Comparing the Braden and Jackson/Cubbin Pressure Injury Risk Scales in Trauma-Surgery ICU Patients.

BACKGROUND: The occurrence of pressure injury in the critical care environment has multiple risk factors. Prevention requires reliable assessment tools to help predict injury risk. The Braden scale, a commonly used risk assessment tool, has been shown to have poor predictive properties in critical care patients. The Jackson/Cubbin scale was developed specifically for pressure injury risk stratification in critically ill patients and has demonstrated acceptable predictive properties in the general critical care population but has not been examined in critically ill trauma-surgical patients. OBJECTIVE: To compare the predictive properties of the Braden and Jackson/Cubbin scales in a trauma-surgical critical care population. METHODS: A retrospective medical records review was performed to evaluate the clinical characteristics of 366 trauma-surgical critical care patients. Additionally, the negative predictive value, positive predictive value, sensitivity, specificity, and receiver operating characteristic curve with area under the curve of the Braden and Jackson/Cubbin scales were determined. RESULTS: The sample consisted of primarily middle-aged (mean [SD], 56 [19] years) men (64%) admitted after trauma (71%). The participants who developed pressure injuries were older, more often required vasopressors and mechanical ventilation, and were less mobile. Predictive properties for the Braden and Jackson/Cubbin scales, respectively, were as follows: negative predictive value, 78% versus 87%; positive predictive value, 53% versus 66%; sensitivity, 17% versus 54%; specificity, 95% versus 92%; and area under the curve, 0.710 versus 0.793. CONCLUSION: The Jackson/Cubbin scale demonstrated superior predictive properties and discrimination compared with the Braden scale for pressure injury risk prediction in critically ill trauma-surgical patients.

Sheltering in place and domestic violence: Evidence from calls for service during COVID-19.

The COVID-19 pandemic has led to an economic slowdown as more people practice social distancing and shelter at home. The increase in family isolation, unemployment, and economic stress has the potential to increase domestic violence. We document the pandemic's impact on police calls for service for domestic violence. The pandemic increased domestic violence calls by 7.5% during March through May of 2020, with effects concentrated during the first five weeks after social distancing began. The increase in reported domestic violence incidents began before official stay-at-home orders were mandated. It is not driven by any particular demographic group but does appear to be driven by households without a previous history of domestic violence.

Buccal feed impaction and surgical correction in captive reindeer.

An 8-year-old female captive reindeer (Rangifer tarandus) (1) was presented for evaluation of bilateral protrusion of the cheeks of 1-month duration. Several members of the herd displayed similar clinical signs. Examination revealed stretching and laxity of the cheek muscles and buccal food impaction. The defect of each cheek was surgically repaired in the field under heavy sedation and local anesthesia in staged procedures; no surgical complications were encountered. The patient recovered uneventfully and long-term prognosis is good. This report describes a surgical treatment for individual animals with cheek laxity and buccal food impaction.

Impaction buccale alimentaire et correction chirurgicale chez un renne en captivité. Un renne femelle en captivité âgée de 8 ans (Rangifer tarandus) (1) a été présenté pour l'évaluation d'une protrusion bilatérale des joues depuis une durée de 1 mois. Plusieurs membres du troupeau manifestaient des signes cliniques semblables. L'examen a révélé de l'étirement et de la laxité des muscles de la joue et une impaction buccale alimentaire. Le défaut de chaque joue a été réparé par une chirurgie sous l'effet d'une sédation puissante et d'une anesthésie locale selon des procédures par étapes; il n'y a eu aucune complication chirurgicale. La patiente s'est bien rétablie et le pronostic à long terme est positif. Ce rapport décrit le traitement chirurgical pour des animaux individuels souffrant de laxité de la joue et d'impaction buccale alimentaire.(Traduit par Isabelle Vallières).