Insurance for Good Losers and the Survival of Chile's Concertación

In the transition from military rule to democracy, the government of Augusto Pinochet bequeathed to Chile a unique electoral law by which all legislative seats are contested in two-member districts. A key implication of this rule is that in order to secure legislative majorities, coalitions have to put their strongest candidates in the most precarious electoral list positions. This generates a divergence of interests between coalitions and politicians. Chile's largest coalition, the Concertación, has resolved the dilemma by providing appointed posts to unsuccessful congressional candidates who accept personal political risk on the coalition's behalf. This study argues that this insurance system has provided the critical glue to hold the coalition together since Chile's transition to democracy in 1990. Recent changes in the electoral environment could threaten the Concertación's control over the appointed posts that have sustained this informal institution. This could jeopardize the Concertación's cohesion during the process of negotiating coalition candidate lists for the 2005 legislative elections.     

Policy Games and Venue‐Shopping: Working the Stakeholder Interface to Broker Policy Change in Rehabilitation Services

How should bureaucrats engage effectively and ethically with stakeholders to achieve legitimate policy change? This essay draws upon findings from a case study of the introduction of an evidence‐based rehabilitation program for injured workers with soft‐tissue injuries in a workers' compensation jurisdiction in Australia. Despite initial enthusiasm for collaborative policy reform, clinical associations soon withdrew their support. In a classic case of venue‐shopping, a coalition of clinical associations formed in opposition to the foundation principles of the proposed policy, overturning the bureaucrats' preferred consultation strategy: a think‐tank comprising of invited clinical experts. The policy game turned from highly cooperative to fiercely competitive. These policy upheavals are interpreted through the lens of two theoretical perspectives: Sabatier's Advocacy Coalition framework, and Scharpf's Actor‐centred Institutionalism framework. The contrasts in perspectives are melded into propositions for bureaucrats seeking to engage with stakeholders in a contested policy drama.     

Organizational downsizing and age discrimination litigation: the influence of personnel practices and statistical evidence on litigation outcomes

The present study examined relationships between reduction-in-force (RIF) personnel practices, presentation of statistical evidence, and litigation outcomes. Policy capturing methods were utilized to analyze the components of 115 federal district court opinions involving age discrimination disparate treatment allegations and organizational downsizing. Univariate analyses revealed meaningful links between RIF personnel practices, use of statistical evidence, and judicial verdict. The defendant organization was awarded summary judgment in 73% of the claims included in the study. Judicial decisions in favor of the defendant organization were found to be significantly related to such variables as formal performance appraisal systems, termination decision review within the organization, methods of employee assessment and selection for termination, and the presence of a concrete layoff policy. The use of statistical evidence in ADEA disparate treatment litigation was investigated and found to be a potentially persuasive type of indirect evidence. Legal, personnel, and evidentiary ramifications are reviewed, and a framework of downsizing mechanics emphasizing legal defensibility is presented.     

3D surface and body documentation in forensic medicine: 3-D/CAD Photogrammetry merged with 3D radiological scanning

A main goal of forensic medicine is to document and to translate medical findings to a language and/or visualization that is readable and understandable for judicial persons and for medical laymen. Therefore, in addition to classical methods, scientific cutting-edge technologies can and should be used. Through the use of the Forensic, 3-D/CAD-supported Photogrammetric method the documentation of so-called "morphologic fingerprints" has been realized. Forensic, 3-D/CAD-supported Photogrammetry creates morphologic data models of the injury and of the suspected injury-causing instrument allowing the evaluation of a match between the injury and the instrument. In addition to the photogrammetric body surface registration, the radiological documentation provided by a volume scan (i.e., spiral, multi-detector CT, or MRI) registers the sub-surface injury, which is not visible to Photogrammetry. The new, combined method of merging Photogrammetry and Radiology data sets creates the potential to perform many kinds of reconstructions and postprocessing of (patterned) injuries in the realm of forensic medical case work. Using this merging method of colored photogrammetric surface and gray-scale radiological internal documentation, a great step towards a new kind of reality-based, high-tech wound documentation and visualization in forensic medicine is made. The combination of the methods of 3D/CAD Photogrammetry and Radiology has the advantage of being observer-independent, non-subjective, non-invasive, digitally storable over years or decades and even transferable over the web for second opinion.     

Traumatic subarachnoid hemorrhage and extracranial vertebral artery injury: a case report and review of the literature

The case is presented of a 19-year-old man who was assaulted and died shortly afterward from a large traumatic basal subarachnoid hemorrhage (TBSAH) that arose from rupture of the left vertebral artery, proximal to the point at which the artery penetrated the dura. The literature regarding TBSAH and vertebral artery rupture is reviewed, and a number of points are highlighted: patients with TBSAH may remain conscious for a period of hours after injury, subcutaneous or muscular bruising may be contralateral to the ruptured vessel, fractures of the transverse processes of the cervical vertebrae and significant pathology of the vertebral artery are not typically associated with TBSAH, and rupture of the vertebral artery may be intracranial, junctional, or extracranial.     

New horizons in forensic radiology: the 60-second digital autopsy-full-body examination of a gunshot victim by multislice computed tomography

The goal of this study was the full-body documentation of a gunshot wound victim with multislice helical computed tomography for subsequent comparison with the findings of the standard forensic autopsy. Complete volume data of the head, neck, and trunk were acquired by use of two acquisitions of less than 1 minute of total scanning time. Subsequent two-dimensional multiplanar reformations and three-dimensional shaded surface display reconstructions helped document the gunshot-created skull fractures and brain injuries, including the wound track, and the intracerebral bone fragments. Computed tomography also demonstrated intracardiac air embolism and pulmonary aspiration of blood resulting from bullet wound-related trauma. The "digital autopsy," even when postprocessing time was added, was more rapid than the classic forensic autopsy and, based on the nondestructive approach, offered certain advantages in comparison with the forensic autopsy.     

Sexual sadism

Definitions of sexual sadism in ICD-10 and DSM-IV will be presented as well as the historical routes of the concept. Today studies on differently selected clinical samples reveal a different distribution of sexual sadism versus masochism with masochism prevailing in general especially outpatient psychiatric facilities, and sadism prevailing in forensic settings, thus corroborating the concept of two separated diagnoses sadism versus masochism. In forensic settings the diagnosis of a sadistic character disorder (sadistic personality disorder [SPD] according DSM-III-R) is found to a much higher degree than in other clinical samples (50-fold). Our own follow-up study on a forensic sample implies that sadism as a paraphilia is of relevance for relapse-rates of sex-offenders. Symptoms of SPD can be combined with sexual sadism, or occur independently. This may corroborate arguments in favor of a dimensional concept of sexual sadism. Symptoms of SPD may then be a sign of generalization of sadistic traits at least in some cases. A concept of two factors contributing to sadistic pleasure is suggested, one taking the aspect of bodily gratification by sexual-aggressive stimuli as decisive, and the other taking inner representation of hostile objects into consideration (stressing the antisocial-anger-rage aspect).     

Rapid determination of carboxyhemoglobin in blood by Oximeter

Different methods to determine carboxyhemoglobin (COHb) in blood are described in the literature. In our laboratory three methods to analyze COHb in post-mortem blood samples were compared: the spectrophotometric method of Maehly, a gas chromatographic method with a thermal conductivity detector (GC-TCD) and the Oximeter. Several COHb containing blood samples of deceased persons were analyzed. Results of all three methods were comparable for low concentrations (ca. 10% COHb) as well as for high concentrations (ca. 80% COHb) regardless of the viscosity of the blood samples. The advantages of the Oximeter when compared to Maehly's method and GC-TCD are extreme short time of analysis (<1min), very small blood volume required (<0.1ml) and easy handling. In our opinion application of the Oximeter is not limited to analyses of blood samples from living persons (e.g. in clinical toxicology); it can as well be used for the determination of COHb in post-mortem blood samples. Hence it is a useful and time saving tool in forensic toxicology.