Malpractice and patient safety descriptors: an innovative grid to evaluate the quality of clinical records

Introduction: The medical record contains all the health information related to the patient’s clinical condition and its evolution during hospitalization. It was defined by the Italian Ministry of Health in 1992 as "The information tool designed to record all relevant demographic and clinical information about a patient during a single episode of hospitalization". The documents and information in a Medical Record must meet the following criteria: traceability, clarity, accuracy, authenticity, pertinence and completeness. The objectives of our study was to develop a tool capable of assessing the quality of the clinical record and pointed the critical point at the Organizational, Technical - Professional, Managerial level. Methods: To evaluate the quality of the medical documentation, we created an assessment grid composed of 4 sections with a total of 92 criteria. This grid was tested on 200 medical records that were randomly selected from 25 (18 medical and 7 surgical) wards of a teaching hospital in Rome. Results: The grid contains 4 sections. The first part regards administrative and clinical data; the second assesses the quality of hospital stay and surgical/invasive procedures; the third part is concerned with the discharge of the patient and the fourth aims to identify the presence of advisory reports given to the patient. This grid has been validated to verify internal consistency with Cronbach's Alpha = 0,743. Conclusions: Medical records were analyzed using a validated tool with grids to identify critical issues in care activities. Weaknesses in the system were identified in order to improve planning. The sample testing also in terms of ‘self-assessment' represents a tool to introduce activities to improve safety and quality of care, greatly reducing the costs of litigation

Principal Eigenvalue of Mixed Problem for the Fractional Laplacian: Moving the Boundary Conditions

We analyze the behavior of the eigenvalues of the following non local mixed problem \left\{ \begin{array}{rcll} (-\Delta)^{s} u &=& \lambda_1(D) \ u &\inn\Omega,\\ u&=&0&\inn D,\\ \mathcal{N}_{s}u&=&0&\inn N. \end{array}\right Our goal is to construct different sequences of problems by modifying the configuration of the sets $D$ and $N$, and to provide sufficient and necessary conditions on the size and the location of these sets in order to obtain sequences of eigenvalues that in the limit recover the eigenvalues of the Dirichlet or Neumann problem. We will see that the non locality plays a crucial role here, since the sets $D$ and $N$ can have infinite measure, a phenomenon that does not appear in the local case (see for example \cite{D,D2,CP})

Sprofondamenti in aree urbane: il caso del parco “Ytzhak Rabin” (via Panama, Roma)

In Rome urban area, within the garden dedicated to Ytzhak Rabin (a portion of the Villa Ada park), occurrence of a few collapses has been observed for the first time in September 2012. In the surroundings, presence of underground cavities- mainly catacombs- is conversely well documented by previous studies. Local authorities were immediately informed of sinkholes formation, because collapses occurred very close to a playground located in a highly frequented sector of the garden. Propagation processes of the phenomena, periodically monitored since their first observation, significantly fastened after a period of heavy rainfalls on Rome area in January- February 2014. Thus, multidisciplinary geophysical investigations have been started in agreement with Civil Protection of Rome Municipality, who has taken preliminary safety measures (installation of fences and danger signals). Hitherto, 28 sinkholes have been identified, aligned along a WNW-ESE trending zone, testifying localized collapses of the roof of underground cavities, probably belonging to the palaeocristian catacomb systems dug nearby Via Salaria. Preliminary geophysical prospections have been performed in a small test area, in order to verify methods applicability and thus program a systematic survey of the whole garden. Drillings, and direct exploration of the accessible galleries, will complete the reconstruction of underground geometry and conservation state of vaults and pillars. Once completed the hazard assessment, the planning of urgent works is expected in order to restore the complete use of the garden.Published25 - 422TR. Ricostruzione e modellazione della struttura crostaleN/A or not JC

Active and capable fault? The case study of Prata D'Ansidonia (L'Aquila, Central Apennine)

The study deals with the morphogenetic meaning of several linear scarps that carved the paleo-landsurface of Valle Daria, an extended geomorphological feature located between Barisciano (AQ) and Prata D'Ansidonia (AQ). These villages are situated in the southern termination of the L'Aquila intermontane basin (one of the largest basin of the central Apennines), nearby the epicentral area of the 6th April 2009 earthquake (Mw 6.1). These scarps, up to 3 meters high and up to 1.5 km long, define narrow/elongated flat-bottom depressions, filled by colluvial deposits. These depressions are carved into fluvial-deltaical conglomerates, dated back to the lower Pleistocene. Even if different authors have interpreted these shapes as a paleodrainage or secondary faults, a morphometrical study of the Valle Daria paleo-landsurface provided several information which cast doubt on these two interpretations. In order to better understand the nature and the state of activity of these lineaments, geological, geomorphological and geophysical surveys were carried out. A paleoseismological trench pointed out two events of deformation. The curvilinear shape of the shear plane seems to be related to a slow deformation, attributable to collapse-phenomena. Three GPR profiles, two ERT profiles and two microgravimetrical profiles seem to corroborate this interpretation. Therefore, this study permits to attribute the genesis of these scarps to tectono-karstic phenomena, excluding the presence of an active and capable fault.Published346-3494T. Sismologia, geofisica e geologia per l'ingegneria sismicaN/A or not JC

Indagini geofisiche e geochimiche di un sinkhole in formazione nell’area di Guidonia (Lazio)

The Plio-Quaternary Acque Albule Basin is already known for the occurrence of sinkholes; since the spring 2014, it has been ongoing the study of an active subsidence process, which formed a depressed area near the Guidonia village. During the last year, the phenomenon has become more intense giving rise to two collapses along the eastern rim of the depression. Thus, geophysical and geogeochemical investigation campaigns started in order to understand the genesis and evolution of the phenomenon. Survey results allowed a geological and structural characterization, showing the presence of “travertino” at the depression margins and its absence therein. It has been recognized, by the geophysics, features with NW-SE and NNE-SSW direction ascribable to a possible depression fracturing and consistent with regional structural trends. Thus, it has been possible to plan and perform geognostic investigation consisting in two drillings aimed to define the stratigraphy of the marginal and inner part of the depression.Published7 - 162TR. Ricostruzione e modellazione della struttura crostaleJCR Journa

RETRACE-3D PROJECT, a multidisciplinary approach for the construction of a 3D crustal model: first results and seismotectonic implications

The RETRACE-3D (centRal italy EarThquakes integRAted Crustal modEl) Project has been launched with the ambitious goal to build, as first result, a new, robust, 3D geological model of broad consensus of the area struck by the 2016-2018 Central Italy seismic sequencePublishedBologna3T. Sorgente sismica4T. Sismicità dell'Itali

Geophysical surveys integrated in the "Il Piano" area (Isola d'Elba, Italy) to goal census and cataloging cavities anthropic origin

Numerosi sprofondamenti si sono verificati nell’ultimo decennio in un’area di fondovalle compresa nel territorio di Rio Marina all’Isola d’Elba (località Il Piano), ed hanno interessato abitazioni, aree agricole e la strada di collegamento tra Rio Marina e Rio nell’Elba, la SP26. Nell’intorno affi ora la formazione del Calcare Cavernoso dove si è sviluppato un sistema caveale, la “Grotta di San Giuseppe”; inizialmente ciò faceva ipotizzare anche la presenza di cavità all’interno del substratocarbonatico. L’integrazione di diversi metodi geofisici indiretti ha evidenziato invece un altro motivo causale di origine antropica nella formazioni di questi sinkhole. Gli obiettivi dello studio sono stati ottenere un modello geologico e idrogeologico della zona; individuare possibili cavità e/o carenze di massa/densità che sarebbero potute evolvere in sprofondamenti; valutare la suscettibilità della zona agli sprofondamenti. Tra i risultati delle indagini geofisiche integrate: a) i modelli gravimetrici 2D e 3D hanno fornito informazioni sulla distribuzione spaziale delle densità nel sottosuolo; b) la 3D-ERT ha caratterizzato il comportamento elettrico dei materiali; c) il metodo H/V ha permesso di stimare lo spessore medio delle alluvioni. Le indagini geofisiche integrate, unite ad un’accurata ricostruzione della trasformazione ambientale dell’area, hanno consentito una caratterizzazione geomorfologica e idrogeologica del territorio. L’interpretazione di questi dati ha permesso di comprendere l’innesco dei fenomeni di sprofondamento e di redarre mappe delle aree a rischio.Published81-907A. Geofisica per il monitoraggio ambientale7SR AMBIENTE – Servizi e ricerca per la societàJCR Journa

Indagini Geofisiche

Nell'ambito del progetto per la Microzonazione sismica dell'area aquilana, coordinata dal DPC, il Gruppo di Lavoro ha condotto le indagini di MS nella Conca di Roio.Published336-3854T. Sismologia, geofisica e geologia per l'ingegneria sismic

Production of He-4 and (4) in Pb-Pb collisions at root(NN)-N-S=2.76 TeV at the LHC

Results on the production of He-4 and (4) nuclei in Pb-Pb collisions at root(NN)-N-S = 2.76 TeV in the rapidity range vertical bar y vertical bar <1, using the ALICE detector, are presented in this paper. The rapidity densities corresponding to 0-10% central events are found to be dN/dy4(He) = (0.8 +/- 0.4 (stat) +/- 0.3 (syst)) x 10(-6) and dN/dy4 = (1.1 +/- 0.4 (stat) +/- 0.2 (syst)) x 10(-6), respectively. This is in agreement with the statistical thermal model expectation assuming the same chemical freeze-out temperature (T-chem = 156 MeV) as for light hadrons. The measured ratio of (4)/He-4 is 1.4 +/- 0.8 (stat) +/- 0.5 (syst). (C) 2018 Published by Elsevier B.V.Peer reviewe