Quantifying the Economics of Medical Malpractice: a view from a civil law perspective

Life is full of uncertainties. Legal rules should have a clear intention, motivation and purpose in order to diminish daily uncertainties. However, practice shows that their consequences are complex and hard to predict. For instance, tort law has the general objectives of deterring future negligent behavior and compensating the victims of someone else’s negligence. Achieving these goals are particularly difficult in medical malpractice cases. To start with, when patients search for medical care they are typically sick in the first place. In case harm materializes during the treatment, it might be very hard to assess if it was due to substandard medical care or to the patient’s poor health conditions. Moreover, the practice of medicine has a positive externality on the society, meaning that the design of legal rules is crucial: for instance, it should not result in physicians avoiding practicing their activity just because they are afraid of being sued even when they acted according to the standard level of care. The empirical literature on medical malpractice has been developing substantially in the past two decades, with the American case being the most studied one. Evidence from civil law tradition countries is more difficult to find. The aim of this thesis is to contribute to the empirical literature on medical malpractice, using two civil law countries as a case-study: Spain and Italy. The goal of this thesis is to investigate, in the first place, some of the consequences of having two separate sub-systems (administrative and civil) coexisting within the same legal system, which is common in civil law tradition countries with a public national health system (such as Spain, France and Portugal). When this holds, different procedures might apply depending on the type of hospital where the injury took place (essentially whether it is a public hospital or a private hospital). Therefore, a patient injured in a public hospital should file a claim in administrative courts while a patient suffering an identical medical accident should file a claim in civil courts. A natural question that the reader might pose is why should both administrative and civil courts decide medical malpractice cases? Moreover, can this specialization of courts influence how judges decide medical malpractice cases

Bullying, cyberbullying and social support: a study in a Portuguese school

Publicado em "Proceedings of INTED2017 Conference". ISBN 978-84-617-8491-2This paper presents a study that was developed with a sample of middle and high school students of the 3rd cycle of a Portuguese school, with an average age of 13.52 years (SD = 0,96) and an almost equal distribution in terms of sex (73 males vs. 70 females) and schooling (44 in the 7th year, 49 in the 8th year and 50 in the 9th year). The results show a prevalence of Observation Behaviour in the Victimization Scale and School Aggression and the dimension Satisfaction with Family in Satisfaction Scale Social Support. It was found that 37% of the sample has experienced Cyberbullying and 59% have had knowledge of Cyberbullying situations, which correlates positively with the Observation and Victimization behaviours of Victimization Scale and School Aggression.info:eu-repo/semantics/publishedVersio

Judicial Independence and Party Politics in the Kelsenian Constitutional Courts: The Case of Portugal

In this paper we test to what extent the Kelsenian-type of constitutional judges are independent from political parties by studying of the Portuguese Constitutional Court. The results yield three main conclusions. First, constitutional judges in Portugal are quite sensitive to their political affiliations and their political party\u27s presence in government when voting. Second, peer pressure is very relevant. Third, the 1997 reform that was enacted to increase judicial independence has had no robust statistically significant effect

Judicial Behavior and Devolution at the Privy Council

In this article, we study judicial behavior at the Judicial Committee of the Privy Council (JCPC). British judges in general, and British high court judges in particular, are perceived to be independent and isolated from political pressure and interference. Furthermore, these judges tend to show a particularly high rate of consensus. This has led many scholars to consider that, contrarily to what holds for several other courts around the world (such as the US Supreme Court), the attitudinal model does not find support when British higher court judges are considered. In this paper we assess whether similar conclusions might be drawn from the JCPC, another British court of last resort. We create a unique dataset to study empirically decisions of the JCPC and investigate the extent to which judges exhibit different judicial behavior depending on the type of appeal being brought to the court, i. e. Commonwealth, devolution and domestic appeals. Our results indicate a higher polarization of judicial behavior in the context of devolution appeals (as measured by separate opinions). We discuss these results in the context of the comparative judicial behavior literature and the role of courts in the common law world (with particular reference to human rights).info:eu-repo/semantics/publishe

O Uso da Internet, o Bullying, o Cyberbullying e o Suporte Social em Jovens do 3º Ciclo: um estudo não experimental correlacional realizado numa Escola Portuguesa

O bullying, visto como “um comportamento consciente, intencional, deliberado, hostil e sistemático, de uma ou mais pessoas, cuja intenção é ferir os outros” (Souza, Simão & Caetano, 2014, pg. 582) existe desde sempre, embora seja considerado recente o seu estudo, enquanto fenómeno com grande impacto, principalmente na vida das crianças e jovens. E as novas tecnologias trouxeram uma nova dimensão ao bullying tradicional – o cyberbullying - ou seja, a violência perpetrada através da internet. Havendo um vínculo estreito entre os dois conceitos, e estando tão presentes na sociedade contemporânea, principalmente entre os adolescentes, sentimos necessidade de desenvolver uma investigação mais profunda sobre esta temática. Optámos assim por correlacionar o bullying, com o cyberbullying, com o apoio social e ainda com o isolamento, porque é relevante e urgente compreender a ligação entre estes fenómenos. Procurámos então saber se na sociedade atual, os jovens que se sentem mais satisfeitos com o apoio que recebem dos outros, estão menos sujeitos ao bullying/cyberbullying (quer seja como vítimas ou como agressores) e se há também alguma relação com o isolamento, dado que esta geração parece mais afastada das relações offline, entre outros fatores devido ao tempo que passam na internet. Neste sentido, o nosso interesse final está na prevenção e intervenção com os jovens e com as relações interpessoais que vivenciam. O estudo incidiu sobre alunos do 3º ciclo de uma escola portuguesa, tendo uma amostra de 145 alunos, com uma idade média de 13,52 anos. Os instrumentos utilizados para a recolha de dados consistiram num Questionário Sociodemográfico, no EVAE - Escala de vitimização e agressão escolar (Cunha,S.M-s/d); no CQ_A-Questionário Cyberbullying (Calvete, Orue, Estevez, Villardón, & Padilla, 2009 - cuja versão portuguesa foi traduzida e adaptada por Pinto e Cunha, em 2011); na ESSS- Escala da Satisfação com o Suporte Social (Ribeiro, J., 1999) e um Questionário sobre a utilização da internet, criado por nós. Concluímos sumariamente que, nos resultados obtidos, não se confirmaram diferenças estatisticamente significativas na EVAE, CBQ E CBQ-V. No entanto, verificámos diferenças estatisticamente significativas na ESSS, mais concretamente nas dimensões da Satisfação com a Família, na Intimidade e na Atividade Social. / Bullying is seen as “a conscious, intentional, hostile and systematic behaviour, from one or more people, with harmful intent towards others” (Souza, Simão & Caetano, 2014, p. 582). Even though its study is considered recent, bullying as a phenomenon of great impact particularly in the lives of children and juveniles has always existed. Additionally, the new technologies have brought a new dimension to the traditional bullying – cyberbullying – i.e. violence attained through the Internet. There is a close relation between these two concepts and being so prevalent in present-day society, especially amongst adolescents, we have identified a need to develop a more in depth research on this subject. We correlate bullying, cyberbullying, social support and isolation aiming to understand the relevant and crucial connections between these occurrences. We then inquired if in nowadays society the youths who feel more fulfilled with the support they receive from others, are less exposed to bullying/cyberbullying (either as victims or aggressors) and if there is any correlation with isolation, as this generation appears more absent of offline relationships, due, among other factors, to the time they expended on the Internet. Our ultimate goal lies in the prevention and intervention with the youths and with the interpersonal relationships they experience. The study focused on students from the 3rd cycle of basic education from a Portuguese school, with a sample of 145 students with a mean age of 13.52 years old. The data was collected using tools such as a Sociodemographic Questioner, a scholar victimization and aggression scale: EVAE (Cunha,S.M-s/d), a Cyberbullying Questioner: CQ_A-Questionário Cyberbullying (Calvete, Orue, Estevez, Villardón, & Padilla, 2009 – Portuguese version translated and adapted by Pinto e Cunha, in 2011), a scale of social support satisfaction: ESS (Ribeiro, J., 1999) and an internet usage Questioner developed by us. In summary, we concluded that the acquired results do not confirm statically significant differences between EVAE, CBQ and CBQ-V. However, statistical differences were observed in ESSS, more specifically in areas of Family Satisfaction, Intimacy and Social Activity

Unidade de Internamento Psiquiátrico para Jovens dos 15 aos 25 Anos: Um Estudo de Follow-up

Introduction: Adolescence and early adulthood are life stages characterized by significant physical, psychological, and social transformations. The transitional age, between 15 and 25 years old, is considered a high-risk period for the development of psychopathology, representing a critical period of opportunities and challenges for mental health intervention. Our objective was to do 4-year follow-up study was conducted on young individuals who were hospitalized during the year 2018 in the acute psychiatric inpatient unit Unidade Partilhada, dedicated to individuals aged 15 to 25 years old. The aim was to assess the sociodemographic and clinical characteristics of the sample, inpatient characteristics, rehospitalization rate, psychopathological status, quality of life, satisfaction with the provided care, and maintenance of follow-up appointments; establishing relationships between the mentioned variables. Methods: Standardized telephone interviews were conducted using the reduced version of the Mental Health Inventory (MHI) and the World Health Organization’s Abbreviated Instrument for Quality of Life Assessment. Clinical records were also consulted. Results: There was a higher percentage of female patients (52.1%). The discharge diagnosis of mood disorders (54.3%) was significantly higher in females, while psychotic disorders (23.4%) were significantly higher in males (Fisher = 40; p<0.001). The duration of hospitalization (average=16.1 days; SD=13.6 days) was significantly longer for psychotic disorders compared to mood disorders (p=0.009). A percentage of 41.5% of young individuals were readmitted, with 6.3% readmitted within 30 days and 35.2% readmitted within 365 days. At the time of the follow-up interview, 80.9% considered themselves “better,” and 62.7% reported being “satisfied” or “very satisfied” with their lives. A percentage of 74.5% continued to receive outpatient care, with significantly lower MHI scores observed among individuals without current follow‐up. A percentage of 37.2% reported being “very satisfied” or “extremely satisfied” with the care provided. Conclusion: Obtaining knowledge and data that allow for the characterization of psychiatric hospitalization during the transitional age is fundamental for the planning, organization, and optimization of care provided to this population. Valuing patient opinions and fostering closer relationships between healthcare professionals and young patients promotes treatment adherence.Introdução: A adolescência e início da idade adulta, são fases do ciclo de vida marcadas por grandes transformações físicas, psicológicas e sociais. A faixa etária de transição, entre os15 e 25 anos, é considerada uma idade de risco para o desenvolvimento de psicopatologia, representando um período crítico de oportunidades e desafios para a intervenção em saúde mental. O nosso objetivo foi realizar um estudo de follow-up a 4 anos dos jovens internados durante o ano de 2018 na unidade de internamento agudo psiquiátrico Unidade Partilhada, destinado a jovens dos 15 aos 25anos de idade; pretendeu‐se avaliar as características sociodemográficas e clínicas da amostra, as características do internamento, a taxa de reinternamento, o estado psicopatológico, qualidade de vida, grau de satisfação com os cuidados prestados e manutenção do seguimento em consulta; estabelecendo relações entre as variáveis mencionadasMétodos: Entrevista telefónica padronizada, com aplicação da versão reduzida do Mental Health Inventory (MHI) e o Instrumento Abreviado de Avaliação da Qualidade de Vida da Organização Mundial de Saúde; consulta de processo clínico.Resultados: Há uma maior percentagem de doentes do sexo feminino (52,1%). O diagnóstico de alta de perturbaçãodo humor (54,3%) foi significativamente superior no sexo feminino e o de perturbação psicótica (23,4%) foi significativamente superior no sexo masculino (Fisher= 40; p<0,001). A duração do internamento (média=16,1 dias; DP=13,6 dias) foi significativamente superior para as perturbações psicóticas em comparação com as perturbações do humor (p=0,009). Dos jovens, 41,5% foram readmitidos, 6,3% num período inferior a 30 dias e 35,2% num período inferior a 365 dias. À data da entrevista de follow-up, 80,9% consideram estar “melhor”; e 62,7% estar “satisfeitos”ou “muito satisfeitos” com a sua vida. Mantêm acompanhamento em consulta 74,5%, sendo a pontuação do MHI significativamente inferior nos jovens sem seguimento atual. Referem estar “muito satisfeitos” ou “mais que muito” com o atendimento prestado, 37,2%.Conclusão: O conhecimento e obtenção de dados que permitam a caracterização do internamento psiquiátrico em idade de transição é fundamental para a planificação, organização e otimização dos cuidados prestados a esta população. A valorização da opinião do doente e a aproximação entre profissionais de saúde e doentes jovens, favorece a adesão ao tratamento

3D bioactive composite scaffolds for bone tissue engineering

Bone is the second most commonly transplanted tissue worldwide, with over four million operations using bone grafts or bone substitute materials annually to treat bone defects. However, significant limitations affect current treatment options and clinical demand for bone grafts continues to rise due to conditions such as trauma, cancer, infection and arthritis. Developing bioactive three-dimensional (3D) scaffolds to support bone regeneration has therefore become a key area of focus within bone tissue engineering (BTE). A variety of materials and manufacturing methods including 3D printing have been used to create novel alternatives to traditional bone grafts. However, individual groups of materials including polymers, ceramics and hydrogels have been unable to fully replicate the properties of bone when used alone. Favourable material properties can be combined and bioactivity improved when groups of materials are used together in composite 3D scaffolds. This review will therefore consider the ideal properties of bioactive composite 3D scaffolds and examine recent use of polymers, hydrogels, metals, ceramics and bio-glasses in BTE. Scaffold fabrication methodology, mechanical performance, biocompatibility, bioactivity, and potential clinical translations will be discussed

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements