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Public Value Accounting: Establishing the Philosophical Basis
Questions of how best to define the ends, justify the means, and measure the performance of governments have preoccupied political economists for centuries. Recently, the concept of public value—defined in terms of the many dimensions of value that a democratic public might want to see produced by and reflected in the performance of government—has been proposed as an alternative approach. This article develops three philosophical claims central to the practice of public value accounting: (1) when the collectively owned assets of government are being deployed, the appropriate arbiter of public value is the collectively defined values of a \"public\" called into existence and made articulate through the quite imperfect processes of democratic governance; (2) the collectively owned assets include not only government money but also the authority of the state; (3) the normative framework for assessing the value of government production relies on both utilitarian and deontological philosophical frameworks.
Journal Article
Animation
With an introduction by John Lasseter-- and very little else in the way of words-- this second book in The Artist Series lavishly showcases the most brilliant animation created by such luminaries as Ub Iwerks, Norm Ferguson, Ben Sharpsteen, Hamilton Luske, Dick Huemer, Grim Natwick, Art Babbitt, Fred Moore, Bill Tytla, Frank Thomas, Ollie Johnston, Milt Kahl, Marc Davis, John Lounsbery, Ward Kimball, Eric Larson, Les Clark, Wolfgang Reitherman, John Sibley, Bill Justice, Clyde Geronimi, Ted Berman, Glen Keane, Andreas Deja, Eric Goldberg, Mark Henn and Tony Bancroft. The artwork-- much of which has never before been published-- offers the opportunity to marvel at the those magical lines of pencil that brought life to so many unforgettable Disney characters. Animation represents a rare opportunity to enjoy a glimpse into the truly spectacular trove of treasures from the Walt Disney Animation Research Library.
Book
Patterns and characteristics of maxillofacial fractures in women
Purpose
Facial trauma in women is complex with physical, psychosocial, and cultural influences impacting clinical presentations. Although multifactorial, assaults and falls are principally reported as the main causes.
Methods
A retrospective review was conducted from January 2012 to January 2017 at the Women and Children’s Hospital and Royal Adelaide Hospital, Adelaide. All maxillofacial fractures in women that attended or were referred to the unit were included in this study. The primary objective was to analyse epidemiological trends of facial fractures and clinical outcomes in the South Australian female population.
Results
There is a bimodal distribution of facial fractures at 25–35 years and 65 + years. Indigenous females were 19.5 years younger than non-indigenous females (30.5 vs 49.9,
P
< 0.001). Approximately half the cohort had a fall-related facial fracture, followed by assault (26.2%), and sports (10.3%). There was a higher proportion of non-alcohol-related trauma from assaults than alcohol-related assaults (72.5% vs 27.5%,
P
< 0.001). Over half (58.0%) of the cohort had a midface fracture. The elderly had increased odds of 1.9 fold for facial fractures in winter, largely from falls, compared to younger women. Associated injuries were present in almost half the elderly women with 2.6 times the risk compared to younger women. Younger women had higher incidences of surgical intervention (52.6% vs 14.3%,
P
< 0.05).
Conclusions
Young women disproportionately experience larger incidences of non-alcohol-related assaults requiring operative intervention of the mandible, whereas elderly women principally suffer fall-related facial fractures with higher rates of associated injuries.
Journal Article
Secondary metopic craniosynostosis after posterior cranial decompression in cloverleaf skull deformity
Cloverleaf skull deformity or Kleeblattschadel syndrome is a severe condition where multiple cranial sutures are absent and prematurely fused, leading to a trilobate head shape. The remaining open sutures or fontanelles compensate for rapid brain expansion, while the constricted fused calvarium restricts brain growth and results in increased intracranial pressure. Recent data show that early posterior cranial and foramen magnum decompression positively affects infants with cloverleaf skulls. However, long-term sequelae are still rarely discussed. We hereby report a child who developed secondary metopic craniosynostosis after posterior cranial decompression, which required a front-orbital advancement and cranial remodelling as a definitive procedure.
Journal Article
Multisuture craniosynostosis: a case report of unusual presentation of chromosome 14q32 deletion
Multisuture craniosynostosis is associated with a number of syndromes and underlying gene mutations. It is rarely caused by chromosome disorders. For the management, multisuture craniosynostosis raises concerns about abnormal head shape and risks of increased intracranial pressure in affected patients. Calvarial reconstruction to reshape the skull shape and expand the intracranial volume plays an essential role in correcting particular problems. Here, we report a 2-month-old female infant presenting with low birth weight, abnormal head shape, dysmorphic facies and pinnae, hypotonia, and feeding difficulty. Three-dimensional computed tomographic scans revealed left unicoronal and sagittal synostoses. Chromosome microarray analysis revealed de novo chromosome 14q32.12–q32.31 deletion. Among the deleted genes,
YY1
and
BCL11B
are the most likely candidate genes causing craniosynostosis. Some clinical features of the patient are similar to Temple syndrome indicating that the deleted region is paternal in origin. In summary, this is a rare case of chromosome 14q32 deletion with multisuture craniosynostosis. We also report the multidisciplinary management and clinical outcomes after early cranial vault remodelling procedures.
Journal Article
Re-imagining early cloverleaf skull deformity management from front to back approach—30 years on
The cloverleaf skull deformity remains among the most complicated craniofacial conditions to successfully manage. Many cases achieve largely unsatisfactory outcomes due to the requirement for frequent reoperation on the cranial vault and failure to deal with all the elements of the craniofaciostenosis in a timely fashion. Early cranial vault surgery without addressing the cranial base deformity and its attendant cerebrospinal fluid flow changes is invariably challenging and disappointing. A recent focus on the expansion of the posterior cranial vault as a primary procedure with the greater volume change allows a delay in fronto-orbital advancement and reduced need for repeat surgery. We herein describe three cases of complex multisuture craniosynostosis with cloverleaf skull deformity who underwent neonatal posterior cranial vault decompression along with foramen magnum decompression. Our report examines the safety and rationale for this pre-emptive surgical approach to simultaneously deal with the cranial vault and craniocervical junction abnormalities and thus change the early trajectory of these complex cases.
Journal Article
Multi-suture craniosynostosis in c.1570C>T (p.Arg524Trp) mutated TRAF7: a case report
Craniosynostosis is a condition of premature fusion of the cranial sutures. Multi-suture craniosynostosis has been found to be associated with a number of syndromes and underlying gene mutations. Tumour necrosis factor receptor-associated factors (TRAFs) are a family of adaptor proteins interacting with cell surface receptors or other signalling molecules. TRAF7 is one of the factors involved in multiple biologic processes, including ubiquitination, myogenesis and toll-like receptor signalling. Here, we report a child who presented with multi-suture craniosynostosis and had the uncommon c.1570C>T (p.Arg524Trp) variant of
TRAF7
.
Journal Article
Facial fractures in the elderly: epidemiology, clinical characteristics, and management
Background
With an ageing population, the elderly will increasingly represent a growing subgroup of trauma. A high-risk group with multiple comorbidities, decreased physiological reserves and frailty, this contributes to the complexity of management in facial trauma. Falls represent the most common presentation for facial-related injuries, but there are variations amongst gender that is important to aid diagnosis, management, and treatment plans. Our aim is to identify epidemiological trends of facial fractures in the elderly, understand differences amongst gender and elderly age groups, and the impact this has on clinical outcomes and management.
Methods
A retrospective review was conducted from January 2012 to January 2017 at the Royal Adelaide Hospital, Adelaide. All facial fractures of the elderly, 65 years and above, that attended or were referred to the unit were included in this study.
Results
Three hundred fifty-five elderly patients presented with a facial fracture with falls (82.5%) as the most common mechanism of injury. The orbitozygomatic fracture was the most common type of facial fracture with 48.7% of the cohort sustaining an associated injury. There were differences between men and women for age, age groups, socioeconomic status, season, alcohol, mechanism of injury, and facial fractures (p<0.05). The 75–85 and 85+ age groups were 2.4 and 15.1 times more likely to have a fall-related facial fracture than the 65–75 age group, and less likely to have surgery (p<0.05). Associated injuries were independently associated with increased length of stay (p<0.001).
Conclusions
Geriatric men and women have differences in facial fractures and aetiologies, but an overall non operative approach was favoured on a balanced approach of comorbidities, function, and quality of life. Elderly patients are complex with associated injuries and comorbidities, and they often require interdisciplinary care across fields of medicine and surgery to minimize their length of stay and yield good outcomes.
Level of evidence: Level III, therapeutic; diagnostic; risk/prognostic study.
Journal Article