Professional liability insurance in Obstetrics and Gynaecology: estimate of the level of knowledge about malpractice insurance policies and definition of an informative tool for the management of the professional activity

<p>Abstract</p> <p>Background</p> <p>In recent years, due to the increasingly hostile environment in the medical malpractice field and related lawsuits in Italy, physicians began informing themselves regarding their comprehensive medical malpractice coverage.</p> <p>Methods</p> <p>In order to estimate the level of knowledge of medical professionals on liability insurance coverage for healthcare malpractice, a sample of 60 hospital health professionals of the obstetrics and gynaecology area of Messina (Sicily, Italy) were recluted. A survey was administered to evaluate their knowledge as to the meaning of professional liability insurance coverage but above all on the most frequent policy forms ("<it>loss occurrence</it>", "<it>claims made</it>" and "<it>I-II risk</it>"). Professionals were classified according to age and professional title and descriptive statistics were calculated for all the professional groups and answers.</p> <p>Results</p> <p>Most of the surveyed professionals were unaware or had very bad knowledge of the professional liability insurance coverage negotiated by the general manager, so most of the personnel believed it useful to subscribe individual "private" policies. Several subjects declared they were aware of the possibility of obtaining an extended coverage for gross negligence and substantially all the surveyed had never seen the <it>loss occurrence </it>and <it>claims made </it>form of the policy. Moreover, the sample was practically unaware of the related issues about insurance coverage for damages related to breaches on informed consent. The results revealed the relative lack of knowledge--among the operators in the field of obstetrics and gynaecology--of the effective coverage provided by the policies signed by the hospital managers for damages in medical malpractice. The authors thus proposed a useful information tool to help professionals working in obstetrics and gynaecology regarding aspects of insurance coverage provided on the basis of Italian civil law.</p> <p>Conclusion</p> <p>Italy must introduce a compulsory insurance system which could absorb, through a mechanism of "distribution of risk", the malpractice litigation and its costs. This will provide compensation in accidental cases where it wouldn't be possible to demonstrate carelessness, imprudence and/or lack of skill.</p

The Fourth Level of Theatrical Awareness

Abstract The Fourth Level of Theatrical Awareness By Greg Scurria, MFA A thesis submitted in partial fulfillment of the requirements for the degree of Master of Fine Arts in Theatre Pedagogy at Virginia Commonwealth University. Virginia Commonwealth University, Master of Fine Arts in Theatre Pedagogy Virginia Commonwealth University, 2010 Major Director: Dr. Noreen C. Barnes, Director of Graduate Studies, Theatre Department This text is a partial record and narrative of the production of John Steinbeck’s Of Mice and Men that opened on May 1st 2009 for a three day run ending May 3rd 2009 and Shel, a collection of Shel Silverstein short plays and poems, which opened on September 18th for a three day run that ended September 20th. It also covers the work done by a small group on Yazmina Reza’s The God of Carnage during the Spring of 2010. The text details the creative process of the two productions while also examining two hypotheses that grew out of that work. It will examine the heightened sense of ownership experienced while working on Of Mice and Men and the subsequent unsuccessful attempt to recreate that atmosphere during Shel. The other hypothesis involves the discovery of the fourth level of theatrical awareness and how it can be used to help actors. The fourth level of theatrical awareness exists outside of the traditional character based exploration of text. Students who examine the text using the fourth level attempt to view the play in its entirety without character bias. Actors using the fourth level look at shape, major themes of the play, and spatial awareness in order to analyze the play using a directorial eye. The possible applications of this work will be discusses as well as concerns about its use. The attempts to apply this fourth level of theatrical awareness in Shel will be discussed, as well as the attempts to find practical applications for the fourth level while working with The God of Carnage. Finally, this paper will outline a plan for implementing the fourth level of theatrical awareness in a production and highlight other areas of exploration involving dramaturgical investigation. As a whole, it will trace the growth and transformation of these ideas and plot a plan to continue expanding on them in the future

Sicilian Cannoli of Enhanced Stability

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Development of modeling techniques for rolling element bearings

Molti sistemi si affidano a cuscinetti volventi per garantire il moto relativo di corpi (e.g. alberi) al fine di minimizzare l'attrito e garantendo comunque il vincolo richiesto. Una predizione accurata della dinamica della macchina richiede la modellazione ad alta fedeltà dei sotto sistemi ed i relativi componenti, inclusi modelli accurati di contatto lubrificato e non. A causa del continuo aumento delle performace richieste e del continuo aumento di densità di potenza, il comportamento a livello di sistema ed il comportamento del singolo componente non possono più essere studiati separatamente. Il forte accoppiamento tra le differenti scale di analisi e l'intrinseca non linearità del contatto non conforme, influenza fortemente la dinamica dell'intero sistema. Questa tesi mira a sviluppare modelli di contatto che garantiscano livelli di fedeltà crescente, sia per contatti di punto (e.g. Cuscinetti a sfere), sia per contatti di linea (e.g. Cuscinetti a rulli). Grazie ai modelli di contatto sviluppati siamo in grado di avere una predizione del comportamento del cuscinetto molto accurata, la quale è inoltre in grado di tenere in considerazione vari fenomeni come giochi interni, momenti giroscopici, lubrificazione, forze centrifughe etc. I modelli proposti offrono la possibilità di investigare il comportamento dei più rilevanti tipi di cuscinetti con 5-dof (gradi di libertà) garantendo un basso costo computazionale senza tuttavia compromettere la fedeltà del modello. Queste tecniche di modellazione sono orientate sia alla descrizione del comportamento del contatto a se stante, ma hanno anche lo scopo di garantire una efficacie analisi multibody di interi sistemi

An advanced modeling technique for rolling element bearings in elastohydrodynamic field

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Natural product extraction via hydrodynamic cavitation

Hydrodynamic cavitation applied to natural product extraction from biological resources is the enabling technology of the bioeconomy. The study identifies the main economic and technical advantages of this relatively new natural product extraction route. Economic benefits chiefly originate from the low cost of manufacturing, low capital expense and superior product quality. The main technical benefits originate from the lack of noxious emissions, ease of scale-up, and highly controllable conditions affording lot-to-lot product consistency. We conclude suggesting arguments for which cavitation technology will be used both by incumbent companies, as well as by new entrants in the natural product market

High Yields of Shrimp Oil Rich in Omega-3 and Natural Astaxanthin from Shrimp Waste

A valued marine oil rich in omega-3 lipids and natural astaxanthin is obtained with remarkably high yield (up to 5 wt %) extending to pink shrimp waste (head and carapace) using the approach to extract fish oil from fish processing byproducts using d-limonene. Biobased limonene is an excellent solvent for both unsaturated lipids and astaxanthin-based carotenoids preventing oxidative degradation during the extraction cycle including solvent separation at 85 °C. Explaining the deep red color of the shrimp oil obtained, computational simulation suggests that d-limonene is also a good solvent for natural astaxanthin abundant in shrimp

Cross-linked natural IntegroPectin films from citrus biowaste with intrinsic antimicrobial activity

Pectin recovered via hydrodynamic cavitation (IntegroPectin) from lemon and grapefruit agri-food waste intrinsically containing antimicrobial bioactive substances (flavonoids, phenolic acids, terpenes, and terpenoids) was used to generate innovative and eco-compatible films that efficiently inhibit the growth of Gram-negative pathogens. Extensive characterization of films confirmed the presence of these substances, which differently interact with the polysaccharide polymer (pectin), plasticizer (glycerol), surfactant (Tween 60), and cross-linker (Ca2+), conferring to these films a unique structure. Besides, IntegroPectin-based films constitute versatile systems for the sustained, controlled, and slow-release (up to 72&nbsp;h) of bioactive substances in an aqueous environment. This feature is crucial for the good in vitro antimicrobial activity exerted by IntegroPectin films against three Gram-negative bacteria (two indicator pathogen strains Pseudomonas aeruginosa ATCC 10145, P. aeruginosa PAO1, and the clinical isolate Klebsiella pneumoniae) that are involved in the global emergence of the antimicrobial resistance. Graphical abstract: [Figure not available: see fulltext.]