Lethal small bowel obstruction due to pica

Up to 25% of institutionalized patients with cognitive deficiencies display pica-like behavior, with an estimated annual incidence of small bowel obstruction of 2%. We present a case based on the forensic autopsy of a 41-year-old woman who died as a result of a missed diagnosis of small bowel obstruction after ingesting a foreign body. The case underlines the importance of precaution when treating patients with cognitive deficiency and/or language deficits and gastrointestinal symptoms. In such cases, it is important to employ a liberal threshold for radiological investigations and, if possible, obtain a medical history from a person close to the patient.     

Red Tape,Rule Burden,and Legitimate Performance Trade-Offs: Results from a Vignette Experiment

Abstract

Goals in the public sector are complex and managers can face situations in which pursuing one legitimate goal necessitates performance trade-offs in other areas. This study tests how knowledge of legitimate performance trade-offs shapes the perception of red tape. Using a vignette experimental design and a sample of university students, between group t-tests and regression analyses suggest that, when evaluating increased rule burden, individuals that are provided with information about how objectively burdensome rules serve alternative values such as equity and effectiveness associate them with lower levels of red tape. A series of Monte Carlo simulations suggest that this effect is substantial.     

The Frontiers of Legal Analysis: Reframing the Transition in Northern Ireland

British constitutional legal discourse is structurally limited in its capacity to capture the complexity of the Good Friday Agreement. Rather than assessing the Agreement in narrow devolutionary terms, it should be seen as a hybrid domestic and international law instrument, making an important contribution to accepted international law norms in relation to self-determination. The Agreement transforms and partly transcends the Northern Ireland conflict by substituting political contestation for violent conflict, and by defining the modalities of conducting that contestation. This analysis complements classical international law perspectives, and opens up the application of legal discourses associated with 'transitional justice' to the legal and political transformation in Northern Ireland. These discourses focus on the problem of reconciling the demands of peace with the imperatives of justice. The Agreement sits squarely in this terrain with its provisions on 'dealing with the past' and 'institutional legacies'. The insights gained here challenge orthodox thinking about conflict-management and the ongoing political process.     

Wasserrechtlicher Eigentümergebrauch und Rohstoffgewinnung

Mit der Einführung einer Entgeltpflicht für die Entnahme von Wasser in Nordrhein-Westfalen ist der erlaubnisfreie wasserrechtliche Eigentümergebrauch in den Mittelpunkt des Interesses gerückt. Denn wer Wasser im Rahmen des Eigentümergebrauchs aus einem oberirdischen Gewässer entnimmt, ist von dieser Entgeltpflicht befreit. Der folgende Beitrag erläutert die im Zusammenhang mit der Gewinnung nichtenergetischer Rohstoffe insoweit relevanten Fragen. * Die Verfasser sind, Mitarbeiter der Anders u.Thomé Rechtsanwaltsgesellschaft mbH in Krefeld