A feasibility study of email communication between the patient's family and the specialist burns team

We investigated whether the parents of burns patients could capture suitable clinical images with a digital camera and add the necessary text information to enable the paediatric burns team to provide follow-up care via email. Four families were involved in the study, each of whom sent regular email consultations for six months. The results were very encouraging. The burns team felt confident that the clinical information in 30 of the 32 email messages (94%) they received was accurate, although in I I of these 30 cases (37%) they stated that there was room for improvement (the quality was nonetheless adequate for clinical decision making). The study also showed that low-resolution images (average size 37 kByte) were satisfactory for diagnosis. Families were able to participate in the service without intensive training and support. The user survey showed that all four families found it easy and convenient to take the digital photographs and to participate in the study. The results suggest that the technique has potential as a low-cost telemedicine service in burns follow-up, and that it requires only modest investment in equipment, training and support.

A review of three years experience using email and videoconferencing for the delivery of post-acute burns care to children in Queensland

A virtual outpatient service has been established in Queensland for the delivery of post-acute burns care to children living in rural and remote areas of the state. The integration of telepaediatrics as a routine service has reduced the need for patient travel to the specialist burns unit situated in Brisbane. We have conducted 293 patient consultations over a period of 3 years. A retrospective review of our experience has shown that post-acute burns care can be delivered using videoconferencing, email and the telephone. Telepaediatric bums services have been valuable in two key areas. The first area involves a programme of routine specialist clinics via videoconference. The second area relates to ad-hoc patient consultations for collaborative management during acute presentations and at times of urgent clinical need. The families of patients have expressed a high degree of satisfaction with the service. Telepaediatric services have helped improve access to specialist services for people living in rural and remote communities throughout Queensland. (C) 2003 Elsevier Ltd and ISBI. All rights reserved.

Diagnostic accuracy of and patient satisfaction with telemedicine for the follow-up of paediatric burns patients

Videoconferencing has become a routine technique for the post-acute burns care of children in Queensland. We compared the agreement between clinical assessments conducted via videoconference and assessments conducted in the conventional, face-to-face manner (FTF). A total of 35 children with a previous burn injury were studied. Twenty-five children received three consecutive assessments: first FTF by a consultant in the outpatient department, then by a second consultant who reviewed the patient via videoconference, and then by the second consultant in person. The second consultant also reviewed another 10 children twice. At each review, the following variables were measured: scar colour, scar thickening, contractures, range of motion, the patient's level of general activity, any breakdown of the graft site, and adequacy of the consultation. Agreement between the two consultants when seeing patients FTF was moderately high, with an overall concordance of 85%. When videoconferencing was used, the level of agreement was almost the same, at 84%. If one consultant reviewed patients FTF first and then via videoconference, the overall concordance was 98%; if the process was reversed, the overall concordance was 97%. This study confirms that the quality of information collected during a videoconference appointment is comparable to that collected during a traditional, FTF appointment for a follow-up burns consultation.

Community-based interventions for the prevention of burns and scalds in children

Background Burns and scalds are a significant cause of morbidity and mortality in children. Successful counter-measures to prevent burn and scald-related injury have been identified. However, evidence indicating the successful roll-out of these counter-measures into the wider community is lacking. Community-based interventions in the form of multi-strategy, multi-focused programmes are hypothesised to result in a reduction in population-wide injury rates. This review tests this hypothesis with regards to burn and scald injury in children. Objectives To assess the effects of community-based interventions, defined as coordinated, multi-strategy initiatives, for reducing burns and scalds in children aged 14 years and under. Search strategy We searched the Cochrane Injuries Group's specialised register, CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, National Research Register and the Web of Knowledge. We also handsearched selected journals and checked the reference lists of selected publications. The searches were last updated in May 2007. Selection criteria Included studies were those that reported changes in medically attended burn and scald-related injury rates in a paediatric population (aged 14 years and under), following the implementation of a controlled community-based intervention. Data collection and analysis Two authors independently assess studies for eligibility and extracted data. Due to heterogeneity between the included studies, a pooled analysis was not appropriate. Main results Of 39 identified studies, four met the criteria for inclusion. Two of the included studies reported a significant decrease in paediatric burn and scald injury in the intervention compared with the control communities. The failure of the other two studies to show a positive result may have been due to limited time-frame for the intervention and/or failure to adequately implement the counter-measures in the communities. Authors' conclusions There are a very limited number of research studies allowing conclusions to be drawn about the effectiveness of community-based injury prevention programmes to prevent burns and scalds in children. There is a pressing need to evaluate high-quality community-based intervention programmes based on efficacious counter-measures to reduce burns and scalds in children. It is important that a framework for considering the problem of burns and scalds in children from a prevention perspective be articulated, and that an evidence-based suite of interventions be combined to create programme guidelines suitable for implementation in communities throughout the world.

Protein losing enteropathy in critically ill adult patients with burns: a preliminary report

Objective: Few data have been published regarding protein losing enteropathy in adult patients with burns. This study characterised the presence of protein-losing enteropathy in adults with burns and examined the relationship between the magnitude of bum size and the severity of protein loss. Methods: Twenty adult patients with burns (BSA 31+/-25%, range 2-80%) were studied. Fluid resuscitation was based on the Parkland's formula. Protein loss into the gastrointestinal tract was measured using faecal alpha(1)-antitrypsin (FA-1-AT) concentrations. Serial measurements of serum protein and albumin concentrations were performed. Results: Fourteen patients demonstrated elevations in FA-1-AT levels. The mean peak FA-1-AT level was 3.6+/-4.2 mg/g dry weight of stool. Two patients demonstrated elevated FA-1-AT excretion 1.5 months and 3 months after the bums. There was a good correlation between burn size and FA-1-AT excretion (R-2=0.40). Conclusions: Protein losing enteropathy was demonstrable in patients with major burns. The magnitude of this phenomenon appears to be proportional to the burns size.

Post-acute burns education via videoconference for occupational therapists in Queensland

For over five years, post-acute burns care for children in regional areas of Queensland has been provided by videoconference. Some 300 specialist burns consultations are conducted by videoconference annually. To support regional health professionals, particularly occupational therapists who play an integral role in the local management of these children, we have instigated a series of monthly education sessions via videoconference. The sessions have addressed a broad range of topics related to the long-term management of children following a burn injury. During the first six months, up to 22 regional sites participated in multipoint videoconferences. The average number of participants per videoconference was 39 and the average duration of each session was 67 min. Participant satisfaction was measured with a routine survey completed by each site at the conclusion of the videoconference. The survey response rate was 88% (n = 95) and overall feedback was extremely positive. 96% of respondents agreed that the programme provided them with new information and that the content was relevant (95%) and of appropriate depth (84%). The educational programme has provided valuable support to a group of professionals who are taking on greater responsibility for the clinical management of children requiring post-acute burns care.

Out in psychology:lesbian, gay, bisexual, trans and queer perspectives

There has been a recent explosion of interest in Lesbian, Gay, Bisexual and Trans Perspective Psychology amongst students and academics, and this interest is predicted to continue to rise. Recent media debates on subjects such as same–sex marriage have fuelled interest in LGBTQ perspectives. This edited collection showcases the latest thinking in LGBTQ psychology. The book has 21 chapters covering subjects such as same sex parenting, outing, young LGBTQ people, sport, learning disabilities, lesbian and gay identities etc. The book has an international focus, with contributors from UK, US, Canada, Australia and New Zealand List of Contributors. Foreword by Jerry J. Bigner. 1. Introducing Out in Psychology (Victoria Clarke and Elizabeth Peel). 2. From lesbian and gay psychology to LGBTQ psychologies: A journey into the unknown (Victoria Clarke and Elizabeth Peel) 3. What comes after discourse analysis for LGBTQ psychology(Peter Hegarty). 4. Recognising race in LGBTQ psychology: Power, privilege and complicity (Damien W. Riggs). 5. Personality, individual differences and LGB psychology (Gareth Hagger Johnson). 6. Heteronormativity and the exclusion of bisexuality in psychology (Meg Barker). 7. A minority within a minority: Experiences of gay men with intellectual disabilities.(Christopher Bennett and Adrian Coyle). 8. Closet talk: The contemporary relevance of the closet in lesbian and gay interaction (Victoria Land and Celia Kitzinger) 9. Romance, rights, recognition, responsibilities and radicalism: Same-sex couples’ accounts of civil partnership and marriage (Victoria Clarke, Carole Burgoyne and Maree Burns). 10. The experience of social power in the lives of trans people (Clair Clifford and Jim Orford). 11. What do they look like and are they among us? Bisexuality, (dis.closure and (Maria Gurevich, Jo Bower, Cynthia M. Mathieson and Bramilee Dhayanandhan). 12. Heterosexism at work: Diversity training, discrimination law and the limits of liberal individualism (Rosie Harding and Elizabeth Peel). 13. Out on the ball fields: Lesbians in sport (Vikki Krane and Kerrie J. Kauer). 14. Homophobia, rights and community: Contemporary issues in the lives of LGB people in the UK (Sonja J. Ellis). 15. Striving for holistic success: How lesbians come out on top (Faith Rostad and Bonita C. Long). 16. On Passing: The Interactional Organization of Appearance Attributions in the Psychiatric Assessment of Transsexual Patients (Susan A. Speer and Richard Green). 17. Alcohol and gay men: Consumption, promotion and policy responses (Jeffrey Adams, Timothy McCreanor and Virginia Braun). 18. Towards a clinical-psychological approach to address the hetero sexual concerns of intersexed women (Lih-Mei Liao). 19. Educational psychology practice with LGB youth in schools: Individual and institutional interventions (Jeremy J. Monsen and Sydney Bailey). 20. Que(e)rying the meaning of lesbian health: Individual(izing and community discourses (Sara MacBride-Stewart). 21. Transsexualism: Diagnostic dilemmas, transgender politics and the future of transgender care (Katherine Johnson). Index.

Spectral domain optical coherence tomography can detect visible and subthreshold laser burns using 532-nm laser

Retinal burns of subthreshold intensity created using micropulsed diode laser, which remain clinically invisible, have been shown to be successful in treating macular edema while minimizing the risk of collateral damage to the retina. A study was conducted to determine whether spectral domain optical coherence tomography (SD-OCT) could be used to detect subthreshold retinal burns created using the 532-nm green wavelength laser. A series of retinal burns of gradually decreasing intensity were created in 10 eyes. Retinal burns produced with duration of laser exposure of 0.03 second or less, although clinically invisible, were detectable on the SD-OCT scan as increased retinal reflectivity confined to the outer retinal layers. This series demonstrates the potential of using SD-OCT imaging to verify delivery of subthreshold laser burns.

Researching language teacher cognition and practice:international case studies

This book presents a novel approach to discussing how to research language teacher cognition and practice. An introductory chapter by theeditors and an overview of the research field by Simon Borg precede eigh case studies written by new researchers, each of which focuses on one approach to collecting data. These approaches range from questionnaires and focus groups to think aloud, stimulated recall, and oral reflective journals. Each case study is commented on by a leading expert in the field - JD Brown, Martin Bygate, Donald Freeman, Alan Maley, Jerry Gebhard, Thoma Farrell, Susan Gass, and Jill Burton. Readers are encouraged to enter th conversation by reflecting on a set of questions and tasks in each chapter.

Producer Jerry Weintraub and reporter for the NY Daily News Pete Hamil on the set of "Cruising" film

General note: Title and date provided by Bettye Lane.