ObjectiveTo describe possible causes of delivery-related severe asphyxia due to malpractice.Design and settingA nationwide descriptive study in Sweden.PopulationAll women asking for financial compensation because of suspected medical malpractice in connection with childbirth during 1990–2005.MethodWe included infants with a gestational age of ≥33 completed gestational weeks, a planned vaginal onset of delivery, reactive cardiotocography at admission for labour and severe asphyxia-related outcomes presumably due to malpractice. As asphyxia-related outcomes, we included cases of neonatal death and infants with diagnosed encephalopathy before the age of 28 days.Main outcome measureSevere asphyxia due to malpractice during labour.ResultsA total of 472 case records were scrutinised. One hundred and seventy-seven infants were considered to suffer from severe asphyxia due to malpractice around labour. The most common events of malpractice in connection with delivery were neglecting to supervise fetal wellbeing in 173 cases (98%), neglecting signs of fetal asphyxia in 126 cases (71%), including incautious use of oxytocin in 126 cases (71%) and choosing a nonoptimal mode of delivery in 92 cases (52%).ConclusionThere is a great need and a challenge to improve cooperation and to create security barriers within our labour units. The most common cause of malpractice is that stated guidelines for fetal surveillance are not followed. Midwives and obstetricians need to improve their shared understanding of how to act in cases of imminent fetal asphyxia and how to choose a timely and optimal mode of delivery.Please cite this paper as:Berglund S, Grunewald C, Pettersson H, Cnattingius S. Severe asphyxia due to delivery-related malpractice in Sweden 1990–2005. BJOG 2008;115:316–323.

REVIEWS 759 Professor Berend has given us a thought-provoking study. In any future edition, care should be taken that 'statnipravo' is not translatedas Rechtsstaat or Griinderzeit as the 'age of boosterism'. Anglo-American College, Prague Z. A. B. ZEMAN King, Jeremy. Budweisers intoCzechsandGermans. A LocalHistogyof Bohemian Politics, I848-I948. Princeton University Press, Princeton, NJ and London, 2002. XV+ 284 pp. Notes. Bibliography.Index. C27.95. THE flood of works now appearing on personal and communal forms of identityin the Habsburglands includes a growingstreamof treatmentswhich arguefor the survivalof markedlylocal loyaltiesmuch longer than historians' incautious use of phrases like 'national question' or 'ethnic contest' would suggest. Recent examples are Conrad Klewing's analysis of Dalmatia, EleonoraBabejov'a's of Pressburg,and the latest(2003) Austrian Histogy Yearbook articles on Galicia. Jeremy King has made a particularlysubtle, thoughtful and stimulatingcontribution to this sub-genre. His starting-pointis the year I848, the 'springtimeof nations', as the cliche has it. Yet most inhabitantsof the southern Bohemian municipality called alternatively Budweis or Ceske Budejovicewere, he claims, at that time stillneither German nor Czech, but literally 'Budweisers',probably knowing both the languages which gave the two differentnames to their town, and feeling attachment to the place itself, ratherthan to any largernational community. Underpinning that stance was a traditionalcommitment to the ethnically neutral dynasty and its authorities; and these continued to moderate and arbitrate the clash of rival national camps over the next half-century and more. Some of King's most insightfulpages are devoted to party politics in Budweis, constantlyrefractedby native concerns, splinteringand regrouping as domestic issues were negotiated by the organs of executive and legislative power within Austriain the constitutionalera. Although explicit German and Czech allegiances gained ground, they suffered from their own internal divisions and from the continuing equivocation or amphibiousness of significant sections of society. On the eve of World War I a settlement roughlyon the lines of the largerMoravian compromiseof I 905 was about to be enacted in Budweis, recognizing the need for rival national selfidentifications ,yet witnessing to the scope for local solution of the resultant problems. The collapse of the Monarchy ostensibly left (besides a small Jewish community, now counted separately)only Czechs and Germans with the former in control. The number of 'Germans', i.e. of first-languageGermanspeakers , in Ceske Budejovice even fell below the 20 per cent threshold necessary for linguistic rights. Yet, King contends, there was still no straight duality especially when Hitler's Reich emerged from 1933 to complicate German loyaltieswithin and beyond Czechoslovakia.In the years from I938 onwards, numerous citizens trimmed with the political wind, declaring or seeking to declare themselves Germans during the time of the Protectorate and Czechs when expulsion threatened in I945. Ironically, the replacement of an ethnicby a racialcriterionfornationalallegiancenow fora spellrestored 760 SEER, 82, 3, 2004 some of the flexibilitywhich previous curial arrangementshad eliminated except, of course, for theJews. King brilliantlydemonstratesthe complexities and ambiguitiesinvolved in the ascriptionof ethnicity according to objective or subjectivecriteria,as the case might be, and the ways in which these were marshalledto servecompeting nationalprogrammes. Yethispurestsubject-matterremainstantalizinglyin the shadows.'Budweisers ', as King freely admits, are difficultto identify, as is the extent of that bilingualismwhich formed their prime defining characteristic.This seems to have been widespreadin Budweis,but littleclear evidence is suppliedfor it or for the intriguingsuggestionof the use there of a mongrel patois or pidgin. Censuses cast scarcely any light on the matter, since they allowed only one language to be recorded. It is probably impossible anyway, as we know from the imponderability of similar kinds of statisticselsewhere (e.g. those nearer home about knowledgeof Welsh),to measurewith any accuracythe sphereof application of such submerged vernaculars and the nature of associated linguistic symbiosis. Hardly easier to assess are the social and political implications. King's own sources may leave us wondering whether many Budweisers were really so ethnically indifferent, when as early as thei86os even culturalassociationslikethe town'schoirswere alreadyrivenby national strife, and when by the turn of the century mob violence became commonplace . The author's reliance on the local press, which usually had an axe to grind, may actuallyundercut his own argument here. And perhaps he is also too ready to assume the impartialityof all those...

188 SHOFAR Fall 1996 Vol. 15, No. 1 .circles in which she traveled, presenting a strong picture of the world of French royalism and counter-revolution. Silverman makes no attempt to treat Gyp any better, or worse, than she deserves. Unlike many biographers who become deeply involved with their subject, Silverman does not pretend that Gyp has been dealt a cruel blow by history. Gyp is forgotten for a reason; this book is not a battle to resurrect a forgotten reputation. Silverman recognizes that Gyp's works are not the stuff of genius, and many are hardly worth a second glance. Her political beliefs are notable . only insofar as they that they formed part of a larger and more dangerous movement. As her antisemitism became more extreme and her moderate friends dropped away, Gyp wedded herself increasingly to authoritarianism and to those people whose progeny would spawn Vichy's National Revolution. Silverman shows that among such people hatred of the Jews was not only considered essential for the salvation of France but became an item of fashion. And it provided Gyp with the dubious benefit of being accepted as "one of the boys." Wm. Laird Kleine-Ahlbrandt Department of History Purdue University Auschwitz and After: Race, Culture and "the Jewish Question" in France, edited by Lawrence D. Kritzman. New York: Routledge, 1995. 335 pp. $17.95 (P). This volume has a number ofgoals, perhaps too many. As the subtitle suggests, it explores how Jews have been understood, by themselves and others, in France since 1945, although of necessity many of the articles range back into the nineteenth century. The editor has put together 19 rather disparate selections, divided into five general parts, ranging from "Philosophy and the Jews" to "Literary Representation" to "Cinematic Images." Some are scholarly articles by American academics, others excerpts from larger works by prominent French authors (tevinas, Lyotard, Vidal-Naquet, Finkielkraut). The tilt is almost entirely toward literature and theory, with no historians (except for Vidal-Naquet, whose expertise is actually in ancient history) and one anthropologist. "Theory" in this context has come to be an incendiary term, suggesting many things, among which are a radical denial of the poSSibility of objective observation and a tendency to murky, jargonized writing. Book Reviews 189 There are several anicles in the collection that are classics of the genre, promising to puzzle, exasperate, or perhaps amuse readers unfamiliar with the field. The editor, identified as someone who has "written extensively ... on French culture and intellectual thought" [as distinguished from non-intellectual thought?], provides as clear an introduction as might be expected, given the subject matter, but his writing, too, is marked by the current fashions, especially in the anicle he contributes to the collection. He does not deign to refer to "themes"; they are topoi. "Dialogic rappon" is the term he uses' for "discussion," and he replaces that old-fashioned word "original" with "originary," one of many words he and others in the collection use that are not in the dictionary-not even the Oxford Unabridged-at least not with the special meaning they have in this field (e.g., defocalized, ideologemes, rhizomes). How does one find out what they mean? Good question. Such stylistic tendencies and the penchant for formulations that revel in contradiction and an often bogus subtlety characterize a fair amount of the writing by the French masters of the genre, whose own neologisms and arcane tangents don't always translate well. Their frequent disregard for stylistic economy has also been picked up by some of their admirers in the United States. But a funher source of confusion exists, in that the literature of the Holocaust, in whatever tongue, has a tendency toward mystical claims, incautious use of terms, and irresponsible striving for effect. Given the sympathy properly extended to those who bear witness to the murder of Europe's Jews, criticism of such lapses is often muted or itself ensconced in crippled, barely penetrable language. A number ofwriters have presented"Auschwitz" as a cosmic intrusion of some son, beyond human ken, comparable to the CrucifIxion-another cosmic, ineffable episode, concerning which normal historical reasoning is impotent and critical thought always on the edge of sacrilege...

Abstract Cognitive psychological research on the fallibility of human memory is reviewed, focusing on evidence of memory distortions and illusions, with the aim of sharing research on memory with clinical psychologists and practitioners who use memory recovery techniques to help clients recover suspected memories of childhood sexual abuse. The memory literature suggests that incautious use of memory recovery techniques may lead some adult clients who were not abused to come to believe that they were. Considerations relevant to assessing whether or not clients have repressed memories of childhood sexual abuse are discussed, as are suggestions for minimizing the risk of leading clients to create illusory memories or beliefs of childhood sexual abuse.

The assessment of maximum life span in a natural population of a species (ecological longevity) meets with several difficulties. Using as an example a long-term data series of a tidal-flat population of the edible cockle, Cerastoderma (Cardium) edule, it is shown that the age of the oldest individual found depends on the sampling effort (both sizc of area sampled and duration of sampling period), on the numbers of cohorts studied and on their size. All of these factors enhance the number of (old) specimens examined and, thus, the chance that a very old individual is encountered. Even in a relatively short-living species such as the cockle, low-effort or low-density estimates were biassed by one or more years. It is argued that the available data on longevity may all be considered underestimates and thus should be used with caution. An example of incautious use is discussed.

PERHAPS no more unexpected accidents ever happened than those which were announced upon the very heels of the first use of x-rays. It was as astonishing as the rays themselves that exposure without painful sensation, to what is apparently a form of light, could cause damage to tissues, which under certain circumstances might amount even to necrosis. There is no analogous clinical fact from which the occurrence of the severer forms of x-ray injuries might have been foreseen. It was a new phenomenon. There was at first no thought of caution and, as a result, reports of injuries came thick and fast during the early and enthusiastic use of the rays, so that it did not take long for all the forms of injury which are now known, to be reported. Indeed, about all of the injuries of consequence that have occurred, occurred during this early period of incautious use.

Difference score measures of organizational behavior variables: A critique

Drug interactions with antihypertensive drugs can be either beneficial or hazardous. The hazardous interactions are relatively infrequent but must be shown so they can be avoided. Those of most importance involve interaction with guanethidine-type agents and tricyclic antidepressants, amphetamine-type anorexiants or phenolpropanolamine-type common cold remedies; combined use of potassium retaining diuretics with potassium supplements; and incautious use of diuretics with cardiac glycosides. The beneficial interactions are the basis for modern antihypertensive therapy and can be of major help if logically applied to therapeutic problems.

A study of 720 autopsy cases from the Instituto Nacional de Neurologia, SSA (INN) and the Centro Hospitalario 20 de Noviembre ISSTE (CH 20 N) was made in order to investigate the frequency of aspiration in postmortem material of neurological cases. Aspiration occurred in 12.5% and 6.5%, respectively, of the cases under study. The clinical features of both groups were quite similar, and slight differences could not account for the uneven proportion of aspiration. When correlating the presence or absence of aspiration in both groups with and without the use of a gastric tube, a significant correlation was found between the use of a tube and the postmortem finding of aspiration. Gastric tube (tube feeding) increases the risk of aspiration six times. Our results support the view that opposes the early, indiscriminate and incautious use of tube feeding in the comatose patient.

Abstract Eighteen years of personal experience of Vidian neurectomy by the author's trans‐antral route in 242 patients is fully reviewed with longterm follow‐up.In otherwise intractable and severe cholinergic (non‐atopic) chronic vasomotor rhinitis, Vidian neurectomy has given complete relief in 94 percent of the patients sustained throughout five to 15‐year follow‐up. The operation has proved valuable in most cases with additional evidence of atopy, but the incidence of complete relief falls to 57 percent.Occasional indications in other conditions are discussed with the results obtained.The need for both meticulous case selection and impeccable technique is stressed. Given these, there now seems no significant risk of material complication. Incautious use of an unsuitable probe for diathermy in the pterygoid canal can give 2 percent risk of serious ophthalmoplegia. Such risk is eliminated by proper use of the author's shouldered probes.

Recent publications about historical performance practice show a growing reliance on the kind of evidence that can be extracted from the old music itself. Such evidence is usually referred to as being either internal or in nature with the borderline between the two types not always clearly drawn. The internal designation applies best to such clues as can be derived from the musical logic of a situation, whereby the context will either suggest, demand, or else exclude certain solutions of an interpretative problem. Evidence is if it is deduced from the notation in a number of different ways. The trend to a wider use of these sources is to be welcomed, since it holds the prospect of opening up a vast reservoir of untapped and potentially important information. However, before the hunt for such highly priced evidence could turn into the semblance of a gold rush, it might be well to recall the familiar words that all that glitters is not gold. All that looks like evidence is not real evidence, and careful analysis is needed to separate the genuine from the imitation. Such analysis may have been missing in a few recent publications that made new claims for the use of notes inigales outside of France, and more specifically in Bach's music. Since an article of mine attempted to show that the notes inegales ought not to be applied to Bach,1 a clarification might be in order. A closer look into these new theories seemed to reveal that incautious use of external evidence played a leading role in their formulation and

INADEQUATE alveolar ventilation leads to retention of carbon dioxide, with accompanying respiratory acidosis. Most patients with chronic obstructive emphysema die with this complication. The importance of infection, sedation and the incautious use of oxygen in the pathogenesis of ventilatory failure has been well described,1 2 3 4 5 6 7 8 9 10 11 and the necessity of increasing alveolar ventilation is stressed.5 , 9 10 11 12 13 14 A variety of mechanical aids and chemical stimuli are recommended.10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 The mechanical assisters in current favor in this country are the various devices for intermittent positive-pressure breathing. Several observations indicate that in patients with advanced disease, this therapy may not be successful,9 , 25 , 26 and Jones et al.26 recently . . .

That chronic poisoning characterized by degenerative changes in the blood, and by physical disability, may result from the continued ingestion of anilin derivatives is well known, as it is also well recognized that acetanilid, one of these products, because of its small cost and its toxicity in excess of others of this group in common use, renders it particularly liable to be the offending agent. Acetanilid is the chief ingredient in headache powders so generally dispensed by pharmacists without prescription, as it is in certain secret nostrums both in use by the rank and file of the profession, and, unfortunately, thus introduced by them to the laity. The toxicity of acetanilid in common with related coal-tar products of the antipyretic group, has long been known, and the serious, if not fatal, results which may follow its incautious use in fevers and debilitating conditions should have in past years been brought

Incautious use of Drugs

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