Théâtralité du désir et de l'aliénation dans l'oeuvre de François Archambault

Nous nous intéresserons ici particulièrement au théâtre de François Archambault en nous attardant à quatre de ses pièces : La société des loisirs (2003), Cul sec (1996), 15 secondes (1998) et Les gagnants (1996-2002). Ces pièces traitent d'une génération désemparée, perdue, sans foi. Une critique de la société actuelle se donne ici à entendre dans la violence du langage, le cynisme et l'humour noir. Le réalisme qui se dégage du théâtre d'Archambault s'inspire aussi d'autres médias comme la télévision, le cinéma, en mettant en scène de brefs tableaux, en exploitant un minimalisme dans le jeu, les gestes, l'action, et s'impose à travers les dialogues où règnent l'anodin, les décors et objets triviaux du quotidien. À ces éléments concrets s'ajoute la prégnance de discours culturels très contemporains (marqués par les impératifs de jouissance). Ce réalisme intègre cependant les jeux avec l'espace-temps (hors-temps, hors-lieux) et met en scène des personnages caricaturaux qui cherchent à se valoriser par les objets qu'ils possèdent ou veulent posséder, cachent leurs malaises par une parole superficielle et apparemment vide trahissant leur misère et la difficile reconnaissance d'un désir non-dit. Dans ce mémoire, nous explorerons la théâtralité et l'anti-théâtralité. L'aliénation à l'image de soi dans le regard de l'autre, les jeux de camouflage et de dévoilement des désirs, les dispositifs d'écriture et de jeu tels que l'inadéquation entre geste et parole, les jeux de masques, la dualité des personnages, l'intertextualité, les scansions des tableaux, le rapport temps-espace mis en scène par Archambault participent d'une poétique qui lui est propre et permettent de lever le voile sur une société contemporaine malade, une génération en mal de vivre, obsédée par la consommation à outrance, plongée dans une vie préprogrammée où il n'y a plus de place pour les véritables désirs, où tout n'est qu'apparence, mensonge et superficialité. Les dispositifs de la parole et les effets théâtraux produits par Archambault témoignent d'un grand Malaise dans la culture, d'une recherche vaine du bonheur.\ud ______________________________________________________________________________ \ud MOTS-CLÉS DE L’AUTEUR : théâtre, François Archambault, théâtralité, réalisme, désir, dénégation, Freud

Indices de qualité alimentaire et syndrome métabolique auprès des Cris de la Baie-James

Les populations autochtones sont aux prises avec un lourd fardeau de maladies chroniques— diabète de type 2 mellitus (DM2), maladies cardiovasculaires (MCV) et syndrome métabolique (MetS). La prévalence de MetS, facteurs de risque du DM2 et des MCV, y est élevée. Une alimentation de faible qualité, constituée de produits ultra-transformés (UPP), a été identifiée comme un facteur aggravant. Récemment, des indices multidimensionnels de qualité alimentaire, comme l’alternative Healthy Eating Index (aHEI-2010), le Food Quality Score (FQS) et l’apport énergétique des UPP selon la classification NOVA, ont généré beaucoup d’intérêts. Plusieurs études épidémiologiques ont observé une relation entre qualité alimentaire et maladies chroniques. Puisqu’à ce jour, aucune étude n’a exploré cette relation chez les populations autochtones, nous avons évalué la relation entre ces trois indices (aHEI-2010, FQS et contribution énergétique des UPP) et la prévalence de MetS chez les Cris de la Baie-James. De l’étude transversale Nituuchischaayihititaau Aschii 2005-09, 811 adultes cris, de sept communautés de la Baie-James, ont été inclus dans les présentes analyses. Les scores de qualité alimentaire ont été calculés à partir de rappels de 24 heures. La présence de MetS a été évaluée selon la dernière définition harmonisée. La relation entre les quintiles des scores de qualité alimentaire et la prévalence de MetS a été évaluée à l’aide de régression logistique. La prévalence de MetS dans notre échantillon était de 56,5%. Nous avons observé qu’une consommation importante de UPP était associée à une élévation du risque de MetS (p-tendance=0,04), une relation marginalement significative avec les scores de aHEI-2010 (p-tendance=0,05) alors qu’aucune relation statistiquement significative n’a été détectée avec le FQS (p-tendance=0,87). Dans un contexte autochtone du Nord québécois, nos résultats suggèrent que la classification NOVA, évaluant la contribution des UPP à l’apport calorique est l’outil d’analyse de qualité alimentaire ayant la relation la plus forte avec le MetS.Indigenous populations worldwide are a facing heavy burden of chronic disease, including type 2 diabetes mellitus (DM2), cardiovascular disease (MCV) and the metabolic syndrome (MetS). The prevalence of the MetS, a cluster of risk factors for DM2 and MCV, is greater among Canadian indigenous communities. Poor diet quality and important intake of ultra-processed products (UPP) have been identified as contributing factors to this problematic. Recently, new multidimensional tools to assess the quality of global diets, such as the alternative Healthy Eating Index (aHEI-2010), the Food Quality Score (FQS) and the dietary share of UPP to the total daily energy intake based on the NOVA classification, have generated a lot of interest. Although important epidemiological studies have observed an association between diet quality and several chronic diseases, these three diet quality assessment tools (aHEI-2010, FQS and the dietary share of UPP), have never been evaluated in relation to the prevalence of MetS among indigenous peoples, notably the Cree (Eeyouch) communities from James Bay, Québec. From the cross-sectional ‘‘Nituuchischaayihititaau Aschii 2005-09” study, 811 Eeyouch adults, comprising seven Eeyou Itschee communities, have been included in the present analysis. Diet quality scores, from the aHEI-2010, the FQS and the dietary share UPP, have been calculated from a 24-hour recall. The presence of MetS has been assessed based on the latest harmonized definition. Logistic regressions were used to evaluate the relation between diet quality score quintiles and MetS prevalence. In our sample, MetS prevalence was established at 56.6%. A higher consumption of UPP was associated with higher risk of MetS (p-trend=0.04). A marginal association was found with aHEI-2010 (p-trend=0.05) while no statistical significant relation was found with FQS (p-trend=0.87) scores quintiles. In the context of Cree communities from Northern Québec, our results suggest that the dietary share of UPP, based on the NOVA classification, is the tool with the strongest association with MetS

Projections of Excess Mortality Related to Diurnal Temperature Range Under Climate Change Scenarios: a multi-country modelling study

Various retrospective studies have reported on the increase of mortality risk due to higher diurnal temperature range (DTR). This study projects the effect of DTR on future mortality across 445 communities in 20 countries and regions

Global short-term mortality risk and burden associated with tropical cyclones from 1980 to 2019: a multi-country time-series study

Summary Background The global spatiotemporal pattern of mortality risk and burden attributable to tropical cyclones is unclear. We aimed to evaluate the global short-term mortality risk and burden associated with tropical cyclones from 1980 to 2019. Methods The wind speed associated with cyclones from 1980 to 2019 was estimated globally through a parametric wind field model at a grid resolution of 0·5° × 0·5°. A total of 341 locations with daily mortality and temperature data from 14 countries that experienced at least one tropical cyclone day (a day with maximum sustained wind speed associated with cyclones ≥17·5 m/s) during the study period were included. A conditional quasi-Poisson regression with distributed lag non-linear model was applied to assess the tropical cyclone-mortality association. A meta-regression model was fitted to evaluate potential contributing factors and estimate grid cell-specific tropical cyclone effects. Findings Tropical cyclone exposure was associated with an overall 6% (95% CI 4-8) increase in mortality in the first 2 weeks following exposure. Globally, an estimate of 97 430 excess deaths (95% empirical CI [eCI] 71 651-126 438) per decade were observed over the 2 weeks following exposure to tropical cyclones, accounting for 20·7 (95% eCI 15·2-26·9) excess deaths per 100 000 residents (excess death rate) and 3·3 (95% eCI 2·4-4·3) excess deaths per 1000 deaths (excess death ratio) over 1980-2019. The mortality burden exhibited substantial temporal and spatial variation. East Asia and south Asia had the highest number of excess deaths during 1980-2019: 28 744 (95% eCI 16 863-42 188) and 27 267 (21 157-34 058) excess deaths per decade, respectively. In contrast, the regions with the highest excess death ratios and rates were southeast Asia and Latin America and the Caribbean. From 1980-99 to 2000-19, marked increases in tropical cyclone-related excess death numbers were observed globally, especially for Latin America and the Caribbean and south Asia. Grid cell-level and country-level results revealed further heterogeneous spatiotemporal patterns such as the high and increasing tropical cyclone-related mortality burden in Caribbean countries or regions. Interpretation Globally, short-term exposure to tropical cyclones was associated with a significant mortality burden, with highly heterogeneous spatiotemporal patterns. In-depth exploration of tropical cyclone epidemiology for those countries and regions estimated to have the highest and increasing tropical cyclone-related mortality burdens is urgently needed to help inform the development of targeted actions against the increasing adverse health impacts of tropical cyclones under a changing climate

Effect modification of greenness on the association between heat and mortality: A multi-city multi-country study

Background: Identifying how greenspace impacts the temperature-mortality relationship in urban environments is crucial, especially given climate change and rapid urbanization. However, the effect modification of greenspace on heat-related mortality has been typically focused on a localized area or single country. This study examined the heat-mortality relationship among different greenspace levels in a global setting. Methods: We collected daily ambient temperature and mortality data for 452 locations in 24 countries and used Enhanced Vegetation Index (EVI) as the greenspace measurement. We used distributed lag non-linear model to estimate the heat-mortality relationship in each city and the estimates were pooled adjusting for city-specific average temperature, city-specific temperature range, city-specific population density, and gross domestic product (GDP). The effect modification of greenspace was evaluated by comparing the heat-related mortality risk for different greenspace groups (low, medium, and high), which were divided into terciles among 452 locations. Findings: Cities with high greenspace value had the lowest heat-mortality relative risk of 1·19 (95% CI: 1·13, 1·25), while the heat-related relative risk was 1·46 (95% CI: 1·31, 1·62) for cities with low greenspace when comparing the 99th temperature and the minimum mortality temperature. A 20% increase of greenspace is associated with a 9·02% (95% CI: 8·88, 9·16) decrease in the heat-related attributable fraction, and if this association is causal (which is not within the scope of this study to assess), such a reduction could save approximately 933 excess deaths per year in 24 countries. Interpretation: Our findings can inform communities on the potential health benefits of greenspaces in the urban environment and mitigation measures regarding the impacts of climate change.Research in context - I-Evidence before this study: Urbanization and climate change have resulted in changes to the urban environment, including the urban heat island effect and contributions to other extreme weather events. Recently, as metropolitan areas have become denser due to rapid urbanization, environmental problems such as high temperatures are also worsening. Many studies showed that high temperatures increase health risks, including mortality. Therefore, identifying factors that could mitigate the high-temperature conditions in urban environments are a crucial part of climate change mitigation strategies. Many studies found that urban green spaces may play an important role in mitigating heat. Specifically, large green spaces have shown a significant and positive cooling effect. Vegetation can promote air convection through shading and evapotranspiration, which indicates that dense vegetation can lower air temperature. Therefore, more greenspace could result in lower temperatures during the warm season, which would lower exposure to high temperatures that impact human health. Importantly, while greenspace can lower exposure to heat, this study examined how greenspace modifies the heat-health relationship. Some studies have investigated this issue. For example, studies found that heat-related mortality and ambulance calls are negatively correlated with the amount of greenspace coverage. However, most previous work on how greenspace modifies the heat-health relationship was based on one country or region. Research is needed on a global scale to understand how greenspace in urban areas among different countries, with different populations, levels of urbanization, and types of greenspace, can modify the relationship between extreme temperatures and health. As climate change is anticipated to increase temperatures and the associated health consequences worldwide, greenspace may be a plausible mitigation strategy for cities in order to address heat-related health impacts at present and in the future. II-Added value of this study: In this study, we explored the effect modification of greenspace on the heat-mortality relationship on a global scale. With a dataset of 452 locations from 24 countries located in various climate zones and continents, this study incorporated variability in greenspace, temperature, and population characteristics. We found that, based on 452 locations, the heat-mortality risks differed with greenspace category and the cities with higher greenspace values had lower heat-mortality risk than those with lower greenspace values. III-Implications of all the available evidence: Our findings provide evidence that higher greenspace reduces the heat-related mortality, which is similar to other previous smaller studies, and our study results were consistent in different countries around various climate zones. These findings indicate that disparate greenspace levels, temperature, and environment settings should be considered when developing policies and strategies in climate change mitigation and public health adaptation. This study adds to the existing literature that greenspace can reduce the urban heat island effect, by providing evidence for the theory that greenspace can also lower the heat-mortality association, and documents such impacts on a global scale.This publication was developed under Assistance Agreement No. RD83587101 awarded by the U.S. Environmental Protection Agency to Yale University. Research reported in this publication was also supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number R01MD012769. Also, this work has been supported by the National Research Foundation of Korea (2021R1A6A3A03038675), Medical Research Council-UK (MR/V034162/1 and MR/R013349/1), Natural Environment Research Council UK (Grant ID: NE/R009384/1), Academy of Finland (Grant ID: 310372), European Union's Horizon 2020 Project Exhaustion (Grant ID: 820655 and 874990), Czech Science Foundation (22-24920S), Emory University's NIEHS-funded HERCULES Center (Grant ID: P30ES019776), and Grant CEX2018-000794-S funded by MCIN/AEI/ 10.13039/501100011033.info:eu-repo/semantics/publishedVersio

Short term association between ozone and mortality: global two stage time series study in 406 locations in 20 countries

Objective To assess short term mortality risks and excess mortality associated with exposure to ozone in several cities worldwide. Design Two stage time series analysis. Setting 406 cities in 20 countries, with overlapping periods between 1985 and 2015, collected from the database of Multi-City Multi-Country Collaborative Research Network. Population Deaths for all causes or for external causes only registered in each city within the study period. Main outcome measures Daily total mortality (all or non-external causes only). Results A total of 45 165 171 deaths were analysed in the 406 cities. On average, a 10 μg/m 3 increase in ozone during the current and previous day was associated with an overall relative risk of mortality of 1.0018 (95% confidence interval 1.0012 to 1.0024). Some heterogeneity was found across countries, with estimates ranging from greater than 1.0020 in the United Kingdom, South Africa, Estonia, and Canada to less than 1.0008 in Mexico and Spain. Short term excess mortality in association with exposure to ozone higher than maximum background levels (70 μg/m 3) was 0.26% (95% confidence interval 0.24% to 0.28%), corresponding to 8203 annual excess deaths (95% confidence interval 3525 to 12 840) across the 406 cities studied. The excess remained at 0.20% (0.18% to 0.22%) when restricting to days above the WHO guideline (100 μg/m 3), corresponding to 6262 annual excess deaths (1413 to 11 065). Above more lenient thresholds for air quality standards in Europe, America, and China, excess mortality was 0.14%, 0.09%, and 0.05%, respectively. Conclusions Results suggest that ozone related mortality could be potentially reduced under stricter air quality standards. These findings have relevance for the implementation of efficient clean air interventions and mitigation strategies designed within national and international climate policies. © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

How urban characteristics affect vulnerability to heat and cold: a multi-country analysis.

BACKGROUND: The health burden associated with temperature is expected to increase due to a warming climate. Populations living in cities are likely to be particularly at risk, but the role of urban characteristics in modifying the direct effects of temperature on health is still unclear. In this contribution, we used a multi-country dataset to study effect modification of temperature-mortality relationships by a range of city-specific indicators. METHODS: We collected ambient temperature and mortality daily time-series data for 340 cities in 22 countries, in periods between 1985 and 2014. Standardized measures of demographic, socio-economic, infrastructural and environmental indicators were derived from the Organisation for Economic Co-operation and Development (OECD) Regional and Metropolitan Database. We used distributed lag non-linear and multivariate meta-regression models to estimate fractions of mortality attributable to heat and cold (AF%) in each city, and to evaluate the effect modification of each indicator across cities. RESULTS: Heat- and cold-related deaths amounted to 0.54% (95% confidence interval: 0.49 to 0.58%) and 6.05% (5.59 to 6.36%) of total deaths, respectively. Several city indicators modify the effect of heat, with a higher mortality impact associated with increases in population density, fine particles (PM2.5), gross domestic product (GDP) and Gini index (a measure of income inequality), whereas higher levels of green spaces were linked with a decreased effect of heat. CONCLUSIONS: This represents the largest study to date assessing the effect modification of temperature-mortality relationships. Evidence from this study can inform public-health interventions and urban planning under various climate-change and urban-development scenarios

Global, regional, and national burden of mortality associated with cold spells during 2000-19: a three-stage modelling study.

BACKGROUND: Exposure to cold spells is associated with mortality. However, little is known about the global mortality burden of cold spells. METHODS: A three-stage meta-analytical method was used to estimate the global mortality burden associated with cold spells by means of a time series dataset of 1960 locations across 59 countries (or regions). First, we fitted the location-specific, cold spell-related mortality associations using a quasi-Poisson regression with a distributed lag non-linear model with a lag period of up to 21 days. Second, we built a multivariate meta-regression model between location-specific associations and seven predictors. Finally, we predicted the global grid-specific cold spell-related mortality associations during 2000-19 using the fitted meta-regression model and the yearly grid-specific meta-predictors. We calculated the annual excess deaths, excess death ratio (excess deaths per 1000 deaths), and excess death rate (excess deaths per 100 000 population) due to cold spells for each grid across the world. FINDINGS: Globally, 205 932 (95% empirical CI [eCI] 162 692-250 337) excess deaths, representing 3·81 (95% eCI 2·93-4·71) excess deaths per 1000 deaths (excess death ratio), and 3·03 (2·33-3·75) excess deaths per 100 000 population (excess death rate) were associated with cold spells per year between 2000 and 2019. The annual average global excess death ratio in 2016-19 increased by 0·12 percentage points and the excess death rate in 2016-19 increased by 0·18 percentage points, compared with those in 2000-03. The mortality burden varied geographically. The excess death ratio and rate were highest in Europe, whereas these indicators were lowest in Africa. Temperate climates had higher excess death ratio and rate associated with cold spells than other climate zones. INTERPRETATION: Cold spells are associated with substantial mortality burden around the world with geographically varying patterns. Although the number of cold spells has on average been decreasing since year 2000, the public health threat of cold spells remains substantial. The findings indicate an urgency of taking local and regional measures to protect the public from the mortality burdens of cold spells. FUNDING: Australian Research Council, Australian National Health and Medical Research Council, EU's Horizon 2020 Project Exhaustion

Projections of Temperature-related Excess Mortality Under Climate Change Scenarios

Summary Background Climate change can directly affect human health by varying exposure to non-optimal outdoor temperature. However, evidence on this direct impact at a global scale is limited, mainly due to issues in modelling and projecting complex and highly heterogeneous epidemiological relationships across different populations and climates. Methods We collected observed daily time series of mean temperature and mortality counts for all causes or non-external causes only, in periods ranging from Jan 1, 1984, to Dec 31, 2015, from various locations across the globe through the Multi-Country Multi-City Collaborative Research Network. We estimated temperature–mortality relationships through a two-stage time series design. We generated current and future daily mean temperature series under four scenarios of climate change, determined by varying trajectories of greenhouse gas emissions, using five general circulation models. We projected excess mortality for cold and heat and their net change in 1990–2099 under each scenario of climate change, assuming no adaptation or population changes. Findings Our dataset comprised 451 locations in 23 countries across nine regions of the world, including 85 879 895 deaths. Results indicate, on average, a net increase in temperature-related excess mortality under high-emission scenarios, although with important geographical differences. In temperate areas such as northern Europe, east Asia, and Australia, the less intense warming and large decrease in cold-related excess would induce a null or marginally negative net effect, with the net change in 2090–99 compared with 2010–19 ranging from −1·2% (empirical 95% CI −3·6 to 1·4) in Australia to −0·1% (−2·1 to 1·6) in east Asia under the highest emission scenario, although the decreasing trends would reverse during the course of the century. Conversely, warmer regions, such as the central and southern parts of America or Europe, and especially southeast Asia, would experience a sharp surge in heat-related impacts and extremely large net increases, with the net change at the end of the century ranging from 3·0% (−3·0 to 9·3) in Central America to 12·7% (−4·7 to 28·1) in southeast Asia under the highest emission scenario. Most of the health effects directly due to temperature increase could be avoided under scenarios involving mitigation strategies to limit emissions and further warming of the planet. Interpretation This study shows the negative health impacts of climate change that, under high-emission scenarios, would disproportionately affect warmer and poorer regions of the world. Comparison with lower emission scenarios emphasises the importance of mitigation policies for limiting global warming and reducing the associated health risks

Short term association between ozone and mortality: global two stage time series study in 406 locations in 20 countries.

OBJECTIVE: To assess short term mortality risks and excess mortality associated with exposure to ozone in several cities worldwide. DESIGN: Two stage time series analysis. SETTING: 406 cities in 20 countries, with overlapping periods between 1985 and 2015, collected from the database of Multi-City Multi-Country Collaborative Research Network. POPULATION: Deaths for all causes or for external causes only registered in each city within the study period. MAIN OUTCOME MEASURES: Daily total mortality (all or non-external causes only). RESULTS: A total of 45 165 171 deaths were analysed in the 406 cities. On average, a 10 µg/m3 increase in ozone during the current and previous day was associated with an overall relative risk of mortality of 1.0018 (95% confidence interval 1.0012 to 1.0024). Some heterogeneity was found across countries, with estimates ranging from greater than 1.0020 in the United Kingdom, South Africa, Estonia, and Canada to less than 1.0008 in Mexico and Spain. Short term excess mortality in association with exposure to ozone higher than maximum background levels (70 µg/m3) was 0.26% (95% confidence interval 0.24% to 0.28%), corresponding to 8203 annual excess deaths (95% confidence interval 3525 to 12 840) across the 406 cities studied. The excess remained at 0.20% (0.18% to 0.22%) when restricting to days above the WHO guideline (100 µg/m3), corresponding to 6262 annual excess deaths (1413 to 11 065). Above more lenient thresholds for air quality standards in Europe, America, and China, excess mortality was 0.14%, 0.09%, and 0.05%, respectively. CONCLUSIONS: Results suggest that ozone related mortality could be potentially reduced under stricter air quality standards. These findings have relevance for the implementation of efficient clean air interventions and mitigation strategies designed within national and international climate policies