Lack Of Return Research Articles

Застосування теорії змін в екологізації бізнесу

The article summarizes scientific approaches to the development of the theory of changes in the greening of business. The scientific and methodological approaches to understanding the basics of the theory of change have been developed. The features of the application of the theory of change in the greening of business are presented. The specifics of the development of the theory of changes in the greening of business on the example of Ukraine are revealed. It is determined that for the Ukrainian realities, the greening of business is implemented mainly in the formal plane in the context of compliance with the norms and standards of environmental development, ensuring environmental taxation, control of environmental pollution standards, which slows down the development of the component of the Ukrainian environmental business and hinders the innovative introduction of elements of the ecological paradigm in our country. The theory of change is a rigorous but necessary process by which groups and stakeholders in planning activities formulate their long-term goals and define the conditions that they believe should precede the achievement of these goals. These conditions are modeled as desired outcomes, organized graphically in a causal structure. Change theory describes the types of interventions (a single program or a coordinated initiative) that lead to the outcomes depicted in the outcome map. Each intervention is linked to an outcome in a causal system, revealing the often complex web of actions required to bring about change. Several factors have been found to make it difficult for multinational companies to take action against climate change, such as a lack of certainty about climate policy, a lack of green technologies, and a lack of return on investment. The use of green practices also remains limited in the International Health Standards (IHR) in both developed and developing countries, due to limited access to finance and skills, lack of information and knowledge about innovation, and, in some cases, poor enforcement of rules. It is determined that for a better and more effective application of the norms and provisions of the theory of changes in the greening of business, it is relevant to introduce professional courses for managers and environmental managers of companies, which will direct the professional training of management staff to the implementation of effective environmental changes in business. It is also relevant to introduce the State-based programs to stimulate the development of greening business in terms of indirect (tax incentives for businesses that implement environmental innovations) and direct incentives for the implementation of environmental changes (preferential lending for greening business).

From linear to a circular economy in the e‐waste management sector: Experience from the transition barriers in the United Kingdom

AbstractE‐waste generation is rising apace, and it is estimated that e‐waste production could reach 74.7 Mt by 2030. Hence, it is essential to develop tactics and methodologies for the formal management and treatment of e‐waste. The implementation of the concepts of a circular economy (CE) has been perceived as an efficient methodology for the efficacious management of such waste; however, the transition process from the linear economy to CE still involves several barriers. There are only a few studies that have integrated the concept of CE with e‐waste management for sustainability. This study will focus on the UK's household e‐waste management sector to identify and analyze the key barriers that impede the transition of the UK's e‐waste management sector to the CE model. For this purpose, a team of experts was formulated and their expertise was captured using the Decision‐making trial and evaluation laboratory (DEMATEL) methodology. The DEMATEL technique employs critical evaluation principles, measures the weights of the evaluation criteria, and helps in finding the most critical barriers through a visual structural model. The DEMATEL method also categorizes the factors into cause‐and‐effect groups and utilizes a visualization model to simplify the interdependence and intensity of the impacts of the various factors. The results revealed that the “Lack of processing technologies,” “Lack of returns and profits,” “Lack of expert knowledge,” “Lack of effective guidance and standards for the proper collection methods,” and “Lack of proper knowledge” are the most significant barriers obstructing the adoption of CE in the management of e‐waste in the United Kingdom. Thus, the government needs to take strong actions to give financial support in terms of incentives to the stakeholders for effective e‐waste handling.

Exploring Rare Disease Patient Attitudes and Beliefs regarding Genetic Testing: Implications for Person-Centered Care.

Most rare diseases are genetic in etiology and characterized by a ‘diagnostic odyssey’. Genomic advances have helped speed up the diagnosis for many rare disorders, opening new avenues for precision therapies. Little is known about patient attitudes, experiences, and beliefs about genetic testing for the rare disease congenital hypogonadotropic hypogonadism (CHH). Methods: We conducted six focus groups with patients with CHH (n = 58). Transcripts were coded by independent investigators and validated by external reviewers. Results: Major themes relating to pre-test experiences were ‘attitudes & beliefs’ (most frequently cited theme), which revealed altruism as a strong motivator for pursuing research testing and ‘information and support,’ which revealed a striking lack of pre-testing decisional support/genetic counseling. Major post-test themes included ‘return of results,’ revealing frustration with the lack of return of results and limited emotional support, and ‘family communication,’ describing challenging intrafamilial communication. Themes describing ethical concerns (i.e., privacy, use of samples) were least frequently noted and related to pre- and post-test experiences. Conclusions: Patients with CHH are highly motivated by altruism when pursuing testing but have significant unmet needs for pre-test decisional support and post-test counseling. It is regarded that patient values, beliefs and experiences can inform more person-centered approaches to genetic testing for rare diseases.

Above and beyond: helping behaviors among nurses in positive and negative reciprocity relationships

PurposeThe purpose of this paper is to explore antecedents of helping behaviors among nurses using a social exchange framework. The paper reports an investigation into the effects of reciprocity, perceived coworker efficacy and stress on active and passive helping behaviors.Design/methodology/approachTo test hypotheses, the authors performed random coefficient modeling on Mplus with data from 155 full-time nurses.FindingsNurses were willing to help coworkers regardless of perceived reciprocity levels in the relationship. Rather, their perceptions of the coworker's efficacy and previous behavior predicted helping.Originality/valueThis manuscript contributes to the literature in a number of ways. First, it provides empirical evidence that individuals will suppress or ignore reciprocity norms during an interdependent task. This lends credence to the idea that social exchanges may need to be examined in light of other variables or at other levels of analysis. Second, it demonstrates that investment behaviors (i.e. helping) can and do occur in exchange relationships despite low reciprocity. Overall, the data suggest that individuals are willing to maintain relationships despite a lack of returns.

Abstract 10214: Stress Testing Prior to Abdominal Aortic Aneurysm Repair: What is Our Return on Investment?

Introduction: The use of stress testing prior to abdominal aortic aneurysm (AAA) repair is highly variable. We examined the financial implications of this variation and its impact on postoperative cardiac events. Methods: We studied patients who underwent elective endovascular (EVAR) or open AAA repair at Vascular Quality Initiative participating centers from 2015–2019. We grouped centers into quintiles by their frequency of preoperative stress testing. We calculated rates of major adverse cardiovascular events (MACE), a composite of in-hospital myocardial infarction, stroke, heart failure, or death, for each quintile. We applied the charges for electrocardiographic, echocardiographic, and nuclear stress tests at our institution in 2019 to the study population to calculate expected charges per 1,000 patients. Results: We studied 27,978 patients who underwent EVAR (mean age: 73.5 ±8.5 years, 81.7% male) and 4,481 who underwent open AAA repair (mean age: 69.5 ±8.1 years, 75.1% male). Stratifying by quintile, stress test frequency ranged from 13.0% to 68.6% (mean: 37.9%) among EVAR patients and 15.9% to 85.0% (mean: 52.8%) among open AAA repair (Figure). The rate of MACE was 1.4% after EVAR and 10.2% after open AAA repair. MACE after EVAR increased with the frequency of stress testing and was 0.9% at 1 st quintile centers vs 1.7% at 5 th quintile centers (p-trend=0.033). There was no association between MACE and stress testing for open AAA repair (p-trend=0.192). The estimated charges for stress testing prior to EVAR was $125,806 per 1,000 patients at 1 st quintile centers, and $664,975 at 5 th quintile centers, while charges prior to open AAA repair were $153,861 per 1,000 patients at 1 st quintile centers, and $825,473 at 5 th quintile centers. Conclusions: More frequent stress testing is associated with high cost without a reduction in MACE. This lack of return on investment highlights the need for more judicious stress test use prior to AAA surgery.

Lack of Return in Nigeria-Biafra Civil War Literature

Abstract When the Nigeria-Biafra civil war ended in July 1970, the Commander in Chief of the Federal Army, General Yakubu Gowon, declared that there was “no victor no vanquished” and, consequently, drew an iron curtain on a painful historical moment. This closure foreclosed further engagements with the events of the war in a manner that imposed a “code of silence” on its historiography. However, in the face of this silence and the silencing of public remembrances, private remembrances have continued to bloom. And in recent times, these remembrance(s) have fertilized a virulent demand for secession. I argue that literary accounts of the conflict question its ‘closure’ through what I call ‘lack of return.’ Relying on Van der Merwe and Gobodo-Madikizela’s conception of narratives as spaces of healing, I engage in a close reading of one fictional account—Saro-Wiwa’s Sozaboy—and two memoirs—Achebe’s There Was a Country and Chukwurah’s The Last Train to Biafra—to examine how narratives of Biafra call attention to the persistent freshness of the wounds and trauma of the war by creating stories that lack denouement. I find that in these texts, the silencing of ordnance doesn’t herald a return home—whether spatially or mentally. Consequently, these stories could be read as palimpsests that reveal a need for spaces of narrative engagements, abreaction, and healing.

Bank adoption of mobile banking: stakeholder perspective

PurposeBank adoption of mobile banking globally remains sporadic. Factors influencing this remain under researched. The purpose of this paper is to explore drivers and barriers of bank adoption of mobile banking from a stakeholder perspective.Design/methodology/approachUsing diffusion of innovation (DOI), a mixed method study was conducted. Data were collected using blogging to inform a two-round modified Delphi study. The opinion of 72 members from six stakeholder industries was sought.FindingsThe results indicate that DOI theory is still applicable within mobile environments in helping to understand the diffusion of mobile banking. Key drivers of bank adoption were global mobile phone penetration, competitive advantage, customer convenience, strategic importance, customer demand, low perceived risk/security concerns and stakeholder partnerships. Findings suggest low levels of customer demand and lack of return on investment (ROI) are key barriers for banks. The findings have strategic implications for industry players highlighting the importance of mobile banking to maintain market share and customer relations. These influences will inform successful mobile banking strategies by raising awareness of major barriers.Originality/valueThis study concentrates on a bank/stakeholder perspective. It confirms that DOI theory is still applicable within mobile environments. It extends understanding of bank adoption providing useful information for all stakeholders. It has implications for banks regarding multi-channel banking and the motivators and challenges influencing its adoption.

Can an initial end-tidal CO2 <1.33 kPa predict lack of return of spontaneous circulation during pre-hospital cardiac arrest?

Results We registered data from 595 cardiac arrest patients; in 58.9 % (n=350) of these cases the pre-hospital critical care teams performed pre-hospital endotracheal intubation. An initial end-tidal CO2 measurement following prehospital endotracheal intubation were available in 270 cases. We identified 22 patients, who had an initial ETCO2 below 1.33 kPa. Four of these patients achieved return of spontaneous circulation. All four patients were admitted to hospital, three with stable circulation and one with ongoing automated CPR due to recurrent cardiac arrest. Conclusion Our results indicates that an initial ETCO2 below 1.33 kPa during pre-hospital cardiac arrest should not be used as a cut-off value for the achievability of return of spontaneous circulation.

Proposals for protection of return cables on SwePol Link

The return cable on the SwePol Link has been introduced as an alternative forced by environmentalists due to lack of social acceptance of other solutions. This is why in the proposed solution water and earth have been replaced by two return cables, although from a technical point of view such a solution is less effective. The last, eleventh fault of the return cable took place on 15 October 2012. In eight earlier cases the faults were caused by electrical failures in the cable in the sea and were located between ten and twenty kilometers from the Polish shore and triggered by disturbances in the northern part of the Polish power grid. In this situation it has been suggested to analyze and introduce one or two solutions shown below which may significantly limit the effects and lower the costs caused by return cable faults: a) assembly of additional surge arresters b) return to electrodes – lack of return cables c) ”partial” electrodes working with one return cable d) operation of the link only with earthings on converter stations. To sum up it needs to be stated that: • a relatively cheap way of protecting return cables against electrical failures is installing surge arresters in the cabinet located next to the cable container on the Polish shore • from the suggested preventive measures it seems reasonable to introduce the above mentioned solutions a) and d) simultaneously, as both of them are simple solutions which require neither considerable financial expenditure nor authorizations and may quickly show the expected results. DOI: 10.12736/issn.2300-3022.2013113 1. Reasons for introducing return cables The return cable on the Sweden-Poland link appeared as an alternative forced by ecologists. The decision on laying the return cables was made only at the stage of laying the main cable. In the original projects the construction of an anode and cathode was assumed, and the electrical circuit was supposed to be closed through the earth. In the proposed solution water and earth were replaced by the return cable; however, from a technical point of view, this solution is worse as the efficiency of the whole connection is lower (it is sufficient to build electrodes of proper low resistance values when closing the circuit through the ground, and the ground resistance practically equals zero). At the time of making the decision to lay the return cable there was no cable with a cross section of at least 1100 mm2 and insulation strength of 20 kV on the market that would be suitable for laying at the bottom of the Baltic Sea. It was decided to lay two cables at the marine section with a cross section of 630 mm2 each, and to lay one cable at the Polish land section with a cross section of 1100 mm2, all with an insulation strength of 20 kV. The first failure of the return cable showed the relevance of the decision to lay two return cables; in a failure scenario the damaged cable is disconnected and the other operates with the load of 473 MW [1, 2, 3, 4]. 2. Damage to return cables The damage to the return cable connecting Sweden and Poland that happened on 15.10.2012 was the eleventh in the history of cable operation (almost ten years had passed since the earlier tenth damage). Previous instances of damage occurred in 2001–2003 (that is, during the guarantee period). The cause of the last damage has not been clearly established yet; however, the final insulation breakdown was certainly of an electrical nature. The damage repair procedure for the return cable of the SwedenPoland link is always pretty much the same. First, it must be established which of the two cables is damaged, then the damaged cable is disconnected from the terminals and using mobile Murray bridges the approximate damage spot is located, which T. Szczepanski | Acta Energetica 1/14 (2013) | 147–152

A Birthday Wish

Today my great-aunt Becky turns 105 years old. When I tell people she is celebrating this milestone, after the initial expression of amused surprise, questions begin. Does she live alone? Does someone help take care of her? Is she still it? Then come deeper probes: does she have her own teeth? Does she need a diaper? After the questions come the inevitable reflections on age and mortality. Some people will comment that they never want to reach that kind of advanced age, but often I’m told how lucky I am to come from a family line with that kind of longevity. Becky herself no longer feels lucky. She did for a while, attributing her intact health to avoiding doctors in general and their medications in particular. She still cracks this joke to me, but the twinkle in her eye has long been replaced with the refraction of a new lens after cataract surgery. She is still alert and her memory is relatively preserved, but memory is almost all that is left. She repeats the same stories, not because she's forgotten whether you've heard them but because she has had no recent new experiences on which to comment. Her sisters and her friends are deceased—even her friend's children are starting to pass. She has watched family members half her age fall ill and succumb even as she herself wishes for release. A common theme is her lament against Medicare. They take my money and I get nothing back for it. Each time, I remind her that the only way to get return on her dollar is to fall sick. Logic fails, however, as she becomes progressively upset about the lack of return on her mandated investment. My patience falters. I nearly yell, “Get sick. Go to the hospital. Recoup your losses!” I hold my tongue and simply remind her how lucky she is to have so little need of Medicare. She looks at me with an expression that clearly states that I have much to learn and she lacks the time and energy to teach me. She tells me almost daily that she's ready to go. She offers herself up nightly in place of younger family members whose health is in jeopardy, but still she wakes to greet the new day. She can't watch TV; her eyesight is too limited. She can't hear music on the radio. She can't hear to use the phone, and even if she could, she cannot see the numbers well enough to dial. And, as mentioned, she has a progressively narrowing cadre of telephone correspondents. She is in virtual solitary confinement. Becky was a vivacious, well-traveled, literate, attractive woman. She was proud nearly to the point of being slightly full of herself. She was born the middle of five sisters and needed to distinguish herself; she did so by living a more glamorous life than her sisters who generated a prodigious number of offspring. She nurtured all of her many nieces and nephews but, by choice or by fate, had no child of her own. That woman is now half of her former height, half of her former weight. She sleeps poorly though the night and wakes late in the mornings. She lingers over breakfast, prolonging the time until she is left with little to do except wait for lunch. She concludes lunch and waits for dinner; eating is one of her few remaining pleasures. She hopes for visitors who sometimes come but more often do not. When she is fortunate enough to have company she tries to contribute to the conversation but the effort exhausts her. Her most fruitful conversations are the ones she holds with loved ones who have departed years before. I wonder if years ago, she blew out her candles and wished to live to a ripe old age. Happy Birthday, Aunt Becky. May your birthday wish come true.

Unobtrusive relevance feedback for personalized TV program guides

Paradoxically, a growing number of available channels in digital cable TV systems brings discomfort to the viewers who now experience difficulties in finding a content that would hold their attention. In such an environment, personalized program guides are needed to assist the viewers in retrieving the preferred programs in reasonable time. The design of these systems is bounded by the demand of unobtrusiveness and the limitations of broadcast infrastructure, with the lack of return (uplink) connection to the network center being the most significant one. In this paper, we investigate learning of user's viewing preferences through mechanism known as relevance feedback. Our goal is to develop a system that would efficiently track the patterns of user's interests without disturbing her viewing habits. Our proposal applies the elements of machine learning and information retrieval theory. We consider three different schemes and validate their performances by series of computer simulations.

Forecast of Antibiotic Development in an Era of Increasing Bacterial Resistance

Over the last decade there has been a decreased number of novel antimicrobial agents introduced to the market due to multiple factors including reduced governmental funding, marginal research and development interest by the pharmaceutical industry, lack of return on investment relative to medications used for chronic illnesses, and spiking microbial resistance trends. In an effort to most judiciously use the available armamentarium of anti-infectives available, many hospitals are implementing stewardship programs to re-direct inappropriate antibiotic use, which is estimated to account for up to 50% of all antibiotics prescribed. These efforts make it increasingly evident that the best defense against inappropriate antimicrobial use is accurate diagnosis of infectious diseases. Both the public and federal government must recognize the need for new and improved antimicrobials, as well as augmented infection control strategies and diagnostic techniques, to appropriately aid in the facilitation of bacterial control or eradication.

Drug treatment of tropical parasitic infections: recent achievements and developments.

Drug development offers potential solutions to a number of tropical health diseases, although the expense of pharmaceutical research and lack of return on investment has limited the production of new agents. The greatest successes have been through the development of single dose therapy and mass treatment control programmes for a number of diseases. We review some of the current treatment regimens for malaria, intestinal helminth infection, onchocerciasis, filariasis and schistosomiasis, and their use in clinical practice. Geographical spread and emergence of drug resistant parasites have hindered the control of malaria, the most important global parasitic infection. Artemisinin compounds have proved effective antimalarial agents producing rapid reduction of parasite load and can be used in combination treatment regimens to combat multidrug resistance. Intestinal helminth infections are widespread, giving rise to nutritional deficiencies and impaired childhood cognitive development. Pregnant women in developing countries are at increased risk of morbidity. Treatment with a single dose benzimidazole such as albendazole or mebendazole has beneficial effects on morbidity and rates of transmission. Diethylcarbamazine has been used in the treatment of onchocerciasis and human filariasis. A complicated escalating dose regimen over several weeks is associated with systemic and allergic reactions and may require corticosteroid cover. Simplified regimens for mass population treatment with ivermectin have proved useful and been used in combination with single dose albendazole and diethylcarbamazine. The African Programme for Onchocerciasis Control in West and Central Africa has been one of the most successful mass control programmes virtually eliminating new infections by a combination of chemotherapy, education and vector control. Schistosomiasis is of increasing importance as a result of the creation of new snail habitats by agricultural and economic development. Praziquantel has become the most widely available and effective chemotherapy for schistosomiasis. There have been a number of reports of persistent schistosome egg shedding after treatment posing concerns about the emergence of drug resistance. Eflornithine has been successfully used in patients with human trypanosomiasis failing melarsoprol therapy however expense and availability have limited its potential. Mass control treatment programmes have targeted schoolchildren, adolescents and pregnant women. The integration of schistosomiasis, onchocerciasis, filariasis and helminth control programmes has been considered as a cost-effective method of delivering treatment. It is likely that future control will be based on this optimisation and integration of existing regimens, rather than the development of new agents.

Depression and Ted Hughes's Crow, or through the Looking Glass and What Crow Found There

Two aspects of Ted Hughes's Crow: From Life and Songs of have proved hard to swallow for some critics, namely, book's language and its imagery, or as Roy Fuller puts it, the pathological violence of its language, its ideas, its sadistic imagery (297). Fuller points out three things here, although it might be more accurate to speak of antiliberal humanist ideas, assuming that has any ideas of its own, which is not certain. any case, epithet anti-human seems to reflect here only ideas, or rather ideals, of certain type of criticism. Writing from much same point of view, Geoffrey Thurley finds a somewhat inhuman, even brutal book, with none of broad strength of best of Hughes's earlier poems. It remains to be seen whether Hughes's abandonment of is ultimately justifiable (189). abandonment of human perspective in is really no more than abandonment of transparent language of metaphysical self, language that bears no recognition of its material (linguistic, cultural, unconscious) determinants. If book can be conceived of as reflective surface, then it is cracked one, one that fails to give any return on humanist preconceptions, or rather returns them in distorted fashion, in pieces. For critic anticipating corroboration of certain literary expectations or ideals, seems to allow of only one response: Calvin Bedient's words, is total nihilist, while is the croak of nihilism (101, 114). CARNIVAL Other criteria than human[ist] perspective are clearly needed if is to be read as anything more than nihilistic lack of returns, as book that sadistically refuses to reciprocate any human idea. Calvin Bedient touches on crux of question: In most of these poems Hughes wastes himself. master of language who tosses words on page - can any aesthetic justify this (114)? Given tile plurality of discourses that inform - biblical narratives, myth, cartoon strip, science, psychoanalysis - and bearing in mind slapstick way in which these discourses are thrown together, book might be 'justified after Bakhtin as carnivalesque literature. What Bakhtin calls the direct authorial (Dialogic 301) is difficult to locate in Crow, in Bakhtin's words, poet here is speaking language, language that has somehow more or less materialized, become objectivized, that he merely ventriloquates (Dialogic 299). To read words at face value is therefore to miss point. Hughes's seemingly evasive comment that poems wrote themselves(1) is to be taken literally: figure of is as much as anything else device for testing out cultural narratives and meanings that are already there, that have already been written; does not so much produce meaning as reaccentuate it, blackly. relationship to language is thematicized in number of poems: Crow's First Lesson, A Disaster, The Battle of Osfrontalis, Crow Goes Hunting. What these poems materialize at level of theme is radical otherness of word as experienced by Crow: Words came with Life Insurance policies - feigned dead. Words came with warrants to conscript him - feigned mad. Words came with blank cheques - He drew Minnie Mice on them. (The Battle of Osfrontalis) - etcetera. Figured as an agent of negativity with regard to ideologically loaded word, only way forward in his quest for self-definition is through kind of discursive loophole. This loophole is dialogical discourse as proposed by Bakhtin and elaborated by Kristeva: In its structures, writing reads another writing, reads itself and constructs itself through process of destructive genesis (Desire 77). Neither cartoon nor Bible story, neither poetry nor prose, improvises its own dialogic space that is littered with fragments of discursive collisions, collisions that concretize and relativize mish-mash of scripture and physics in and through which is, in Hughes's words, intermittently conscious (Reply 111). …

Arteriography of renal transplants.

Arteriograms were reviewed in 60 cases of renal transplant dysfunction and correlated with the final diagnosis. Angiographic refinements included selective injections, 2-4X direct magnification, and flow-dependent injection rates. Angiography permitted recognition of common causes of post-transplantation dysfunction, including acute vasomotor nephropathy (AVN), acute refection (AR), chronic rejection, and obstruction of the ureter, renal artery, or renal vein. In 28 patients with AVN or AR who had technically adequate cortical microangiograms, classification was correct in 57%, indeterminate in 36%, and erroneous in 7%. In addition to its diagnostic value, angiography provides some prognostic information in AR, permitting prediction of functional return when the pattern suggests AVN and lack of return when cortical necrosis is indicated.

REARRANGEMENT STUDIES WITH 14C: XIX. THE REACTION OF 2-PHENYL-1-14C-ETHANOL WITH THIONYL CHLORIDE

The reaction of 2-phenyl-1-14C-ethanol with thionyl chloride in pyridine, dioxane, toluene, or excess thionyl chloride as solvent gave 2-phenylethyl chloride showing, respectively, about 0, 15, 44, and 48% rearrangement of the 14C-label from the C-1 to the C-2 positions. When reactions of 2-phenyl-1-14C-ethauol or 2-p-anisyl-1-14C-ethanol with thionyl chloride in dioxane or excess thionyl chloride were carried only to partial completion and the undecomposed chlorosulphites hydrolyzed by aqueous sodium hydroxide, the recovered alcohols showed only 0.1 to 0.5% isotope position rearrangement. This indicated a lack of return from ion-pairs to isotopically rearranged 2-arylethylchlorosulphite and suggested that the first stage of ionization may involve ion-pairs with structures that will not result in rearrangement on return to covalent bonding, or that the first ion-pair may decompose faster than it can return to reactant. The possibility that rearrangements via rigidly oriented ion-pairs and via the concerted SNi′ mechanism may represent the two extremes of a graded series is discussed. It is suggested that the relative contributions from the ion-pair and from the SNi′ mechanisms will depend on the stability of the carbonium ion as well as on the nature of the reaction solvent.

Traumatic tendovaginitis of the fifth dorsal compartment of the wrist

Disability of the hand and wrist occurs quite frequently after injury to the wrist. Although several causes have been listed in the literature, lack of return to normal function because of tendovaginitis involving the fifth dorsal compartment of the wrist has not been generally recognized and rarely has been reported in the literature. During the past 11 years, tendovaginitis involving the fifth dorsal compartment of the wrist, through which courses the extensor digiti quinti proprius tendon, has been diagnosed as a complication of approximately 5% of fractures and injuries in the wrist joint in adults. It has never been found in children or young adults up to the second decade of life. Perhaps, the commonest precipitating cause has been a simple Colles fracture. The entity apparently causes little or no problem as long as the wrist remains immobilized in plaster. Symptoms and signs pointing to the presence of this condition