| 1. |
- Bass, Gary Alan, 1979-, et al.
(author)
-
Techniques for mesoappendix transection and appendix resection: insights from the ESTES SnapAppy study
- 2023
-
In: European Journal of Trauma and Emergency Surgery. - : Springer Science and Business Media LLC. - 1863-9933 .- 1615-3146 .- 1863-9941. ; 49, s. 17-32
-
Journal article (peer-reviewed)abstract
- Introduction: Surgically managed appendicitis exhibits great heterogeneity in techniques for mesoappendix transection and appendix amputation from its base. It is unclear whether a particular surgical technique provides outcome benefit or reduces complications. Material and methods: We undertook a pre-specified subgroup analysis of all patients who underwent laparoscopic appendectomy at index admission during SnapAppy (ClinicalTrials.gov Registration: NCT04365491). We collected routine, anonymized observational data regarding surgical technique, patient demographics and indices of disease severity, without change to clinical care pathway or usual surgeon preference. Outcome measures of interest were the incidence of complications, unplanned reoperation, readmission, admission to the ICU, death, hospital length of stay, and procedure duration. We used Poisson regression models with robust standard errors to calculate incident rate ratios (IRRs) and 95% confidence intervals (CIs). Results: Three-thousand seven hundred sixty-eight consecutive adult patients, included from 71 centers in 14 countries, were followed up from date of admission for 90days. The mesoappendix was divided hemostatically using electrocautery in 1564(69.4%) and an energy device in 688(30.5%). The appendix was amputated by division of its base between looped ligatures in 1379(37.0%), with a stapler in 1421(38.1%) and between clips in 929(24.9%). The technique for securely dividing the appendix at its base in acutely inflamed (AAST Grade 1) appendicitis was equally divided between division between looped ligatures, clips and stapled transection. However, the technique used differed in complicated appendicitis (AAST Grade 2 +) compared with uncomplicated (Grade 1), with a shift toward transection of the appendix base by stapler (58% vs. 38%; p < 0.001). While no statistical difference in outcomes could be detected between different techniques for division of appendix base, decreased risk of any [adjusted IRR (95% CI): 0.58 (0.41–0.82), p = 0.002] and severe [adjusted IRR (95% CI): 0.33 (0.11–0.96), p = 0.045] complications could be detected when using energy devices. Conclusions: Safe mesoappendix transection and appendix resection are accomplished using heterogeneous techniques. Technique selection for both mesoappendix transection and appendix resection correlates with AAST grade. Higher grade led to more ultrasonic tissue transection and stapled appendix resection. Higher AAST appendicitis grade also correlated with infection-related complication occurrence. Despite the overall well-tolerated heterogeneity of approaches to acute appendicitis, increasing disease acuity or complexity appears to encourage homogeneity of intraoperative surgical technique toward advanced adjuncts.
|
|
| 2. |
- Forssten, Maximilian Peter, 1996-, et al.
(author)
-
Surgical management of acute appendicitis during the European COVID-19 second wave: safe and effective
- 2023
-
In: European Journal of Trauma and Emergency Surgery. - : Springer Science and Business Media LLC. - 1863-9933 .- 1615-3146 .- 1863-9941. ; 49, s. 57-67
-
Journal article (peer-reviewed)abstract
- Introduction: The COVID-19 (SARS-CoV-2) pandemic drove acute care surgeons to pivot from long established practice patterns. Early safety concerns regarding increased postoperative complication risk in those with active COVID infection promoted antibiotic-driven non-operative therapy for select conditions ahead of an evidence-base. Our study assesses whether active or recent SARS-CoV-2 positivity increases hospital length of stay (LOS) or postoperative complications following appendectomy. Methods: Data were derived from the prospective multi-institutional observational SnapAppy cohort study. This preplanned data analysis assessed consecutive patients aged ≥ 15years who underwent appendectomy for appendicitis (November 2020–May 2021). Patients were categorized based on SARS-CoV-2 seropositivity: no infection, active infection, and prior infection. Appendectomy method, LOS, and complications were abstracted. The association between SARS-CoV-2 seropositivity and complications was determined using Poisson regression, while the association with LOS was calculated using a quantile regression model. Results: Appendectomy for acute appendicitis was performed in 4047 patients during the second and third European COVID waves. The majority were SARS-CoV-2 uninfected (3861, 95.4%), while 70 (1.7%) were acutely SARS-CoV-2 positive, and 116 (2.8%) reported prior SARS-CoV-2 infection. After confounder adjustment, there was no statistically significant association between SARS-CoV-2 seropositivity and LOS, any complication, or severe complications. Conclusion: During sequential SARS-CoV-2 infection waves, neither active nor prior SARS-CoV-2 infection was associated with prolonged hospital LOS or postoperative complication. Despite early concerns regarding postoperative safety and outcome during active SARS-CoV-2 infection, no such association was noted for those with appendicitis who underwent operative management.
|
|
| 3. |
- Calás, M. B., et al.
(author)
-
What to do about "The Human" in Organization Studies? : Thinking/saying/ doing with the Anthropocene, pandemics, and thereafters
- 2023
-
In: A Research Agenda for Organization Studies, Feminisms and New Materialisms. - : Edward Elgar Publishing Ltd.. - 9781800881273 - 9781800881266 ; , s. 177-194
-
Book chapter (other academic/artistic)abstract
- Each of the chapters in this volume, from the introduction to this end(ing), engaged in a conversation about producing knowledge in, about, with "organization studies" at a time when we (us, the human inhabitants of this Earth) are facing calamitous conditions, probably leading to our/its destruction, and (some more than others) are wondering what is to be done. As members of the management and organization studies (MOS) scholarly community, all the authors in this project are deeply concerned about the "knowledge" our common field is producing as "legitimate", for it seems not only inadequate for addressing those calamitous conditions but also that this kind of knowledge may be implicated in reproducing the harms we all decry. The aim here has not been to critique the field on the basis of what it produces but to acknowledge conditions perpetuating the production of those forms of knowledge more generally, and to offer positive alternatives which may make a difference in what is produced, perhaps contributing to a better world‚ over and over again. The message this chapter and all other chapters hope to convey is the possibility of "thinking, saying and doing otherwise". But can we truly question the very notion of "the human" supporting "legitimate knowledge"? Can we truly focus on producing processual knowledge with indefinite aims? In other words, is the becoming of an organization studies produced with feminist new materialisms possible? Responding to those questions, and following the original proposal for this volume, this chapter is the voice of the collectivity articulating 'the-world-and-beyond' as envisioned in each of the prior chapters. Taking this approach resonates as well with new materialisms: "'a doing with' which cannot be a 'doing alone' -more like a world of on-going assembling".
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Holgersson, Charlotte, et al.
(author)
-
Executive search as ethnosociality : A cross-cultural comparison
- 2016
-
In: International Journal of Cross Cultural Management. - : SAGE Publications. - 1470-5958 .- 1741-2838. ; 16:2, s. 153-169
-
Journal article (peer-reviewed)abstract
- In this article, we explore how executive search consultants in Austria, Finland and Sweden address ethnicity. Our findings suggest that while consultants working in these different sociocultural settings may attribute different meanings to ethnicity, they share a tendency to evade questions of ethnicity with regard to the search process. We specify three discursive practices that serve to eliminate questions of ethnicity from executive search: constructing whiteness as self-evident, constructing varieties of whiteness (articulating deficiency and lack for those not belonging to Us), and distancing responsibility for the current situation to clients and society. In view of these findings, we argue that executive search can be understood as an arena for ethnosociality that stops cultural diversity at the door of management suites and serves to undermine efforts to promote cross-cultural understanding in organizations. Our study indicates that sustaining whiteness as a privileged ethnicity takes multiple forms. While executive search consultants play an important role in these processes, it is suggested that they inherit a more fundamental problem in society and they have few opportunities to change the ethnic status quo at the top.
|
|
| 9. |
- Tienari, J., et al.
(author)
-
And then there are none : On the exclusion of women in processes of executive search
- 2013
-
In: Gender in Management. - : Emerald. - 1754-2413 .- 1754-2421. ; 28:1, s. 43-62
-
Journal article (peer-reviewed)abstract
- Purpose: The purpose of this paper is to explore the ways in which gender is "done" in executive search. The authors uncover how the ideal candidate for top management is defined in and through search practices, and discuss how and why women are excluded in the process. Design/methodology/approach: The study is based on in-depth interviews with male and female Austrian, Finnish and Swedish executive search consultants. The authors study the ways in which consultants talk about their work, assignments, clients, and candidates, and discern from their talk descriptions of practices where male dominance in top management is reinforced. Findings: The ways in which gender is "done" and women are excluded from top management are similar across socio-cultural contexts. In different societal conditions and culturally laden forms, search consultants, candidates and clients engage in similar practices that produce a similar outcome. Core practices of executive search constrain consultants in their efforts to introduce female candidates to the process and to increase the number of women in top management. Research limitations/implications: The study is exploratory in that it paves the way for more refined understandings of the ways in which gender plays a role in professional services in general and in practices of executive search in particular. Practical implications: Unmasking how gender is woven into the executive search process may provide openings for "doing" gender differently, both for consultants and their clients. It may serve as a catalyst for change in widening the talent pool for top management. Originality/value: Research on gendered practices in executive search is extremely rare. The study provides new insights into this influential professional practice and its outcomes.
|
|
