Ser intelectual: Sor Juana Ines de la Cruz, Rosario Castellanos y Rosario Ferre ante el feminismo latinamericano

The purpose of this thesis is to use literature to bridge the gap between two distinct theories: the theory of the intellectual and feminist theory. Initially, I discuss the changing definitions of the intellectual over time—including the definitions presented by Voltaire, Jean- Jacques Rousseau, Antonio Gramsci, and Howard Zinn. However, when evaluated as separate and conflicting theories, each of them fails to depict the complexities of the intellectual as a societal figure. Therefore, I chose to use the characterization of the intellectual presented by Edward Said in Representations of the Intellectual: The 1993 Reith Lectures (1991). Said defines the intellectual in an inclusive rather than exclusive manner by amalgamating previous articulations of the theory of the intellectual to create a nuanced depiction of this societal role. I then continue on to discuss the definition, purpose, and goals of the theory of feminism in general. Furthermore, I distinguish Latin American feminism from general feminist theory citing varying sociocultural factors (i.e. religion and ethnicity) as the underlying purpose for this distinction. After analyzing Respuesta a Sor Filotea de la Cruz (1691) by Sor Juana Inés de la Cruz, Mujer que sabe latin…(1974) by Rosario Castellanos, and El coloquio de las perras (1991) by Rosario Ferré, I conlude that these three women fulfill the societal roles attributed to the intellectual through their work as Latin American feminist writers. By questioning and criticizing the misogynistic rhetoric and norms of patriarchal society, Sor Juana Inés de la Cruz, Rosario Castellanos, and Rosario Ferré connect the intellectual and feminist theories

an international survey before and during the COVID-19 pandemic

Funding Information: The Société Française d’Anesthésie et de Réanimation (SFAR), Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC), Sociedad Argentina de Terapia Intensiva (SATI), Sociedad Chilena de Medicina Intensiva (SOCHIMI), Associação de Medicina Intensiva Brasileira (AMIB-Net) and the Brazilian Research in Intensive Care Network (BricNet) supported this survey. We would also like to thank our friend Tiago Rocha for making the amazing logo for this study. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brazil (CAPES)—Finance Code 001. Publisher Copyright: © 2022, The Author(s).Background: Since the publication of the 2018 Clinical Guidelines about sedation, analgesia, delirium, mobilization, and sleep deprivation in critically ill patients, no evaluation and adequacy assessment of these recommendations were studied in an international context. This survey aimed to investigate these current practices and if the COVID-19 pandemic has changed them. Methods: This study was an open multinational electronic survey directed to physicians working in adult intensive care units (ICUs), which was performed in two steps: before and during the COVID-19 pandemic. Results: We analyzed 1768 questionnaires and 1539 (87%) were complete. Before the COVID-19 pandemic, we received 1476 questionnaires and 292 were submitted later. The following practices were observed before the pandemic: the Visual Analog Scale (VAS) (61.5%), the Behavioral Pain Scale (BPS) (48.2%), the Richmond Agitation Sedation Scale (RASS) (76.6%), and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) (66.6%) were the most frequently tools used to assess pain, sedation level, and delirium, respectively; midazolam and fentanyl were the most frequently used drugs for inducing sedation and analgesia (84.8% and 78.3%, respectively), whereas haloperidol (68.8%) and atypical antipsychotics (69.4%) were the most prescribed drugs for delirium treatment; some physicians regularly prescribed drugs to induce sleep (19.1%) or ordered mechanical restraints as part of their routine (6.2%) for patients on mechanical ventilation; non-pharmacological strategies were frequently applied for pain, delirium, and sleep deprivation management. During the COVID-19 pandemic, the intensive care specialty was independently associated with best practices. Moreover, the mechanical ventilation rate was higher, patients received sedation more often (94% versus 86.1%, p < 0.001) and sedation goals were discussed more frequently in daily rounds. Morphine was the main drug used for analgesia (77.2%), and some sedative drugs, such as midazolam, propofol, ketamine and quetiapine, were used more frequently. Conclusions: Most sedation, analgesia and delirium practices were comparable before and during the COVID-19 pandemic. During the pandemic, the intensive care specialty was a variable that was independently associated with the best practices. Although many findings are in accordance with evidence-based recommendations, some practices still need improvement.publishersversionpublishe

Key mechanisms by which post-ICU activities can improve in-ICU care: results of the international THRIVE collaboratives

Objective: To identify the key mechanisms that clinicians perceive improve care in the intensive care unit (ICU), as a result of their involvement in post-ICU programs. Methods: Qualitative inquiry via focus groups and interviews with members of the Society of Critical Care Medicine’s THRIVE collaborative sites (follow-up clinics and peer support). Framework analysis was used to synthesize and interpret the data. Results: Five key mechanisms were identified as drivers of improvement back into the ICU: (1) identifying otherwise unseen targets for ICU quality improvement or education programs—new ideas for quality improvement were generated and greater attention paid to detail in clinical care. (2) Creating a new role for survivors in the ICU—former patients and family members adopted an advocacy or peer volunteer role. (3) Inviting critical care providers to the post-ICU program to educate, sensitize, and motivate them—clinician peers and trainees were invited to attend as a helpful learning strategy to gain insights into post-ICU care requirements. (4) Changing clinician’s own understanding of patient experience—there appeared to be a direct individual benefit from working in post-ICU programs. (5) Improving morale and meaningfulness of ICU work—this was achieved by closing the feedback loop to ICU clinicians regarding patient and family outcomes. Conclusions: The follow-up of patients and families in post-ICU care settings is perceived to improve care within the ICU via five key mechanisms. Further research is required in this novel area

Enablers and Barriers to Implementing ICU Follow-Up Clinics and Peer Support Groups Following Critical Illness: The Thrive Collaboratives

OBJECTIVES: Data are lacking regarding implementation of novel strategies such as follow-up clinics and peer support groups, to reduce the burden of postintensive care syndrome. We sought to discover enablers that helped hospital-based clinicians establish post-ICU clinics and peer support programs, and identify barriers that challenged them. DESIGN: Qualitative inquiry. The Consolidated Framework for Implementation Research was used to organize and analyze data. SETTING: Two learning collaboratives (ICU follow-up clinics and peer support groups), representing 21 sites, across three continents. SUBJECTS: Clinicians from 21 sites. MEASUREMENT AND MAIN RESULTS: Ten enablers and nine barriers to implementation of "ICU follow-up clinics" were described. A key enabler to generate support for clinics was providing insight into the human experience of survivorship, to obtain interest from hospital administrators. Significant barriers included patient and family lack of access to clinics and clinic funding. Nine enablers and five barriers to the implementation of "peer support groups" were identified. Key enablers included developing infrastructure to support successful operationalization of this complex intervention, flexibility about when peer support should be offered, belonging to the international learning collaborative. Significant barriers related to limited attendance by patients and families due to challenges in creating awareness, and uncertainty about who might be appropriate to attend and target in advertising. CONCLUSIONS: Several enablers and barriers to implementing ICU follow-up clinics and peer support groups should be taken into account and leveraged to improve ICU recovery. Among the most important enablers are motivated clinician leaders who persist to find a path forward despite obstacles

Fear, Anxiety, and the Assemblage of the Posthuman in Spanish and Catalan Science Fiction (1912-2018)

The overarching goal of this project is to present a more nuanced view of the underexamined affective dimension of Homo sapiens’ ever-changing relationships to technology and science by examining the posthuman trope in science fiction narratives (e.g., artificial intelligence, cyborgs, robots, etc.), and to do so with a non-Anglophone corpus as a way to disrupt the English-language dominance of Science Fiction Studies. To that end, this project uses textual analysis to trace the various ways in which the posthuman amasses affective significance as it is taken up in by Spanish and Catalan authors in different historical moments. Blending affect, assemblage, decolonial, feminist, and queer theories, I propose and develop the analytic of “posthuman assemblage” as a way to account for the definitional slipperiness and affective stickiness of the posthuman. The core contention of this study is that fear and anxiety are the primary affective forces that draw posthuman assemblages into formation in Spanish and Catalan science fiction, much like gravity’s influence on celestial bodies, coalescing them into existence and relationship with one another. In Chapter 2, I argue that fear of human annihilation and anxiety about losing control over societal, scientific, and technological development are the fundamental affective forces that shape the posthuman in three works from the 1910s: Homes artificials by Frederic Pujulà, “Mecanópolis” by Miguel de Unamuno, and El hijo del Doctor Wolffan (un hombre artificial) by M.A. Bedoya. In Chapter 3, I contend that fears about the disintegration of cohesive collective identities of A) Man and B) empire animate the posthuman in the Domingo Santos’s Asimov-inspired robot novel Gabriel (1962) and the revised version Gabriel revisitado (2005). Reading Santos’s novels alongside Jamaican decolonial theorist Sylvia Wynter, I argue, reveals how the posthuman functions as a racializing assemblage that constructs science fictional racial hierarchies based on historical examples. Chapter 4 examines Rosa Montero’s novels Lágrimas en la lluvia (2011), El peso de corazón (2015), and Los tiempos del odio (2018), a series inspired by Philip K. Dick’s novel Do Androids Dream of Electric Sheep (1968) and Ridley Scott’s film adaptation Blade Runner (1982). I propose that fear and anxiety regarding the posthuman in Montero’s novels bifurcates into individual and collective dimensions. On an individual level, the posthuman protagonist fears disablement above all; with respect to the collective, fear and anxiety shape the actions of State and non-state groups in orchestrating the demise of certain (post)humans while protecting others. The conclusion examines commonalities between the primary texts analyzed and proposes that studying Spanish and Catalan science fiction can offer crucial insights for addressing contemporary polemics about science and technology

Social Network Characteristics and HIV Risk Among African American, Asian/Pacific Islander, and Latino Men Who Have Sex With Men

OBJECTIVES: To examine how social networks influence HIV risk among U.S. racial/ethnic minority men who have sex with men (MSM) and whether the associations of social network characteristics with risk vary by race/ethnicity. METHODS: A chain-referral sample of 403 African American, 393 Asian/Pacific Islander, and 400 Latino MSM recruited in Los Angeles County, CA completed a questionnaire, which asked about their egocentric social networks, safer sex peer norms, and male anal intercourse partners. HIV-nonconcordant partnerships were those reported by respondents as serodisconcordant or where self and/or partner serostatus was unknown. RESULTS: Overall, 26% of the sample reported HIV-nonconcordant unprotected anal intercourse (UAI) with a non-primary male partner in the prior six months. In a GEE logistic model that controlled for race/ethnicity, age, nativity, incarceration history, and HIV status, being in a more dense network was associated with less HIV-nonconcordant UAI (adjusted odds ratio [AOR]=0.92, 95% confidence interval [CI]=0.86–0.99, p=0.0467). In addition, the effect of safer sex peer norms on HIV-nonconcordant UAI was moderated by ego-alter closeness (p=0.0021). Safer sex peer norms were protective among those reporting “medium” or “high” ego-alter closeness (AOR=0.70, 95% CI=0.52–0.95, p=0.0213 and AOR=0.48, 95% CI=0.35–0.66, p<0.0001, respectively), but not among those reporting “low” ego-alter closeness (AOR=0.96, 95% CI=0.63–1.46, p=0.8333). The effects of density, closeness, and norms on HIV-nonconcordant UAI did not differ by race/ethnicity. CONCLUSIONS: The significant association of social network characteristics with UAI point to network-level factors as important loci for both ongoing research and HIV prevention interventions among U.S. MSM of color

Relationship Characteristics Differ Based on Use of Substances with Sex among an Urban Internet Sample of HIV-Discordant and HIV-Positive Male Couples

Previous research with men who have sex with men (MSM) has found that substance use with sex is strongly associated with HIV acquisition and poor adherence to HIV treatments. Although some studies have assessed male couples’ use of substances with unprotected anal sex, little is known on whether differences in their relationship dynamics are associated with their usage. Current HIV prevention initiatives underscore the importance of studying male couples’ relationship dynamics. Using dyadic data from 28 HIV-positive and 58 HIV-discordant male couples, this analysis sought to: (1) describe, by substance type, whether neither, one, or both partners in the couple used a particular substance with sex within their relationship or outside of the relationship, respectively, and (2) assess, by substance type, whether relationship characteristic differences existed between these three groups of couples with respect to substance use with sex within and outside the relationship. Data from 86 dyads came from a cross-sectional, Internet study. Multivariate multinomial regression models were employed to achieve the aims. Except for alcohol, most did not use substances with sex. Within the relationship, those who used with sex varied by substance type; outside the relationship, most couples had only one partner who used with sex regardless of substance type. Several relationship characteristic differences were noted between the groups of couples. Within the relationship, marijuana and erectile dysfunction medication (EDM) use with sex was associated with having less tangible resources; for outside the relationship, these were associated with perceiving to have greater quality of alternatives. In general, amyl nitrates and party drug use with sex were associated with viewing the main partner as being less dependable for trustworthiness. Marijuana and party drug use with sex within the relationship and EDM use with sex outside the relationship were negatively associated with being able to communicate constructively. Mixed results were noted for relationship satisfaction. Additional research is urgently needed for prevention and promotion of healthy relationships for male couples who use substances with sex