830 resultados para Holocaust survivors
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Lorsque les aléas naturels se déroulent en catastrophes, les réponses des religieux, de l’Etat, et d’autres acteurs puissants dans une société révèlent à la fois les relations complexes entre ces parties et leur pouvoir dans la production des espaces auxquelles les survivants accèdent. La réponse en cas de catastrophe comprend la création d’espaces post-catastrophes, tels que des centres d’évacuation, des logements de transition et des sites de réinstallation permanente, qui ciblent spécifiquement un sous-ensemble particulier de survivants, et visent à les aider à survivre, à faire face, et à se remettre de la catastrophe. Les acteurs puissants dans une société dirigent les processus de secours, de récupération et de reconstruction sont des acteurs puissants qui cherchent à problématiser et à rendre un problème technique dans des termes qu’ils sont idéalement placés pour aborder à travers une variété d'interventions. Ce projet de recherche vise à répondre à la question: où les survivants d'une catastrophe reconstruisent-ils leurs vies et leurs moyens de subsistance? Il enquête sur un cas spécifique de la migration environnementale dans laquelle des dizaines de milliers d'habitants ont été déplacés de façon permanente et temporaire de leurs résidences habituelles après le typhon Sendong à Cagayan de Oro, Philippines en 2011. La recherche est basée sur des entretiens avec les acteurs puissants et les survivants, des vidéos participatives réalisées par des survivants pauvres urbains, et des activités de cartographie. L’étude se fonde sur la théorie féministe, les études de migration, les études dans la gouvernementalité, la recherche sur les changements de l’environnement planétaire, et les études régionales afin de situer les diverses expériences de la migration dans un contexte géographique et historique. Cette thèse propose une topographie critique dans laquelle les processus et les pratiques de production d’espaces post-catastrophe sont exposés. Parce que l’espace est nécessairement malléable, fluide, et relationnelle en raison de l'évolution constante des activités, des conflits, et des expériences qui se déroulent dans le paysage, une analyse de l'espace doit être formulée en termes de relations sociales qui se produisent dans et au-delà de ses frontières poreuses. En conséquence, cette étude explore comment les relations sociales entre les survivants et les acteurs puissants sont liées à l’exclusion, la gouvernementalité, la mobilité, et la production des espaces, des lieux et des territoires. Il constate que, si les trajectoires de migration de la plupart des survivants ont été confinés à l'intérieur des limites de la ville, les expériences de ces survivants et leur utilisation des espaces urbains sont très différentes. Ces différences peuvent être expliquées par des structures politiques, économiques, et sociales, et par les différences religieuses, économiques, et de genre. En outre, il fait valoir que les espaces post-catastrophe doivent être considérés comme des «espaces d’exclusion» où les fiduciaires exercent une rationalité gouvernementale. C’est-à-dire, les espaces post-catastrophe prétendument inclusives servent à marginaliser davantage les populations vulnérables. Ces espaces offrent aussi des occasions pour les acteurs puissants dans la société philippine d'effectuer des interventions gouvernementales dans lesquelles certaines personnes et les paysages sont simplifiées, rendues lisibles, et améliorés.
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The effectiveness of antiretroviral therapy (ART) transformed the pediatric HIV epidemic. The disease changed significantly over the course of three decades: while early in the epidemic it was almost always fatal, it has become a chronic condition. This study examined how perinatally-infected youth experience the impact of HIV in their lives. A qualitative study using interpretative phenomenological analysis (IPA) was conducted. Twenty in-depth interviews were carried out among 12 women and 8 men aged 18 to 30 years in Puerto Rico. These were conducted in Spanish, audio-recorded, transcribed and translated into English. While narrating their experiences, participants were interpreting what the situation meant to them and how they make sense of it. Three topics emerged: (1) perception and response to treatment and illness, particularly their lived experiences with ART; (2) disclosure experiences; and (3) family matters. Most participants challenged their therapy, in most cases to force their caregivers to disclose their status. Problems with adherence were attributed to busy schedules or forgetfulness. Participants experienced the disfiguring adverse effects of ART, which they endured for years without being informed that ART was the cause of these. Participants’ experiences with disclosure demonstrated the importance of validating them as individuals capable of managing their health. The paternalistic approach of withholding their diagnosis to spare them suffering resulted in increased anxiety. Participants acknowledged the difficulties of revealing their HIV status to their partners. They referred to family and friends as essential in coping with HIV. However, some encountered discrimination and stigma within their families. Participants who had suffered the loss of their parents found other parental figures such as adoptive parents or other family members. Most participants expressed a desire to have children. Perinatally HIV-infected youth will require health services for the rest of their lives. The adult health care into which they transition should consider their needs and journey. Services should consider including family members. This study underscores the need for improved access to mental health services. It is also essential to transcend medical treatment and develop a broader perspective of health care. Health care services should include reproductive decision-making counselling services.
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RATIONALE: As more preterm infants recover from severe bronchopulmonary dysplasia (BPD), it is critical to understand the clinical consequences of this condition on the lung health of adult survivors.
OBJECTIVES: To assess structural and functional lung parameters in young adult BPD survivors and preterm and term controls Methods: Young adult survivors of BPD (mean age 24) underwent spirometry, lung volumes, transfer factor, lung clearance index and fractional exhaled nitric oxide measurements together with high-resolution chest tomographic (CT) imaging and cardiopulmonary exercise testing.
MEASUREMENTS AND MAIN RESULTS: 25 adult BPD survivors, (mean ± SD gestational age 26.8 ± 2.3 weeks; birth weight 866 ± 255 g), 24 adult prematurely born non-BPD controls (gestational age 30.6 ± 1.9 weeks; birth weight 1234 ± 207 g) and 25 adult term birth control subjects (gestational age 38.5 ± 0.9 weeks; and birth weight 3569 ± 2979 g) were studied. BPD subjects were more likely to be wakened by cough (OR 9.7, 95% CI: 1.8 to 52.6), p<0.01), wheeze and breathlessness (OR 12.2, 95%CI: 1.3 to 112), p<0.05) than term controls after adjusting for sex and current smoking. Preterm subjects had greater airways obstruction than term subjects. BPD subjects had significantly lower values for FEV1 and FEF25-75 (% predicted and z scores) than term controls (both p<0.001). Although non-BPD subjects also had lower spirometric values than term controls, none of the differences reached statistical significance. More BPD subjects (25%) had fixed airflow obstruction than non-BPD (12.5%) and term (0%) subjects (p=0.004). Both BPD and non-BPD subjects had significantly greater impairment in gas transfer (KCO % predicted) than term subjects (both p<0.05). Eighteen (37%) preterm participants were classified as small for gestational age (birth weight < 10th percentile for gestational age). These subjects had significantly greater impairment in FEV1 (% predicted and z scores) than those born appropriate for gestational age. BPD survivors had significantly more severe radiographic structural lung impairment than non-BPD subjects. Both preterm groups had impaired exercise capacity compared to term controls. There was a trend for greater limitation and leg discomfort in BPD survivors.
CONCLUSIONS: Adult preterm birth survivors, especially those who developed BPD, continue to experience respiratory symptoms and exhibit clinically important levels of pulmonary impairment.
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Doxorubicin (Dox), a mainstay of adjuvant breast cancer treatment, is associated with cardiac toxicity in the form of left ventricular dysfunction (LVD), LV diastolic dysfunction, or LV systolic dysfunction. Study objectives were to evaluate the prevalence of LVD in long-term breast cancer survivors treated with Dox and determine if brain-type natriuretic peptide (BNP) may help identify patients at risk for LVD. Patients who participated in prospective clinical trials of adjuvant Dox-based chemotherapy for breast cancer with a baseline left ventricular (LV) ejection fraction evaluation from 1999 to 2006 were retrospectively identified from the St Vincent's University Hospital database. Patients were invited to undergo transthoracic echocardiography, BNP analysis, and cardiovascular (CV) risk factor assessment. LVDD was defined as left atrial volume index >34 mL/m(2) and/or lateral wall E prime <10 m/s, and LVSD as LVEF <50 %. Of 212 patients identified, 154 participated, 19 patients had died (no cardiac deaths), and 39 declined. Mean age was 60.7 [55:67] years. A majority of the patients (128, 83 %) had low CV risk (0/1 risk factors), 21 (13.6 %) had 2 RFs, and 5 (3.2 %) ≥3 RFs. BMI was 27.2 ± 4.9 kg/m(2). Median Dox dose was 240 mg/m(2) [225-298]; 92 patients (59.7 %) received ≤240 mg/m(2) and 62 (40.3 %) > 240 mg/m(2). Baseline LVEF was 68.2 ± 8 %. At follow-up of 10.8 ± 2.2 years, LVEF was 64.4 ± 6 %. Three (1.9 %) subjects had LVEF <50 % and one (0.7 %) had LVDD. Dox >240 mg/m2 was associated with any LVEF drop. BNP levels at follow-up were 20.3 pg/ml [9.9-36.5] and 21.1 pg/ml [9.8-37.7] in those without LVD and 61.5 pg/ml [50-68.4] in those with LVD (p = 0.04). Long-term prospective data describing the impact of Dox on cardiotoxicity are sparse. At over 10 years of follow-up, decreases in LVEF are common, and dose related, but LVD as defined is infrequent (2.6 %). Monitoring with BNP for subclinical LVD needs further evaluation.
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Employment issues for cancer survivors (CS) were investigated fromthe perspective of Northern Ireland government general employmentadvisors. An e-survey was designed and developed based on the resultsof a scoping search of journal articles, previously validatedquestionnaires and relevant related surveys; discussions of draftversions of the e-survey and method with lead representatives ofstakeholder organizations; and a pilot study with seven prospectiverespondents. The e-survey and subsequent reminder to employmentadvisors were distributed internally by the government employmentadvisory agency. The e-survey was completed by 78/156 (50%) advisors,the majority of whom (74%) received a request for advicein the last year from at least one CS. Most CS used the employmentservice less than 1 year (52%) or 1 year or more after treatment(32%). Fatigue was the most commonly reported barrier to returningto work (10%) and staying in work (14%), and a supportiveemployer was the top facilitating factor in returning to (21%) andcontinuing in (27%), employment. Although most advisors had apositive attitude about a CS’s capacity to return to work, half wereuncertain about how best to advise cancer survivors.
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Purpose. To identify stroke survivors with symptoms of poststroke depression and the extent of psychiatry needs and care they have received while on physiotherapy rehabilitation. Participants. Fifty stroke survivors (22 females and 28 males) at the outpatient unit of Physiotherapy Department, University of Nigeria Teaching Hospital, Enugu, who gave their informed consent, were randomly selected. Their age range and mean age were 26–66 years and 54.76 ± 8.79 years, respectively. Method. A multiple case study of 50 stroke survivors for symptoms of poststroke depression was done with Beck’s Depression Inventory, mini mental status examination tool, and Modified Motor Assessment Scale. The tests were performed independently by the participants except otherwise stated and scored on a scale of 0–6. Data were analyzed using -test for proportional significance and chi-square test for determining relationship between variables, at p < 0.05. Results. Twenty-one (42.0%) stroke survivors had symptoms of PSD, which was significantly dependent on duration of stroke ( = 21.680, df = 6, and p = 0.001), yet none of the participants had a psychiatry review. Conclusions. Symptoms of PSD may be common in cold compared to new cases of stroke and may need psychiatry care while on physiotherapy rehabilitation.
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Thesis (Master's)--University of Washington, 2016-08
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Aims and objectives. To explore the psychosocial needs of patients discharged from intensive care, the extent to which they are captured using existing theory on transitions in care and the potential role development of critical care outreach, follow-up and liaison services. Background. Intensive care patients are at an increased risk of adverse events, deterioration or death following ward transfer. Nurse-led critical care outreach, follow-up or liaison services have been adopted internationally to prevent these potentially avoidable sequelae. The need to provide patients with psychosocial support during the transition to ward-based care has also been identified, but the evidence base for role development is currently limited. Design and methods. Twenty participants were invited to discuss their experiences of ward-based care as part of a broader study on recovery following prolonged critical illness. Psychosocial distress was a prominent feature of their accounts, prompting secondary data analysis using Meleis et al.’s mid-range theory on experiencing transitions. Results. Participants described a sense of disconnection in relation to profound debilitation and dependency and were often distressed by a perceived lack of understanding, indifference or insensitivity among ward staff to their basic care needs. Negotiating the transition between dependence and independence was identified as a significant source of distress following ward transfer. Participants varied in the extent to which they were able to express their needs and negotiate recovery within professionally mediated boundaries. Conclusion. These data provide new insights into the putative origins of the psychosocial distress that patients experience following ward transfer. Relevance to clinical practice. Meleis et al.’s work has resonance in terms of explicating intensive care patients’ experiences of psychosocial distress throughout the transition to general ward–based care, such that the future role development of critical care outreach, follow-up and liaison services may be more theoretically informed.
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Introduction and background: Survival following critical illness is associated with a significant burden of physical, emotional and psychosocial morbidity. Recovery can be protracted and incomplete, with important and sustained effects upon everyday life, including family life, social participation and return to work. In stark contrast with other critically ill patient groups (eg, those following cardiothoracic surgery), there are comparatively few interventional studies of rehabilitation among the general intensive care unit patient population. This paper outlines the protocol for a sub study of the RECOVER study: a randomised controlled trial evaluating a complex intervention of enhanced ward-based rehabilitation for patients following discharge from intensive care. Methods and analysis: The RELINQUISH study is a nested longitudinal, qualitative study of family support and perceived healthcare needs among RECOVER participants at key stages of the recovery process and at up to 1 year following hospital discharge. Its central premise is that recovery is a dynamic process wherein patients’ needs evolve over time. RELINQUISH is novel in that we will incorporate two parallel strategies into our data analysis: (1) a pragmatic health services-oriented approach, using an a priori analytical construct, the ‘Timing it Right’ framework and (2) a constructivist grounded theory approach which allows the emergence of new themes and theoretical understandings from the data. We will subsequently use Qualitative Health Needs Assessment methodology to inform the development of timely and responsive healthcare interventions throughout the recovery process. Ethics and dissemination: The protocol has been approved by the Lothian Research Ethics Committee (protocol number HSRU011). The study has been added to the UK Clinical Research Network Database (study ID. 9986). The authors will disseminate the findings in peer reviewed publications and to relevant critical care stakeholder groups.
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Introduction: Female sex is predictive of poor functional outcome in stroke, even after correction for prognostic factors. Poor quality of life (QoL) is observed in stroke survivors, with lower scores seen in the most disabled patients. We used data from the TAIST trial to assess the relationship between sex and QoL after ischaemic stroke. Methods: TAIST was a randomised controlled trial assessing the safety and efficacy of tinzaparin versus aspirin in 1,484 patients with acute ischaemic stroke. QoL was measured at 180 days post randomisation using the short-form 36 health survey which assesses QoL across eight domains. The relationship between sex and each domain was assessed using ordinal regression, both unadjusted and adjusted for key prognostics factors. Results: Of the 1,484 patients randomised into TAIST, 216 had died at 180 days post randomisation. 1,268 survivors were included in this analysis, 694 males (55%), 574 females (45%). Females tended to score lower than males across all QoL domains (apart from general health); statistically significant lower scores were seen for physical functioning (odds ratio (OR) 0.58, 95% confidence interval (CI) 0.47-0.72), vitality (OR 0.79, 95% CI 0.64-0.98) and mental health (OR 0.75, 95% CI 0.61-0.93). The results for physical functioning and mental health remained significant after adjustment for prognostic variables (OR 0.73, 95% CI 0.58-0.92; OR 0.76, 95% CI 0.60-0.95 respectively). Conclusions: QoL, in particular physical function and mental health domains, is lower in female patients after stroke. This difference persists even after correction for known prognostic factors such as age and stroke severity.
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This book is a synthesizing reflection on the Holocaust commemoration, in which space becomes a starting point for discussion. The author understands space primarily as an amalgam of physical and social components, where various commemorative processes may occur. The first part of the book draws attention to the material aspect of space, which determines its character and function. Material culture has been a long ignored and depreciated dimension of human culture in the humanities and social sciences, because it was perceived as passive and fully controlled by human will, and therefore insignificant in the course of social and historical processes. An example of the Nazi system perfectly illustrates how important were the restrictions and prohibitions on the usage of mundane objects, and in general, the whole material culture in relation to macro and micro space management — the state, cities, neighborhoods and houses, but also parks and swimming pools, factories and offices or shops and theaters. The importance of things and space was also clearly visible in exploitative policies present in overcrowded ghettos and concentration and death camps. For this very reason, when we study spatial forms of Holocaust commemoration, it should be acknowledged that the first traces, proofs and mementoes of the murdered were their things. The first "monuments" showing the enormity of the destruction are thus primarily gigantic piles of objects — shoes, glasses, toys, clothes, suitcases, toothbrushes, etc., which together with the extensive camps’ space try to recall the scale of a crime impossible to understand or imagine. The first chapter shows the importance of introducing the material dimension in thinking about space and commemoration, and it ends with a question about one of the key concepts for the book, a monument, which can be understood as both object (singular or plural) and architecture (sculptures, buildings, highways). However, the term monument tends to be used rather in a later and traditional sense, as an architectural, figurative form commemorating the heroic deeds, carved in stone or cast in bronze. Therefore, the next chapter reconstructs this narrower line of thinking, together with a discussion about what form a monument commemorating a subject as delicate and sensitive as the Holocaust should take on. This leads to an idea of the counter-monument, the concept which was supposed to be the answer to the mentioned representational dilemma on the one hand, and which would disassociate it from the Nazi’s traditional monuments on the other hand. This chapter clarifies the counter-monument definition and explains the misunderstandings and confusions generated on the basis of this concept by following the dynamics of the new commemorative form and by investigating monuments from the ‘80s and ‘90s erected in Germany. In the next chapter, I examine various forms of the Holocaust commemoration in Berlin, a city famous for its bold, monumental, and even controversial projects. We find among them the entire spectrum of memorials – big, monumental, and abstract forms, like Peter Eisenman’s Memorial to the Murdered Jews of Europe or Daniel Liebeskind’s Jewish Museum Berlin; flat, invisible, and employing the idea of emptiness, like Christian Boltanski’s Missing House or Micha Ullman’s Book Burning Memorial; the dispersed and decentralized, like Renata Stih and Frieder Schnock’s Memory Places or Gunter Demnig’s Stumbling Blocks. I enrich descriptions of the monuments by signaling at this point their second, extended life, which manifests itself in the alternative modes of (mis)use, consisting of various social activities or artistic performances. The formal wealth of the outlined projects creates a wide panorama of possible solutions to the Holocaust commemoration problems. However, the discussions accompanying the building of monuments and their "future life" after realization emphasize the importance of the social component that permeates the biography of the monument, and therefore significantly influences its foreseen design. The book also addresses the relationship of space, place and memory in a specific situation, when commemoration is performed secretly or remains as unrealized potential. Although place is the most common space associated with memory, today the nature of this relationship changes, and is what indicates popularity and employment of such terms as Marc Augé’s non-places or Pierre Nora’s site of memory. I include and develop these concepts about space and memory in my reflections to describe qualitatively different phenomena occurring in Central and Eastern European countries. These are unsettling places in rural areas like glades or parking lots, markets and playgrounds in urban settings. I link them to the post-war time and modernization processes and call them sites of non-memory and non-sites of memory. Another part of the book deals with a completely different form of commemoration called Mystery of memory. Grodzka Gate - NN Theatre in Lublin initiated it in 2000 and as a form it situates itself closer to the art of theater than architecture. Real spaces and places of everyday interactions become a stage for these performances, such as the “Jewish town” in Lublin or the Majdanek concentration camp. The minimalist scenography modifies space and reveals its previously unseen dimensions, while the actors — residents and people especially related to places like survivors and Righteous Among the Nations — are involved in the course of the show thanks to various rituals and symbolic gestures. The performance should be distinguished from social actions, because it incorporates tools known from religious rituals and art, which together saturate the mystery of memory with an aura of uniqueness. The last discussed commemoration mode takes the form of exposition space. I examine an exhibition concerning the fate of the incarcerated children presented in one of the barracks of the Majdanek State Museum in Lublin. The Primer – Children in Majdanek Camp is unique for several reasons. First, because even though it is exhibited in the camp barrack, it uses a completely different filter to tell the story of the camp in comparison to the exhibitions in the rest of the barracks. For this reason, one experiences immersing oneself in all subsequent levels of space and narrative accompanying them – at first, in a general narrative about the camp, and later in a specifically arranged space marked by children’s experiences, their language and thinking, and hence formed in a way more accessible for younger visitors. Second, the exhibition resigns from didacticism and distancing descriptions, and takes an advantage of eyewitnesses and survivors’ testimonies instead. Third, the exhibition space evokes an aura of strangeness similar to a fairy tale or a dream. It is accomplished thanks to the arrangement of various, usually highly symbolic material objects, and by favoring the fragrance and phonic sensations, movement, while belittling visual stimulations. The exhibition creates an impression of a place open to thinking and experiencing, and functions as an asylum, a radically different form to its camp surrounding characterized by a more overwhelming and austere space.
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This book consists of two main parts. The first part offers a basic methodological introduction, presenting a concise but multifaceted overview of current problems of collective memory. The second part contains a set of interviews with former prisoners of concentration camps carried out by the authors. The research was conducted by Paweł Greń and Łukasz Posłuszny and focuses on issues of collective and cultural memory illustrated by individual life experiences of concentration camps prisoners. The field of oral history serves as the framework of analysis and narrative inquiry as its research tool. Interviews and additional research materials were collected by the authors and are not available in previous publications, making this work a precious supplement to the current scholarly body of knowledge and achievements in the discipline of memory studies. According to the authors, current historical and literary publications provide an incomplete picture of the WWII and its aftermaths for survivors, because descriptions of the war and imprisonment in the camp play still a dominate role in narratives. The importance of these issues in autobiographies is unquestionable and highly needed to create a common identity among generation of prisoners, though authors often wanted to perceive the fate of individuals in a broader perspective – including the periods before and after the war. Hence, interviews stressed personal experiences and their understanding over time by former prisoners. The interviews covered many topics on life before, during and after the camp – among them daily and neutral routines, but also difficult matters. The latter were connected on the one hand with traumatic events or harsh memories and emotions, and on the other hand with less extensively highlighted threads of prisoners’ lives - such as issues of the body and sexuality – and their dependence on particular representation or narrative. The authors are convinced that the book serves not only as a record of past remembered by eyewitnesses, but it also depicts their accounts in wider contexts and discourses, which expose specific dimensions of told and written stories. In the book Questions for Memory one examine the approach proposed by young scholars. Interviews were conducted from 2009-2011, seventy years after the end of the second world war, and this initiative was the result of questions and doubts of the authors from the existing literature. They also wanted to use the unique opportunity to meet with eyewitnesses and record their stories, because when they pass away we will irretrievably lose the possibility to listen to them and to pose sensitive questions. The majority of the interviewees were prisoners of KL Auschwitz-Birkenau, and their experiences differed greatly from each other based on social background and specific experience in the camps as well as their post-camp and postwar life. Aside from persons whose stories are already well known and open, readers will hear the stories of those who spoke only reluctantly and very rarely, or who had remained silent until the present author’s research. Qualitative differences between interviews occurred on the level of established relationship and atmosphere of trust, which varied according to circumstances and individual character and personality. For P. Greń and Ł. Posłuszny, each interviewed person is equally and highly valued due to the collected material and the personal experience of the meetings. Among the ten interviews placed in the book, seven of them are the stories told by women. Their testimonies exemplify realities of everyday prisoners’ existence and gravitate towards mirroring specifically feminine perspectives of imprisonment. For women, crucial problems stemmed from experiences of body that intertwine with suffering, feeling of shame and humiliation. Early discussions on holocaust literature and issues of representation that shaped the Polish narrative and collective memory imposed imperatives of silence on certain topics. A solution for reconciling heroic and inhuman deeds in stories with completely human physiology was impossible and improper for many years. There were also questions about life after, ways of dealing with a trauma or reflections on the present time. During conversations the authors attempted to come closer to something distant and incomprehensible for their generation and for people who did not experience the camps. Despite the fact that there have been seventy years of dealing with these events in literature, art, drama, film, memoirs and scientific works, the past still breeds more questions than answers. The book Questions for Memory serves as an example of this phenomenon.