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

Replication Data for: Historical climate trends, deforestation, and maize and bean yields in Nicaragua

Nicaragua has already experienced substantial climate change, in part due to a loss of one half of its forest cover in the last half-century. In this study, we assess the extent to which historical climate trends have contributed to stagnating yields for maize (Zea mays) and bean (Phaseolus vulgaris), the two main staple crops in the country. We first analyze 40 years of historical weather data throughout Nicaragua to estimate trends, and assess the extent to which these trends correlate with spatial deforestation patterns. Then, we create a regression model linking department-level maize and bean yields with seasonal weather conditions, and use the model to estimate the impact of historical climate trends on yields. Regressions are run for yields on both harvested and sown area, with the latter accounting for the effect of complete crop losses. Results confirm strong warming trends throughout the country, with daytime temperatures in deforested areas warming at more than double the rate of global averages in the tropics. Decreases in rainfall frequency are also seen almost everywhere, along with an earlier end to the rainy season. Regression model results show, as expected, that red bean is a highly temperature-sensitive crop, and that maize is more water-limited than bean due to its longer seasonal duration. Warming temperatures and less frequent rainfall have led to drought-related losses for both crops in the main commercial production areas, while heavier rains at planting and harvest have also negatively affected yields, especially for bean. Moreover, reduced precipitation in December and January has negatively impacted production for bean in the commercially important apante, or dry season, on the humid Atlantic side of the country. In these areas, however, substantial model uncertainty remains for maize, with an alternative model formulation showing substantial benefits from drier and sunnier conditions. At an annual, national scale, beans have been more affected by climate trends since 1970 than maize, with -5% yield declines per decade on harvested area for bean and -4% for maize, and -12% and -7% yield declines respectively on sown area(with the alternative model showing gains for maize). Climate adaptation responses include government efforts to limit bean exports to control consumer prices, a switch from red to black bean for commercial sales and export, and area expansion and migration for bean in order to maintain production levels

Historical climate trends, deforestation, and maize and bean yields in Nicaragua

AbstractNicaragua has already experienced substantial climate change, in part due to a loss of one half of its forest cover in the last half-century. In this study, we assess the extent to which historical climate trends have contributed to stagnating yields for maize (Zea mays) and bean (Phaseolus vulgaris), the two main staple crops in the country. We first analyze 40 years of historical weather data throughout Nicaragua to estimate trends, and assess the extent to which these trends correlate with spatial deforestation patterns. Then, we create a regression model linking department-level maize and bean yields with seasonal weather conditions, and use the model to estimate the impact of historical climate trends on yields. Regressions are run for yields on both harvested and sown area, with the latter accounting for the effect of complete crop losses. Results confirm strong warming trends throughout the country, with daytime temperatures in deforested areas warming at more than double the rate of global averages in the tropics. Decreases in rainfall frequency are also seen almost everywhere, along with an earlier end to the rainy season. Regression model results show, as expected, that red bean is a highly temperature-sensitive crop, and that maize is more water-limited than bean due to its longer seasonal duration. Warming temperatures and less frequent rainfall have led to drought-related losses for both crops in the main commercial production areas, while heavier rains at planting and harvest have also negatively affected yields, especially for bean. Moreover, reduced precipitation in December and January has negatively impacted production for bean in the commercially important apante, or dry season, on the humid Atlantic side of the country. In these areas, however, substantial model uncertainty remains for maize, with an alternative model formulation showing substantial benefits from drier and sunnier conditions. At an annual, national scale, beans have been more affected by climate trends since 1970 than maize, with −5% yield declines per decade on harvested area for bean and −4% for maize, and −12% and −7% yield declines respectively on sown area (with the alternative model showing gains for maize). Climate adaptation responses include government efforts to limit bean exports to control consumer prices, a switch from red to black bean for commercial sales and export, and area expansion and migration for bean in order to maintain production levels

Replication Data for: Climate change adaptation of coffee production in space and time

Coffee is grown in more than 60 tropical countries on over 11 million ha by an estimated 25 million farmers, most of whom are smallholders. Several regional studies demonstrate the climate sensitivity of coffee (Coffea arabica) and the likely impact of climate change on coffee suitability, yield, increased pest and disease pressure and farmers’ livelihoods. The objectives of this paper are (i) to quantify the impact of progressive climate change to grow coffee and to produce high quality coffee in Nicaragua and (ii) to develop an adaptation framework across time and space to guide adaptation planning. We used coffee location and cup quality data from Nicaragua in combination with the Maxent and CaNaSTA crop suitability models, the WorldClim historical data and the CMIP3 global circulation models to predict the likely impact of climate change on coffee suitability and quality. We distinguished four different impact scenarios: Very high (coffee disappears), high (large negative changes), medium (little negative changes) and increase (positive changes) in climate suitability. During the Nicaraguan coffee roundtable, most promising adaptation strategies were identified, which we then used to develop a two-dimensional adaptation framework for coffee in time and space. Our analysis indicates that incremental adaptation may occur over short-term horizons at lower altitudes, whereas the same areas may undergo transformative adaptation in the longer term. At higher elevations incremental adaptation may be needed in the long term. The same principle and framework is applicable across coffee growing regions around the world. (2016-10

3er. Coloquio: Fortalecimiento de los Colectivos de Docencia

Las memorias del 3er. Coloquio de Fortalecimiento de Colectivos de Docencia deben ser entendidas como un esfuerzo colectivo de la comunidad de académicos de la División de Ciencias y Artes para el Diseño, en medio de la pandemia COVID-19, con el fin de: • Analizar y proponer acciones concretas que promuevan el mejoramiento de la calidad docente en la División. • Proponer acciones que permitan continuar fortaleciendo los cursos con modalidad a distancia (remotos). • Ante un escenario que probablemente demandará en el mediano plazo, transitar del modelo remoto a un modelo híbrido, proponer acciones a considerar para la transición de los cursos. • Planear y preparar cursos de nivelación de conocimientos, para cuando se transite a la impartición de la docencia de manera mixta o presencial, dirigidos a los alumnos que no hayan tenido oportunidad de desarrollar actividades relevantes para su formación, como prácticas de talleres y laboratorios, visitas, o alguna otra actividad relevante

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data