Run Me a River

The rich history of river life in Kentucky permeates Janice Holt Giles’s novel Run Me a River. Set in 1861, at the beginning of Kentucky’s reluctant entry into the Civil War, the novel tells the story of a five-day adventure on the Green River. Aboard the Rambler, a ramshackle steamboat, Captain Bohannon Cartwright and his crew journey 184 miles and pick up two extra passengers along the way. The boatmen rescue “Sir Henry” Cole, a former Shakespearean actor, and his granddaughter Phoebe from their skiff when it overruns in a squall. As romance blossoms between Phoebe and Captain Bo, a conflict escalates between Confederate and Union forces fighting for control of the river. Janice Holt Giles (1905-1979), author of nineteen books, lived and wrote near Knifley, Kentucky, for thirty-four years. Her biography is told in Janice Holt Giles: A Writer\u27s Life.https://uknowledge.uky.edu/upk_english_language_and_literature_north_america/1066/thumbnail.jp

The Plum Thicket

Janice Holt Giles had a life before her marriage and writing career in Kentucky. Born in Altus, Arkansas, Giles spent many childhood summers visiting her grandparents there. After the success of her historical novel The Kentuckians in 1953, she planned to write a second frontier romance. But a visit to Altus caused her imagination to drift from Kentucky in 1780 to western Arkansas in 1913. At age forty-eight—the same age as Giles at the writing of the novel—the heroine Katie Rogers recalls her first visit alone to her grandparent’s home in Stanwick, Arkansas. Eight-year-old Katie spends her summer climbing the huge mulberry tree and walking with her wise grandfather, a veteran of bloody Shiloh. She is fascinated, not frightened, by the grave of an unknown child in the nearby plum thicket. Throughout the visit Katie helps Aunt Maggie plan her wedding and looks forward to the three-day Confederate Reunion. But the Reunion—and the summer—end violently, as guilt, repression, and miscegenation are unearthed. “That summer was the end of a whole way of life,” Katie realizes, for she can never again dwell in the paradise of childhood. In Katie Rogers, Giles voiced her own lament for “the beautiful and the unrecoverable past.” To her publisher Giles wrote, “Out of my forty-odd years of living, much of whatever wisdom I have acquired has been distilled into this book.” This new edition of The Plum Thicket gives Giles’s many fans a powerful, moving glimpse into the mind and heart of this beloved author. Janice Holt Giles (1905-1979), author of nineteen books, lived and wrote near Knifley, Kentucky, for thirty-four years. Her biography is told in Janice Holt Giles: A Writer\u27s Life.https://uknowledge.uky.edu/upk_english_language_and_literature_north_america/1065/thumbnail.jp

Act of Contrition

Act of Contrition focuses on the intimate relationship between Regina, a widow, and Michael, a young doctor whose wife left him for another man. Having found happiness in one another, they desire nothing more than to be together. Yet in the eyes of the Catholic Church, Michael is not free to divorce his wife and marry Regina. In an emotional climax Regina must decide if she loves Michael enough to give him up or if she’ll force him to choose between her and God. By modern standards, Giles’s love scenes are tasteful, and the general atmosphere of ecumenism within today’s Catholic Church renders moot many of the tensions in the novel. Yet in 1957 Giles’s agent and publisher feared the work would cause irreparable harm to her reputation. As late as 1972 Giles was revising in the hopes of seeing the novel published. Finally her wish is fulfilled. Janice Holt Giles (1905-1979), author of nineteen books, lived and wrote near Knifley, Kentucky, for thirty-four years. Her biography is Janice Holt Giles: A Writer\u27s Life. Fans of Janice Holt Giles will welcome her resurrection in this moving romance. —Journal of the Jackson Purchase Historical Society For fans of Janice Holt Giles’s work, her new novel Act of Contrition will be a pleasant surprise. —Kentucky Living A fascinating study in how the evolution of social history acts as a counterpoint to the constancy of human nature. —Lexington Herald-Leader Important for many reasons, not the least of which is the way it broadens our view of Giles\u27s immense gifts. —Appalachian Heritage At last! A love story written by Janice Holt Giles in 1957 and hidden away in archives since her death in 1979 is finally in print. Giles declared Act of Contrition one of the best books she had ever written. —Dianne Watkins Stuart A truly timeless tale that transcends generations. —Knoxville News-Sentinel A truly timeless tale that transcends generations as well as outlasting the obstacles they placed. —Louisville Courier-Journalhttps://uknowledge.uky.edu/upk_english_language_and_literature_north_america/1067/thumbnail.jp

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London