Influenza vaccination during pregnancy prevents influenza among women and their infants but remains underused among pregnant women. We aimed to quantify the risk of antenatal influenza and examine its association with perinatal outcomes.

We did a prospective cohort study in pregnant women in India, Peru, and Thailand. Before the 2017 and 2018 influenza seasons, we enrolled pregnant women aged 18 years or older with expected delivery dates 8 weeks or more after the season started. We contacted women twice weekly until the end of pregnancy to identify illnesses with symptoms of myalgia, cough, runny nose or nasal congestion, sore throat, or difficulty breathing and collected mid-turbinate nasal swabs from symptomatic women for influenza real-time RT-PCR testing. We assessed the association of antenatal influenza with preterm birth, late pregnancy loss (≥13 weeks gestation), small for gestational age (SGA), and birthweight of term singleton infants using Cox proportional hazards models or generalised linear per month of pregnancy during the influenza season, and antenatal influenza was associated with increased risk for some adverse pregnancy outcomes. These findings support the added value of antenatal influenza vaccination to improve perinatal outcomes.

US Centers for Disease Control and Prevention.

For the Thai, Hindi, Marathi and Spanish translations of the abstract see Supplementary Materials section.

For the Thai, Hindi, Marathi and Spanish translations of the abstract see Supplementary Materials section.There are well-documented physiologic changes that occur in the human body during the aging process, such as decreased body fat, decreased muscle mass, cellular senescence, changes in skin pH, decreased metabolism, decreased immune function, vascular changes, altered tissue perfusion, nutritional status changes, and poor hydration. These changes affect skin integrity and wound healing, and raise the risk of pressure-related skin injury. This article discusses aging as a risk factor for pressure injury (PrI). Topics include evidence for advancing age as a significant PrI risk factor, identifying pathophysiologic changes/mechanisms of aging, and specific PrI preventive interventions to consider in older adults.Patients in critical care units have a multitude of diseases and conditions that contribute to their illness and as such are susceptible to comorbid conditions such as heel pressure injuries. Prevention is a key strategy to avoid heel pressure injury occurrence. Risk factor identification can help a clinician identify those patients at risk for a heel pressure injury requiring timely prevention strategies. The purpose of this article is to raise awareness regarding the critical care patient’s vulnerability to heel pressure injuries and strategies that can help avoid their occurrence or expedite their healing if occur.Nutrition is an important component in the prevention and treatment of pressure injuries. Although the point at which insufficient nutrient consumption affects the body’s capability to support skin integrity has not been demarcated, what is known is that reduced intake of food and fluids/water and weight loss can increase the risk of developing pressure injuries. Protein and its building blocks, amino acids, are essential for tissue growth and repair during all phases of wound healing. Sufficient macronutrients (carbohydrates, protein, fats, and water) and micronutrients (vitamins and minerals) are vital for the body to support tissue integrity and prevent breakdown.Deep tissue pressure injury (DTPI) is a serious form of pressure injuries. The condition remains invisible for up to 48 hours and then progresses rapidly to full-thickness skin and soft tissue loss. Many other conditions that lead to purple skin can be misidentified as DTPI, making the diagnosis difficult at times. A thorough history exploring exposure to pressure is imperative.Unstageable pressure injuries are widely understood to be full-thickness pressure injuries in which the base is obscured by slough and/or eschar. Correct identification of these pressure injuries can be challenging among health care professionals and, although treatments vary, débridement is key. Although the available research on unstageable pressure injuries is growing, there still is considerable need for advancements in the science regarding identification, treatment, and outcomes in critical care patients.Medical device-related pressure injuries result from use of medical devices, equipment, furniture, and everyday objects in direct contact with skin and because of increased external mechanical load leading to soft tissue damage. The resultant pressure injury generally mirrors the pattern or shape of the device. The nurse and clinician must be hypervigilant of increased risk of pressure injuries with the use of these devices. This article provides evidence-based information regarding the most common devices that cause pressure injuries in adults and describes current best evidence-based prevention strategies. Evidence-based prevention strategies are key to minimizing the harm devices can cause.Pressure injury prevention in critically ill pediatric patients can be challenging. The current article discusses pressure injury prevention and treatment with attention to unique aspects of pediatric physiology that influence risk for pressure injury. Medical device-related pressure injuries are particularly problematic in pediatric patients; therefore, this article presents best practice in preventing pediatric medical device-related pressure injuries. Treatment of pressure injuries is also discussed, with special attention to products that should be used with caution or avoided.Pressure injury treatments are tailored to the characteristics of the wound. Wound depth, exudate, presence of infection, and patient goals of care will guide appropriate dressing and treatment selection. TCPOBOP The interprofessional team, patient, and family should collaborate to create a plan of care for wound healing.Pressure injuries are areas of damage to the skin and underlying tissue caused by pressure or pressure in combination with shear. Pressure injury prevention in the critical care population necessitates risk assessment, selection of appropriate preventive interventions, and ongoing assessment to determine the adequacy of the preventive interventions. Best practices in preventive interventions among critical care patients, including skin and tissue assessment, skin care, repositioning, nutrition, support surfaces, and early mobilization, are described. Unique considerations in special populations including older adults and individuals with obesity are also addressed.