Breaking gridlock: the determinants of health policy change in Congress

Prior to the 2010 health care reforms, scholars often commented that health policy making in Congress was mired in political gridlock, that reforms were far more likely to fail than to succeed, and that the path forward was unclear. In light of recent events, new narratives are being advanced. In formulating these assessments, scholars of health politics tend to analyze individual major reform proposals to determine why they succeeded or failed and what lessons could be drawn for the future. Taking a different approach, we examine all health policies proposed in the U.S. House of Representatives between 1973 and 2002. We analyze these bills' fates and the effectiveness of their sponsors in guiding these proposals through Congress. Setting these proposed policies against a baseline of policy advancements in other areas, we demonstrate that health policy making has indeed been far more gridlocked than policy making in most other areas. We then isolate some of the causes of this gridlock, as well as some of the conditions that have helped to bring about health policy change.     

A Commentary on the MND Model and the Boone Critique: “Saying It Doesn’t Make It So”

We appreciate Boone’s (2011, this issue) critique of Rogers, Bender, and Johnson’s (2011, this issue) analysis of the Malingered Neurocognitive Dysfunction (MND) criteria. She raised good points and appeared in general agreement regarding several crucial limitations of the MND model. However, Boone remained mostly silent on several issues including the compelling results from our methodological review of MND studies and Criteria A through D. When provided, her comments tended to be very selective and were often presented with little or no empirical support. This contrasting pattern of strong statements and weak evidence appears to unintentionally parallel the MND model, which was documented in our original analysis. As a result of her criticism, however, we clarified our point regarding methodological limitations in establishing levels of TBI and its potential relevance to determinations of feigned cognitive impairment. We hope that these spirited discussions will stimulate a much-needed review and a fundamental revamping, if not replacement, of the MND model.     

Exclusion from patentability of diagnostic methods practised on the human body:Article 52(4) EPC

The exclusion of diagnostic methods practised on the human bodyfrom patentability was subject to clarification from the EnlargedBoard of Appeal in case G 1/04 of 16 December 2005. This casegives a practical example of the application of the EnlargedBoard's decision.     

An Analysis of Miranda Warnings and Waivers: Comprehension and Coverage

Miranda warnings enshrine the constitutional rights of custodial suspects against self-incrimination. However, the wording and sentence complexity of Miranda warnings and waivers vary dramatically from jurisdiction to jurisdiction. This study is the first extensive investigation of Miranda warning variations examining 560 Miranda warnings from across the United States. With Flesch-Kincaid reading comprehension as a useful metric, Miranda warnings varied from very simple comprehension (i.e., grade 2.8) to requiring postgraduate education. Miranda warnings are composed of five components (e.g., silence and evidence against you); marked variations were also observed in the comprehensibility of individual components. On average, the Miranda warning component on "continuing rights" requires a reading comprehension level six grades higher than the comparatively simple expression of the right to silence. Similar analyses were conducted on Miranda waivers. The content of these warnings differed on such issues as communicating (a) when access to an attorney would be granted (e.g., 45.9% specified only "during questioning") and (b) explicitly that indigent legal services were free (e.g., 31.8% directly informed suspects). Finally, the study identified representative Miranda components at different levels of reading comprehension as a template for further research.     

Glaucoma diagnostic invention ruling puts flesh on bones of G 1/04

The exclusion of diagnostic methods practised on the human bodyfrom patentability was subject to clarification from the EnlargedBoard of Appeal in Case G 1/04 of 16 December 2005. This casegives a practical example of the application of the EnlargedBoard's decision.     

Taphonomic changes to blunt force trauma: a preliminary study

This study examines the effects of taphonomic processes on blunt force trauma (BFT) through an experimental study involving pig heads. Of particular concern is the possibility that taphonomic changes can create pseudo-trauma and/or conceal evidence of actual trauma. BFT was inflicted on 10 pig skulls using a hammer. The skulls were subsequently exposed to the environment for 12 months. Seven taphonomic changes were evaluated: the freeze-thaw cycle; rodent gnawing; carnivore scavenging; presence/weight of soil; presence/weight of rain and snow; movement/displacement of bones; and discoloration due to sun bleaching and grass staining. Taphonomic effects varied between cancellous, compact, fresh, and degreased bone. Freezing and thawing, exposure to rain and snow, movement of the skulls, and soil erosion altered and, in some cases disguised, pre-existing trauma. Rodent and carnivore activity did not obliterate evidence of BFT. Recommendations for evaluating BFT on remains affected by taphonomic processes are presented. As each taphonomic process outlined by this study has the potential to disguise antemortem injury, the authors propose that one must carefully examine large, circular openings in the skull that may represent the remnant evidence of BFT.     

Personal Identification Using the Frontal Sinus*

Abstract: The frontal sinuses are known to be unique to each individual; however, no one has tested the independence of the frontal sinus traits to see if probability analysis through trait combination is a viable method of identifying an individual using the frontal sinuses. This research examines the feasibility of probability trait combination, based on criteria recommended in the literature, and examines two other methods of identification using the frontal sinuses: discrete trait combinations and superimposition pattern matching. This research finds that most sinus traits are dependent upon one another and thus cannot be used in probability combinations. When looking at traits that are independent, this research finds that metric methods are too fraught with potential errors to be useful. Discrete trait combinations do not have a high enough discriminating power to be useful. Only superimposition pattern matching is an effective method of identifying an individual using the frontal sinuses.