Pain, Impairment, and Disability in the AMA Guides

Physicians use the American Medical Association's Guides to the Evaluation of Permanent Impairment, 5th edition to evaluate millions of disability applicants each year. As major contributors to the chapter in the Guides devoted to assessing impairment associated with pain, we confronted the difficulties of incorporating pain into the Guides' overall evaluation system. Analysis of these difficulties is complicated by the paucity of research on the Guides, and by ambiguities and contradictions that pervade it. We propose that the ambiguities can be reduced if impairment is consistently defined in terms of organ or body part derangement, and disability in terms of activity limitations at the level of the whole person. We also propose a distinction between objective factors that may influence a person's ability to perform activities following injury. We suggest that when physicians examine disability applicants, they should evaluate both objective measures of organ or body part dysfunction and subjective reports of applicants -- especially ones regarding pain. We conclude that a comprehensive medical evaluation of disability applicant encompasses more than an impairment assessment.     

A New Dynamism in World Politics: Increasingly Skillful Individuals?

Our inquiry is the first phase of a project designed to explore systematically whether individuals are becoming more equipped to play a central role in world affairs. It hypothesizes that individuals have undergone a skill revolution, leading them to be more analytically competent, emotionally capable, and politically effective in assessing events, developing alternatives, and executing effective political action. The first phase is confined to the skills of elites: we tested the predicted generational changes by analyzing the skills of three types of individuals—elected officials in the U.S. Congress, witnesses at congressional hearings, and contributors to the daily press in three countries—in two widely separated epochs as they evaluated events across three issue areas—foreign affairs, international trade, and human rights. In doing so we randomly selected nearly one thousand paragraph-sized statements and coded them according to the methodology prescribed by the Integrative Complexity Coding Manual. All in all, our findings supported the hypothesis: the skill level of the sampled individuals was found to have increased over several generations by a statistically significant (P < .001) average greater than 10 percent. Each issue area also showed gains in the same direction between the two epochs and across all types of elites; and all of these results also met the 95 percent confidence level for statistical significance. Inasmuch as this finding does not negate the possibility of a long-term trend toward more capable publics, it points to the need for further research into the dynamics whereby world politics may become increasingly sensitive to demands at the micro level.     

Multi-resolution image fusion technique and its application to forensic science

Image fusion is a process of combining two or more images into an image. It can extract features from source images, and provide more information than one image can. Multi-resolution analysis plays an important role in image processing, it provides a technique to decompose an image and extract information from coarse to fine scales. In some practical forensic examinations (such as the cartridge image check), we cannot obtain all information from just one image; on the contrary, we need information from images with difference light sources (or light ways). In this paper, we apply an image fusion method based on multi-resolution analysis to forensic science. Synthetic and real images (such as images from closed-up photography and flash photography) are used to show the capability of the multi-resolution image fusion technique.     

Suicide by 120 stab wounds of the chest?

The case history of a suicide due to 120 stab wounds of the chest is presented. The victim was a 41 years old man with a paranoid-hallucinative psychosis. The problem to distinguish homicides and suicides is discussed by the well-known criminalistic and forensic-medical criterias. Induced by this very unusual case the autopsy material with stab wounds was analyzed retrospectively (n = 246, out of about 14,000 autopsies at the Institut of Forensic Medicine in Hamburg). Cases with more than 40 single lesions are normally homicides. However, the pattern of the injuries is more important than the number--especially in doubtful cases.     

Group-specific component imaging from trace material using isoelectric focussing and electroblotting

GC-subtyping was carried out on blood stains, that had been made on glass and stored under room temperature-conditions. Using isoelectric focusing in polyacrylamide gel, followed by transfer to nitrocellulose membrane by semi-dry-electroblotting and detection with enzyme-linked antibody complex the GC-detection was possible even after 64 days. Methodical problems are discussed.