Fictional Projection and Search for Identity in Muriel Spark’s African Spaces

Literary and feminist criticism on Muriel Spark seems to ignore the fact that the meaning of her work is rooted in her experiences in Africa for six years. The purpose of this essay is to review her short stories and novels, which take place in lands of natives and colonists, in order to detect common features of these spaces, particularly how the writer projects herself through characters who construct and deconstruct social conventions in a metafictive way. Thus, the novelist questions concepts such as masculine and feminine roles, madness, matrimony, ethnicity, social class and most of all, she questions her own identy as a writerA través de la proyección de Muriel Spark sobre las narradores de varias novelas y breves relatos, que tienen lugar en espacios africanos, descubrimos la deconstrucción de convencionalismos y categorías sobre género, sexo, etnia, clase social, etc. Spark, se sirve del ojo crítico de las narradoras, para cuestionar irónicamente las costumbres de la sociedad colonial y británica. Además, mediante estrategias de ficción onírica y misticismo, reconstruye la naturaleza humana y replantea los limites entre la cordura y la locura. Así, autobiografía y obra literaria se completan mutuamente, sin que se puedan escindir los limites de una y otra. En ambos casos, autobiografía y relatos, los paisajes extremos y cambios climáticos del contienente africano constituye un parangón al proceso de la búsqueda de su identidad

Proyección ficticia y búsqueda de la identidad en los espacios africanos de Muriel Spark / Fictional Projection and Search for Identity in Muriel Spark’s African Spaces

RESUMEN: La crítica literaria y feminista sobre Muriel Spark parece desatender la importancia de que la escritora enraice el sentido de su carrera literaria en sus experiencias de seis años en África. El presente artículo repasa los breves relatos y novelas que se desarrollan en estas tierras de colonos y nativos, con el propósito de detectar los rasgos comunes de todos estos espacios; en concreto cómo la escritora se proyecta sobre sus protagonistas para deconstruir y reconstruir meta-fictivamente convenciones sociales, roles masculinos y femeninos, la locura, el matrimonio, la etnia, la clase social, y sobre todo, su propia identidad como escritora. ABSTRACT: Literary and feminist criticism on Muriel Spark seems to ignore the fact that the meaning of her work is rooted in her experiences in Africa for six years. The purpose of this essay is to review her short stories and novels, which take place in lands of natives and colonists, in order to detect common features of these spaces, particularly how the writer projects herself through characters who construct and deconstruct social conventions in a metafictive way. Thus, the novelist questions concepts such as masculine and feminine roles, madness, matrimony, ethnicity, social class and most of all, she questions her own identy as a writer

Diverse Large HIV-1 Non-subtype B Clusters Are Spreading Among Men Who Have Sex With Men in Spain

In Western Europe, the HIV-1 epidemic among men who have sex with men (MSM) is dominated by subtype B. However, recently, other genetic forms have been reported to circulate in this population, as evidenced by their grouping in clusters predominantly comprising European individuals. Here we describe four large HIV-1 non-subtype B clusters spreading among MSM in Spain. Samples were collected in 9 regions. A pol fragment was amplified from plasma RNA or blood-extracted DNA. Phylogenetic analyses were performed via maximum likelihood, including database sequences of the same genetic forms as the identified clusters. Times and locations of the most recent common ancestors (MRCA) of clusters were estimated with a Bayesian method. Five large non-subtype B clusters associated with MSM were identified. The largest one, of F1 subtype, was reported previously. The other four were of CRF02_AG (CRF02_1; n = 115) and subtypes A1 (A1_1; n = 66), F1 (F1_3; n = 36), and C (C_7; n = 17). Most individuals belonging to them had been diagnosed of HIV-1 infection in the last 10 years. Each cluster comprised viruses from 3 to 8 Spanish regions and also comprised or was related to viruses from other countries: CRF02_1 comprised a Japanese subcluster and viruses from 8 other countries from Western Europe, Asia, and South America; A1_1 comprised viruses from Portugal, United Kingom, and United States, and was related to the A1 strain circulating in Greece, Albania and Cyprus; F1_3 was related to viruses from Romania; and C_7 comprised viruses from Portugal and was related to a virus from Mozambique. A subcluster within CRF02_1 was associated with heterosexual transmission. Near full-length genomes of each cluster were of uniform genetic form. Times of MRCAs of CRF02_1, A1_1, F1_3, and C_7 were estimated around 1986, 1989, 2013, and 1983, respectively. MRCA locations for CRF02_1 and A1_1 were uncertain (however initial expansions in Spain in Madrid and Vigo, respectively, were estimated) and were most probable in Bilbao, Spain, for F1_3 and Portugal for C_7. These results show that the HIV-1 epidemic among MSM in Spain is becoming increasingly diverse through the expansion of diverse non-subtype B clusters, comprising or related to viruses circulating in other countries

Estudio de los comportamientos femeninos en las novelas de Muriel Spark

Muriel Spark es una novelista escocesa contemporánea que dirige su impulso vital empirista hacia la recreación literaria de sus experiencias, de tal modo que no sólo se concibe a sí misma como señora de su vida, sino que, en contra de formalistas y otros teóricos de la literatura, sobre todo, se sabe dueña de su metaficción particular.Su desarrollo literario demuestra que está más en contacto con el tema de la locura humana de lo que cualquiera de las revisiones monográficas o críticas haya podido insinuar. Heredera de la trágica historia de la mujer en la psiquiatría británica desde el siglo XVIII, Spark crea heroínas que denuncian el rol ineludiblemente asignado a la mujer en la cultura patriarcal. Su estilo, no obstante, no es el del explícito ensayo moralista; al contrario, Spark prefiere su personalísima desegregación del arte, mediante la cual destruye cualquier principio teórico o moral con crueldad y sarcasmo inusitado, e incita al lector escandalizado a que naturalice o dé sentido a los errores de la humanidad, sugiriéndole redefiniciones de conceptos tales como el fenómeno patológico, la feminidad, lo espiritual, el psicoanálisis, etc. En el análisis de cuatro novelas, se observan distintos tipos de coerción de la libertad femenina: familiar, política, social y espiritual. Ésta última es siempre fallida, pues la novelista encarna un compromiso católico-junguiano que confía en el despliegue del inconsciente colectivo para compensar la falta de autoconscienciación de los hombres. Al igual que gran parte de la literatura de mujer, la espiritualidad femenina continúa llena de ambigüedades, pero a diferencia de dicha tradición, las heroínas de Spark cada vez más encuentran la salida de la locura, resolviendo sus múltiples divisiones internas en evoluciones firmes que definen su unicidad y desafían cómicamente el problema del mal

Easy Reading: development of a manual cognitively adapted to young people with intellectual disabilities in the Animal Care Specialty of the Liceo University Diploma

A partir del material elaborado en los Proyectos INNOVA-Docencia 244/2021 y 164/2022, se pretende crear un manual en lectura fácil, dirigido al estudiantado con discapacidad intelectual de la Especialidad de Cuidado de Animales del Diploma Liceo.Depto. de Farmacología y ToxicologíaFac. de VeterinariaFALSEsubmitte

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research