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.     

Wasserrechtlicher Eigentümergebrauch und Rohstoffgewinnung

Mit der Einführung einer Entgeltpflicht für die Entnahme von Wasser in Nordrhein-Westfalen ist der erlaubnisfreie wasserrechtliche Eigentümergebrauch in den Mittelpunkt des Interesses gerückt. Denn wer Wasser im Rahmen des Eigentümergebrauchs aus einem oberirdischen Gewässer entnimmt, ist von dieser Entgeltpflicht befreit. Der folgende Beitrag erläutert die im Zusammenhang mit der Gewinnung nichtenergetischer Rohstoffe insoweit relevanten Fragen. * Die Verfasser sind, Mitarbeiter der Anders u.Thomé Rechtsanwaltsgesellschaft mbH in Krefeld     

The Contested Council: Conflict Dimensions of an Intergovernmental EU Institution

Recent research has tried to uncover the political space in which the Council of Ministers of the European Union decides. Rather than the left-right conflict or a cleavage between governments with national and supranational attitudes, this article shows that a redistributive dimension, decisively shapes the interactions in this most important legislative body of the European Union. In contrast to extant studies, we employ ex ante rather than ex post preference data and rely on correspondence analysis as a means to identify the underlying dimensions of contestation. The article concludes with an empirical investigation of how enlargement will affect the emerging political space within the European Union. Our quantitative analysis suggests that the gulf between net-contributors and net-receivers will further deepen.     

Postretrenchment Politics: Policy Feedback in Chile's Health and Pension Reforms

Through a comparison of three periods of health and pension reform in Chile, this article develops an explanation for the incremental form of social policy change that some Latin American nations have witnessed in recent years, despite the dramatic rise of left governments. It describes “postretrenchment politics,” which constitutes a realignment in the way politics plays out in countries that have undergone social policy retrenchment. In postretrenchment politics, the strengthened position of private business interests, combined with political learning legacies and lock‐in effects generated by reforms, results in incremental political change, despite renewed efforts by left parties to address inequality. Global capital also plays an important contextual role, and may influence postretrenchment politics. In postretrenchment politics, newly reformed systems may achieve greater equity, but they do so in fragmented form.     

The Responsible Migrant,Reading the Global Compact on Migration

Law and Critique - In 2016, the international community, in reaction to the growing number of ‘tragedies’ occurring as people attempted to move across borders, met to discuss large...     

Government Communication Effectiveness and Satisfaction with Police Performance: A Large‐Scale Survey Study

For the last two decades, performance management theories and practices have focused on outcome‐oriented management but have paid little attention to the role of public communication. Using multiple large data sets from Kansas City, Missouri, for 2009–14, this research suggests that the perceived effectiveness of public communication has a more substantial impact on public satisfaction with police protection and crime prevention than neighborhood crime rates and broken windows factors and that perceived effectiveness moderates the negative impact of crime rates. After controlling for residents’ demographic characteristics, the authors find that the perceived effectiveness of communication is associated with public satisfaction with the content and quality of the city website and the government television channel. The implications for public safety management and police–citizen relations as well as directions for future research on public communication strategies and public performance management are presented.     

Germany’s Renewable Energy Shift: Addressing Climate Change

This essay considers how the state can be used successfully to initiate and support an energy shift from nuclear energy to renewable energy, as demonstrated by Germany’s Renewable Energy Act from 2000 and its previous Electricity Feed-in-Law (1991). As a result of these nationwide policies, Germany has reduced levels of greenhouse gas emissions, has a higher level of both energy security and employment in the renewable energy industry than the US. Germany is a global leader in this industry and provides a model for other nations in this regard.     

The Future of Leadership in Public Universities: Is Shared Leadership the Answer?

Leadership of public universities has come under fire—from scandals, from funding, from students, from every direction. Top‐down leadership of institutions of higher education has been described as a “disease.” Shared governance—a mechanism of faculty representation in the leadership and decision‐making processes—a seeming alternative, has been described as “a recipe for paralysis.” In this article, the authors proffer shared leadership as a potential elixir for leading public institutions of higher learning, unleashing creative potential, focusing on pressing strategic imperatives, and enabling sustainable systems that leverage true talent to maximum effect. It is time to move beyond the moribund myth of top‐down heroic leadership and beyond the bureaucratic, political quagmire of the current state of affairs in shared governance. Is shared leadership the answer?