33 research outputs found

    Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

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    Abstract: 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

    Point-by-point model calculation of the prompt neutron multiplicity distribution ν

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    Prompt neutron multiplicity distributions ν(A) are required for prompt emission correction of double energy (2E) measurements of fission fragments to determine pre-neutron fragment properties. The lack of experimental ν(A) data especially at incident neutron energies (En) where the multi-chance fission occurs impose the use of ν(A) predicted by models. The Point-by-Point model of prompt emission is able to provide the individual ν(A) of the compound nuclei of the main and secondary nucleus chains undergoing fission at a given En. The total ν(A) is obtained by averaging these individual ν(A) over the probabilities of fission chances (expressed as total and partial fission cross-section ratios). An indirect validation of the total ν(A) results is proposed. At high En, above 70 MeV, the PbP results of individual ν(A) of the first few nuclei of the main and secondary nucleus chains exhibit an almost linear increase. This shape is explained by the damping of shell effects entering the super-fluid expression of the level density parameters. They tend to approach the asymptotic values for most of the fragments. This fact leads to a smooth and almost linear increase of fragment excitation energy with the mass number that is reflected in a smooth and almost linear behaviour of ν(A)

    IRIS: an Infrared Imager and Spectrometer for the Anglo-Australian Telescope

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    AbstractWe describe a versatile infrared camera/spectrograph, IRIS, designed and constructed at the Anglo-Australian Observatory for use on the Anglo-Australian Telescope. A variety of optical configurations can be selected under remote control to provide several direct image scales and a few low-resolution spectroscopic formats. Two cross-dispersed transmission echelles are of novel design, as is the use of a modified Bowen-Burch system to provide a fast f/ratio in the widest-field option. The drive electronics includes a choice of readout schemes for versatility, and continuous display when the array is not taking data, to facilitate field acquisition and focusing.The linearity of the detector has been studied in detail. Although outwardly good, slight nonlinearities prevent removal of fixed-pattern noise from the data without application of a cubic linearising function.Specific control and data-reduction software has been written. We describe also a scanning mode developed for spectroscopic imaging.</jats:p
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