Dead Children Research Articles

Bill and Melinda Gates honored with Lasker~Bloomberg Public Service Award

The 2013 Lasker~Bloomberg Award for Public Service recognizes the extraordinary impact made by Bill and Melinda Gates toward improving global public health through the work of their foundation. Bill Gates made his fortune as one of the giants of the modern computer industry; today he and his wife Melinda may be equally well known for their worldwide work in philanthropy. Founded in 2000, the Bill & Melinda Gates Foundation is now the largest private foundation in the U.S. (1). The foundation has provided more than $26 billion in grant funding for all of its programs since inception and in recent years has invested nearly $2 billion annually for global health projects alone (2). What started as a simple desire to help those less fortunate blossomed into a bold organization, willing to take on seemingly insurmountable public health challenges. The concept behind the Bill & Melinda Gates Foundation began to take shape in the late nineties. Bill Gates recalled, “For my wife Melinda and me, the problem of global health inequity became visible fifteen years ago, when we saw a simple pie chart in the newspaper breaking down the major causes of death among children. One of the bigger slices of the pie, representing 500,000 dead children annually, was labeled: rotavirus. I had never heard of rotavirus. Melinda had never heard of it. It turns out it is the leading cause of diarrhea, preventable with a vaccine that only children in rich countries were getting. Our reaction was somewhere between disbelief and disgust. How could we not have seen even the barest outlines of this tragedy?”(3). This observation set in motion a new sense of urgency in Bill and Melinda Gates and started them on the ambitious path of trying to make a difference in public health and save lives. Bill and Melinda Gates (Figure ​(Figure1)1) may not have been public health experts at the time, but over the course of the next few years, they assembled a team of experts in science, medicine, and policy and undertook an initiative to address the biggest killers in the developing world. Dr. Tadataka (Tachi) Yamada, President of the Global Health Program at the Bill & Melinda Gates Foundation from 2006–2011, recently told the JCI, “Because of the sincerity of their commitment and the depth of their passion, Bill and Melinda really established not just a foundation but a new way of thinking about how to address inequities in health care.” Yamada credits the foundation for bringing the resources and partnerships needed to convert independent global health projects into coordinated efforts and accelerating implementation campaigns. Yamada said, “I think the Gates Foundation brought a sense of urgency, passion, and commitment that allowed the world to be more ambitious in a way, to solve some very difficult problems that seemed almost beyond solution. In addition, the Gates Foundation invested very substantially in research and development for new solutions to health care problems.” Figure 1 Bill and Melinda Gates, recipients of the 2013 Lasker~Bloomberg Public Service Award, on a recent trip to Bihar, India.

Soins palliatifs du nouveau-né et cultures

The period of palliative care is a difficult time for parents and caregivers because they are all weakened by the proximity of death. First of all, because of religious and cultural differences, parents and families cannot easily express their beliefs or the rituals they are required to develop; second, this impossibility results in conflicts between the caregiver team and the family with consequences for both. Caregivers are concerned to allow the expression of religious beliefs and cultural demands because it is assumed that they may promote the work of mourning by relating the dead child to its family and roots. However, caregivers' fear not knowing the cultural context to which the family belongs and having inappropriate words or gestures, as sometimes families dare not, cannot, or do not wish to describe their cultural background. We attempt to differentiate what relates to culture and to religion and attempt to identify areas of potential disagreement between doctors, staff, and family. Everyone has to work with the parents to open a space of freedom that is not limited by cultural and religious assumptions. The appropriation of medical anthropology concepts allows caregivers to understand simply the obligations imposed on parents by their culture and/or their religion and open access to their wishes. Sometimes help from interpreters, mediators, ethnopsychologists, and religious representatives is needed to understand this reality.

Genetic Modification and the Public Good

Genetic engineering (GMO-technology) offers great opportunities to contribute to the public good by improving public health, e.g. by improving the micro-nutrient status of poor populations, cost effectively and – therefore – sustainably. The prime example for such a project from the public domain for public good is ‘Golden Rice’ (www.goldenrice.org). There are exclusive public funds involved (from altruistic organizations), no dependence from industry except for in-kind support and help in acquiring free licenses for humanitarian use. There is no financial reward for anyone involved. The only beneficiaries are the poor in developing countries. Theoretically, when considering the arguments of the anti-GMO lobby, this is an ideal application of GMO-technology. However, Golden Rice is considered a Trojan Horse, which must be prevented under all circumstances. The consequence: millions of avoidable blind and dead children. The author considers those who are responsible for this avoidable suffering of many innocent children (and mothers at childbirth) a crime to humanity. There are those who commit this deliberately and those who are participating passively, such as numerous ‘humanitarian organizations’ and ‘decision makers’ in politics and elsewhere. There is a wealth of scientific information and broad consensus that GMO-technology is at least as safe as any other technology involved in any context with our food or our environment. What we experience here is an example of ‘unreason’ and a perfect example in the context of The March of Unreason. Our ‘enlightenment’ and science-based successful European culture is on the verge of being replaced by unreason-based failure and lack of culture.

Literary Barbed Wire

Literary Barbed Wire

Tsunami Waves of Destruction: The Creation of the “New Australian Catastrophe”

Tsunami Waves of Destruction: The Creation of the “New Australian Catastrophe”

Women’s Writing in the British Atlantic World: Memory, Place and History, 1550–1700 by Kate Chedgzoy

Reviewed by: Women’s Writing in the British Atlantic World: Memory, Place and History, 1550–1700 by Kate Chedgzoy Mary Ann O’Donnell Kate Chedgzoy. Women’s Writing in the British Atlantic World: Memory, Place and History, 1550–1700. Cambridge: Cambridge, 2007. Pp. vii + 267. £55; $115.99. This is a book about memory and memorials, about the ways memory sustains in times of woe and maintains the past in the face of the present. Ms. Chedgzoy astutely finds a pattern in the writings from what she calls the “British Atlantic World,” a term that does not quite have the breadth of the seventeenth-century transatlantic world, even as it covers much the same territory, but focuses on women who wrote in “British” spaces rather than those who spanned the ocean. Thus, the world of this book includes women who composed in the Celtic tongues of Ireland, Scotland, and Wales as well as those who wrote in England and the English-speaking colonies. The organizing principle is the memorializing of women’s experiences between the two Acts of Union as the world inhabited by these women lurched toward “modernity.” Women’s writings in this period had long been domestic—recipes, excerpts of sermons, household needs. But as the chaos of the seventeenth century overwhelmed their world, particularly during the Civil Wars and the Interregnum, women’s writing expanded to record the battles and conflicts around them, to manage their estates in the absence of husbands and fathers, to comfort imprisoned loved ones, to call themselves and others to witness God’s justice and mercy, to inscribe the lives of their dead children and spouses. Thus, it is fitting that the book opens with Anne Bradstreet’s memory of her Andover house destroyed by fire—an iconic poem of loss and recollection that itself was saved from loss by the poet’s son Simon. Simon’s rescue work in preserving his mother’s record of loss is echoed by Ms. Chedgzoy’s recovery of a number of women whose work has been largely unnoticed, and as Simon recognized the need to preserve—and remember—so too does this book. Particularly interesting is the third chapter, on the oral traditions of the Welsh, Irish, and Scottish women, through whose work Ms. Chedgzoy moves confidently, providing translations of major segments. The recording of these documents in itself shows a shift in attitudes of their contemporaries in that their works were deemed important enough to preserve in writing. At times, the Celtic works are juxtaposed with works by English women who lived [End Page 266] at roughly the same time in Wales, Ireland, and Scotland. For example, the section on Wales begins with the well-known transplant, Katharine Philips, who in her poem “On the Welch Language” “engages with Wales” in “almost ethnographic tones,” while noting that the local language “hath her beauty Lost.” Ms. Chedgzoy places in dramatic parallel with Philips one Magdalen Lloyd, a transplant from Wales in domestic service in London, whose memories provide comfort and “human connections despite geographical separation.” The chapter on “Women’s Writings and the Memory of War” examines Bradstreet’s mediation of past history and current civil war in the 1640s. Attention is also turned to the step-daughters of Margaret Cavendish—Elizabeth Brackley and Jane Cavendish—and their turn to memories that sustained them through the trials of the Civil War, while their father was first in battle and later in exile, and their ancestral homes were besieged and sometimes occupied by Roundheads. Not enough is done with these two fascinating women. Their manuscript collection, Bod. MS. Rawl. 16, an admixture of verse; a play about marriage choices, Concealed Fansyes; and a strange Pastorall involving witches, is discussed without much logic, and, oddly, there is no reference to the publication of Concealed Fansyes (ed. Nathan Comfort Starr, PMLA, 1931). But the chapter turns quickly to Lady Hester Pulter, whose manuscript in the Brotherton Collection (Lt q 32) contains over one hundred poems and an unfinished prose romance, this latter not discussed. Pulter’s poems are highly political, and use public spaces and landscapes as sites of memory for the lost world of the Royalists in...

Healing: The Spiritual Work in Palliative Care

Healing: The Spiritual Work in Palliative Care

Tanatosemiosis: comunicación con los niños difuntos. Tumbas, colores, epitafios, exvotos y memoria(s)

The term tanatosemiosis stems from our critical approaches to productions on communication with the deceased (mainly Finol and Fernandez, 1996, Finol and Finol, 2009 and Bernal Botero, 2010). These ideas will be used to analyze the problematic of deceased children (angelitos or “little angels”) in two chronotopic specificities: the public cemeteries of Corrientes Province in Argentina and the remembrance of dead children in the Community of Villa Olivari (Corrientes). The funerary practices regarding children are considered especially distinct to those of adults. The remembrance, the tombs, the epitaphs and the votive offerings form not only specific interpretative, symbolic and subjective schemes, but also communicative logics strongly rooted in what Finol and Fernandez (1996) called the “semiotics of feminine”. These communicational frameworks, like symbolic configurations, (re) appear in the rituals, colors, tombs, epitaphs and votive offerings; constituting specific tan atosemiotic systems of beliefs-habits. The methodology used draws from transdisciplinary contributions from Anthropology, Communication and Semiotics. The analyzed corpus was constructed on the base of first-hand data collected between 2005 and 2010.

Crescendo em catingueira: criança, família e organização social no semiárido nordestino

Este artigo etnográfico tem como objetivo apresentar as crianças catingueirenses (semiárido da Paraíba), destacando sua participação na vida social e familiar, através do desvelamento das contingências cotidianas que enfrentam, assim como as expectativas adultas em relação a elas. Para isso, minha estratégia é, através de três memórias etnográficas - um evento na igreja envolvendo uma criança de 3 anos, o ritual de apresentação dos novos membros à comunidade e um cortejo fúnebre de um anjinho - pensar as crianças pequenas como risíveis, as crianças maiores como aprendizes e a infância como período de trabalho e de aprendizado moral. O texto revela um universo em que as crianças se tornam agentes imprescindíveis para o bom funcionamento da unidade familiar e, de modo mais geral, de toda a comunidade.

Mapping Inbetweenness: A Conceptual Model for War-induced Resettlement

The policy oriented aspects, some scholars, institutions, and organizations have played a vital role in the study of the nature and sequence of conflict induced internal displacement from different perspectives. However large majority of such studies have confined merely to identify the grievances and agonies of the IDPs, and thereby recommending the relevant authorities to adopt necessary action to resettle such IDPs. In this context my research is going to be somewhat different from the above conventional approach. Hence, the aim of my research is to identify the conflict induced displacement from a perspective of inbetweenness experiencing due to loosing of their fix points by the CIIDPs throughout the different phases of displacement resettlement continuum. The sample (focus groups) of this research is consisting of IDPs belonging to three different ethnicities, located at different geographical areas of the country. Also the duration of their being as IDPs in the camps has also taken into consideration in selection of these focus groups. The qualitative approach, not completely devoid from quantitative methods has been used for the research. The main techniques applied in data collection are consisting of: conducting of in depth discussions, cognitive mapping and observation. The results revealed that CIIDPs were concern of many fix points. There were fix points assigned values of different degrees by the CIIDPs, among them. Also it should be noted that the characteristics of such fix points were also varied from one another. When broken, some of the lost-fix points can of course be re-established, while some others cannot; for instance, a dead child is forever lost a burned down houses may be rebuilt. However, when people flee, most fix-points become fluid, even those that are tied to material goods. Also some of fix points were tangible whereas some were intangible. It was also revealed that under each fix points there were many inbuilt concerned tangible or intangible elements. For an example, if dislocation from the land is considered as losing of a major tangible fix pint by someone, along with that he or she would tend to lose many other spiritual fix points such as the possession, wealth, the collateral value, inheritance, sentimental attachments, social status, human dignity etc. Some loosen fix points such as dead husband may be very valuable for some IDPs while some others not. This of course depend on how far that particular fix point or set of fix points cause to the uncertainty, unstable livelihood and change. Therefore it can be argued that the status of inbetweenness of CIIDPs is characterized by unfixed fix-points, unstable livelihood systems, uncertainty and change, everything essentially determined by factors outside their control. However, the cognition of CIIDPs’ ambitions proved that the existing inbetweenness of IDPs would not be overcome completely, even though they have fully recovered from their loosen fix points that they have undergone due to being IDPs because new fix points need to be established further more. Identification of inbetweenness from the perspective of fix points of the CIIDPs will invariably add a new dimension that would be of immense importance to the policy makers who are currently looking at the issues of IDPs merely as a question of relocation or provision of a shelter.

Multidimensional life-table analysis of the effect of child mortality on total fertility in India, 1992–93, 1998–99, 2005–06

This paper presents a new method for estimating the effect of child mortality on the total fertility rate (TFR). The method is based on discrete-time survival models of parity progression that allow construction of a multivariate multidimensional life table of fertility with four dimensions: woman's age, parity, duration in parity, and number of previous child deaths. Additional socio-economic variables are included in the set of predictor variables in the underlying survival models of parity progression. The life table yields a replacement rate, which measures the effect of one additional child death on the TFR. The method is illustrated by applying it to three Indian National Family Health Surveys. Major findings are that dead children are incompletely replaced, and that the replacement rate rises as the TFR falls, reflecting women's increasing ability to control their fertility.

Mutation analysis and prenatal diagnosis of a Chinese family with X-linked severe combined immunodeficiency

To analyze the mutation of IL2RG gene in a Chinese family with a birth history of a dead child suspected of X-linked severe combined immunodeficiency (X-SCID), and to perform prenatal diagnosis with DNA sequencing. Blood samples of the parents of the dead child and chorionic villi at gestational age 11 weeks were collected. Eight exons comprising the open reading frame as well as their exon/intron boundaries of IL2RG gene were analyzed by PCR and bi-directional sequencing. A heterozygous nucleotide substitution c.690C > T (R226C) in exon 5 was detected in the mother, but not in the father. In the second pregnancy of the mother, the mutation of R226C was not detected in the male fetus by prenatal diagnosis, and the heterozygous mutation was detected in the female fetus of the third pregnancy. The reliability of the prenatal genetic diagnosis was confirmed by the one-year follow-up after the neonates were born. The mutation of c.690C>T in IL2RG gene may be the pathologic cause of the proband with X-SCID. DNA sequencing combining sex determination is a valid strategy for prenatal diagnosis of X-SCID.

Surrealism under the Knife in Myla Goldberg's Wickett's Remedy

Surrealism under the Knife in Myla Goldberg's <i>Wickett's Remedy</i>

Association between pregnancy intention and optimal breastfeeding practices in the Philippines: a cross-sectional study.

BackgroundThe effect of pregnancy intention on post-natal practices like breastfeeding is still poorly understood in the Philippines. In this light, this study aims to determine the association between pregnancy intention and optimal breastfeeding practices in the Philippines.MethodsThis is a cross-sectional study design using the 2003 Philippine National Demographic and Health Survey. Logistic regression analysis was used to determine the independent association of pregnancy intention and optimal breastfeeding practices. The study includes 3,044 last-born children aged 6–36 months at the time of survey. Dead children were also included as long as their age of death satisfies the age criterion.ResultsChildren born from mistimed pregnancies are more likely to have late breastfeeding initiation compared to children born from wanted pregnancies (OR = 1.44; 90%CI: 1.17-1.78). However, this occurs only among children belonging to households with low socio-economic status. Among children belonging to households with high socio-economic status, no significant effect of pregnancy intention on breastfeeding initiation was observed. Children born from unwanted pregnancies are less likely to have short breastfeeding duration (OR = 0.60; 90%CI: 0.48-0.76). However, this occurs only among children belonging to households with high socioeconomic status. No significant effect of pregnancy intention on breastfeeding duration was observed among children belonging to households with low socio-economic status.ConclusionThe findings of this study suggest that there are different effects of pregnancy intention on the two types of optimal breastfeeding practices examined. With regards to breastfeeding duration, it was found that among infants belonging to high SES, the odds of having short breastfeeding duration is lower among children born from unwanted pregnancies compared to children born from wanted one. Conversely, children belonging to low SES household, the odds of having late breastfeeding initiation among children born from mistimed pregnancies are higher compared to children born from wanted pregnancies.

Post-mortem skeletal surveys in suspected non-accidental injury

To evaluate potential differences between live (LSS) and post-mortem skeletal surveys (PMSS) in cases of non-accidental injury (NAI). All skeletal surveys (SS) performed for suspected NAI over a 5year period were retrospectively reviewed. Demographic details, injuries obtained, artefacts, and radiographic difficulties encountered during LSS and PMSS were recorded. Of 195 surveys performed, there were significantly fewer positive PMSS (11/128; 8.6%) than LSS (16/67; 23.8%), but no difference between the actual injuries encountered. Of those who had a positive SS, dead children were significantly younger (mean age 2.6±3.4 months old) than live children (7.8±6.9 months old; p<0.05). Thirty-six percent of all contemporary digital radiographs contained artefacts, particularly in PMSS (599/1504; 39.8%) compared to LSS (269/904: 29.7%; p<0.001), which were mostly patient identification labels (55.1 versus 21.6%; p<0.001). PMSS demonstrated death-related radiographic complications in 10.6% of cases. Radiographic imaging in deceased children is not easy, and yields significant artefacts, which may hamper image interpretation. A technique for obtaining multiple views of a limb in fixed flexion deformity to maximize the diagnostic potential is described. Careful consideration of these factors would maximize the diagnostic yield in this unique patient population.

Ballywhinney Girl (review)

Reviewed by: Ballywhinney Girl Elizabeth Bush Bunting, Eve . Ballywhinney Girl; illus. by Emily Arnold McCully. Clarion, 2012. 32p. ISBN 978-0-547-55843-1 $16.99 R* 5-8 yrs. Maeve is out in the Irish bog with her grandfather when, while cutting a strip of peat from the ground, he unearths a body: "Run on home and tell your ma. Tell her to phone the Ballywhinney police." Having delivered the message, Maeve hustles back to the scene of the assumed crime, but the police recognize at once that this isn't a murder victim but a mummy. Archaeologists are summoned and the sergeant urges Maeve to go on home, but she's having none of that. She hangs on the archaeologists' every word as they suggest Grandpa's find is probably a girl, about a thousand years old ("I gasped. A girl! A girl like me, a thousand years ago dead and dropped into this quiet place. Who was she? What had happened?"). The remains are carefully removed, the police keep the family informed of the whereabouts of the Ballywhinney Girl, and Maeve takes some comfort in the report that the dead child was found to have flowers beside her, "the kind that line the lanes of Ballywhinney." Seeing the mummy as an object on exhibit in a glass museum case brings Maeve to tears; only when she returns home, sets a rock on the original burial site, and imagines Ballywhinney Girl returning to walk in the moonlight does she bring peaceful closure to the episode. Here Bunting acknowledges children's strong interest in the mysteries—and grotesqueries—of death, but also credits her young audience with an equally strong sense of awe, respect, and sympathetic imagination. Maeve's voice and the natural flow of dialogue make this a pleasure to read aloud, and McCully's watercolor scenes capture a placid landscape and cozy home suddenly jolted from the quotidian into the extraordinary. A closing note remarks on other "bog body" discoveries that inform this fictional tale. Copyright © 2012 The Board of Trustees of the University of Illinois

Death, nasomaxillary complex, and sleep in young children

This is an investigation of anatomical and sleep history risk factors that were associated with abrupt sleep-associated death in seven children with good pre-mortem history. Seven young children with abrupt deaths and information on health status, sleep history, death scene report, and autopsy performed in a specialized unit dedicated to investigation of abrupt death in young children were investigated Seven age and gender matched living children with obstructive-sleep-apnea (OSA) were compared to the findings obtained from the dead children. Two deaths results from accidents determined by the death scene and five were unexplained at the death scene. History revealed presence of chronic indicators of abnormal sleep in all cases prior death and history of an acute, often mild, rhinitis just preceding death in several. Four children, including three infants, were usually sleeping in a prone position. Autopsy demonstrated variable enlargement of upper airway soft tissues in all cases, and in all cases, there were features consistent with a narrow, small nasomaxillary complex, with or without mandibular retroposition. All children were concluded to have died of hypoxia during sleep. Our OSA children presented similar complaints and similar facial features. Anatomic risk factors for a narrow upper airway can be determined early in life, and these traits are often familial. Their presence should lead to greater attention to sleep-related complaints that may be present very early in life and indicate impairment of well been and presence of sleep disruption. Further investigation should be performed to understand the role of upper airway infection in the setting of anatomically small airway in apparently abrupt death of infants and toddlers.

Аналіз летальності та факторів підвищеного ризику народження дітей з уродженими вадами серця

Проведено ретроспективний аналіз 251 історії хвороб померлих дітей, вивчена частота летальності вiд ізольованих уроджених вад серця 27 новонароджених і 26 дітей першого року життя за період 2006–2010 рр. Встановлено, що серед усіх вроджених вад розвитку, які займають 68,1 % всієї патології, вроджені вади серця зустрічалися у кожному третьому випадку летальності новонароджених і в кожному другому — у дітей першого року життя. Летальність новонароджених з уродженими вадами серця зустрічалася у більшості випадків серед дівчаток і у дітей, які проживали у місті. Виявлені деякі фактори ризику, які могли бути і/або були причиною виникнення вроджених вад серця під час вагітності. Вивчення частоти летальності має важливе значення для раннього кардіохірургічного лікування.

Особливості соматичного і репродуктивного статусу у жінок, які народили дитину з природженими вадами розвитку, та їх визначення з використанням методу «випадок — контроль», за даними Львівського обласного клінічного перинатального центру за 2007–2009

Проведено збір та аналіз клініко-епідеміологічних і медико-статистичних даних із 162 джерел первинної документації (історії пологів (форма 096/о) і розвитку новонароджених (форма 097/о)) про дітей, які народились у Львівському обласному клінічному перинатальному центрі в 2007–2009 роках із природженими вадами розвитку, з використанням методу «випадок — контроль», шляхом заповнення реєстраційних карт.При порівнянні спектра показників репродуктивного анамнезу відмічено більший відсоток померлих дітей, мертвонароджень, анемії при вагітності, гестозу першої половини вагітності, гестозу другої половини вагітності, патологічних пологів у матерів, які народили дитину з природженою вадою розвитку, ніж у жінок контрольної групи.Вроджені аномалії за даними ультразвукової діагностики під час вагітності виявлено у 31,6 %. Діагностовано 4 випадки синдрому Арнольда — Кіарі (spina bifida і внутрішня гідроцефалія); по 3 випадки гідроцефалії, гастрошизису, атрезії тонкого кишечника; по 2 випадки множинних природжених вад розвитку, синдрому гіпоплазії лівих відділів серця, синдрому Дауна, вродженої діафрагмальної кисти, омфалоцеле, вродженої атрезії прямої кишки; по одному випадку spina bifida, вродженої відсутності передпліччя та кисті, рабдоміоми лівого шлуночка, енцефалоцеле.

Brian Friel: Theatre and Politics (review)

Reviewed by: Brian Friel: Theatre and Politics Helen Heusner Lojek Brian Friel: Theatre and Politics, by Anthony Roche, pp. 235. London: Palgrave Macmillan, 2011. $90. Although Brian Friel is best known in the United States for Translations (1980) and Dancing at Lughnasa (1990), the list of his dramatic works is large and varied, and represents significant intersections between theater and politics on both sides of the Irish border. Anthony Roche’s new study provides both an introduction to the author he rightly terms “Ireland’s leading contemporary playwright,” and a nuanced examination that will expand the understandings of readers and theatergoers already familiar with Friel. Roche draws on his own extensive experience as an interpreter of Irish drama (his indispensable Contemporary Irish Drama, the second edition of which appeared in 2009, for example), on his familiarity with multiple productions of the plays, on archival collections of Friel’s papers in the National Library of Ireland, on correspondence in the Guthrie Theatre Archive in Minnesota, and on first-hand experience with the politics of Irish theater, government, and society. The resulting analysis reveals the multiple factors and rethinkings that produced the now-familiar polished shapes of Friel’s plays. This multi-sourced approach is particularly effective in drawing out contemporary political resonances in such texts as Translations and Faith Healer. Roche’s understanding of the circumstances of performance, and his knowledge of the actors who embodied parts—which were sometimes written with them in mind—enhances his exploration of the ways that different productions have illuminated aspects of the plays. He is alive to Friel’s ability to incorporate new forms, revitalizing his drama with sometimes radical scripts and experiments. Chapter Five, “The Politics of Space,” makes a significant contribution to the emerging discussion of the use of space in Irish drama, and the book as a whole opens up all the plays—including those that audiences may have struggled to understand and appreciate. The approach is largely but not strictly chronological, allowing Roche to juxtapose plays that illuminate each other, and [End Page 150] to reveal the extent to which Friel over the years has sometimes changed not only his focus but also his mind, ranging from “ambivalence” to “outright contradiction” about such matters as success, his own early works, the need for artists to address political tensions, and directors. Both experts and relative novices will find these analyses helpful. Roche’s direct reliance on theory is subtle. He incorporates details of theory, plot, and history without talking down to his readers. For those unfamiliar with Friel’s 1958 radio play To This Hard House, for example, Roche makes clear and succinct links between that early work and both King Lear and Translations. Roche is alive to Friel’s linguistic allusions: Skinner, in The Freedom of the City, echoes King Lear; Friel’s notes for Wonderful Tennessee suggest that Taoiseach Charles Haughey’s personality “fed into” the creation of Terry Martin; there are details in Molly Sweeney that owe a debt to work by neurologist Oliver Sacks and to images of blindness in Oedipus Rex and King Lear. The dead children that are so notable a feature in drama by Friel (and for that matter, many other Irish playwrights) begin with the dead baby in another 1958 radio play, A Sort of Freedom. Roche demonstrates an admirable willingness to explore, but not impose, unusual explanations that some might regard as far-fetched. His discussion of Yolland’s disappearance in Translations takes on precisely this challenge, as Roche draws connections between the nineteenth-century Doalty twins and the twentieth century’s paramilitary groups and British army. The nuanced discussion of both text and politics reveals the richness of Friel’s work. Readers of this study are likely to hope that Roche—whose broad range and influences match those of the playwright he discusses—will in the future address issues that are not his concern here. Roche places Friel clearly in the traditions of both Irish and British drama, but spends little time on other English-language drama. Arthur Miller’s use of flashbacks and of sets combining various spaces, for example, merits discussion, as does Miller’s understanding of “Tragedy and...