The Emergence of Hospital Federations: An Integration of Perspectives from Organizational Theory

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68464/2/10.1177_107755878704400206.pd

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Explaining Technology

A long tradition explains technological change as recombination. Within this tradition, this Element develops an innovative combinatorial model of technological change and tests it with 2,000 years of global GDP data and with data from US patents filed between 1835 and 2010. The model explains 1) the pace of technological change for a least the past two millennia, 2) patent citations and 3) the increasing complexity of tools over time. It shows that combining and modifying pre-existing goods to produce new goods generates the observed historical pattern of technological change. A long period of stasis was followed by sudden super-exponential growth in the number of goods. In this model, the sudden explosion of about 250 years ago is a combinatorial explosion that was a long time in coming, but inevitable once the process began at least two thousand years ago. This Element models the Industrial Revolution as a combinatorial explosion