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

Réfugiés politiques et diplomates pour l'institution d'une République sarde sous la protection de la France (1796-1800)

Francioni Federico. Réfugiés politiques et diplomates pour l'institution d'une République sarde sous la protection de la France (1796-1800). In: Cahiers de la Méditerranée, n°57, 1, 1998. Bonaparte, les îles méditerranéennes et l'appel de l'Orient [Actes du Colloque d'Ajaccio 29-30 Mai 1998] pp. 101-124

The role of human rights in the regulation of private military and security companies

Published version of EUI AEL WP 2010/0

The role of human rights in the regulation of private military and security companies general report : universal and regional systems : Latin America, Africa and Asia

Private Military and Security Companies (PMSCs) usually provide specialized expertise or services of a military or police nature, particularly high-tech intelligence, military training and support as well as surveillance and protection to strategic installations, high-ranking officials and economic plants of special importance. They are either hired by governments to supplement regular military forces or employed by private corporations and firms. PMSCs’ activity can take place both in peacetime (usually providing police and security services) and in time of war, frequently involving recourse to armed force through the performance of typical conflict operations. It is thus evident how PMSCs operations might affect the enjoyment of most human rights, the effectiveness of which is particularly jeopardized in the course of armed conflicts or other situations of emergency, which represent the typical contexts in which PMSCs operate. All human rights that are most in danger of being affected by PMSCs are contemplated and protected by the relevant international law instruments. This general report provides an overview of these instruments and tries to ascertain how relative obligations and remedial processes can have an impact on the regulation of PMSCs and on their accountability for human rights breaches. It examines universal instruments and the regional instruments that are in force in Latin America, Africa and Asia, as well as the practice of the monitoring bodies established by such instruments, with special attention on states’ positive obligations to make all reasonable efforts to ensure that private actors, including PMSCs, do not cause human rights violations

Reflections on the impact of communism on Italian international law scholarship : 1945-1989

What has been the impact of Communism on the European scholarship of international law in the post-World War II period ? What are lingering differences today in the attitudes of scholars from West and East Europe twenty years after the end of the cold war? This paper, which is part of a series of country studies, is aimed at contributing to a reflection on these questions by focusing on Italy and Italian international law scholarship in the period 1945-1989. The research has covered the responses of Italian scholars to some of the major international crises triggered by Soviet Communism during the Cold War, the influence of Communist theories of international law on Italian doctrine, Communism as an object of study by Italian international law scholars, and the influence of Communism on the active political engagement of Italian scholars. Surprisingly, the conclusion is that such influence has been extremely limited, in spite of the profound impact of Communism on post World-War II Italian political and social life