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- Gray, William, et al.
(författare)
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"This Dream of arctic rest" : Memory, Metaphor and Mental Illnessin Jenny Diski’s Skating to Antarctica
- 2009
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Ingår i: Cold Matters. - Umeå : Umeå University and Royal Skyttean Society. - 9789188466709 ; , s. 125-140
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Bokkapitel (refereegranskat)abstract
- Jenny Diski's Skating to Antarctica, an autobiographical text published in 1997, engages with Antarctica not only as a literal place, but also as a location of the mind. Her imaginative response to what has traditionally been perceived as an inhuman landscape allows her to view the Polar regions as a mental space, signifying a complex system of images and symbols. Diski's physical voyage functions primarily as a metaphor for her attempt to locate an interior psychological terrain, the discovery of which will dispel her profound sense of self-estrangement.This article contends that Diski's use of the interconnecting metaphors of skating, ice and frozen or numbed emotions provide a rich tapestry of associations which serve to illuminate the process whereby traumatic experiences can subsequently manifest themselves in depression and mental illness. In this respect, the narrative, which explores the author's passion for emotional oblivion and obsession with the colour white, represents a desire to experience her life as an accretion of meaning.
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- Drake, TM, et al.
(författare)
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Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study
- 2020
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Ingår i: BMJ global health. - : BMJ. - 2059-7908. ; 5:12
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Tidskriftsartikel (refereegranskat)abstract
- Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings.MethodsA multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI).ResultsOf 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI.ConclusionThe odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.
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