In direct breach of managerial edicts: A practice approach to creative deviance in professional service firms

Drawing on practice as a meta-theoretical lens, we explore creative deviance (CD): wilful violation of managerial orders by employee(s) to pursue creative ideas. Data for our inquiry comes from in-depth interviews with middle managers and employees in two professional service firms (PSFs). We argue that two distinct organising processes are necessary for the emergence of CD in practice: organising configuration and formalisation of R&D processes. We develop these dimensions to produce a typology of interrelated ideal types of outcomes when employees are explicitly instructed to stop pursuing an idea. We found three salient organising practices (technical concerns for efficiency and metrics, suppression of metistic knowledge and disjointed managerial responses to violations of sanctioned organising procedures), which may operate in combination or serially, to foster CD in practice. We conclude with some key implications for the theory and practice of creativity in PSFs. © 2018 RADMA and John Wiley & Sons Ltd

Free abdominal fluid without obvious solid organ injury upon CT imaging: an actual problem or simply over-diagnosing?

Whereas a non-operative approach for hemodynamically stable patients with free intraabdominal fluid in the presence of solid organ injury is generally accepted, the presence of free fluid in the abdomen without evidence of solid organ injury not only presents a challenge for the treating emergency physician but also for the surgeon in charge. Despite recent advances in imaging modalities, with multi-detector computed tomography (CT) (with or without contrast agent) usually the imaging method of choice, diagnosis and interpretation of the results remains difficult. While some studies conclude that CT is highly accurate and relatively specific at diagnosing mesenteric and hollow viscus injury, others studies deem CT to be unreliable. These differences may in part be due to the experience and the interpretation of the radiologist and/or the treating physician or surgeon

Arteriovenous fistula of the superior gluteal artery as a complication of posterior iliac crest bone graft harvesting: 3D-CT angiography and arterial embolization

Superior gluteal artery injuries are rare, but potentially serious complications that occur during posterior iliac crest bone graft harvesting. The authors reported an arteriovenous fistula of the superior gluteal artery, which occurred as a complication during posterior iliac crest bone graft harvesting and was diagnosed with 3D-CT angiography, then treated with arterial embolization