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Farm tractors are large, heavy, powerful vehicles with a high center of gravity. When driven carelessly on sloping, irregular, or slippery ground, tractors can overturn sideways and cause the death by crush asphyxia of the driver or passengers, especially if appropriate safety equipment is not fitted or used. The aim of this review is to focus on the diagnostic difficulties with which coroners and forensic pathologists have to cope when a confirmation of crush asphyxia after tractor side rollover is required by judicial authorities. Forensic investigations in such cases must involve the meticulous analysis of the death scene and the mechanical characteristics of the vehicle together with accurate postmortem and toxicological examination.

A case of the accidental death of a 42-year-old male injured by a screw log splitter in the yard of a private house necessitated a post-mortem examination and the technical evaluation of the machinery. The autopsy revealed fatal traumatic lesions to the head, caused by impact with a downward-moving log. Analysis of the scene of the accident showed that the machinery was not equipped with safety systems and was used incorrectly by the operators. The decision of the Criminal Court determined the absence of liability of the parties to be persecuted.

Observational prospective population-based incidence study. The main objective of this study was to assess the incidence of traumatic spinal cord injuries (TSCIs) and incidence rates, in order to provide estimates by age, gender, characteristics and cause. This study was conducted at acute-care spinal cord injury (SCI) hospitals and SCI centers from 11 Italian regions, between 1 October 2013 and 30 September 2014. Data of all consecutive patients with acute TSCI who met the inclusion criteria were obtained through case reporting by clinicians. The data were collected into a web database. Incidence rates and incidence rate ratios were calculated and stratified by age, gender, cause, level and completeness. From 50% of the entire population of Italy, 445 new cases of TSCI were included. The crude incidence rate of TSCI was 14.7 cases per million per year (95% CI: 13.4–16.4); the overall male to female ratio was 4:1 and the mean age was 54. Complete information was available in 85% of the sample and revealed tetraplegia in 58% and incomplete lesion in 67% of cases. The leading cause of TSCI was falls (40.9%) followed by road traffic accidents (33.5%). The leading cause was falls for patients over 55 and road traffic accidents for patients under 55. The changing trend of TSCI epidemiology concerns the increase in the average age of TSCI people and the increase of both cervical and incomplete lesions. The etiology shows the primacy of falls over road traffic accidents and suggests the need for a change in prevention policies.

La gestione del rischio clinico, quale strumento per migliorare la qualità e l’appropriatezza delle prestazioni sanitarie, sta acquisendo negli ultimi anni un ruolo sempre più centrale nelle politiche di Clinical Governance. Uno dei principali fattori alla base di tale ascesa è la necessità di arginare il crescente contenzioso nell’ambito della responsabilità sanitaria con strumenti che permettano di mappare il profilo di rischio delle strutture ospedaliere e territoriali e, al contempo, di porre in essere strumenti di prevenzione/correzione delle criticità rilevate. Tale necessità è stata resa ancora più cogente dall’introduzione di franchigie assicurative molto elevate (anche oltre il milione di euro) e dal ritiro di molte compagnie assicurative dal mercato della medical malpractice, che ha indotto diverse aziende (in taluni casi intere Regioni) ad attivare sistemi di autogestione dei sinistri.

Agricultural work encompasses a variety of activities which carry with them different risks. One such activity is working at height, a frequent cause of fatal accidents. The aim of this work is to describe and discuss a typical case of a fall from height in order to understand the traumatic consequences of such accidents, to analyze the dynamics and lesions, and highlight the dangers of working at height. These falls, which may involve farm workers who are officially or unofficially employed, can produce injuries whose seriousness is not always strictly correlated to the height of the fall.

Issue Patient safety is one of the most important goals in healthcare facilities and it must be guaranteed in all steps and settings of patient pathways. To improve patient safety standards in Friuli Venezia Giulia an Italian north-eastern region, in 2011 it has been started a project that involved all the public and private healthcare facilities (both hospitals and Long Term Care Facilities) operating in the Regional Health System. Description The project was focused on ten patient safety related topics (clinical record, …

The objective of this study was to investigate current levels of work safety in agriculture, based on interviews conducted in a composite sample of 103 farms located in the region Friuli Venezia Giulia (North-East of Italy). The survey has outlined a number of patterns that were consistently found across all types of farms and only slightly varied depending on farm size, type of production and location. The results were used to define guidelines for safety experts on the field with new, updated approaches for risk assessment and accident prevention in the farms.