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Hospital-acquired pressure injuries have a significant impact on quality of life. Health care organizations continually strive to improve care and patient satisfaction, for the well-being of the patient and the fiscal health of the organization. A commitment to protecting skin and reducing risk for pressure injury in the perioperative setting is gaining momentum. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had a profound global impact, affecting people's physical and mental health, and their social and economic circumstances. Mitigation measures have disproportionately affected women. Studies have reported menstrual cycle and psychological disturbance associated with the pandemic. Pregnancy is a risk factor for severe COVID-19 disease. Reports have also demonstrated associations between COVID-19 infection, vaccination and Long COVID syndrome and reproductive health disturbance. However, studies are limited and there may be significant geographical variation. Also there is bias amongst published studies, and menstrual cycle data was not included in COVID-19 and vaccine trials. Longitudinal population based studies are required. In this review we discuss existing data, along with recommendations for further research required in this area. We also discuss a pragmatic approach to women presenting with reproductive health disturbance in the era of the pandemic, encompassing a multi-system assessment of psychological, reproductive health and lifestyle. [ABSTRACT FROM AUTHOR]

Abstract: Aims: The aims of this study were to examine the relationship between admission blood glucose and mortality in a large, unselected cohort of acutely ill medical patients and to assess the impact of diabetes on this relationship. Methods: We studied the broad pattern of acute medical admissions over an eight year period and the impact of admission serum glucose on in-hospital mortality. Significant predictors of outcome, including acute illness severity and co-morbidity, were entered into a multivariate regression model, adjusting the univariate estimates of the glycaemic status on mortality. Results: There were 45,068 consecutive acute medical emergency admissions between 2005 and 2012. The normoglycaemic (>4.0 ≤7.0mmol/l) cohort (86%) had a 3.9% in-hospital mortality. Both hypoglycaemia (OR: 3.23: 95% CI: 2.59–4.04; p <0.001) and hyperglycaemia (OR: 2.1; 95% CI: 1.9–2.4; p <0.001) predicted an increased risk of an in-hospital death. Neither of these increased risks were fully adjusted nor explained by a highly predictive outcome model, using multiple acute illness parameters. Hyperglycaemia did not carry similar adverse prognostic implications for patients with diabetes. Conclusion: In patients without diabetes, an abnormal serum glucose is independently predictive of an increased mortality among the broad cohort of acute emergency medical patients. Similar disturbances of glucose homeostasis for patients with diabetes do not confer equivalent adverse prognostic implications. [Copyright &y& Elsevier]

Providing small enteral feedings for parenterally fed preterm infants during the first few weeks of life improves feeding tolerance. However, it is not known whether these feedings achieve this result via stimulation of gut growth and/or maturation of function. The minimal level needed to attain these responses is also critical to identify, because neonatologists often limit feeding volumes to minimize the risk of necrotizing enterocolitis. Thus, we determined the dose-response relationships between enteral feeding volume and gastrointestinal growth and small intestine motor function. Newborn canine pups (n = 51) received 0, 2.5, 5.0, 7.5, 10, 30 or 100% of their daily fluid intake enterally with the remainder given parenterally for 4-5 d. Motor activity was recorded, blood drawn for determination of gastrin and motilin, and intestinal tissue harvested for determination of DNA and protein content and morphology. Feeding volumes that provided 30% or more of daily fluid intake significantly increased small intestinal mucosal growth above that of unfed pups, but feeding volumes that provided as little as 10% of daily fluid intake significantly induced maturation of motor patterns beyond that of unfed pups. Plasma concentrations of gastrin and motilin did not differ among groups. We conclude that small enteral feedings typically used for minimal enteral feeding strategies improve feeding tolerance by triggering maturation of motor function but not gut growth in neonatal dogs. Small feeding volumes trigger this maturation as well as large volumes. [ABSTRACT FROM AUTHOR]

Abstract: Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy and is associated with a range of maternal and neonatal complications and conditions. Given increasing levels of prevalence worldwide, there are growing calls for the implementation of screening practices to identify and treat positive GDM cases. This paper uses a unique dataset to investigate the role of healthcare centre accessibility on the decision to attend for screening, employing geographic information systems, econometric and simulation techniques. We focus on the extent to which ‘travel distance to screening hospital site’ impacts upon the individual''s screen uptake decision, whether significant geographic inequalities exist in relation to accessibility to screening, and the likely impact on uptake rates of providing screening services at a local level via primary care. Our findings have important implications for the provision of GDM screening services. [Copyright &y& Elsevier]