L’un contre l’autre : la dialectique de l’auteur et de la lectrice chez Serge Doubrovsky

Depuis qu’en 1977, en quatrième de couverture de Fils, Serge Doubrovsky employa le mot « autofiction » pour décrire son roman, les études doubrovskiennes ont eu tendance à se focaliser sur les questions génériques que sous-tendait ce néologisme. Ainsi on a écarté un autre aspect, tout aussi important, de l’œuvre de l’auteur : celui du lien avec le lecteur qui, en plus d’être mis en scène dans chacune des autofictions doubrovskiennes, est associé dès Fils au rapport complexe, inextricable et conflictuel entre les sexes. « J’écris mâle, me lis femelle », dit le narrateur-écrivain ‘Serge Doubrovsky’ – lui qui vivra sous nos yeux une série d’histoires passionnelles avec des compagnes qui sont également ses lectrices. Repris d’épisode en épisode, le rapport entre le héros doubrovskien et sa compagne du moment rappelle les hypothèses de Doubrovsky dans Corneille ou la dialectique du héros (1963), inspirées de la dialectique hégélienne du Maître et de l’Esclave. Cette thèse s’attache donc à analyser la relation dialectique auteur-lectrice telle que mise en scène et approfondie dans l’ensemble de l’édifice autofictionnel. Après présentation et étude des mécanismes dont se sert l’auteur pour construire son Lecteur Modèle (Première partie), les trois autres sections principales de la thèse sont consacrées à l’analyse de Fils et Un amour de soi (1977 et 1982 ; Deuxième partie) ; du Livre brisé et de l’Après-vivre (1989 et 1994 ; Troisième partie) ; et enfin de Laissé pour conte (1999 ; Quatrième partie). Il s’agira enfin de montrer la portée non seulement littéraire, mais également sociale (la réflexion s’élargit à chaque épisode pour aborder les questions de la réception contemporaine de l’œuvre littéraire) et historique (le motif Maître-Esclave s’inscrit dans l’Histoire de l’Europe du XXe siècle, plus précisément la Seconde Guerre mondiale et la Shoah) du thème dialectique doubrovskien.

The work of nurse practitioners : a national work sampling study

Aim: This paper is a report of a study of variations in the pattern of nurse practitioner work in a range of service fields and geographical locations, across direct patient care, indirect patient care and service-related activities. Background. The nurse practitioner role has been implemented internationally as a service reform model to improve the access and timeliness of health care. There is a substantial body of research into the nurse practitioner role and service outcomes, but scant information on the pattern of nurse practitioner work and how this is influenced by different service models. --------- Methods: We used work sampling methods. Data were collected between July 2008 and January 2009. Observations were recorded from a random sample of 30 nurse practitioners at 10-minute intervals in 2-hour blocks randomly generated to cover two weeks of work time from a sampling frame of six weeks. --------- Results: A total of 12,189 individual observations were conducted with nurse practitioners across Australia. Thirty individual activities were identified as describing nurse practitioner work, and these were distributed across three categories. Direct care accounted for 36.1% of how nurse practitioners spend their time, indirect care accounted for 32.2% and service-related activities made up 31.9%. --------- Conclusion. These findings provide useful baseline data for evaluation of nurse practitioner positions and the service effect of these positions. However, the study also raises questions about the best use of nurse practitioner time and the influences of barriers to and facilitators of this model of service innovation.

A snapshot of Australian nurse practitioners’ extended practice activities

Introduction The Australian Nurse Practitioner Project (AUSPRAC) was initiated to examine the introduction of nurse practitioners into the Australian health service environment. The nurse practitioner concept was introduced to Australia over two decades ago and has been evolving since. Today, however, the scope of practice, role and educational preparation of nurse practitioners is well defined (Gardner et al, 2006). Amendments to specific pre-existing legislation at a State level have permitted nurse practitioners to perform additional activities including some once in the domain of the medical profession. In the Australian Capital Territory, for example 13 diverse Acts and Regulations required amendments and three new Acts were established (ACT Health, 2006). Nurse practitioners are now legally authorized to diagnose, treat, refer and prescribe medications in all Australian states and territories. These extended practices differentiate nurse practitioners from other advanced practice roles in nursing (Gardner, Chang & Duffield, 2007). There are, however, obstacles for nurse practitioners wishing to use these extended practices. Restrictive access to Medicare funding via the Medicare Benefit Scheme (MBS) and the Pharmaceutical Benefit Scheme (PBS) limit the scope of nurse practitioner service in the private health sector and community settings. A recent survey of Australian nurse practitioners (n=202) found that two-thirds of respondents (66%) stated that lack of legislative support limited their practice. Specifically, 78% stated that lack of a Medicare provider number was ‘extremely limiting’ to their practice and 71% stated that no access to the PBS was ‘extremely limiting’ to their practice (Gardner et al, in press). Changes to Commonwealth legislation is needed to enable nurse practitioners to prescribe medication so that patients have access to PBS subsidies where they exist; currently patients with scripts which originated from nurse practitioners must pay in full for these prescriptions filled outside public hospitals. This report presents findings from a sub-study of Phase Two of AUSPRAC. Phase Two was designed to enable investigation of the process and activities of nurse practitioner service. Process measurements of nurse practitioner services are valuable to healthcare organisations and service providers (Middleton, 2007). Processes of practice can be evaluated through clinical audit, however as Middleton cautions, no direct relationship between these processes and patient outcomes can be assumed.

Delineating the practice profile of advanced practice nursing : a cross-sectional survey using the modified strong model of advanced practice

AIMS: To test a model that delineates advanced practice nursing from the practice profile of other nursing roles and titles. BACKGROUND: There is extensive literature on advanced practice reporting the importance of this level of nursing to contemporary health service and patient outcomes. Literature also reports confusion and ambiguity associated with advanced practice nursing. Several countries have regulation and delineation for the nurse practitioner, but there is less clarity in definition and service focus of other advanced practice nursing roles. DESIGN: A statewide survey. METHODS: Using the modified Strong Model of Advanced Practice Role Delineation tool, a survey was conducted in 2009 with a random sample of registered nurses/midwives from government facilities in Queensland, Australia. Analysis of variance compared total and subscale scores across groups according to grade. Linear, stepwise multiple regression analysis examined factors influencing advanced practice nursing activities across all domains. RESULTS: There were important differences according to grade in mean scores for total activities in all domains of advanced practice nursing. Nurses working in advanced practice roles (excluding nurse practitioners) performed more activities across most advanced practice domains. Regression analysis indicated that working in clinical advanced practice nursing roles with higher levels of education were strong predictors of advanced practice activities overall. CONCLUSION: Essential and appropriate use of advanced practice nurses requires clarity in defining roles and practice levels. This research delineated nursing work according to grade and level of practice, further validating the tool for the Queensland context and providing operational information for assigning innovative nursing service.

A randomized controlled pilot study comparing aqueous cream with a beeswax and herbal oil cream in the provision of relief from postburn pruritis

Postburn itch is reported to affect up to 87% of the burn population. Although treatments for postburn itch are multimodal, they remain consistently ineffective. However, recent anecdotal evidence from several outpatients at a tertiary referral hospital suggests that a cream combining beeswax and several herbal oils may be effective in the minimization of postburn itch. The aim of this study was to test the efficacy of beeswax and herbal oil cream against the standard treatment of aqueous cream in the provision of relief from the symptoms of postburn itch. A randomized controlled trial compared two groups using a visual analog scale, frequency of cream application, itch recurrence after cream application, use of antipruritic medications, and sleep disturbance to determine the effect of itch severity and duration. Fifty-two participants were enrolled in the study (84% male) with a mean age of 35 years (SD = 16) and mean burn TBSA of 7.2% (SD = 7.7). Study results found that the beeswax and herbal oil cream reduce itch after application more frequently than aqueous cream (P = .001). In addition, when managed with beeswax and herbal oil cream, participants found that their itch recurred later (P ≤ .001) and their use of antipruritic medications was lower (P = .023). Findings of this study suggest beeswax and herbal oil cream to be more effective in the minimization of postburn itch than aqueous cream. Given this, a larger study examining the efficacy of beeswax and herbal oil cream appears warranted.

Reducing pressure injuries in critically ill patients by using a patient skin integrity care bundle (InSPiRE)

Purpose To test an interventional patient skin integrity bundle, InSPiRE protocol, on the impact of pressure injuries (PrIs) in critically ill patients in an Australian adult intensive care unit (ICU). Methods Before and after design was used where the group of patients receiving the intervention (InSPiRE protocol) was compared with a similar control group who received standard care. Data collected included demographic and clinical variables, skin assessment, PrI presence and stage, and a Sequential Organ Failure Assessment (SOFA) score. Results Overall, 207 patients were enrolled, 105 in the intervention group and 102 in the control group. Most patients were men, mean age 55. The groups were similar on major demographic variables (age, SOFA scores, ICU length of stay). Pressure injury cumulative incidence was significantly lower in the intervention group (18%) compared to the control group for skin injuries(30.4%) (χ2=4.271, df=1, p=0.039) and mucous injuries (t test =3.27, p=<0.001) . Significantly fewer PrIs developing over time in the intervention group (Logrank= 11.842, df=1, p=<0.001) and patients developed fewer skin injuries (>3 PrIs/patient = 1/105) compared with the control group (>3 injuries/patient = 10/102) (p=0.018). Conclusion The intervention group, recieving the InSPiRE protocol, had lower PrI cumulative incidence, and reduced number and severity of PrIs that developed over time. Systematic and ongoing assessment of the patient's skin and PrI risk as well as implementation of tailored prevention measures are central to preventing PrIs.

Identifying advanced practice: A national survey of a nursing workforce

Background The size and flexibility of the nursing workforce has positioned nursing as central to the goals of health service improvement. Nursing's response to meeting these goals has resulted in proliferation of advanced practice nursing with a confusing array of practice profiles, titles and roles. Whilst numerous models and definitions of advanced practice nursing have been developed there is scant published research of significant scope that supports these models. Consequently there is an ongoing call in the literature for clarity and stability in nomenclature, and confusion in the health industry on how to optimise the utility of advanced practice nursing. Objectives To identify and delineate advanced practice from other levels of nursing practice through examination of a national nursing workforce. Design A cross-sectional electronic survey of nurses using the validated Advanced Practice Role Delineation tool based on the Strong Model of Advanced Practice. Participants Study participants were registered nurses employed in a clinical service environment across all states and territories of Australia. Methods A sample of 5662 registered nurses participated in the study. Domain means for each participant were calculated then means for nursing position titles were calculated. Position titles were grouped by delineation and were compared with one-way analysis of variance on domain means. The alpha for all tests was set at 0.05. Significant effects were examined with Scheffe post hoc comparisons to control for Type 1 error. Results The survey tool was able to identify position titles where nurses were practicing at an advanced level and to delineate this cohort from other levels of nursing practice, including nurse practitioner. The results show that nurses who practice at an advanced level are characterised by high mean scores across all Domains of the Strong Model of Advanced Practice. The mean scores of advanced practice nurses were significantly different from nurse practitioners in the Direct Care Domain and significantly different from other levels of nurse across all domains. Conclusions The study results show that the nurse practitioner, advanced practice nurse and foundation level registered nurse have different patterns of practice and the Advanced Practice Role Delineation tool has the capacity to clearly delineate and define advanced practice nursing. These findings make a significant contribution to the international debate and show that the profession can now identify what is and what is not advanced practice in nursing.

Elämästä autofiktioksi : Lajitradition jäljillä Pirkko Saision romaanisarjassa Pienin yhteinen jaettava, Vastavalo ja Punainen erokirja

Pirkko Saisio's trilogy Pienin yhteinen jaettava (The Smallest Shared Dividend, 1998), Vastavalo (Against the Light, 2000), and Punainen erokirja (The Red Book of Separation, 2003), depicts the development of a masculine girl who at the end of the trilogy comes out as a homosexual women, a mother, and a writer. The main character is named Pirkko Saisio, and many of the events are picked from Saisio's real life. Nevertheless, the author wants the trilogy to be read as a novel, not a memoir. The present study analyses the generic elements of Saisio s trilogy and contextualizes the narrative identity that Saisio is creating in her fiction. Following Alastair Fowler s theory of genres as types without strict borders and a tendency to hybridity, the trilogy is linked to several genres. Serge Doubrovsky s genre concept of autofiction is the basis for the analysis: it explains the trilogy s borderline identity between autobiography and novel, and designates the main elements that render Saisio s autobiographical narrative into fiction. Both Doubrovsky and Saisio emphasize the role of the unconscious in writing, and at the same time stress the importance of a skilled composition. As well as autofiction, the trilogy is analyzed as a Bildungsroman, a confession and conversion narrative, a coming-out -narrative and a portrait-of-the-artist novel. Each genre is illuminated by its paradigmatic work: Wilhelm Meister s Apprenticeship by Goethe, The Confessions by St. Augustine, and The Well of Loneliness by Radclyffe Hall. The parallelisms between Saisio s trilogy and the typical plots of the genres and thematics of the classics show how the tradition works in Saisio s text. The thematic parallelisms highlight Saisio s concern for the conflicts that occur between an individual and the surrounding society, while the similarities in plots question the autobiographicality of Saisio s narrative but also clarify how Saisio refines the traditional genres. Read in the light of Saisio s trilogy, the classics are shown to have their gender-transgressive elements that the non-normative reader can identify with. Saisio s text also challenges universalizing claims about genre and gender. As a narrative of identity it follows the example of 1970s essentialistic coming-out stories, but at the same time depicts the notion of identity in a manner that manifests postmodern ideas about identity as multiple and ever-transforming. Keywords: autobiographicality, autofiction, identity narrative, genre research, Bildungsroman, conversion narrative, confession, coming-out story, a portrait-of-an-artist novel

Quase imperceptível: arte participativa e ficção

Esta dissertação levantou um conjunto de questões relacionadas à reflexão do meu processo artístico, tendo como ponto de partida as imagens poéticas da casa, do dormir, do desabrigo, da invisibilidade e da visibilidade que culminaram em trabalhos acerca dos moradores de rua, da acessibilidade e do uso da cidade. Para analisar as experiências artísticas participativas realizadas em âmbito urbano, foi apresentado um estudo da produção de artistas como Flávio de Carvalho, Lygia Clark e Hélio Oiticica, assim como os conceitos de site specific e site oriented (KWON 1998). Acerca dos trabalhos que envolvem relações e propostas de convivência, foi acessado o livro Estética Relacional (BOURRIAUD 2009) e o texto Antagonismos e Estética Relacional (BISHOP 2004). O ato de ouvir e as histórias narradas durante as propostas participativas aproximaram o estudo da ideia de autoficção (DOUBROVSKY 1977) e da escrita de si (FOULCAULT 2002). A relação com o desenho foi observada como produção de sentido, assim como foi problematizado o papel do artista a partir da observação do papel do mediador, revelando possibilidades outras de definição com base nos conceitos de participação total (OITICICA 1967), e artista-etc. (BASBAUM 2013).

A escrita de Ilse Losa para a infância e a juventude

Tese de Doutoramento, Estudos Portugueses, 15 de Setembro de 2015, Universidade dos Açores.

Cru ; suivi de Cruauté nécessaire : le devoir d'une vérité autobiographique chez Guibert, Dustan et Rémès

Situé entre entre le roman et le récit personnel, Cru. prend la forme d'un aller-retour entre fiction et autobiographie. Le texte, construit à l'aide d'une écriture syncopée et brute, présente deux personnages homosexuels à l'ère « post-sida », alors que ceux-ci tentent de comprendre ce que veut dire « être un homme » dans un contexte social où le mépris (envers les autres et soi-même) est encore présent, mais peut-être encore plus pernicieux qu'auparavant, parce que camouflé sous l'idée d'une acceptation globale. Au final, Cru. soulève la délicate question du droit à la vérité dans une démarche autobiographique et celle de l'implication de la cruauté dans un récit qui ne concerne pas que l'auteur, mais son entourage aussi. Cruauté nécessaire : le devoir d'une vérité autobiographique chez Guibert, Dustan et Rémès est un essai qui vise l'analyse de différents procédés se rattachant à l'écriture autobiographique homosexuelle des années 1990, particulièrement aux textes appartenant à la littérature du sida. Si l'autobiographie vise, dans une certaine mesure, le dévoilement de la vérité, comment ne pas parler de cruauté alors que les auteurs qui la pratiquent y vont de révélations qui ne concernent pas qu'eux? Si le processus d'écriture autobiographique se veut bénéfique, le résultat est-il purement diabolique? Il faudra d'abord, évidemment, définir ce que l'on entend par « vérité » et « cruauté » (lire « bénéfique » et « maléfique »). En ce qui concerne le Bien et le Mal, les textes de Bataille et Nietzsche contribueront à définir deux concepts qui peuvent, souvent, être relatifs. En confrontant les textes des trois auteurs français – tous séropositifs au moment de l'écriture – à différentes théories autobiographiques (Doubrovsky, Lejeune, Miraux) et identitaires (Foucault, Schecter, Butler), et à certains écrits sur le devoir et la responsabilité (Donner, Brooks), l'on tentera de démontrer que la cruauté dont Guibert, Dustan et Rémès font preuve est essentielle à l'écriture autobiographique.

As crônicas de Caio Fernando Abreu: entre o fato e a ficção

O presente trabalho tem por objetivo analisar as crônicas de Caio Fernando Abreu. Num primeiro momento serão verificadas como se dão as discussões a respeito da crônica enquanto gênero. Para tanto serão utilizados conceitos de Castello (2007), Candido (1993), Arrigucci (1986), Coutinho (1984), Melo (2002), Coelho (2002) e Chaparro (1998), que ajudarão a situar a crônica como gênero de fronteira entre expedientes literários e jornalísticos. Num segundo momento, serão analisadas especificamente as crônicas de Caio, buscando assim diagnosticar a maior presença de aspectos provindos da literatura em detrimentos dos jornalísticos. Além disso, também serão buscadas as diferenças que se apresentaram no gênero crônica, quando comparadas com parte da produção ficcional do autor. Para tanto serão abordados aspectos da linguagem e a ausência de personagens homossexuais nas crônicas. Esse grupo de crônicas será classificado como intimista. Ainda nesse capítulo será verificado como foram tratados dois temas que estiveram presentes em contos e crônicas de Caio: o final feliz nos relacionamentos amorosos e o sentimento de ausência da pessoa amada. Um último momento de análise buscará tratar da relação existente entre a vida pessoal do autor e o conteúdo de suas crônicas. Esse grupo de textos, classificado como dramático, utilizará o conceito de autoficção de Doubrovsky (2007)

"...all diese fingierten, notierten, in meinem Kopf ungefähr wieder zusammengesetzten Ichs". Autobiographie und Autofiktion

Dass jede literarische Selbstdarstellung fiktionale Elemente beinhaltet, ist in der gegenwärtigen Autobiographie-Diskussion unbestritten. Mit dem von Serge Doubrovsky geprägten Terminus »Autofiktion« hat sich die Forschung verstärkt literarischen Texten zugewendet, die fiktionales und faktuales Erzählen der eigenen Biographie mehr oder minder offensichtlich vermischen und so die Problematik literarischer Selbstthematisierung reflektieren. Ausgehend von der theoretischen Diskussion um Autobiographie und Autofiktion werden Texte und Textentwürfe von Robert Walser, Annemarie Schwarzenbach, Paul Nizon, Friedrich Dürrenmatt und Urs Widmer mit ihren je eigenen und nicht selten eigenwilligen Konzepten des literarischen Umgangs mit der Biographie untersucht. Mit Beiträgen von Peter Gasser, Wolfram Groddeck, Lucas Marco Gisi, Heidy Margrit Müller, Ulrich Weber, Reto Sorg, Elio Pellin und Irmgard Wirtz.

Psicoanálisis y literatura : La auto-ficción

El propósito del artículo es ilustrar la aplicabilidad de la noción de autofiction como instrumento de análisis crítico del texto literario desde una perspectiva eminentemente psicoanalítica. Para ello se ha de estudiar la categoría de autofiction (acuñada por el escritor y crítico francés Serge Doubrovsky y continuada por textos de Philippe Gasparini y Jean-Luc Pagès, entre otros) para luego aplicarla como instrumento crítico al análisis de Los deseos oscuros y los otros. Diarios de New York (l978-l982) de Luisa Valenzuela

Psicoanálisis y literatura : La auto-ficción

El propósito del artículo es ilustrar la aplicabilidad de la noción de autofiction como instrumento de análisis crítico del texto literario desde una perspectiva eminentemente psicoanalítica. Para ello se ha de estudiar la categoría de autofiction (acuñada por el escritor y crítico francés Serge Doubrovsky y continuada por textos de Philippe Gasparini y Jean-Luc Pagès, entre otros) para luego aplicarla como instrumento crítico al análisis de Los deseos oscuros y los otros. Diarios de New York (l978-l982) de Luisa Valenzuela