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Providing the first meta-analysis of risk factors for pressure ulcer development in adult patients.Pressure ulcers remain a serious health complication for patients and nursing staff. However, there is a lack of statistical evidence for risk factors as previous research did not include any quantitative synthesis.Meta-analysis, using PRISMA guidelines.Studies from PubMed, Embase, CINAHL Complete, Web of Science, Cochrane Library, and other reviews and sources were screened and checked against the inclusion criteria. The risk of bias was evaluated using a slightly modified QUIPS tool. Data regarding population, design, statistical analysis and risk factors were extracted. Meta-analysis with comparable studies was conducted for age, sex, and Braden scale. The sub-group analysis was used to account for heterogeneity.28 studies with 570,162 patients were entered in meta-analysis. Older age and a low total Braden scale score increased the risk for pressure ulcers. All subscales excluding 'moisture' reached significance in meta-analysis based only on few studies, however, limiting overall evidence. Male sex achieved mixed results, too.The first meta-analytic analysis shows evidence for age and Braden scale as risk factors for pressure ulcer development. Limitations regarding study quality and heterogeneity must be considered, highlighting the need for unifying certain conditions in risk factor research.Patients at risk for new pressure ulcers can be identified by their total Braden score and age, whereas the latter is also connected to deeper pressure ulcers. Nurses and health personnel should pay great attention to patients in older age and undergo specific training to utilise and evaluate the Braden scale effectively, if necessary.

To accelerate sustainability transitions, policymakers have to set clear targets for the decline and phase-out of unsustainable technologies. As such decisions are contested, many different actor groups engage in the politics and discourse around decline. This chapter compares the debates surrounding coal phase-out in three countries: the UK, Germany and Finland. Despite major differences, e.g. in the relevance of coal for energy supply and jobs, we find many similarities in discourse dynamics, key arguments and the actor groups engaged. Our findings can therefore inform debates about coal and other unsustainable technologies in places where phase-outs are still pending. Our analysis advances the repertoire of comparative studies in transitions research, and shows how the technological innovation systems framework can be mobilized to also explore processes of technology decline.

In socio-technical transitions research, capacities relevant for transformations have primarily been assessed at systemic or niche levels, with capacities of individual actors to engage in transformative activities not yet well-conceptualized. This paper draws on theories of power in transitions, transformative social innovation and social practice theory to develop a conceptual framework for transformative capacities at the level of the individual citizen. We argue that in order to change social practices and foster successful bottom-up transitions, different forms of capacities - with regards to the elements of a social practice (meanings, competences and materials/resources) - are required. As a next step, the framework developed based on different literatures from transitions research and sociology will be tested empirically in an online-survey targeted at individuals engaged in social innovation. The objective is to better understand social processes of change and the conditions for them, in order to support the development of participatory governance models.

International journal of environmental research and public health : IJERPH 19(2), 761 (2022). doi:10.3390/ijerph19020761 special issue: "Special Issue "New Advances in Nursing Care" / Special Issue Editor: Dr. Raúl Juárez-Vela, Guest Editor", Published by MDPI, Basel

OBJECTIVE: Risk factors for mortality in patients with subdural hematoma (SDH) include poor Glasgow Coma Scale (GCS), pupil non-reactivity, and hemodynamic instability on presentation. Little is published regarding prognosticators of SDH in the elderly. This study aims to examine risk factors for hospital mortality and withdrawal of life-sustaining measures in an octogenarian population presenting with SDH. METHODS: A prospectively collected multi-center database of 3,279 TBI admissions to 45 different U.S. trauma centers between 2017–2019 was queried to identify patients >79 years old presenting with SDH. Factors collected included baseline demographic data, past medical history, antiplatelet/anticoagulant use, and clinical presentation (GCS, pupil reactivity, injury severity scale [ISS]). Primary outcome data included hospital mortality/discharge to hospice care and withdrawal of life-sustaining measures. Multivariate logistic regression analyses were used to identify factors independently associated with primary outcome variables. RESULTS: A total of 695 patients were isolated for analysis. Of the total cohort, the rate of hospital mortality or discharge to hospice care was 22% (n=150) and the rate of withdrawal of life-sustaining measures was 10% (n=66). A multivariate logistic regression model identified GCS 80 years with SDH. Pre-existing CHF may further predict withdrawal of life-sustaining measures.

ZusammenfassungDamit im hektischen Arbeitsalltag keine wichtigen Informationen mehr verloren gehen, stellen wir Ihnen das Teaming Board vor. Es ist ein lösungsorientiertes Führungsinstrument, mit dem sich die Informationsweitergabe und Prozessgestaltung in der Patientenversorgung verbessern lassen. Dabei bringt es Leitungen und Mitarbeitende aller Qualifikationsstufen zusammen und hält Beratungsergebnisse tagesaktuell und strukturiert fest.