Failure time in the fiber-bundle model with thermal noise and disorder

The average time for the onset of macroscopic fractures is analytically and numerically investigated in the fiber-bundle model with quenched disorder and thermal noise under a constant load. We find an implicit exact expression for the failure time in the low-temperature limit that is accurately confirmed by direct simulations. The effect of the disorder is to lower the energy barrier.Comment: 11 pages, 6 figures; accepted for publication in Phys. Rev.

Medico-legal assessment of personal damage in older people: report from a multidisciplinary consensus conference

Ageing of the global population represents a challenge for national healthcare systems and healthcare professionals, including medico-legal experts, who assess personal damage in an increasing number of older people. Personal damage evaluation in older people is complex, and the scarcity of evidence is hindering the development of formal guidelines on the subject. The main objectives of the first multidisciplinary Consensus Conference on Medico-Legal Assessment of Personal Damage in Older People were to increase knowledge on the subject and establish standard procedures in this field. The conference, organized according to the guidelines issued by the Italian National Institute of Health (ISS), was held in Bologna (Italy) on June 8, 2019 with the support of national scientific societies, professional organizations, and stakeholders. The Scientific Technical Committee prepared 16 questions on 4 thematic areas: (1) differences in injury outcomes in older people compared to younger people and their relevance in personal damage assessment; (2) pre-existing status reconstruction and evaluation; (3) medico-legal examination procedures; (4) multidimensional assessment and scales. The Scientific Secretariat reviewed relevant literature and documents, rated their quality, and summarized evidence. During conference plenary public sessions, 4 pairs of experts reported on each thematic area. After the last session, a multidisciplinary Jury Panel (15 members) drafted the consensus statements. The present report describes Conference methods and results, including a summary of evidence supporting each statement, and areas requiring further investigation. The methodological recommendations issued during the Conference may be useful in several contexts of damage assessment, or to other medico-legal evaluation fields

CEFALEA DA PUNTURA LOMBARE, IPOTENSIONE LIQUORALE (S.I.H.) E TROMBOSI VENOSA CEREBRALE (C.V.T.) IN GRAVIDANZA. IPOTESI EZIOPATOGENETICHE A CONFRONTO

The lumbar puncture, a basic clinical procedure, involves also important changes in the circulation of the liquor according to the Monro-Kellie law. The postural headache and the associated neurological disorders, mainly the abducens palsy, are quite similar to the clinical picture observed in the SIH (Spontaneous Intracranic Hipotension). The Author presents a casistic review of adverse effects, headache and neurological disorders, after lumbar puncture in the obstetric anesthesiology, and discusses the possible ethiological hypotheses, with particular regard to the CVT onset (Cerebral Venous Thrombosis) as a result of a lumbar puncture. Patients with headaches that is refractory to usual therapy and patients with neurological deficit require cerebral imaging

Il Clinical Risk Management oggi: dal sistema alla persona. Aspetti medico-legali

Evitare il \u201crischio clinico\u201d prevenendo i c.d. \u201ceventi avversi\u201d iatrogeni, tanto nel rispetto del principio bioetico di precauzione quanto in quello della riduzione del danno, \ue8 stato un obiettivo che ha assunto una rilevanza progressivamente crescente nell\u2019ultimo decennio. La ricerca di strumenti di prevenzione si \ue8 imperniata attorno alla idea che la responsabilit\ue0 di tali eventi non fosse da attribuire tanto all\u2019errore di un singolo individuo quanto piuttosto ad errori e falle organizzative e logistiche del \u201csistema\u201d. Tuttavia dalle analisi critiche delle strategie di gestione del rischio tuttora impiegate appare evidente come, nonostante le imponenti risorse applicate, i risultati siano piuttosto modesti se confrontati con gli auspici. Sembrano essere responsabili di tale fallimento da un lato le difficolt\ue0 di motivazione dei team clinici, in assenza di un adeguato confronto crociato fra strutture sanitarie, e l\u2019impropria acquisizione di metodiche di analisi e prevenzione del rischio da realt\ue0 troppo diverse dal complesso ambito della Salute Pubblica. D\u2019altro canto trascurare l\u2019importanza di un sistematico controllo degli errori diagnostici rispetto a quanto accade per le carenze, pi\uf9 facilmente evidenziabili, del sistema organizzativo sembra altres\uec discutibile alla luce dei pi\uf9 recenti studi internazionali. In tal senso la Medicina Legale, con l\u2019esperienza maturata nel contesto dei casi di responsabilit\ue0 professionale, risulta certamente accreditata per una collaborazione alla futura gestione di un risk management incentrato, diversamente da quanto accade oggi, sulle strategie di prevenzione dell\u2019errore diagnostico

UN MONDO CHE CAMBIA: COME DEFINIREE VALUTARE OGGI LA DISABILITA

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L'inserimento mirato dei disabili. Un percorso accidentato tra "complessit\ue0" e "possibilit\ue0"

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Cap. 17: Assicurazioni Sociali

Obiettivi del capitol