Essay on Burns, with The cotter's Saturday night and other poems from Burns;

Mode of access: Internet.

The efficacy of an augmented virtual reality system to alleviate pain in children undergoing burns dressing changes : a randomised controlled trial

In children, the pain and anxiety associated with acute burn dressing changes can be severe, with drug treatment alone frequently proving to be inadequate. Virtual reality (VR) systems have been successfully trialled in limited numbers of adult and paediatric burn patients. Augmented reality (AR) differs from VR in that it overlays virtual images onto the physical world, instead of creating a complete virtual world. This prospective randomised controlled trial investigated the use of AR as an adjunct to analgesia and sedation in children with acute burns. Forty-two children (30 male and 12 female), with an age range of 3–14 years (median age 9 years) and a total burn surface area ranging from 1 to 16% were randomised into a treatment (AR) arm and a control (basic cognitive therapy) arm after administration of analgesia and/or sedation. Pain scores, pulse rates (PR), respiratory rates (RR) and oxygen saturations (SaO2) were recorded pre-procedurally, at 10 min intervals and post-procedurally. Parents were also asked to grade their child's overall pain score for the dressing change. Mean pain scores were significantly lower (p = 0.0060) in the AR group compared to the control group, as were parental pain assessment scores (p = 0.015). Respiratory and pulse rates showed significant changes over time within groups, however, these were not significantly different between the two study groups. Oxygen saturation did not differ significantly over time or between the two study groups. This trial shows that augmented reality is a useful adjunct to pharmacological analgesia.

Laser doppler imaging in a paediatric burns population

Objective Laser Doppler imaging (LDI) was compared to wound outcomes in children's burns, to determine if the technology could be used to predict these outcomes. Methods Forty-eight patients with a total of 85 burns were included in the study. Patient median age was 4 years 10 months and scans were taken 0–186 h post-burn using the fast, low-resolution setting on the Moor LDI2 laser Doppler imager. Wounds were managed by standard practice, without taking into account the scan results. Time until complete re-epithelialisation and whether or not grafting and scar management were required were recorded for each wound. If wounds were treated with Silvazine™ or Acticoat™ prior to the scan, this was also recorded. Results The predominant colour of the scan was found to be significantly related to the re-epithelialisation, grafting and scar management outcomes and could be used to predict those outcomes. The prior use of Acticoat™ did not affect the scan relationship to outcomes, however, the use of Silvazine™ did complicate the relationship for light blue and green scanned partial thickness wounds. Scans taken within the 24-h window after-burn also appeared to be accurate predictors of wound outcome. Conclusion Laser Doppler imaging is accurate and effective in a paediatric population with a low-resolution fast-scan.

Misericordiae Antemortem - The 1955 Mount Superbus Crash

On the 9th April 1955, RAAF Lincoln Bomber A73-64, on a mercy flight to transfer a critically ill infant from Townsville to Brisbane, crashed at Mount Superbus killing the four crew and two civilians on board. The immediate search and rescue was organised by a group of Brisbane bushwalkers who were camping in the area. Police and RAAF personnel subsequently joined the civilians at the crash site to recover the victims. During their initial search of the crash they located what were believed to be the remains of five adults. The arrival of the RAAF Senior Medical Officer (SMO) the following day revealed that only four adult bodies had been found and the bodies of both civilians, an adult and infant, were missing. Later that day the remains of six victims were recovered from the crash site and conveyed to the Warwick Police Station for identification. The RAAF SMO was responsible for the identifications of the aircrew while the Government Medical Officer, police and coroner were responsible for the identifications of the civilians. Eight days later, further remains of the infant were found by a civilian looking through the wreckage. This paper uses archival records not previously researched from a Disaster Victim Identification (DVI) perspective to stimulate interest among forensic practitioners, criminologists and other interested parties in the history of DVI and how practices in Australia have evolved.

Play and heal : randomized controlled trial of Ditto intervention efficacy on improving re-epithelialization in pediatric burns

BACKGROUND: The relationships between pain, stress and anxiety, and their effect on burn wound re-epithelialization have not been well explored to-date. The aim of this study was to investigate the effect of the Ditto (a hand-held electronic medical device providing procedural preparation and distraction) intervention on re-epithelialization rates in acute pediatric burns. METHODS/DESIGN: From August 2011 to August 2012, children (4-12 years) with an acute burn presenting to the Royal Children's Hospital, Brisbane, Australia fulfilled the study requirements and were randomized to [1] Ditto intervention or [2] standard practice. Burn re-epithelialization, pain intensity, anxiety and stress measures were obtained at every dressing change until complete wound re-epithelialization. RESULTS: One hundred and seventeen children were randomized and 75 children were analyzed (n=40 standard group; n=35 Ditto group). Inability to predict wound management resulted in 42 participants no longer meeting the eligibility criteria. Wounds in the Ditto intervention group re-epithelialized faster than the standard practice group (-2.14 days (CI: -4.38 to 0.10), p-value=0.061), and significantly faster when analyses were adjusted for mean burn depth (-2.26 days (CI: -4.48 to -0.04), p-value=0.046). Following procedural preparation at the first change of dressing, the Ditto group reported lower pain intensity scores (-0.64 (CI: -1.28, 0.01) p=0.052) and lower anxiety ratings (-1.79 (CI: -3.59, 0.01) p=0.051). At the second and third dressing removals average pain (FPS-R and FLACC) and anxiety scores (VAS-A) were at least one point lower when Ditto intervention was received. CONCLUSIONS: The Ditto procedural preparation and distraction device is a useful tool alongside pharmacological intervention to improve the rate of burn re-epithelialization and manage pain and anxiety during burn wound care procedures.

An audit of first-aid treatment of pediatric burns patients and their clinical outcome

This study describes the first aid used and clinical outcomes of all patients who presented to the Royal Children's Hospital, Brisbane, Australia in 2005 with an acute burn injury. A retrospective audit was performed with the charts of 459 patients and information concerning burn injury, first-aid treatment, and clinical outcomes was collected. First aid was used on 86.1% of patients, with 8.7% receiving no first aid and unknown treatment in 5.2% of cases. A majority of patients had cold water as first aid (80.2%), however, only 12.1% applied the cold water for the recommended 20 minutes or longer. Recommended first aid (cold water for >or=20 minutes) was associated with significantly reduced reepithelialization time for children with contact injuries (P=.011). Superficial depth burns were significantly more likely to be associated with the use of recommended first aid (P=.03). Suboptimal treatment was more common for children younger than 3.5 years (P<.001) and for children with friction burns. This report is one of the few publications to relate first-aid treatment to clinical outcomes. Some positive clinical outcomes were associated with recommended first-aid use; however, wound outcomes were more strongly associated with burn depth and mechanism of injury. There is also a need for more public awareness of recommended first-aid treatment.

Comparison of three different dressings for partial thickness burns in children : study protocol for a randomised controlled trial

BACKGROUND: In the paediatric population, pain and distress associated with burn injuries during wound care procedures remain a constant challenge. Although silver dressings are the gold standard for burn care in Australasia, very few high-level trials have been conducted that compare silver dressings to determine which will provide the best level of care clinically. Therefore, for paediatric patients in particular, identifying silver dressings that are associated with lower levels of pain and rapid wound re-epithelialisation is imperative. This study will determine whether there is a difference in time to re-epithelialisation and pain and distress experienced during wound care procedures among Acticoat, Acticoat combined with Mepitel and Mepilex Ag dressings for acute, paediatric partial thickness burns. METHODS/DESIGN: Children aged 0 to 15 years with an acute partial thickness (superficial partial to deep partial thickness inclusive) burn injury and a burn total body surface area of

Silver absorption on burns after the application of Acticoat : data from pediatric patients and a porcine burn model

Silver dressings have been widely used to successfully prevent burn wound infection and sepsis. However, a few case studies have reported the functional abnormality and failure of vital organs, possibly caused by silver deposits. The aim of this study was to investigate the serum silver level in the pediatric burn population and also in several internal organs in a porcine burn model after the application of Acticoat. A total of 125 blood samples were collected from 46 pediatric burn patients. Thirty-six patients with a mean of 13.4% TBSA burns had a mean peak serum silver level of 114 microg/L, whereas 10 patients with a mean of 1.85% TBSA burns had an undetectable level of silver (<5.4 microg/L). Overall, serum silver levels were closely related to burn sizes. However, the highest serum silver was 735 microg/L in a 15-month-old toddler with 10% TBSA burns and the second highest was 367 microg/L in a 3-year old with 28% TBSA burns. In a porcine model with 2% TBSA burns, the mean peak silver level was 38 microg/L at 2 to 3 weeks after application of Acticoat and was then significantly reduced to an almost undetectable level at 6 weeks. Of a total of four pigs, silver was detected in all four livers (1.413 microg/g) and all four hearts (0.342 microg/g), three of four kidneys (1.113 microg/g), and two of four brains (0.402 microg/g). This result demonstrated that although variable, the level of serum silver was positively associated with the size of burns, and significant amounts of silver were deposited in internal organs in pigs with only 2% TBSA burns, after application of Acticoat.

Portrait of Albert Einstein wearing glasses Portraits Men

Digital Image

Portrait of Albert Einstein wearing glasses Portraits Men

Digital Image

Short-term survival of discarded pearl perch (Glaucosoma scapulare Ramsay, 1881) caught by hook-and-line in Queensland, Australia

Post-release survival of line-caught pearl perch (Glaucosoma scapulare) was assessed via field experiments where fish were angled using methods similar to those used by commercial, recreational and charter fishers. One hundred and eighty-three individuals were caught during four experiments, of which >91% survived up to three days post-capture. Hook location was found to be the best predictor of survival, with the survival of throat- or stomach-hooked pearl perch significantly (P < 0.05) lower than those hooked in either the mouth or lip. Post-release survival was similar for both legal (≥35 cm) and sub-legal (<35 cm) pearl perch, while those individuals showing no signs of barotrauma were more likely to survive in the short term. Examination of the swim bladders in the laboratory, combined with observations in the field, revealed that swim bladders rupture during ascent from depth allowing swim bladder gases to escape into the gut cavity. As angled fish approach the surface, the alimentary tract ruptures near the anus allowing swim bladder gases to escape the gut cavity. As a result, very few pearl perch exhibit barotrauma symptoms and no barotrauma mitigation strategies were recommended. The results of this study show that pearl perch are relatively resilient to catch-and-release suggesting that post-release mortality would not contribute significantly to total fishing mortality. We recommend the use of circle hooks, fished actively on tight lines, combined with minimal handling in order to maximise the post-release survival of pearl perch.

Age-based demographics of the pearl perch Glaucosoma scapulare (Ramsay, 1881)

Summary: This research represents the first age-based demographic assessment of pearl perch, Glaucosoma scapulare (Ramsay, 1881), a highly valued species endemic to coastal waters off central eastern Australia. The study was conducted across the species' distribution that encompasses two state jurisdictions (Queensland in the north and New South Wales in the south) using data collected approximately 10 years apart in each state. Estimates of age were made by counting annuli (validated using marginal increment ratios) in sectioned sagittal otoliths. The maximum estimated age was 19 years. Pearl perch attained approx. 12 cm fork length (FL) after one year, 21 cm FL after 2 years and 29 cm FL after 3 years. Fish from the southern end of the species' distribution grew significantly more slowly than those from the northern part of its range. Commercial landings in the north were characterized by greater proportions of larger (>40 cm FL) and older (>6 years) fish than those in the south, with landings mainly of fish between 3 and 6 years of age. The observed variations in age-based demographics of pearl perch highlight the need for a better understanding of patterns of movement and reproduction in developing a model of population dynamics and life-history for this important species. There is a clear need for further, concurrent, age-based studies on pearl perch in the northern and southern parts of its distribution to support the conclusions of the present study based on data collected a decade apart. © 2013 Blackwell Verlag GmbH.

The great errand 1939-1955

The novel was written in 2001. Description of post-war Germany from the viewpoint of a German, Fritz Meyer, who was a member of a local Nazi Youth organization in Sonneborn. He fought as a soldier and fell into the hands of the English in Northern France. He was taken to Canada as a prisoner of war. He escaped the camp and found refuge at a German family. Description of erotic encounters. Reflection on Nazi ideology. At the request of the family he returns to Germany for something subscribed as "the great errand", taking up the identity of a former American G.I. Desolation of post-war Germany. Confrontation with British emigre soldiers. Identifying with the anger of his German countrymen. Reflection on the Bible and the denial of the Jewish roots of Christianity. Creating an underground network of conspiracy with former Nazi leaders and high members of the Catholic church in order to continue the ideals of National Socialism. Donations from secret supporters abroad. Connections with the political leaders in the newly established German Republic. Revisionist history.

Board of Delegates of American Israelites records 1859-1881, 1887, 1932

Contains printed copies of the 1860 constitution and by-laws, copies of proceedings and annual reports, 1859-1877, of the Board of Delegates; report on Jews in Roumania, an 1874 annual report of the Hebrew Benevolent and Orphan Asylum Society, manuscript minute books and minutes of meetings, 1859-1876, resolutions, executive, financial, ritual slaughtering and other special committee reports, newspaper clippings and correspondence with synagogues and organizations in the U.S. who constitute the membership of the Board of Delegates, with the Union of American Hebrew Congregations with whom they later merged, the Union's Board of Delegates of Civil and Religious Rights, and with individuals and organizations in foreign countries including the Alliance Israelite Universelle, the Anglo-Jewish Association, the Board of Deputies of British Jews, the Committee for the Roumanian Jews (Berlin), the Koenigsberg Committee, and the London Roumanian Committee.