Biting Through an Arteriovenous Hemodialysis Graft: An Unusual Method of Suicide

Abstract:  Patients on long-term hemodialysis often have multiple medical and social problems with associated psychological stress and depression. The suicide rate in this population is higher than the general population, and suicides have been reported following severing or disconnection of hemodialysis vascular access sites. We report a patient on chronic hemodialysis with a history of depression and suicidal ideation who bit into his forearm arteriovenous graft and exsanguinated.     

Political Parties: Towards a New Theoretical Synthesis

Three conceptions of the political party can be distinguished. They are Seller's socio-cultural cleavage approach; Lawson's notion of the linkage party, based upon participatory, policy-responsive, clientele reward and government directive linkages; and Offerlé's conception of parties as political enterprises concentrating upon partisan supply to the political market. After suggesting that, whatever their partial merits, none of these approaches provides the basis for a comprehensive theory of political parties, a dual party approach is prepared. Every party exists in and for itself as well as interacting with a constraining environment. A dialectical model, based upon relations between internal decision-making and external competition within the context of the rules of the game, offers the best prospect of further advance in the study of political parties.