1,418,595 research outputs found
The Opie Recordings: What’s Left to be Heard?
No full textThis chapter presents an analysis of selected recordings from the Opie Collection of Children's Games in the National Sound Archive. It contextualises them with an account of the Opies' research approach, and identifies three themes emerging from the recordings which are not found in published work by the Opies. These are: the strong rleatinoship between children's media cultures and traditional play cultures; more extensive variation of words and music in the singing games; and more extreme examples of obscene and scatological rhymes
Recommended from our members
Burn-in policies for products having dormant states
No full textMany systems might have a long time dormant period, during which the systems are not operated. For example, most building services products are installed while a building is constructed, but they are not operated until the building is commissioned. Warranty terms for such products may cover the time starting from their installation times to the end of their warranty periods. Prior to the commissioning of the building, the building services products are protected by warranty although they are not operating. Developing optimal burn-in policies for such products is important when warranty cost is analysed. This paper considers two burn-in policies, which incur different burn-in costs, and have different burn-in effects on the products. A special case about the relationship between the failure rates of the products at the dormant state and at the operating state is presented. Numerical examples compare the mean total warranty costs of these two burn-in policies
Stochastically ordered subpopulations and optimal burn-in procedure
No full textBurn-in is a widely used engineering method which is adopted to eliminate defective items before they are shipped to customers or put into the field operation. In the studies of burn-in, the assumption of bathtub shaped failure rate function is usually employed and optimal burn-in procedures are investigated. In this paper, however, we assume that the population is composed of two ordered subpopulations and optimal burn-in procedures are studied in this context. Two types of risks are defined and an optimal burn-in procedure, which minimizes the weighted risks is studied. The joint optimal solutions for the optimal burn-in procedure, which minimizes the mean number of repairs during the field operation, are also investigated.
The use of topical sodium hypochlorite in the management of Pseudomonas aeruginosa burn wound infection
No full textThe aim of the study is: 1. To undertake a meta-analysis of Pseudomonas aeruginosa burn wound infection. 2. To undertake a retrospective audit of Pseudomonas aeruginosa burn wound infection at the Red Cross War Memorial Children's Hospital. 3. To investigate the local effects of sodium hypochlorite solutions in Pseudomonas aeruginosa burn wound infection with regards to efficacy and toxicity
A History of Burn Care
No full textBurn injuries are still one of the most common and devastating injuries in human and the treatment of major burns remains a major challenge for physicians worldwide. Modern burn care involves many components from initial first aid, burn size and burn depth assessment, fluid resuscitation, wound care, excision and grafting/ coverage, infection control and nutritional support. Progress in each of these areas has contributed significantly to the overall enhanced survival of burn victims of the past decades. Most major advances in burn care occurred in the past 50 years, spurred on by wars and great fires. The use of systemic antibiotics and topical antiinfective agents greatly reduced sepsis related mortality. This along with the improvement of new surgical and skin grafting techniques allowed the earlier excision and coverage of deep burns which resulted in greatly improved survival rates and better functional and aesthetic outcome. In this book we look back at how the treatment of burns has evolved over the past decades and hundreds of years. The advancement of burn care has been closely associated with our deeper understanding of its pathophysiology; we have now come to understand the impact that burn injuries have in the multiple fields of current medical science i.e. in metabolism and circulation, electrolyte balance and nutrition, immunology and infection, inflammation, pulmonary function and wound healing
Long-term persistance of the pathophysiologic response to severe burn injury.
No full textMain contributors to adverse outcomes in severely burned pediatric patients are profound and complex metabolic changes in response to the initial injury. It is currently unknown how long these conditions persist beyond the acute phase post-injury. The aim of the present study was to examine the persistence of abnormalities of various clinical parameters commonly utilized to assess the degree hypermetabolic and inflammatory alterations in severely burned children for up to three years post-burn to identify patient specific therapeutic needs and interventions.
Nine-hundred seventy-seven severely burned pediatric patients with burns over 30% of the total body surface admitted to our institution between 1998 and 2008 were enrolled in this study and compared to a cohort non-burned, non-injured children. Demographics and clinical outcomes, hypermetabolism, body composition, organ function, inflammatory and acute phase responses were determined at admission and subsequent regular intervals for up to 36 months post-burn. Statistical analysis was performed using One-way ANOVA, Student's t-test with Bonferroni correction where appropriate with significance accepted at p<0.05. Resting energy expenditure, body composition, metabolic markers, cardiac and organ function clearly demonstrated that burn caused profound alterations for up to three years post-burn demonstrating marked and prolonged hypermetabolism, p<0.05. Along with increased hypermetabolism, significant elevation of cortisol, catecholamines, cytokines, and acute phase proteins indicate that burn patients are in a hyperinflammatory state for up to three years post-burn p<0.05.
Severe burn injury leads to a much more profound and prolonged hypermetabolic and hyperinflammatory response than previously shown. Given the tremendous adverse events associated with the hypermetabolic and hyperinflamamtory responses, we now identified treatment needs for severely burned patients for a much more prolonged time
Pattern of Childhood Burn Injuries and their Management Outcome at Bugando Medical Centre in Northwestern Tanzania.
No full textBurn injuries constitute a major public health problem and are the leading cause of childhood morbidity and mortality worldwide. There is paucity of published data on childhood burn injuries in Tanzania, particularly the study area. This study was conducted to describe the pattern of childhood burn injuries in our local setting and to evaluate their management outcome. A cross sectional study was conducted at Bugando Medical Centre (in Northwestern Tanzania) over a 3-year period from January 2008 to December 2010. Data was collected using a pre-tested coded questionnaire and statistical analyses performed using SPSS software version 15.0. A total of 342 burned children were studied. Males were mainly affected. Children aged = 2 were the majority accounting for 45.9% of cases. Intentional burn injuries due to child abuse were reported in 2.9% of cases. Scald was the most common type of burns (56.1%). The trunk was the most commonly involved body region (57.3%). Majority of patients (48.0%) sustained superficial burns. Eight (2.3%) patients were HIV positive. Most patients (89.8%) presented to the hospital later than 24 h. The rate of burn wound infection on admission and on 10th day were 32.4% and 39.8% respectively.Staphylococcus aureus were more common on admission wound swabs, with Pseudomonas aeruginosa becoming more evident after 10th day. MRSA was detected in 19.2% of Staphylococcus aureus. Conservative treatment was performed in 87.1% of cases. Surgical treatment mainly skin grafting (65.9%) was performed in 44 (12.9%) of patients. The overall average of the length of hospital stay (LOS) was 22.12 ± 16.62 days. Mortality rate was 11.7%. Using multivariate logistic regression analysis; age of the patient, type of burn, delayed presentation, clothing ignition, %TBSA and severity of burn were found to be significantly associated with LOS (P < 0.001), whereas mortality rate was found to be independently and significantly related to the age of the patient, type of burn, HIV positive with stigmata of AIDS, CD4 count, inhalation injury, %TBSA and severity of burn (P < 0.001). Childhood burn injuries still remain a menace in our environment with virtually unacceptable high morbidity and mortality. There is need for critical appraisal of the preventive measures and management principles currently being practiced
Factors Influencing Provision of Care to Hospitalized Peadiatrics Burn Patients: A Qualitative Study Among Nurses in Muhimbili National Hospital Dar es salaam, Tanzania
No full textThe increase number of burn patients‘ admission in Muhimbili National Hospital indicated that burn injury is still a problem in our setting. In July 2011 up to June 2012 a total of 6135 paediatrics patients were admitted in MNH due to various diseases of which 319 patients were admitted due to burn injury. This is equal to 5.2% of all paediatrics admission (unpublished report). However hospital management made good coordination and availability of working equipments in order to archive optimal care for paediatric burn patients. Even though Health care providers especially nurse were facing some difficulties in provision of burn care. The main objective of this study was to explore nurses‘ perceptions on factors influencing provision of care to pediatric burn patients among nurses at Muhimbili National Hospital. Five in depth interviews were conducted in order to explore nurses‘ perception on factors that may influence provision of nursing care to hospitalized pediatric burn patients. This study was conducted from May 2012 to June 2012 in MNH. Simple observation method was used to complement data obtained through in-depth interviews. The study informants were sampled by using purposive sampling procedure. Data was analyzed by using content analysis approach. Findings The present study revealed two major categories which include motivating factors and barriers in provision of burn care. Participants described the use of closed method of wound dressing as an important skill that accelerates healing, decrease risk of wound contamination and decreased number of contractures. Presence of team work in burn care, facilitated patients recovery through reviewed and discussed management of patients as a team. Availability of equipments helped nurses to perform nursing care smoothly. Furthermore, participants felt gratified and increased work performance when they saw patients who sustained very severe burn injury recovering and going back home. Despite the fact that burn care was found somehow successfully in Muhimbili National Hospital (MNH), participants revealed several factors that hindered provision of care. These factors include limited resources, patient workload, and lack of standard skills. Participants described that there were limited human and non human resources, such as shortage of staffing which resulted into overworking, physical and emotional exhaustion among nurses, lack of water which is the mainstay of infection prevention control, lack of specimen equipment like pus swab. Since burn patient are at risk of infection therefore they need to take pus swab frequently. Nevertheless, participants expressed that they lack standard skills on burn care since there was no special training on burn care. Instead they were teaching themselves in the sense that experienced nurses in burn unit were teaching new nurses who came to work in burn unit. The finding of this study revealed that there are both positively and negatively factors that influence provision of burn care. Positive factor (motivation) needed to be maintained but action is required to be taken in order to reduce negative factors. More public health enlightenment is needed on prevention and initial intervention for burns in children. Community need to be aware that prevention of burn should be a priority since caring for burnt patient is very expensive. Further studies are needed in large population since this information is not conclusive to factors influence burn care in Tanzania.\ud
\u
Objective estimates of the probability of death in acute burn injury: A Proposed Taiwan Burn Score
No full textBACKGROUND: This study aimed to develop an objective model for predicting mortality after burn injury in Taiwan.
METHODS: From 1997 to 2010, 23,147 patients with acute burn injury in 44 hospitals were retrospectively reviewed. Variables examined were age, sex, depth and extent of burn, inhalation injury, flushing time, hospital admission and referral status, intensive care unit admission, and mortality. Logistic regression analyses were used to evaluate risk factors. Model performance and calibration was evaluated by measures of discrimination and goodness-of-fit statistic, respectively. A nomogram of four major risk factors was used to calculate the probability of mortality.
RESULTS: Only 22,665 patients (mean [SD] age, 31.05 [22.67] years; mean second-degree and third-degree burn sizes, 8.67% [10.64%] and 3.25% [10.91%], respectively) survived until discharge, for a mortality rate of 2.08%.
CONCLUSION: Burn depth is an important predictive factor for mortality. An objective model can help estimate the probability of death in acute burn injury.國外SCIY紙本US
Classifying Weak, and Strong Components using ROC Analysis with Application to Burn-in
No full textAny population of components produced might be composed of two sub-populations: weak components are less reliable, and deteriorate faster whereas strong components are more reliable, and deteriorate slower. When selecting an approach to classifying the two sub-populations, one could build a criterion aiming to minimize the expected mis-classification cost due to mis-classifying weak (strong) components as strong (weak). However, in practice, the unit mis-classification cost, such as the cost of mis-classifying a strong component as weak, cannot be estimated precisely. Minimizing the expected mis-classification cost becomes more difficult. This problem is considered in this paper by using ROC (Receiver Operating Characteristic) analysis, which is widely used in the medical decision making community to evaluate the performance of diagnostic tests, and in machine learning to select among categorical models. The paper also uses ROC analysis to determine the optimal time for burn-in to remove the weak population. The presented approaches can be used for the scenarios when the following information cannot be estimated precisely: 1) life distributions of the sub-populations, 2) mis-classification cost, and 3) proportions of sub-populations in the entire population
- …
