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.

Deep dermal burn injury results in scarless wound healing in the ovine fetus

Early to mid-term fetuses heal cutaneous incisional wounds without scars; however, fetal response to burn injury has not been ascertained. We present a fetal model of thermal injury and subsequent analysis of fetal and lamb response to burn injury. A reproducible deep dermal burn injury was created in the fetus by application of water at 66 degrees C for 7 seconds, and at 82 degrees C for 10 seconds to the lamb. Macroscopically, the area of fetal scald was undetectable from day 7 post injury, while all lamb scalds were readily identified and eventually healed with scarring. Using a five-point histopathology scoring system for alteration in tissue morphology, differences were detected between control and scalded skin at all stages in lamb postburn, but no difference was detected in the fetal model after day 7. There were also large differences in content of alpha-smooth muscle actin and transforming growth factor-beta 1 between control and scalded lamb and these differences were statistically significant at day 14 (P < 0.01). This novel model of fetal and lamb response to deep dermal injury indicates that the fetus heals a deep burn injury in a scarless fashion. Further elucidation of this specific fetal process of burn injury repair may lead to improved outcome for patients with burn injury.

Effect of smoke inhalation on viscoelastic properties and ventilation distribution in sheep

Smoke inhalation injuries are the leading cause of mortality from burn injury. Airway obstruction due to mucus plugging and bronchoconstriction can cause severe ventilation inhomogeneity and worsen hypoxia. Studies describing changes of viscoelastic characteristics of the lung after smoke inhalation are missing. We present results of a new smoke inhalation device in sheep and describe pathophysiological changes after smoke exposure. Fifteen female Merino ewes were anesthetized and intubated. Baseline data using electrical impedance tomography and multiple-breath inert-gas washout were obtained by measuring ventilation distribution, functional residual capacity, lung clearance index, dynamic compliance, and stress index. Ten sheep were exposed to standardized cotton smoke insufflations and five sheep to sham smoke insufflations. Measured carboxyhemoglobin before inhalation was 3.87 +/- 0.28% and 5 min after smoke was 61.5 +/- 2.1%, range 50-69.4% ( P < 0.001). Two hours after smoke functional residual capacity decreased from 1,773 +/- 226 to 1,006 +/- 129 ml and lung clearance index increased from 10.4 +/- 0.4 to 14.2 +/- 0.9. Dynamic compliance decreased from 56.6 +/- 5.5 to 32.8 +/- 3.2 ml/ cmH(2)O. Stress index increased from 0.994 +/- 0.009 to 1.081 +/- 0.011 ( P < 0.01) ( all means +/- SE, P < 0.05). Electrical impedance tomography showed a shift of ventilation from the dependent to the independent lung after smoke exposure. No significant change was seen in the sham group. Smoke inhalation caused immediate onset in pulmonary dysfunction and significant ventilation inhomogeneity. The smoke inhalation device as presented may be useful for interventional studies.

Effects of fire on the structure and composition of open eucalypt forests

Fires are integral to the healthy functioning of most ecosystems and are often poorly understood in policy and management, however, the relationship between floristic composition and habitat structure is intrinsically linked, particularly after fire. The aim of this study was to test whether the variability of habitat structure or floristic composition and abundance in forests at a regional scale can be explained in terms of fire frequency using historical data and experimental prescribed burns. We tested this hypothesis in open eucalypt forests of Fraser Island off the east coast of Australia. Fraser Island dunes show progressive stages in plant succession as access to nutrients decreases across the Island. We found that fire frequency was not a good predictor of floristic composition or abundance across dune systems; rather, its affects were dune specific. In contrast, habitat structure was strongly influenced by fire frequency, independent of dune system. A dense understorey occurred in frequently burnt areas, whereas infrequently burnt areas had a more even distribution of plant heights. Plant communities returned to pre-burn levels of composition and abundances within 6 months of a fire and frequently burnt areas were dominated by early successional species of plant. These ecosystems were characterized by low diversity and frequently burnt areas on the east coast were dominated by Pteridium. Greater midstorey canopy cover in low frequency areas reduces light penetration and allows other species to compete more effectively with Pteridium. Our results strongly indicate that frequent fires on the Island have resulted in a decrease in relative diversity through dominance of several species. Prescribed fire represents a powerful management tool to shape habitat structure and complexity of Fraser Island forests.

Precipitation and Fire Effects on Flowering of a Rare Prairie Orchid

A small, isolated population of the threatened western prairie fringed orchid (Platanthera praeclara Sheviak & Bowles) occurs at Pipestone National Monument, Minnesota, in a mesic prairie that is periodically burned to control invasive cool-season grasses. During 1995-2004, monitoring counts of flowering orchids in the monument varied considerably for different years. Similar precipitation amounts in the spring and histories of burning suggest that fire and precipitation in the spring were not the causes of the variation. For the eight non-burn years in the monitoring record, we compared the number of flowering plants and the precipitation amounts during six growth stages of the orchid and found a 2-variab1e model (precipitation during senescence/bud development and precipitation in the dormant period) explained 77% of the annual variation in number of flowering plants. We also conducted a fire experiment in early May 2002, the typical prescribed burn period for the monument, and found that the frequency of flowering, vegetative, and absent plants observed in July did not differ between burned and protected locations of orchids. We used the model and forecasts of precipitation in the spring to develop provisional burn decision scenarios. We discussed management implications of the scenarios.

Experimental investigation of performance, emission and combustion characteristics of an indirect injection multi-cylinder CI engine fuelled by blends of de-inking sludge pyrolysis oil with biodiesel

De-inking sludge can be converted into useful forms of energy to provide economic and environmental benefits. In this study, pyrolysis oil produced from de-inking sludge through an intermediate pyrolysis technique was blended with biodiesel derived from waste cooking oil, and tested in a multi-cylinder indirect injection type CI engine. The physical and chemical properties of pyrolysis oil and its blends (20 and 30 vol.%) were measured and compared with those of fossil diesel and pure biodiesel (B100). Full engine power was achieved with both blends, and very little difference in engine performance and emission results were observed between 20% and 30% blends. At full engine load, the brake specific fuel consumption on a volume basis was around 6% higher for the blends when compared to fossil diesel. The brake thermal efficiencies were about 3-6% lower than biodiesel and were similar to fossil diesel. Exhaust gas emissions of the blends contained 4% higher CO2 and 6-12% lower NOx, as compared to fossil diesel. At full load, CO emissions of the blends were decreased by 5-10 times. The cylinder gas pressure diagram showed stable engine operation with the 20% blend, but indicated minor knocking with 30% blend. Peak cylinder pressure of the 30% blend was about 5-6% higher compared to fossil diesel. At full load, the peak burn rate of combustion from the 30% blend was about 26% and 12% higher than fossil diesel and biodiesel respectively. In comparison to fossil diesel the combustion duration was decreased for both blends; for 30% blend at full load, the duration was almost 12% lower. The study concludes that up to 20% blend of de-inking sludge pyrolysis oil with biodiesel can be used in an indirect injection CI engine without adding any ignition additives or surfactants.

Structural effects in photopolymerized sodium AMPS hydrogels crosslinked with poly(ethylene glycol) diacrylate for use as burn dressings

Synthetic hydrogel polymers were prepared by free radical photopolymerization in aqueous solution of the sodium salt of 2-acrylamido-2-methylpropane sulfonic acid (Na-AMPS). Poly(ethylene glycol) diacrylate (PEGDA) and 4,4'-azo-bis(4-cyanopentanoic acid) were used as the crosslinker and UV-photoinitiator, respectively. The effects of varying the Na-AMPS monomer concentration within the range of 30-50% w/v and the crosslinker concentration within the range of 0.1-1.0% mol (relative to monomer) were studied in terms of their influence on water absorption properties. The hydrogel sheets exhibited extremely high swelling capacities in aqueous media which were dependent on monomer concentration, crosslink density, and the ionic strength and composition of the immersion medium. The effects of varying the number-average molecular weight of the PEGDA crosslinker from = 250 to 700 were also investigated. Interestingly, it was found that increasing the molecular weight and therefore the crosslink length at constant crosslink density decreased both the rate of water absorption and the equilibrium water content. Cytotoxicity testing by the direct contact method with mouse fibroblast L929 cells indicated that the synthesized hydrogels were nontoxic. On the basis of these results, it is considered that photopolymerized Na-AMPS hydrogels crosslinked with PEGDA show considerable potential for biomedical use as dressings for partial thickness burns. This paper describes some structural effects which are relevant to their design as biomaterials for this particular application. © 2013 Copyright Taylor and Francis Group, LLC.

Engines for combined heat and power

Spark-ignited (SI) gas engines are for the use of fuel gas only and are limited to the flammable range of the gas; this means the range of a concentration of a gas or vapor that will burn after ignition. Fuel gas like syngas from gasification or biogas must meet high quality and chemical purity standards for combustion in SI gas engines. Considerable effort has been devoted to fast pyrolysis over the years and some of the product oils have been tested in diesel or dual-fuel engines since 1993. For biogas conversion, usually dual-fuel engines are used, while for synthesis gas the use of gas engines is more common. The trials using wood derived pyrolysis oil from fast pyrolysis have not yet been a success story and these approaches have usually failed due to the high corrosivity of the pyrolysis oils.

Combustion and emission characteristics of a typical biodiesel engine operated on waste cooking oil derived biodiesel

Waste cooking oils can be converted into fuels to provide economical and environmental benefits. One option is to use such fuels in stationary engines for electricity generation, co-generation or tri-generation application. In this study, biodiesel derived from waste cooking oil was tested in an indirect injection type 3-cylinder Lister Petter biodiesel engine. We compared the combustion and emission characteristics with that of fossil diesel operation. The physical and chemical properties of pure biodiesel (B100) and its blends (20% and 60% vol.) were measured and compared with those of diesel. With pure biodiesel fuel, full engine power was achieved and the cylinder gas pressure diagram showed stable operation. At full load, peak cylinder pressure of B100 operation was almost similar to diesel and peak burn rate of combustion was about 13% higher than diesel. For biodiesel operation, occurrences of peak burn rates were delayed compared to diesel. Fuel line injection pressure was increased by 8.5-14.5% at all loads. In comparison to diesel, the start of combustion was delayed and 90% combustion occurred earlier. At full load, the total combustion duration of B100 operation was almost 16% lower than diesel. Biodiesel exhaust gas emissions contained 3% higher CO2 and 4% lower NOx, as compared to diesel. CO emissions were similar at low load condition, but were decreased by 15 times at full load. Oxygen emission decreased by around 1.5%. Exhaust gas temperatures were almost similar for both biodiesel and diesel operation. At full engine load, the brake specific fuel consumption (on a volume basis) and brake thermal efficiency were respectively about 2.5% and 5% higher compared to diesel. Full engine power was achieved with both blends, and little difference in engine performance and emission results were observed between 20% and 60% blends. The study concludes that biodiesel derived from waste cooking oil gave better efficiency and lower NOx emissions than standard diesel. Copyright © 2012 SAE International.

Developing Ecological Criteria for Prescribed Fire in South Florida Pine Rockland Ecosystems

The pine rocklands of South Florida, characterized by a rich herbaceous flora with many narrowly endemic taxa beneath an overstory of south Florida slash pine (Pinus elliottii var. densa), are found in three areas: the Miami Rock Ridge of southeastern peninsular Florida, the Lower Florida Keys, and slightly elevated portions of the southern Big Cypress National Preserve. Fire is an important element in these ecosystems, since in its absence the pine canopy is likely to be replaced by dense hardwoods, resulting in loss of the characteristic pineland herb flora. Prescribed fire has been used in Florida Keys pine forests since the creation of the National Key Deer Refuge (NKDR), with the primary aim of reducing fuels. Because fire can also be an effective tool in shaping ecological communities, we conducted a 4-year research study which explored a range of fire management options in NKDR. The intent of the study was to provide the Fish and Wildlife Service and other land managers with information regarding when and where to burn in order to perpetuate these unique forests.