From Decubitus and Pressure Ulcers to Pressure Injuries
Bibliographic record
Abstract
Thirty-two years ago, the first issue of Decubitus (February 1988) was published. The founding editor, Dr Roberta Abruzzese, believed that the journal would be “a compendium of prevention and treatment of pressure ulcers.”1 Although the range of topics we cover has expanded significantly, the new co–editors-in-chief thought it would be important to mark the start of our 32nd year with a themed issue focused on pressure injuries. It was difficult to choose from the many wonderful articles, but we hope you will enjoy the ones we have included. Marcel Proust said, “The real voyage of discovery consists not in seeking new landscapes, but in having new eyes.”2 With that in mind, it was interesting to reread that first issue and ponder why the journal was named Decubitus. Why was this “outdated” term used instead of “pressure ulcer?” At the time, there were passionate clinicians on both sides of the terminology debate; arguments for both terms were made at professional conferences and in the early issues of the journal. Once again, there is dialogue about terminology, this time between “pressure ulcer” and “pressure injury.” The article by Dr Delmore and colleagues provides some data from the global community about this change. Another topic that Dr Abruzzese broached in her inaugural editorial was the lack of an accepted standard for pressure injury staging.1 She wrote that the journal should be a forum to discuss staging issues. To this end, we have included a commentary by Dr Jeffrey Levine covering both historical and recent insights into pressure injury staging. Our founding editor also emphasized the importance of preventing pressure injuries and urged healthcare professionals to “become more sophisticated in prevention.”1 Because medical devices are a risk factor for pressure injuries, we wanted to share with you information about the Braden QD scale. The Braden Q tool, developed by Quigley and Curley in 1996 for use in pediatrics, is now revised and includes medical devices as an assessable variable.3,4 Visit the website for more information about the new “Braden QD,” to obtain permission to use it in your practice5 and to download the form.6 The Braden QD scale is available in English and Finnish, with other language translations to come. Another concept that Dr Abruzzese explored was pressure injury incidence. Therefore, an article on pressure injury prevalence in the vulnerable spinal cord injury population was chosen to be part of this special issue. You may be surprised by their conclusions! Perhaps most critically, Dr Abruzzese stipulated that current topics should be included in the journal to stimulate comments, questions, and dialogue in our community. This month’s CME article is one example of this; we hope it will serve as a call to action for clinicians and professional organizations to further clarify concepts and terminology around skin changes at end of life. We can only hope that revisiting these concepts and reflecting on our practice experience will foster new insights from the latest literature and research. We invite your opinions on this issue’s content through a reader survey: www.surveymonkey.com/r/ASWC2019. The survey will be open until June 30, 2019. We plan to publish the results in a future issue of the journal for all to read.FigureElizabeth A. Ayello, PhD, RN, CWON, ETN, MAPWCA, FAANFigureR. Gary Sibbald, MD, DSc (Hons), MEd, BSc, FRCPC (Med Derm), FAAD, MAPWCA, JM
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.004 | 0.030 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.002 | 0.007 |
| Scholarly communication | 0.006 | 0.008 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.006 | 0.015 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
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".