Lethal small bowel obstruction due to pica

Up to 25% of institutionalized patients with cognitive deficiencies display pica-like behavior, with an estimated annual incidence of small bowel obstruction of 2%. We present a case based on the forensic autopsy of a 41-year-old woman who died as a result of a missed diagnosis of small bowel obstruction after ingesting a foreign body. The case underlines the importance of precaution when treating patients with cognitive deficiency and/or language deficits and gastrointestinal symptoms. In such cases, it is important to employ a liberal threshold for radiological investigations and, if possible, obtain a medical history from a person close to the patient.     

Eating Problems and the Self-Concept: Results Based on a Representative Sample of Norwegian Adolescent Girls

The joint role of self-esteem and unstable self-perceptions for eating problems was investigated in a representative Norwegian population sample of girls in 3 age groups (N = 5287; aged 12–19 years). Three scales from the 12-item Eating Attitudes Test (EAT-12) measured eating problems: Restriction, Bulimia-food preoccupation, and Diet. Girls low on all EAT scales were most often characterized by high self-esteem combined with stable self-perceptions, whereas girls high on all EAT-scales were characterized by having low self-esteem and unstable self-perceptions. Bulimic tendencies and dieting were more common in older groups, whereas high scores on all EAT-scales simultaneously were equally common in all ages. The findings gave initial support to the continuity hypothesis in indicating that the age trends for eating problems, except for restrictive tendencies, followed those of eating disorders and in that the risk factors found for eating problems parallel those reported for eating disorders.     

Social Capital in Denmark: A Deviant Case?

If social capital is important for democratic governance, then it is important how social capital develops. In this article the development of social capital in Denmark is studied on four dimensions: civic norms, social trust, civic involvement and social networks. In contrast to Robert Putnam's findings for the US, no evidence is found of a general weakening of social capital in Denmark. The findings are surprising, because Denmark faces some of the same tendencies that according to Putnam lie behind the decline of social capital in the US. The last section therefore discusses various institutional aspects that may help explain the difference. It is argued that the welfare state facilitates the production of social capital, partly by supporting civil society infrastructure, partly by the very structure of its institutions.     

Negotiating normative premises in democracy promotion: Venezuela and the Inter-American Democratic Charter

ABSTRACT

This article analyses negotiations on democracy promotion by looking at the case of the Inter-American Democratic Charter. It argues that Venezuela contested the concept of representative democracy during the Charter negotiations, advancing the notion of “participatory and protagonist democracy” and that, even if it was unsuccessful in its demands, the country contributed to deepening the debate on the concept of democracy, on which there is far from worldwide consensus. The article suggests that the main drivers of the negotiation process and the final agreement were domestic political changes in Venezuela, specific features of the negotiations, and the structural position of Venezuela in the field of democracy promotion in the global and regional contexts, which were, at the time, favourable to a compromising attitude to conclusion of the Charter, even if not to the concept of democracy.