Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

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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

Textile technologies for space

Статья посвящена проблеме создания отражающей поверхности антенн из металлотрикотажных сетеполотен. Рассмотрены особенности технологии получения отражающей поверхности с заданными физико-механическими и радиофизическими характеристиками, описаны методы их исследования.Article is devoted a problem of creation of a reflecting surface of aerials from metal jersey. Features of technology of reception of a reflecting surface with set mechanical and radio physical characteristics are considered, methods of their research are described

Mechanical Activation of Al/MoO3 Thermite as a Component of Energetic Condensed Systems to Increase Its Effciency

In the present work a stoichiometric energetic compositions Al+MoO3 prepared by dry mixing and by reactive milling of micro-scale particles were investigated. Morphology, particle size and surface structure of produced powders were examined using scanning electron microscopy, atomic-force microscopy, laser diffractometry and BET analysis. DSC/TG data were processed to obtain kinetic mechanism of the reaction between Al and MoO3. The combustion rate of Al+MoO3 thermite mixture increases with pressure, reaching a maximum at ~10 atm, and then decreases with further pressure increase. The rise of combustion rate at the low range of pressure is associated with the rise in the extent of the vapour phase penetrating the pores of the pressed sample as the ambient pressure increases. However, at a higher pressure the gas formation is suppressed, and the melt formed in the combustion process can selectively wet the pores resulting in inhibition of reaction. Burning rates of mechanical activated system Al+MoO3 are two times higher then not-activated system at ambient pressure ~10 atm and 8 times higher at ~40 atm. In additional experiments, nano-scale MoO3 powder was prepared by evaporation with a subsequent condensation onto cooled plate in an inert-gas fow. Scanning electron microscopy showed that nano-MoO3 particles are absolutely spherical with mean diameter ~100 nm, and atomic-force microscopy 278 D. Meerov et al. reveals smaller particles with mean diameter ~5-30 nm. DSC/TG data showed that the nano-MoO3 starts to sublime earlier than micro MoO3. The use of nano-sized components could considerably increase the burning rates of energetic condensed systems, because of its large specifc surface, lower temperature of sublimation, and high reaction ability

Combustion of Energetic Systems Based on HMX and Aluminum: Infuence of Particle Size and Mixing Technology

In this work the complex experimental investigation of the microstructure and burning parameters of HMX-monopropellant and 25%Al/75%HMX energetic systems was carried on with the particle size variation. Components, their mixtures, pressed samples, and the combustion products (agglomerates) collected from a burning surface by QPCB (quench particle collection bomb) technique were investigated. Two types of HMX particles: micro-sized (mHMX) and ultrafne (uHMX) and aluminium powders: micro- and ultra-sized (ALEXTM) were used. Morphology and particle size were examined by atomic-force microscopy (AFM), scanning electron microscopy (SEM) and BET-analysis. AFM analysis shows the ALEXTM average volume particle size is 180 nm. It was shown, that the monopropellant's burning rates of the micro- and ultra-sized HMX are almost identical in the pressure range 20-100 atm. Two mixing technologies to prepare Al/HMX compositions were used: (i) conventional "dry" mixing and (ii) "wet" technique with ultrasonic processing in diethyl ether. Applying of ultrasonic technique results in a burning rate increase up to 18% comparing to "dry" mixing (under pressure 60 atm). The highest combustion rate was determined for composition of mHMX/ALEXTM (porosity 13%). Infuence of component N. Muravyev et al. size and composition's microstructure on the burning rate of energetic systems is discussed and analyzed