Traumatic tear of tibialis anterior during a Gaelic football game: A case report

Reports of traumatic injury to the anterior lower leg muscles are scarce, with only a handful of reports of traumatic injury to the tibialis anterior. A database search of Medline, Cinhal, and Sports Discus only revealed three such cases, and they did not result from a direct sporting injury. This report documents the case of a traumatic rupture of tibialis anterior muscle in a young female Gaelic football player. It details the surgical repair and management of tibialis anterior muscle and the physiotherapy rehabilitation to full function.

Securing international society: Towards an English School discourse of security

English School approaches to international politics, which focus on the idea of an international society of states bound together by shared rules and norms, have not paid significant explicit attention to the study of security in international relations. This is curious given the centrality of security to the study of world politics and the recent resurgence of English School scholarship in general. This article attempts to redress this gap by locating and explicating an English School discourse of security. We argue here that there is indeed an English School discourse of security, although an important internal distinction exists here between pluralist and solidarist accounts, which focus on questions of order and justice in international society respectively. In making this argument, we also seek to explore the extent to which emerging solidarist accounts of security serve to redress the insecurity of security in international relations: the tendency of traditional security praxes to privilege the state in ways that renders individuals insecure.

Social inclusion, new regionalism and associational governance: The Queensland experience

In recent years there has been a resurgence of decentralized social governance concerned with the spatial dimensions of disadvantage. This article examines aspects of this resurgence in the Australian state of Queensland where, after the hasty birth of 'place management' in response to the rise of 'Hansonism', a plethora of 'joined-up' policy initiatives were undertaken in relation to the regional dimensions of poverty. We propose that these trends reflect in part new ways of thinking about the spatial aspects of disadvantage which have emerged in recent years and which have the potential to take regional policy beyond the narrow confines imposed by neoliberal economic orthodoxy. These new ways of thinking have arisen in social policy through the refraining of disadvantage in terms of social exclusion and in regional economic policy through the influence of the so-called 'new regionalism'. The article shows how together these bodies of theory point us towards a new model of 'associational governance'. The article reviews recent Queensland experience and indicates those features of 'associational governance' which have become characteristic of locality-based social policy ideas in Queensland. 'Joined-up' and regional policy aspirations of the Queensland State government have shown the influence of these new approaches. The political and policy sustainability of these trends, however, is uncertain. The lingering shadow of managerialism and neoliberal policy frameworks remains a significant barrier to the innovation and viability of these approaches. More directly, the inherent limits of the 'local' or 'regional' initiatives in the face of broader national and global factors will significantly constrain the capacity of associational governance systems to deliver positive democratic, social and economic outcomes. The article examines recent Queensland policy refors in light of this complex set of factors and concludes by offering directions for future research and policy development.

Clinically active Crohn's disease in the presence of a low C-reactive protein

Objective. Clinical interest in C-reactive protein (CRP) - a component of the innate immune system - has focused mainly on its worth as an indicator of disease activity. There has been a resurgence of interest in CRP in the Crohn's disease ( CD) literature because several trials of new treatments for active CD have been characterized by both a large proportion of patients with low CRP ( < 10 mg/l) at entry to the trials and by a negative therapeutic outcome. It is therefore of interest to study the clinical characteristics of patients who are thought to have at the same time both active CD and a low CRP. Material and methods. Patients were prospectively recruited as part of the Brisbane IBD clinical and research programme. Subjects were included in the low CRP group only if there were complete datasets for CRP on all occasions of active CD, and CRP was < 10 mg/l. Active disease was defined as CD activity index (CDAI) > 200. The low CRP group was compared with patients in the raised CRP group for a range of clinical variables as well as the major NOD2 variants. Results. There were data sets for 223 CD patients, with a mean disease duration of 12 years. Of these, 22 patients fulfilled the criteria for low CRP. The low CRP group ( group 1) showed significant differences for disease site (p < 0.01) and for BMI (p = 0.006) compared to the raised CRP group ( group 2). Specifically, group 1 had a predominance of pure ileal disease (95% versus 53%) and lack of pure colonic disease (0% versus 24%) compared to group 2, and their BMI was significantly lower (20.3 kg/m(2) versus 25.0 kg/m(2)). Groups 1 and 2 did not differ with respect to Vienna behaviour at diagnosis, smoking, appendicectomy, extra-intestinal manifestations of CD, or NOD2 SNP variants. There was a trend for low CRP patients with previous ileal resection to evolve to a stricturing phenotype. Fat wrapping was noted in 11/13 (85%) of low CRP patients undergoing ileal resections. Conclusions. Patients with CD and a persistently low CRP in the face of active disease were characterized by an almost exclusive ileal disease distribution and a low BMI, compared to those with a raised CRP. These patients had a similar frequency and distribution of NOD2/CARD15 variants. Stricturing ( v inflammatory or penetrating) behaviour may explain some low CRP. Despite the abnormally low BMI, fat wrapping was noted in the majority of low CRP patients undergoing ileal resection.

The use of hypertonic saline for treating intracranial hypertension after traumatic brain injury

The past decade has witnessed a resurgence of interest in the use of hypertonic saline for low-volume resuscitation after trauma. Preliminary studies suggested that benefits are limited to a subgroup of trauma patients with brain injury, but a recent study of prehospital administration of hypertonic saline to patients with traumatic brain injury failed to confirm a benefit. Animal and human studies have demonstrated that hypertonic saline has clinically desirable physiological effects on cerebral blood flow, intracranial pressure, and inflammatory responses in models of neurotrauma. There are few clinical studies in traumatic brain injury with patient survival as an end point. In this review, we examined the experimental and clinical knowledge of hypertonic saline as an osmotherapeutic agent in neurotrauma.

The Bali bombs and the tourism development cycle

This paper analyses the impact of the Bali bombings on international visitor arrivals in Bali and compares this crisis with previous crises with reference to Butler’s hypothetical tourism area life cycle. The paper demonstrates that the Bali bombings had by far the greatest impact on international tourism visitation than any other crisis in the island’s history. Such was the severity of the decline in Bali that both national and local measures were taken to restore confidence. Important though these measures were, they do not fully account for the strong resurgence in international arrivals, suggesting that the destination has not yet reached consolidation in accordance with Butler’s hypothesis and that the strength of the resurgence owes much to the underlying trend of the development phase associated with the general picture proposed by Butler.

From point defects to plate tectonic faults

Understanding and explaining emergent constitutive laws in the multi-scale evolution from point defects, dislocations and two-dimensional defects to plate tectonic scales is an arduous challenge in condensed matter physics. The Earth appears to be the only planet known to have developed stable plate tectonics as a means to get rid of its heat. The emergence of plate tectonics out of mantle convection appears to rely intrinsically on the capacity to form extremely weak faults in the top 100 km of the planet. These faults have a memory of at least several hundred millions of years, yet they appear to rely on the effects of water on line defects. This important phenomenon was first discovered in laboratory and dubbed ``hydrolytic weakening''. At the large scale it explains cycles of co-located resurgence of plate generation and consumption (the Wilson cycle), but the exact physics underlying the process itself and the enormous spanning of scales still remains unclear. We present an attempt to use the multi-scale non-equilibrium thermodynamic energy evolution inside the deforming lithosphere to move phenomenological laws to laws derived from basic scaling quantities, develop self-consistent weakening laws at lithospheric scale and give a fully coupled deformation-weakening constitutive framework. At meso- to plate scale we encounter in a stepwise manner three basic domains governed by the diffusion/reaction time scales of grain growth, thermal diffusion and finally water mobility through point defects in the crystalline lattice. The latter process governs the planetary scale and controls the stability of its heat transfer mode.

Heritage language loss and the implications for ethnic identity maintenance over time

Language has been seen as a central pillar to ethnic identity. When the possibility of heritage language loss becomes imminent, therefore, concern turns towards the consequences for feelings of ethnic group membership. Heritage language researchers have indicated that the heritage language is so strongly associated with the individual’s cultural background that heritage language loss could have negative implications for the sense of identity to the ethnic group. This study investigates the relationship between language and ethnic identity over time among Gaelic learners in Nova Scotia. In order to identify the specific processes of heritage language use, the Gaelic learners are compared to French (second language), learners living in the same English-speaking milieu. Path analyses reveal that, only among Gaelic learners, there is an initial separation of language and ethnic identity, but that, over time, ethnic identity is a direct outcome of language use. The results support Edwards’ (1985), contention, at least in the case of heritage languages, that language and identity are not always strongly linked. It is suggested that this may be especially true in contexts where there is little opportunity for contact with members of the heritage language group.