Deaths associated with liposuction: case reports and review of the literature

Tumescent liposuction is a common cosmetic procedure that is performed as an outpatient service in physician's offices and is largely believed to be safe. The protuberant areas of the body containing the undesirable fat deposits are injected with normal saline containing lidocaine and epinephrine for pain control and hemostasis, and the waterlogged cells are suctioned out via cannula through a small incision. We recently encountered three cases in which deaths were attributed to this procedure. Two showed fat embolization in the lung and one died from fluid overload. The osmium tetroxide post-fixed lung sections showed fat emboli in the interstitial capillaries and arterioles. We reviewed the recent literature and found that pulmonary thromboemboli, fat embolization, fluid overload, and lidocaine and epinephrine intoxication are found at autopsy in many cases. Forensic pathologists responsible for determining the cause and manner of death should become familiar with the postmortem findings and risks of liposuction therapy and communicate them to their clinical colleagues and communities.     

Coming to Terms with Intramural Differences Over Policy Frameworks: How Policy Researchers Accommodate Rival Claims Among their Peers

Although we readily scrutinize conflicts among political stakeholders, similar attention is seldom paid to how we deal with contestable understandings within our own field of inquiry. Debates over competing scholarly perspectives and contested models are rarely subject to any systematic postmortem or attempts to account for differential survival. Given the indeterminacy of many of our conceptual schemes, empirical data seldom carry the day to a resolution all can accept. Accordingly, there are eventually many different versions of any given dispute, each offering a different path to resolution or equanimity. Disputants retire and conflicts fade, providing a demographic resolution of sorts, but not a scientific or a conceptual one. The work presented here claims that there is much to be gained from systematic scrutiny of our conceptual disputes, especially as a means to access the different perspectives we assume to handle them. We argue that there is an internal logic to the different perspectives on any given dispute. It is not the dispute per se that draws our interest; but rather, how any given dispute generates multiple interpretations and reconstructed versions. We propose and illustrate an approach to analyzing disputes that makes their internal logic more transparent and attends to the pathways that emerge for resolution. We will find, in the process, that there are some reliable routes to conciliation and some fault lines that remain unstable.     

Föderalismus und wohlfahrtsstaatliche Entwicklung. Österreich und die Schweiz im Vergleich

Starting from the stylised fact that federal institutions are held to be inimical to welfare state expansion, this paper examines the ways in which federalism has shaped the dynamics of welfare state development in Switzerland and Austria. A comparison of these different federal polities reveals that the welfare breaking effect attached to federalism crucially depends on the extent of vertical power separation. In both countries economic competition among constituent units did not fuel a race to the bottom in social standards. In Switzerland, the most important reason connected to federalism for why federal social policy was delayed and downsized was policy-preemption by the cantons and their considerable influence on the federal policymaking process. In contrast, the Austrian Länder neither had major social policy competencies nor an effective veto power which allowed them to block the centralisation of public policy. Instead, federalism is subordinate to the partisan arena at the central state level which itself is dominated by political parties quite favourable to welfare state expansion.     

Searching for Symptoms of Political Shirking: Congressional Foreign Travel

Despite the hypothesized propensity for shirking to marklegislative institutions, the evidence is rather equivocal;moreover, most of the research has focused exclusively onlegislator voting, thereby constraining whatevergeneralizations might emerge. The purpose of this paper is tocontribute to the debate over the question of politicalshirking by extending the range of phenomena examined toinclude congressional foreign travel. Our analysis providesevidence that opportunism is a problem in Congress. We findthat last-period problems have arisen in the area of foreigntravel, and that increased scrutiny to the problem on the partof Congress only shifted consumption patterns, i.e.,legislators began taking foreign junkets near, but not at theend of, their legislative careers. Not all foreign travelshould be construed as worthless junketing since there isstrong evidence that some foreign travel is related tomembers' responsibilities on congressional committees.     

Interministerielle Netzwerke: Formale und informelle Koordinationsstrukturen bei der Vorbereitung der deutschen Verhandlungspositionen zur Regierungskonferenz 1996

How do German ministries manage the preparation of national negotiation positions for EU intergovernmental conference? After a survey of the debate on organizational deficits of the interministerial coordination in Germany, we are consulting decision- and organization-theoretic approaches in IR. Drawing on organizational economics we concretise and supplement these older frameworks. We conceive the management of a governmental organization as a specific aggregation of heterogeneous preferences and information. Applying social network analysis we take into account formal as well as informal aspects of coordination channels. The objective of this article is to make visible the complex structures and processes that constitute foreign policy making, and to provide a preliminary assessment of its efficiency.