Seventeen-year Medical Professional Liability Experience in a Level III University Hospital

2020 ◽  
Vol 21 ◽  
Author(s):  
Matteo Bolcato ◽  
Giacomo Fassina ◽  
Matteo Sanavio ◽  
Aprile Anna
Keyword(s):  
Medical Professional ◽  
University Hospital ◽  
Medical Liability ◽  
Public Healthcare ◽  
Legal Analysis ◽  
Professional Liability ◽  
Time Period ◽  
The Difference ◽  
Set Up ◽  
Types Of Error

Introduction: In recent decades, the number of medical professional liability disputes have grown exponentially, becoming a well-studied aspect of public healthcare. Legal medicine is an essential tool in managing this phenomenon. Methods: This article reports the results of the analysis of disputes for medical professional liability in a Level III University Hospital in Italy. The study covers the time period from 01.01.2003 to 31.12.2019. Discussion: The difference in the rate of compensation between the various medical fields or types of error depends on specific medico-legal characteristics. The aim of advanced healthcare systems is to prevent medical liability disputes by analyzing this phenomenon and improving clinical risk management programs. In particular, according to our study, events related to organizational deficiencies are the most preventable. In addition, through the use of a dedicated reporting procedure, medico-legal analysis of malpractice cases may be the key to risk reduction. Conclusion: Every major hospital should set up a medico-legal watchdog responsible for collecting and analyzing information on professional medical liability disputes in order to prevent and manage such events.

scholarly journals The Impact of Defense Expenses in Medical Malpractice Claims

2012 ◽  
Vol 40 (1) ◽  
pp. 135-142 ◽  
Author(s):  
Aaron E. Carroll ◽  
Parul Divya Parikh ◽  
Jennifer L. Buddenbaum
Keyword(s):  
Medical Malpractice ◽  
The United States ◽  
Medical Professional ◽  
Liability Insurance ◽  
Medical Liability ◽  
Professional Liability ◽  
Medical Specialties ◽  
Insurance Premiums ◽  
Malpractice Claims ◽  
The Impact

Whenever health care reform is debated, the state of the medical professional liability (MPL) system (i.e., medical malpractice system) in the United States re-emerges as an issue of importance. What exactly is broken with the MPL system and what the implications are is a point of contention among different stakeholder groups. Recent data demonstrate that medical liability premiums have been improving in recent years and the majority of premiums remained flat in 2010. General agreement still exists, however, that medical professional liability insurance premiums have become unaffordable for many physicians, and coverage has become less available, especially for certain medical specialties and in specific areas of the country.Multiple factors go into the determination of medical professional liability insurance premiums including return on investments, reinsurance costs, claims frequency, average amount paid out on malpractice claims, defense expenses, and administrative costs such as underwriting expense.

Medical professional liability claims in Barcelona (2004–2009). Medico-legal analysis

2020 ◽  
Vol 46 (2) ◽  
pp. 56-65
Author(s):  
Dolors Giménez Pérez ◽  
Amadeo Pujol-Robinat ◽  
Josep Castellá García ◽  
Anna Espinal Berenguer ◽  
Ana Vázquez Fariñas ◽  
...  
Keyword(s):  
Medical Professional ◽  
Legal Analysis ◽  
Professional Liability ◽  
Liability Claims

scholarly journals Secondary Vulvodynia Patients Show Reduced Bacterial Diversity in Vestibular Microbiome

2020 ◽  
Author(s):  
Anu Aalto ◽  
Pashupati Mishra ◽  
Sari Tuomisto ◽  
Tiina Ceder ◽  
Kati Sundström ◽  
...  
Keyword(s):  
Bacterial Diversity ◽  
Bacterial Species ◽  
Alpha Diversity ◽  
Outpatient Setting ◽  
University Hospital ◽  
Healthy Controls ◽  
Sexual Pain ◽  
Time Period ◽  
The Difference ◽  
Differential Abundance Analysis

AbstractIntroductionLocalized Provoked Vulvodynia (LPV) is a quite common form of sexual pain among young women. Primary LPV (e.g. pain from the first attempted intercourse) and secondary LPV (pain-free time period before the initiation of symptoms) have been suggested to develop via different pathomechanisms. As inflammation is one possible trigger in LPV, changes in vaginal and/or vulvar microbiome may be an initiator of the inflammatory process leading to peripheral neurosensitization and predisposing women to LPV.AimAim of this pilot study was to find out, whether there are differences in vestibular microbiome between LPV patients and controls.Materials and MethodsThirty women with LPV (8 with primary and 22 with secondary LPV) and 21 controls were prospectively recruited to the study from Kanta-Häme Central Hospital and Tampere University Hospital (TAUH). Paired vestibular samples were collected in clinical outpatient setting and analyzed with 16s rRNA sequencing.ResultsLPV patients had lower BMI, were younger and more often nulliparous than controls. Patients with secondary vulvodynia had reduced (p = 0.06) bacterial species diversity (alpha diversity) and more clustered (p= 0.05) vaginal microbiome community (beta diversity) compared to healthy controls. Differential abundance analysis identified 31 bacterial taxa that contributed to the difference in bacterial composition between secondary cases and controls (p < 0.05). Bacteria taxa that were increased among patients were Gardneralla vaginalis (p<0.0001), Peptoniphilus spp (p<0.0001), Prevotella amnii (p<0.0001) and Streptococcus spp (p=0.0001). Several bacterial species were more abundant among healthy controls reflecting reduced bacterial diversity among patients.ConclusionIn patients with secondary LPV changes in vulvar microbiome may contribute to pathogenesis of LPV and ultimately lead to targeted therapeutic options. These preliminary findings need to be confirmed in a larger study.

Hepatitis A Seroprevalence Among Patients with Chronic Hepatitis B Infection: A Cross-Sectional Study in Iran During 2016-2017

2020 ◽  
Vol 20 (5) ◽  
pp. 748-751
Author(s):  
Seyed Ali Dehghan Manshadi ◽  
Neda Alijani ◽  
Mohammadreza Salehi ◽  
Omid Dadras ◽  
SeyedAhmad SeyedAlinaghi ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Hepatitis A ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Reasonable Approach ◽  
The Difference ◽  
Prevention Method

Introduction: The aim of this study was to determine the prevalence of exposure to hepatitis A by means of serologic markers in chronic hepatitis B patients, with the secondary aim of finding the best prevention method for hepatitis A infection in susceptible groups of our setting. Methods: During the period between 2016 and 2017, we recruited 403 hepatitis B patients aged more than 14 years and regularly attending the infectious diseases clinic at a referral university hospital, Tehran, Iran. A blood sample was collected from all the patients and tested for hepatitis A IgG. The data was analyzed by SPSS v.19. Results: Although none of the patients had previously received hepatitis A vaccine, the results for serologic level of hepatitis A IgG, demonstrated positive results in 379 (94%) cases. The mean age of patients with negative and positive IgG was 29.17 and 42.46 years, respectively; the difference was statistically significant (P≤0.001). The majority of seronegative patients were young adults aged < 25 years and 25 to 35 years (P <0.001). Conclusion: Seroprevalence of hepatitis A in chronic HBV patients in Iran is high. As HBV infected patients younger than 35 years could be seronagative for HAV infection, evaluation of these patients for HAV infection and vaccination of seronegative patients would be a reasonable approach.

scholarly journals COVID-19 does not stop obstetrics: what we need to change to go on safely birthing. The experience of a University Obstetrics and Gynecology Department in Milan

2020 ◽  
Vol 48 (9) ◽  
pp. 997-1000
Author(s):  
Nikita Alfieri ◽  
Stefano Manodoro ◽  
Anna Maria Marconi
Keyword(s):  
Health System ◽  
University Hospital ◽  
Obstetrics And Gynecology ◽  
Daily Routine ◽  
Clinical Services ◽  
Wuhan City ◽  
Set Up

AbstractSince SARS-COV-2 appeared in Wuhan City, China and rapidly spread throughout Europe, a real revolution occurred in the daily routine and in the organization of the entire health system. While non-urgent clinical services have been reduced as far as possible, all kind of specialists turned into COVID-19 specialists. Obstetric assistance cannot be suspended and, at the same time, safety must be guaranteed. In addition, as COVID-19 positive pregnant patients require additional care, some of the clinical habits need to be changed to face emerging needs for a vulnerable but unstoppable kind of patients. We report the management set up in an Obstetrics and Gynecology Unit during the COVID-19 era in a University Hospital in Milan, Italy.

Experimental Investigation into Driver Behavior along Curved and Parallel Diverging Terminals of Exit Interchange Ramps

2021 ◽  
pp. 036119812199742
Author(s):  
Alberto Portera ◽  
Marco Bassani
Keyword(s):  
Design Stage ◽  
Lane Change ◽  
Age And Gender ◽  
Traffic Conditions ◽  
Current Design ◽  
The Difference ◽  
Safety Countermeasures ◽  
And Gender ◽  
Set Up ◽  
Curve Radius

Current design manuals provide guidance on how to design exit ramps to facilitate driving operations and minimize the incidence of crashes. They also suggest that interchanges should be built along straight roadway sections. These criteria may prove ineffective in situations where there is no alternative to terminals being located along curved motorway segments. The paper investigates driving behavior along parallel deceleration curved terminals, with attention paid to the difference in impact between terminals having a curvature which is the same sign as the motorway segment (i.e., continue design), and those having an opposite curvature (i.e., reverse design). A driving simulation study was set up to collect longitudinal and transversal driver behavioral data in response to experimental factor variations. Forty-eight drivers were stratified on the basis of age and gender, and asked to drive along three randomly assigned circuits with off-ramps obtained by combining experimental factors such as motorway mainline curve radius (2 values), terminal length (3), curve direction (2), and traffic conditions (2). The motorway radius was found to be significant for drivers’ preferred speed when approaching the terminal. Terminal length and traffic volume do not have a significant impact on either longitudinal or transversal driver outputs. However, the effect of curve direction was found to be significant, notably for reverse terminals which do not compel drivers to select appropriate speeds and lane change positions. This terminal type can give rise to critical driving situations that should be considered at the design stage to facilitate the adoption of appropriate safety countermeasures.

scholarly journals Condensation/immersion mode ice-nucleating particles in a boreal environment

2020 ◽  
Vol 20 (11) ◽  
pp. 6687-6706
Author(s):  
Mikhail Paramonov ◽  
Saskia Drossaart van Dusseldorp ◽  
Ellen Gute ◽  
Jonathan P. D. Abbatt ◽  
Paavo Heikkilä ◽  
...  
Keyword(s):  
Field Campaign ◽  
Particle Species ◽  
Entire Field ◽  
Time Period ◽  
Regional Sources ◽  
Range Transport ◽  
Thermodynamic Conditions ◽  
Set Up ◽  
Boreal Environment ◽  
Measurement Location

Abstract. Ice-nucleating particle (INP) measurements were performed in the boreal environment of southern Finland at the Station for Measuring Ecosystem–Atmosphere Relations (SMEAR II) in the winter–spring of 2018. Measurements with the Portable Ice Nucleation Chamber (PINC) were conducted at 242 K and 105 % relative humidity with respect to water. The median INP number concentration [INP] during a 6-week measurement period was 13 L−1. The [INP] spanned 3 orders of magnitude and showed a general increase from mid-February until early April. No single dominant local or regional sources of INPs in the boreal environment of southern Finland could be identified. Rather, it is hypothesised that the INPs detected at SMEAR II are a result of long-range transport and dilution of INPs sourced far from the measurement site. Despite high variability, the measured [INP] values fall within the range expected for the [INP] measured elsewhere under similar thermodynamic conditions. The [INP] did not correlate with any of the examined parameters during the entire field campaign, indicating that no one single parameter can be used to predict the [INP] at the measurement location during the examined time period. The absence of a correlation across the entire field campaign also suggests that a variety of particles act as INPs at different times, although it was indirectly determined that ambient INPs are most likely within the size range of 0.1–0.5 µm in diameter on average. On shorter timescales, several particle species correlated well with the [INP]. Depending on the meteorological conditions, black carbon (BC), supermicron biological particles and sub-0.1 µm particles, most likely nanoscale biological fragments such as ice-nucleating macromolecules (INMs), correlated with the INP signal. However, an increase in the concentration of any of these particle species may not necessarily lead to the increase in the [INP]; the reasons for this remain unknown. Limitations of the instrumental set-up and the necessity for future field INP studies are addressed.

scholarly journals Large numbers of vertebrates began rapid population decline in the late 19th century

2016 ◽  
Vol 113 (49) ◽  
pp. 14079-14084 ◽  
Author(s):  
Haipeng Li ◽  
Jinggong Xiang-Yu ◽  
Guangyi Dai ◽  
Zhili Gu ◽  
Chen Ming ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Population Size ◽  
Threatened Species ◽  
Driving Forces ◽  
Population Decline ◽  
Cumulative Effect ◽  
Extinction Time ◽  
Time Period ◽  
Large Numbers ◽  
The Difference

Accelerated losses of biodiversity are a hallmark of the current era. Large declines of population size have been widely observed and currently 22,176 species are threatened by extinction. The time at which a threatened species began rapid population decline (RPD) and the rate of RPD provide important clues about the driving forces of population decline and anticipated extinction time. However, these parameters remain unknown for the vast majority of threatened species. Here we analyzed the genetic diversity data of nuclear and mitochondrial loci of 2,764 vertebrate species and found that the mean genetic diversity is lower in threatened species than in related nonthreatened species. Our coalescence-based modeling suggests that in many threatened species the RPD began ∼123 y ago (a 95% confidence interval of 20–260 y). This estimated date coincides with widespread industrialization and a profound change in global living ecosystems over the past two centuries. On average the population size declined by ∼25% every 10 y in a threatened species, and the population size was reduced to ∼5% of its ancestral size. Moreover, the ancestral size of threatened species was, on average, ∼22% smaller than that of nonthreatened species. Because the time period of RPD is short, the cumulative effect of RPD on genetic diversity is still not strong, so that the smaller ancestral size of threatened species may be the major cause of their reduced genetic diversity; RPD explains 24.1–37.5% of the difference in genetic diversity between threatened and nonthreatened species.

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