The ankle injury--indications for the selective use of X-rays

The radiograph is rapidly superseding the clinical examination as the diagnostic tool for acute ankle injuries. Twenty-four independent variables which might help distinguish between soft tissue injuries and fractures at the ankle were identified and then used prospectively to study 150 consecutive patients with ankle injuries. Nineteen patients had fractured ankles (12.7 per cent) and 131 (87.3 per cent) had soft tissue injuries. Only the patient's ability to bear weight on the injured ankle and the presence of tenderness over the lateral aspect of the ankle below the malleolus proved to be helpful. When these 2 signs were present together, regardless of all other variables, there was a 97.5 per cent probability of soft tissue injury P < 0.005). This study suggests that careful patient assessment will permit more discriminating use of ankle X-rays.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/25237/1/0000679.pd

Schumpeter: Theorist of the Avant-Garde

This paper argues that Schumpeter’s 1911 edition of ‘Theory of Economic Development’ can be fruitfully read as a theory of the avant-garde, in line with such theories developed by artistic avant-garde around the same time, in particular by the Italian Futurists. In particular it will show that both Schumpeter and other avant-garde theorists sought to break with past (1), identify an avant-garde who could force that break (2), find new ways to represent the dynamic world (3), embrace the new and dynamic (4) and promote a perpetual dynamic process, instead of a specific end-state or utopia (5). This new reading helps us to understand the cultural meaning of this seminal text in economics. Secondly it greatly facilitates our understanding of the differences with the later interwar German edition and English edition, which were more cautious in their embrace of the new, less focused on the individual qualities of the entrepreneur and placed more emphasis on historical continuity. Thirdly this reading suggests a different reason for the bifurcation between Schumpeter and the rest of the Austrian school of economics. Traditionally this split is explained by Schumpeter’s affinities with the Lausanne School, this paper instead suggests that the crucial break between Schumpeter on the one hand and Böhm-Bawerk, Wieser and later members of the Austrian School on the other hand is their theory of and attitude toward social change

Management education and the theatre of the absurd

In this paper we adopt a humanities perspective to reflect on the nature of business schools and management education (Vargish, 1991; March & Weil, 2005; Adler, 2006; McAuley & Sims, 2009). Business schools have been criticised for becoming the “hired hands” of business (Khurana, 2007) to the detriment of a higher purpose, institutions that champion a utilitarian morality, the shallowness and indeed the dangers of which are revealed in various business scandals and especially the financial crisis of 2007-8, the effects of which cast a long shadow over today’s economic and social landscape. This has led to the criticism that business schools have lost part of their essential “philosophic connection” to issues of humanity and human identities (Augier & March, 2011: 233-4). We argue that one way to encourage philosophical reconnection is to expand management education’s engagement with the humanities (Czarniawska & Gagliardi, 2006)

On averting the tragedy of the commons

One of the enduring facts of the human condition is that the earth's resources are finite and its environment fragile. It is also evident that human behavior is rarely based on an appreciation of these facts. While the outlook may be bleak, so are some of the proposed solutions. Reasonable people have suggested that, to survive, an environmentally enlightened authoritarian government must be adopted. This article suggests that such a solution is unworkable, in part because it fails to consider critical aspects of human nature. A framework is proposed for developing solutions compatible with human capabilities.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/48163/1/267_2005_Article_BF01867519.pd

CT findings after laparoscopic repair of ventral hernia

OBJECTIVE. We describe CT findings after laparoscopic repair of ventral hernia with emphasis on formation of postoperative fluid collections that can mimic recurrent bowel herniation or infected postoperative fluid collections. CONCLUSION. The porous property of the mesh used in laparoscopic repair of ventral hernia allows reaccumulation of fluid in the existing hernia sac or spaces in the subcutaneous tissues that can be created by laparoscopic manipulation. These fluid collections should be expected and are differentiated from infected fluid collections or hernia recurrence by clinical presentation, laboratory data, and lack of ancillary features associated with true hernia such as presence of hernia sac, herniated mesentery, or bowel obstruction.link_to_subscribed_fulltex

Bullet emboli to the systemic and venous circulation

The rarity of bullet emboli leads to frequent delays in diagnosis and inadequate early management. Our recent experience with this entity is described, and 153 cases reported in the English-language literature are reviewed and summarized. The majority of cases occurs as a consequence of civilian violence among men in their 20s and 30s. Most bullet emboli follow the direction of blood flow, although 15% of venous bullets cause embolization in a retrograde manner. One in 10 arterial emboli follow a right-heart or venous injury. Arterial bullets are symptomatic in 80% of cases, venous bullets in only one third. The choice of surgical management must be individualized according to the symptoms caused by the bullet and its location in the vascular system. In general, arterial bullet emboli are removed because of symptoms or findings of acute peripheral ischemia. Arterial and venous emboli not causing symptoms should be removed according to the risk of possible displacement and further embolization. Selective intraoperative angiograms and phlebograms can precisely localize the migrating bullet and permit appropriate placement of incisions before removal