190 research outputs found
Punitive Damages: A Relic That Has Outlived Its Origins
The doctrine of punitive damages truly is an ancient legal concept that inexplicably has evaded commitment to the archives of history. Irrespective of the questionable validity of the doctrine at early common law, the simple fact remains that none of the historical justifications supports the punitive damage theory in today\u27s tort reparations system. The quest to bestow increasing compensation no longer can justify punitive damage awards because actual damages currently recoverable compensate plaintiffs more than adequately for every conceivable element of physical, emotional, or imagined injury. The desire to inflict punishment, likewise, represents an insupportable basis for awarding quasi-criminal fines in a civil context, and is inconsistent with ancient and modern jurisprudence because the civil law historically has been premised upon the concept of compensation and not penal retribution...
Part II of this Article traces the evolution of the punitive dam-age theory, including ancient origins and current status. Part III explores the various justifications theorized in support of the doctrine\u27s present viability. Part IV analyzes the patchwork applications and conflicting standards that measure conduct warranting an award of punitive damages, the treatment of vicariously liable corporate defendants, and other factors that affect the doctrine.This part emphasizes that punitive damages are awarded on the basis of highly questionable rationale and in an absurdly confusing and noticeably destructive manner. Part V argues for the complete abolition of the punitive damage concept: ratio potest allegari deficiente lege . In the absence of complete abolition of punitive damages, part VI asserts the urgent need for immediate stringent limitations on a doctrine that currently operates as an undisciplined and unfettered juggernaut of destruction in the civil tort system. Responsible jurisprudence, however, argues forcefully in favor of relegating this legal dinosaur to an era that long since has passed
The Emergence of Punitive Damages in Product Liability Actions: A Further Assault on the Citadel.
Abstract Forthcoming
The Duty to Warn and Instruct for Safe Use in Strict Tort Liability Symposium - Texas Community Property Law in Transition.
Abstract Forthcoming
The Emergence of Punitive Damages in Product Liability Actions: A Further Assault on the Citadel.
Abstract Forthcoming
On the thermoelectricity of correlated electrons in the zero-temperature limit
The Seebeck coefficient of a metal is expected to display a linear
temperature-dependence in the zero-temperature limit. To attain this regime, it
is often necessary to cool the system well below 1K. We put under scrutiny the
magnitude of this term in different families of strongly-interacting electronic
systems. For a wide range of compounds (including heavy-fermion, organic and
various oxide families) a remarkable correlation between this term and the
electronic specific heat is found. We argue that a dimensionless ratio relating
these two signatures of mass renormalisation contains interesting information
about the ground state of each system. The absolute value of this ratio remains
close to unity in a wide range of strongly-correlated electron systems.Comment: 15 pages, including two figure
Stroke Ready: a multi-level program that combines implementation science and community-based participatory research approaches to increase acute stroke treatment: protocol for a stepped wedge trial
Abstract
Background
Post-stroke disability is common, costly, and projected to increase. Acute stroke treatments can substantially reduce post-stroke disability, but few patients take advantage of these cost-effective treatments. Practical, cost-efficient, and sustainable interventions to address underutilized acute stroke treatments are currently lacking. In this context, we present the Stroke Ready project, a stepped wedge design, multi-level intervention that combines implementation science and community-based participatory research approaches to increase acute stroke treatments in the predominately African American community of Flint, Michigan, USA.
Methods
Guided by the Tailored Implementation of Chronic Disease (TICD) framework, we begin with optimization of acute stroke care in emergency departments, with particular attention given to our safety-net hospital partners. Then, we move to a community-wide, multi-faceted, stroke preparedness intervention, with workshops led by peer educators, over 2 years. Measures of engagement of the safety-net hospital and the feasibility and sustainability of the implementation strategy as well as community intervention reach, dose delivered, and satisfaction will be collected. The primary outcome is acute stroke treatment rates, which includes both intravenous tissue plasminogen activator, and endovascular treatment. The co-secondary outcomes are intravenous tissue plasminogen activator treatment rates and the proportion of stroke patients who arrive by ambulance.
Discussion
If successful, Stroke Ready will increase acute stroke treatment rates through emergency department and community level interventions. The stepped wedge design and process evaluation will provide insight into how Stroke Ready works and where it might work best. By exploring the relative effectiveness of the emergency department optimization and the community intervention, we will inform hospitals and communities as they determine how best to use their resources to optimize acute stroke care.
Trial registration
ClinicalTrials.gov
Trial Identifier
NCT03645590
.https://deepblue.lib.umich.edu/bitstream/2027.42/148211/1/13012_2019_Article_869.pd
Barriers and facilitators to reducing frequent laboratory testing for patients who are stable on warfarin: a mixed methods study of de-implementation in five anticoagulation clinics
Abstract
Background
Patients on chronic warfarin therapy require regular laboratory monitoring to safely manage warfarin. Recent studies have challenged the need for routine monthly blood draws in the most stable warfarin-treated patients, suggesting the safety of less frequent laboratory testing (up to every 12 weeks). De-implementation efforts aim to reduce the use of low-value clinical practices. To explore barriers and facilitators of a de-implementation effort to reduce the use of frequent laboratory tests for patients with stable warfarin management in nurse/pharmacist-run anticoagulation clinics, we performed a mixed-methods study conducted within a state-wide collaborative quality improvement collaborative.
Methods
Using a mixed-methods approach, we conducted post-implementation semi-structured interviews with a total of eight anticoagulation nurse or pharmacist staff members at five participating clinic sites to assess barriers and facilitators to de-implementing frequent international normalized ratio (INR) laboratory testing among patients with stable warfarin control. Interview guides were based on the Tailored Implementation for Chronic Disease (TICD) framework. Informed by interview themes, a survey was developed and administered to all anticoagulation clinical staff (n = 62) about their self-reported utilization of less frequent INR testing and specific barriers to de-implementing the standard (more frequent) INR testing practice.
Results
From the interviews, four themes emerged congruent with TICD domains: (1) staff overestimating their actual use of less frequent INR testing (individual health professional factors), (2) barriers to appropriate patient engagement (incentives and resources), (3) broad support for an electronic medical record flag to identify potentially eligible patients (incentives and resources), and (4) the importance of personalized nurse/pharmacist feedback (individual health professional factors). In the survey (65% response rate), staff report offering less frequent INR testing to 56% (46–66%) of eligible patients. Most survey responders (n = 24; 60%) agreed that an eligibility flag in the electronic medical record would be very helpful. Twenty-four (60%) respondents agreed that periodic, personalized feedback on use of less frequent INR testing would also be helpful.
Conclusions
Leveraging information system notifications, reducing additional work load burden for participating patients and providers, and providing personalized feedback are strategies that may improve adoption and utilization new policies in anticoagulation clinics that focus on de-implementation.https://deepblue.lib.umich.edu/bitstream/2027.42/137702/1/13012_2017_Article_620.pd
Measurement of the production of a W boson in association with a charm quark in pp collisions at √s = 7 TeV with the ATLAS detector
The production of a W boson in association with a single charm quark is studied using 4.6 fb−1 of pp collision data at s√ = 7 TeV collected with the ATLAS detector at the Large Hadron Collider. In events in which a W boson decays to an electron or muon, the charm quark is tagged either by its semileptonic decay to a muon or by the presence of a charmed meson. The integrated and differential cross sections as a function of the pseudorapidity of the lepton from the W-boson decay are measured. Results are compared to the predictions of next-to-leading-order QCD calculations obtained from various parton distribution function parameterisations. The ratio of the strange-to-down sea-quark distributions is determined to be 0.96+0.26−0.30 at Q 2 = 1.9 GeV2, which supports the hypothesis of an SU(3)-symmetric composition of the light-quark sea. Additionally, the cross-section ratio σ(W + +c¯¯)/σ(W − + c) is compared to the predictions obtained using parton distribution function parameterisations with different assumptions about the s−s¯¯¯ quark asymmetry
Barriers and facilitators to reducing frequent laboratory testing for patients who are stable on warfarin: a mixed methods study of de-implementation in five anticoagulation clinics
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