My life / Bill Clinton

Described as a 'diary dump' and as a monstrous ego trip, Bill Clinton's 957-page autobiography My Life is packed with the names of nearly everyone he's met since he started school, in chronological order. David Palmer teaches American Studies at Flinders University, Scott Burchill lectures in International Relations at Deakin University. On this week's Book Talk they talk with Jill Kitson about Clinton's book and agree on its historical importance.

Anti-Americanism: recent sources

Anti-American sentiment has, it would seem, increased in the wake of the election of George Bush, jr. and the US’s response to the events of
September 11. Commentators within the US, and globally, have analysed the recent variants of a long-standing condition. Below is a review of recent coverage of the phenomenon. The entries for the print sources are divided into:

(1) analyses of anti-Americanism written in the US,
(2) accounts of international expressions of anti-Americanism.

A randomized trial of protocol-directed sedation management for mechanical ventilation in an Australian intensive care unit

Objective: To compare protocol-directed sedation management with traditional non-protocol-directed practice in mechanically ventilated patients. Design: Randomized, controlled trial. Setting: General intensive care unit (24 beds) in an Australian metropolitan teaching hospital. Patients: Adult, mechanically ventilated patients (n = 312). Interventions: Patients were randomly assigned to receive sedation directed by formal guidelines (protocol group, n = 153) or usual local clinical practice (control, n = 159). Measurements and Main Results: The median (95% confidence interval) duration of ventilation was 79 hrs (56-93 hrs) for patients in the protocol group compared with 58 hrs (44-78 hrs) for patients who received control care (p = .20). Lengths of stay (median [range]) in the intensive care unit (94 [2-1106] hrs vs. 88 (14-962) hrs, p = .58) and hospital (13 [1-113] days vs. 13 (1-365) days, p = .97) were similar, as were the proportions of subjects receiving a tracheostomy (17% vs. 15%, p = .64) or undergoing unplanned self-extubation (1.3% vs. 0.6%, p = .61). Death in the intensive care unit occurred in 32 (21%) patients in the protocol group and 32 (20%) control subjects (p = .89), with a similar overall proportion of deaths in hospital (25% vs. 22%, p = .51). A Cox proportional hazards model, after adjustment for age, gender, Acute Physiology and Chronic Health Evaluation II score, diagnostic category, and doses of commonly used drugs, estimated that protocol sedation management was associated with a 22% decrease (95% confidence interval 40% decrease to 2% increase, p = .07) in the occurrence of successful weaning from mechanical ventilation. Conclusions: This randomized trial provided no evidence of a substantial reduction in the duration of mechanical ventilation or length of stay, in either the intensive care unit or the hospital, with the use of protocol-directed sedation compared with usual local management. Qualified high-intensity nurse staffing and routine Australian intensive care unit nursing responsibility for many aspects of ventilatory practice may explain the contrast between these findings and some recent North American studies. (C) 2008 Lippincott Williams & Wilkins, Inc.

‘My history is a tile in a mosaic’ : an interview with Jim Cullen

JIM CULLEN was born in Queens, New York, and attended public schools on Long Island. He received his B.A. in English from Tufts University, and his A.M. and Ph.D. degrees in American Civilization from Brown University. He has taught at a number of colleges and universities, including Harvard and Brown. He is currently a teacher, and serves on the Board of the Trustees, at the Ethical Culture Fieldston School in New York City. Jim is married to historian Lyde Cullen Sizer and has four children.
CONTEXT: Dr Glenn Moore co-ordinates the subject 'Searching for the American Dream’ at The University of Melbourne. For the last nine years he has taken second and third year history students to Boston, New York and Washington, D.C to explore the philosophy of genius loci. Dr Moore gets students to work in food banks, visit homeless shelters, museums and organizes an array of guest speakers with experts such as Boston public defender, Denise Regan, Neera Tanden, Hillary Clinton’s campaign manager and Alec Ross, vice president of One Economy. As the leading expert on the American Dream, with the publication of so many books in American history such as: The American Dream: A Short History of an Idea that Shaped a Nation, Born in the U.S.A.: Bruce Springsteen and the American Tradition and Restless in the Promised Land: Catholics and the American Dream, Jim Cullen has spoken to the students for the last five years. I interviewed him prior to his recent discussion with the students in New York on 5 July 2006 at the Fashion Institute of Technology.