1,720,956 research outputs found
Is hospital autopsy auditing suitable for clinical risk management? Actualities and perspectives of auditing in the autopsy room following Italian Law 24/2017 on patient safety
Full text linkBACKGROUND: autopsies are a valuable tool for understanding the physiopathology of a disease and it is the gold standard to assess the cause of death. The clinical autopsy is the ultimate medical service for a patient and plays a crucial role in the context of quality control, education of physicians and other medical personnel, as well as mitigation of risk of malpractice claims.OBJECTIVE: This study aims to demonstrate the importance of improving an autopsy service and the relevance of this investigation procedure in daily clinical practice by evaluating the rate of major discrepancies between the assumed cause of death and the ascertained cause of death after a complete post mortem investigation. A further aim is to classify these discrepancies as class I or class II discrepancies according to Goldman's criteria in order to asses performance quality.METHODS: a retrospective study of the hospital autopsies performed from June 2018 to March 2020 was conducted by considering a diversified dataset, including age and sex of the deceased as well as the clinical and pathological causes of death.RESULTS: 362 cases were taken into consideration. Major discrepancies were found in 71.3% of cases, with a class I error of 22.7% and a class II error of 48.6%. The most frequent misdiagnoses were cardiovascular disorder, embolism and aneurism rupture.DISCUSSION: The rate of major discrepancies and the rate of class I and class II errors are way above the rate found in literature. Despite the high rate of major discrepancy evidences collected from hospital autopsies (i.e. certainty of the cause of death, unknown comorbidities) strengthened the legal defense in cases of medical malpractice litigation. In our experience, by accurately determining the cause of death, revealing new or unexpected findings and possible diagnostic or technical errors, postmortem examinations can significantly contribute to the improvement of team performance and quality of care.CONCLUSION: The presence of clinicians during autopsy and the early sharing of results can be considered a new auditing strategy for hard clinical cases. Finally, by providing a clearer understanding of the nature and cause of the illness, the autopsy results assisted in the grieving process by reassuring family members that action or inaction on their part had not contributed to the death
Fentanyl transdermal patch: The silent new killer?
Full text linkBackground: Transdermal fentanyl patches represent an excellent alternative for the treatment of chronic and cancer-related pain, but can lead to death due to their incorrect use or increasing abuse. Purpose: Present an overview of literature regarding fentanyl patch related fatalities. Methods: Literature research into PubMed database for all types of publications. Search terms were “fentanyl”,“patch” and “death”. Additional publications by manual examination of references of the PubMed results were included. Results and conclusions: To date 29 publications about transdermal fentanyl patch related deaths are available onPubMed and their time span is of 26 years. A total of 674 deaths related to fentanyl were found, 658 associated with transdermal fentanyl patch. Use of patches was more frequently in males (68 %) than in females (32 %) and in the 31–40 and 41–50 decades. The most frequent route of administration was the transdermal route, followed by oral and intravenous route. Cause of death was in 63.5 % of cases drug abuse, followed by accidental death (16.2 %), death unrelated to fentanyl (13.3 %) and suicide (2.8 %). The use of concomitant drugs was reported in 19 of the 29 publications and antidepressant followed by benzodiazepines and ethanol were the most frequent discovered drugs. In conclusion, fentanyl transdermal patch misuse and abuse is a major problem and still need to be completely addressed
Aspetti medico legali delle armi da fuoco a munizionamento singolo
No full textQuesta tesi si propone di analizzare le caratteristiche della lesione balistica ed in particolare del foro d’ingresso a livello cutaneo.
Quando un fatto delittuoso avviene con l’impiego di un’arma da fuoco, le indagini forensi hanno lo scopo di stabilire il tipo di arma usato e il suo calibro, il numero di colpi esplosi, la distanza da cui tali colpi sono stati sparati e la posizione reciproca tra la vittima e l’aggressore. Queste informazioni sono ricavabili da un’attenta analisi del foro d’ingresso, con specifico riguardo ai fenomeni secondari dello sparo, quali l’orletto ecchimotico-escoriativo,
l’alone di ustione, di affumicatura, di punteggiatura e il “tatuaggio”, unitamente all'analisi del tramite e della ferita
d’uscita. Per la comprensione della dinamica del fenomeno è poi indispensabile la rilevazione delle caratteristiche dei reperti, quali i bossoli e i proiettili esplosi eventualmente rinvenuti sulla scena del sopralluogo, quindi è importante conoscere i principali costituenti di un’arma da fuoco ed i fenomeni della balistica interna, intermedia e terminale
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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