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

A Multi-Granularity 2-Tuple QFD Method and Application to Emergency Routes Evaluation

Quality function deployment (QFD) is an effective approach to satisfy the customer requirements (CRs). Furthermore, accurately prioritizing the engineering characteristics (ECs) as the core of QFD is considered as a group decision making (GDM) problem. In order to availably deal with various preferences and the vague information of different experts on a QFD team, multi-granularity 2-tuple linguistic representation is applied to elucidate the relationship and correlation between CRs and ECs without loss of information. In addition, the importance of CRs is determined using the best worst method (BWM), which is more applicable and has good consistency. Furthermore, we propose considering the relationship matrix and correlation matrix method to prioritize ECs. Finally, an example about evaluating emergency routes of metro station is proposed to illustrate the validity of the proposed methodology

Green Supply Chain Decision and Management under Manufacturer’s Fairness Concern and Risk Aversion

This study focuses on the impact of a supply chain manufacturer’s fairness concern and risk aversion on the green supply chain and constructs a two-level green supply chain consisting of a manufacturer and a retailer. It compares three models: the manufacturer is a risk-neutral and fair-neutral, the manufacturer is a risk-averse and fair-neutral, and the manufacturer is a risk-averse and fair-concerned decision maker. In three cases, this paper examines how the manufacturer’s risk aversion and fairness concerns the impact product green level, retail price, and the wholesale price in the green supply chain. Consumers are sensitive to pricing strategies and product green level. The results are as follows: the manufacturer’s risk aversion leads to an increase in the retailer’s profit, and the manufacturer’s profit decreases with the increase in the risk aversion coefficient. Second, when demand meets certain conditions and the manufacturer has advantageous fairness concerns, the manufacturer benefits from fairness concerns, the retailer’s profit decreases with the manufacturer’s fairness concerns coefficient, and the manufacturer’s risk aversion will lead to a decline in the product green level. Third, when the manufacturer believes that the risk is relatively large, they reduce the technology investment of green products; thus, the fairness concerns of the manufacturer will affect the investment of green products and increase the green level of products. For enterprises: When supply chain members face various risks, they need to consider the specific needs of consumers and other members’ behavioral preferences. They can put forward a more scientific prediction of market demand and rational decision making. For customers: they should not only pay attention to changes in market prices, but should also pay attention to changes in the behavioral preferences of supply chain members, as customers are in line with their own interests based on the choice of high-quality green production

How Does Internet Use Promote Farmer Entrepreneurship: Evidence from Rural China

Entrepreneurship and innovation are important driving forces for economic sustainable development. Despite the rapid popularity of the Internet in rural areas, whether—and if so, how—the Internet use may affect farmer entrepreneurship remains a key research gap. This paper studies the impact of the use of the Internet on farmer entrepreneurship and its mechanism by using Probit model, the Karlson–Holm–Breen (KHB) method and China Family Panel Studies (CFPS) dataset from 2014 to 2018. It is found that: (1) Use of the Internet has a positive impact on farmer entrepreneurship, and this result remains robust after addressing endogeneity. (2) Necessity entrepreneurship is more likely to be affected by use of the Internet than opportunity entrepreneurship. (3) Use of the Internet can significantly influence necessity entrepreneurship by affecting farmers’ risk attitude, social capital and information acquisition, while opportunity entrepreneurship is not affected by these mediating effects. (4) Among three mediating effects, the effect of social capital accounts for the largest contribution to the impact of the use of the Internet on farmer entrepreneurship. Our empirical findings could provide theoretical references for policies or reforms intended to promote entrepreneurship in rural regions

A Multi-Granularity 2-Tuple QFD Method and Application to Emergency Routes Evaluation

Quality function deployment (QFD) is an effective approach to satisfy the customer requirements (CRs). Furthermore, accurately prioritizing the engineering characteristics (ECs) as the core of QFD is considered as a group decision making (GDM) problem. In order to availably deal with various preferences and the vague information of different experts on a QFD team, multi-granularity 2-tuple linguistic representation is applied to elucidate the relationship and correlation between CRs and ECs without loss of information. In addition, the importance of CRs is determined using the best worst method (BWM), which is more applicable and has good consistency. Furthermore, we propose considering the relationship matrix and correlation matrix method to prioritize ECs. Finally, an example about evaluating emergency routes of metro station is proposed to illustrate the validity of the proposed methodology

How Does Internet Use Promote Farmer Entrepreneurship: Evidence from Rural China

Entrepreneurship and innovation are important driving forces for economic sustainable development. Despite the rapid popularity of the Internet in rural areas, whether—and if so, how—the Internet use may affect farmer entrepreneurship remains a key research gap. This paper studies the impact of the use of the Internet on farmer entrepreneurship and its mechanism by using Probit model, the Karlson–Holm–Breen (KHB) method and China Family Panel Studies (CFPS) dataset from 2014 to 2018. It is found that: (1) Use of the Internet has a positive impact on farmer entrepreneurship, and this result remains robust after addressing endogeneity. (2) Necessity entrepreneurship is more likely to be affected by use of the Internet than opportunity entrepreneurship. (3) Use of the Internet can significantly influence necessity entrepreneurship by affecting farmers’ risk attitude, social capital and information acquisition, while opportunity entrepreneurship is not affected by these mediating effects. (4) Among three mediating effects, the effect of social capital accounts for the largest contribution to the impact of the use of the Internet on farmer entrepreneurship. Our empirical findings could provide theoretical references for policies or reforms intended to promote entrepreneurship in rural regions

Early-warning analysis of crowd stampede in metro station commercial area based on internet of things

Crowd stampede has attracted significant attention of emergency management researchers in recent years. Early-warning of crowd stampede in metro station commercial area is discussed in this paper under the context of Internet of Things (IoT). Metro station commercial area is one of the entity carriers of E-commerce. IOT is a new concept of realizing intelligent sense, monitoring, tracking and management, which can be used in early-warning analysis of crowd stampede in metro station. Stampede risk early-warning in commercial area plays an important role in ensuring the operation of e-commerce online. Firstly, the laws and characteristics of the crowd movement in the commercial area of metro station are studied, which include the laeuna effect, block effect and aggravation effect. Secondly, the early-warning paradigm is constructed from four dimensions, ie. function, modules, principle and process. And then, under the IOT environment, the AHPsort II is applied to integrate the early-warning information and classify the stampede risk level. Finally, the paper takes the commercial area of Wuhan A metro station as an example to verify the practicability and effectiveness of the AHPsort II application to early-warning of crowd stampede in metro station commercial area.Funding Agencies|National Social Science Foundation of China [15AGL021]</p

Fuzzy TOPSIS-EW Method with Multi-Granularity Linguistic Assessment Information for Emergency Logistics Performance Evaluation

The operation of emergency logistics plays a prominent role in reducing the consequences of disasters. Based on the establishment of a comprehensive evaluation system with the whole period of the disaster cycle that covers emergency preparation, response, and recovery, this paper proposes a fuzzy-symmetrical Technique for Order Preference by Similarity to Ideal Solution-Entropy Weight (TOPSIS-EW) method with multi-granularity linguistic assessment (MGLA) information to evaluate the performance of emergency logistics. Furthermore, the proposed evaluation method is employed to evaluate the performance of emergency logistics in Wenchuan earthquake, five worst-hit regions (i.e., Wenchuan County, Beichuan County, Qingchuan County, Mianzhu City, Shifang City) were ranked as V, III, I, II, IV, respectively. Finally, the effectiveness and reliability of the method are verified by comparison with the other two related methods and a sensitivity analysis. Based on the comprehensive evaluation results, some specific managerial suggestions are proposed to improve the emergency logistics capacity