Factors in rehospitalisation for severe pressure ulcer care in spinal cord injury/disorders.

OBJECTIVE: Repeated hospital admissions (RHA) for ongoing pressure ulcer (PU) care remains a significant challenge in the clinical management of the spinal cord injury/disorders (SCI/D) population. The current study investigated the significance of risk factors for PU treatment and RHA. METHOD: A retrospective chart review of veterans admitted to the Louis Stokes Cleveland Department of Veterans Affairs Medical Center (LSCDVAMC) Spinal Cord Injury (SCI) unit for Category III or IV PUs was carried out. A random sample of 105 individuals with SCI/D, evaluated by the Wound Care Team (WCT) from 2006 to 2009 was assessed. Multiple PU development risk factors were extracted from the electronic health record system using standardised data collection forms and entered into the Spinal Cord Injury Pressure Ulcer Database (SCIPUD). Potential associations with RHA were analysed. RESULTS: Twenty variables were initially identified as potentially related to PU development. Descriptive statistics and statistically significant associations between risk factors and RHA were determined. Demographic factors showed no significant association with RHA. Duration of injury, power wheelchair use and sub-optimally managed spasticity (SMS) were significantly associated with higher RHA. Sub-optimally managed neurogenic bowel (SMNB) at admission was significantly associated with reduced RHA. CONCLUSION: Factors previously found to be predictive of initial PU development may not, in fact, be predictive of RHA. Some protective trends were observed, such as polypharmacy and marital status, but these did not reach statistical significance in this preliminary study of admission characteristics, warranting further research. DECLARATION OF INTEREST: There were no external sources of funding for this study. The authors have no conflicts of interests to declare.

Repeatability and clinical utility in stereophotogrammetric measurements of wounds.

OBJECTIVE: To investigate the hypothesis that stereophotogrammetric wound size monitoring shows suitable inter-observer reliability and user acceptance for clinical practice use. METHOD: Veterans admitted for conservative management of severe pressure ulcers were eligible for inclusion in the study. Three-dimensional (3D) digital wound images were independently captured by two expert and two non-expert nurse-observers using a commercially available stereophotogrammetry system,weekly for 6 weeks.A double-blinded analyst generated 3D wound reconstructions, using software to determine geometry. Clinical opinion of wound progression was provided by an expert physician. RESULTS: Thirteen wounds were assessed with more than 80% of all images being readable. Interclass correlation of 0.9867 (p < 0.000 I) was observed. Compared with clinical opinion, 3D wound measurement was sensitive between improving and static wounds for wound perimeter, volume, depth and length. CONCLUSION: These preliminary findings suggest that 3D wound measurement minimises differences in wound measurement between expert and non-expert observers, suggesting it could be implemented with high reliability in health-care settings where several observers are involved in wound care management.

The influence of divergent growth selection of semen traits, fertility and hatchability.

The effects of divergent growth selection for 18 generations on semen characteristics, fertility and hatchability were investigated. Males from the low weight line produced semen with a significantly (P less than or equal to 0.05) higher sperm concentration and a highly significantly (P less than or equal to 0.01) lower methylene blue reduction time than the males from the high line. Differences between lines for semen volume, sperm motility, percent of live sperm, fertility and hatchability were not statistically significant.

Zinc oxide to induce molt in layers.

The effects of the addition of Zn as ZnO to diets to induce molt were evaluated against a fasted control. Experiment 1 involved 315 Leghorn hens, 15 months old, randomly distributed among five treatments, each replicated seven times with 9 hens per replicate. Hens fasted for 10 days were compared with hens fed diets to which ZnO was added at 10,000, 5,000, or 2,500 ppm for 7, 14, or 21 days. No significant differences were observed among treatments for days to return to 50% production, hen-day and hen-housed production, egg weight, grams egg per hen-day, grams of feed per gram egg, mortality, or Haugh units during the 22-week experimental period. Experiment 2 involved 420 Leghorn hens, 18 months old, randomly distributed among five treatments, each replicated seven times with 12 hens per replicate. Treatments involved fasting for 10 days or feeding diets with 10,000, 5,000, or 2,500 ppm ZnO fed for 7, 14, or 21 days. Hens fasted and hens fed diets with 10,000 ppm ZnO at the start of the experiment ceased production in significantly less time (4.6 to 6 days) than hens fed 5,000 ppm ZnO (14.3 to 14.9 days); however, days to return to 50% production from the start of the experiment did not differ among treatments. Feed consumption and feed cost per hen day during molt were lowest (P less than .05) in the fasted hens.(ABSTRACT TRUNCATED AT 250 WORDS)