans les rapports mondiaux de développement pour les années 2008 et 2009 de la Banque Mondiale qui tracent le justificatif intellectuel des politiques de décentralisation. Ensuite, je compare ce langage à celui utilisé par la société civile en Tunisie qui propose d’octroyer des « réparations » aux « régions victimes » au lieu de la pour redresser les injustices territoriales vécus sous le régime précèdent, au lieu d’une simple politique de décentralisation définie comme l’autonomie politique, financière et administrative des communes. Cette comparaison est importance puisqu’elle montre deux modèles de développement divergents et nous aide à repenser l’universalité du concept de la décentralisation à partir de la Tunisie.This article explores the language of decentralization policies in post-revolution Tunisia. It argues that international financial institutions mobilize a particular language about decentralization to create new clients and reinvent themselves in a shifting political landscape. Decentralization policies have gained traction in the Middle East and North Africa region post-Arab revolutions partially as a result of these shifting priorities and their accompanying language. In a region with limited decentralization experiences, it is not enough to look at incentives of politicians to decentralize or the effects of decentralization programs once they are rolled out. Instead, we need to look at the confluence of domestic pressures to pluralize the terrain of politics and development agendas born outside the region’s borders which frames decentralization as an appropriate development framework at this juncture. To make this argument, I analyze the language of World Bank flagship publications that constitute the intellectual backbone for decentralization programs. I then turn to Tunisia and compare the language of these reports with the language that activists use to characterize decentralization in relation to regional inequalities. At stake in this comparison are two discourses of decentralization that call forth diverging development models: one model focuses on the financial, administrative and political autonomy of municipalities from the central government, while the other calls for reparations and a desire for a state that restores past injustices. This language forces us to rethink the mode of politics undergirding decentralization policies, and accordingly to re-theorize decentralization from a particular place on the map, from Tunisia.الملخص: تتطرّق هذه الورقة الى اللغة التي تصيغ سياسات اللامركزية في تونس بعد الثورة. تقترح الورقة ان المؤسسات المالية الدولية تهدف الى إعادة انتاج نفسها و استقطاب زبناء جدد عبر اللغة التي تصيغ فيها اللامركزية كسياسة اقتصادية ناجعة و ملائمة للتغيرات التي طرأت بعد الثورات العربية. إذ لا يكفي بأن نتنبّه إلى حوافز متخذي القرار أو آثار السياسات التي طُبِّقت عندما ندرس اللامركزية. بل يجب أن نعير إنتباه إلى تلاقي الضغوطات المحلية التي تهدف الى تشجيع التعددية السياسية في أنظمة كانت بمعظمها ديكتاتورية و منغلقة مع أجندات تنماوية طوتها الجهات المانحة و روّحت فيها اللامركزية على أنها سياسة ملائمة ما بعد الثورة. للدفاع عن هذه النظرية، أقوم بتحليل اللغة المستعلمة في تقارير التنمية العالمية لسنة 2008 و 2009 و هي تقارير رئيسية يقرر فيها البنك الدولي توجهاته التنماوية في المشاريع التي يقوم بها في شتّى أنحاء العالم. ثم أقوم بقرانة هذا المضمون إلى اللغة التي يستعملها المجتمتع المدني في تونس للمطالبة بسياسات تنمويّة في الجهات المهمّشة تردّ لهذه الجهات حقّها في التنمية عبر جبر الضرر الجماعي و ليس عبر اللامركزية بتعريفها كالاستقلال المالي و الاداري و السياسي للسلط المحلية. تكمن أهميّة هذه المقارنة في التنبه الى أهمية اللغة المستعمتلة في الاشارة الى سياسات اللامركزية بغية تركيز مفهموم نظري جديد لهذه السياسات ينطلق من واقع البلدان التي تقوم بتطبيقها، بدل الاعتماد على مفهموم نظري صيغ من قبل الجهات المانحة فقط

Spaces of Expectation: Local Politics in Post-revolution Tunisia

In this dissertation, I bring the analytical perspectives of urban and development studies to bear on a set of questions related to democratic transformation. In 2011, a revolution ended the 23-year-long authoritarian reign of Zine El Abideen Ben Ali, inaugurating Tunisia’s Second Republic. My inquiry is situated within this geography and historical conjuncture. I ask: what are the emergent forms of democratizing politics in post-revolution Tunisia? Rather than emphasizing national level dynamics or procedural dimensions of “democratic transition,” I show that the city and the intimate space of the home are privileged sites for understanding how democratic aspirations are structured. Local politics take shape as a result of claims-making and place-making. In other words, I trace a politics that emanates from the rearrangement of the material and spatial relations of urban space. I focus on the local, in its everydayness of city-making and its politics to understand the formation of both spaces in relation to democracy. This dissertation is based on over eighteen months of ethnographic research conducted in Tunisia between 2014 and 2017. My research reflects my position as an Arab citizen and participant in the regional uprisings and revolutions of the period, a development worker, and finally a scholar of the global South, committed to decentering conventional circuits of knowledge production, and producing scholarship anchored in place.I argue that in Tunisia the citizen-participants of a new democratic order reconstitute municipalities into relational entities that I call spaces of expectation. I demonstrate that rather than bounded institutions of local governance, claims-makers constitute municipalities into porous entities situated between the street and the state, where substantive democracy is continuously put to the test. I define spaces of expectation as the gendered and financialized thresholds of democracy. In one sense, this dissertation is about democracy as it relates to making the urban and building the city. In another sense, it is about the tension between the desire for local-level solutions and the concomitant refusal of the state’s modes of rule; a struggle to redefine state-society relations. In yet another rendition, the dissertation is about municipalization as a multiscalar project of heterogeneous temporalities consolidated at the intersection of debt, participatory democracy and global development imperatives. The six substantive chapters that make up this dissertation explore different regimes of politics with their heterogeneous temporalities which manifest at different scales. Taken together, the chapters show how intimate textures, institutional configurations, and global development prerogatives coalesce to produce urban democratic time in post-revolution Tunisia. This dissertation makes three contributions. The first is to demonstrate that the local is produced in a dialectic multi-scalar fashion, from the intimate space of the home, to the development prerogatives of international financial institutions. The second is to show that women’s labor of building the city from its informal peripheries is a condition of possibility for democratizing politics. The final contribution is to indicate that the institutionalization of protest politics remakes political subjectivities and reconfigures the city. When it is cemented at the local level, it constitutes an opportunity for sustaining the revolution’s radical demands under different forms

Economic and geopolitical dimensions of renewable vs. nuclear energy in North Africa

Addressing issues of renewable energy in North Africa must incorporate concerns regarding the compatibility of energy mixes with the nature of political regimes, their geopolitical relevance, and their socio-economic effects, in addition to economic cost-benefit deliberations. One important and under-researched aspect of nuclear energy refers to the trade-off between socio-economic development and political power conservation. Competing interests in North Africa\u27s energy market as well as aspects of regional cooperation capacity are important when assessing the choice between renewable and nuclear energy. Therefore, the future course of meeting North Africa\u27s energy needs is subject to a complex political and economic interplay between domestic and geopolitical development interests. The objective of this paper is to explore this complexity in more detail. We argue that the identification of any energy alternative as superior is hardly convincing unless certain standards of inclusive governance are met. We also find that it is important to highlight political–economic differences between energy importers like Morocco and Tunisia and energy exporters like Algeria, Libya, and Egypt