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Recently, the ethical rather than just the economic resonance of entrepreneurship has attracted attention with researchers highlighting entrepreneurship and ethics as interwoven processes of value creation and management. Recognising that traditional normative perspectives on ethics are limited in application in entrepreneurial contexts, this stream of research has theorised entrepreneurship and ethics as the pragmatic production of useful effects through the alignment of public—private values. In this article, we critique this view and use Kant's concept of reflective judgement as discussed in his Critique of the Power of Judgement to theorise ethical entrepreneurial practice as the capacity to routinely break free from current conventions through the imaginative creation and use of self-legislating maxims. Through an analysis of the narratives of 12 entrepreneurs, we suggest there are three dimensions to reflective judgement in entrepreneurial contexts: (1) Social Performance; (2) Public Challenge and; (3) Personal Autonomy. Whilst the entrepreneurs were alive to the importance of commercial return, their narratives demonstrated further concern for, and commitment to, standards that they rationally and imaginatively felt as being appropriate. In our discussion, we integrate the findings into existing theoretical categories from entrepreneurship studies to better appreciate ethics within the context of value creation.

Background and objective Patients presenting with interstitial lung disease (ILD) are getting older. In the older people, although idiopathic pulmonary fibrosis (IPF) is the most common ILD, the rate of unclassifiable ILD remains high after multidisciplinary discussion (MDD). One explicative factor could be the less frequent use of surgical lung biopsy (SLB) in this population because of its associated risks. Transbronchial lung cryobiopsy (TBLC) is a particularly interesting alternative to SLB in the diagnostic approach of ILD in older people subjects. Our objective was to assess the safety and diagnostic yield of TBLC in older people, as compared to younger patients. Methods We conducted a retrospective observational study in patients with ILD who underwent TBLC from 2015 to 2023. Individuals were defined as “older people” if they were older than or equal to 75 years. Results Out of 110 patients, 26 were classified as older people, with a median age of 78 years (IQR 76–79). In the whole cohort, the most represented HRCT pattern was \"indeterminate\" (27%). The rate of severe TBLC complications was 8% in the older people and 12% in the non-older people ( p  = 0.73). The diagnostic yield of TLBC was 85% in the older people and 79% in the non-older people (p = 0.50). In the older people group, the most common diagnoses after MDD were fibrotic hypersensitivity pneumonitis (31%) and IPF (31%). Conclusion In ILD workup, the benefit/risk ratio of TBLC seems to be favorable in the older people, encouraging it to be proposed first in selected patients when clinical features are not appropriate for IPF.

This study investigated the clinical features and disease course of sarcoidosis diagnosed in patients > 70 years of age. A retrospective analysis was made of cases treated at the University Hospital in Nantes, France, between 1986 and 2000. The diagnosis of sarcoidosis was confirmed histopathologically. Cases involving progressive cancer and active tuberculosis were excluded. Thirty white patients with sarcoidosis diagnosed after age 70 years (mean, 74 years) were included. An alteration of general health (asthenia and/or anorexia and/or weight loss) was frequent (53%) and characteristic of the systemic form of the disease. Dyspnea was a fairly common sign (23%). The intrathoracic form of sarcoidosis was most frequent (43.3%). Diagnosis was difficult and lengthy, and symptomatology was atypical. Accessory salivary gland biopsy was an important contributing factor to diagnosis (70.6% were positive). Oral corticosteroid therapy was often required (60.7%). The disease course was satisfactory overall (81.8% of cases), but only for 50% of patients in intrathoracic stage IV. The clinical presentation of sarcoidosis in elderly subjects is mainly characterized by an alteration of general health. Diagnosis is difficult and should include accessory salivary gland biopsy. Therapy frequently involves corticosteroids. Overall prognosis is similar to that for young subjects.

AbstractObjectivesTo determine whether patient reported outcomes improve after single stage versus two stage revision surgery for prosthetic joint infection of the hip, and to determine the cost effectiveness of these procedures.DesignPragmatic, parallel group, open label, randomised controlled trial.SettingHigh volume tertiary referral centres or orthopaedic units in the UK (n=12) and in Sweden (n=3), recruiting from 1 March 2015 to 19 December 2018.Participants140 adults (aged ≥18 years) with a prosthetic joint infection of the hip who required revision (65 randomly assigned to single stage and 75 to two stage revision).InterventionsA computer generated 1:1 randomisation list stratified by hospital was used to allocate participants with prosthetic joint infection of the hip to a single stage or a two stage revision procedure.Main outcome measuresThe primary intention-to-treat outcome was pain, stiffness, and functional limitations 18 months after randomisation, measured by the Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) score. Secondary outcomes included surgical complications and joint infection. The economic evaluation (only assessed in UK participants) compared quality adjusted life years and costs between the randomised groups.ResultsThe mean age of participants was 71 years (standard deviation 9) and 51 (36%) were women. WOMAC scores did not differ between groups at 18 months (mean difference 0.13 (95% confidence interval −8.20 to 8.46), P=0.98); however, the single stage procedure was better at three months (11.53 (3.89 to 19.17), P=0.003), but not from six months onwards. Intraoperative events occurred in five (8%) participants in the single stage group and 20 (27%) in the two stage group (P=0.01). At 18 months, nine (14%) participants in the single stage group and eight (11%) in the two stage group had at least one marker of possible ongoing infection (P=0.62). From the perspective of healthcare providers and personal social services, single stage revision was cost effective with an incremental net monetary benefit of £11 167 (95% confidence interval £638 to £21 696) at a £20 000 per quality adjusted life years threshold (£1.0; $1.1; €1.4).ConclusionsAt 18 months, single stage revision compared with two stage revision for prosthetic joint infection of the hip showed no superiority by patient reported outcome. Single stage revision had a better outcome at three months, fewer intraoperative complications, and was cost effective. Patients prefer early restoration of function, therefore, when deciding treatment, surgeons should consider patient preferences and the cost effectiveness of single stage surgery.Trial registrationISRCTN registry ISRCTN10956306.

The mother-daughter bond is a complex, diverse, lifelong, intimate connection that significantly affects development. While studies of intergenerational relations during old age have increased, as have those examining the mother-daughter relationship during adolescence, particularly those among Black and Latina pairs, only a few have examined adult mother-daughter relationships among African Americans. Only a few studies have examined the influence Black mothers have on their daughters' development. Using Black feminist thought as a theoret alical model, this article reports findings from a qualitative study that explored Black adult daughters' perceptions of the impact their mothers had on the development of their self-worth/self-esteem, resilience, and coping strategies. Seventeen Black mothers and daughters described the lessons they learned and the forms in which these lessons were conveyed from their mothers. Implications of the findings for future research are drawn.

According to the SSC approach to entrepreneurship (Mitchell et al., 2011, 2014a), entrepreneurial cognition consists of four themes: action-oriented, embodied, situated and distributed. [...]the distributed theme contends that cognition is spread across various social actors and tools in the natural world (see Smith and Semin, 2004). [...]in an agent-based simulation, that modeled the interactive probabilities among internal cognition and external situations like exchange formation, a greater percentage of variance was explained by external-based social situations than internal-based cognitions (Mitchell et al., 2014b, 2012). Overall, research and theory in this vein demonstrates that, “cognitive activity routinely exploits structure in the natural and social environment” (Robbins and Aydede, 2009, p. 3). [...]entrepreneurial cognition and action in social situations connects the person within a situation with their thinking and motivation (Fiske and Taylor, 1984).