WHS Guidelines for the Treatment of Pressure Ulcers: 2023 Update

The major populations at risk for developing pressure ulcers are older adults who have multiple risk factors that increase their vulnerability, people who are critically ill and those with spinal cord injury/disease. The reported prevalence of pressure ulcers in the United States is 2.5 million. However, this estimate is derived from acute care facilities and does not include people who are living at home or in nursing facilities. Despite the implementation of hospital and facility-based preventive measures, the incidence of pressure ulcers has not decreased in decades. In addition to the burden of pain, infection and death, it is estimated that hospital-acquired pressure ulcers cost the health system $26.8 billion annually with over 50% of the cost attributed to treating Stage 3 and 4 pressure injuries. Thus, it is critical to examine the literature and develop guidelines that will improve the outcomes of this complex and costly condition. This guideline update is a compendium of the best available evidence for the treatment of Pressure Ulcers published since the last update in 2015 and includes a new section based on changing demographics entitled ‘Palliative wound care for seriously ill patients with pressure ulcers’. The overall goal of the Wound Healing Society Guideline project is to present clear, concise and commercial free guidelines that clinicians can use to guide care, that researchers can use to develop studies that will improve treatment and that both clinicians and researchers can use to understand the gaps in our knowledge base

Aerobically Derived Lactate Stimulates Revascularization and Tissue Repair via Redox Mechanisms

This chapter explores the ways in which music can generate its own religious culture, inspiring a devotion and discipline that can provoke tensions between ‘two religions’: of musicians and of the clergy. The author traces the history of Christianity’s relationship to musical culture, including 17th century clashes over musical style and diversity. As music expressed and emotionally actualized Scripture in new ways, there were arguments about whether, for example, music should be the ‘mistress’ of the biblical text or vice versa. In parsing music’s proper relationship to more propositional aspects of faith, the author invites a reading of music as rhetoric, something not reducible to a ‘stable semantic equivalence’ with a text. From the Monteverdi Vespers of 1610 to the Lutheran environment of J.S. Bach, the author explores the performative, sensual, and subjective dimensions of church music, suggesting that its meaning is discerned not only by the relevant text but also by the contexts of listeners: their circumstances, expectations, and emotive reception. Butt suggests that a critical tension between a musical tradition and a religious one could even be productive, resisting closed, simplistic systems, forming a dialectic that benefits both music culture and religious practice