Las víctimas del delito y el abuso del poder del terrorismo

[ES] El fenómeno del terrorismo provoca graves problemas políticos, económicos y sociales, no sólo al Estado sino a las víctimas, a sus familiares y a toda la comunidad, presentándose actualmente con nuevas técnicas y estrategias, potenciado por la globalización. Partiendo de la definición de terrorismo, y analizando brevemente la tipología de terroristas, se estudian las diferentes formas de victimación, su impacto, así como las estrategias y respuestas victimológicas, examinando asimismo los diferentes modelos de atención frente a este fenómeno.[EU] Terrorismoaren fenomenoak arazo politiko, ekonomiko eta sozialak sortarazten ditu, ez bakarrik Estatuari baizik eta kaltetuei, beraien senideei eta komunitate osoari ere. Globalizazioak indartuta, egun teknika eta estrategia berriekin agertzen zaigu. Terrorismoaren definizioa kontutan hartuta, eta terrorista desberdinen tipologia aztertu eta gero, biktimazio forma desberdinak hausnartzen dira, bere eragina, estrategia eta erantzun biktimologikoak, eta era berean fenomeno honi aurre egiteko laguntza eredu desberdinak aztertzen dira.[FR] Le phénomène du terrorisme provoque des sérieux problèmes politiques, économiques et sociaux, non seulement à l’État mais aux victimes, à sa famille et à toute la communauté, se déployant actuellement avec de nouvelles techniques et stratégies, renforcé par la globalisation. En partant de la définition de terrorisme,et en analysant brièvement la typologie de terroristes, on étudie les différentes formes de victimisation, son impact, ainsi que les stratégies et les réponses de la Victimologie, en examinant aussi les différents modèles d’assistance face à ce phénomène.[EN] Terrorism produces serious politic, economic and social problems, not only for the Estate but for victims, relatives and the whole community too. Now it is present through new techniques and strategies, boosted by globalization. Starting from the definition of terrorism, and analysing briefly the typology of terrorists, different forms of victimization and their impact as well as strategies and victimological responses are studied, and different models to face these phenomena are examined

Las víctimas del delito y el abuso del poder del terrorismo

[ES] El fenómeno del terrorismo provoca graves problemas políticos, económicos y sociales, no sólo al Estado sino a las víctimas, a sus familiares y a toda la comunidad, presentándose actualmente con nuevas técnicas y estrategias, potenciado por la globalización. Partiendo de la definición de terrorismo, y analizando brevemente la tipología de terroristas, se estudian las diferentes formas de victimación, su impacto, así como las estrategias y respuestas victimológicas, examinando asimismo los diferentes modelos de atención frente a este fenómeno.[EU] Terrorismoaren fenomenoak arazo politiko, ekonomiko eta sozialak sortarazten ditu, ez bakarrik Estatuari baizik eta kaltetuei, beraien senideei eta komunitate osoari ere. Globalizazioak indartuta, egun teknika eta estrategia berriekin agertzen zaigu. Terrorismoaren definizioa kontutan hartuta, eta terrorista desberdinen tipologia aztertu eta gero, biktimazio forma desberdinak hausnartzen dira, bere eragina, estrategia eta erantzun biktimologikoak, eta era berean fenomeno honi aurre egiteko laguntza eredu desberdinak aztertzen dira.[FR] Le phénomène du terrorisme provoque des sérieux problèmes politiques, économiques et sociaux, non seulement à l’État mais aux victimes, à sa famille et à toute la communauté, se déployant actuellement avec de nouvelles techniques et stratégies, renforcé par la globalisation. En partant de la définition de terrorisme,et en analysant brièvement la typologie de terroristes, on étudie les différentes formes de victimisation, son impact, ainsi que les stratégies et les réponses de la Victimologie, en examinant aussi les différents modèles d’assistance face à ce phénomène.[EN] Terrorism produces serious politic, economic and social problems, not only for the Estate but for victims, relatives and the whole community too. Now it is present through new techniques and strategies, boosted by globalization. Starting from the definition of terrorism, and analysing briefly the typology of terrorists, different forms of victimization and their impact as well as strategies and victimological responses are studied, and different models to face these phenomena are examined

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

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

Fondos de Ayuda o Reparación para víctimas de delitos y abuso de poder

El siguiente artículo es un enfoque descriptivo con respecto algunos fondos de ayuda o reparación para víctimas que consideramos representativos ya sea de delitos o de abuso de poder y violaciones de Derechos Humanos. Presenta la importancia de que los operadores que trabajan con víctimas tengan en cuenta los Estándares como guía para el diseño, implementación y evaluación de la política pública en el tema. Establece, además, los principios de calidad que deben regir al Fondo. Ofrece una tipología basada en el alcance u órgano operador de los fondos. A modo de ejemplo, se analizan fondos innovadores dentro de la tipología ofrecida, detallando los estándares que los guían, sus bene ciarios, procedimiento, mecanismos de asistencia o reparación y formas de vinculación;  nalmente se ofrece además un cuadro que ayudará a académicos y tomadores de decisiones a dimensionar rápidamente la diversidad y alcance de los fondos