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.

Breastfeeding self-efficacy of women using second-line strategies for healthy term infants in the first week postpartum : an Australian observational study

Background Breastfeeding self-efficacy (BFSE) supports breastfeeding initiation and duration. Challenges to breastfeeding may undermine BFSE, but second-line strategies including nipple shields, syringe, cup, supply line and bottle feeding may support breastfeeding until challenges are resolved. The primary aim of this study was to examine BFSE in a sample of women using second-line strategies for feeding healthy term infants in the first week postpartum. Methods A retrospective self-report study was conducted using the Breastfeeding Self-Efficacy Scale - Short Form (BSES-SF), demographic and infant feeding questionnaires. Breastfeeding women who gave birth to a singleton healthy term infant at one private metropolitan birthing facility in Australia from November 2008 to February 2009 returned anonymous questionnaires by mail. Results A total of 128 (73 multiparous, 55 primiparous) women participated in the study. The mean BSES-SF score was 51.18 (Standard deviation, SD: 12.48). The median BSES-SF score was 53. Of women using a second-line strategy, 16 exceeded the median, and 42 were below. Analyses using Kruskal-Wallis tests confirmed this difference was statistically significant (H = 21.569, p = 0.001). The rate of second-line strategy use was 48%. The four most commonly used second-line strategies were: bottles with regular teats (77%); syringe feeding (44%); bottles with wide teats (34%); and nipple shields (27%). Seven key challenges were identified that contributed to the decision to use second-line strategies, including: nipple pain (40%); unsettled infant (40%); insufficient milk supply (37%); fatigue (37%); night nursery care (25%); infant weight loss > 10% (24%); and maternal birth associated pain (20%). Skin-to-skin contact at birth was commonly reported (93%). At seven days postpartum 124 women (97%) were continuing to breastfeed. Conclusions The high rate of use of second-line strategies identified in this study and high rate of breastfeeding at day seven despite lower BFSE indicate that such practices should not be overlooked by health professionals. The design of this study does not enable determination of cause-effect relationships to identify factors which contribute to use of second-line strategies. Nevertheless, the significantly lower BSES-SF score of women using a second-line strategy highlights this group of women have particular needs that require attention.

'You can name her' : ritualised grieving by an Australian woman for her stillborn twin

The stillbirth of an Australian infant in the mid-20th Century was an event often left unacknowledged. Mothers of stillborn babies were often told to 'forget about it and have another baby.' Siblings of these babies were often not encouraged to discuss them, and were even left unaware of their birth and death. This paper explores this phenomenon in an Australian case study. When Nancy was born in 1937, her twin sister was stillborn. As was customary at that time, the deceased baby was buried unnamed in an unmarked plot without ceremony. Little was said of her thereafter. Seventy-three years later, Nancy finally undertook a number of activities with ritualised features that acknowledged, named, mourned and honoured her sister.

Women's health in the global village

As we stand at the beginning of the 21st century and behold the world before us, it seems that we are living in a time of profound change. Everywhere we look change seems afoot, demolishing our traditional securities and hastily building new ones in their place. Modern medical science has been an integral part of this change. It is not possible to ignore the advances of modern medicine nor the realities of scientific uncertainties for they are part of the shared context of our lives today. I In the past 50 years we have witnessed the discovery of DNA and more recently the mapping of the human genome, the birth of the world's first in-vitro fertilisation baby, followed by thousands worldwide in the period since, the discovery of human stem cells and the birth of Dolly the cloned sheep in Scotland. Furthermore, the processes of globalisation have ensured that an event that occurs on one side of the globe becomes an item on the evening news on the other side, creating the impression that all change takes place on our doorstep. Some of these events have provoked deep angst in the community, sparking public debate over the ethics of science and the boundaries to be imposed by law. All of these developments have changed the realm of the possible. While these advances in medical science spark debate in the developed countries, in less developed countries high rates of infectious diseases and infant and maternal mortality and the challenges of access to adequate food and clean water are priorities, highlighting international differences in health care. This article explores these differences through an analysis of globalisation and reproduction. It seeks to analyse both the meaning of globalisation and the impact of globalising trends on health laws and policies as regulators of women's health within the global village.

Antibodies mediate formation of neutrophil extracellular traps in the middle ear and facilitate secondary pneumococcal otitis media

Otitis media (OM) (a middle ear infection) is a common childhood illness that can leave some children with permanent hearing loss. OM can arise following infection with a variety of different pathogens, including a coinfection with influenza A virus (IAV) and Streptococcus pneumoniae (the pneumococcus). We and others have demonstrated that coinfection with IAV facilitates the replication of pneumococci in the middle ear. Specifically, we used a mouse model of OM to show that IAV facilitates the outgrowth of S. pneumoniae in the middle ear by inducing middle ear inflammation. Here, we seek to understand how the host inflammatory response facilitates bacterial outgrowth in the middle ear. Using B cell-deficient infant mice, we show that antibodies play a crucial role in facilitating pneumococcal replication. We subsequently show that this is due to antibody-dependent neutrophil extracellular trap (NET) formation in the middle ear, which, instead of clearing the infection, allows the bacteria to replicate. We further demonstrate the importance of these NETs as a potential therapeutic target through the transtympanic administration of a DNase, which effectively reduces the bacterial load in the middle ear. Taken together, these data provide novel insight into how pneumococci are able to replicate in the middle ear cavity and induce disease.

Design of a garment for data collection of toddler language and physical activity

Design process phases of development, evaluation and implementation were used to create a garment to simultaneously collect reliable data of speech production and intensity of movement of toddlers (18-36 months). A series of prototypes were developed and evaluated that housed accelerometer-based motion sensors and a digital transmitter with microphone. The approved test garment was a top constructed from loop-faced fabric with interior pockets to house devices. Extended side panels allowed for sizing. In total, 56 toddlers (28 male; 28 female; 16-36 months of age) participated in the study providing pilot and baseline data. The test garment was effective in collecting data as evaluated for accuracy and reliability using ANOVA for accelerometer data, transcription of video for type of movement, and number and length of utterances for speech production. The data collection garment has been implemented in various studies across disciplines.

Transformation in educational practices through STEM

The need for strong science, technology and innovation linkages between Higher Education Institutions (HEIs) and industries is a pivotal point for middle-income countries in their endeavor to enhance human capital in socioeconomic development. Currently, the University-Industry partnerships are at an infant stage in Sri Lankan higher education context. Technological maturity and effective communication skills are contributing factors for an efficient graduate profile. Also, expanding internship programs in particular for STEM disciplines provide work experience to students that would strengthen the relevance of higher education programs. This study reports historical overviews and current trends in STEM education in Sri Lanka. Emphasis will be drawn to recent technological and higher education curricular reforms. Data from the last 10 years were extracted from the higher education sector and Ministry of Higher Education Policy portfolios. Associations and trend analysis of the sector growth were compared with STEM existence, merger and predicted augmentations. Results were depicted and summarised based on STEM streams and disciplines. It was observed that the trend of STEM augmentation in the Sri Lankan Higher Education context is growing at a slow but steady pace. Further analysis with other sectors in particular, Industry information, would be useful and a worthwhile exercise.

Locating people in video from semantic descriptions : a new database and approach

The location of previously unseen and unregistered individuals in complex camera networks from semantic descriptions is a time consuming and often inaccurate process carried out by human operators, or security staff on the ground. To promote the development and evaluation of automated semantic description based localisation systems, we present a new, publicly available, unconstrained 110 sequence database, collected from 6 stationary cameras. Each sequence contains detailed semantic information for a single search subject who appears in the clip (gender, age, height, build, hair and skin colour, clothing type, texture and colour), and between 21 and 290 frames for each clip are annotated with the target subject location (over 11,000 frames are annotated in total). A novel approach for localising a person given a semantic query is also proposed and demonstrated on this database. The proposed approach incorporates clothing colour and type (for clothing worn below the waist), as well as height and build to detect people. A method to assess the quality of candidate regions, as well as a symmetry driven approach to aid in modelling clothing on the lower half of the body, is proposed within this approach. An evaluation on the proposed dataset shows that a relative improvement in localisation accuracy of up to 21 is achieved over the baseline technique.

Lung recruitment and endotracheal suction in ventilated preterm infants measured with electrical impedance tomography

Aims Although suctioning is a standard airway maintenance procedure, there are significant associated risks, such as loss of lung volume due to high negative suction pressures. This study aims to assess the extent and duration of change in end-expiratory level (EEL) resulting from endotracheal tube (ETT) suction and to examine the relationship between EEL and regional lung ventilation in ventilated preterm infants with respiratory distress syndrome. Methods A prospective observational clinical study of the effect of ETT suction on 20 non-muscle-relaxed preterm infants with respiratory distress syndrome (RDS) on conventional mechanical ventilation was conducted in a neonatal intensive care unit. Ventilation distribution was measured with regional impedance amplitudes and EEL using electrical impedance tomography. Results ETT suction resulted in a significant increase in EEL post-suction (P < 0.01). Regionally, anterior EEL decreased and posterior EEL increased post-suction, suggesting heterogeneity. Tidal volume was significantly lower in volume-guarantee ventilation compared with pressure-controlled ventilation (P = 0.04). Conclusions ETT suction in non-muscle-relaxed and ventilated preterm infants with RDS results in significant lung volume increase that is maintained for at least 90 min. Regional differences in distribution of ventilation with ETT suction suggest that the behaviour of the lung is heterogeneous in nature.

The Hollywood effect : a comparative study of costume in Australia and the Proposition

This paper compares costuming practices in Baz Luhrmann’s Australia (2008) and John Hillcoat’s The Proposition (2005) and argues that high production values, such as in the blockbuster Australia, are not neutral mechanisms of production, but powerful prescriptive elements which do not result in a successful representation of cultural specificity. Australia is a typical blockbuster, it employs a large number of extras, it features compelling landscape shots, has been shot across four different locations and sets, and, importantly, is an international production with the 20th Century Fox. The film’s costumes were designed by Catherine Martin, who received an Oscar nomination in 2009. While global exposure of fashion in film and through celebrities’ endorsements has consolidated a historical synergy between the fashion industry and Hollywood, the Australian film and fashion industries have had a very limited exchange. Baz Luhrmann’s film is Australia’s first instance of promo-costuming and use of tie-in labels (Ferragamo, R.M.Williams, Prada, Paspaley). Catherine Martin thoroughly researched 1930s women’s wear, indigenous and stockmen’s clothing, and set up to make all costumes with a large team of costumiers and seamstresses, striving for authenticity. The Proposition won its costume designer Margot Wilson an AFI in 2005 for best costume, but compared to Australia the story, location and costumes are far harsher. Filmed around Winton in far west Queensland, the director John Hillcoat and Director of Photography Benoit Delhomme were insistent about realism, and emphasising the harshness of the Australian landscape. The realism of the costumes was derived from the fabrics and manufacturing, as well as the way they were shot, with the actors often wearing two or three layers of heavy wool during days of shooting in 50 degree heat, and the details of making and breaking down. The implication is that both films are culturally specific as they both deal with an Australian story. However, Australia is clearly produced according to a Hollywood blockbuster model, and closely matches Hollywood’s narrative and aesthetic characteristics, while The Proposition is a more modest film that eschews these conventions of beauty and glossed history. Despite its western genre-orientation, The Proposition is more successful than Australia when it comes to costuming, because its costumes are not only functional to the narrative, but, in Roland Barthes’ words, they also fulfil a prestation. This prestation highlights the social and cultural conflicts on which colonial Australia was founded, instead of gilding, and gliding, over them.

Space within the surface : the patterned surfaces of Florence Broadhurst and Jim Thompson

The Woods Bagot 2007 refurbishment of the Qantas and British Airways Bangkok Business lounge in the Survarnabhumi Airport features wall finishes designed by wallpaper designer, Florence Broadhurst (1899-1977) and Thai Silk trader, Jim Thompson (1906-1967). This distinctive selection, which is proclaimed on the airport’s website, of patterned wall surfaces side by side draws attention to their striking similarities and their defining differences . Thompson and Broadhurst would appear to be worlds apart, but here in the airport their work brings them together. Thompson, the son of a wealthy cotton family in America, worked as an architect before joining the army. He moved to Bangkok to start The Thai Silk Company in 1948. Broadhurst was born on a farm in Mt. Perry, Queensland. She began her career as a performance artist, as part of an Australian troupe in Shanghai, moving onto pursue a career in fashion design, catering to the middle and upper classes in London. Upon her return to Australia, Broadhurst started a print design company in 1959. Both Broadhurst and Thompson pursued multiple careers, lived many lives, and died under mysterious circumstances. Broadhurst was murdered in 1977 at her Sydney print warehouse, which remains an unsolved crime. Thompson disappeared in Malaysia in 1967 and his body has never been found. This chapter investigates the parallels between Thompson and Broadhurst and what lead them to design such popular patterns for wall surfaces towards the end of their careers. While neither designer was a household name, their work is familiar to most, seen in the costume and set design of films, on the walls of restaurants and cafes and even in family homes. The reason for the popularity of their patterns has not previously been analysed. However, this chapter suggests that the patterns are intriguing because they contain something of their designers’ identities. It suggests that the coloured surface provides a way of camouflaging and hiding its subjects’ histories, such that Broadhurst and Thompson, consciously or unconsciously, used the patterned surface as a plane in which their past lives could be buried. The revealing nature of the stark white wall, compared with the forgiveness provided by the pattern in which to hide, is elaborated by painter and advocate for polychromatic architecture, Fernand Léger in his essay, “The Wall, The Architect, The Painter (1965).” Léger writes that, “the modern architect has gone too far in his magnificent attempts to cleanse through emptiness,” and that the resultant white walls of modernity create ‘an impalpability of air, of slick, brilliant new surfaces where nothing can be hidden any longer …even shadows don’t dare to enter’. To counter the exposure produced by the white wall, Thompson and Broadhurst designed patterned surfaces that could harbour their personal histories. Broadhurst and Thompson’s works share a number of commonalities in their design production, even though their work in print design commenced a decade apart. Both designers opted to work more with traditional methods of pattern making. Broadhurst used hand-operated screens, and Thompson outsourced work to local weavers and refrained from operating out of a factory. Despite humble beginnings, Broadhurst and Thompson enjoyed international success with their wall patterns being featured in a number of renowned international hotels in Bahrain, Singapore, Sydney, and London in the 1970s and 1980s. Their patterns were also transferred to fabric for soft furnishings and clothing. Thompson’s patterns were used for costumes in films including the King and I and Ben Hur. Broadhurst’s patterns were also widely used by fashion designers and artists, such as Akira Isogowa‘s costume design for Salome, a 1998 production by the Sydney Dance Company. Most recently her print designs have been used by skin illustrator Emma Hack, in a series of works painting female bodies into Broadhurst’s patterns. Hack’s works camouflage the models’ bodies into the patterned surface, assimilating subject and surface, hinting at there being something living within the patterned wall. More than four decades after Broadhurst’s murder and five decades since Thompson’s disappearance, their print designs persist as more than just a legacy. They are applied as surface finishes with the same fervour as when the designs were first released. This chapter argues that the reason for the ongoing celebration of their work is that there is the impalpable presence of the creator in the patterns. It suggests that the patterns blur the boundary between subject and surface.

Parent's socio-economic status and social support as risks for child mortality : consideration of health equity in The Gambia

A matched case-control study of mortality to children under age five was conducted to consider associations with parents' socio-economic status and social support in the Farafenni Demographic Surveillance Site (DSS). Cases and controls were selected from Farafenni DSS, matched on date of birth, and parents were interviewed about personal resources and social networks. Parents with the lowest personal socio-economic status and social support were identified. Multivariate multinomial regression was used to consider whether the children of these parents were at increased risk of either infant or 1-4 mortality, in separate models using either parents' characteristics. There was no benefit found for higher SES or better social support with respect to child mortality. Children of fathers who had the poorest social support had lower 1-4 mortality risk (OR=0.52, p=0.037). Given that socio-economic status was not associated with child mortality, it seems unlikely that the explanation for the link between father's social support and mortality is linked to resource availability. Explanations for the risk effect of father's social ties may lie in decision-making around health maintenance and health care for children.

Beyond enterprise resource planning projects : Innovative strategies for competitive advantage

ABSTRACT A rapidly changing business environment and legacy IT problems has resulted in many organisations implementing standard package solutions. This 'common systems' approach establishes a common IT and business process infrastructure within organisations and its increasing dominance raises several important strategic issues. These are to what extent do common systems impose common business processes and management systems on competing firms, and what is the source of competitive advantage if the majority of firms employ almost identical information systems and business processes? A theoretical framework based on research into legacy systems and earlier IT strategy literature is used to analyse three case studies in the manufacturing, chemical and IT industries. It is shown that the organisations are treating common systems as the core of their organisations' abilities to manage business transactions. To achieve competitive advantage they are clothing these common systems with information systems designed to capture information about competitors, customers and suppliers, and to provide a basis for sharing knowledge within the organisation and ultimately with economic partners. The importance of these approaches to other organisations and industries is analysed and an attempt is made at outlining the strategic options open to firms beyond the implementation of common business systems.

Food and beverage intake in Australian children aged 12-16 months participating in the NOURISH and SAIDI studies

Objective To describe the quantity and diversity of food and beverage intake in Australian children aged 12–16 months and to determine if the amount and type of milk intake is associated with dietary diversity. Methods Mothers participating in the NOURISH and South Australian Infant Dietary Intake (SAIDI) studies completed a single 24-hour recall of their child's food intake, when children (n=551) were aged 12–16 months. The relationship between dietary diversity and intake of cow's milk, formula or breastmilk was examined using one-way ANOVA. Results Dairy and cereal were the most commonly consumed food groups and the greatest contributors to daily energy intake. Most children ate fruit (87%) and vegetables (77%) on the day of the 24-hour recall while 91% ate discretionary items. Half the sample ate less than 30 g of meat/alternatives. A quarter of the children were breastfeeding while formula was consumed by 32% of the sample, providing 29% of daily energy intake. Lower dietary diversity was associated with increased formula intake. Conclusions The quality of dietary intake in this group of young children is highly variable. Most toddlers were consuming a diverse diet, though almost all ate discretionary items. The amount and type of meat/alternatives consumed was poor. Implications Health professionals should advise parents to offer iron-rich foods, while limiting discretionary choices and use of formula at an age critical in the development of long-term food preferences.