were fully informed of the likelihood of associated abnormalities, were most anxious to have the child's life preserved. The meningocele was therefore excised without anaesthesia when the baby was 5 hours old; no neural elements were observed in the wall of the sac, but the gap was so large that skin-flaps extending on to the buttocks and up over the shoulders had to be utilized to cover it. A cerebrospinal fistula appeared at the junction of the flaps, but dried up in a fortnight, when the child was discharged in perfect health. Four months later it began to show signs of hydrocephalus; the circumference of the head increased from 18% in. at the age of 7 months to 192 in. at 13 months and 202 in. at 16 months, the corresponding average measurements in normal girl children being 17 in., 172 in., and 18 in, with a variation of ha!f an inch either way (Tredgold, 1937). The child appeared listless and took no interest in its surroundings. It was then sent by its doctor to a neurological hospital whence it returned with an offer to cauterize its choroid plexuses ; this was refused.In the meantime I had been informed (Jefferson) of the existence of the Arnold-Chiari malformation ; I thereupon performed a cerebello-medullary decompression and found a perfect example of the condition (Fig. 421). The bone, being soft, was very easy to remove, and on opening the dura the herniated cerebellum and flattened medulla were seen to extend on the posterior surface of the cord as far downwards as the posterior arch of the third cervical vertebra, which was included in the decompression. No exudate or adhesions were seen in the subarachnoid space ; it was not, of course, possible to ascertain the condition of the cerebral gyri, but there was no radiological evidence of craniolacuna. Suture of the upper part of the wound in layers was difficult on account of the absence of layers and cerebrospinal fistula appeared here. The child became drowsy and irritable a week after operation and its condition gave rise to considerable anxiety, but the fistula closed spontaneously and the child was again discharged.The head measurements have reverted to a normal rate of increase, and the parents are delighted. They say that the child at 6 months after operation is much brighter and more interested in its surroundings and is beginning to talk, and clinical observation confirms this favourable impression. It will be some considerable time, however, before it is possible to assess the extent of the cerebral recovery; my only regret is that I was not aware earlier of the existence of the syndrome, so that the development of hydrocephalus could have been arrested or prevented before the brain became distended. The child has in addition a mild degree of congenital dislocation of one hip which hinders its attempts at walking, but which should respond readily to treatment, and slight impairment of circulation in the same leg, which is already improving spontaneously.Comment.-The advice given to many parents in the past has been that in view of the gloo...

purpose: To analyse the connection between the psychological contract, employee engagement and organisational commitment in the context of positive management and to create a theoretical background for future research. methodology/approach: A qualitative narrative literature review.implications for society/further research: The relationship between the psychological contract, employee engagement and organisational commitment forms an important base for further research. The concepts are linked to positive management, which makes it even a more interesting field to study.value of the paper (originality paper): The psychological contract, employee engagement and commitment are frequently researched, independently of each other. But the focus of this paper is to research the relation between the concepts. In particular, the attention is asked for the relationship between the psychological contract and employee engagement. To retain engaged employees in organisations research of organisational commitment is required. limitations of the paper:The research is a qualitative literature review. Studies in different contexts are compared. The relationship between the psychological contract and employee engagement has not been extensively studied, as shown by the current literature. It is advisable to carry out a quantitative literature review in the future if sufficient studies are carried out in this area.keywords: positive management, psychological contract, employee engagement, organisational commitment paper type: Qualitative narrative literature review

In a changing and uncertain environment, the psychological contract becomes more important. This research attempts to explain of the degree of fulfi lment of the psychological contract has an eff ect on solidarity behaviour of employees. Just as the psychological contract, solidarity behaviour is becoming more important. Employees have increasing responsibility for the quality of work and employers expect that employees work together and focus on mutual eff orts to achieve the goals of the organization. A vignette-study, including a questionnaire with descriptions of specifi c situations, is used enabling an systematic and adequate analysis. Results support a positive eff ect between the degree of fulfi lment of the psychological contract and organization solidarity. Theories of social exchange and justice play an important role in the explanation of this relationship. This fi nding shows that the psychological contract may be an important tool for the management of an organization to infl uence behaviour of employees. A fi nding of great value for the management of organizations.

The histology of the uterine turnours was that of Sections from the ovaries showed interstitial hremortypical fibroleiomyomata. There was no evidence of rhage, but no evidence of any ovarian tumour. any sarcomatous change or of any undue degenerative process. Conspicuous features were the intense congestion and engorgement of the intramural uterine vessels and the extensive degree of interstitial hremorrhage.

‘Social return’ (SR) is a term in the Netherlands that summarises all efforts to integrate people with a mental or physical handicap in the labour market. It is an important political topic because government wants not only an inclusive society but also a decrease of expenditures on social benefits; an important topic for employers, because organisations can profile themselves as socially responsible; and a topic for applied research, finding ways and means of realising the concept. The Rotterdam University of Applied Sciences is mainly involved because of the value of SR for applied research and the development of solutions that work. Several projects have been implemented with third parties, all of them involving students, e.g. through BA graduation research. However, the research also shows that there is no large-scale adoption among entrepreneurs yet. Three problems have been identified: (1) the SR policy currently has many negative side effects; (2) entrepreneurs must recognize that the involvement of employees with a SR indication not only costs money but may also contribute to profits; (3) insufficient attention is paid to finding the proper match between possible employees and suitable jobs (possibly with an adapted working environment). However, ‘social return’ is a feasible concept and the problems may be addressed. At the same time the initial efforts on realising ‘social return’ point at the importance of organisational culture. The main aim of this paper is to show the link between organisational culture and the successful implementation of social return.