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.     

突出重点注重实效不断提高区社校办学水平

和平区社会主义学校成立于1999年。多年来,在区委、区政府,各民主党派区级组织、区党校和有关部门的关心、支持下,我们坚持以邓小平理论和“三个代表”重要思想为指导,坚持正确的办学方向,充分发挥区社校在统战教育培训中的主阵地作用,开拓进取,努力使区社校成为培养统一战线人     

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.     

The Present and Future Fiscal Problems of the Two New Yorks: What Happened This Time

The state and city of New York have chronic fiscal difficulties, namely, expenditures that tend to exceed revenues by significant amounts. The deficits were moderate in the 1980s but have become large and acute in the 1990s as the state and city economies have been in a prolonged recession. Deficits are expected to continue well into the future. Supply side factors, particularly high wage levels, are the main causes of the state's deficits. For the city, supply side factors, particularly high employment, and demand side factors are main causes. Federal aid reduction is a minor cause. The city's fiscal condition is compared with that of the thirty other largest U.S. cities in a regression analysis which updates Gramlich's analysis of the period immediately before the famous New York City fiscal crisis of 1975.     

The Costs and Benefits of Transferring Technology Infrastructures Underlying Complex Standards: The Case of IPv6

Industry stakeholders and Internet experts generally agree that networks using Internet Protocol version 6 (IPv6), an Internet communications standard which is being promoted strongly by many parties, would be technically superior to today’s networks, which are largely based on IPv4. The improvements designed for IPv6 could provide numerous benefits to Internet users, network administrators, and applications developers; among these potential benefits are cost reductions due to improved security and increased efficiency, improvements to existing products and services, and innovations leading to new products and services. However, there is wide disagreement about the characteristics and timing of benefits associated with IPv6, and the costs associated with the transition could be substantial. In this paper, we will discuss the likely costs of a transition to IPv6 for the major stakeholders and the potential benefits. Subsequently, we will introduce the cost impact of an accelerated adoption case and discuss potential ways in which the government could become involved in the process. This paper is based on a broader study funded by the National Telecommunications and Information Administration (NTIA) and National Institute of Standards and Technology (NIST). We wish to thank Greg Tassey, Fred Lee, Tim Sloan, B. Keith Fulton, John Streck, and Baran Erkel for comments and suggestions on earlier versions of this paper.     

Women who molest children

In only nine of approximately 600 cases of child molestation in New Hampshire and Vermont was the perpetrator found to be a woman. Case histories and some testing data show a history of sexual assault as a child, frequent offense in the company of a dominant male partner, and a major disinhibition as a result of severe character disorder or limited intelligence. These factors not only interfered with maternal bonding and nurturing behavior but also contributed to suspension of judgment about the appropriateness of sexual contact with children.