Role Of Overseer Research Articles

Increased Gradients After Aortic Valve Replacement With the Perceval Valve: The Role of Oversizing

Significant underexpansion or distortion of valved stents may be associated with altered leaflet function, leading to increased transprosthetic gradients and, possibly, early structural degeneration. We investigated the relationship between a computed tomography measure of the degree of oversizing and the early hemodynamic and clinical outcomes in patients undergoing aortic valve replacement with the Perceval sutureless aortic valve (LivaNova, Saluggia, Italy). The degree of oversizing of the implanted prosthesis was calculated as the ratio between the patients' aortic annulus cross-sectional area and the exvivo cross-sectional area of the implanted prosthesis in 151 Perceval patients who underwent preoperative cardiac computed tomography. This value was then entered in a multivariate analysis to ascertain its role as a predictor of increased postoperative gradient. The operative mortality was 1.3%. Procedural success, defined as having a normally functioning valve in the proper anatomical location, was achieved in 150 patients (99.3%). The mean transprosthetic gradient was 13.4 ± 5.0 mm Hg, and 23 patients (15.2%) showed a gradient of 20 mm Hg or more at discharge or at the 1-month follow-up. The degree of oversizing of the implanted prosthesis was the most important predictor of increased postoperative gradient (odds ratio, 1.264; 95% confidence interval, 1.147 to 1.394; p < 0.0001). Interestingly, other relevant factors (patients' body surface area, prosthesis size) were not associated with increased gradients. Our study demonstrates that excessive oversizing should be avoided in Perceval patients and suggests that a different sizing algorithm, possibly based on cardiac computed tomography, should be developed. Further studies are needed to optimize the sizing strategy for the Perceval sutureless valve.

Constitutional Conflict and Congressional Oversight

This Article offers a novel explanation of divergent congressional and executive behavior and legal doctrine in oversight disputes. It constructs a unified theory of congressional oversight, but it is one that requires a degree of conflict, tension, and disagreement between the political branches to endure. This framework is particularly timely as the Judiciary is poised to make the most significant decision in an interbranch dispute since Watergate. Practical, day-to-day congressional oversight disputes betray a deep canyon between Congress and the President that cuts to the very foundations of our constitutional structure. Hierarchy and entitlement characterize the congressional perspective, with Congress in the role of overseer with fixed substantive rights to obtain desired information. Congress cloaks itself in the language of criminal investigation and litigation. In contrast, equality and competing interests characterize the Executive Branch view, such that congressional oversight requests are the opening salvo in an iterative, negotiation process between co-equal branches. The Executive Branch sees no presumptive congressional right to define the manner, form, quantity, or messenger of the information to be provided. Among the formal and informal remedies to enforce its oversight prerogatives, Congress prefers contempt. However, contempt is problematic when the resisting party is an Executive Branch official following Executive Branch policy. Because the constitutional scheme places a premium on good-faith negotiation between Congress and the Executive Branch, congressional self-help is more appropriate than litigation for interbranch oversight disputes. While abstention and restraint should be the hallmark of Article III courts presented with bickering political branches, there is an important role for the Judiciary. As such, this Article offers principles that should guide courts to facilitate, or approximate, accommodation and compromise.

Supervisors of Small Worlds: The Role of Overseers on Colonial South Carolina Slave Plantations

The established historiography of slavery includes a substantial body of work on the colonial period, with particular emphasis upon the Atlantic slave trade and the development of the plantation system and the slave community embedded within it. However, one key element in the organization of plantations has received little attention: the overseers. Slave owners and slaves are well represented in documentary sources, yet overseers, despite their importance in the plantation system, remain shadowy figures in the story of slavery in the colonial era. Overseers were charged with the responsibility of supervising slave labor and maintaining the plantation owners’ human property. With a particular focus on the slave plantations of Henry Laurens, one of South Carolina's most successful and influential slave-owning entrepreneurs, this work explores the precise function of overseers within the colonial slave society of South Carolina. It will challenge the conventional image of overseers as poor, white, brutish task-masters, and show that in fact, only some of those in the occupation conformed to this crude stereotype. The role of overseer was vital to the day-to-day operation of slavery but it entailed neither absolute authority nor social standing. Analyzing recruitment patterns, overseers’ backgrounds, their daily role and activities, payment methods and rewards, their personal ambitions, employer-overseer-slave relations, and the prejudices men in this role faced, reveals much about those from the lower stratum of white society in colonial South Carolina. Using the often fragmentary evidence the overseer emerges from the shadows as a far more rounded and human figure than in the established historiography or popular culture. Many overseers proved hardworking, effective and prospered from their role on the plantation. This work not only reveals why many men became overseers despite the stigma attached to the job, but also sheds light on the complexities involved in slave ownership and ordering multi-racial plantation communities in the early American South.

Policy Disputes as a Source of Administrative Controls: Congressional Micromanagement of the Department of Defense

Is congressional micromanagement an unwarranted and inappropriate intrusion into the operations of the federal bureaucracy? Focusing on congressional oversight of the Defense Department, Kenneth R. Mayer shows that budgetary and administrative micromanagement are legislative tools for achieving policy preferences within DoD. He argues that calls for reform of micromanagement must take the policy making prerogatives of Congress into account. Congressional activity on the defense budget-line-item changes, programmatic restrictions, requests for reports and information-is often criticized as micromanagement. Micromanagement is viewed as an inappropriate intrusion by Congress into executive branch affairs, and is said to result in inefficiency. Critics of micromanagement urge Congress to return to a policy-focused view of the defense budget, in which reviews of national security strategy and requirements would replace program-level and management instructions. In doing so, Congress would return to its proper role of overseer of national policy and would vastly increase the efficiency with which the defense budget could be managed.