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.     

Constitutionalism and federalism in the ‘future of Europe’ debate: the German dimension

This paper examines some of the constitutional aspects of the ‘Future of Europe’ reform process in the light of interactions between German and ‘European’ federalism. Many aspects of the traditions of German federalism and German post-war constitutionalism have been influential, if not to say formative, for the evolution of the EU. These aspects are set out as a frame for the paper, before more detailed analysis of the constitutional process and a particular focus on the division of competences. The constitutional outcome reveals clear German ‘fingerprints’, though that finding needs to be balanced by a recognition of the constitutional debate as multi-perspectival, involving all member states both separately and collectively.     

Globalization and institutional competitiveness

Only dead institutions do not change and only rarely do institutions change by themselves. To maintain performing institutions takes institutional entrepreneurs who are willing to take risks and who possess the capacity and the talent to innovate. A regulation discourse, in contrast to a marketization discourse, would not picture the relationship between globalization and institutional change as a deterministic one. Rather, it would expect that all kinds of actors play a large number of different roles in the course of ongoing institutional change. The result of such complex institutional change, at the level of welfare states, multinational businesses, public administration, and training systems, to mention just a few of the empirical areas covered in this special issue, cannot be fully understood by applying an overly rigid, static, and dualistic approach to modern capitalist economies. The concept of institutional competitiveness, on the contrary, allows for institutional entrepreneurship and institutional hybrids constituting pulsating polities.