Outcome and patients' satisfaction after functional treatment of acute lateral ankle injuries at emergency departments versus family doctor offices

BACKGROUND: In some Western countries, more and more patients seek initial treatment even for minor injuries at emergency units of hospitals. The initial evaluation and treatment as well as aftercare of these patients require large amounts of personnel and logistical resources, which are limited and costly, especially if compared to treatment by a general practitioner. In this study, we investigated whether outsourcing from our level 1 trauma center to a general practitioner has an influence on patient satisfaction and compliance. METHODS: This prospective, randomized study, included n = 100 patients who suffered from a lateral ankle ligament injury grade I-II (16, 17). After radiological exclusion of osseous lesions, the patients received early functional treatment and were shown physical therapy exercises to be done at home, without immobilization or the use of stabilizing ortheses. The patients were randomly assigned into two groups of 50 patients each: Group A (ER): Follow-up and final examination in the hospital's emergency unit. Group B (GP): Follow-up by general practitioner, final examination at hospital's emergency unit. The patients were surveyed regarding their satisfaction with the treatment and outcome of the treatment. RESULTS: Female and male patients were equally represented in both groups. The age of the patients ranged from 16 - 64 years, with a mean age of 34 years (ER) and 35 years (GP). 98% (n = 98) of all patients were satisfied with their treatment, and 93% (n = 93) were satisfied with the outcome. For these parameters no significant difference between the two groups could be noted (p = 0.7406 and 0.7631 respectively). 39% of all patients acquired stabilizing ortheses like ankle braces (Aircast, Malleoloc etc.) on their own initiative. There was a not significant tendency for more self-acquired ortheses in the group treated by general practicioners (p = 0,2669). CONCLUSION: Patients who first present at the ER with a lateral ankle ligament injury grade I-II can be referred to a general practitioner for follow-up treatment without affecting patient satisfaction regarding treatment and treatment outcome.

Automation of shear-wave splitting parameter determination of local earthquakes at Yellowstone : application as indicator of crustal stress and temporal variation

Shear-wave splitting can be a useful technique for determining crustal stress fields in volcanic settings and temporal variations associated with activity. Splitting parameters were determined for a subset of local earthquakes recorded from 2000-2010 at Yellowstone. Analysis was automated using an unsupervised cluster analysis technique to determine optimum splitting parameters from 270 analysis windows for each event. Six stations clearly exhibit preferential fast polarization values sub-orthogonal to the direction of minimum horizontal compression. Yellowstone deformation results in a local crustal stress field differing from the regional field dominated by NE-SW extension, and fast directions reflect this difference rotating around the caldera maintaining perpendicularity to the rim. One station exhibits temporal variations concordant with identified periods of caldera subsidence and uplift. From splitting measurements, we calculated a crustal anisotropy of ~17-23% and crack density ~0.12-0.17 possibly resulting from stress-aligned fluid filled microcracks in the upper crust and an active hydrothermal system.

One size does not fit all: Entrepreneurial families’ reliance on family offices

Family offices are organisations dedicated to the management of entrepreneurial families’ private wealth. Based on agency theory, we analyse types of family offices with regard to the families’ goals and the control mechanisms used to ensure goal achievement. Family-dominant management and private client structures involve stronger emphasis on non-financial goals in single and multi-family offices than in non-family-dominant management and open client structures. Variations in family involvement, ranging from family dominance to the complete absence of family ownership and/or management, and diverse client structures justify the differential reliance on formal and informal control mechanisms.

Prières d'un coeur israélite : imre lev : livre d'offices et recueil de prières et de méditations pour toutes les circonstances de la vie

publ. par la Société consistoriale des bons livres. (Verf.: Arnaud Aron)

"Two hundred ninety-four": Remediation and multimodal performance in tourist placemaking

We offer here a multimodal discourse analysis of a range of verbal (writing and speech), nonverbal (movement and gesture) and technological (photography and video) resources used by tourists at the Leaning Tower of Pisa. In doing so, we pin-point the recycling and layering of mediatized representations (e.g. guidebooks and official brochures), mediated actions (e.g. climbing the Tower or posing in front of it), and remediated practices (e.g. posting a YouTube video of oneself climbing the 294 steps to the top of the Tower). Through this kind of empirically-based examination of tourists’ discursive and embodied performances – their ways of talking about and behaving in spaces – we witness how people never simply visit places but are always actively shaping and making these places. The Leaning Tower of Pisa is, therefore, as much an emergent production of the tourist imagination as it is a pre-existing, lop-sided construction of stone.

Musique réligieuse ancienne et moderne en usage dans les temples consistoriaux israélites de Paris : offices du sabbat et de toutes les fêtes ; cérémonies nuptiales et services divers ; récitations

Samue͏̈l David

Aristeas the Tourist

"Herodotus the Tourist" was the title given by James Redfield to his inquiry into Herodotus's ethnological system (Classical Philology, 80.2, 1985: 97-118). Redfield's insights, together with François Hartog's monograph The mirror of Herodotus (University of California Press, 1988), definitively modified our interpretation of Herodotus's Histories. In the present paper, I analyse the so-called Letter of Aristeas from a narratological perspective, suggesting that the anonymous author of the Letter deliberately constructed his main character ("Aristeas") as a Herodotus-like figure, who visits Judea and Jerusalem as yet another "tourist". In so-doing, the author's pseudo-ethnographic text produces a specific Jewish self-definition and identity in the Hellenistic period, mirroring both Greek representations of the Jews as a people of philosophers, and a Jewish interpretation of the ideal bios philosophikos, best typified through the Jewish compliance with the Mosaic legislation.