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Objective: This study assessed compliance with the best practices for pressure injury prevention among ICU patients at a tertiary hospital in São Paulo, Brazil. Introduction: Intensive care patients are at high risk of developing a pressure injury; preventing this requires a best practice protocol. Method: This best practice implementation project was conducted in a Brazilian tertiary hospital in three phases following the JBI Model of Evidence-based Healthcare. Ten criteria derived from the best available evidence were audited and monitored before and after best practice implementation. Results: The baseline and follow-up audits evaluated 28 patients at each step. A total of 448 h of care were analyzed using a monitoring camera and medical records. Compliance with all 10 audited criteria increased, with a 50% reduction in the prevalence of pressure injuries in intensive care. Of the 223 employees, 71% claimed to have some knowledge of pressure injury prevention, and 66% reported adequate adherence to prevention protocols. Conclusion: The audit and feedback strategy improved compliance with the criteria. Future audits are needed to promote the sustainability of evidence-based practice. [ABSTRACT FROM AUTHOR]

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The article discusses the urban history and mythology of Trieste, Italy beginning in the early 18th century. Topics include the origins of the city as a small town in the beginning of the 18th century, the diverse origins of people arriving in the city during its period of population growth in the 1700s, and economic and urban growth during this time. Other topics include boundaries of the city, relations between Trieste and Venice, Italy and Vienna, Austria, and merchants in the city.

Planning a city is a systematic process that includes time, space, and groups of people who must communicate. However, due to security problems in such war-ravaged countries as Afghanistan, the traditional forms of public participation in the planning process are untenable. In particular, due to gathering space difficulties and culture issues in Afghanistan, women and religious minorities are restricted from joining male-dominated powerholders' face-to-face meetings which are nearly always held in fixed places called masjids (religious buildings). Furthermore, conducting such discussions with human facilitation biases the generation of citizen decisions that stimulates an atmosphere of confrontation, causing another decision problem for urban policy-making institutions. Therefore, it is critical to find approaches that not only securely revolutionize participative processes but also provide meaningful and equal public consultation to support interactions among stakeholders to solve their shared problems together. Toward this end, we propose a joint research program, namely, crowd-based communicative and deliberative e-planning (CCDP), a blended approach, which is a mixture of using an artificial-intelligence-led technology, decision-support system called D-Agree and experimental participatory planning in Kabul, Afghanistan. For the sake of real-world implementation, Nagoya Institute of Technology (Japan) and Kabul Municipality (Afghanistan) have formed a novel developed and developing world partnership by using our proposed methodology as an emerging-deliberation mechanism to reframe public participation in urban planning processes. In the proposed program, Kabul municipality agreed to use our methodology when Kabul city needs to make a plan with people. This digital field study presents the first practical example of using online decision support systems in the context of the neighborhood functions of Gozars, which are Kabul's social and spatial urban units. The main objective was to harness the wisdom of the crowd to innovative suggestions for helping policymakers making strategic development plans for Gozars using open call ideas, and for responding to equal participation and consultation needs, specifically for women and minorities. This article presents valuable insights into the benefits of this combined approach as blended experience for societies and cities that are suffering long-term distress. This initiative has influenced other local Afghan governments, including the cities of Kandahar and Herat as well as the country's central government's ministry of urban planning and land, which has officially expressed its intention to collaborate with us. [ABSTRACT FROM AUTHOR]

Sustainable urban planning (SUP) is crucial in the development of sustainable cities, as also underlined by the New Urban Agenda. Nature-based solutions (NBS) are increasingly being recognized for their potential to offer multiple benefits that are necessary in order to cope with present and future urban challenges. The European policy framework, including the recently released European Green Deal, could strongly boost the role and recognition of NBS and SUP as drivers of sustainable and inclusive urban transition. Through a content analysis of current environmental European policies, strategies and agreements, this paper provides (i) an overview of the state of the art of the environmental European policy framework and the recognized role of NBS and SUP in reaching defined objectives, and (ii) insights on where NBS and SUP could play a larger role within this framework. On this basis, the paper identifies gaps and develops recommendations for a better integration of such concepts into the current framework. [ABSTRACT FROM AUTHOR]

Objective: to analyze pressure injury (PI) incidence and risk factors in patients with COVID-19 admitted to an Intensive Care Unit and characterize the identified PIs., Method: a retrospective cohort study, consisting of 668 patients, carried out between March 2020 and February 2021. Clinical/demographic and PI variables were collected from medical records and electronic database. Data were analyzed using descriptive and inferential statistics. Logistic regression was performed to analyze risk factors for PI., Results: PI incidence was 30.2% (n=202), with the majority located in the sacral region (52.9%) and in stage 1 (39%). Risk factors were age (p<0.001), Diabetes Mellitus (p=0.005), length of stay (p<0.001), immunosuppression (p=0.034), nutritional risk (p=0.015) and mechanical ventilation (p<0.001)., Conclusion: PI incidence in critically ill patients with COVID-19 was high.

Complete laminin alpha2 (LAMA2) deficiency causes approximately half of congenital muscular dystrophy (CMD) cases. Many loss-of-function mutations have been reported in these severe, neonatal-onset patients, but only single missense mutations have been found in milder CMD with partial laminin alpha2 deficiency. Here, we studied nine patients diagnosed with CMD who showed abnormal white-matter signal at brain MRI and partial deficiency of laminin alpha2 on immunofluorescence of muscle biopsy. We screened the entire 9.5 kb laminin alpha2 mRNA from patient muscle biopsy by direct capillary automated sequencing, single strand conformational polymorphism (SSCP), or denaturing high performance liquid chromatography (DHPLC) of overlapping RT-PCR products followed by direct sequencing of heteroduplexes. We identified laminin alpha2 sequence changes in six of nine CMD patients. Each of the gene changes identified, except one, was novel, including three missense changes and two splice-site mutations. The finding of partial laminin alpha2 deficiency by immunostaining is not specific for laminin alpha2 gene mutation carriers, with only two patients (22%) showing clear causative mutations, and an additional three patients (33%) showing possible mutations. The clinical presentation and disease progression was homogeneous in the laminin alpha2-mutation positive and negative CMD patients., (Copyright 2003 Wiley-Liss, Inc.)