Lateral ankle ligament injury : an experimental and clinical study

Sport has become one of the most popular methods of spending freetime and consequently is of great social importance. fn recent studies concerning sports injuries in the Netherlands (BoersmaSIUtter et al. - 1979, v.Rens 1982) it was estimated that about 20% of all registered sportsmen sustain a sports injury every year, resulting in about 800.000 sports injuries in one year. Ankle sprain was found to be the most frequent injury, accounting for 18-21% of all sports injuries. Accordingly, ankle sprain is diagnosed in about 150.000 sportsmen every jear. The medical consequences of this finding were already clearly recognized in 1975 by Cedell as he stated: 11 Ankle injuries constitute a quantitative therapeutic problem that must be solved in the best way considering the ava-Ilable economic and medical resources. However, the demand for higher quality in the treatment must not be omitted. A reliable diagnostic procedure, providing an accurately specified diagnosis would enable an appropriate therapy for ankle sprains. Consequently, all kinds of sequelae, like chronic sprain, ankle instability, damage to the articular cartilage and osteo-arthrosis, resulting from misdiagnosis and mistreatment, can be prevented (O'Donoghue - 1958, Blain et a!. 1962, Grand 1973, Tenino - 1973, v .Barth - 1975, Fulp - 1975, Kooyman and Ponsen 1976, McCluskey et al. - 1976, Seiler and Holzrichter 1977, Stepanuk -1977, Speeckaert - 1978, Jungmichel - 1978, Tausch - 1978). The study presented in this thesis was set up to evaluate the diagnostic significance of arthrography in diagnosing recent ankle ligament ruptures and to assess the value of early surgical repair of ruptured lateral ankle ligaments as a method of treatment, with the above-mentioned considerations in mind. The two suppositions underlying this study are: 1. The value of the anterior talofibular ligament in stabilizing the ankle joint is generally underestimated. 2. Early surgical repair can improve the process of ligament healing by providing adequate coaptation of ligament ends, thereby leading to early functional recovery. The investigations were prompted by the promising results of surgical repair lateral ankle ligament ruptures, obtained in 63 patients within a pilot study, carried out in the period of May 1977 until April 1979 at the surgical department of the Zeeweg Hospital IJmuiden (Head: F. Schreuder M.D.). The results of a prospective clinical study, carried out at the surgical department of the St. Hippolytus Hospital Delft (Head: W.M. Oosterwijk M.D. Ph.D.) will be compared to the results of other therapeutic modalities as found in literature and will be combined with the findings of an experimental study on the process of ligament healing, carried out at the Laboratory of Experimental Surgery at the Erasmus University Rotterdam, under the supervision of Prof. D.L. Westbroek M.D

Policy cost-effectiveness of a hospital-tailored multi-faceted implementation strategy for introduction of a short stay admission programme following breast cancer surgery

Surgical oncolog

Urban Maori art : the third generation of contemporary Maori artists : identity and identification

Kia u ki tou kawai tupuna, kia matauria ai, i ahu mai !we i hea anga ana koe ko hea Trace out your ancestral stem, so that it may be known where you come from and in which direction you are going. The intention of this thesis is to examine and interpret the artistic careers and practice of University of Auckland Bachelor of Fine Arts graduates Lisa Reihana (1987), Brett Graham (1989), and Michael Parekowhai (1990), and University of Canterbury Bachelor of Fine Arts graduates Shane Cotton (1989) and Peter Robinson (1989). These urban artists are from a third generation of contemporary Maori artists, and they have been selected for this study because they represent a phenomenon within the New Zealand arts establishment. Graduating within three years of one another, they have instantly and successfully mapped out their artistic careers, rapidly rising in status nationally, and internationally, over the past decade. An examination of how contemporary Maori art has been defined by Maori and Pakeha critics and artists, and who is legitimised as Maori artists, presented as the debate between an essentialist and a post-modern, post-colonial argument, frames the context for this survey of identity and identification. The thesis investigates a contemporary Maori art movement: presenting a whanau of artists who form an artistic and educational support network of contemporaries, that whakapapa back to the Tovey generation - the kaumatua artists, influential in the work of Shane Cotton (Ngati Hine, Nga Puhi), Brett Graham (Ngati Koroki Kahukura), Michael Parekowhai (Nga-Ariki/Te Aitanga, Rongowhakaata) Lisa Reihana (Ngati Hine, Nga Puhi, Ngai Tu), and Peter Robinson (Kai Tahu). The artistic whanau now includes Cotton, Graham, Parekowhai, Reihana and Robinson who in turn influence and support their third generation peers, subsequently informing the artistic practice of the fourth generation of contemporary Maori artists, and forming a vital link in the continuation and development of the contemporary Maori art movement. The sesquicentenary of the Treaty of Waitangi in 1990 raised the question, once again, of how we identify as a nation, specifically, is there a New Zealand bicultural identity? The historically familiar focus on forming a partnership between the tangata whenua and Pakeha continued to be of importance for the nation as it approached the end of the millenium. The issue for New Zealand, as a country populated by a diverse range of migrant and locally born peoples, more recently, has become less concerned with 'creating' a bicultural identity and more interested in visually representing a multicultural nation. The last decade of the second millenium (1990 - 2000), is the main focus of this study because each one of the five artists profiled is conscious of speaking between two cultures, and they utilise their artistic works as the vehicle through which to investigate their Maoritanga and their bicultural reality. In a global climate of an increased awareness involving the rights of indigenous peoples, the third generation of contemporary urban Maori artists, the thesis will argue, became cultural ambassadors both nationally and internationally, their work an institutionally acceptable bicultural fusion of Pakeha and Maori concerns. The easy facility with which they negotiate between these two worlds makes them a pivotal generation in any study of contemporary Maori art. This thesis aims to reveal the changing and sometimes controversial face of contemporary Maori art, establishing the necessity for this change, revealing where the artists position themselves as a result of their geographical location within New Zealand, and in terms of their own connection to their Maori heritage and knowledge of their whakapapa, investigating issues of identity and identification