Determining weight-bearing tissue condition using peak reactive hyperemia response trend and ultrasonographic features: implications for pressure ulcer prevention

Frequent repositioning is important to prevent pressure ulcer (PU) development, by relieving pressure and recovering damages on skin areas induced by repetitive loading. Although repositioning is the gold standard to prevent PU, there is currently no strategy for determining tissue condition under preventive approaches. In this study, the peak reactive hyperemia (RH) trends and ultrasonographic (US) features are compared with the tissue condition under histopathological examination to determine the potential use of these features in determining the tissue condition noninvasively. Twenty-one male Sprague–Dawley rats (seven per group), with body weight of 385–485 g, were categorized into three groups and subjected to different recovery times, each with three repetitive loading cycles at skin tissues above of right trochanter area. The first, second, and third groups were subjected to short (3 minutes), moderate (10 minutes), and prolonged (40 minutes) recovery, respectively, while applying fixed loading time and pressure (10 minutes and 50 mmHg, respectively), to provide different degree of recovery and tissue conditions (tissue damage and tissue recovery). Peak RH was measured in the three cycles to determine RH trend (increasing, decreasing, and inconsistent). All rat tissues were evaluated using ultrasound at pre- and post-experiment and rated by two raters to categorize the severity of tissue changes (no, mild, moderate, and severe). The tissue condition was also evaluated using histopathological examination to distinguish between normal and abnormal tissues. Most of the samples with increasing RH trend is related to abnormal tissue (71%); while inconsistent RH trends is more related to normal tissue (82%). There is no relationship between the tissue conditions evaluated under ultrasonographic and histopathological examination. Peak RH trend over repetitive loading may serve as a new feature for determining the tissue condition that leading to pressure ulcer

Case Study: Wellness, tourism and small business development in a UK coastal resort: Public engagement in practice

This article examines the scope of well-being as a focus for tourism and its potential as a tool for small business development, particularly the opportunities for tourism entrepreneurs in coastal resorts. The study reports an example of public engagement by a research team and the co-creation of research knowledge with businesses to assist in business development by adapting many existing features of tourist resorts and extending their offer to wider markets. The synergy between well-being and public health interests also brings potential benefits for the tourism workforce and the host community. The Case Study outlines how these ideas were tested in Bournemouth, a southern coastal resort in the UK, in a study ultimately intended to be adopted nationally and with more wide reaching implications for global development of the visitor economy. Local changes ascribed to the study are assessed and its wider potential is evaluated