Loose Ends Research Articles

The arduous quest for translating health care productivity gains into cost savings. Lessons from their evolution at economic scoring agencies in the Netherlands and the US

We analyze the assessments of recent health reforms by the Congressional Budget Office (CBO) in the United States and the Bureau for Economic Policy Analysis (CPB) in the Netherlands.Both reforms aim to capitalize on productivity gains, which is appealing for policymakers because of the potential for cost savings while maintaining – or enhancing – quality and access. These measures however generally translate into more health care, rather than care that is affordable and appropriate. Scoring agencies therefore have rightfully been reluctant to assign significant savings to these measures.Thus with regard to cost savings, both agencies instead have favored more traditional policy measures in the past. They are however increasingly mapping out loose ends and dilemmas for payers, including information asymmetries, reputation issues and provider business models that contradict the goals of policymakers. This calls for further exploring this avenue and the development of more integrated agendas that might commit actors and the spread of best practices.

Interpreting Anselm's thought about divine justice: dealing with loose ends

AbstractOver the last fifty years studies of Anselm of Canterbury's concept of divine justice have delivered different results. The aim of this article is to present the results of a new comprehensive inquiry, based on the interpretation of key passages about justice in Anselm's theological works. The article argues that Anselm works with three definitions of God's justice. The first is the most traditional: God's justice is his right dealing with good and bad. The second definition follows the Anselmian concept of God: God's justice is his acting according to his being that than which nothing greater can be conceived. The third definition is God's rightness of will, preserved for its own sake. The article concludes that the attempt to show how these three definitions are related to each other brings to light tensions and loose ends in Anselm's works.

The Musical Legacy of Karlheinz Stockhausen: Looking Back and Forward. Ed. by M. J. Grant and Imke Misch

The editors of this brief volume, M. J. Grant and Imke Misch, caution the reader from the outset that its contents, derived from the 2011 conference whose title the volume shares, represent the work in progress of individual researchers (p. 7). As such the volume makes no claims to comprehensiveness, nor promises a lack of loose ends. The contents broadly follow a chronological order, with particular weight given to the ‘classically’ serial Stockhausen of the 1950s and to LICHT (1977–2003), a trajectory highlighted in Misch’s introductory essay, which, too, draws out important themes for Stockhausen, many of which the volume returns to: the quest for innovation, the question of the parameter and its subdivision, the musicalization of text and action, and the relation of music to faith. The volume begins in fine form, with a set of excellent contributions from Mark Delaere, Maarten Quanten, Marcus Zagorski, and You Nakai. Delaere’s contribution develops his recent work on the history of early serialism and, in particular, Karel Goeyvaerts’s influence on Stockhausen as revealed through the correspondence between the two composers. As Delaere observes, the correspondence is revealing in biographical terms, showing Stockhausen’s rapidly developing technical abilities, the evolving compositional work of both composers, and their (sometimes biting) judgements of the work of their contemporaries. Perhaps most significantly, it allows a richer assessment of the early aesthetics of post-war European serialism, particularly in the ways in which the categories of the static, the pure, the truthful, and the spiritual were negotiated by the two composers.

Fine-scale analysis of an assassin bug's behaviour: predatory strategies to bypass the sensory systems of prey

Some predators sidestep environments that render them conspicuous to the sensory systems of prey. However, these challenging environments are unavoidable for certain predators. Stenolemus giraffa is an assassin bug that feeds on web-building spiders; the web is the environment in which this predator finds its prey, but it also forms part of its preys' sophisticated sensory apparatus, blurring the distinction between environment and sensory systems. Stenolemus giraffa needs to break threads in the web that obstruct its path to the spiders, and such vibrations can alert the spiders. Using laser vibrometry, this study demonstrates how S. giraffa avoids alerting the spiders during its approach. When breaking threads, S. giraffa attenuates the vibrations produced by holding on to the loose ends of the broken thread and causing them to sag prior to release. In addition, S. giraffa releases the loose ends of a broken thread one at a time (after several seconds or minutes) and in this way spaces out the production of vibrations in time. Furthermore, S. giraffa was found to maximally reduce the amplitude of vibrations when breaking threads that are prone to produce louder vibrations. Finally, S. giraffa preferred to break threads in the presence of wind, suggesting that this araneophagic insect exploits environmental noise that temporarily impairs the spiders' ability to detect vibrations. The predatory behaviour of S. giraffa seems to be adaptated in intricate manner for bypassing the sophisticated sensory systems of web-building spiders. These findings illustrate how the physical characteristics of the environment, along with the sensory systems of prey can shape the predatory strategies of animals.

“Are the new proposals for reform of directors’ disqualification requirements in the UK sufficient or cosmetic?”

Purpose The paper aims to examine the circumstances in which directors who fail to perform their duties and responsibilities with due diligence can be sanctioned and to evaluate whether the recent changes for reform both in the UK and European Union (EU) are adequate to deter directors from misfeasance or to cure defects in the law. The purpose of this paper is to articulate regulatory regimes for disqualification of corporate directors and the proposed changes to tighten loose ends in this area of commercial law. This paper articulates the duties and responsibilities of Corporate Officer and the varied context in which they are manifested in the UK. Owing to the onerous nature of corporate directorship, directors cannot passively sit in boardrooms or on their committees, but they need to demonstrate that they are hands on to get things done as expected. The first part of the paper articulates the current regimes on director’s disqualification so that it is used as a basis to examine the efficacy of the proposed changes for reform both on this area in the UK and Europe. The second part of the paper examines the proposed reform for change both in UK and in Europe and their efficacy to plug in law and practice. This area of corporate law is increasingly regulated by a number of agencies to ensure that directors perform their duties and responsibilities with due diligence. Design/methodology/approach The paper is structured in two parts whereby the first part examines the framework for disqualification of corporate directors and related issues in the UK. The second part articulates recent changes in the law on director’s disqualification with a view to evaluate whether these changes are robust enough to enhance the position of shareholders to ensure the company is well-managed for their interests or whether overregulation is inimical to the company by hindering directors from executing their corporate responsibilities with a measure of discretion. Findings The findings reflect that regulatory reforms should be evolved and implemented to strike a balance in ensuring that regulatory regimes are implemented not to penalise corporate directors unnecessarily but also to ensure that rules are respected. The paper urges caution because overregulation can inhibit corporate director from taking necessary risks (to be more guarded) to secure their positions. Research limitations/implications The paper was written on the basis of secondary and primary data sources often also alluding to empirical cases studies. It would have been better to carry out structured interviews to corroborate some of the findings of the paper. Practical implications Corporate governance is an onerous task, and thus, it requires corporate officers to exercise due diligence in execution of their duties and responsibilities. Getting the issue of corporate governance wrong often has ramifications for the company and respective corporate officers. These ramifications include not least penalising individual directors by disqualification from holding corporate directorship or the company being wound up altogether. Social implications Corporation plays an important role in the society such as creating employment opportunities, markets for goods and services, generating revenues to governments and the list goes on. Therefore, the way they are managed has important implications for societies and governments. Originality/value Even though the paper was written on the basis of primary and secondary data sources, it was done in a distinctive manner to foster the objective for writing it.

Devil-nets of clues: True Detective and the search for meaning

Abstract This article examines the first season of the hit television series True Detective (2014) with respect to the claim that it deliberately adopted a form fitting the new world of digital television. The article argues that this embrace is less than complete: the show seeks an immersive, novelistic experience rather than something entirely new. It further argues that this immersive experience is supported by the series’ richly detailed background and by its invocation of various aspects of weird fiction. The article also discusses some of the institutional factors shaping the series: the availability of the puzzle film genre as an interpretive framework, the existence of an audience interested in assuming the attitude of what Jason Mittell has called the forensic fan, and the choice of a traditional, one-episode-per-week release schedule. Finally, the article discusses the show’s ending and the disappointed reactions of critics and fans, arguing that the idea that the show intended to exploit digitization by adopting a more game-like approach, offering clues that could only be found using digital tools, is undercut by the many loose ends left unresolved by the finale. The article concludes that the density and detail of the series’ background, inviting viewers to explore, should be regarded not as providing pieces of a puzzle to be solved, but as an opportunity to deepen viewer engagement.

Thread: Somatic Lives of a Thing

Thread: Somatic Lives of a Thing

The String Puppet Technique: A Useful Tool for Transumbilical Surgery

Introduction: Transumbilical single-port surgery (TSPS) has emerged to outdare minimally invasive surgery by trying to obtain better aesthetic results, further reduction of morbidity, and further enhanced postoperative recovery. Nonetheless, TSPS entails many challenges. One of them is the limited triangulation of the surgical instruments, which does not contribute to proper organ retraction during surgery. This makes dissection uncomfortable and difficult for the surgeon, and tissue retraction has to be accomplished by using fixation or sling sutures instead of another trocar. The learning curve of TSPS is harsh, because experience is needed to learn to manage the external crowding and collision of instruments, select the most adequate surgical instrument set to be used, and also wisely choose the best patient candidates for this type of procedure.1 The string puppet technique described in this article and displayed in the video (run time 1 minute, 51 seconds) is a useful TSPS maneuver that helps achieve optimal organ retraction. An internal grasper is used to hold organs or tissues inside the abdominal cavity but can be moved, directed, and controlled externally through leashes, just like a puppeteer manipulates a puppet. Materials and Methods: A straight needle with a 2.0 nylon suture is introduced through the skin in the epigastric region. The needle is then externalized through a 12-mm umbilical trocar using a 10-mm scope with a 6-mm working channel. The needle is removed from the suture and the loose end of the suture is held or fixed externally to avoid sliding inside the abdominal cavity. The procedure is repeated on the right flank. Once the two loose ends of the sutures are outside of the abdomen, they are both tied up to a stainless steel alligator clamp. The grasper is placed at the tip of the laparoscope with its jaws open and descends into the abdominal cavity through the operating channel. Once inside, the grasper can be directed and secured to the target area with the aid of a Thomas forceps. The alligator clamp allows for strong organ retraction but also easy repositioning. In this video, the infundibulum is held by the grasper and external traction is provided by means of both sutures. Movement and position of the organ or tissue can be adjusted and corrected during the surgery to accommodate to the surgeon's needs. Once no longer necessary, the grasper can be withdrawn along with both sutures through the umbilical port. Results and Conclusions: One of the major difficulties of TSPS is to achieve proper organ retraction. The string puppet technique is a useful maneuver to overcome this problem and can be used in any area of the abdomen. It is easy to perform, unexpensive, and does not require any sophisticated instruments. No competing financial interests exist. Runtime of video: 1 mins 51 secs

Loose Ends: Considerations on the Aftermaths of the Celtic Tiger and the Northern 'Troubles'

n/a

Chromosomes at loose ends.

Broken ends of a budding yeast chromosome exhibit increased mobility, presumably to facilitate repair by recombination. A new study reports that increased mobility reflects the untethering of the broken chromosome, triggered by a DNA damage response that phosphorylates the Cep3 kinetochore protein and weakens the association between the centromere and the spindle pole body.

The Charmed Children of Rookskill Castle by Janet Fox (review)

Reviewed by: The Charmed Children of Rookskill Castle by Janet Fox Alaine Martaus Fox, Janet The Charmed Children of Rookskill Castle. Viking, 2016 [400p] ISBN 978-0-451-47633-3 $16.99 Reviewed from galleys R Gr. 5-8 Sent to a boarding school in remote Scotland to avoid the Blitz, twelve-year-old Katherine Bateson and her two younger siblings try to be brave and carry on, as their parents and country expect. The castle, however, hides untold perils within its secret passages and behind its hidden doors, and the children discover evidence of a German spy in their midst. Odder still is the beautiful and enigmatic Lady who runs the school and the silent, ghostlike children who haunt the castle’s hallways. Logical Katherine wants to focus on unmasking the spy, but as the students start disappearing one by one, she and American classmate Peter turn their attention to the supernatural mystery and uncover an ancient, magical secret that may stir powers with Katherine herself. Despite its boarding school setting, this delightful, spooky read evokes the spirit of Lewis more than that of Rowling, and fans of the [End Page 354] Narnia series are certain to love its old-school charms. The Lady and her castle are suitably creepy yet fascinating, and while flashbacks to the Lady’s own sad history don’t redeem her from villainy, they do give her an intriguing nuance. Katherine, meanwhile, is a formidable heroine with powers both intellectual and magical, and readers will appreciate her struggle to accept things beyond her understanding. The spy subplot is less successful, but the novel brings the two narrative threads together nicely in the end. Various loose ends and the continued German threat create room for likely sequels, which should thrill both historical mystery and middle-grade fantasy fans alike. Copyright © 2016 Board of Trustees of the University of Illinois

Tying Down Loose Ends in the Chlamydomonas Genome: Functional Significance of Abundant Upstream Open Reading Frames.

The Chlamydomonas genome has been sequenced, assembled, and annotated to produce a rich resource for genetics and molecular biology in this well-studied model organism. The annotated genome is very rich in open reading frames upstream of the annotated coding sequence (‘uORFs’): almost three quarters of the assigned transcripts have at least one uORF, and frequently more than one. This is problematic with respect to the standard ‘scanning’ model for eukaryotic translation initiation. These uORFs can be grouped into three classes: class 1, initiating in-frame with the coding sequence (CDS) (thus providing a potential in-frame N-terminal extension); class 2, initiating in the 5′ untranslated sequences (5UT) and terminating out-of-frame in the CDS; and class 3, initiating and terminating within the 5UT. Multiple bioinformatics criteria (including analysis of Kozak consensus sequence agreement and BLASTP comparisons to the closely related Volvox genome, and statistical comparison to cds and to random sequence controls) indicate that of ∼4000 class 1 uORFs, approximately half are likely in vivo translation initiation sites. The proposed resulting N-terminal extensions in many cases will sharply alter the predicted biochemical properties of the encoded proteins. These results suggest significant modifications in ∼2000 of the ∼20,000 transcript models with respect to translation initiation and encoded peptides. In contrast, class 2 uORFs may be subject to purifying selection, and the existent ones (surviving selection) are likely inefficiently translated. Class 3 uORFs are found in more than half of transcripts, frequently multiple times per transcript; however, they are remarkably similar to random sequence expectations with respect to size, number, and composition, and therefore may in most cases be selectively neutral.

I Woke Up Dead at the Mall by Judy Sheehan (review)

Reviewed by: I Woke Up Dead at the Mall by Judy Sheehan April Spisak Sheehan, Judy I Woke Up Dead at the Mall. Delacorte, 2016 [288p] Library ed. ISBN 978-0-553-51247-2 $20.99 Trade ed. ISBN 978-0-553-51246-5 $17.99 E-book ed. ISBN 978-0-553-51248-9 $10.99 Reviewed from galleys R Gr. 8-10 Sarah’s dead. She was happy at her dad’s wedding and then she woke up at the Mall of America, wearing the worst bridesmaid’s dress ever and no longer alive. It’s a major bummer, but her perky death coach is determined to help her tie up her loose ends and go into the light. The worst thing that can happen is that one will become one of the walkers, lost souls stuck in loops of a painful moment in their lives who can walk for years, even decades, without any resolution. Sarah thinks she is too smart for that, and for the rules, so she starts breaking regulations immediately—falling for a cute dead guy, trying to solve her murder (it turns out she was poisoned), and making contact with the living world. The pace is measured, which works well in a book about the undead who don’t flow through the rapid path toward reincarnation; the ones who are stuck for various reasons can be around for a long time, after all. The philosophical scenes about life, death, family, and friendships are effective, and they are lightened by Sarah’s sharp, snarky wit. She realizes when she is being an obnoxious teen but generally embraces it, as it worked for her when she was alive; the book wisely allows her to soften a bit by the end, becoming more open to seeing the struggles others hide rather than judging them by what they show. Malls are sort of like limbo anyway, so it was a clever jump to just go ahead and make one a literal way-stop for the dead. [End Page 326] Copyright © 2016 The Board of Trustees of the University of Illinois

Recognition and the Forgotten Senses in the Odyssey

Introduction Recognition in the Odyssey typically hinges on a visual or visualizable sign of some sort. There are, however, three recognition scenes--between Odysseus and his dog, his Nurse, and his bow--which turn instead on nonvisual triggers. Touch occasions Eurycleia's recognition of her master, as it does Odysseus's reunion with his bow, while there are strong hints that his sharp sense of smell is what enables Argus to detect his master behind the ragged appearance of a beggar. These three scenes, based as they are on senses other than sight, expose the fissures in Odysseus's otherwise flawless disguise, and reveal his surprising vulnerability. As David Howes (2005, 10) observes in Empire of the Senses, how the senses are valued in any given society is not only culturally determined but also hierarchical: The senses are typically ordered in hierarchies. In one society or social context sight will head the list of the senses, in another it may be hearing or touch. Such sensory rankings are always allied with social rankings and employed to order society. The dominant group in society will be linked to esteemed senses and sensations while subordinate groups will be associated with less-valued or denigrated senses. In the West, the dominant group--whether it be conceptualized in terms of gender, class, or race--has conventionally been associated with the supposedly 'higher' senses of sight and hearing, while subordinate groups (women, workers, non-Westerners) have been associated with the so-called lower senses of smell, taste, and touch. The gendered social valuation of the senses in the Odyssey is in line with what Howes describes as typical for Western societies: sight and sound are allied with social prestige, while touch and smell are more prevalent among subordinate groups, particularly women and animals. Argus and Eurycleia mobilize these 'lower' senses during their interactions with Odysseus. Women, moreover, are often the first to notice bodily semata, perhaps because of their involvement in rituals of hospitality which brings them into close contact with the physical self. (1) And as weavers, women are practitioners of a supremely tactile art. (2) This may mark them as closer to 'nature' and supposedly less suited for positions of political power, but their tactile expertise is also what allows female characters in Homer to 'see through' the superficially altered appearances that confound their male counterparts. (3) Even Odysseus, a hero of metis (cunning) rather than bia (force), resorts to uncharacteristic aggression when he is confronted with Eurycleia's discerning touch. The forgotten senses of touch and smell thus reinforce, at the same time that they call into question, the Odyssey's gendered and political status quo. By pointing up the dangers of discovery that Odysseus barely escapes, such seemingly loose ends in the 'disguise' strand of the epic hint at alternative outcomes to the hero's nostos. Odysseus's is a homecoming whose precarious reliance on the dynamics of vision-centered reintegration could easily have been overwritten by a single sleight of hand or nose. Recognition and the Senses There are two main types of recognition in the Odyssey, each of which performs a distinctive narrative function. I refer to these as anagnorisis and noesis, even though those particular nouns do not occur in Homer. (4) Recognition scenes involving anagnorisis tend to be framed by a social relationship that requires reactivation. Through the agency of a visualizable sign (e.g., a particular bodily form [demas]-, the shape of the head, hands, or feet; a scar; a special token; or the smooth surface of a weapon), a connection is re-established between Odysseus and some member of his domestic inner circle. (5) The scar on his thigh is the sign (sema) that is most often summoned to confirm recognition (anagnorisis) of Odysseus; as such, it is an externalization of a durative social identity. …

Factors influencing customers preference and satisfaction in online shopping-a study with reference to Chennai city

Online shopping is a form of electronic commerce whereby consumers directly buy goods or services from a seller over the internet without an intermediary service. It is defined as, the process by consumers directly buy goods or services from a seller in real-time, without an intermediary service, over the internet. The pros of online shopping are shop 24/7, comfort of own home, privacy, save on gas, comparison shopping easier and discount coupons available online. The cons of online shopping are cannot touch the product, credit card insecurity, shipping/handling cost, returns more difficult and errors in billing. Even though the pros and cons are the two sides of online shopping, the retailing is an attractive business emerging out of shadows in the past two years. Even as loose ends of retailing plans are being tied up, online shopping has begun catching the attention of many entrepreneurs. Apart from online shopping, certain online services like matchmaking, job searching, auctions, share trading and banking are becoming increasingly popular. This could well be the beginning of an e-tail revolution. This paper attempts to understand how this strategy frames its origin in Chennai city in southern India. A questionnaire survey was handled out to evaluate the preference of internet shopping by the consumers.

From the Sublime to City Crime ed. by Maurizio Ascari, Stephen Knight

Maurizio Ascari, and Stephen Knight, eds. From Sublime to City Crime. Monaco: LiberFaber, 2015. Pp. 297. 20 [euro]. From Sublime to City Crime comprises twelve essays--not including editors' co-authored introduction--covering a period in development of British, American, and European crime fiction that snugly overlaps what we conventionally style period of international Romanticism. Several of these were originally published in a thematic issue of Italian journal La Questione Romantica, co-edited by Maurizio Ascari and Stephen Knight under title Crime and Sublime. Among British writers, volume ranges from William Godwin and Mary Wollstonecraft through Thomas De Quincey and James Hogg to G. M. W. Reynolds, author of sprawling serialized novel The Mysteries of London, whose first weekly number appeared in October 1844. Their American cohort is represented by Charles Brockden Brown and Edgar Allan Poe, while Honore de Balzac, Eugene Sue, and a handful of pioneering Scandinavians draw our attention to continental developments. The editorial intention ostensibly embracing all of these essays, aside from their shared generic and historical focus, is to reveal gradual precipitation of what came to be called a subgenre of crime fiction epitomized by whodunnit and traditionally distinguished by its foregrounding of investigator's (inevitably successful) problem-solving abilities, out of a vigorous but more heterogeneous category of popular fiction founded on compelling--i.e., sublime--power of sheer mystery and terror of crime itself. The ideological underpinnings of this literary-historical understanding are not, in themselves, new, and can be traced back to Foucault's Discipline and Punish and its critical progeny, like D. A. Miller's The Novel and Police. In words of editors Ascari and Knight, Out of disciplinary procedures came a hero. He, at times she, resolved threats through skill, application, and occasionally courage.... Fulfilling ideological destiny of classic bourgeois fiction ... detective knotted loose ends of individualistic anxiety for isolated cerebral workers of late capitalism (9-10). What Ascari and Knight add to this by-now standard account of detection's disciplinary impact is an eye for persistence of as the underground river of later detective fiction that despite--or, perhaps more accurately, because of--its repression by Enlightened forces of rational investigation enduringly remains dynamo of excitement and anxiety that both drives narrative of crime and insistently demands its euphemisations (10). That, at least, is announced thesis of this collection, and while it is not, for various reasons, consistently realized by contributions that follow, it does provide a useful vade mecum. The contributions themselves--by scholars spanning globe from Slovakia to Canada and Italy to Australia--are uneven in rigor as well as depth, but all provide useful entrees for Romanticists looking to engage with ever-growing body of criticism on crime fiction and its governing poetics. The essays are arranged in roughly chronological order from 1790s to 1840s, moving at same time from Anglophone trans-Atlantic sphere to continent and back at last to England. Among those scholars familiar to British Romanticists, Maurice Hindle, editor of Penguin's groundbreaking 1988 edition of Caleb Williams, kicks things off with a close examination of Godwin's debts to Edmund Burke's Sublime and Gothic tradition, setting loose parameters for discussing these topics in essays that follow. Here sublimity under investigation is almost invariably of Burkean variety, linked to terror and largely interchangeable with the Gothic. The contributors following Hindle include Alessandra Calanchi on Brockden Brown's aural sublime, Ascari examining element of power (104) that co-inhabits De Quincey's writings on murder and his Gothic revenge fiction, Struan Sinclair on Poe's superperceivers, Giacomo Mannironi on Balzac's debts to British Romanticism, Heather Worthington on Blackwood's fictions of physician/lawyer Samuel Warren, and Anna Kay on mid-century popular reception and sublime interpretation of real-life murderess Maria Manning. …

A novel bougie for exchange of double lumen tube.

Sir, Exchanging double-lumen endotracheal tube (DLT) with single lumen conventional endotracheal tube (ET) at the conclusion of thoracic[1] and cardiac surgeries is a common procedure, which is usually performed anticipating the need of postoperative mechanical ventilation. This step assumes critical magnitude especially in those patients whose initial airway control becomes difficult. Moreover, depending on the type of surgery, its duration and fluids infused during surgery, an airway which was initially normal has the propensity to become difficult by the end of surgery. Mucosal oedema, bleeding and retained secretions which are common after surgical procedures can further complicate the airway anatomy. Various techniques are been described for replacing DLT by ET.[2,3] Among the popular methods are using bougies, airway guides or airway exchange catheters, whereby the DLT is removed over an airway guide, and the guide remains in the trachea which allows immediate access to the airway whenever reintubation is needed.[4] Currently, several types of bougies are available for initial airway access as well as the exchange of DLT with ET including the common gum elastic bougie. In our institute, the “SGPGI bougie” was developed by the second author which is made with the help of Ryle's tube and three extra-long guide wires (used in laparoscopic renal/urological procedures) are incorporated inside throughout its length [Figure 1]. The distal end is made angulated at a distance of approximately 5 cm at an angle of 100-110° [Figure 1] and its orifices are hermetically sealed. The proximal end is shaven and then hermetically sealed so that no loose end of the guide wire stays outside. Figure 1 Indigenous bougie with arrow showing angulated tip “SGPGI bougie” scores over the conventional gum elastic bougie because it has an increased length of 100 cm as compared to gum elastic bougie which is 60 cm long to accommodate the length of DLT. The bougie/airway guides must be of adequate length to ensure tracheal insertion of the DLT. DLT's of adult sizes (37°F, 39°F and 41°F) are 45 cm long and to exchange them over a bougie additional the length of bougie (>70 cm) is required[3] to provide the required safety margin while railroading the ET and avoid the dislodgement of the bougie [Figure 2]. SGPGI bougie is reusable and can be sterilized either using glutaraldehyde or ethylene oxide. Thus, this device scores on the cost-benefit aspect, especially in resource, crunched set ups. It can be rolled up due to its malleability, and its compactness makes its storage and transportation easier. The presence of an angulated tip and its atraumatic nature are the properties this device shares with the conventional gum elastic bougie. Figure 2 Comparison of length of indigenous bougie with gum elastic bougie Even though various types of indigenous bougies are described in medical literature,[5,6,7,8] our indigenous bougie promises to be an effective alternative to conventional bougie as tube exchanger for DLT with ET. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

James Larkin Pearson: A Biography of North Carolina’s Longest-Serving Poet Laureate by Gregory S. Taylor

Reviewed by: James Larkin Pearson: A Biography of North Carolina’s Longest-Serving Poet Laureate by Gregory S. Taylor Carol Boggess James Larkin Pearson: A Biography of North Carolina’s Longest-Serving Poet Laureate. By Gregory S. Taylor. (Lanham, Md., and other cities: Lexington Books, 2015. Pp. [xx], 225. $85.00, ISBN 978-1-4985-0519-2.) This biography of James Larkin Pearson begins with a brief history of North Carolina. From colonial days the state was stereotyped as the home of grubby, uncivilized, and uneducated people. Yet the negative nickname “Tar Heel” eventually became a source of pride. Likewise, Pearson began life as a poor, uneducated mountain boy from a farm family, but through hard [End Page 703] work he became the state’s official poet. “He was,” Gregory S. Taylor claims, “a prime example of the Tar Heel spirit” (p. xv). Through dogged persistence, Pearson turned hardship into opportunity, defeat into achievement, and personal beliefs and problems into poetry. The book chronicles Pearson’s long life from his birth in 1879 in Wilkes County to his death and burial, also in Wilkes County, in 1981. Though Pearson never moved far, he played multiple roles: son, husband, caretaker, father, farmer, journalist, printer, and poet. Pearson wanted his personal story to be available and spent years writing his autobiography, although he never completed it. Taylor relies heavily on Pearson’s account but also draws from letters and papers in the collections at Wilkes Community College and the University of North Carolina at Chapel Hill. While remaining true to Pearson’s intent to be intimate and personal, Taylor’s work presents the story objectively, chronologically, and fully. Pearson’s life was filled with good times and bad. As a child he felt like a misfit, but through ambition and ingenuity, he became a successful young man, marrying his sweetheart, Cora Wallace, in 1907 and working as a writer and printer. When Cora’s chronic illness emerged and their baby was stillborn, difficulties mounted. Later they adopted a child, but Cora remained an invalid. The family settled in the small community of Boomer, North Carolina, where Pearson established his paper The Fool-Killer. His goal was to address every issue of the time, exposing fools and false ideas through humor and brutal honesty. The public loved his effort, and the paper thrived until World War I, about which he remained uncharacteristically silent. But his tenacity and effort ensured that the paper lasted until the Great Depression, when Pearson gave it up and returned to farming. Cora’s death in 1934 was his low point. But Pearson’s recovery began that same year when he addressed the North Carolina Literary and Historical Association with his speech, “The Soul of Poetry,” which improved his spirit and moved the audience. Newspapers called him the North Carolinian who “‘put the life of the people into poetry’” (p. 131). His private life also improved with his marriage to Eleanor Fox. World War II brought another downturn in what Taylor calls Pearson’s “rollercoaster” life (p. 149). But through it all, Pearson continued to write poems and self-publish his books. In 1953 he was named North Carolina’s poet laureate, a title he retained for twenty-eight years. Pearson was always known for his traditional style, which placed him with the nineteenth-century Fireside poets rather than the twentieth-century Moderns. He openly criticized the new poet as being “a slapdash word-slinger with loose ends flapping all over the place” (p. 155). Pearson was a man of strong opinions on many topics, including poetry. This biography illuminates his life with its long succession of troubles, triumphs, and strong opinions better than it explores his literary accomplishments. Personal struggles plus his ability to overcome hardship characterize this notable Tar Heel’s life, and Taylor’s retelling of that life makes the book a compelling read. [End Page 704] Carol Boggess Mars Hill University Copyright © 2016 The Southern Historical Association

Further Reflections on Locke's Medical Remains


 
 
 Over the last fifteen years with the assistance of other scholars I have been attempting to understand the nature and importance of Locke’s interest in and practice of medicine. This has involved a sustained analysis of Locke’s medical and chymical remains and an attempt to mesh Locke’s medical interests with his views on natural philosophy. In this paper I would like to tidy up a number of loose ends in my study of Locke the physician. More specifically, I would like, first, to adduce to some evidence that I had previously overlooked (and some I had chosen not to mention) that impinges on some of my claims and interpretations of Locke and medicine. Secondly, I want to respond to one line of criticism of my interpretation of Locke’s medical writings. Thirdly, perhaps most interestingly, I would like to draw attention to a minor connection between Locke and one of England’s lesser-known female philosophers. This hitherto unnoticed evidence appears in two of Locke’s medical notebooks and is a tantalizing Lockean connection at an important moment in women’s philosophical thought in late seventeenth-century England.
 
 

Enforcement of annulled awards: towards a better analytical approach

This article comments on cases where enforcement of annulled awards has either occurred or been discussed. It summarizes and compares the existing analytical approaches, indicating advantages and disadvantages of each, concluding with a proposal in favour of adopting the French view, considering it the approach that, albeit displaying certain loose ends, is the preferable among those extant.