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.     

The Norwegian Barents Sea Management Plan and the EC Marine Strategy Directive: Some Political and Legal Challenges with an Ecosystem-Based Approach to the Protection of the European Marine Environment

This article addresses some of the implications of the EU's proposed Marine Strategy Directive for ongoing work in the regional seas conventions and for national work on regional marine strategies. The starting point is the proposed directive's focus on the ecosystem approach to the protection of the marine environment. Key elements within this approach are analysed, such as integration of environmental considerations into other policy areas; introduction of ecological quality objectives; and establishment of holistic monitoring and assessment programmes. Is it possible to transform these concepts into legally binding obligations? What will the implications of the proposed directive be for the rights and obligations of EU Member States under international law? A Management Plan for the Norwegian Part of the Barents Sea ('Barents Plan') was adopted by the Norwegian Government in March 2006 and approved by the Norwegian Storting (Parliament) in June 2006. It provides an example of a concrete application of the concepts in the proposed directive. Based on an analysis of the proposed Marine Strategy Directive and the Barents Plan, some key political and legal challenges are discussed in this article.     

School punishment and interpersonal exclusion: Rejection,withdrawal, and separation from friends

School suspension is a common form of punishment in the United States that is disproportionately concentrated among racial minority and disadvantaged youth. In labeling theories, the implication is that such stigmatized sanctions may lead to interpersonal exclusion from normative others and to greater involvement with antisocial peers. I test this implication in the context of rural schools by 1) examining the association between suspension and discontinuity in same-grade friendship ties, focusing on three mechanisms implied in labeling theories: rejection, withdrawal, and physical separation; 2) testing the association between suspension and increased involvement with antisocial peers; and (3) assessing whether these associations are stronger in smaller schools. Consistent with labeling theories, I find suspension associated with greater discontinuity in friendship ties, based on changes in the respondents’ friendship preferences and self-reports of their peers. My findings are also consistent with changes in perceptual measures of exclusion. Additionally, I find suspension associated with greater involvement with substance-using peers. Some but not all of these associations are stronger in smaller rural schools. Given the disproportionate distribution of suspension, my findings indicate that an excessive reliance on this exclusionary form of punishment may foster inequality among these youth.     

Re-Conceptualising Notions of Chinese-ness in a Southeast Asian Context. From Diasporic Networking to Grounded Cosmopolitanism

East Asia - This paper explores the role of the Chinese in a Southeast Asian business cum societal context; from different approaches towards Chinese-ness via different notions of intra- and...     

Sketches for a Democratic Utopia

I want to sketch the general shape of several new structures that would in my view provide stronger support for democracy than is provided by any existing society. I call these sketches for a democratic Utopia not because I would expect these structures to inaugurate a perfect democracy, whatever that might be, nor because they are beyond human reach. On the contrary the institutions I want to suggest are well within human reach. I call them Utopian only because I am not able to point with confidence to the historical forces that are likely to bring them about.
The structures I have in mind are designed to strengthen freedom and equality among citizens of democratic orders.     

Methodological development: structured outcome assessment and community risk monitoring (SORM)

This paper describes an effort to develop a clinical tool for the continuous monitoring of risk for violence in forensic mental health clients who have left their institutions and who are dwelling in the community on a conditional release basis. The model is called Structured Outcome Assessment and Community Risk Monitoring (SORM). The SORM consists of 30 dynamic factors and each factor in SORM is assessed in two ways: The current absence, presence or partial och intermittent presence of the factors, which is an actuarial (systematized and 'objective') assessment. Secondly, the risk effect, i.e. whether the presence/absence of factors currently increases, decreases or is perceived as unrelated to violence risk, is a clinical (or impressionistic) assessment. Thus, the factors considered via the SORM can be coded as risk factors or protective factors (or as factors unimportant to risk of violence) depending on circumstances that apply in the individual case. Further, the SORM has a built-in module for gathering idiographical information about risk-affecting contextual factors. The use of the SORM and its potential as a risk monitoring instrument is illustrated via preliminary data and case vignettes from an ongoing multicenter project. In this research project, patients leaving any of the 9 participating forensic hospitals in Sweden is assessed at release on a variety of static background factors, and the SORM is then administered every 30 days for 2 years.     

Spontaneous rupture of the urinary bladder

The report presents the case of a 33-year-old man under the primary assumption of homicide in which the court-ordered autopsy revealed death as a result of bleeding due to a spontaneous rupture of the urinary bladder. The article gives a short summary of the pathomorphological findings and their respective causes, for example the typical location of the rupture at the posterior wall and roof of the bladder and the common concomitant drunkenness. Furthermore, obligatory forensic investigations--beside the autopsy--are mentioned and discussed.     

Fatalities after injuries by wild animals

The article summarises three fatalities after attacks by wild animals. The first case describes a 90-year-old woman who died as a result of pneumonia after a bear fell on her and caused multiple chest fractures. The second case deals with a 76-year-old woman who was hit in the middle face by the hoof of a camel and, thereafter, died of myocardial infarction. The third case describes a 27-year-old biologist who died from severe blunt trauma after an attack of a wild living elephant. The article gives a summary of typical injury patterns of selected wild animals and outlines potential reasons of death as a result of the injuries.     

Is Leadership in the Eye of the Beholder? A Study of Intended and Perceived Leadership Practices and Organizational Performance

Leadership is a matter of both intentions and perceptions, which do not necessarily always match. Because employees’ motivation and commitment are only affected by leadership if they notice it, employee‐perceived leadership is expected to have a stronger correlation with organizational performance than leader‐intended leadership. This expectation is tested for transformational and transactional leadership, as both types of practices are expected to increase performance. Using a sample of 1,621 teachers and 79 Danish high school principals, the authors find that leader‐intended and employee‐perceived transformational and transactional leadership are only weakly correlated and that only employee‐perceived leadership practices (both transformational and transactional) are significantly related to objectively measured school performance. The results show that it is important to distinguish between intended and perceived leadership and that leaders should be aware of how their practices are perceived.