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.     

A NEW LOOK AT AN OLD ISSUE:

In 1997, the Office of Child Support Enforcement initiated the State Child Access and Visitation (AV) Grant Program, which involves annual awards of $10 million to states to promote the development of programs to alleviate access problems. Telephone interviews with 970 parents who used mediation, parent education, and supervised visitation programs funded by AV grants in nine states revealed that the programs are reaching diverse groups of parents including many low-income, non-White, and unmarried parents who receive no other type of access assistance. The programs also appear to be achieving the major objectives posited for them by the federal government. One-third to one-half of noncustodial parents in every program type reported that parent–child contact increased following program participation, with supervised visitation users who typically had the lowest levels of parent–child contact reporting a significant increase in the number of days of contact. A review of child support records for 173 program users in three states revealed that child support payments increased among participants following program participation, especially for never-married parents who paid a significantly higher proportion of what they owed. These findings are similar to results reported in a five-state study of mediation programs funded by AV grants that was conducted by the Office of the Inspector General. However, both studies have some serious limitations, including low response rates and the absence of a nontreatment comparison group.     

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     

Migration,rank-size distribution,and economic development: The case of Mexico

This is an examination of whether city size is truly an independent variable when the relationships between city size and certain economic and social phenomena are considered. A new hypothesis is presented that postulates that relative or systemic city size is an independent variable that affects urban growth patterns through varying, non-optimum migration flows. The hypothesis is tested using official Mexican data for the period 1960 to 1970.