Hasil untuk "American literature"

J. Joglar, M. K. Chung, Anastasia L Armbruster et al.

AIM The "2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation" provides recommendations to guide clinicians in the treatment of patients with atrial fibrillation. METHODS A comprehensive literature search was conducted from May 12, 2022, to November 3, 2022, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Library, the Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. Additional relevant studies, published through November 2022, during the guideline writing process, were also considered by the writing committee and added to the evidence tables, where appropriate. STRUCTURE Atrial fibrillation is the most sustained common arrhythmia, and its incidence and prevalence are increasing in the United States and globally. Recommendations from the "2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" and the "2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" have been updated with new evidence to guide clinicians. In addition, new recommendations addressing atrial fibrillation and thromboembolic risk assessment, anticoagulation, left atrial appendage occlusion, atrial fibrillation catheter or surgical ablation, and risk factor modification and atrial fibrillation prevention have been developed.

P. Heidenreich, B. Bozkurt, D. Aguilar et al.

AIM The "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure" replaces the "2013 ACCF/AHA Guideline for the Management of Heart Failure" and the "2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure." The 2022 guideline is intended to provide patient-centric recommendations for clinicians to prevent, diagnose, and manage patients with heart failure. METHODS A comprehensive literature search was conducted from May 2020 to December 2020, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from MEDLINE (PubMed), EMBASE, the Cochrane Collaboration, the Agency for Healthcare Research and Quality, and other relevant databases. Additional relevant clinical trials and research studies, published through September 2021, were also considered. This guideline was harmonized with other American Heart Association/American College of Cardiology guidelines published through December 2021. Structure: Heart failure remains a leading cause of morbidity and mortality globally. The 2022 heart failure guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to managing patients with heart failure, with the intent to improve quality of care and align with patients' interests. Many recommendations from the earlier heart failure guidelines have been updated with new evidence, and new recommendations have been created when supported by published data. Value statements are provided for certain treatments with high-quality published economic analyses.

P. Heidenreich, Biykem Bozkurt, David Aguilar et al.

AIM The "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure" replaces the "2013 ACCF/AHA Guideline for the Management of Heart Failure" and the "2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure." The 2022 guideline is intended to provide patient-centric recommendations for clinicians to prevent, diagnose, and manage patients with heart failure. METHODS A comprehensive literature search was conducted from May 2020 to December 2020, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from MEDLINE (PubMed), EMBASE, the Cochrane Collaboration, the Agency for Healthcare Research and Quality, and other relevant databases. Additional relevant clinical trials and research studies, published through September 2021, were also considered. This guideline was harmonized with other American Heart Association/American College of Cardiology guidelines published through December 2021. STRUCTURE Heart failure remains a leading cause of morbidity and mortality globally. The 2022 heart failure guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to managing patients with heart failure, with the intent to improve quality of care and align with patients' interests. Many recommendations from the earlier heart failure guidelines have been updated with new evidence, and new recommendations have been created when supported by published data. Value statements are provided for certain treatments with high-quality published economic analyses.

M. Galmiche, P. Déchelotte, G. Lambert et al.

BACKGROUND Eating disorders (EDs) lead to multiple psychiatric and somatic complications and thus constitute a major public health concern. OBJECTIVES The aim of this study was to give an exhaustive view of the studies reporting the prevalence of the different EDs or total EDs and to study their evolution. METHODS A literature search following PRISMA Guidelines and limited to studies in English or French published between 2000 and 2018 was performed and relevant studies were included in this systematic review on the prevalence of EDs. The literature search revealed 94 studies with accurate ED diagnosis and 27 with broad ED diagnosis. RESULTS In 94 studies with accurate ED diagnosis, the weighted means (ranges) of lifetime ED were 8.4% (3.3-18.6%) for women and 2.2% (0.8-6.5%) for men. The weighted means (ranges) of 12-month ED prevalence were 2.2% (0.8-13.1%) for women and 0.7% (0.3-0.9%) for men. The weighted means (ranges) of point prevalence were 5.7% (0.9-13.5%) for women and 2.2% (0.2-7.3%) for men. According to continents, the weighted means (ranges) of point prevalence were 4.6% (2.0-13.5%) in America, 2.2% (0.2-13.1%) in Europe, and 3.5% (0.6-7.8%) in Asia.In addition to the former, 27 other studies reported the prevalence of EDs as broad categories resulting in weighted means (ranges) of total point prevalence of any EDs of 19.4% (6.5-36.0%) for women and 13.8% (3.6-27.1%) for men. CONCLUSIONS Despite the complexity of integrating all ED prevalence data, the most recent studies confirm that EDs are highly prevalent worldwide, especially in women. Moreover, the weighted means of point ED prevalence increased over the study period from 3.5% for the 2000-2006 period to 7.8% for the 2013-2018 period. This highlights a real challenge for public health and healthcare providers.

M. Davies, D. D’Alessio, J. Fradkin et al.

The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the prior position statements, published in 2012 and 2015, on the management of type 2 diabetes in adults. A systematic evaluation of the literature since 2014 informed new recommendations. These include additional focus on lifestyle management and diabetes self-management education and support. For those with obesity, efforts targeting weight loss, including lifestyle, medication, and surgical interventions, are recommended. With regards to medication management, for patients with clinical cardiovascular disease, a sodium–glucose cotransporter 2 (SGLT2) inhibitor or a glucagon-like peptide 1 (GLP-1) receptor agonist with proven cardiovascular benefit is recommended. For patients with chronic kidney disease or clinical heart failure and atherosclerotic cardiovascular disease, an SGLT2 inhibitor with proven benefit is recommended. GLP-1 receptor agonists are generally recommended as the first injectable medication.

J. Joglar, M. K. Chung, Anastasia L Armbruster et al.

AIM The "2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Patients With Atrial Fibrillation" provides recommendations to guide clinicians in the treatment of patients with atrial fibrillation. METHODS A comprehensive literature search was conducted from May 12, 2022, to November 3, 2022, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Library, the Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. Additional relevant studies, published through November 2022, during the guideline writing process, were also considered by the writing committee and added to the evidence tables, where appropriate. STRUCTURE Atrial fibrillation is the most sustained common arrhythmia, and its incidence and prevalence are increasing in the United States and globally. Recommendations from the "2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" and the "2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" have been updated with new evidence to guide clinicians. In addition, new recommendations addressing atrial fibrillation and thromboembolic risk assessment, anticoagulation, left atrial appendage occlusion, atrial fibrillation catheter or surgical ablation, and risk factor modification and atrial fibrillation prevention have been developed.

B. Hoh, N. Ko, S. Amin‐Hanjani et al.

AIM The "2023 Guideline for the Management of Patients With Aneurysmal Subarachnoid Hemorrhage" replaces the 2012 "Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage." The 2023 guideline is intended to provide patient-centric recommendations for clinicians to prevent, diagnose, and manage patients with aneurysmal subarachnoid hemorrhage. METHODS A comprehensive search for literature published since the 2012 guideline, derived from research principally involving human subjects, published in English, and indexed in MEDLINE, PubMed, Cochrane Library, and other selected databases relevant to this guideline, was conducted between March 2022 and June 2022. In addition, the guideline writing group reviewed documents on related subject matter previously published by the American Heart Association. Newer studies published between July 2022 and November 2022 that affected recommendation content, Class of Recommendation, or Level of Evidence were included if appropriate. STRUCTURE Aneurysmal subarachnoid hemorrhage is a significant global public health threat and a severely morbid and often deadly condition. The 2023 aneurysmal subarachnoid hemorrhage guideline provides recommendations based on current evidence for the treatment of these patients. The recommendations present an evidence-based approach to preventing, diagnosing, and managing patients with aneurysmal subarachnoid hemorrhage, with the intent to improve quality of care and align with patients' and their families' and caregivers' interests. Many recommendations from the previous aneurysmal subarachnoid hemorrhage guidelines have been updated with new evidence, and new recommendations have been created when supported by published data.

G. Couser, R. G. Thomson

E. Bleecker, A. Menzies-Gow, D. Price et al.

Systemic corticosteroid use to manage uncontrolled asthma and its associated healthcare burden may account for important health-related adverse effects. We conducted a systematic literature review to investigate the real-world extent and burden of systemic corticosteroid use in asthma. We searched MEDLINE and Embase databases to identify English-language articles published in 2010–2017, using search terms for asthma with keywords for oral corticosteroids and systemic corticosteroids. Observational studies, prescription database analyses, economic analyses, and surveys on oral/systemic corticosteroid use in children (>5 yr old), adolescents (12–17 yr old), and adults with asthma were included. We identified and reviewed 387 full-text articles, and our review included data from 139 studies. The included studies were conducted in Europe, North America, and Asia. Overall, oral/systemic corticosteroids were commonly used for asthma management and were more frequently used in patients with severe asthma than in those with milder disease. Long-term oral/systemic corticosteroid use was, in general, less frequent than short-term use. Compared with no use, long-term and repeated short-term oral/systemic corticosteroid use were associated with an increased risk of acute and chronic adverse events, even when doses were comparatively low. Greater oral/systemic corticosteroid exposure was also associated with increased costs and healthcare resource use. This review provides a comprehensive overview of oral/systemic corticosteroid use and associated adverse events for patients with all degrees of asthma severity and exposure duration. We report that oral/systemic corticosteroid use is prevalent in asthma management, and the risks of acute and chronic complications increase with the cumulative oral corticosteroid dosage.

Dr. Anu Lakshmi Babu

This paper explores the intricate relationship between Native American identity and the land, emphasising the spiritual, cultural and communal dimensions of this bond. Rooted in Indigenous cosmologies that view land, animals, plants and spirits as interconnected components of a shared identity, the study highlights how land-based identity fosters reciprocal respect and stewardship. Drawing on Anibal Quijano’s theory of decoloniality and Leanne Simpson’s concept of ‘land as pedagogy’, the paper situates Indigenous struggles over land, tradition and identity within ongoing processes of colonial power that seek to commodify and erase Indigenous epistemologies. The paper focuses on the Native American Chippewa author Louise Erdrich’s The Last Report on the Miracles at Little No Horse, throwing light on the character Father Damien Modeste, whose spiritual journey from Catholic missionary to an embrace of Native animism and cultural hybridity symbolises broader decolonial struggles for sovereignty and cultural survival. The study argues that reclaiming land is both a political and deeply spiritual act for Indigenous communities, constituting an essential process of decolonial resistance and identity restoration amid colonial attempts to sever these vital connections.

Yovany Salazar Estrada, Rita Jáimez Esteves

Los autores se proponen interpretar y evidenciar la identidad lingüística de los emigrantes ecuatorianos que se han dirigido a países de mayor desarrollo, en especial Estados Unidos, Canadá, España, Alemania y Gran Bretaña. Para ello, se fundamenta en obras testimoniales escritas por los protagonistas, cuyas publicaciones oscilan entre 1996 y 2015. Con la orientación de las teorías devenidas de las ciencias sociales y humanas, particularmente de la lingüística, luego de la aplicación de la metodología y técnicas propias de la investigación bibliográfico-documental, se concluye que existe una significativa representación de cuatro elementos vinculados con el idioma y dialecto empleado por los emigrantes mientras permanecen fuera del Ecuador: problemáticas que enfrentan los ecuatorianos por desconocimiento de la lengua utilizada en los países de llegada; estrategias de comunicación interpersonal empleadas por los emigrantes hasta adquirir nociones básicas del nuevo idioma; diferencias en el uso del español, entre ecuatorianos y peninsulares; y asimilación del habla española como estrategia de integración de los ecuatorianos en España.

Ariel Horowitz

In his seminal book <i>Zakhor: Jewish History and Jewish Memory</i> (1982), renowned historian Yosef Hayim Yerushalmi argues that it is literature and culture, and not historiography, that shaped Jewish collective memory for generations. In Yerushalmi’s telling, the boundaries between historiography and literature, “truth” and “myth,” are set and strict. However, the reception of Yerushalmi’s work itself challenges this assumption and obscures the clear-cut distinctions between literature and historiography. This paper reads Yerushalmi’s book alongside its preface, written by Harold Bloom, in an attempt to understand <i>Zakhor</i> not only as a historiographic argument, but as a narrative of Jewish modernity, a literary meditation, embodying the very shift in collective memory that Yerushalmi himself lamented. The paper then explores the ways in which Yerushalmi’s work has inspired two prominent contemporary American Jewish writers: Joshua Cohen, in his novel <i>The Netanyahus</i> (2021), and Nicole Krauss, in her short story “Zusya on the Roof” (2013). In their literary work, one can hear echoes of Yerushalmi’s work, distinct and identifiable, yet incorporated in a fictional, imaginative world. <i>Zakhor</i> thus serves not only as an inspiration but as a catalyst for a deep, insightful rendering of Jewish history and one’s grappling with it.

Luca Fiorito

This note reproduces a brief article by Thomas Nixon Carver, a leading Progressive Era American economist on what was then called the ‘Negro Question’. This virtually unknown piece represents a striking instance of blaming the victim for her/his condition which is to be found in the economic literature of the period.

Aazad Abbas, Imran Saleh, Graeme Hoit et al.

Objective: Smart insufflation (SI) techniques relying on valve and membrane-free insufflation are increasing in usage. Although considerable literature exists demonstrating the benefits of SI on procedural ease and patient outcomes, there remains a paucity describing the financial impact of these devices. The purpose of this study was to determine the financial and efficiency impact of these devices on the operating room and inpatient wards of a hospital. Methods: A discrete event simulation model representing a typical mid-sized North American hospital comparing SI to traditional insufflation (TI) was generated. The National Surgical Quality Improvement database from 2015 to 2019 was used to populate the model with data supplemented from the literature. Outcomes included length of stay (LOS), duration of surgery (DOS), annual procedure volume, profit, return on investment (ROI), and gross profit margin (GPM). From the literature review, DOS savings were 10–32 minutes/case, while LOS savings were 0–3 days/case. Results: Implementation of an SI led to an increase in annual throughput of 42–346 (4.4%–36.6%) cases for all procedures and 38 to 297 (4.3%–33.3%) cases for complex procedures. LOS was found to be decreased by 175–614 (18.3%–64.2%) days for all procedures and 231 to 614 (35.6%–77.9%) cases for complex procedures with the implementation of an SI. Together, this resulted in an increase in net profit of $104,685 per annum. The ROI of SI over the TI device was >1000%, and the GPM for the TI was 90.0%, while the GPM for the SI was 71.7%. Conclusion: Despite the initial financial investment being greater, the implementation of SI offsets these expenses and yields significant financial benefits. Our study demonstrates the financial benefits of SI over TI and illustrates how granular operational and financial analyses of technologies are essential to aid in sound healthcare procurement decision making.

Oksana G. Shostak

An important layer of this research is dedicated to critical studies, which are directed at the strategies of creating a peculiarly Indian literary theory and practice. We have a desire to separate the indigenous tradition from the broad American, in particular, Anglo-American and recognize Indian writing as a component of the multicultural paradigm. Currently, there is a noticeable confrontation between two camps of literary critics: one of them is oriented to European literary theories and believes that they should form the basis of literary interpretations of indigenous writers’ works; another wing is determined by the need to clarify the peculiarities of the literary paradigm of “Indian realism” in the context of a globalized society taking into account new literary models of the perception of ethnic minorities. The need to write the article is caused by the lack of a comprehensive understanding of the problem in Ukrainian literary studies and the growing objective interest in the works of Native American writers, in particular Susan Power. The article proposes a conceptual and methodological determination of the study of a literary text written in the style of Indian realism, which makes it possible to reveal the raised scientific problem at many levels. The article examines how the drama of loss, search and a new acquisition of national identity by the Sioux people was artistically and aesthetically reflected in the text of Susan Power`s novel “The Grass Dancer”. The presentation and consideration of the problem of national and cultural identity provides an opportunity to see the artistic diversity in the understanding of the personal destiny of a person and the people in general, literary ideas about the Sioux people beliefs peculiarities, their aesthetic component and place in the national cultural canon. The main thing is to avoid the trap of a politicized and ideologized theory of multiculturalism, in which modern critics increasingly see an opportunity to interpret the texts of indigenous writers, which is actually the ideology of colonial domination hidden behind political correctness. The main purpose of this article is to outline a coherent theoretical and empirical model of multi-level functioning of Dakota national identity concept in the novel “The Grass Dancer” by Susan Power. Also the aim is to substantiate the leading concept of Sioux national identity literary manifestations interpretation as a unique code, epistemological, socio-cultural and artistic-aesthetic factor that plays a significant role in the modern worldview formation process and myth-making of Dakota society representatives. The following article involves historical-cultural and structural approaches, which correspond to the purpose and tasks of the research; methods of cultural-semantic analysis and phenomenological methods were also used. The persistent deconstruction of the Eurocentric canon of world literature, not only at the level of academic discussions, but also in the system of university teaching of world literature, demands new texts such as “The Grass Dancer”. The reformatting of canons is, of course, a permanent process, but the globalization of the literary canon today acquires a qualitatively new scale and breadth proposed by Susan Power. Multiculturalism with its influence on cultural dynamics and the idea of national and cultural identity can’t be considered the driving cultural stimulus of changes in all its ambiguity. To an even greater extent, transculturalism, proposed by Power, aimed at defining common interests and common values across cultural and national borders for non-native readers. That is her main contribution to the construction of a more globalized literary canon. Susan Power as a Native American writer has repeatedly addressed the specified range of the Indigenous problems, which constantly tested the agreement prevalent in the nonnative science with the most urgent problems of Native literary studies.

Norma Olvera, Molly Matthews-Ewald, Rongfang Zhang et al.

Weight concern and body image dissatisfaction continue to be understudied among African American and Hispanic women. To address the gap in the extant literature, this study examined a sample of Hispanic and African American women (N = 477, Mean_age = 43.7 years) and explored (a) differences in weight concern and body image dissatisfaction; (b) the contribution of perceived weight status and body image dissatisfaction to weight concern; and (c) the extent to which the association between body image dissatisfaction and weight concern was moderated by ethnicity. Participants completed a health survey and a figure rating scale. The findings indicated that Hispanic women compared to African American women endorsed smaller silhouettes as an ideal body size (<i>χ</i>²(7, <i>n</i> = 436) = 22.36, <i>p</i> = 0.002, Cramer’s V = 0.23). More Hispanic women (77%) than African American women (62%) had a discrepancy between their perceived actual and ideal body size. The relationship between body image dissatisfaction and weight concern varied by ethnicity. That is, the relationship between body image dissatisfaction and weight concern was statistically significant among African American women (<i>β</i> = 0.21, <i>p</i> = 0.008) but was insignificant among Hispanic women (<i>β</i> = 0.11, <i>p</i> = 0.135). This study has implications regarding the identification of risk factors associated with weight concern.

Karen Robinson, Alissa V. Fial, L. Hanson

INTRODUCTION Although breastfeeding has been shown to improve health outcomes for infants, African American women initiate and continue breastfeeding at lower rates than women from other racial groups. This scoping review was conducted to assess the effect racism, bias, and discrimination have on breastfeeding care, support, and outcomes for African American women. METHODS A scoping review was performed of the literature published between January 2010 through December 2019 using databases MEDLINE via PubMed, CINAHL, Cochrane Library, PsycINFO, and Sociological Abstracts. Studies that examined racism, bias, or discrimination with breastfeeding as an outcome were included. After a review of titles and abstracts of the articles using exclusion and inclusion criteria, 5 full-text articles were included in the scoping review. RESULTS The qualitative and quantitative studies reviewed provide the perspectives of pregnant and postpartum African American women as well as those of health care providers. African American women's experiences of racism adversely affected both breastfeeding initiation and duration. Health care providers' biased assumption that African American women would not breastfeed affected the quality of breastfeeding support provided to them. Specifically, African American women received fewer referrals for lactation support and more limited assistance when problems developed. This scoping review provides evidence that African American women experience racism, bias, and discrimination affecting breastfeeding care, support, and outcomes. DISCUSSION Racism, bias, and discrimination are modifiable barriers that adversely affect breastfeeding among African American women. Researchers and health care providers are encouraged to consider the effect of racism, bias, and discrimination on breastfeeding care, support, and outcomes.

Sahrish Shah, MBBS, Meritxell Urtecho, MD, Mohammed Firwana, MBBS et al.

Objective: To summarize the available evidence about the perioperative management of patients who are receiving long-term antiplatelet therapy and require elective surgery/procedures. Methods: This systematic review supports the development of the American College of Chest Physicians guideline on the perioperative management of antiplatelet therapy. A literature search of MEDLINE, EMBASE, Scopus and Cochrane databases was conducted from each database’s inception to July 16, 2020. Meta-analyses were conducted when possible. Results: In patients receiving long-term antiplatelet therapy and undergoing elective noncardiac surgery, the available evidence did not show a significant difference in major bleeding between a shorter vs longer antiplatelet interruption, with low certainty of evidence (COE). Compared with patients who received placebo perioperatively, aspirin continuation was associated with increased risk of major bleeding (relative risk [RR], 1.31; 95% CI, 1.15-1.50; high COE) and lower risk of major thromboembolism (RR, 0.74; 95% CI, 0.58-0.94; moderate COE). During antiplatelet interruption, bridging with low-molecular-weight heparin was associated with increased risk of major bleeding compared with no bridging (RR, 1.86; 95% CI, 1.24-2.79; very low COE). Continuation of antiplatelets during minor dental and ophthalmologic procedures was not associated with a statistically significant difference in the risk of major bleeding (very low COE). Conclusion: This systematic review summarizes the current evidence about the perioperative management of antiplatelet therapy and highlights the urgent need for further research, particularly with the increasing prevalence of patients taking 1 or more antiplatelet agents.

Adriane Wynn, Samantha Tweeten, Eric McDonald et al.

<h4>Background</h4>The Eliminate Hepatitis C San Diego County Initiative was established to provide a roadmap to reduce new HCV infections by 80% and HCV-related deaths by 65% by 2030. An estimate of the burden of HCV infections in San Diego County is necessary to inform planning and evaluation efforts. Our analysis was designed to estimate the HCV burden in San Diego County in 2018.<h4>Methods</h4>We synthesized data from the American Community Survey, Centers for Disease Control and Prevention, California Department of Public Health, Public Health Branch of California Correctional Health Care Services, San Diego Blood Bank, and published literature. Burden estimates were stratified by subgroup (people who inject drugs in the community [PWID], men who have sex with men in the community [MSM], general population in the community [stratified by age and sex], and incarcerated individuals). To account for parameter uncertainty, 100,000 parameter sets were sampled from each parameter's uncertainty distribution, and used to calculate the mean and 95% confidence interval estimates of the number of HCV seropositive adults in San Diego in 2018.<h4>Findings</h4>We found there were 55,354 (95% CI: 25,411-93,329) adults with a history of HCV infection in San Diego County in 2018, corresponding to an HCV seroprevalence of 2.1% (95% CI: 1.1-3.4%). Over 40% of HCV infections were among the general population aged 55-74 and one-third were among PWID.<h4>Conclusion</h4>Our study found that the largest share of infections was among adults aged 55-74, indicating the importance of surveillance, prevention, testing, and linkages to care in this group to reduce mortality. Further, programs prioritizing PWID for increased HCV testing and linkage to care are important for reducing new HCV infections.

Claudia Caño Rivera

A partir de las fotografías de Graciela Iturbide, Elena Poniatowska crea el texto Juchitán de las mujeres utilizando como hilo conductor la reivindicación de la mujer juchiteca. Poniatowska no solo interpreta las imágenes, sino que les proporciona un contexto e interrelaciona a los personajes unos con otros, formando así una red de vínculos sociales y afectivos, implícitos en la fotografía y desarrollados en el texto. Por otro lado, en Forward Kioto, de Juan Villoro, los personajes son influenciados por las fotografías que se van mencionando, para las que el autor incluye su propia interpretación a la par que juega con el simbolismo presente en ellas, creando así una red de significados que se relacionan con el texto y con los sucesivos acontecimientos que el protagonista va contando. Su relato suscita una reflexión en torno a la comunicación visual y escrita, planteando, al mismo tiempo, un debate sobre la identidad mexicana. From Graciela Iturbide’s photographs, Elena Poniatowska writes Juchitán de las mujeres placing the vindication of the juchiteca women as the guiding thread. Poniatowska not only describes the images, but also gives the reader some context and connects the characters with each other, creating, in this way, a social and affective network that is implicit in the photography. On the other side, Juan Villoro’s Forward Kioto’s characters are influenced by the photographs mentioned throughout the story. Villoro includes his own reading of the photographs and plays with its symbolism, developing its meaning and relating it with the text as well as the events that the protagonist narrates. His tale poses a reflection on visual and written communication, and a debate about Mexican identity.