Fatal complications related to diagnostic barium enema

Thousands of barium enemas are performed in the United States each year without incident. Occasionally complications arise, only a few of which are fatal. Perforation is the most frequent serious complication of this procedure. Two instances of fatal perforation, one colonic and the other vaginal, are described, and the relevant literature is reviewed.     

Teaching "street law" to the criminally insane

A course in "Street Law" was taught to forensic patients by law students, following a format used by Georgetown University Law Center. Although the course has been taught to high school students and inmates of correctional facilities, this was the first time it has been extended to mental patients found not guilty of crimes by reason of insanity. An outstanding feature of the course was marked enthusiasm shown by patients who, through long institutionalization, had become apathetic, indifferent, and despairing. Their readiness and ability to learn brought to mind a couple of old sayings often heard around mental hospitals, "I may be crazy but I'm not stupid," and "Sometimes you can't tell the patients from the staff." The staff of at least one ward has picked up "teaching and learning to use as a central theme in treatment of patients, not abandoning traditional methods, but shifting the emphasis from therapy to teaching as a way of getting the patient's interest in his own rehabilitation. Judges, reviewing cases for release, have looked quizzical when the patients' active participation in a "law course" has been used as evidence of satisfactory progress.     

Somali Community Organizations in London and Toronto: Collaboration and Effectiveness

This article considers the high number of Somali community organizationsin both London and Toronto. Drawing on interviews in both locationswith Somali women refugees and discussions with those involvedin their resettlement, evidence shows that many Somalis continueto feel marginalized in terms of service provision and thatcollective representation is limited, despite the high numberof specifically Somali organizations that exist. Through a comparisonof the Somali community organizations in London and Toronto,this article highlights factors which have inhibited the developmentof a united, collaborative Somali voice. Contributory factorsare shown to derive partly from the persistent clan dynamicsamong Somalis and the solutions Somalis find, and partly fromfailings in service and funding provision. It is argued that,in the Somali case, exclusionary dynamics undermine the roleof community organizations in rebuilding community and belongingand providing a safe and empowering setting in which individualsand communities may regain confidence and begin the processof integration within the receiving society.