"American business can assist [African] hands”: the Kennedy administration, US corporations, and the Cold War struggle for Africa

While there has been significant historical interest in President Kennedy’s approach to Africa, historians have not considered in-depth how American economic aid to Africa became tied to the expansion of US business involvement on the subcontinent. A close examination of these issues reveals that the Kennedy administration saw the US Agency for International Development (USAID)’s economic aid programs as a critical mechanism for the resolution of America’s balance of export payments problems, and that Kennedy administration officials worked assiduously to bring American corporate interests to bear on questions of African economic development. This essay argues that the Kennedy administration promoted and fostered an environment that encouraged increased American business investment in Africa. This contention emerges from an analysis of the evolution of Kennedy’s views on Africa, including his support for African nationalist aspirations and for economic development and education, and their impact on administration policy. We examine sources from the Kennedy administration and from the papers of G. Mennen Williams, Kennedy’s Undersecretary of State for Africa and in so doing, we argue that the Kennedy administration fostered an approach to Sub-Saharan African economic development that forged a robust relationship between government aid and American business investment. The Kennedy administration’s embrace of the principles of free enterprise heralded a major shift in US relations with Africa. This point is further underscored by our examination of the significant growth of US-headquartered multinational corporations’ investments in Africa during and immediately following Kennedy’s presidency

Are Postoperative Complications More Common with Single-Stage Bilateral (SBTKR) Than with Unilateral Knee Arthroplasty: Guidelines for Patients Scheduled for SBTKR

A significant number of patients with degenerative arthritis of the knee require bilateral knee arthroplasty. Single-stage bilateral total knee arthroplasty (SBTKR) has been associated with increased patient morbidity and mortality. At our institution, the following steps have been taken to minimize the risks to patients undergoing this procedure: regional anesthesia and analgesia, invasive monitoring, postoperative observation in an intensive care unit setting, and aggressive management of hemodynamic aberrations. We reviewed the medical records of 462 sequential total knee arthroplasty patients, consisting of 169 SBTKR and 293 unilateral total knee arthroplasty (UTKR) cases. A total of 122 patients from each group were matched for age, weight, and a history of ischemic heart disease and hypertension. Patients for SBTKR exhibited a significantly higher incidence of fat embolism syndrome and cardiac arrhythmias than UTKR patients. There were no deaths in either group and the incidence of other serious postoperative complications was low and similar between the two groups. Elderly patients (∼75 years old) had more postoperative complications. With aggressive clinical management SBTKR can be safely performed in selected patients. Guidelines for the selection of these patients are presented