Cutaneous antisepsis with chlorhexidine or povidone-iodine, usually with alcohol, has been extensively studied. This review of published studies reveals that sequential use of povidone-iodine and chlorhexidine leads to a greater reduction in the bioburden of aerobic and anaerobic bacteria on the skin, lower risk of intravascular catheter colonization, and lower risk of surgical site infection compared to use of either agent alone. As such, sequential use of cutaneous antiseptic agents may further reduce risk of surgical site infections, as well as infections associated with insertion of transdermal devices such as nephrostomy tubes, left-ventricular assistance devices, and intravascular catheters.

Beginning in the 1840s, high-ranking officials within the East India Company began a concerted effort to confiscate and annex princely states, citing misrule or a default of blood heirs. In response, metropolitan reformers and their Indian allies orchestrated a sustained legalistic defense of native sovereignty in the public sphere and emerged as vocal opponents of colonial expansionism. Adapting concepts put forth by both law of nations theorists and contemporary jurists, they sought to preserve longstanding treaties and defend the princes' exercise of internal sovereignty. The colonial government's failure to adequately define the basis of its modern “paramountcy” invited such creative maneuvering. Reformist opposition to the annexation of Awadh, the dispossession of the Nawab of the Carnatic, and the confiscation of Mysore demonstrates that international law did not simply function as a Eurocentric tool of subordination, but could also provide a bulwark against colonial depredations.

Laboratory-identified bloodstream infections (LAB-ID BSIs) in recently discharged patients are likely to be classified as healthcare-associated community-onset (HCA-CO) infections, even though they may represent hospital-onset (HO) infections. A review of LAB-ID BSIs among patients discharged within 14 days revealed that 109 of 756 cases (14.4%) were HO infections. The BSI risk being misclassified as HCA CO may underestimate the hospital infection risk.

This article undertakes the first systematic examination of Frank’s (1979, 1981, 1987, 1990, 2007b, 2008) claim that Old Norse influence is discernible in the language of Beowulf. It tests this hypothesis first by scrutinizing each of the alleged Nordicisms in Beowulf, then by discussing various theoretical considerations bearing on its plausibility. We demonstrate that the syntactic, morphological, lexical, and semantic peculiarities that Frank would explain as manifestations of Old Norse influence are more economically and holistically explained as consequences of archaic composition. We then demonstrate that advances in the study of Anglo-Scandinavian language contact provide strong reasons to doubt that Old Norse could have influenced Beowulf in the manner that Frank has proposed. We conclude that Beowulf is entirely devoid of Old Norse influence and that it was probably composed ca. 700, long before the onset of the Viking Age.

This article is about two generations of women in south-western Chad – the baou déné and the mosso. It addresses the puzzle of how these groups of women are present in the everyday life of the region known as ‘useful’ Chad, while women as economic agents are absent from stories about the region and about successive schemes to make it profitable. The baou déné are wealthy farmers, but the last generation of these ‘women who have a lot of things’ is disappearing. Younger women are referred to as mosso, meaning ‘to fall down’. They are more likely to make a living from small trade than from farming and their lives are defined by precarity. Drawing on a range of historical and contemporary sources, I show how the erasure of women happened in different ways over time. In the colonial era, administrators and travel writers were unable to imagine that women transformed forests into cotton fields. In this century, the idea that women farm just like men was disseminated by oil companies, facilitating land expropriation while drowning out stories of women's marginalization. The baou déné and the mosso are the products of specific historical processes and profit-making schemes, and the silences about women's places in them helped make profits, empire and ‘useful’ Chad possible.

The purpose of this study was to examine and compare the creative musical identities of pre-service music education students in the United States and Singapore. The Creative Identity in Music (CIM) measure was utilized with both US and Singapore pre-service music teacher populations (n = 274). Items of the CIM relate to music-making activities often associated with creativity in music education in the literature, including composition, improvisation and popular music performance. Results suggest, similar to findings of previous research, that while both populations are similar in their degree of creative music-making self-efficacy and are similarly willing to allow for creativity in the classroom, Singaporean pre-service music teachers value the areas of creative identity and the use of popular music listening/performing within the learning environment to a significantly greater extent (p < 0.0001) than their US counterparts.

Warwick Heale has recently defended the notion of individualized and personalized Quality-Adjusted Life Years (QALYs) in connection with health care resource allocation decisions. Ordinarily, QALYs are used to make allocation decisions at the population level. If a health care intervention costs £100,000 and generally yields only two years of survival, the cost per QALY gained will be £50,000, far in excess of the £30,000 limit per QALY judged an acceptable use of resources within the National Health Service in the United Kingdom. However, if we know with medical certainty that a patient will gain four extra years of life from that intervention, the cost per QALY will be £25,000. Heale argues fairness and social utility require such a patient to receive that treatment, even though all others in the cohort of that patient might be denied that treatment (and lose two years of potential life). Likewise, Heale argues that personal commitments of an individual (religious or otherwise), that determine how they value a life-year with some medical intervention, ought to be used to determine the value of a QALY for them. I argue that if Heale’s proposals were put into practice, the result would often be greater injustice. In brief, requirements for the just allocation of health care resources are more complex than pure cost-effectiveness analysis would allow.

The tube category of a modular tensor category is a variant of the tube algebra, first introduced by Ocneanu. As a category, it can be decomposed in two different, but related, senses. Firstly, via the Yoneda embedding, the Hom spaces decompose into summands factoring through irreducible functors, in a manner analogous to decomposing an algebra as a sum of matrix algebras. We describe these summands. Secondly, under the Yoneda embedding, each object decomposes into irreducibles, which correspond to primitive idempotents in the category itself. We identify these idempotents. We make extensive use of diagram calculus in the description and proof of these decompositions.