Observatorio Complutense para la Seguridad Clínica Odontológica

Depto. de Medicina Legal, Psiquiatría y PatologíaFac. de MedicinaFALSEsubmitte

Professional liability in oral surgery : legal and medical study of 63 court sentences

Objectives: Dentistry, like all other health care professions, has in recent years been subjected to an increase in legal pressure by patients. Nevertheless, there are areas of activity in dentistry in which, whether because of their frequency or due to the importance of the damage and sequelae claimed, this legal pressure is greater. Amongst these areas of activity is that of oral surgery. Study design: To be meticulously analyzed in this report are 63 sentences issued by courts of second instance or higher levels regarding lawsuits involving oral surgery. The data collection file includes 13 variables. The descriptive and comparative statistical study by cross-referencing certain variables provides us with a clear and accurate picture of the lawsuit profile. Results and conclusions: Implantological surgery was the practice subject to the most claims due to surgery (55.6 percent: 35 sentences), and it drew our attention that in 71.4% of all cases (45 sentences) there was a ruling against the professional. The most frequent range of damage payments was between ?18,001 and ?60,000 (40.9%: 18 sentences), the highest amount having been ?24,000, an important factor to take into account when contracting professional civil liability insurance. © Medicina Oral S. L

Methodology for Flexible Modeling of Escalator Multibody Systems

This paper presents some particular escalator modelling features and methodologies developed to dramatically reduce time cost regarding two aspects: computation and implementation. CITEF (Railway Technologies Research Centre) has been modelling escalators for three years. During this time, several static, kinematic and dynamic escalator models have been developed and improved. In parallel, automation tools mainly intended for saving time cost have been described in a piecemeal fashion. These tools are based on the repetitiveness of the bodies, and a definition of the joints, forces and loops, and on the cyclic movement of most of the bodies involved. In addition, noise signals have been programmed from MATLAB to simulate them in SIMPACK software in order to apply robust design methods for studying and optimizing certain parameters

Paleopatología dental de siete cabezas egipcias momificadas del Museo de Antropología Forense de la Univ. Complutense de Madrid

X Congreso Nacional de Paleopatología. Univesidad Autónoma de Madrid, septiembre de 200

Patient safety in dentistry : dental care risk management plan

Objectives: Although the safety of patients has been one of the inherent concerns of dental practice, but because the proposals made in the field of dentistry are few and improperly structured, this paper constitutes an attempt to present a proposal titled "Plan for Dental Health Care Risk Management," promoted by the General Council of Dentists of Spain, including a description of the proposed work methodology. Design: The "risk management plan" proposed in this paper is based on applying the basic concepts dealt with in patient safety to the field of dentistry, due to the fact that the available bibliography contains no specific "health care risk management plan" for dentistry specifically. Results and conclusions: In order to implement health care risk management in the field of dental care provided at any level throughout Spain, a seven-step plan which covers the main objectives in Patient Safety is provided. © Medicina Oral S. L

Analysis of 415 adverse events in dental practice in Spain from 2000 to 2010

Introduction: The effort to increase patient safety has become one of the main focal points of all health care profes - sions, despite the fact that, in the field of dentistry, initiatives have come late and been less ambitious. The main objective of patient safety is to avoid preventable adverse events to the greatest extent possible and to limit the negative consequences of those which are unpreventable. Therefore, it is essential to ascertain what adverse events occur in each dental care activity in order to study them in-depth and propose measures for prevention. Objectives: To ascertain the characteristics of the adverse events which originate from dental care, to classify them in accordance with type and origin, to determine their causes and consequences, and to detect the factors which facilitated their occurrence. Material and Methods: This study includes the general data from the series of adverse dental vents of the Spanish Observatory for Dental Patient Safety (OESPO) after the study and analysis of 4,149 legal claims (both in and out of court) based on dental malpractice from the years of 2000 to 2010 in Spain. Results: Implant treatments, endodontics and oral surgery display the highest frequencies of adverse events in this series (25.5%, 20.7% and 20.4% respectively). Likewise, according to the results, up to 44.3% of the adverse events which took place were due to predictable and preventable errors and complications. Conclusions: A very significant percentage were due to foreseeable and preventable errors and complications that should not have occurred

Methodologies for Designing and Developing New Concepts in Vertical Transportation

Escalator and moving walkway are multibody systems with a design of more than a century. Developed methodology allows studying and improving any subsystem of both systems. In addition, new concepts can be developed and tested without the necessity and cost of a real construction. CITEF (Railway Technologies Research Centre) has been modelling escalators for more than four years. Several complex and innovative models has been developed to characterize static, kinematic and dynamic escalator behaviour. The high number of mechanical elements that are part of escalators complicate modelling task. In this way, methodologies and tools have been developed in order to automate these task and saving computational and time costs. Developed methodologies have been validated with the results of comparing real measurements and simulated outputs from a dynamic model

Definition and temporal evolution of the heat and cold waves over the Spanish Central Plateau from 1961 to 2010

The temporal behavior of the annual frequency of heat and cold waves observed between 1961 and 2010is established for the Spanish Central Plateau and for the two sub-areas in it. The series of daily maximumand minimum temperature anomalies for the working areas were calculated from the daily data concerningtemperature anomalies. The thresholds of these series of anomalies, determined by the P10 and P90 percentilesvalues, were obtained. Heat waves occur when there are two or more consecutive days on which the maximumand minimum temperature anomalies are simultaneously greater than the values of the thresholds obtainedfor the P90 percentile. The heat waves that affected the Spanish Central Plateau and the two sub-areas duringthe period of time considered were identified and their monthly and annual frequencies were obtained. Likewise,a cold wave is considered to have occurred when there are two or more consecutive days on which themaximum and minimum temperature anomalies are simultaneously lower than the thresholds establishedby the corresponding P10 percentiles. The cold waves occurring in the study area were identified and theirmonthly and annual frequencies in the study period were established. According to the results, the monthswith highest number of heat waves between 1961 and 2010 were May (25 waves) and June (23 waves).Trend analysis of the series of annual frequencies indicates that there was an increasing trend towards theoccurrence of heat waves, with a confidence level greater than 99%. The linear model established indicatesthat an increase had occurred in the frequency of heat waves in the Spanish plateau of the order of 0.6 wavesevery 10 years. Regarding cold waves, these were detected in each month of the year and their frequencyranged between eight and 16 events per year. The months with lowest number of cold waves were April(nine), July (eight) and August (nine), and the months with the highest number were March, May, June andOctober, with 16 cold waves. The years with the highest number of cold waves were 1969, 1971 and 1977,with seven cases. In the other years the annual rate was between one and six. Trend analysis of the series ofannual frequencies indicated that there was a decreasing frequency of cold waves, at the confidence levelof 99%. When a linear model was considered for the Spanish Central Plateau a decreasing frequency of thecold waves of the order of 0.54 waves in every 10 years was observed from 1961 to 2010.Se establece el comportamiento temporal de las frecuencias anuales de olas de calor y frío observadas entre 1961 y 2010 en la Meseta Central española y en las dos zonas que se pueden diferenciar en ella. A partir de los datos diarios de anomalías de temperatura se determinan las series de anomalías diarias de temperaturas máxima y mínima para las áreas de trabajo. Se obtienen los valores umbrales de dichas series de anomalías, determinados por los percentiles P10 y P90. Se establece la existencia de ola de calor cuando se observan dos o más días consecutivos en los que las anomalías de temperatura máxima y de temperatura mínima superan, simultáneamente, los valores de los umbrales establecidos por el P90. Se identifican las olas de calor que han afectado a la Meseta Central española, y a las dos subzonas durante el periodo de estudio y se establecen sus frecuencias mensuales y anuales. Asimismo, considerando que existe una ola de frío cuando hay dos o más días consecutivos en que los valores de temperaturas máximas y mínimas diarias son inferiores, simultáneamente, a los umbrales establecidos por el P10, se identifican las olas de frío y se establecen sus frecuencias mensuales y anuales en el periodo de estudio. Los resultados indican que los meses con mayor número de olas de calor entre 1961 y 2010 son mayo (25 olas) y junio (23 olas). El análisis de tendencia de las series de frecuencias anuales obtenidas indica que existe una tendencia creciente de olas de calor a un nivel de confianza mayor del 99%. El modelo lineal establece que se ha producido un aumento en la frecuencia de olas de calor en la Meseta Central española del orden de 0.6 olas cada 10 años. En cuanto a las olas de frío, se detectan olas de frío todos los meses del año en número que oscila entre ocho y 16 olas. Los meses con menor número son abril (nueve), julio (ocho) y agosto (nueve), y los meses con mayor número son marzo, mayo, junio y octubre con 16 olas. Los años con mayor número de olas de frío son 1969, 1971 y 1977 con siete casos; en el resto de los años la frecuencia anual está comprendida entre uno y seis. El análisis de tendencia de la serie de frecuencias anuales indica que existe una tendencia decreciente de las olas de frío a un nivel de confianza del 99%. Si se considera un modelo lineal, en la Meseta Central española se ha producido, entre 1961 y 2010, una disminución de olas de frío del orden de 0.54 olas cada 10 años

Analysis of temporal behavior of climate variables using artificial neural networks: an application to mean monthly maximum temperatures on the Spanish Central Plateau

A forecasting model for the mean monthly maximum temperatures (TMaxMean) using an artificial neuronal network (ANN) of the multilayer perceptron type (Multilayer Perceptron, MLP) has been developed. This model forecast the TMaxMean variable one month ahead after the last data point of the climate series. The study area considered is the central plateau of the Iberian Peninsula (Castilla y León and Castilla la Mancha). The data series of mean monthly maximum temperature (TMaxMean) were obtained of the observations at the stations of the synoptic and climatological network of the Agencia Estatal de Meteorología (AEMET). The data set is divided into two samples of training and testing. The training data set is used for the model development and the test set is used to evaluate the established model. The parameters of the ANN are fitted experimentally. A supervised training of the MLP ANN is performed. We used a backpropagation (BP) training algorithm with a variable learning rate. After that we evaluated the forecasting skills of the model from the coefficient of determination (R2), the mean square root error (MSE) and the dispersion and sequence graphics of the real and simulated series. The results obtained with the model (indicates a good fit between the real and simulated series) are compared with those obtained with ARIMA models. The results are similar, while the model ANN is able to adjust the extreme values of the real series and certain anomalies, which is not the case with ARIMA models

Proposal of a "Checklist" for endodontic treatment

Objectives: On the basis of the 'Surgical Checklist' proposed by the WHO, we propose a new Checklist model adapted to the procedures of endodontic treatment. Study Design: The proposed document contains 21 items which are broken down into two groups: those which must be verified before beginning the treatment, and those which must be verified after completing it, but before the patient leaves the dentist's office. Results: The Checklist is an easy-to-use tool that requires little time but provides, order, logic and systematization by taking into account certain basic concepts to increase patient safety. Discussion: We believe that the result is a Checklist that is easy to complete and which ensure the fulfillment of the key points on patient safety in the field of endodontics