Sustained high serum malondialdehyde levels are associated with severity and mortality in septic patients

This book digs into an area of international migration studies that has gained prominence in the past couple of decades: migrant smuggling. The regional focus is southern Europe, which receives immigrants from many African and Asian countries. Migrant smuggling is discussed in relation to EU and national policies, aimed at combating irregular migration, including increased surveillance and border controls.The authors are no newcomers to the field. Anna Triandafyllidou is a leading scholar in migration studies, having published extensively on various topics dealing with migration in Europe, and with a special interest in Greece and southern Europe. Thanos Maroukis, on the other hand, is an early career academic whose publications have focused specifically on migration in Greece. It is, therefore, not surprising that the authors approached this topic of migrant smuggling from Africa and Asia to Europe by focusing mainly on the situation in Greece and the Turkish-Greek route. The book is based on fieldwork, participant observation and interviews conducted in Athens. The empirical material is extensive, covering a broad range of actors.peer-reviewe

National survey: how do we approach the patient at risk of clinical deterioration outside the ICU in the spanish context?

Background: Anticipating and avoiding preventable intrahospital cardiac arrest and clinical deterioration are important priorities for international healthcare systems and institutions. One of the internationally followed strategies to improve this matter is the introduction of the Rapid Response Systems (RRS). Although there is vast evidence from the international community, the evidence reported in a Spanish context is scarce. Methods: A nationwide cross-sectional research consisting of a voluntary 31-question online survey was performed. The Spanish Society of Intensive, Critical and Coronary Care Medicine (SEMICYUC) supported the research. Results: We received 62 fully completed surveys distributed within 13 of the 17 regions and two autonomous cities of Spain. Thirty-two of the participants had an established Rapid Response Team (RRT). Common frequency on measuring vital signs was at least once per shift but other frequencies were contemplated (48.4%), usually based on professional criteria (69.4%), as only 12 (19.4%) centers used Early Warning Scores (EWS) or automated alarms on abnormal parameters. In the sample, doctors, nurses (55%), and other healthcare professionals (39%) could activate the RRT via telephone, but only 11.3% of the sample enacted this at early signs of deterioration. The responders on the RRT are the Intensive Care Unit (ICU), doctors, and nurses, who are available 24/7 most of the time. Concerning the education and training of general ward staff and RRT members, this varies from basic to advanced and specific-specialized level, simulating a growing educational methodology among participants. A great number of participants have emergency resuscitation equipment (drugs, airway adjuncts, and defibrillators) in their general wards. In terms of quality improvement, only half of the sample registered RRT activity indicators. In terms of the use of communication and teamwork techniques, the most used is clinical debriefing in 29 centers. Conclusions: In terms of the concept of RRS, we found in our context that we are in the early stages of the establishment process, as it is not yet a generalized concept in most of our hospitals. The centers that have it are in still in the process of maturing the system and adapting themselves to our context