PERSPECTIVAS CONTEMPORÂNEAS NA COBRANÇA DE ALIMENTOS: UMA ANÁLISE DA EFETIVIDADE JURÍDICA DAS MEDIDAS COERCITIVAS INDIRETAS

This article addresses contemporary perspectives on child support collection, analyzing the legal effectiveness of indirect coercive measures in Brazilian law. Nonpayment of child support compromises human dignity, and due to the insufficiency of direct coercive measures, such as civil imprisonment, indirect measures have been adopted to ensure compliance with the support obligation. The study employs a qualitative and deductive approach, analyzing legislation, doctrine, jurisprudence, and scholarly articles. The objectives achieved involve understanding the applicability and effectiveness of indirect coercive measures, such as suspension of the National Driver's License (CNH), passport seizure, bank account and credit card blockage. The research shows that these measures prove more effective than civil imprisonment, pressuring the debtor without violating their fundamental rights. The application of indirect coercive measures should be analyzed on a case-by-case basis, considering the particularities of each situation, and respecting the debtor's fundamental rights. Child support collection is a relevant social issue, involving the protection of human dignity and the minimization of social inequalities, demanding effective public policies, and strengthening collection mechanisms. The article concludes that indirect coercive measures represent a new perspective on child support collection in Brazil, being an effective and less burdensome alternative to civil imprisonment. Legal practitioners and society must work towards ensuring the effectiveness of child support collection and the protection of the fundamental human rights of the recipients.Este artículo analiza la efectividad de medidas coercitivas indirectas en la recaudación de manutención de menores en Brasil, ante la insuficiencia de medidas directas como el encarcelamiento civil. Se utiliza un enfoque cualitativo y deductivo, examinando legislación, doctrina, jurisprudencia y artículos académicos. Se evalúa la aplicabilidad y efectividad de medidas indirectas, como suspensión de la Licencia Nacional de Conducir, decomiso de pasaporte, bloqueo de cuentas bancarias y tarjetas de crédito. La investigación muestra que estas medidas resultan más efectivas que el encarcelamiento civil, presionando al deudor sin violar sus derechos fundamentales. La aplicación de medidas coercitivas indirectas debe considerar las particularidades de cada caso y respetar los derechos del deudor. La recaudación de manutención de menores es un problema social relevante, requiriendo políticas públicas efectivas y fortalecimiento de mecanismos de recaudación. El artículo concluye que las medidas coercitivas indirectas son una alternativa efectiva y menos gravosa que el encarcelamiento civil, y aboga por garantizar la efectividad de la recaudación y protección de los derechos humanos fundamentales de los beneficiarios.Este artigo aborda as perspectivas contemporâneas na cobrança de alimentos, analisando a efetividade jurídica das medidas coercitivas indiretas no Direito brasileiro. A inadimplência alimentar compromete a dignidade da pessoa humana e, diante da insuficiência das medidas coercitivas diretas, como prisão civil, medidas indiretas têm sido adotadas para garantir o cumprimento da obrigação alimentar. O estudo utiliza uma abordagem qualitativa e dedutiva, analisando legislação, doutrina, jurisprudência e artigos científicos. Os objetivos alcançados envolvem a compreensão da aplicabilidade e efetividade de medidas coercitivas indiretas, como a suspensão da Carteira Nacional de Habilitação (CNH), apreensão do passaporte, bloqueio de contas bancárias e cartões de crédito. A pesquisa mostra que essas medidas se revelam mais efetivas do que a prisão civil, pressionando o devedor sem violar seus direitos fundamentais. A aplicação das medidas coercitivas indiretas deve ser analisada caso a caso, considerando as particularidades de cada situação e respeitando os direitos fundamentais do devedor. A cobrança de alimentos é uma questão social relevante, que envolve a proteção da dignidade humana e a minimização das desigualdades sociais, demandando políticas públicas efetivas e fortalecimento dos mecanismos de cobrança. O artigo conclui que as medidas coercitivas indiretas representam uma nova perspectiva na cobrança de alimentos no Brasil, sendo uma alternativa efetiva e menos gravosa à prisão civil. Operadores do direito e a sociedade devem atuar no sentido de garantir a efetividade da cobrança de alimentos e a proteção dos direitos humanos fundamentais dos alimentandos.Este artigo aborda as perspectivas contemporâneas na cobrança de alimentos, analisando a efetividade jurídica das medidas coercitivas indiretas no Direito brasileiro. A inadimplência alimentar compromete a dignidade da pessoa humana e, diante da insuficiência das medidas coercitivas diretas, como prisão civil, medidas indiretas têm sido adotadas para garantir o cumprimento da obrigação alimentar. O estudo utiliza uma abordagem qualitativa e dedutiva, analisando legislação, doutrina, jurisprudência e artigos científicos. Os objetivos alcançados envolvem a compreensão da aplicabilidade e efetividade de medidas coercitivas indiretas, como a suspensão da Carteira Nacional de Habilitação (CNH), apreensão do passaporte, bloqueio de contas bancárias e cartões de crédito. A pesquisa mostra que essas medidas se revelam mais efetivas do que a prisão civil, pressionando o devedor sem violar seus direitos fundamentais. A aplicação das medidas coercitivas indiretas deve ser analisada caso a caso, considerando as particularidades de cada situação e respeitando os direitos fundamentais do devedor. A cobrança de alimentos é uma questão social relevante, que envolve a proteção da dignidade humana e a minimização das desigualdades sociais, demandando políticas públicas efetivas e fortalecimento dos mecanismos de cobrança. O artigo conclui que as medidas coercitivas indiretas representam uma nova perspectiva na cobrança de alimentos no Brasil, sendo uma alternativa efetiva e menos gravosa à prisão civil. Operadores do direito e a sociedade devem atuar no sentido de garantir a efetividade da cobrança de alimentos e a proteção dos direitos humanos fundamentais dos alimentandos

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

A multi-country analysis of COVID-19 hospitalizations by vaccination status

Background: Individuals vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), when infected, can still develop disease that requires hospitalization. It remains unclear whether these patients differ from hospitalized unvaccinated patients with regard to presentation, coexisting comorbidities, and outcomes. Methods: Here, we use data from an international consortium to study this question and assess whether differences between these groups are context specific. Data from 83,163 hospitalized COVID-19 patients (34,843 vaccinated, 48,320 unvaccinated) from 38 countries were analyzed. Findings: While typical symptoms were more often reported in unvaccinated patients, comorbidities, including some associated with worse prognosis in previous studies, were more common in vaccinated patients. Considerable between-country variation in both in-hospital fatality risk and vaccinated-versus-unvaccinated difference in this outcome was observed. Conclusions: These findings will inform allocation of healthcare resources in future surges as well as design of longer-term international studies to characterize changes in clinical profile of hospitalized COVID-19 patients related to vaccination history. Funding: This work was made possible by the UK Foreign, Commonwealth and Development Office and Wellcome (215091/Z/18/Z, 222410/Z/21/Z, 225288/Z/22/Z, and 220757/Z/20/Z); the Bill & Melinda Gates Foundation (OPP1209135); and the philanthropic support of the donors to the University of Oxford's COVID-19 Research Response Fund (0009109). Additional funders are listed in the "acknowledgments" section

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study (Intensive Care Medicine, (2021), 47, 2, (160-169), 10.1007/s00134-020-06234-9)

The original version of this article unfortunately contained a mistake. The members of the ESICM Trials Group Collaborators were not shown in the article but only in the ESM. The full list of collaborators is shown below. The original article has been corrected