Reconciling social enterprise: beyond the paradox perspective

PurposeThe paper aims to critically review the increasingly taken-for-granted view of social enterprise (SE) as inherently paradoxical and tackles the research question as follows: are the tensions experienced by SE and social entrepreneurs (SEnt) actually paradoxical and if not, what are the implications for theory and practice?Design/methodology/approachA paradox theory (PT) approach has been utilized to explore the implications, validity and helpfulness of the paradox perspective in understanding and managing the tensions that are inherent in SE.FindingsConceptualizing the primary tension of doing social good through commercial activity as a paradox is argued to be a limiting misnomer that conspires to reify and perpetuate the tensions that SE and SEnt have to manage. Drawing upon PT, the findings of the paper reconceptualize these tensions as myths, dilemmas and dialectics, which are subsequently used to develop a more complete ontological framework of the challenges that arise in SE and for SEnt.Practical implicationsReconceptualizing the “inherent paradoxes” of SE as either dilemmas or dialectics affords a means of pursuing their successful resolution. Consequently, this view alleviates much of the pressure that SE managers and SEnt may feel in needing to pursue commercial goals alongside social goals.Originality/valueThe work presents new theoretical insights to challenge the dominant view of SE as inherently paradoxical.

The Gatekeeper’s Dilemma: “When Should I Transfer This Customer?”

When Should I Transfer This Customer? “Please hold while I transfer you to next level of support.” Most of us have been on the receiving end of this message. In this study, the authors look at transfers from the service worker’s perspective. They create an online experiment in which participants play the role of call center agents who need to decide whether to transfer a virtual service request or continue attempting to resolve it. Consistent with compensation schemes common in call centers, participants receive a bonus for each successful resolution and may pay a penalty if they transfer. The authors find that these incentives generally work well; however, agents appear to overreact to transfer penalties by handling more requests than they should and transferring too few requests. Although this may be good news for customers who dislike being transferred, such behaviors may be costly for the call center; thus, managers need to be careful when rolling out complex compensation schemes.

Quadruple Term Gestation of Quadri-Chorionic Quadri-Amniotic Pregnancy After Artificial Insemination: A Case Report

Background: To solve infertility, modern science has promoted assisted reproduction techniques such as in vitro fertilization, ovulation induction, and artificial insemination. Quadruple-type multiple pregnancies occur in 1 of every 500,000 pregnancies, and it is estimated that 90% occur due to assisted reproductive techniques, which often lead to numerous complications. Case presentation: Here we present a case of a 33-year-old woman, who desired pregnancy, but had a history of primary infertility diagnosed by hysterosalpingography, and endometriosis, which was treated by fulguration and medical management. Concomitantly, the patient was anovulatory. To fulfill her wish, she underwent homologous artificial insemination, after treatment, she successfully conceived quadri-chorionic quadri-amniotic infants, who were born at 37.2 weeks, without perinatal or maternal complications.Conclusion: This paper presented the parameters of prenatal care, appropriate management approach, and successful resolution without maternal-fetal complications despite the inherent risks of this type of pregnancy.

Successful non-surgical treatment of pseudomonas choroidal abscess in cystic fibrosis with previous double lung transplantation

Pseudomonas aeruginosa choroidal abscess is a rare condition which tends to affect patients with cystic fibrosis (CF) who have undergone double lung transplantation. Various surgical treatment strategies have been described but almost universally have had a dismal prognosis. We present a case of pseudomonas choroidal abscess in a CF patient with previous double lung transplantation who was managed with medical treatment, with intravitreal and systemic antibiotics, without surgical intervention, which led to successful resolution of the choroidal abscess, preservation of the eye and retention of vision.

A case report of Aceclofenac induced Drug induced Hypersensitivity syndrome

<p>Drug-induced hypersensitivity syndrome (DIHS) is an unusual, potentially life-threatening, multi-organ adverse drug reaction. DIHS usually develops 2-6 weeks after drug initiation. We report a case of 21 years old female with maculopapular rash associated with fever and generalised lymphadenopathy, 15 days after intake of aceclofenac. Treatment with intravenous corticosteroids, antibiotics and fluids along with cessation of the offending drug resulted in successful resolution.</p>

O-EGS08 Endoluminal Vacuum Therapy (EVT) for leaks in the upper gastrointestinal (UGI) tract; 10-years’ experience in a specialist Oesphagogastric centre

Background Endoluminal vacuum therapy (EVT) is an emerging treatment strategy for UGI leaks. When compared to traditional treatments strategies EVT is reported to reduce morbidity and mortality, especially in patients with delayed presentation and established sepsis. We report the outcomes for patients with UGI leaks and perforations treated with EVT using an ad-hoc endoluminal vacuum device (EVD) in a tertiary UK hospital over a 10-year period. Methods Sixty-seven patients with UGI leaks from disparate causes were treated with EVT between April 2011 and July 2021. The ad-hoc EVD was constructed using a piece of open cell foam sutured around the distal end of a nasogastric tube, and placed endoscopically either through the perforation and into the extra-luminal leak cavity OR intraluminally depending on the morphology of the leak cavity. Continuous negative pressure (125mmHg) was applied. Endoscopic re-evaluation of the leak cavity with change of EVD was performed every 48-120 hours depending on the patients clinical condition. Information related to treatment and outcome was recorded prospectively. Results Patients had a median age of 66 years (range 23-92), and median Apache II score of 21 (range 4-36) at presentation. Fifty-two leaks were oesophageal (78%), 12 gastric (18%), 2 duodenal (3%), and 1 pharangeal (1%). The leak cause was anastomotic in 26 (39%), iatrogenic in 20 (30%), spontaneous in 19 (28%), and traumatic in 2 (3%). The median number of EVD changes required to heal the leak was 6 (range 1-27), and median length of hospital stay was 42 days (range 1-182). Successful resolution of the leak was achieved in 59 patients (88%). Eight (12%) patients died during treatment. There were no complications related to insertion of the EVD. Conclusions EVT is an effective treatment for UGI leaks which can be delivered safely in a tertiary oesophagogastric centre, and used to treat a wide range of leak causes in critically unwell patients. Further studies are required to develop a standardized procedure to improve the ease with which EVT can be delivered. This will enable broader adoption of EVT for this group of patients.

A Brunn’s cyst as a cause of bladder outlet obstruction: a case report

A Brunn’s cyst in the proximity of the bladder neck is a rare cause of bladder outlet obstruction. This case study concerns a 45-year-old male presenting with bladder outlet obstruction secondary to a Brunn’s cyst. A provisional diagnosis of Brunn’s cyst was based on ultrasonography, CT scan and cystoscopic examination which indicated a cystic lesion at the bladder neck. Transurethral resection of the cyst was performed with successful resolution of the obstructive voiding symptoms. The final diagnosis of this case based on the pathology is a Brunn’s cyst.