Pregnancy,Cesarean, and Pheochromocytoma: A Case Report and Literature Review

A 43‐year‐old full‐term pregnant woman (gravida 2, para 1, medical history of gestational diabetes mellitus) developed a sudden and malignant hypertension with hemoptysis, sweat, and tachycardia during a scheduled C‐section. A dead newborn was delivered and was successfully resuscitated. The mother died after resistant cardiac arrest. Autopsy and pathological analyses revealed an acute pulmonary edema and a necrotic and hemorrhagic voluminous tumor of the left adrenal gland, which was a pheochromocytoma. Pheochromocytoma is a rare tumor of the adrenal glands which secretes catecholamines. In pregnant women, its symptoms can mimic gestational hypertension, preeclampsia or eclampsia, and gestational diabetes mellitus. The gestational diabetes mellitus was presumed to be a symptom of the pheochromocytoma, and cardiopulmonary failure the result from the necrosis of the tumor provoked by gravid uterus compression. From a medico‐legal point of view, the tumor could not have been suspected during the pregnancy.     

A political genealogy of political economy

If, at the end of the eighteenth century, political economy became the prevailing representation of economic phenomena, this was due to the fact that, better than other economic or political discourses, it constructed a political framework in which three forces could co-exist. These forces were those that all the authors of this century tried to articulate: the state, capitalism, and those who tried to protect themselves from their power.     

The Word: An Essay on Seeing,Owning, and the Sacred

In the classical period of ancient Greece, Logos had a variety ofmeanings, most or all of which connoted one aspect or another ofHeraclitus's conception of the term, ``the rational governing principleof the universe'. The triadic semiotics of Charles Sanders Peircesuggests that, through the linguistic sign, humans construct structuresof meaning, which form the cognitive Worlds in which humans exist, thesubstantive content of consciousness, and which, as such, provide theexplanation for the Cosmos. The three-term Peircean Sign becomestriadic, however, only in conjunction with Peirce's Ground, whichprovides particular substantive values that form the basis ofconstructing the meaningful World. Thus, it is possible, for example, totrace in the heterogeneity of judicial doctrine in United States law thealternative sets of values that are available; the function ofWorld creation proceeds when the Ground is suffused with a particularvalue set. If Logos is conceptualized in terms of these value sets, thenit can be understood in terms of ``the rational governing principle ofthe World.' In this understanding, the substantive content of theGround becomes equated with the Sacred. This conceptualization alsoprovides an alternative way of understanding the opening of the Gospelof John in the Christian Bible and the concept of the Trinity inChristian doctrine in terms of the creative powers of humans through theSign. The fact of this same creative power also provides a way ofunderstanding the strong limitations in ancient Israel on pronouncingthe Tetragrammaton.     

Governance Structures and Political Processes in a Public System: Lessons from Quebec

Debates about the form and nature of changes in the management of public systems have for some time now been articulated under the theme of governance. All definitions of governance are related to the problems of securing convergence among a diversity of actors and organizations, of redistributing power in an organizational or social field characterized by a high level of heterogeneity and of gaining sufficient legitimacy to act in the name of the collectivity. This paper concentrates on the dynamics involved in the emergence of new governing capabilities in public systems. More precisely we study the implementation of regionalization policies in the health care field (in this case of Canada) conceived as one major attempt to renew the governance structures in a large public system. Our study draws on the comparative analysis of empirical regulation in three health regions as contrasted with three ideal type models of governance in regionalized systems. The first model is inspired by an economic approach to organizational behaviour and focuses on mandate‐giving, execution and control. The second model is based on a political interpretation of behaviours and focuses on negotiation processes between actors. Finally, the third model is based on the theory of deliberation as well as the institutional school of policy analysis and focuses on direct public participation in public affairs. Evidence for this article is primarily derived from interviews with key informants and documentary analysis. Our analysis shows that none of the three models is sufficient in itself to grant regional structures the authority and legitimacy they need to create added value in terms of regulation that could ensure their survival. Regional Boards are thus forced by environmental constraints to conceive and implement original mixes of these models. The two predominant logics in regional action are inspired by the first two models although the last one also has an influence. Overall, our study also suggests that the implementation of new sources of governing authorities in a public system is rather fragile because of dependence on existing institutions. Clearly, the attempt to modify the dynamics of governance in a given system must be conceived as a political exercise and not just as a technical problem consisting of the rational adjustment of policy instruments.     

Industry–University Research Centers: A Multivariate Analysis of Member Retention

Although a growing literature documents the benefits of industry–university research centers, most centers experience a significant amount of turnover among their industrial members. In order to gain a better understanding of this phenomenon, the current study attempts to identify factors that predict member renewal (DV). Questionnaire data were collected from industrial respondents (N=249) participating in 39 centers funded by the NSF IUCRC program. Structural, member benefits and administrative process variables were used to predict the dependent variable. Logistic regression analyses identified three significant predictors: professional networking benefits, research relevance and administrative operations. Implications of these findings for public policy, cooperative research management and future research are discussed.