ANALYSIS OF DEATHS DURING THE "FIRST WAVE" IN THE POLICLINICO UNIVERSITY HOSPITAL OF BARI: THE IMPACT OF SARS-COV-2 PANDEMIC

Since March 2020, Italy has been one of the countries to record the highest mortality and morbidity rate related to the SARS-CoV-2 pandemic. The measures aimed at contrasting the spread of the virus have led to a rapid and profound reorganization of health services. The Puglia Region has identified in the A.O.U.C. "Policlinico di Bari", 3rd level hospital, the main regional hub for combating the pandemic emergency, providing for the conversion of certain nosocomial complexes into COVID-hospital. This produced a simultaneous reduction in user volumes and outpatient and elective services. With the present study, the death forms relating to patients who died at the Policlinico Hospital in the quarter February 15, 2020 - May 15 of 2020 were analyzed, making a comparison with the same quarter for the years 2011, 2018, and 2019 and evaluating the impact of the first wave" on the number of deaths and their distribution in the operating units of the main hospital of the region. The analysis showed in the first wave" the increase in the rate of emergency hospitalisations and the simultaneous increase in the number of deaths particularly evident in the emergency room and the clinical area units. © 2021 Giuffre Editore SpA. All rights reserved.

NEW MEDICAL-LEGAL PROBLEMS IN THE SCHOOL FIELD: DISTANCE LEARNING DURING COVID-19 EMERGENCY

The Coronavirus emergency has led, also in schools, to significant management and organizational problems related to guaranteeing health safety for both school staff and students. The use of dad (distance learning) and DID (integrated digital teaching) methods, while on the one hand it has offered the possibility of reducing the spread of the infectious risk, on the other hand gives rise to new responsibilities both for teachers and parents of minors, not easy to resolve, even in the face of an obvious legislative deficiency as a result of too rapid emergency investment. Who should take care of the students during the lessons not in presence? Who is responsible for their learning and safety? Who and how should intervene if students or the teacher run into problems during a distance lesson? What protection are there for minors but also for schools? What is the role of parents in this context? The current legislation does not adapt to the telematic social context and does not make it possible to clarify any responsibilities in schools. The same authors, at the end of the examination, propose solutions to some of the numerous problems emerged, as an exclusive further point of reflection. The Authors, motivated by the national chaos generated by the non-organizational uniformity, propose numerous ideas for reflection, with references both to the jurisprudential field and to the more specifically scientific-medicolegal one, not only limited to current events, but also with a view to a presumed future increasingly massive use of tools for the digitization of educational processes and education, pending a clarifying intervention by the Legislator, in concert with the institutions. © 2021 Giuffre Editore SpA. All rights reserved.

The Phon Effect In The Abandoned Mummified

Social isolation, confinement in the domestic context up to abandonment, phenomena as serious as they are frequent in modern society, has been emphasized by the advent of the Sars-Covid19 pandemic. The authors report the case of a 39-year-old woman found lifeless and in a partial state of mummification ("hair dryer effect"), lying on her back on the bed and covered, in part, by a quilt. At the foot of the bed a hairdryer was found connected to the electrical outlet. The environmental conditions favored the initiation of special transformative putrefactive processes, such as that of mummification. Investigating a mummified body found, to determine the cause and manner of death, can be difficult for the forensic pathologist. For the definition of the time of death we generally use the degree of evolution of postmortal transformative phenomena which, as we move away from the moment of death, offer less and less possibilities to delimit this period within narrow time limits, especially when these phenomena are strongly affected by the environmental factors in the context of which the corpse has stayed, as occurred in the present case. A careful analysis of the places where the death occurred and the circumstantial data possibly available to the coroner can provide useful data for the proper assessment of the case. The reporting of this event must be considered an important isolated case study for the analysis of the mummification process, as well as a warning light on an increasingly widespread social problem. © 2021, Journal of Legal, Ethical and Regulatory Issues. All Rights Reserved.

The protection of health in prison during the covid-19 pandemic

Being detained in jail is an acknowledged risk factor for physical and psychiatric morbidity.The impact of COVID-19 pandemic on the penitentiary system, already characterized by criticalities in terms of healthcare, including high infectious risk, has been considered a source of further danger within the prison and for the community.This problem has been raised by several observers, in the absence of a shared approach between states.The Italian Government enacted a series of measures aimed at penitentiary structures, to contain and manage health and safety risks. General precautions for infections prevention have been used, including frequent hands washing and environmental cleaning and disinfection procedures. Physical distancing in jail is extremely chal-lenging, and we deem that it was still impossible to apply it, despite the release of almost 8000 detainees, among those at greater health risk. Measures have been also ordered to limit external contacts with detainees, including a substantial or absolute sus-pension of visits from relatives, operators and lawyers, replaced by video meetings. Quarantine and isolation of suspect cases has also been ordered, including new prisoners. Despite unfavorable premises the analysis we did on available data indicates lower infection rate and lethality rate in prison than in general population. In this paper a synthetic framework of the sanitary problems in detention will be provided, then the data will be analyzed, providing possible interpretations potentially useful for the management of the pandemic at the community level. Infectious surveillance, compliance with sanitation standards, early treatment of suspected cases, lower mean age, efficacious isolation and quarantine strategies may explain the better outcomes in Italian penitentiary system, also in the impossibility to systematically apply physical distancing. © Pensa MultiMedia Editore – Rassegna Italiana di Criminologia-Anno 49° (XIV nuova serie) n. 4/2020.

Medical Legal Aspects of Telemedicine in Italy: Application Fields, Professional Liability and Focus on Care Services During the COVID-19 Health Emergency.

Telemedicine services can be classified into the macro-categories of specialist Telemedicine, Tele-health and Tele-assistance. From a regulatory perspective, in Italy, the first provision dedicated to the implementation of Telemedicine services is represented by the Agreement between the Government and the Regions on the document bearing "Telemedicine-National guidelines," approved by the General Assembly of the Superior Health Council in the session of 10th July 2012 and by the State Regions Conference in the session of 20th February 2014. Scientifically, several studies in the literature state that information and communication technologies have great potential to reduce the costs of health care services in terms of planning and making appropriate decisions that provide timely tools to patients. Another clear benefit is the equity of access to health care. The evolution of telemedicine poses a series of legal problems ranging from the profiles on the subject of authorization and accreditation to those concerning the protection of patient confidentiality, the definition and solution of which, in the absence of specific regulatory provisions, is mainly left to the assessment of compatibility of the practices adopted so far, with the general regulatory framework. In terms of professional liability, it is necessary to first clarify that the telemedicine service is comparable to any diagnostic-therapeutic health service considering that the telemedicine service does not replace the traditional health service, but integrates the latter to improve its effectiveness, efficiency and appropriateness.

Prevention and protection measures of healthcare workers exposed to SARS-CoV-2 in a university hospital in Bari, Apulia, Southern Italy.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-related infection has a major impact on public health, and healthcare workers (HCWs) are exposed to high biological risk. This paper describes the prevention procedures introduced at the University Hospital of Bari, Italy to reduce the risk to HCWs, consisting of enhanced preventive measures and activation of a report system to collect HCWs' contacts. Twenty-three confirmed cases of infection (0.4% of all HCWs) were reported in the 30-day observation period following implementation of the protocol. This shows that correct management of HCWs' contacts is essential to avoid nosocomial clusters.