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Martha P. Nochimson has written a lively and fascinating book about some famous ‘founding titans’ of U.S. television authorship, one that answers and raises important matters concerning the status ...

In both the social sciences and pop cultural representation, gay men’s open relationships are consistently described according to a contradictory logic in which coupled gay men may enjoy non-exclusive sexual practices because they are able to separate sex from emotional attachment and only on the condition that they separate sex from emotional attachment. Since the emotional response to outside sexual partners that should not occur always is a threat, gay men are cautioned to institute and obey rules to produce and enforce a boundary or separation, in the interest of protecting primary coupled relationships. This article argues that the failure to forestall an emotional response outside, beyond, and despite the boundaries of the couple has an important ethical value in the post-Obergefell world of gay normalization. An excess of love, flaring up where it shouldn’t, holds open the possibility of other forms of community, sociality, and relationality.

Background Lung-protective ventilation (LPV) improves outcomes for patients with acute respiratory distress syndrome (ARDS) through administration of low tidal volumes (≤ 6.5 ml/kg predicted body weight [PBW]) with co-titration of positive end-expiratory pressure and fraction of inspired oxygen. Many patients with ARDS, however, are not managed with LPV. The purpose of this study was to understand implementation barriers and facilitators to the use of LPV and a computerized LPV clinical decision support (CDS) tool in intensive care units (ICUs) in preparation for a pilot hybrid implementation-effectiveness clinical trial. Methods We performed an explanatory sequential mixed methods study from June 2018 – March 2019 to evaluate variation in LPV adherence across 17 ICUs in an integrated healthcare system with > 4,000 mechanically-ventilated patients annually. We analyzed 47 key informant interviews of ICU physicians, respiratory therapists (RTs) and nurses in 3 of the ICUs using a qualitative content analysis paradigm to investigate site variation as defined by adherence level (low, medium, high) and identify barriers and facilitators to LPV and LPV CDS tool use. Results Forty-two percent of patients had an initial set tidal volume ≤ 6.5 ml/kg PBW during the measurement period (site range: 21–80%). LPV CDS tool use was 28% (site range: 6%-91%). This study’s main findings revealed multi-factorial facilitators and barriers to use that varied by ICU site adherence level. The primary facilitator was that LPV and the LPV CDS tool could be used on all mechanically-ventilated patients. Barriers included a persistent gap between clinician attitudes regarding the use of LPV and actual use; the perceived loss of autonomy associated with using a computerized protocol; the nature of physician-RT interaction in ventilation management; and the lack of clear organization measures of success. Conclusions Variation in adherence to LPV persists in ICUs within a healthcare delivery system that was an early adopter of LPV. Strategies to increase adherence to LPV for ARDS patients should include initiating low tidal ventilation on all mechanically ventilated patients, establishing and measuring adherence measures, and focused education addressing the physician-RT interaction. These strategies represent a blueprint for a future hybrid implementation-effectiveness trial.

Weaponization of state-backed, foreign investments by China is an emerging national security threat in the United States and the European Union. The U.S. and E.U. have espoused similar policy goals—to address the threat without closing their markets to foreign direct investment—while fostering increased cooperation between allied partners in screening transactions.On the surface, the recent, China-specific measures taken by the U.S. and the investment screening framework adopted by the E.U. appear reflective of an alignment of those policy goals. Indeed, many commentators have suggested that is exactly what is happening. However, closer examination reveals a stark divergence. The U.S. has a robust screening mechanism that has evolved into a weapon of economic warfare. The E.U. meanwhile, remains a patchwork of conflicting—or nonexistent—national regulations overlaid by a comparatively toothless investment screening framework.There is a tendency to attribute this divergence to structural differences between the United States and European Union. This in-depth comparison of U.S. and E.U. investment screening mechanisms exposes a split that goes beyond application and into actual policy. This revelation should temper expectations that the E.U. is equipping itself to block transactions that are of concern to the U.S.

Composition work is an artistic method of work with identity and emotions, used in therapy, counseling, coaching, and training. Practiced in the context of constructivist counseling and grounded in...

In 1991, a BBC taskforce inquired into the organization’s efficiency. One of its reports, BBC the Entrepreneur, observed that ‘commerce is no longer incompatible with the BBC’s core businesses’ and that, ‘entrepreneurialism was a requirement of the 1980s and will still have an important part to play in the public sector in the 1990s. The BBC’s involvement in commerce signals that it is a part of the market.’ In fact, the BBC had participated in the market since the 1950s, running co-productions, selling merchandise and publications, exploiting its archive, and sponsoring exhibitions, although these activities were constrained by an overwhelming institutional sense of the virtues of public service broadcasting. However, by the 1990s, as this report indicated, there was a radical shift towards welcoming commercial values as a means to underpin and stimulate entrepreneurial behaviour. This article tracks the career of Mr Blobby, a humorous character featured on the variety show Noel’s House Party (1991–1998)...

We argue here that rather than being threatened by new modes of delivery and of viewing, television persists and that this can be charted by examining the familiarity and recognisability of television across the post-World War II period, looking at British, American and Australian programmes, personalities and practices, including promotion. The article presents a case study of the BBC sitcom The Good Life to show some ways that television persists. It considers the sitcom genre, institutional practices, repeat screenings, particular types of spin-off programmes and the place of the show in the subsequent careers of the main actors.

A discussion of Michael Caine in Alfie

Adequate pain control following anterior cruciate ligament reconstruction (ACL) often requires regional nerve block. The femoral nerve block (FNB) has been traditionally employed. Ultrasound application to regional nerve blocks allows for the use of alternatives such as the saphenous nerve block following ACL reconstruction.This study evaluated postoperative analgesia provided by the subsartorial saphenous nerve block (SSNB) compared to that provided by the traditional FNB for patients undergoing ACL reconstruction with patellar tendon (bone-tendon-bone (BTB)) autografts.A randomized, blinded, controlled clinical trial was conducted using 80 ASA I-III patients, ages 16-65, undergoing ACL reconstruction with BTB. The individuals assessing all outcome measures were blinded to the treatment group. Postoperatively, all patients received cryotherapy and parenteral hydromorphone to achieve numeric rating scale pain scores less than 4. At discharge, patients were given prescriptions for oral opioid analgesics and a scheduled NSAID. Patients were instructed to complete pain diaries and record oral opioid utilization. Patients were contacted on postoperative days (POD) 1 and 2 to ascertain the level of patient satisfaction with the analgesic regimen.No differences between the two groups were found. Patient demographics and postoperative pain scores at rest were not different. In addition, there was no difference in opioid use, as measured in daily oral morphine equivalents between groups. A small but statistically significant report of higher patient satisfaction with the FNB was found on POD 1 but not on POD 2.These data support our hypothesis that the SSNB provides similar and adequate postoperative analgesia when compared to the FNB, following arthroscopic ACL reconstruction with patellar tendon autograft.

Taking critical aim at an emergent cultural demand for family “acceptance” of queer youth and at the trope of parental love offered “no matter what,” this essay resists the occlusion of long-standing traditions of queer pedagogy and acculturation in contemporary “pro-LGBT” discourses. Via an analysis of the musical sitcom Glee, the essay tracks how an insistence on parental acceptance displaces the knowledge, experience, and instruction of other gay people, as well as the cultural practices and traditions that have long sustained queer lives. Focusing on the coming out of gay boy Kurt Hummel and the outing of girl-loving cheerleader Santana Lopez, I highlight the aesthetic and discursive strategies that permit young queers to resist the demands associated with parental acceptance or at least manage and survive its inadequacies.

Luke Sunderland. Old French Narrative Cycles: Heroism between Ethics and Morality, Gallica 15. Cambridge: D. S. Brewer, 2010. Pp. xiii + 204. ISBN: 978-1-84384-220-0. Old French Narrative Cycles couples an unconventional corpus with a sophisticated approach to the question of heroism based on Jacques Lacan's theories of morality, ethics, perversion, and the sublime. In its choice of texts--narratives collected into thirteenth-century cyclical manuscripts such as the epic Cycle de Guillaume, the Vulgate and Tristan cycles of Arthurian prose romance, and the Roman de Renart--Sunderland's book is an example of recent efforts to rethink medieval literature from the viewpoint of manuscript production and dissemination rather than the modern critical edition (perhaps best exemplified by Digital Humanities projects such as the Roman de la Rose Digital Library and Medieval Francophone Literary Culture Outside France). (1) And in its choice of interpretive strategies, the book is in explicit conversation with other British scholars who have remained committed to the productive dialogue between medieval literature and high European theory (especially psychoanalysis), such as Sarah Kay, Simon Gaunt, and Miranda Griffin. In his introduction, Sunderland argues that the four cycles under consideration are all shaped by an "aesthetic of cyclicity" that "cuts across genre" (3): an "aim for completeness" (2) that generates, links, and organizes texts narrating entire heroic lives, entire lineages, or other groupings of heroes such as the Grail quest knights. Sunderland borrows Jacques Derrida's notion of the supplement and Gilies Deleuze and Felix Guattari's figure of the rhizome, however, to describe how the very mechanisms of cyclical elaboration always undermine a text's completeness (9). Every end can, after all, serve as a point of departure for new beginnings, just as every provisional beginning or ending can find itself in the middle of new backstories, enfances, updates, and continuations. The upshot of this focus on shifting textual (re)production is an acknowledgment that medieval texts cannot be fixed, even in their seemingly most ambitiously authorized versions, the luxury cyclical codices of the thirteenth century. Rather, in Sunderland's elegant description, medieval texts are "the agglutinative substrates of series of successive continuations and reworkings" (1). This conceptualization of cycles as "texts that are not 'one,' not countable nouns" (178) is somewhat at odds with Sunderland's decision to base each of the book's four chapters on a single version of the four cycles (20); however, each chapter ends with a fascinating exploration of alternate versions recorded in alternate manuscripts. Sunderland's second line of inquiry, outlined in the last half of his introduction, concerns the function of heroism in cyclical narratives. Rather than rely on received ideas about heroism as idealism or exemplarity, Sunderland theorizes heroism from within Lacanian psychoanalysis. Working carefully through Lacan's treatment of courtly love as sublimation as well as his engagement with Immanuel Kant's thinking on the moral law, Sunderland derives a definition of heroism as submission to the law of the greater good or le bien, a submission that is perverse because motivated by "desire for the law" and yielding "gratification [...] found in renunciation of gratification" (13). This perverse, self-sacrificial heroism emerges in contradistinction to Lacan's sense of the ethical, which entails "a radical assertion of freedom and autonomy through the rejection of existing discourses and ideologies" (17). While Sunderland advances an overarching argument that the thirteenth century valorized a perverse commitment to moral ideals (15), the analysis of the cyclical narratives pursued in the book's four chapters produces a more varied and nuanced view. Sunderland's first chapter, on the Guillaume Cycle, begins with an analysis of the titular hero's nephew Vivien, whose commitment to heroic self-sacrifice is narrated in chansons de geste such as Aliscans, Les Enfances Vivien, and La Chevalerie Vivien. …

Post-liver transplant patients require lifelong immunosuppressive care and monitoring. Computerized alerts can aid laboratory monitoring, but it is unknown how the distribution of alerts changes over time. We describe the changes over time of the distribution of computerized alerts for laboratory monitoring of post-liver transplant immunosuppressive care. Data were collected for post-liver transplant patients transplanted and managed at Intermountain Healthcare between 2005 and 2012. Alerts were analyzed based on year triggered, time since transplantation, hospitalization status, alert type, action taken (accepted or rejected), reason given for the action taken, and narrative comments. Alerts for overdue laboratory testing became more prevalent as time since transplantation increased. There is an increased need to support monitoring for overdue laboratory testing as the time since transplantation increases. Alerts should support providers as they monitor the evolving needs of post-transplant patients over time. We identify opportunities for improving laboratory monitoring of post-liver transplant patients.

In the epic imaginary of the twelfth-century chanson de geste the Charroi de Nimes, the political bond between a lord and his vassal reproduces the expectations, tensions, and aggressions of the relationship between aristocratic fathers and sons. The displacement of this negative affect is the ultimate cause of one of the Charroi’s more conventional aspects, its depiction of a religiously sanctioned conquest of a rich city in Muslim Spain. My reading of the text is framed by the variable and nuanced history of eleventh- and twelfth-century inheritance practices, and also by critical readings of certain historiographic narratives, such as Georges Duby’s famous essay on feudal ‘youth’ and biographical accounts of the contentious relationship between William the Conqueror and his son Robert Curthose. Freud’s and Lacan’s analyses of Oedipal conflict and the threat of castration as fantasies governing the relations between male generations also illustrate these textual tensions between medieval rulers ...

Aims To determine whether substituting Seeking Safety (SS), a manualized therapy for comorbid substance use disorders (SUD) and post-traumatic stress disorder (PTSD) for part of treatment-as-usual (TAU) improves substance use outcomes. Design Randomized controlled effectiveness trial. Settings Out-patient Veterans Administration Health Care System SUD clinic. Participants Ninety-eight male military Veterans with a SUD and co-occurring PTSD symptomatology. Measurements Drug and alcohol use and PTSD severity, measured on the first day of treatment, and 3 (i.e. the planned end of SS sessions) and 6 months following the baseline assessment. Treatment attendance and patient satisfaction were measured following treatment (3-month follow-up). Active coping was measured at treatment intake and following treatment. Findings SS compared to TAU was associated with better drug use outcomes (P

‘The Store of the Worlds’ is a science-fiction short story by Robert Sheckley, first published in Playboy in 1959.1 Making sure he is not followed, Mr Wayne makes an illicit visit to a small shack built from junk – the Store of the Worlds. The proprietor is Mr Tompkins, ‘a tall crafty looking old fellow with narrow eyes and downcast mouth’ (2006: 39) who offers a bargain: for the price of all one’s worldly goods, and ten years off your life, Tompkins will provide access to your heart’s desire: anything –money, sex, power, any fantasy imaginable. This is a familiar science fiction conceit of ‘many-worlds’ – the postulation of simultaneous alternate universes – based on then very recent thinking derived from the margins of quantum physics;2 in this version the idea is that the world sheds off an infinite number of possibilities of itself at each moment and the Store provides access to these. The choice of which world an individual experiences is decided by his or her deepest desire. Wayne questions the authenticity of the process: ‘For all I know you’ll give me a drug and I’ll just dream!’ he says. ‘Everything I own just for a – shot of heroin and a lot of fancy words!’ (ibid.: 41). He leaves the Store and returns home to his suburban family, two children, a job in the stock market, but is haunted by the promise and possibilities of the Store. However, his ordinary life distracts him from acting on the temptation to return, and over the next year he enjoys the usual, if mundane, fortunes of the normal life: children’s birthdays and illnesses, the ups and downs of marriage and business, all punctuated by holidays, seasonal breaks and romantic trips with his wife.

The article argues for the necessity of taking into account not only the chronology of adaptation but also the chronology of encounter, using as a starting point an instance of an adaptation student who had seen the 1951 Disney film Alice in Wonderland as a child many times, long before her subsequent encounter with Lewis Carroll’s Alice’s Adventures in Wonderland. It considers a selection of adaptations of Carroll’s work, including the 1950 Disney television promotion of its 1951 film and the 1966 Jonathan Miller’s BBC adaptation, to explore the probable consequences of different sequences of encounter.

The opening up and digitisation of archives offers many potential benefits for television historians. Drawing on the author's experience as a scholar, this paper explores the advantages and possible costs of this change.

This study explored the associations of posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), and depressive symptoms with employment, social support, and subjective functioning in 100 women who were seeking mental health assistance after intimate partner violence. Depressive disorders showed significant associations with low levels of social support, diminished self-esteem, reduced quality of life, and elevated negative social problem-solving orientation. PTSD severity was significantly associated with low self-esteem and elevated negative problem orientation, while severity of GAD was only associated with negative problem orientation. Results are discussed in light of current service models for women who have experienced intimate partner violence.