CANADIAN PRACTICE GUIDELINES RECOMMENDATIONS FOR PRESSURE ULCERS: SITTING, RECUMBENCY, MOBILITY.
Bibliographic record
Abstract
Pressure ulcers are a significant health disruption, impacting every aspect of a person’s life including personal care routines, changes in use of time and activity choice, and alterations in work and leisure as well as impacting family 1,2,3 . It is estimated that 75% of people with a spinal cord injury will develop a pressure ulcer during their life time 4 . Several best practice guidelines for pressure ulcer prevention and treatment exist but a Canadian guideline specific to spinal cord injury was lacking. To address this gap the Rick Hansen Institute and the Ontario Neurotrauma Foundation funded the development of the Canadian Best Practice Guidelines for Prevention and Management of Pressure Ulcers in Persons with Spinal Cord Injury 5 . During the development stage of this guideline the steering committee reviewed the existing best practice guidelines and completed a comprehensive literature search across 6 electronic databases with the assistance of a medical librarian. Review of the literature and existing guidelines by an inter-professional expert panel from across Canada found that several of the existing best practice guidelines identify the need to include an evaluation of the support surfaces being used by the individual as part of the full assessment; however, little information was provided to guide assessment and intervention of support surfaces. The panel and the steering committee both felt strongly that there was a need to more fully address the influence of not only support surfaces but also posture, mobility and general physical conditioning on pressure ulcer prevention and management within a best practice guideline. To this end, this practice guideline developed chapters addressing sitting support surfaces including wheelchairs, seating and other sitting surfaces, beds, mattresses and recumbent positions and mobility including transfers, repositioning, weight-shifting and general physical conditioning. Overarching the content of these chapters are the principles associated with using a 24 hour approach to pressure management. This workshop will highlight the key points and evidence-based recommendations from these chapters of this new Canadian best practice guideline. References
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.059 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.010 | 0.011 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.007 | 0.003 |
| Research integrity | 0.007 | 0.009 |
| Insufficient payload (model declined to judge) | 0.030 | 0.013 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".