Politics, power, and "palabras" mirrored in contemporary chicana literature

One of the main characteristics of politics is its close connection with power whose positive effect is to work for the common good. However, there is also the risk of political power being used in a less benevolent way. On the one hand, concrete acts are what makes power visible and tangible, yet on the other hand written and oral speech acts will achieve the same end. Then again, words which are spoken or noted down on paper are only one way to get a message across, since everything that remains unsaid also has considerable effects. Missing or fragmentary information hints at the tendency of public institutions to overlook or neglect certain population groups thus putting the members of those groups at a disadvantage, impeding their participation within society. The subsequent analysis of contemporary Mexican-American prose will examine the interactions and effects of political communication in the USA by studying literary characters and their lives as well as the legislative framework and the arguments of individuals in key positions of society. Examining the literary representation of these interrelated aspects in Ana Castillo’s novel So Far From God will expose the connections between political acts and statements as well as the effects of the corresponding communication or lack thereof on the people concerned. The interdisciplinary approach of the analysis makes use of scientific knowledge regarding power, language, sociology and cultural studies in order to provide deeper insights into the interaction of politics and literature.La política está marcada por el ejercicio del poder, cuyo efecto positivo consiste en asegurar el bienestar común. Sin embargo, el poder político conlleva el riesgo de ser utilizado con motivos no filantrópicos. El poder en sus diferentes formas se vuelve palpable y visible, por un lado, por acciones concretas, así como también por expresiones escritas y orales. De esta forma, no solamente las palabras orales o escritas tienen efecto, sino también las cosas no expresadas. La falta de información o la información expresada de una forma incompleta indica que las instituciones públicas tienden a omitir o descuidar algunos grupos de la población, por lo que los integrantes de dichos grupos quedan en desventaja al participar de la vida social. El siguiente análisis de prosa mexicana-americana muestra el vínculo y el efecto de las comunicaciones políticas en los EUA, lo que se observa tanto en los destinos personales de personajes literarios, como en la legislación fundamental y las formas de argumentación de los dirigentes en posiciones claves en la sociedad. El estudio de la representación literaria de estas relaciones en la novela So Far From God de Ana Castillo deja discernir claramente el lazo entre los actos políticos y las declaraciones y expone las consecuencias, que aquella comunicación o la falta de ella significa para los afectados. El enfoque interdisciplinario de este análisis se apoya en conocimientos ganados en la investigación de poder, el lenguaje, la sociología y las ciencias culturales para adquirir una comprensión más profunda de la interacción entre la política y la literatura

Fatigue bei Multipler Sklerose unter besonderer Berücksichtigung komorbider schlafmedizinischer Erkrankungen

Schlafmedizinische Erkrankungen sind häufig bei MS-Patienten, welche unter einer MS-Fatigue leiden. Es existiert ein signifikanter Zusammenhang zwischen erhöhten Werten in der Modified Fatigue Impact Scale (MFIS) und der Fatigue Severity Scale (FSS) und dem Vorliegen einer schlafmedizinischen Erkrankung. In zukünftigen MS-Fatigue-Studien sollten schlafmedizinische Erkrankungen als wichtiger Störfaktor regelhaft untersucht und berücksichtigt werden. Die Behandlung einer komorbiden schlafmedizinischen Erkrankung scheint die MS-Fatigue zu bessern. Die Verbesserung der Lebensqualität und die Erhaltung der Erwerbsfähigkeit stellen weitere Gründe dar, welche für die konsequente Behandlung einer komorbiden schlafmedizinischen Erkrankung sprechen. Schlafmedizinische Untersuchungen wie die Polysomnographie können zudem möglicherweise neue Erkenntnisse über eine Beeinträchtigung des motorischen Systems bei MS-Patienten liefern, da ein erhöhter Index an periodischen Beinbewegungen im REM-Schlaf einen Risikofaktor für einen erhöhten Grad der Behinderung darstellt. Ambulante Polysomnographien, welche bei den Patienten zu Hause durchgeführt werden, weisen nur einen geringen Habituationseffekt (First-Night-Effect) auf

The Berlin Treatment Algorithm: recommendations for tailored innovative therapeutic strategies for multiple sclerosis-related fatigue

More than 80% of multiple sclerosis (MS) patients suffer from fatigue. Despite this, there are few therapeutic options and evidence-based pharmacological treatments are lacking. The associated societal burden is substantial (MS fatigue is a major reason for part-time employment or early retirement), and at least one out of four MS patients view fatigue as the most burdensome symptom of their disease. The mechanisms underlying MS-related fatigue are poorly understood, and objective criteria for distinguishing and evaluating levels of fatigue and tiredness have not yet been developed. A further complication is that both symptoms may also be unspecific indicators of many other diseases (including depression, sleep disorders, anemia, renal failure, liver diseases, chronic obstructive pulmonary disease, drug side effects, recent MS relapses, infections, nocturia, cancer, thyroid hypofunction, lack of physical exercise). This paper reviews current treatment options of MS-related fatigue in order to establish an individualized therapeutic strategy that factors in existing comorbid disorders. To ensure that such a strategy can also be easily and widely implemented, a comprehensive approach is needed, which ideally takes into account all other possible causes and which is moreover cost efficient. Using a diagnostic interview, depressive disorders, sleep disorders and side effects of the medication should be identified and addressed. All MS patients suffering from fatigue should fill out the Modified Fatigue Impact Scale, Epworth Sleepiness Scale, the Beck Depression Inventory (or a similar depression scale), and the Pittsburgh Sleep Quality Index (or the Insomnia Severity Index). In some patients, polygraphic or polysomnographic investigations should be performed. The treatment of underlying sleep disorders, drug therapy with alfacalcidol or fampridine, exercise therapy, and cognitive behavioral therapy-based interventions may be effective against MS-related fatigue. The objectives of this article are to identify the reasons for fatigue in patients suffering from multiple sclerosis and to introduce individually tailored treatment approaches. Moreover, this paper focuses on current knowledge about MS-related fatigue in relation to brain atrophy and lesions, cognition, disease course, and other findings in an attempt to identify future research directions

Umweltproteste in China: alles BANANA?

Im Juli 2012 kam es in den chinesischen Städten Shifang und Qidong zu großen und gewaltsamen Protesten gegen Industrieprojekte, von denen die Bewohner Umweltschäden sowie gesundheitliche und wirtschaftliche Beeinträchtigungen befürchteten. Beide Projekte wurden inzwischen von den lokalen Regierungen gestoppt. Die Proteste in Shifang und Qidong lassen sich in einen größeren Trend zunehmender Umweltproteste einordnen, der spätestens mit den „Spaziergängen“ in Xiamen im Jahr 2007 bekannt geworden ist. Beide Fälle sind typisch für diese neue Form des Bürgeraktivismus, der die chinesische Regierung vor erhebliche Herausforderungen stellt. Bürgerliche Aktivisten in China bedienen sich unkonventioneller Formen des Protests und greifen auch zur Gewalt. Dahinter steht nicht kleinbürgerlicher Egoismus, sondern eine tiefe Krise des Vertrauens zwischen Bürger und Staat. In China ist eine deutliche Zunahme des bürgerlichen Aktivismus festzustellen. Die Zahl an Protesten, Petitionen und sogenannten E-Movements nimmt seit dem Jahr 1993 kontinuierlich zu; die Zahl der Umweltproteste wächst besonders schnell. Die gängige Stigmatisierung dieser Proteste als NIMBY-Phänomene (not in my backyard), von Stadtplanern auch mit dem Akronym BANANA (build absolutely nothing anywhere near anyone) gekennzeichnet, die nur aus lokalem Eigeninteresse der Bevölkerung erfolgen, greift zu kurz, da sie die Beschränkungen des autoritären politischen Kontexts in China übergeht. Chinesische Bürgeraktivisten fordern die Einhaltung bestehender Rechte, ihr Zorn richtet sich gegen das Fehlverhalten lokaler Regierungen und sie sind bereit, dafür erhebliche politische Risiken einzugehen. Die Protestierenden besitzen eine erhöhte Risikobereitschaft, da sie das Vertrauen in die Lokalregierungen verloren und ein stärkeres Umwelt- und Rechtsbewusstsein entwickelt haben. Mangelnde institutionelle Mechanismen der Partizipation und die Möglichkeiten der Information über neue soziale Medien erhöhen zusätzlich den Druck auf die Regierung. Die Regierung hat bisher keine umfassende Strategie zum Umgang mit dem neuen bürgerlichen Aktivismus, da sie mit den rasanten sozialen Veränderungen nicht Schritt halten kann. Dies verweist auf die grundlegende Diskrepanz wirtschaftlichen Aufschwungs und politischen Stillstands. Angesichts der Politisierung einer jungen Generation bürgerlicher Aktivisten könnte diese reaktive Haltung für das Regime gefährlich werden

Invisible, inaudible, influential? Reclaiming Latino life

Even before the first Anglo-American settlers arrived in the New World, there had been a variety of literary and other cultural productions on the North American continent by people of diverse ethnic origin. Likewise, by the mid-sixteenth century, administrative, cultural and educational institutions had been introduced to North America by Spanish explorers, missionaries, and colonists (Kanellos 2). Today roughly one in six people in the United States of America belongs to the group labeled “Latinos” or “Hispanics”, according to the 2010 census. Despite these facts and figures and despite centuries of Latino traditions and cultural expressions on the American continent and particularly on what is now the U.S. Southwest, the works of Latinos have been looked upon as those of an insignificant minority. In fact, Hispanics are assigned the status of “the Other”. They have been struggling to overcome rejections and stereotypes, striving to be heard and seen so they might be perceived as authentic individuals instead of outsiders or intruders. The subsequent analysis of Latino literary and other cultural productions will examine the interaction or rather interdependence of visibility, audibility and status. The focus of the study will be on concrete reflections and consequences of those aspects. Being unseen and unheard among others will lead not only to lower self-esteem but it also means having a smaller share in contributing to the construction of the historical legacy of Latinos in the United States. As Latino art is receiving more attention, the power mechanisms in society become more transparent. At the same time, both individual lives and collective identities have a chance to be reassessed in less stereotypical terms.Ya antes de llegar los primeros colonizadores angloamericanos al Nuevo Mundo, en Norteamérica vivían personas de los orígenes étnicos más diversos que han legado a la posteridad un sinnúmero de obras literarias y culturales de todo tipo. A mediados del siglo XVI, los exploradores, misioneros y colonizadores españoles habían establecido ya instituciones administrativas, culturales y educativas (Kanellos 2). Según el censo demográfico de 2010, hoy por hoy uno de cada seis habitantes de EE.UU. forma parte del denominado grupo de los “latinos” o “hispanos”. Obviando estos hechos y cifras, así como las tradiciones y los legados culturales centenarios de los latinos en el continente americano, especialmente en el territorio que conforma el actual sudoeste de los EE.UU., las obras de los latinos han sido relegadas a la categoría de obras de una minoría insignificante. De hecho, los hispanos han obtenido el estatus de “los Otros”. La demanda y reivindicación de los latinos es la de superar el rechazo y los estereotipos, de ser oídos, vistos y contemplados como auténticos individuos y no como marginados o intrusos. El siguiente análisis de varias obras literarias y culturales estudia el entramado de condiciones de la visibilidad, la audibilidad y el estatus. Las reflexiones y las consecuencias concretas de estos aspectos forman el núcleo central del análisis. No ser vistos ni oídos en una comunidad no sólo menoscaba la autoestima sino que también significa participar en menor medida en la construcción del legado histórico de los latinos en los EE.UU. A medida que el arte latino recibe mayor atención, también aumenta la transparencia de los mecanismos de poder en la sociedad. Así se ofrece, además, la ocasión de aquilatar de una forma nueva y menos estereotipada tanto las vidas singulares como las identidades colectivas

The first night effect in multiple sclerosis patients undergoing home-based polysomnography

Background: The first night effect (FNE) is a polysomnography (PSG) habituation effect in the first of several consecutive in-laboratory PSGs (I-PSGs). The ENE is caused by the discomfort provoked by electrodes and cables and the exposure to an unfamiliar environment. A reverse ENE (RENT) with an improved sleep in the first night is characteristic of insomnia, presumably because the video PSG in the sleep laboratory leads to a decrease in the negatively toned cognitive activity. Therefore, two or more I-PSGs are required for an accurate diagnosis. Although the FNE is well documented in I-PSG, little is known about the FNE and the RFNE in home-based PSGs (H-PSGs). Methods: This is a retrospective analysis of a recently published cross-sectional study using H-PSG. Sixty-three consecutive patients suffering from multiple sclerosis (MS) were investigated by two consecutive H-PSGs without video. The differences between the first and second H-PSGs were analyzed. The patients were classified into four subgroups: no sleep disorder, insomnia, sleep-related breathing disorders (SRBDs), and periodic limb movement disorder or restless legs syndrome (PLMD/RLS). Results: MS patients suffering from insomnia showed no RFNE. MS patients with SKIM or PLMD/RLS showed no reduced sleep efficiency but significantly less slow wave sleep. Furthermore, SRBD patients showed significantly less non-rapid eye movement (N REM) sleep, and PLMD/RLS patients were significantly awake longer in the first night after sleep onset (increased wake-after-sleep-onset time) and showed a higher rapid eye movement (REM) latency. Conclusion: SRBD and PLMD/RLS patients showed a significant FNE. Two consecutive H-PSGs are required in these patients to obtain a precise hypnogram even in the ambulatory field. In MS patients suffering from insomnia, no RFNE was found, and in insomnia patients one H-PSG seems to be sufficient

Sleep disorders reduce health-related quality of life in multiple sclerosis (Nottingham Health Profile data in patients with multiple sclerosis)

Quality of Life (QoL) is decreased in multiple sclerosis (MS), but studies about the impact of sleep disorders (SD) on health-related quality of Life (HRQoL) are lacking. From our original cohort, a cross-sectional polysomnographic (PSG) study in consecutive MS patients, we retrospectively analysed the previously unpublished data of the Nottingham Health Profile (NHP). Those MS patients suffering from sleep disorders (n = 49) showed significantly lower HRQoL compared to MS patients without sleep disorders (n = 17). Subsequently, we classified the patients into four subgroups: insomnia (n = 17), restless-legs syndrome, periodic limb movement disorder and SD due to leg pain (n = 24), obstructive sleep apnea (n = 8) and patients without sleep disorder (n = 17). OSA and insomnia patients showed significantly higher NHP values and decreased HRQoL not only for the sleep subscale but also for the "energy" and "emotional" area of the NHP. In addition, OSA patients also showed increased NHP values in the "physical abilities" area. Interestingly, we did not find a correlation between the objective PSG parameters and the subjective sleep items of the NHP. However, this study demonstrates that sleep disorders can reduce HRQoL in MS patients and should be considered as an important confounder in all studies investigating HRQoL in MS

Poor sleep in multiple sclerosis correlates with Beck Depression Inventory values, but not with polysomnographic data

Objectives. Pittsburgh Sleep Quality Index (PSQI) values correlate with depression, but studies investigating the relationship between PSQI values and polysomnographic (PSG) data showed inconsistent findings. Methods. Sixty-five consecutive patients with multiple sclerosis (MS) were retrospectively classified as "good sleepers" (GS) (PSQI ≤ 5) and "poor sleepers" (PS) (PSQI > 5). The PSG data and the values of the Visual Analog Scale (VAS) of fatigue, Modified Fatigue Impact Scale (MFIS), Fatigue Severity Scale (FSS), Epworth Sleepiness Scale (ESS), and the Beck Depression Inventory (BDI) were compared. Results. No significant differences were found either for PSG data or for ESS, MFIS, and FSS values; but PS showed significantly increased BDI and VAS values. Conclusions. Poor sleep is associated with increased depression and fatigue scale values

Periodic limb movements during REM sleep in multiple sclerosis: a previously undescribed entity

Background: There are few studies describing periodic limb movement syndrome (PLMS) in rapid eye movement (REM) sleep in patients with narcolepsy, restless legs syndrome, REM sleep behavior disorder, and spinal cord injury, and to a lesser extent, in insomnia patients and healthy controls, but no published cases in multiple sclerosis (MS). The aim of this study was to investigate PLMS in REM sleep in MS and to analyze whether it is associated with age, sex, disability, and laboratory findings. Methods: From a study of MS patients originally published in 2011, we retrospectively analyzed periodic limb movements (PLMs) during REM sleep by classifying patients into two subgroups: PLM during REM sleep greater than or equal to ten per hour of REM sleep (n=7) vs less than ten per hour of REM sleep (n=59). A univariate analysis between PLM and disability, age, sex, laboratory findings, and polysomnographic data was performed. Results: MS patients with more than ten PLMs per hour of REM sleep showed a significantly higher disability measured by the Kurtzke expanded disability status scale (EDSS) (P=0.023). The presence of more than ten PLMs per hour of REM sleep was associated with a greater likelihood of disability (odds ratio 22.1; 95% confidence interval 3.5–139.7; P<0.0001), whereas there were no differences in laboratory and other polysomnographic findings. Conclusion: PLMs during REM sleep were not described in MS earlier, and they are associated with disability measured by the EDSS

a previously undescribed entity

Background: There are few studies describing periodic limb movement syndrome (PLMS) in rapid eye movement (REM) sleep in patients with narcolepsy, restless legs syndrome, REM sleep behavior disorder, and spinal cord injury, and to a lesser extent, in insomnia patients and healthy controls, but no published cases in multiple sclerosis (MS). The aim of this study was to investigate PLMS in REM sleep in MS and to analyze whether it is associated with age, sex, disability, and laboratory findings. Methods: From a study of MS patients originally published in 2011, we retrospectively analyzed periodic limb movements (PLMs) during REM sleep by classifying patients into two subgroups: PLM during REM sleep greater than or equal to ten per hour of REM sleep (n=7) vs less than ten per hour of REM sleep (n=59). A univariate analysis between PLM and disability, age, sex, laboratory findings, and polysomnographic data was performed. Results: MS patients with more than ten PLMs per hour of REM sleep showed a significantly higher disability measured by the Kurtzke expanded disability status scale (EDSS) (P=0.023). The presence of more than ten PLMs per hour of REM sleep was associated with a greater likelihood of disability (odds ratio 22.1; 95% confidence interval 3.5–139.7; P<0.0001), whereas there were no differences in laboratory and other polysomnographic findings. Conclusion: PLMs during REM sleep were not described in MS earlier, and they are associated with disability measured by the EDSS