Clenched Fist Research Articles

“Come to the Street!”: Urban Protest, Brazil 2013

(ProQuest: ... denotes non-US-ASCII text omitted.)When demonstrations overtook Brazilian cities in June, critics from Leftto Right were quick to assert what they were not: they were not organized by recognizable, tried-and-true forms of social protest (social movements, political parties, labor unions, churches, professional associations, human rights groups, NGOs); they were leaderless; they lacked political articulation; they had no consolidated agenda; they refused the Press; they disdained elected politicians and rejected a decade of ruling Workers' Party (PT) megapublicity about Brazilian successes. In short, they were splintered, anarchic, unrepresentative, unverifiable, ungrateful, and apolitical. Yet, by mid-June, more than a million people were participating in demonstrations, clearly mobilized by something rather than nothing. Their sustained force rendered the regularly-consulted media pundits, politicians, and political scientists, usually so confident, shocked not clueless. Every day and night massive numbers of citizens in all of Brazil's major cities and many smaller ones accepted the riotous invitation Vem pra rua! (Come to the street!) that was distributed through social media, held high on cardboard posters, and stamped on t-shirts (Figure 1). Often emblazoned on a clenched fist, the invitation became a hortatory take the street that individuals felt compelled to extend and multitudes to heed.Given this massive response, the call for insurgence, though suddenly answered, could only have developed out of a deep popular of what and how to protest. To find this sense of the people, one needs to look at the itself as the domain of urban insurgence. As in Occupy and Indignado movements elsewhere, the Brazilian protesters voiced their grievances under a tide of posters, overwhelmingly handwritten and individually carried, rather than collective banners or flags of political parties (the latter often aggressively repressed by the protestors themselves). The initial spark was a 20-cent fare increase (approximately $0.10 USD) for public buses in a number of cities. The Movimento Passe Livre (the Free Fare Movement, MPL) called for a protest march in Paulo on June 6, 2013. Founded in 2003 to challenge a fare increase in Salvador, Bahia, MPL has ever since demanded that public transportation be considered a fundamental constitutional right, campaigned for massive investments, and developed economic models to justify its battle cry-tarifa or zero fare-as a radical measure to address Brazil's public transportation nightmare.The first march in Paulo mobilized around 6,000 protestors focused on public transportation. Their marching chant was if the fare doesn't go down, the city will (which rhymes in Portuguese and challenges the famous slogan Sao Paulo never stops). By the sixth march on June 20, many cities including Paulo had indeed stopped, as a million and more people took to the streets of Brazil to publicize their revulsion at current conditions (Figure 2). Many were moved initially to protest the egregious police violence against demonstrators in Paulo. By mid- June, their anger had mushroomed far beyond 20 cents to target a hive of issues displayed individually, brilliantly, countlessly on posters: stop police violence; urban mobility is a right; a teacher is worth more than [soccer star] Neymar; there is money for the World Cup, there is money for health and education; housing is a right-stop evictions; the vandals are the politicians; freedom of expression; say no to the 'gay cure'; justice delayed is justice denied; where is Amarildo? [who disappeared while in police custody]; and so on and on. Transportation, infrastructure, health, education, housing, women-gay-indigenous-black-citizen rights, corruption, political reform (parties, elections, congress), justice, security, environment, specific legislation, energy (nuclear, hydro, oil), and violence. …

Why Do We Fight?: Conflict, War, and Peace by N. Walker

Walker, Niki. Why Do We Fight?: Conflict, War, and Peace. Toronto: Owlkids Books, 2013. Print.In this work, Niki Walker explores the general nature of conflict. She relates basic aspects of international politics - the existence of power elites, the formation of alliances, the rise of disputes - to the politics of school life. Along the way, she defines such terms as “negotiation,” “mediation,” “arbitration” and “sanctions.” She mentions examples of 20th century warfare: the post WWII Cold War, the Suez Crisis, and outlines the history of the current crisis in Afghanistan. The role of the United Nations is discussed. Most impressive is her insertion of pertinent quotes; for example, the chapter entitled “Cooperation or Combat?” begins with the words of Indira Gandhi: “You can’t shake hands with a clenched fist.”Walker is an experienced writer of non-fiction for children and this work demonstrates her typical proficiency. The book is well organized with good transitions between successive chapters. The index is rather brief, but the terms therein are consistent with the text. There is an informative list of sources.In a departure from her usual literary style, Walker occasionally attempts to use trendy language. There is a risk here: the vernacular of today’s young reader may be rejected as dated by tomorrow’s. This quibble aside, the book is highly recommended for use with upper elementary students. In particular, it could be a useful resource for Remembrance Day activities. Reviewer: Leslie AitkenHighly recommended: 4 out of 4 starsLeslie Aitken’s long career in librarianship involved selection of children’s literature for school, public, special and university collections. She is the former Curriculum Librarian at the University of Alberta.

Biomechanical Comparison of 3 Methods of Scapholunate Ligament Reconstruction

To compare the biomechanical characteristics of 3 methods of scapholunate (SL) ligament reconstruction, including 1 that provides a biological central axis tether. Twelve fresh-frozen cadaver limbs were mounted on a jig that allowed for wrist and finger motion by tendon loading. The specimens were randomized to receive the SL axis method (SLAM) reconstruction, the Blatt capsulodesis (BC), or the modified Brunelli tenodesis (MBT). Fluoroscopic images were taken to measure the SL interval and SL angle invarious positions. The specimens were evaluated in 4 states: intact, with the SL and radioscaphocapitate ligaments cut, after reconstruction, and after reconstruction followed by 100cycles of simulated motion. After cycling, the MBT and the SLAM reconstructions performed significantly better than the BC in recreating the intact SL interval in a clenched fist posture. The SLAM SL interval trended to be closer to the intact state than the MBT SL interval. The SLAM reconstruction also trended toward greater restoration of the native SL angle in the clenched fist posture than either the MBT or the BC. The SL ligament reconstruction that uses a 2-tailed tendon autograft placed along the axis of rotation of the SL joint and secured both at the scaphoid and the lunate minimized creep and reconstructed the critical dorsal SL ligament. The SLAM achieved improved the SL interval and SL angle correction compared with conventional techniques of SL ligament reconstruction. The SLAM method may be a useful alternative for SL ligament reconstruction.

Hand and fibrillin‐1 deposition abnormalities in Loeys–Dietz syndrome—expanding the clinical spectrum

Loeys-Dietz syndrome (LDS) is an autosomal dominant connective tissue disorder characterized by hypertelorism, bifid uvula, cleft palate and arterial tortuosity. We report on a patient with LDS, bearing mutation in the TGFβR2 gene, whose prenatal examination demonstrated clenched fists and club feet, suggesting arthrogryposis multiplex congenita. Postnatal assessment showed digital abnormalities, including brachydactyly, camptodactyly, partial syndactyly and absent distal phalanges. With the lack of fibrillin-1 microfibril deposition as well as impaired and inadequate elastic fiber assembly in our patient's fibroblasts, we speculate that the skeletal abnormalities seen in this patient with LDS are the result of lack of these components in embryonal perichondrium and in blood vessels. We suggest that LDS should be included in the differential diagnosis of joint contractures seen pre and postnatally. Prenatal diagnosis of LDS would be important in parental counseling and early post natal diagnosis could prompt treatment before the development of detrimental vascular complications.

Albright’s hereditary osteodystrophy

A 22-year-old man was referred to our endocrine clinic for evaluation of asymptomatic hypocalcemia. His past medical history included hypothyroidism on oral thyroxine replacement. On physical examination, he was obese and had a short stature with a round face. Both of his fourth and fifth fingers were shortened (Fig. 1a) with absence of the fourth and fifth knuckles on clenched fists, showing the characteristic ‘‘knuckle, knuckle, dimple, dimple’’ appearance (Fig. 1b). The patient reported that his mother also had shortened ring fingers (Fig. 1c) and dimpling over the fourth knuckles of clenched fists (Fig. 1d). Significant laboratory investigations showed a low calcium level of 7.8 mg/dL (normal 8.4–10.2 mg/dL), a high phosphate level of 5 mg/dL (normal 2.5–4.5 mg/dL), and markedly elevated parathyroid hormone (PTH) level of 496 pg/dL (normal 12–65 pg/dL). His 25-hydroxy vitamin D level was within normal range. In contrast, his mother had normal calcium, phosphate, vitamin D and PTH levels. The patient’s clinical features, including short stature, obesity, round face, and shortening of the fourth and fifth metacarpal bones, are compatible with those of Albright’s hereditary osteodystrophy (AHO). Given his family history, hypothyroidism, biochemical abnormalities, and characteristic physical findings of AHO, the patient was diagnosed as pseudohypoparathyroidism type Ia (PHP-Ia). The patient’s mother, on the other hand, was diagnosed as pseudo-pseudohypoparathyroidism (PPHP) due to lack of disturbances of calcium homeostasis. The patient was treated with oral vitamin D and calcium supplements. After 3 months of therapy, his serum calcium, phosphate and PTH levels were normalized. One of the skeletal abnormalities of AHO—‘‘knuckle, knuckle, dimple, dimple’’ appearance of the hand resulting from premature closure of the epiphyses—is known as knuckle-dimple sign or Archibald’s sign (Fig. 1b, d) [1, 2]. Clinical manifestations of AHO can be present in both PHP-Ia and PPHP. There are different forms of PHP, namely, type I (subdivided into type Ia and Ib) and type II. Their working classifications, biochemical and clinical findings are described as in Table 1 [3]. The PHP-I is the most common and is due to mutations in the GNAS gene. This gene codes for the stimulatory alpha-subunit of the trimeric Gs protein that connects G-protein coupled receptors of various hormones (particularly thyroid-stimulating hormone, TSH) with their intracellular signaling cascades [3, 4]. The primary response to PTH by the kidneys is to increase renal tubular calcium reabsorption and phosphate excretion. Mutations in GNAS gene lead to hormonal resistance of renal tissues to PTH, which causes hypocalcemia and hyperphosphatemia; and a decreased response to TSH results in primary hypothyroidism. The patient’s mother has a phenotype of AHO with preserved calcium metabolism, consistent with PPHP (Table 1). PPHP characteristically displays an inheritance pattern known as tissue-specific paternal gene imprinting— only females can transmit the full disease with Z. Min (&) Department of Medicine, Division of Infectious Diseases, Allegheny General Hospital, 420 East North Avenue, East Wing, Suite 407, Pittsburgh, PA 15212, USA e-mail: zmin@wpahs.org

Titus Andronicus (review)

Reviewed by: Titus Andronicus Stephen Purcell Titus AndronicusPresented by the Royal Shakespeare Company at the Swan Theatre, Stratford-upon-Avon. 05 16–10 26, 2013. Directed by Michael Fentiman. Designed by Colin Richmond. Lighting by Chris Davey. Music and sound by Tom Mills. Movement by Ann Yee. Fights by Kate Waters. With Stephen Boxer (Titus), Ben Deery (Publius/Messenger), Richard Durden (Marcus), Richard Goulding (Bassianus), Kevin Harvey (Aaron), John Hopkins (Saturninus), Gwilym Lloyd (Aemilius), Perry Millward (Demetrius), Matthew Needham (Lucius), Rose Reynolds (Lavinia), Katy Stephens (Tamora), Badria Timimi (Nurse), Dwane Walcott (Clown), Jonny Weldon (Chiron) and others. There is something both disturbing and strangely exhilarating about gratuitous violence in the theater. In the Swan, the anticipation was tangible. Signs on the doors into the auditorium warned that this production “contains scenes of graphic violence.” A young woman in the row in front of me spoke excitedly about the prospect of getting “splattered with blood.” An RSC shop assistant warned me during the interval about the bloodbath that was to conclude the second half. Michael Fentiman’s production of Titus Andronicuswas set in a post-modern fusion of classical Rome, fascist Italy and modern Britain. Institutions loomed large: the set evoked an abbey, with its mosaic floor and its Gothic windows, and a Roman eagle design was emblazoned across a black curtain. In a pre-show sequence, a trio of nurse-like nuns silently [End Page 545]washed three corpses, while the opening scene established that the Roman Tribunes belonged to some kind of priest-like order. Saturninus was a militaristic blackshirt, and Bassianus wore a fashionable grey suit; both sported Roman eagle armbands as they addressed the audience from the balcony at the back of the stage, casting us as citizens of Rome. Stephen Boxer’s Titus, meanwhile, sat on the stage beneath them amid the corpses of his sons, withdrawn from politics and stained with battle. Characters saluted one another in this world with a clenched fist—one of the production’s first indications that it was set in a society based on the public display of strength. This helped to explain Titus’s willingness to throw his weight behind Saturninus’s claim to power despite the fact that the latter was clearly a dangerous megalomaniac: John Hopkins’s Saturninus hungrily undressed Lavinia’s shoulders only seconds after being made Emperor, and when he chastised her for leaving him “like a churl” (1.1.482), his intense, barely-suppressed mania provoked audience laughter. Later on in the play, we saw that this Emperor wore his crown even in the bath. The production trod a difficult line between comedy and horror. Some moments were both funny and awful: Kevin Harvey’s Aaron played at puppetry with Titus’s severed hand; a zany, goggled messenger (Ben Deery) delivered the heads of Titus’s sons in a pram; at the start of the second half, the handless Lavinia (Rose Reynolds) attempted to peel and eat a boiled egg. The production’s presentation of the Clown exemplified this uneasy mix of horror and comedy: Dwane Walcott’s Clown had evidently been blinded in an accident, or perhaps an attack, which had left his face heavily scarred, and this piteous figure of fun was hanged on stage. As in most productions of this play, some moments were deeply unpleasant to watch. Following her rape and mutilation, the stumps of Lavinia’s arms were bound with her own shorn hair, now matted with blood. The scene in which she was reunited with her father and brother was painful: the actors’ bodies were tense and restricted in movement, making no contact at all with one another until Titus’s line, “O, what a sympathy of woe is this” (3.1.148)—at which point he touched Lavinia’s shoulders, and she flinched. Aaron’s murder of the Nurse was particularly brutal; after an initial blow he stabbed her a second time, needlessly, in the crotch, to gasps from the audience. Both the Nurse and Bassianus took some time to die, putting me in mind of the protracted agony of Tim Roth’s character Mr. Orange in Quentin Tarantino’s Reservoir Dogs(1992). [End Page...

Eikenella corrodens Septic Arthritis of the Hip

AbstractEikenella corrodens septic arthritis is commonly seen in “clenched fist injuries” as well as in those who are chronic finger or nail biters. In these cases, contamination of the open wound with saliva along with the proximity of joint to the skin results in septic arthritis. We report a case

Edward Hallarran Bennett: Bennett's Fracture of the Base of the Thumb

Bennett's fracture involves part of the base of the metacarpal bone of the thumb. The fracture line runs obliquely and involves the joint between the first metacarpal and the adjacent carpal bone--the trapezium. The shaft of the metacarpal is pulled proximally by the action of the long muscles attached to the thumb, so a fracture-dislocation of the thumb carpo-metacarpal joint results. The injury occurs typically in young men as a result of a blow on the clenched fist, either in a fall or, very often, in landing a blow in boxing. Now this joint happens to be of extreme importance in fine movements of the thumb, because it is here that opposition of the thumb takes place. Look at your own hand; now put the tip of your thumb onto the tip of your index finger; this is opposition and only man and monkeys can carry out this action. It is this important movement that you use when writing, when holding a scissors or a scalpel. When you look at the two bones articulating together they resemble someone sitting on a saddle and the joint, the only one of its kind in your limbs, is appropriately called a 'saddle joint'.

Radial Wrist Extensors as a Dynamic Stabilizers of Scapholunate Complex

Wrist stabilization is ensured by the complex of stabilizers, both static (intrinsic and extrinsic ligaments) and dynamic ones (flexor and extensor sinews of the wrist). Extrinsic carpal ligaments link both carpal rows with forearm, while the intrinsic ones connect individual carpal bones. From among intrinsic ligaments, the most significant from clinical point of view is scapholunate ligament (scapholunate lig.--SL). Instability of the SL resulting from SL ligament tear is the most frequent type of carpal instability. If untreated or undiagnosed, it may lead to destabilization of the carpal rows, and in the final stage to massive degenerative changes with SLAC (scapholunate advanced collapse). The aim of the study was to present a hypothesis of a possible influence of radial extensors of the wrist as dynamic stabilizers for SL complex, based on which it is possible to discern the partial ligament tear with accompanying damage of static stabilizers of the complex. This hypothesis was based on radiological tests carried out on 5 patients, with acute partial SL ligament tear, which was confirmed during wrist arthroscopy. The outcome was presented as well, with its visualization in radiological tests. The picture of rotary subluxation of the scaphoid -signet ring sign in PA view and strengthening in stress position (clenched fist) was demonstrated in all 5 patients. In 2 patients who had wrist arthroscopy performed it was observed that the palmar and proximal part of SL ligament were injured, yet no damage of dorsal part was reported. In MRI tests of these patients, an additional injury of dorsal intercarpal ligament was revealed. Correction of the scaphoid reduction in position of clenched fist may result from influence of radial extensors of the wrist (both short and long) as dynamic stabilizers of SL complex. This imagining is a completion of the radiological symptoms so far occurring in this SL instability. In case of acute, partial scapholunate ligament tear, reduction of scapholunate subluxation and its internal fixation with the lunate and capitate for a 6-week period may be an optional procedure.

Long-Term Use of a Static Hand-Wrist Orthosis in Chronic Stroke Patients: A Pilot Study

Background. Long-term splinting, using static orthoses to prevent contractures, is widely accepted in stroke patients with paresis of the upper limb. A number of stroke patients complain about increased pain and spasticity, which leads to the nonuse of the orthosis and a risk of developing a clenched fist. Objectives. Evaluating long-term use of static hand-wrist orthoses and experienced comfort in chronic stroke patients. Methods. Eleven stroke patients who were advised to use a static orthosis for at least one year ago were included. Semistructured telephone interviews were conducted to explore the long-term use and experienced comfort with the orthosis. Data were analyzed using descriptive statistics. Results. After at least one year, seven patients still wore the orthosis for the prescribed hours per day. Two patients were unable to wear the orthosis 8 hours per day, due to poor comfort. Two patients stopped using the orthosis because of an increase in spasticity or pain. Conclusions. These pilot data suggest that a number of stroke patients cannot tolerate a static orthosis over a long-term period because of discomfort. Without appropriate treatment opportunities, these patients will remain at risk of developing a clenched fist and will experience problems with daily activities and hygiene maintenance.

Carpal tunnel syndrome diagnosis by a self‐normalization process and ultrasound compound imaging

Carpal tunnel syndrome (CTS) is the common entrapment neuropathy that occurs due to compression of the median nerve at the wrist. Ultrasound images have been used to highlight anatomical variants of the median nerve, and CTS is thought to be associated to enlargement of the cross-sectional area (CSA) of the median nerve. However, there remains controversy regarding the most appropriate cutoff values of the computer measurements including the CSA, flattening ratio, and palmar bowing of median nerve, especially given that they can be influenced by image artifacts and factors that differ between individual patients. This study proposed a modified ultrasound compound imaging technique by moving fingers to reduce image artifacts, and the estimates of the normalized CSA [i.e., CSA at the wrist (CSAw) to CSA at the midforearm] with the aim of reducing discrepancies in CSA estimates and improving the ability of CTS discrimination. The subjects were examined with their arms supine and while they were making repetitive movements of their fingers (from an open palm into a clenched fist) within 3 s. By a commercial ultrasound scanner with a 10-MHz linear array transducer, a total of 70 images were acquired in each subject. The frame rate of ultrasound system was 25 fps. Nine frames in the acquisition sequence that had produced partial speckle decorrelation were incoherently added to form a compound image, and the inplane motion of them was corrected using the multilevel block-sum pyramid algorithm. The manual contours outlined by ten experimenters and three physicians were used to test the performance in determining the boundary of the median nerve. The receiver operating characteristic (ROC) curve was used to evaluate the usefulness of the estimates in distinguishing healthy volunteers from CTS patients. The manual contours of the median nerve in the compound images had an average area overlap exceeding 90% and relatively small area errors. The areas under the ROC curve obtained using the CSAw estimates for the original and compound images were 0.60 ± 0.09 (mean ± standard error) and 0.80 ± 0.05, respectively; that using normalized CSA estimates for the original and compound images were 0.76 ± 0.04 and 0.89 ± 0.04, respectively. The results show that variations in the CSAw values of compound images for healthy overweight and obese subjects can adversely influence CTS diagnosis, but that this can be overcome using the normalized CSA estimate of compound images. Compound imaging provides images of superior quality for determining the location of the median nerve boundary. Using the normalized CSA estimate would assist in eliminating problems associated with variability between populations, since the subject becomes his or her own internal control, thereby improving the ultrasound-based diagnosis of CTS.

Perception of affect in biological motion cues in anorexia nervosa

Nonverbal motion cues (a clenched fist) convey essential information about the intentions of the actor. Individuals with anorexia nervosa (AN) have demonstrated impairment in deciphering intention from facial affective cues, but it is unknown whether such deficits extend to deciphering affect from body motion cues. We examined the capacities of adults with AN (n = 21) or those weight restored for ≥12 months (WR; n = 20) to perceive affect in biological motion cues relative to healthy controls (HC; n = 23). Overall, individuals with AN evidenced greater deficit in discriminating affect from biological motion cues than WR or HC. Follow-up analyses showed that individuals with AN differed especially across two of the five conditions--deviating most from normative data when discriminating sadness and more consistently discriminating anger relative to WR or HC. Implications of these findings are discussed in relation to some puzzling interpersonal features of AN.

Poststroke Spasticity Management

Poststroke spasticity (PSS) is a common complication associated with other signs and symptoms of the upper motor neuron syndrome, including agonist/antagonist co-contraction, weakness, and lack of coordination. Together, they result in impairments and functional problems that can predispose to costly complications. The goal of PSS management should take into consideration not only reduction of muscle hypertonia but also the impact of PSS on function and well-being. Therapeutic interventions focus on peripheral and central strategies, such as physical techniques to increase muscle length through stretching and pharmacological modulation. Although there are few comparative studies on the superiority of one method over another, it appears that optimal management of PSS involves a combined and coordinated compendium of therapies that encompass cost-effective pharmacological and surgical interventions, along with rehabilitative efforts. Spasticity, commonly defined as “a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex, as one component of the upper motor neuron syndrome,”1 is a common complication of stroke. It contributes to the impairments and disabilities that negatively impact functional recovery. Consequently, PSS, along with weakness and lack of coordination, result in gait abnormalities and problems with arm use. In addition to functional limitations, spasticity, when inappropriately treated, may lead to reduced quality of life, increased pain, and joint contractures. Three community-based studies that followed-up stroke survivors for 3 to 12 months reported an incidence of PSS between 17% and 43%.2–4 Certain factors are recognized as predictors of PSS: stroke lesions in the brain stem; hemorrhagic stroke and younger age;5 and severe paresis and hemihypesthesia at stroke onset.3 To quantify the full impact of PSS, assessment should include a measure of passive stretch, volitional movement, and active/passive function.6,7 The benefit of …

Psychopathological Hand Disorders: A Rare Somatoform Reaction to Psychological Conflicts

Psychopathological Hand Disorders: A Rare Somatoform Reaction to Psychological Conflicts

What is simulation for?

What is simulation for?

Gothic Domesticity in Eugene O'Neill's Desire Under the Elms

Gothic Domesticity in Eugene O'Neill's <i>Desire Under the Elms</i>

P-1366 - Psychopathological hand disorders: a rare somatoform reaction to psychological conflicts

This article introduces two cases of pathological hand disorder, a rare category associated with contractures of fingers and abnormal posture of the hand. Both of these patients had history of traumatic life experiences in the past and their hand deformity could not be explained by a general medical condition. Psychopathological hand disorders including clenched fist syndrome and psychoflexed hand are somatoform conditions which represent “conversion” of emotional turmoil to physical symptoms in a symbolic manner. Prognosis seems to be poor . This fact is partly related to the interdisciplinary nature of the problem. The patient needs simultaneous psychiatric, neurologic and surgical help to reach both the proper diagnosis and management. Without considering the underlying psychological conflicts, invasive procedures are not helpful. Involvement of the key family members can be helpful for the patient to overcome the feeling of loneliness and helplessness. On the other hand, unnecessary and too much attention can be a rewarding response which keeps the situation unchanged. The patients need consistent, supportive care by their therapist to help them to get more adaptive solution for their problems. The therapist needs to know the protective role of the symptom and the patient's need to keep and maintain this posture. In some patients , the symptoms protect them from more destructive behaviors. This behavior shows the need to cope with unbearable psychological distress and to regain a sense of stability. These needs have to be addressed before any corrective intervention.

A new recreational mechanism for the boxer’s knuckle: cause for concern?

Traumatic injuries of the metacarpophalangeal joints are a common occurrence in professional and recreational sports such as boxing and martial arts, especially the fourth and fifth metacarpals. Injury usually results from a forceful impact with a clenched fist. The spectrum of injuries varies from simple skin laceration to extensor mechanism disruption, dorsal capsule rupture, metacarpal fractures and carpometacarpal joint injuries. These injuries are well documented in boxers as well as in patients who had been involved in fights and assaults. We report on two patients sustaining similar injuries to the dorsum of the hand but following punching of a recreational 'punching machine'. We describe the patterns of injury encountered and summarise the treatment. For clinical and safety reasons as well as the potential medicolegal implications, we believe it is important to highlight this mechanism of injury.

Empower my decisions: The effects of power gestures on confirmatory information processing

Recent research has shown that social power systematically influences information processing in many ways, and can be induced simply via powerful gestures or postures. The current studies investigated the impact of embodied power on confirmatory information processing after decision making. Based upon previous social power research, we hypothesized that individuals who posed in powerful ways (making a clenched fist or sitting in an open, expansive posture) would systematically prefer decision-consistent over decision-inconsistent information; an effect known as selective exposure, or biased assimilation. Four studies consistently indicated that bodily positioning associated with high levels of power induced greater confirmatory tendencies in the evaluation and search stages of a subsequent, decision-relevant information task (Studies 1–4). This tendency is unlikely to be due to mere physical strain (Study 4), and was mediated by differences in experienced decision certainty (Studies 3 and 4); indicating that the embodiment of high power makes people more confident regarding the validity of their decisions. Consequently, high-power posers systematically prefer information that is consistent with their decision preference.

Hamlet Without the Prince

Hamlet Without the Prince Christopher Fitz-Simon In all the vexations, triumphs and reversals of my dramatic career at St. Columba’s College—a century-old boys’ school inconveniently situated in the picturesque foothills of the Dublin Mountains—I never imagined that but a few years later I would find myself in the unique and privileged position of observing a fully staged performance of Hamlet in the same location, without its leading player. My kinsman Tyrone Guthrie, a relative of my mother’s, invited me and his niece Julia Butler to the opening night of his production of Hamlet at the Gate Theatre in June 1951. I was sixteen at the time, and living in the Guthrie home, Annaghmakerrig, County Monaghan, where my father was managing the estate as a retirement post. Ronald Ibbs, an English actor who settled in Ireland in the 1940s, played Hamlet. The production was announced as being “in modern dress,” which the Dublin theater columnists snidely attributed to a desire by the management to save money on costumes; in the event, it emerged that the residents of this twentieth-century Danish palace were sumptuously and nostalgically attired—as indeed was customary in all European courts at that time—in the outdated yet expensive habilments of previous generations. Julia and I were at separate boarding schools and an exeat for each of us was achieved following a formal exchange of letters between the director of the production and our respective headmaster and headmistress. Julia’s headmistress was so incensed at the idea of an Elizabethan play being presented in modern dress! that for a moment there was doubt that she would allow her pupil out for the evening; she relented when she learned that she would be introduced to the celebrated Tyrone Guthrie when he called for his niece at Knockrabo School. I had no difficulty in obtaining an exeat from my headmaster, the warden of St. Columba’s. I was at that time entirely stagestruck, but any night out in the city would have been a novelty and an excitement. At 6:30 pm I boarded the [End Page 9] single-decker bus that plied from Kilmashogue Bridge to the city center and arrived in time to recognize several famous faces from the world of stage, screen, and radio edging their way through the Gate’s cramped hallway. There was the truly glamorous Noelle Middleton, the earliest Irish announcer on BBC Television; the man with the face like a clenched fist must certainly be “K,” the soubriquet of Séamus Kelly, the Irish Times theater critic; the exceedingly corpulent gentleman and the lady who made up for it by being as thin as a pikestaff were the earl and countess of Longford who would have leased the Gate to Ronald Ibbs Productions for the run of the play. Then Tony Guthrie arrived with Julia and her friend Sarah Perry. It had been explained as being part of the exeat transaction that he should also deliver these young ladies back to their seat of educational incarceration following the three-hour performance. In the two intermissions, Tony led us across the street to a cafeteria named Rio for coffee and colored cakes—Julia whispered that he didn’t want to get embroiled with autograph seekers in the theater lobby. He asked our opinions of various actors and looked pleased when I said I thought Godfrey Quigley as Horatio was especially good. I had seen the Olivier motion picture of Hamlet that summer and we had read the play in school so I felt supremely knowledgeable. Tony didn’t enquire what we thought of the Ophelia, who was Mrs. Ronald Ibbs, and I sensed that he felt that had he done so I might be forced to say she seemed a little, well, heavy, for the part; had I been asked I would have suggested that she would have made “a fine Gertrude.” However, as Miss Coralie Carmichael was (I thought) a superb Gertrude—as regal and guilt-consumed as Eileen Herlie in the film—any bold suggestion of replacing her with Mrs. Ibbs might have spoiled the composure of the intermission coffee party. After the actors had...