Empirical Perspectives on Mediation and Malpractice

The use of mediation in the medical malpractice context is examined. The impact of any court-related alternative dispute resolution program is also discussed

What Is a Life Worth in North Carolina? A Look at Wrongful-Death Awards

This Article examines the amounts recovered in 123 wrongful-death cases filed in North Carolina over a five-year period. The dataset is unique in that it includes both jury verdicts and settlements. Although the injury - death - was the same in each of these cases, the amounts recovered varied greatly. Several patterns emerge from the data. First, there is a strong negative correlation between age and the amount recovered. Second, the manner in which the decedent died seems to make a difference. Violent deaths, for example, led to larger recoveries than did nonviolent deaths. Third, jury verdicts produced much larger recoveries than did settlements. Finally, the results underscore the critical role of insurance in wrongful death cases

What Is a Life Worth in North Carolina? A Look at Wrongful-Death Awards

This Article examines the amounts recovered in 123 wrongful-death cases filed in North Carolina over a five-year period. The dataset is unique in that it includes both jury verdicts and settlements. Although the injury - death - was the same in each of these cases, the amounts recovered varied greatly. Several patterns emerge from the data. First, there is a strong negative correlation between age and the amount recovered. Second, the manner in which the decedent died seems to make a difference. Violent deaths, for example, led to larger recoveries than did nonviolent deaths. Third, jury verdicts produced much larger recoveries than did settlements. Finally, the results underscore the critical role of insurance in wrongful death cases

Empirical Perspectives on Mediation and Malpractice

The use of mediation in the medical malpractice context is examined. The impact of any court-related alternative dispute resolution program is also discussed

Empirical Perspectives on Mediation and Malpractice

Rapporten baseras på strukturerade intervjuer och sammanlagt intervjuades 18 personer, med två till 30 års yrkeserfarenhet som aktivt deltagit i prioriteringsarbete med vertikala rangordningslistor. Resultatet av intervjuerna visade både på underlättande och försvårande faktorer för delaktighet i prioriteringsarbete. Sjuksköterskorna uttryckte svårigheter dels med att få gehör för sina synpunkter och dels med att precisera vad som enligt deras uppfattning är omvårdnad ur ett helhetsperspektiv. De framförde också att omvårdnadsåtgärder vare sig hade varit föremål för prioriteringsdiskussioner eller senare inkluderats i rangordningslistan. Bland arbetsterapeuter och sjukgymnaster upplevdes den rangordningslista de själva arbetat fram som en trygghet i kliniskt beslutsfattade och stöd för öppenhet i kommunikation med allmänheten. Representanter för samtliga vårdyrkesgrupper i undersökningen upplevde det svårt att inkludera den egna professionens yrkesspecifika åtgärder i rangordningen. Det framkom också att uppdraget med att ta fram rangordningslistor måste vara tydligt beskrivet och att prioriteringar bör diskuteras utifrån ett brett behovsperspektiv i väl förberedda multiprofessionella grupper. Arbete med öppna prioriteringar och rangordningslistor kräver många olika perspektiv och förutsätter att alla samverkande professioner har likvärdiga förutsättningar. Riktade utbildningsinsatser inom omvårdnad och rehabilitering behövs för att tillämpning av den nationella modellen för öppna vertikala prioriteringar ska få en vidare användning även inom dessa områden.　 When health services cannot meet all care needs we must set priorities. This has always been done, but seldom in a systematic way. In Sweden, the Health Services Act places the responsibility for healthcare priority setting on local governing bodies (mainly the county councils and regions). The task of priority setting is grounded in the ethical platform and must apply across all health services. In 2003, the Östergötland County Council initially decided that specific limitations must be established regarding the supply of health services. However, follow-up of the county-council-wide effort to set priorities reveals that this work has not reached far enough down into the organisation. Earlier reports from the National Centre for Priority Setting in Health Care describe the initial political decision-making process, the extent to which the policy decisions have been implemented in health care, and the progress of the county council’s prioritisation initiative from 2003 to 2006. With this report we aim to increase knowledge regarding how staff groups other than management- level physicians participated in establishing vertical ranking lists during this period and how these lists were used in Östergötland County Council

miRNA contributions to pediatric-onset multiple sclerosis inferred from GWAS.

ObjectiveOnset of multiple sclerosis (MS) occurs in childhood for approximately 5% of cases (pediatric MS, or ped-MS). Epigenetic influences are strongly implicated in MS pathogenesis in adults, including the contribution from microRNAs (miRNAs), small noncoding RNAs that affect gene expression by binding target gene mRNAs. Few studies have specifically examined miRNAs in ped-MS, but individuals developing MS at an early age may carry a relatively high burden of genetic risk factors, and miRNA dysregulation may therefore play a larger role in the development of ped-MS than in adult-onset MS. This study aimed to look for evidence of miRNA involvement in ped-MS pathogenesis.MethodsGWAS results from 486 ped-MS cases and 1362 controls from the U.S. Pediatric MS Network and Kaiser Permanente Northern California membership were investigated for miRNA-specific signals. First, enrichment of miRNA-target gene network signals was evaluated using MIGWAS software. Second, SNPs in miRNA genes and in target gene binding sites (miR-SNPs) were tested for association with ped-MS, and pathway analysis was performed on associated target genes.ResultsMIGWAS analysis showed that miRNA-target gene signals were enriched in GWAS (P = 0.038) and identified 39 candidate biomarker miRNA-target gene pairs, including immune and neuronal signaling genes. The miR-SNP analysis implicated dysregulation of miRNA binding to target genes in five pathways, mainly involved in immune signaling.InterpretationEvidence from GWAS suggests that miRNAs play a role in ped-MS pathogenesis by affecting immune signaling and other pathways. Candidate biomarker miRNA-target gene pairs should be further studied for diagnostic, prognostic, and/or therapeutic utility

Engineering behaviour and mechanical - empirical relationships for a problematic New Zealand tropical residual soil

Unlike sedimentary clays, many residual soils do not exhibit clear mechanical-empirical relationships to assist in their engineering characterisation. In contrast, this paper discusses one residual clay in which such relationships may be determined, and examines whether the effects of structure in this clay may be assessed using a framework previously developed for sedimentary clays. The Northland Allochthon residual clay of New Zealand is a problematic soil of the fersiallitic type, prone to slope instability. Atterberg limit tests on soils from five field sites in the same geological unit show considerable variation, but that they are mechanically related. Triaxial tests were performed on reconstituted and intact soil specimens from one field site. Normalization of the strength envelope using the equivalent stress on the intrinsic compression line suggests that soil structure, destroyed in reconstituted specimens, plays a role in the shear strength of this soil in its intact state. Overconsolidated behaviour, in the absence of geological preloading, suggests the existence of a pseudo-preconsolidation pressure associated with weathering processes. The results show that the saturated mechanical behaviour of this residual soil is in line with that of sedimentary clays and that mechanical-empirical relationships developed for such clays may be applied in this case

Terrain-aided navigation for long-range AUVs in dynamic under-mapped environments

Deploying long‐range autonomous underwater vehicles (AUVs) mid‐water column in the deep ocean is one of the most challenging applications for these submersibles. Without external support and speed over the ground measurements, dead‐reckoning (DR) navigation inevitably experiences an error proportional to the mission range and the speed of the water currents. In response to this problem, a computationally feasible and low‐power terrain‐aided navigation (TAN) system is developed. A Rao‐Blackwellized Particle Filter robust to estimation divergence is designed to estimate the vehicle's position and the speed of water currents. To evaluate performance, field data from multiday AUV deployments in the Southern Ocean are used. These form a unique test case for assessing the TAN performance under extremely challenging conditions. Despite the use of a small number of low‐power sensors and a Doppler velocity log to enable TAN, the algorithm limits the localisation error to within a few hundreds of metres, as opposed to a DR error of 40 km, given a 50 m resolution bathymetric map. To evaluate further the effectiveness of the system under a varying map quality, grids of 100, 200, and 400 m resolution are generated by subsampling the original 50 m resolution map. Despite the high complexity of the navigation problem, the filter exhibits robust and relatively accurate behaviour. Given the current aim of the oceanographic community to develop maps of similar resolution, the results of this study suggest that TAN can enable AUV operations of the order of months using global bathymetric models