Urban tourism as a bone of contention. Four explanatory hypotheses and a caveat

This commentary responds to recent debates surrounding the observable proliferation and intensification of controversies and disputes surrounding urban tourism. It argues that coming to terms with conflicts about and around tourism in cities represents an important frontier for research and puts forth some observations about its causes and characteristics, the debates they have sparked, and our scholarly engagement with them so far. In particular, the commentary will address (i) the role of urban tourism’s massive and often rapid growth; (ii) the fact that backlashes in cities are often less directed against tourism in its entirety than against particular kinds of tourism (or tourists); (iii) the need to look at contestations surrounding urban tourism not in isolation from, but in firm connection to the more general rise of struggles and protests in and about urban space unfolding in cities worldwide ; (iv) the extent to which contestations are are linked to the ongoing, and, it seems, accelerating, geographical spread of tourism; and, lastly, (v) the need to critically engage with the notion of tourism itself and move beyond essentialising narratives that portray tourism as an alltogether distinct, easily separable social phenomenon

‘Destination’ Berlin revisited. From (new) tourism towards a pentagon of mobility and place consumption

This article is concerned with the increasing role and relevance of tourism in processes of urban change as well as its overlap and interplay with other mobilities and place consumption practices. It responds to recent debates surrounding the extension and intensification of ‘touristification’ processes in urban areas and uses the case of Berlin to draw attention to a number of intricacies and complexities that complicate their interpretation. The main argument the article advances is that developments in Berlin which are currently discussed under the rubric of ‘touristification’ can by no means be exclusively attributed to tourism, however conceived, and instead illustrate the need to adopt new ways of approaching and understanding what is perceived as tourism-induced urban change. To this end, the article will present a preliminary heuristic portrayal of (tourism) mobility and place consumption as a pentagon with five interrelated but distinct dimensions and present several salient issues and questions that warrant further investigation. The paper will conclude with some brief reflections concerning the wider implications of the increased centrality of mobility flows and place consumption practices in today's cities. These, it will be argued, not only challenge the way we think about tourism. Rather, they also raise fundamental questions concerning our understanding of cities and neighbourhoods, the ‘legitimacy’ of particular claims over them, as well as several traditional precepts of modern urban planning and management

Urban tourism as a bone of contention. Four explanatory hypotheses and a caveat

This commentary responds to recent debates surrounding the observable proliferation and intensification of controversies and disputes surrounding urban tourism. It argues that coming to terms with conflicts about and around tourism in cities represents an important frontier for research and puts forth some observations about its causes and characteristics, the debates they have sparked, and our scholarly engagement with them so far. In particular, the commentary will address (i) the role of urban tourism’s massive and often rapid growth; (ii) the fact that backlashes in cities are often less directed against tourism in its entirety than against particular kinds of tourism (or tourists); (iii) the need to look at contestations surrounding urban tourism not in isolation from, but in firm connection to the more general rise of struggles and protests in and about urban space unfolding in cities worldwide ; (iv) the extent to which contestations are are linked to the ongoing, and, it seems, accelerating, geographical spread of tourism; and, lastly, (v) the need to critically engage with the notion of tourism itself and move beyond essentialising narratives that portray tourism as an alltogether distinct, easily separable social phenomenon

Getting back into the “business of making things”. On the promise and perils of the “productive city”

In recent years there has been much talk about a return of manufacturing (and production at large) to cities in advanced capitalist countries and the many benefits this can bring to urban economies and communities. This trend is reflected in the fact that the idea of the "productive city" is increasingly doing the rounds in urban planning and policy discourses. But what exactly is meant by this idea and which "urban producers" are actually being referred to when it is propagated? This debate article starts from the premise that not only the potentials but also the pitfalls, conflicts and contradictions arising from the current discourse on urban production and related ideas warrant critical investigation. Following on from this, it argues that the idea of the "productive city", in its current form, should not be seen as an innocuous idea to be embraced but as a starting point, indeed as a heuristic, for exploring the future of making in cities, as well as for a more general debate about what makes 21st century cities "productive" and what kind of "productivity" urban policy and planning practice should strive for

Urban tourism as a source of contention and social mobilisations: a critical review

Across the globe, there has been a proliferation of manifestations of discontent and protest around tourism-related issues in cities. This points to an increasing “politicization from below” of the impacts of the visitor economy on people and places, which is the result of the quantitative and qualitative transformation of urban tourism, and of the ways in which tourism has been governed (or not) in contemporary cities. This critical review discusses the variety of tourism-related social mobilisations recently witnessed in cities. It distinguishes between multi-focal versus single-issue mobilisations; between those purposefully and primarily focused on tourism and those which have integrated tourism within broader urban struggles; between those with a radical, progressive agenda for urban change versus those primarily defending narrower interests or exhibiting reactionary or hostile characteristics. The paper ends by discussing how urban governance and public policies have responded so far to the conflicts and social mobilisations around tourism

Urban tourism as a source of contention and social mobilisations: a critical review

Across the globe, there has been a proliferation of manifestations of discontent and protest around tourism-related issues in cities. This points to an increasing “politicisation from below” of the impacts of the visitor economy on people and places, which is the result of the quantitative and qualitative transformation of urban tourism, and of the ways in which tourism has been governed (or not) in contemporary cities. This critical review discusses the variety of tourism-related social mobilisations recently witnessed in cities. It distinguishes between multi-focal versus single-issue mobilisations; between those purposefully and primarily focused on tourism and those which have integrated tourism within broader urban struggles; between those with a radical, progressive agenda for urban change versus those primarily defending narrower interests or exhibiting reactionary or hostile characteristics. The paper ends by discussing how urban governance and public policies have responded so far to the conflicts and social mobilisations around tourism

Age, Comorbidity, Frailty in Observational and Analytic Studies of Neurological Diseases

BACKGROUND: Comorbidities are rarely taken into account in studies of neurological conditions although they may be a confounder of the outcome and treatment. The relationship between comorbidities and neurological conditions is also problematic as comorbidities may be symptoms of the underlying cause of the neurologic condition or long-term adverse effects of the treatment. SUMMARY: There is evidence that several common neurological conditions have an increased burden of somatic and psychiatric comorbidities compared with matched samples from the general population. Depression is probably the most common comorbidity. Both psychiatric and somatic comorbidities have been shown to account for some of the premature mortality encountered in these neurological conditions. Comorbidities and age can also be important factors in the response and tolerance to treatment, and can alter the general outcome of a disease. KEY MESSAGES: Age and comorbidities should not be overlooked in the observation and assessment of neurological conditions and their treatment

Urban tourism and its discontents: an introduction

This chapter examines Belfast, Northern Ireland as a case study in order to analyse how the politics of tourism development intersect with the politics of ethnic conflict in deeply divided cities with histories of violent conflict. Policy-makers began strategizing Belfast's comeback long before the conflict was settled. Protestants, in turn, frame the hardships of their communities in light of the Catholic community's growing financial and political influence. As Baker states, if there is one thing that can be said for sectarianism, it gives meaning to one's life and it is free at the point of entry'. The economic growth that was supposed to undermine ethnic tension has become a driver of the old conflict in a new form. Groups are also attempting to circumvent state constraints by seeking investment from international organizations such as the European Union or the International Fund for Ireland

Newer Antiepileptic Drugs in Status Epilepticus: Prescription Trends and Outcomes in Comparison with Traditional Agents.

Newer antiepileptic drugs (AEDs) are increasingly prescribed; however, relatively limited data are available regarding their use in status epilepticus (SE) and the impact on outcome. The aim of this study was to explore the evolution in prescription patterns of newer and traditional AEDs in this clinical setting, and their association with prognosis. We analyzed our prospective adult SE registry over a 10-year period (2007-2016) and assessed the yearly use of newer and traditional AEDs and their association with mortality, return to baseline conditions at discharge, and SE refractoriness, defined as treatment resistance to two AEDs, including benzodiazepines. In 884 SE episodes, corresponding to 719 patients, the prescription of at least one newer AED increased from 0.38 per SE episode in 2007 to 1.24 per SE episode in 2016 (mostly due to the introduction of levetiracetam and lacosamide). Traditional AEDs (excluding benzodiazepines) decreased over time from 0.74 in 2007 to 0.41 in 2016, correlating with the decreasing use of phenytoin. The prescription of newer AEDs was independently associated with a lower chance of return to baseline conditions at discharge (odds ratio [OR] 0.58, 95% confidence interval [CI] 0.40-0.84) and a higher rate of SE refractoriness (OR 19.84, 95% CI 12.76-30.84), but not with changes in mortality (OR 1.08, 95% CI 0.58-2.00). We observed a growing trend in the prescription of newer AEDs in SE over the last decade; however, our findings might suggest an associated increased risk of SE refractoriness and new disability at hospital discharge. Pending prospective, comparative studies, this may justify some caution in the routine use of newer AEDs in SE

Recurrence of status epilepticus: Prognostic role and outcome predictors.

OBJECTIVE: Predictors of morbidity and mortality after status epilepticus (SE) have been studied extensively in hospital- and population-based cohorts. However, little attention has been directed toward SE recurrence after an incident episode. We investigated clinical and demographic characteristics of patients presenting SE recurrence and its specific prognostic role. METHODS: In this observational cohort study, we screened our prospective registry of consecutive adults with SE between April 2006 and February 2014. Demographic and clinical data were compared between incident and recurrent SE episodes; risk of SE recurrence was assessed through survival analysis, and the prognostic role of SE recurrence with multivariable logistic regressions. RESULTS: Of the incident cohort (509 patients), 68 (13%) experienced recurrent SE. The cumulative recurrence rate over 4 years was 32%. Recurrence risk was significantly reduced after an acute SE etiology (hazard ratio [HR] 0.5, 95% confidence interval [CI] 0.31-0.82; p = 0.005), and was borderline increased in women (HR 1.59, 95% CI 0.97-2.65; p = 0.06). Although recurrent SE episodes showed lower morbidity and mortality, prognosis was independently related to Status Epilepticus Severity Score (STESS) and potentially fatal etiology, but not to SE recurrence. SIGNIFICANCE: This study provides class III evidence that SE recurrence involves a significant proportion of patients, and that recurrence risk is independently associated with chronic etiology and to a lesser extent with female gender. However, contrary to underlying cause and SE severity, SE recurrence per se does not independently correlate with outcome. Early identification of patients at higher risk of SE recurrence may influence their management during follow-up