An autopsy case of intraoperative death due to pulmonary fat embolism—possibly caused by release of tourniquet after multiple muscle-release and tenotomy of the bilateral lower limbs

We report a case of a juvenile male with muscle rigidity caused by cerebral palsy who experienced intraoperative sudden death due to pulmonary fat embolism after multiple muscle-release and tenotomy of the bilateral lower limbs. Data were obtained through review of the surgical and anesthesia records, as well as from autopsy and histopathological examination. All surgical procedures were performed within the same operation, beginning with the right lower limb and then proceeding with the left lower limb, with application of a pneumatic tourniquet to avoid intraoperative hemorrhage. Slight changes in the hemodynamics were noticed after release of the right tourniquet. Further, sudden onset of hypotension, severe bradycardia, and a marked decrease in percutaneously monitored oxygen saturation occurred just after release of the left tourniquet when the left limb was raised for casting. The patient died despite immediate and vigorous cardiopulmonary resuscitation. At autopsy performed 20 h after death, examination of the lungs revealed a pale surface, slight edema, and obvious fat droplets in the vessels at the cut surfaces. Histopathological examination with fat staining was notable for the presence of pulmonary fat embolism. These results suggest that restoration of venous return after removal of the tourniquet combined with massive fat embolism from dead spaces was the likely cause of death.     

Stage of Change as a Predictor of Attrition Among Men in a Batterer Treatment Program

This study assessed the contribution of the men's stage of change to the prediction of attrition among men attending a batterer treatment program. As outlined by the transtheoretical model of change, men were classified into the precontemplation, contemplation, or action stage based on their level of change motivation and behavior. It was hypothesized that men in the precontemplation stage would dropout of treatment at higher rates than men in later stages of change. Participants were 308 men who enrolled in a batterer treatment program over the course of 1 year, 61.4% of whom dropped out of treatment. Counselor rated, but not self-rated stage of change significantly predicted treatment completion once traditionally used demographic, contextual, and personality variables were taken into account. Specifically, men identified by counselors as being in the precontemplation stage were 2.3 times as likely as men rated in the contemplation stage and 8.8 times as likely as men rated in the action stage to dropout of treatment. Referral source, age, and history of arrest also made significant contributions to the prediction of attrition. The best combination of predictors led to the successful classification of 72% of the cases, 98% of the dropouts but only 19% of the completers. Discussion focuses on the limitations of current findings and their implications for the use of the transtheoretical model to predict attrition from batterer treatment.     

Leisure Experience, Prison Culture, or Victimization? Sex Offenders Report on Prison Gambling

Opportunities for gambling in mainstream North American society have increased greatly over the past two decades. Despite the popularity of legalized gambling and attention it is receiving among social science researchers and economists, gambling within jails and prisons has been overlooked. This study utilized a semistructured interviewing procedure (Smith, 1995) to gain information about prison gambling from 11 sexual offenders on parole—all had spent significant time incarcerated. Qualitative analyses of responses suggest that offenders may gamble in various forms and for a variety of reasons, including a means of alleviating boredom, providing excitement and risk, and an opportunity to socialize. Prison gambling appears to be a complex phenomenon. A substantial amount of prison gambling seems to be associated with certain psychosocial benefits, while for a minority of cases there may be severe violence and victimization.     

医疗损害赔偿纠纷案件法律适用的冲突与调适

医疗损害赔偿是当今社会的热点问题,也是司法审判实践中的重点、难点问题。由于该类案件处理中现行法律适用原则存在的误区,导致审判实践中同案不能同判的现象时有发生。这不仅损害当事人的合法权益,而且严重损害我国法律的尊严。文中阐述了现行法律适用原则存在的主要问题及由此产生的严重影响,并从理论上通过对现行适用原则中区分对待的医疗事故以及其它医疗损害的剖析,明确了医疗损害的内涵及其责任性质,进而提出对《条     

精神障碍患者约束和隔离措施的法律规制

约束和隔离是严重剥夺精神障碍患者人身自由的强制措施。约束和隔离实施中所存在的非人道性、危险性和负面效果使得该措施饱受争议,因而法律只允许在例外情况下使用约束和隔离措施,并对其实施条件和程序予以严格限制。即,在实体上明确约束和隔离措施的适用条件和情形,在程序上明确约束和隔离措施的实施步骤,从而构筑起约束、隔离的法律规制体系。     

《中日韩投资协定》的构建

签署双边投资协定是国家间相互保护投资的主要法律途径。但是近年来,越来越多的经济一体化协定尤其是自由贸易协定在对贸易自由化问题进行规范的同时,也对投资等问题加以规定,形成了自由贸易协定投资规则与双边投资协定并存的局面。为了加速中日韩经济一体化进程,三国决定先行签署《中日韩投资协定》,作为未来中日韩自由贸易协定的组成部分。在这种背景下,对《中日韩投资协定》构建的基本原则、具体条款的设计、与双边投资协定的关系进行深入探讨,可以对正在进行的中日韩三边投资协定谈判提供可行性建议。     

农村群体性纠纷防治的法律机制

农村群体性纠纷是农村社会尖税矛盾和突出问题的特殊表现。我国农村群体性纠纷的不断发生和升级,暴露了我国在制度建设、管理措施等方面存在严重缺陷。当前,对农村群体性纠纷的解决,基层干部习惯于采用传统的思想教育手段、行政手段,对法律手段的运用较为薄弱。从方法论之角度,采用法律手段解决农村群体性纠纷是“治本”之策。因此,必须健全预防和处理农村群体性纠纷的法律机制。     

论教唆犯的未遂形态

教唆犯的未遂是共同犯罪理论中最为复杂的问题之一。人们习惯于从立法之实然对教唆犯进行研究,使得对教唆犯的未遂形态的认定仅限制在《刑法》第二十九条第二款的规定上,从本条的立法精神来看,我国《刑法》规定被教唆人没有实施被教唆之罪也成立教唆犯未遂,然而这一规定并不合理。对于教唆犯的未遂形态的认定,不应囿于立法之实然规定,应该站在应然高度对教唆犯予以定位。     

制度反腐：转型期腐败治理新效能

更加注重制度建设,拓展从源头上防治腐败工作,这是从根本上加强反腐倡廉建设,从源头上解决腐败问题的必然选择。构建制度反腐体系是提高中国共产党执政能力的内在要求,也是建设廉洁政府的必然选择。加强反腐倡廉制度建设,在完善和创新制度的同时,还要在增强制度的执行力上下功夫,这就要突破儒家传统政治文化,秉持反腐制度设计＂无赖原则＂;弥补制度建设先天性不足,构建操作性强的反腐制度;推进法理型反腐路线,提升反腐制度建设的严密性。