Kip

Non-ficition by Carol Manwarin

Spring

Non-fiction by Carol Manwarin

Unexpected side-effects: urban policies and market responses

Should cities invest in public transport systems, even if they might slow growth? Can an HOV lane reduce congestion when drivers circumvent it? Is unpredictability of police enforcement a good thing for reducing drunk-driving? These and other surprising facts were presented at the recent IGC mini-cities conference. Research highlighted below showcases the importance of accounting for market and behavioral responses in designing policies

Why the left loses: explaining the decline of centre-left parties

Are centre-left parties across Europe facing a future of decline? Drawing on a new book, Rob Manwaring and Paul Kennedy argue that an essential element in any robust democracy is an effective centre-left. However, centre-left parties now face a number of major challenges, from the rise of new parties, to the erosion of their traditional support bases, and only by addressing these challenges can their decline be halted

The use of intravascular ultrasound imaging to improve use of inferior vena cava filters in a high-risk bariatric population

ObjectivePulmonary embolism is the leading cause of death after gastric bypass procedures for obesity, approximating 0.5% to 4%. All bariatric patients, but especially the super-obese, which have a body mass index (BMI) >50 kg/m2, are at significant risk for postoperative venous thromboembolism (VTE). Visualization and weight limitations of fluoroscopy tables exclude most bariatric and all super-obese patients from inferior vena cava (IVC) filter placement using fluoroscopy. Intravascular ultrasound (IVUS)-guided IVC filter placement is the only modality that allows these high-risk patients to have an IVC filter placed.MethodsHospital and outpatient records of the 494 patients who underwent gastric bypass procedures from January 1, 2004, to May 31, 2006, were reviewed. All patients who had concurrent IVC filter placement with the use of IVUS guidance were selected. Comorbidities, outcomes, and complications were recorded.ResultsWe identified 27 patients with mean BMI of 70 ± 3 kg/m2; of these, 25 were super-obese (BMI >50 kg/m2). Procedures included five laparoscopic and 22 open gastric bypass operations. All patients underwent concurrent IVC filter placement using IVUS guidance. In addition to super-obesity, indications for IVC filter placement included history of VTE (n = 4), known hypercoagulable state (n = 2), and profound immobility (n = 21). Mean follow up was 293 ± 40 days. Technical success rate was 96.3%. There were no catheter site complications. In one surviving patient, a nonfatal pulmonary embolism was detected by computed tomography 2 months postoperatively. Two patients died, and autopsy excluded VTE as the cause of death in both.ConclusionThis study suggests efficacy of IVUS-guided IVC filter placement in preventing mortality from pulmonary embolism in high-risk bariatric patients, including the super-obese. IVUS-guided IVC filter placement can be safely performed with an excellent success rate in all bariatric patients, including the super-obese, who otherwise would not be candidates for IVC filter placement due to the limitations imposed by their large body habitus

Capacity and culpability

How should the criminal law account for defendants’ incapacities? It’s often claimed that some incapacities make individuals less culpable for wrongdoing. But what follows if this is true? Like many others, I claim that the criminal law ought not to convict offenders disproportionately to their culpability. Thus, if incapacities render individuals less culpable, then the criminal law ought to account for that lowered culpability. But rather than accepting this ‘culpability principle’ under the guise of non-instrumentalist retributivism, I instead derive it from instrumental considerations regarding fair labelling. Next, I survey how the law accounts for incapacities. I generate and populate a novel threefold taxonomy of incapacity rules, comprising what I call incapacity doctrines, incapacity relativisations, and counterfactual incapacity relativisations. I then defend the use of these incapacity rules from certain critiques, including from those who argue for the abolition of some incapacity rules. Many incapacity rules are formulated not (only) by reference to their target incapacities, but (also) by reference to certain proxy attributes, and in particular to the relevant incapacity’s aetiology. I defend the use of such proxies but critique those rules which require proof of aetiological proxies in addition to proof of the underlying incapacity. The final chapters ask why and how incapacities exculpate. I defend the widely accepted view that incapacities exculpate if they make defendants less able to conform to the requirements of a norm. Finally, I ask what it means for one to be incapable of something. I argue that we cannot rely only on metaphysical considerations when ascribing incapacities for the attribution culpability