A sudden death with lung embolism after inadvertent infusion of zinc oxide shake lotion

A 74-year old woman in postoperative treatment after a colonic surgery died immediately after perfusion of about 1.5 mL of a white emulsion which was believed to contain 1% propofol via cardiac catheter into the right atrium. It was strongly suspected that a syringe with a zinc oxide shake lotion (consisting of 20% ZnO, 20% talc, 25% glycerol and 35% water) which was intended for external treatment had been mistaken for the propofol syringe. During autopsy, an anatomic cause of death could not be found. In order to exclude an intoxication and to determine the significance of the perfusion fluid in this context, toxicological and histological investigations were performed. Propofol and other drugs applied to the patient were found in therapeutic or sub-therapeutic range. However, in comparison to a control case, the zinc concentrations determined by AAS were about 200 times higher in lung tissue, 10 times higher in heart blood and 3–4 times higher in kidney and liver tissue. No increase was seen in venous blood. Histology showed a strong embolism of the lung tissue with birefingent sharp-edged crystals, which were identified as the talcum, and an amorphous component (ZnO). The same embolism was seen to a medium extent also in the brain sections and to a low extent in heart, liver, pancreas and kidney. Pulmonary embolism by talcum and zinc oxide was established as the cause of death which occurred by syringe swap due to insufficient security precautions in the drug administration. The results are discussed in context of pulmonary microembolism cases frequently described for drug addicts after injection of crashed talcum containing tablets.     

Faire la paix au Mali: les limites de l’acharnement contre-terroriste

RÉSUMÉ

L’intervention internationale au Mali est conduite sur la base d’un cadre conceptuel douteux et d’une grille d’analyse peu rigoureuse, soit la thèse de la menace terroriste. Un dispositif militaire impressionnant a ainsi été mobilisé pour contrer cette menace. Nous soutenons que l’importance et la centralité accordées aux efforts contre-terroristes sapent les efforts de résolution des conflits maliens. Face aux critiques concernant le contre-terrorisme, la réponse a été de redoubler d’efforts, via la création d’une force conjointe du G5 Sahel et une présence militaire étrangère en croissance au Sahel-Sahara. Le Mali se retrouve ainsi au centre des débats sur l’avenir du maintien de la paix et des interventions militaires internationales. Au final, le résultat est une posture de guerre perpétuelle qui est perçue comme nécessaire pour concevoir tout espoir de paix et de réconciliation.     

How Citizens Respond to Outputs,Outcomes, and Costs: A Survey Experiment About an HIV/AIDS Program

Government performance measurement is often faulted for focusing on outputs, while citizens are said to demand more information on outcomes to hold government accountable. To compare the influence of these measures, we randomized 774 participants to receive outcome or output information about a real HIV prevention program, with or without cost information, in a survey experiment. Citizens expressed less support for spending on the program when shown outcomes (infections prevented), rather than outputs (people served). Showing participants the high cost of treating HIV/AIDS boosted support for program spending, but did not make outcome information more persuasive. We interpret these results as partly a reaction to the high per-unit cost of an outcome in an HIV prevention program. But it may reflect a tendency of citizens simply to misinterpret less costly outputs, including serving more people, as if these were outcomes. This bias has implications for performance reporting and accountability.     

Exporting Security: Success and Failure in the Securitization and Desecuritization of Foreign Military Interventions

Alongside humanitarian motives, the pursuit of security is the main justification given by states for their foreign military interventions. This is constructed as an ‘export of security’, part of a strategy to combat material and ideological threats abroad in order to enhance the sending state’s security. Such securitized justifications are highly ambiguous, with the military intervention itself often becoming a source of insecurity. Given the Janus-faced nature of military securitization, what are the conditions for a successful securitization move leading to foreign military intervention? In response to this question, the following article compares separate cases of security exports undertaken by the United States (US), Germany and Japan. It is argued that a stable commitment to a military intervention on the part of a sending state is only possible if the pre-intervention securitization process includes a successful desecuritization move once there are boots on the ground. This argument underlines the fundamental ambiguity of securitization moves, as well as the importance of and conditions for audience acceptance. Furthermore, this article proposes a template for exploring the links between securitization and desecuritization.     

Exploring the Deep Antecedent of Public Service Motivation

Contrarily to most studies of the antecedents of public service motivation (PSM) focusing on the proximal work environment or personal characteristics, we seek to explore plausibly important deep antecedents of PSM that lie in the formative years of a person’s upbringing. Using an online survey of public service professionals that asked detailed background questions, we find that three deep antecedents are associated with lower overall PSM and its constitutive elements: growing up in a religious family, growing up in a family with a conservative point of view, and (surprisingly) being raised by a parent who served in the military.     

Stress and Emotional Reactivity as Explanations for Gender Differences in Adolescents’ Depressive Symptoms

In this longitudinal study, we examined whether certain types of stressful events and how individuals respond to these events would explain gender differences in depressive symptoms among adolescents. We hypothesized that certain stressful events would mediate the relationship between gender and depressive symptoms. We also hypothesized that individual differences in emotional reactivity would impact part of this relationship. Lastly, we examined whether gender differences in early childhood temperament might explain gender differences in emotional reactivity in adolescence. We examined these hypotheses in a sample of 315 adolescents (51% females; 93% Caucasian; 3% African–American; and 1% each Hispanic, Asian–American, and Native American) participating in a longitudinal study of child development since birth. We used multiple regression and constrained nonlinear regression to analyze the data. Results indicated that stressful events significantly mediated gender differences in depression, and that individual differences in emotional reactivity to these stressors significantly moderated the relationship between stress and depression. We also observed significant gender differences in emotional reactivity to these stressors; temperamental differences in withdrawal negativity in infancy were marginally significant in mediating gender differences in emotional reactivity to stress in adolescence.

Experimenting with public sector innovation: Revisiting Gow for the digital era

In 1988, James Iain Gow surveyed public servants across Canada on how they access and utilize research from various sources and how that is linked to policy innovation. He documented this research in his book Learning from Others (1994). Thirty years later, we replicate selected parts of the original survey conducted by Gow, but also add an experimental dimension that tests how subjects respond to public service innovations from around the world. We randomly alter key features of those innovations to examine if public servants reveal patterns in the way they process these innovations and make judgements about their suitability or promise.