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Aiming at the problems of small thermal power units and biomass mixed combustion units with small generation loads and insufficient primary frequency modulation capability, which cannot be connected to the virtual power plant, this paper adopts a variety of flexibility retrofit methods for the units and explores the peak load capability of the units. Then, multiple units are coupled, and the unit coupling scheme with better economy and environmental protection is screened using comprehensive evaluation indexes. While evaluating the peaking load space of multiple unit coupling, the units' primary frequency regulation capability and new energy consumption capability are improved. According to the calculation results, the low-pressure cylinder zero-output retrofit has the largest peaking potential among different technical paths, in which unit #3 has 27.55 MW of peaking space. The compression heat pump decoupling retrofit has the best economy, in which the daily profit of unit #3 increases from 0.93 to 1.02 million CNY with an increase of 0.09 million CNY. After the unit has been retrofitted with steam extraction, the three units can be coupled to meet the national feed-in standards. The multiple unit coupling can accommodate up to 203.44 MW of other energy sources while meeting the standard. [ABSTRACT FROM AUTHOR]

The management of burns is costly and complex. The problem is compounded in low and middle income countries (LMICs) where the incidence of burn injuries is high but infrastructure and funding for management and prevention is limited. Cost of illness studies allows for quantification of the costs associated with public health problems. Without cost quantification, focus and allocation of funding is challenging. The authors explored the availability of cost-focused burns research data in a target LMIC. The focus of their research was Nepal. A structured literature review including published papers, Ministry of Health (MOH) and World Health Organization (WHO) statistics was conducted to identify cost of illness studies or evidence relating to burn-related resource and costs. Gaps in the evidence base were highlighted. Research methodologies from other LMICs were reviewed. We found 32 papers related to burn injury in Nepal, one key MOH document and one relevant WHO data source. Most research focused on the epidemiology and etiology of burns in Nepal. Of the papers, only 14 reported any type of burn-related resource use and only 1 paper directly reported (limited) cost data. No studies attempted an overall quantification of the cost of burns. MOH statistics provided no additional insight into costs. Our study found an almost complete lack of cost-focused burns research in Nepal. Primary research is needed to quantify the cost of burns in Nepal. Initial focus could usefully be on the cost of care in tertiary hospitals. A full cost of burns for Nepal remains some way off. [ABSTRACT FROM AUTHOR]

In response to the COVID-19 pandemic, working from home became the new normal for many professionals. While this was beneficial in managing the rapidly spreading virus, it had varying impacts on the mental health of those previously not accustomed to remote work. This paper provides a critical reflection of the researcher's experience of conducting interviews with survivors of trauma while working from home. The research aimed to understand the experiences of significant others supporting patients with severe burn injury in the Intensive Care Unit (ICU). As an experienced ICU nurse, the researcher has well developed personal coping strategies for dealing with complex trauma and in working with significant others of patients with severe burn injury in hospital settings. Due to the pandemic, data collection moved from face-to-face in the hospital, as originally intended, to phone or videoconference interviews. 17 participants were recruited, with all participants given the option of videoconference (n = 3) or telephone interviews (n = 14). Interviews had an average length of 55 minutes. This paper discusses the strategies adopted to cope with the sharing of significant others' experiences of trauma while in the home environment. Careful consideration was needed for the researcher, the participants and those within the homes of both researcher and participant, in terms of psychological safety, ethical considerations and rapport building. [ABSTRACT FROM AUTHOR]

In addition a paper that was being published at the same time by a highly respected European laboratory, EFECTIS, authored by Eric Guilluame directly supports the results we obtained.[3] Babrauskus goes on to criticize the study by claiming that it does not accurately reflect the real environment. The corresponding author of the letter has questioned the independence and ethics of the testing laboratory and authors. [Extracted from the article]

Trauma-informed care practices are associated with a culture of safety following traumatic experiences, including medical trauma. An interactive, web-based training package ('Responsive CARE') was developed for voluntary uptake by paediatric burns health professionals to increase staff knowledge about trauma-informed practice. This paper reports on a mixed methods process evaluation conducted alongside a preliminary effectiveness study of 'Responsive CARE'. The process evaluation was conducted using The Consolidated Framework for Implementation Research (CFIR) and a logic model, to examine feasibility of both the intervention and implementation strategy. Health practitioners (including senior managers) delivering care to children and caregivers attending an outpatient burns service were eligible to enrol in 'Responsive CARE'. Qualitative interview data and quantitative metadata were used to evaluate the implementation outcomes (adoption, acceptability, fidelity, feasibility and preliminary effectiveness). Children and caregivers attending an outpatient service for change of burn wound dressing or burn scar management during the 3-month control or 3-month intervention period were eligible to enrol in the effectiveness study. The impact on child pain and distress, as well as cost, was investigated using a pretest-posttest design. Thirteen (from anticipated 50 enrolled) health professionals (all female) with mean 10 years (SD=11) of experience with paediatric burns hospital-based outpatient care completed an average of 65% (range 36% to 88%) of available content. Twenty-five semi-structured interviews were completed with health practitioners (21 female) and with 14 caregivers (11 female). Four themes were identified as influencing feasibility and acceptability of the intervention: 1) Keeping a trauma-informed lens; 2) Ways of incorporating trauma-informed care; 3) Working within system constraints; and 4) Being trauma-informed. Preliminary effectiveness data included 177 participants (median age 2 years, and median total body surface area burn 1%). Causal assumptions within the logic model were unable to be fully tested, secondary to lower-than-expected adoption and fidelity. We found no significant difference for pain, distress and per-patient hospital care costs between groups (pre- and post-intervention). Future implementation strategies should include organizational support to keep a trauma-informed lens and to incorporate trauma-informed principles within a medical model of care. Despite efforts to co-design a staff education intervention and implementation approach focused on stakeholder engagement, adaptations are indicated to both the intervention and implementation strategies to promote uptake highlighting the complexity of changing clinician behaviours. ● The Consolidated Framework for Implementation Research was a good fit for study purpose. ● Strategies targeting stakeholder engagement were insufficient for optimal uptake. ● Assessing readiness and capacity for change may be central to successful implementation. [ABSTRACT FROM AUTHOR]

Multiplatform messaging applications also referred to as cross-platform instant messaging play an important role in delivery of healthcare and education with its low cost, ease of use and accessibility. To evaluate the existing evidence regarding the use of multiplatform messaging applications in facilitating consultations and decision-making processes in the context of burns care, as well as to assess the impact of such applications on burns care and rehabilitation. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and PROSPERO protocol CRD42021265203. The CASP and JBI tools were used to evaluate the quality of the studies. Eight hundred fifty-three papers were retrieved from PubMed, CINAHL, Scopus, EMBASE and LILACS published up to July 2022 (updated August 2023) with no time restrictions applied. An analysis of the seven studies included in this review, inclusive of 16 Multiplatform messaging applications, revealed six themes. These encompassed the utilization of social media for directing and managing clinical practice, as a mode of communication, for evaluating the quality-of-care provision, for investigating available platforms and their technological features, measuring quality of life and for examining issues related to confidentiality. Multiplatform messaging applications offer a solution for individuals with burn injuries to stay in direct contact with burn specialist clinicians for their follow-up and subsequent rehabilitation phase of recovery. • Multiplatform messaging applications play an important role in burn care. • Such platforms avoid unnecessary admissions and are easily accessible and cost- effective. • Multiplatform messaging apps allow burn survivors and caregivers to maintain direct communication with clinicians. • Multiplatform messaging applications lack transparency regarding confidentiality and privacy. [ABSTRACT FROM AUTHOR]

Evidence on the impact of virtual care for patients with burn injuries is variable. This review aims to evaluate its use in remote assessment, rounding, and follow-up through outcomes of efficacy, usability, costs, satisfaction, clinical outcomes, impacts on triage and other benefits/drawbacks. A PRISMA-compliant qualitative systematic review (PROSPERO CRD42021267787) was conducted in four databases and the grey literature for primary research published between 01/01/2010 and 12/31/2020. Study quality was appraised using three established tools. Evidence was graded by the Oxford classification. The search provided 481 studies, of which 37 were included. Most studies (n = 30, 81%) were Oxford Level 4 (low-level descriptive/observational) designs and had low appraised risk-of-bias (n = 20, 54%). Most applications were for the acute phase (n = 26, 70%). High patient compliance, enhanced specialist access, and new educational/networking opportunities were beneficial. Concerns pertained to IT/connection, virtual communication barriers, privacy/data-security and logistical/language considerations. Low-to-moderate-level (Oxford Grade C) evidence supported virtual burn care's cost-effectiveness, ability to improve patient assessment and triage, and efficiency/effectiveness for remote routine follow-up. We find growing evidence that virtual burn care has a place in acute-phase specialist assistance and routine outpatient follow-up. Low-to-moderate-level evidence supports its effectiveness, cost-effectiveness, usability, satisfactoriness, and capacity to improve triage. • Virtual care may improve assessment and triage of patients with burn injuries. • Routine follow-up via virtual care may save cost/travel without hindering outcomes. • Comparative evidence lacking, unclear superiority among programs and vs. in-person. • Only 4 randomized controlled trials in 37 identified papers, study quality varied. [ABSTRACT FROM AUTHOR]

Despite activities to introduce low-carbon energy sources worldwide, the share of conventional facilities burning organic fuels remains high. One approach to address this problem is to look for solutions to reduce energy consumption. There are various research projects in the area of energy efficiency that lead to diverse results—such as models, methodologies, new data and theories. On the other hand, induction motor drives are becoming a major consumer of electric power because of their wide range of applications. In this paper, after careful selection and systematization of 151 literature sources, an extensive study and criteria analysis of the existing state of affairs in the area of energy efficiency improvement of induction motor drives has been carried out. Five major and 48 minor research areas in this field have been identified. The results show that issues related to the adaptation of scientific results and the conditions for their effective and wide-ranging application in practice have not been discussed and investigated so far. Adaptation should take into account the possibilities of data acquisition, including data from measurements; the competences of energy managers; and the type of information provided to them. Based on the seven conclusions formulated below, summary recommendations are made to direct future research towards the justification of models for increasing the power efficiency of induction drives, adapted for use by energy managers. [ABSTRACT FROM AUTHOR]

Electrical trauma is associated with significant morbidity and mortality, which have been reduced by improved medical care, as measured by the length of stay (LOS) as a marker for this population's quality of care. This paper will review the clinical and demographic characteristics, LOS in the hospital, and variables related to patients with electrical burns. A retrospective cohort study was conducted at a specialized burn unit in Southwest Colombia. Five hundred seventy-five electrical burn-related admissions from 2000 to 2016 were reviewed for the LOS and variables including patient-related (age, gender, marital status, education, and occupation), location of the accident (domestic vs labor-related), voltage, direct contact, arc, flash, flame, clinical presentation (burn surface area, depth, single or multiple organ injury, secondary infection, and abnormal labs), and treatment (surgical procedures and intensive care unit [ICU] admission). Univariate and bivariate analysis, with its 95% CI (confidence interval). We also performed a multiple logistic regression. LOS was correlated to males, age greater than 20 years, construction workers, high voltage injuries, severe burns by area and depth, infection, ICU admission, and multiple surgical procedures or extremity amputation. LOS due to electrical injury was observed to be significantly associated with the following variables, carpal tunnel release (OR [odds ratio]= 4.25, 95% CI [confidence interval] 1.70–5.20); amputation (OR = 2.81, 95% CI 1.60–5.10); infection (OR = 2.60, 95% CI 1.30–5.20); site of infection, mainly wound (OR = 1.30, 95% CI 1.10–1.44); associated injury (OR = 1.72, 95% CI 1.00–3.24); work or domestic accident (OR = 1.83, 95% CI 1.00–3.32); aged 20–40 years (OR = 1.41, 95% CI 1.00–2.10); CPK (OR = 1.40, 95% CI 1.00–2.00); and third-degree burns (OR = 1.55, 95% CI 1.00–2.80). Risk factors for LOS secondary to electrical injury should be appropriately addressed. Prevention at high-risk workplaces is imperative. Mitigating the injury with appropriate management of infection and timely surgical interventions play an essential role in the successful treatment of these patients. [ABSTRACT FROM AUTHOR]

I draw your attention, as patient safety experts, to a paper on MRI skin burns from 4 years prior.[4] Krista read the paper carefully and contacted me and stated that it completely matched her own patient experience. On October 11, 2022, I received a thoughtful email from Miss Krista Votruba from Kansas, US. Recently, functional garments have become popular in the market.[5] However, asking patients to change their clothes before MRI to prevent skin burns may not be common practice among professionals in some countries. [Extracted from the article]

Appropriate and timely first aid reduces morbidity in burns. This study aims to assess the knowledge of first aid in burns among healthcare workers (HCW) and nonhealthcare workers. (NHCW). A survey, distributed in both paper and Google survey formats, presented five sample cases with multiple-choice answers. Participants recorded the most suitable first aid management for each scenario. Correct answers were provided on completion. Out of the total 753 participants, only 89 (11.8%) got all five answers correct. 16% HCW and 6% NHCW could answer all 5 questions correctly (with a true HCW:NHCW ratio of 2.67:1). Providing care for individuals with burns substantially raised the probability of giving accurate responses (p = 0.0001). While attending the general First Aid Course did not affect the responses (p = 0.08), participation in the Burns First Aid Course demonstrated slightly improved results (p = 0.052). The scenario involving liquid petroleum gas leakage saw a high proportion of correct responses, likely influenced by media coverage. We find a clear need for adequate training in burns first aid due to low awareness among healthcare workers (HCW) and non-healthcare workers (NHCW). Factors such as participation in burn first aid courses and gaining firsthand experience in treating burns were found to be linked to improved knowledge of burns prevention and first aid. Utilizing various media channels could be a valuable strategy to reach a broader audience, especially in remote and inaccessible areas. • There is limited awareness of burns first aid and prevention among both healthcare and non-healthcare workers • Experience in treatment of burn injuries improves knowledge of burns first aid better than first aid training. • Efficient use of multimedia and technology enhances burns prevention and first aid knowledge, reaching remote areas. [ABSTRACT FROM AUTHOR]

Occupational and physical therapists who routinely provide potentially painful and distressing rehabilitation to burn survivors are at risk for developing compassion fatigue. Burn therapists may also experience compassion satisfaction based on the successes their patients accomplish. The purpose of this review was to synthesize the literature related to compassion fatigue and satisfaction in therapists who work with burn survivors, explore previously reported predictors and mediators of (and responses to) these constructs, and identify gaps in the literature. Original, peer-reviewed papers published from journal inception to May 2023 were obtained from 5 electronic bibliographic databases: CINAHL, Embase, PsycINFO, PubMed, and Web of Science. Studies were eligible if they (1) reported compassion fatigue or its related concepts and (2) focused on occupational or physical therapists who work with burn survivors directly or as a member of a multidisciplinary burn treatment team. The initial search revealed 284 articles, 2 of which met inclusion criteria and are summarized in this scoping review. Neither article focused solely on burn therapists but examined the experiences of multidisciplinary burn team members working in single burn centers in North America. Both studies used a cross-sectional survey-based design to assess concepts related to compassion fatigue and compassion satisfaction. This scoping review uncovered important gaps in the literature related to compassion fatigue or satisfaction in burn therapists. More research is needed to better understand the interplay between concepts as well as their relationship to burn therapists' outcomes. [ABSTRACT FROM AUTHOR]

Burns are characterized by difficult treatment, poor prognosis, and high mortality especially in elderly patients. The aim of this paper is to study the epidemiological and clinical characteristics of elderly burn patients admitted to a major burn center from 2016 to 2020. The data of 471 elderly burn patients admitted to our burn center from January 2016 to December 2020 were retrospectively analyzed. Demographic and clinical variables of different age groups were statistically analyzed, and variables related to length of stay (LOS) and hospitalization costs were analyzed through linear regression models. The mean age of included patients was 69.03 years. Scald injuries accounted for 42.7% of all burns with the extremities being the most commonly affected anatomic site (46.5%). Approximately 67.5% and 5.9% of all patients suffered from full-thickness burns and inhalation injuries, respectively. These patients required more surgical procedures, longer operation durations, and higher costs compared with other burn patients. The mean LOS was 17 days with a mortality rate of 2.1%. There were statistically significant differences in the etiological characteristics and clinical manifestations of burn patients in different age groups. Individualized targeted prevention and treatment strategies should be performed according to the clinical characteristics and relevant risk factors of each patient. [ABSTRACT FROM AUTHOR]

Modern societies and industrial sectors are serviced through storage and distribution centres (SDCs) such as supermarkets, malls, warehouses, etc. Large quantities of supplies are stocked here, e.g., food grains, clothes, shoes, pharmaceuticals, electronics, plastics, edible oils, electrical wires/equipment, petroleum products, painting materials, etc. Fires due to the burning of these materials are categorized into six classes, viz., Class A, Class B, Class C, Class D, Class K, and Class F. A fire is extinguished better when the right type of fire retardant is used. A thumb rule on firefighting also says, "never fight a fire if you do not know what is burning". In this paper, we have proposed an Intelligent Decision Support System (ID2S4FH) to generate a real-time 'fire-map' of such SDCs during a fire hazard. We have interfaced six tin-oxide-based gas sensor elements, a temperature and humidity sensor, and a particulate matter (PM) sensor with microcontrollers to capture the real-time signature patterns of the ambient air. We burned sixteen different types of materials belonging to six classes of fire and created a dataset consisting of 2400 samples. The sensor array responses were then pre-processed and analysed using various classifiers trained in different analysis space domains. Among the classifiers, four classifiers achieved 'all correct' identification of the fire classes of 80 unknown test samples, and the lowest mean squared error (MSE) achieved was 2.81 × 10−3. During a fire hazard, our proposed ID2S4FH can generate real-time fire maps of SDCs and help firefighters to extinguish the fire using the appropriate fire retardant. [ABSTRACT FROM AUTHOR]

The purpose of this nursing project is to improve the nursing integrity rate of the patient after oral free flap surgery, and the quality of medical care. Nursing staff in the burn intensive care unit of a medical center had failed to detect and report abnormal changes of the oral flap tissue in time, which caused irreversible damage to the oral free flap. After investigation through observation and examination paper, it was confirmed that the problem was successfully addressed by holding physical on-the-job education courses, drawing cartoon pictures of the monitoring process after oral free flap surgery, designing mnemonic phrase and limericks, recording multi-media teaching videos and uploading them to a digital learning platform, and drawing 2D stereoscopic images for teaching and auditing systems. The correcting rate of the nursing care cognition of oral free flap surgery had increased from 79.9% to 100%, while the care integrity rate has increased from 79.1% to 97.5%. Through effective countermeasures, this project not only improves the care integrity rate, but also improves overall satisfaction. It is expected to be implemented to relevant units to promote overall care quality and maintain patient's safety. [ABSTRACT FROM AUTHOR]

Copyright of Plastic Surgery & Burns / Chirurgia Plastyczna i Oparzenia is the property of Evereth Publishing Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Electrical burns (EI) differ from other burn injuries in the immediate treatment given and delayed sequelae they manifest. This paper reviews our burn center's experience with electrical injuries. All patients with electrical injuries admitted from January 2002 to August 2019 were included. Demographics; admission, injury, and treatment data; complications, including infection, graft loss, and neurologic injury; pertinent imaging, neurology consultation, neuropsychiatric testing; and mortality were collected. Subjects were divided into those who were exposed to high (>1000 volts), low (<1000 volts), and unknown voltage. The groups were compared. P < 0.05 was considered significant. One hundred sixty-two patients with electrical injuries were included. Fifty-five suffered low voltage, 55 high voltage, and 52 unknown voltage injuries. High voltage injuries were more likely to be male (98.2% vs. 83.6% low voltage vs. 94.2% unknown voltage, p = 0.015), to experience loss of consciousness (69.1% vs. 23.6% vs. 33.3%, p < 0.001), cardiac arrest (20% vs. 3.6% vs. 13.4%, p = 0.032), and undergo amputation (23.6% vs. 5.5% vs. 8.2%, p = 0.024). No significant differences were observed in long-term neurological deficits. Twenty-seven patients (16.7%) were found to have neurological deficits on or after admission; 48.2% recovered, 33.3% persisted, 7.4% died, and 11.1% did not follow-up with our burn center. Electrical injuries are associated with protean sequelae. Immediate complications include cardiac, renal, and deep burns. Neurologic complications, while uncommon, can occur immediately or are delayed. • Retrospective review of electrical burn injuries. • Subjects suffering high-voltage electrical injuries had higher rates of amputation. • Immediate complications included cardiac, renal, and deep burns. • Neurologic complications, while uncommon, occurred either immediately or later on. [ABSTRACT FROM AUTHOR]

Background: Much of the recent literature on bromelain based enzymatic debridement of burn injury has focused on its use in smaller burn injury and specialist areas such as the hands or genitals (Krieger et al., 2012; Schulz et al., 2017a,b,c,d). This is despite the original papers describing its use in larger burn injury (Rosenberg et al., 2004, 2014). The current EMA license for Nexobrid™ advises that it should not be used for burn injuries of more than 15% TBSA and should be used with caution in patients with pulmonary burn trauma and suspected pulmonary burn trauma. The original safety and efficacy trial of NexoBrid™ limited its use to 15% TBSA aliquots with concern regarding the effect of bromelain on coagulation. In a European consensus paper of experienced burns clinicians, now on its second iteration, 100% of respondents agreed that "up to 30% BSA can be treated by enzymatic debridement based on individual decision" (Hirche et al., 2017). Hofmaenner et al.'s recent study on the safety of enzymatic debridement in extensive burns larger than 15% provides some further evidence that "bromelain based enzymatic debridement can be carried out safely in large-area burns" (Hofmaenner et al., 2020) but the literature is scant in these larger debridement areas. In our centre we have been using enzymatic debridement for resuscitation level burn injury since 2016. We have gained significant learning in this time; this article aims to describe our current protocol for enzymatic debridement in this patient population and highlight specific learning points that might aid other centres in using enzymatic debridement for larger burn injury.Method: We performed a search of the IBID database to identify all adult patients who satisfied the inclusion criteria of resuscitation level burn injury (defined as total burn surface area (TBSA) ≥15% in patients aged >16 years), or level 3 admission following burn injury and who underwent Enzymatic Debridement. A case note review was completed, and details comprising patient demographics, TBSA, mechanism of burn, presence of inhalation injury, sequencing of debridement, length of ICU and hospital stay, blood product utilisation and the need for autografting were recorded. No ethical approval has been sought for this retrospective review.Results: We identified 29 patients satisfying the inclusion criteria (Table 1). Between June 2016 and June 2020 the average total burn size of patients who had at least some of their burn treated by enzymatic debridement increased from 21.4% in 2016/17 to 34.7% in 2019/20. In these patients the actual area treated by enzymatic debridement also increased from 11.9% TBSA to 20.3% TBSA. 19 patients (66%) had enzymatic debridement performed within 24 h of injury, a further 2 patients (7%) within 48 h after injury. Patients were more likely to have enzymatic debridement commenced in the first 24 h after injury if they had circumferential limb injury (39% vs 9%) or were planned for enzyme only debridement (78% vs 28%). Those who were planned for combination enzyme and surgical debridement were more likely to have enzymatic debridement commenced after the first 48 h (75%). We have performed enzymatic debridement overnight on one occasion, for a patient who presented with circumferential limb injury and was determined to undergo urgent debridement.Conclusion: Much of the literature has described the use of enzymatic debridement in smaller burns, and specialist areas. However, it is our opinion that the advantages of enzymatic debridement appear to be greater in larger burns with a facility for whole burn excision on the day of admission in the ICU cubicle. We have demonstrated significantly reduced blood loss, improved dermal preservation, reduced need for autografting, and a reduction in the number of trips to theatre. We would advocate that both the team and the patient need to be as prepared as they would be for a traditional surgical excision. The early part of our learning curve for enzymatic debridement in resuscitation level injuries was steep, and we were able to build on experience from managing smaller injuries. We recommend any team wishing to using enzymatic debridement gain experience in the same way and develop robust local pathways prior to attempting use in larger burn injuries. [ABSTRACT FROM AUTHOR]

The article documents the life changes and challenges that are experienced by individuals who suffer from burns with long-lasting injury, and what are the available support mechanisms for these individuals. The experiences are drawn from a qualitative phenomenological inquiry conducted at a leading facility for burns treatment in Navi Mumbai, where people from across the country can access free non-cosmetic corrective surgery for burn-related contracture. In-depth interviews have been conducted with nine participants and three key informants. Burns are commonly experienced as a disabling phenomenon, with the repercussions being experienced in the activities of daily living, finances, social roles, and social participation. We have noted, not only the changes in physical and emotional self but also the difficulty in accepting the changed self. Traversing and negotiating the fragmented healthcare system has been a baffling experience that is riddled with expensive, complex, and protracted treatment procedures. The uncertainty around the prognosis and treatment are sources of distress for the participants and their families. The paper concludes by indicating the need and scope for social work interventions in the lived experiences of adult burn survivors. [ABSTRACT FROM AUTHOR]

Copyright of Annals of Burns & Fire Disasters is the property of Euro-Mediterranean Council for Burns & Fire Disasters and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Plastic Surgery & Burns / Chirurgia Plastyczna i Oparzenia is the property of Evereth Publishing Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction and Objective: Burns are thermal injuries that may have a wide variety of clinical consequences from simple injuries to mortality. There are many aspects that must be medicolegally addressed in both non-survivors and survivors from burn injuries. The objective of this study was to determine sociodemographic characteristics, injury patterns, treatment requirements and prognoses of patients with burn injuries to evaluate the findings of neglect-abuse and forensic reporting processes. This study also aimed to contribute to the medicolegal classification criteria in respect of the factors that have an effect on the prognosis in the analyses.Material and Method: The study was conducted by retrospective review of digital files and paper records of patients who received therapy in the Burns Unit of KTU Farabi Hospital between 1st January, 2013, and 31st December, 2017.Results: Evaluation was made of a total of 1225 patients, comprising 769 (62.8%) males and 456 (37.2%) females, with a mean age of 21.8 ± 23.8 years (range, 1-89 years). The mean burnt body surface area was 14.29 ± 13.74. A trauma-related psychiatric disorder was diagnosed in 60 (4.9%) patients during treatment. When the medical history and physical examination findings were evaluated together, burn injuries suggested physical abuse in 54 patients (4.4%). The doctors who evaluated the patients with burn injuries in the emergency room and those who applied treatment in the Burns Unit made a forensic notification for 379 (30.9%) patients. The mean age of non-survivors was significantly higher than that of patients who survived to discharge (56.54 ± 28.60 years for non-survivors and 19.39 ± 23.12 years for survivors; p < 0.001).Conclusion: Burn injuries are frequently encountered, and they require precautionary measures. Burn injuries due to abuse are more frequently observed in the elderly and especially in children. Thus, the findings must be correctly interpreted, and more effort should be made to improve the knowledge of healthcare professionals about forensic reporting. Moreover, regulations should be implemented in respect of the medicolegal classification of trauma. [ABSTRACT FROM AUTHOR]

Kraft pulp production generates residues and by‐products of significant importance to the mill. Solid residues from forestry activities are commonly used to generate steam in power boilers. In the recovery cycle, black liquor generates steam (and subsequently energy) by burning in the Tomlinson boiler, while white liquor is regenerated. Well‐developed alternative technologies can use these residues and by‐products to generate different types of biofuels. This review addresses the use of such technologies integrated with Kraft mills, in the concept of biorefineries, showing advantages, disadvantages, and successful examples. Solid residues from forestry can be used to produce bio‐oil through processes such as fast pyrolysis and hydrothermal liquefaction. Bio‐oils are currently used for heating through combustion in commercial/industrial boilers, but greater appreciation occurs if used as biofuels, which is done through catalytic upgrading processes. Black liquor gasification generates synthesis gas, which can be burned for energy co‐generation, used to produce synthetic fuels, or as a hydrogenating agent for bio‐oil or crude tall oil catalytic upgrading. Kraft biorefineries are gradually being implemented, justifying efforts to improve existing and new biomass conversion technologies. [ABSTRACT FROM AUTHOR]

References 1 Blais MS, Carpenter K, Fernandez K. Comparative room burn study of furnished rooms from the United Kingdom, France and the United States. Dear editor, We have concerns about the Blais et al. paper "Comparative Room Burn Study of Furnished Rooms from the United Kingdom, France and the United States" in the March 2020 issue of I Fire Technology i [[1]]. The study compared fire growth and smoke toxicity in mock burn rooms each containing a couch and chair purchased from either the United Kingdom, France, or the United States. [Extracted from the article]

Consistent evidence has emerged over many years that the mortality and morbidity outcomes for burn patients in low and middle-income countries (LMICs) lag behind those in more resource rich countries. Interburns is a charity that was set up with the aim of working to reduce the disparity in the number of cases of burns as well as the outcomes for patients in LMICs. This paper provides an overview of a cyclical framework for quality improvement in burn care for use in LMICs that has been developed using an iterative process over the last 10 years. Each phase of the process is outlined together with a description of the tools used to conduct a gap analysis within the service, which is then used to frame a programme of capacity enhancement. Recent externally reviewed projects have demonstrated sustained improvement with the use of this comprehensive and integrated approach over a three-year cycle. This overview paper will be supported by further publications that present these results in detail. [ABSTRACT FROM AUTHOR]

Environment Barrier Coatings (EBCs) working in real service process meet not only environment of high-temperature gases with thermal gradient burning, but also condition of sand blasting. In this paper, EBCs made by plasma spray with Si bond coat and Yb2Si2O7 top coat were tested by surface blasting and hot-gas thermal gradient burning. Firstly, the sand-blasting behavior of the EBCs was analyzed. The results showed that the blasting caused the cracking and spallation of the coatings. Secondly, the surface burning morphology was analyzed at different sample zones after the burning test at 1 400 ℃,and the coating failure behavior at the center burning zone was studied. The results indicated that the coating failure was directly related to the diffusion of Si. According to the microstructure and micro composition study, the mechanism of the coating burning failure induced by Si diffusion was clarified in discussion. [ABSTRACT FROM AUTHOR]

Syria has been facing a dreadful crisis for the past 11 years, which has had a significant toll on the healthcare system of the country, and its ability to adequately manage acute injuries. In this research, we study the epidemiology and outcomes of burn patients admitted to the burn center of Al-Mouwasat Hospital in Damascus, Syria. A retrospective cohort research was conducted from January 2017 to December 2021. All accessible paper-based medical records of burn injury patients admitted to the hospital were evaluated. ABSI score was used to classify injury degrees. Chi-square test and logistic regression model were used to study the association between demographic variables and outcomes. Of the 641 patients, 367 (57.3%) were males and 274 (42.7%) were females. Children represented more than half of our sample 377 (58.8%). The most common cause of burns was flame 393 (61.3%), followed by scalding 199 (31.0%). Most of the patients had a more than 10% TBSA of burns 511 (79.7%). 209 (32.6%) patients had a moderate ABSI score, followed by moderately severe in 149 (23.2%) patients. Children, patients who had high ABSI scores, and those who needed respiratory support were more likely to die than others 2.545 (1.079-6.004), 9.208 (4.061-20.879), respectively. Death was the outcome of third of the hospitalized patients. Furthermore, Children made up more than half of the sample, and had the highest rates of leaving the hospital against medical advice. These results underline the importance of an updated nationally uniformed protocol for the management of burn patients. [ABSTRACT FROM AUTHOR]

Copyright of Plastic Surgery & Burns / Chirurgia Plastyczna i Oparzenia is the property of Evereth Publishing Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Although antibiotic has been frequently used for the treatment of infection, it has led to the emergence of resistant problem. Plant-derived compounds are alternative source for discovering novel therapeutics. Flavonoid is widely distributed and present in plant kingdom. This compound possessed several pharmacological properties including antibacterial. This review aims to present some information about the potency of flavonoids as antibacterial compound including their mechanism of antibacterial action as well as the relationship between their activity and flavonoid structure. The synergistic effect of flavonoids when used in combination with antibiotics against resistant bacterial is also described. Published literatures were collected from data bases such as PubMed, Google Scholar, Science Direct and Scopus. Scientific papers were selected based on information of antibacterial activity of flavonoid compounds. The information may provide an insight on the potency of flavonoid compounds to overcome resistant problem. [ABSTRACT FROM AUTHOR]

Hydrogen is increasingly being positioned as an essential part of low-carbon transitions. While the role of hydrogen in decarbonising industrial processes and transportation has received growing attention in recent years, very little research has focused on hydrogen as a fuel for homes. This paper uses theories of social practice to illustrate how the physical and chemical properties of hydrogen may disrupt domestic practices of cooking and heating. It focuses on one specific characteristic of hydrogen, that it burns with a near-invisible flame, and reports on a research project that investigated how one hundred people in the North East of England believed this would change their sensorially mediated social practices of heating and cooking. Participants imagined their practices of cooking would be severely disrupted while their practices of heating would be largely unaffected. The paper concludes by summarising the implications of the research for policy, industry, and researchers interested in hydrogen transitions; that these two key home domestic practices have potentially different transition pathways. • Utilises social practice theory to conceptualise how hydrogen transitions will take place in homes. • Focuses on the use of hydrogen for cooking and heating, and how gas-energised practices are sensorially mediated. • Finds that the near-invisibility of hydrogen's flame may be a disruption to cooking, but not heating. • Develops implications for policy, industry, and social science researchers interested in hydrogen transitions. [ABSTRACT FROM AUTHOR]

Competence in healthcare is a recognized expectation by consumers. In 2018 following an extensive review and consensus-building process, burn nursing practice competencies were published. Clinical nurse leaders were called upon to use these published competencies in practice as a basis for the requisite knowledge and skills needed in the care of the burn-injured individual. In 2019 at the 51st Annual Meeting of the American Burn Association, nurses from four U.S. burn centers reported on their center's incorporation of the competencies within their educational nursing curriculums. This paper provides a forum for each of the lead authors from Rhode Island Hospital Burn Center, the University of Utah Health Burn Trauma Intensive Care Unit, Parkland Regional Burn Center, and the University of Chicago Medicine Burn Center to outline their current utilization of the new burn nurse competencies and plans for future use. [ABSTRACT FROM AUTHOR]

Background: Burn care is centralized in highly specialized burn centers in Europe. These centers are of limited capacity and may be overwhelmed by a sudden surge in case of a burn mass casualty incident. Prior incidents in Europe and abroad have sustained high standards of care through well-orchestrated responses to share the burden of care in several burn centers. A burn mass casualty incident in Romania in 2015 sparked an initiative to strengthen the existing EU mechanisms. This paper aims to provide insight into developing a response plan for burn mass casualties within the EU Civil Protection Mechanism.Methods: The European Burns Association drafted medical guidelines for burn mass casualty incidents based on a literature review and an in-depth analysis of the Romanian incident. An online questionnaire surveyed European burn centers and EU States for burn mass casualty preparedness.Results: The Romanian burn mass casualty in 2015 highlighted the lack of a burn-specific mechanism, leading to the late onset of international transfers. In Europe, 71% of respondents had existing mass casualty response plans, though only 35% reported having a burn-specific plan. A burns response plan for burn mass casualties was developed and adopted as a Commission staff working document in preparation for further implementation. The plan builds on the existing Union Civil Protection Mechanism framework and the standards of the WHO Emergency Medical Teams initiative to provide 1) burn assessment teams for specialized in-hospital triage of patients, 2) specialized burn care across European burn centers, and 3) medevac capacities from participating states.Conclusion: The European burn mass casualty response plan could enable the delivery of high-level burn care in the face of an overwhelming incident in an affected European country. Further steps for integration and implementation of the plan within the Union Civil Protection Mechanism framework are needed. [ABSTRACT FROM AUTHOR]

Background: Only a few papers are published on the safety and effectiveness of acute burn care in low-income countries. A cohort study was therefore carried out to determine such outcomes.Methods: The study was conducted in a rural Tanzanian hospital in 2017-2018. All patients admitted with burns were eligible. Complications were scored during admission as an indication for safety. Survivors of severe burn injuries were evaluated for time of reepithelialization, graft take, disability (WHODAS2.0) and quality of life (EQ5D-3L) up to 3 months post-injury, as an indication of effectiveness.Results: Patients presented on average at 5 days after injury (SD 11, median 1, IQR 0-4). Three patients died at admission. The remaining 79 were included in the cohort. Their median age was 3 years (IQR 2-9, range 0.5-49), mean TBSA burned 12% (SD10%) and mortality rate 11.4%. No surgery-related mortality or life-threatening complications were observed. Skin grafting was performed on 29 patients at a delayed stage (median 23 days, IQR 15-47). Complications of skin grafts included partial (25% of procedures) and complete graft necrosis (8% of procedures). The mean time to reepithelialization was 52 (SD 42) days after admission. Disability and quality of life improved from admission to 3 months after injury (p<0.001, p<0.001, respectively).Conclusion: In this resource-limited setting patients presented after a delay and with multiple complications. The mortality during the first two weeks after admission was high. Surgery was found to be safe and effective. A significant improvement in disability and quality of life was observed. [ABSTRACT FROM AUTHOR]

Objective: To compare the effectiveness of cellular versus acellular amnion in patients with superficial facial burns at tertiary care hospital burn center of Punjab. Study Design: Randomized Control Trial. Setting: Department of Burn and Plastic Surgery, Jinnah Burn and Reconstructive Surgery Center, Lahore. Period: 1st September 2020 to 31st December 2021. Methods: A total of 60 patients who fulfilled the inclusion criteria were recruited after the informed consent and were randomly divided into two groups with 30 patients in Group A and 30 patients in Group B. Group A patients had acellular amnion application and Group B had cellular amnion application over the superficial facial burns. The data was noted on a predesigned proforma and analyzed by using IBM-SPSS.Version.25 and was compared in terms of outcome measures. Results: The mean age in Group A and B was 37.7+9.86 and 38.1+9.37(range20-70 years) respectively and mean pain score was 8.5+0.937 in group A and 8.7+0.897 in group B. Hypersensitivity reaction was seen in 13.33% in group A vs 26.67% patients in Group B, infection rate of 8.33% in Group A vs 25% in Group B, Healing in 31.67% vs 18.33% in Group A and B respectively while in Group A the need for skin graft was noted in 8.33% vs 20% in group B patients and the difference was significant statistically (p=0.045). Conclusion: Application of Acellular amnion is better choice than Cellular amnion over facial burns with less hypersensitivity reaction, infection rate, need of skin graft and with improved wound healing. [ABSTRACT FROM AUTHOR]

The use of robust evidence is a key component of providing high quality care to patients. Synthesised evidence to support clinical decision-making is lacking for many aspects of clinical burn care. Identifying the most important areas of care that lack high quality evidence and requires research is necessary, as funding for primary research is limited. Priority setting research studies are a joint endeavour between patients, carers and clinicians to identify and rank topics for research in a healthcare area in order to reduce research waste. Such an exercise has yet to be undertaken in burns. The aim of this paper is to outline the importance of research prioritisation in burn care, to discuss how it facilitates the maximum benefit from limited research funding and to explain the methodologies used. [ABSTRACT FROM AUTHOR]

While a Miller N-path filter is capable of channel selection at RF, it cannot sufficiently reject harmonic responses before going through the baseband circuitry. To suppress the second harmonic at the LNA output, this paper adds a feedback path to the conventional Miller N-path filter. The added feedback path distinguishes between the first and the second harmonic and exhibits a relatively large loop gain for the latter. As a result, the design suppresses the second harmonic at RF nodes. This is achieved without losing the desired characteristics of a conventional Miller N-path at the fundamental harmonic. The design example is a 500-MHz four-path filter simulated with the 90 nm CMOS. It achieves 13 dB gain, 2.6 dB noise figure, and + 9.6 dBm out-of-band IIP3 at 50 MHz offset from the center frequency and burns 16 mW of power. [ABSTRACT FROM AUTHOR]

Copyright of Transactions of the Foundry Research Institute / Prace Instytutu Odlewnictwa is the property of Lukasiewicz Research Network, Krakow Institute of Technology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pseudomonas aeruginosa is one of the main causes of healthcare-associated infection in Europe that increases patient morbidity and mortality. Multi-resistant pathogens are a major public health issue in burn centers. Mortality increases when the initial antibiotic treatment is inappropriate, especially if the patient is infected with P. aeruginosa strains that are resistant to many antibiotics. Phage therapy is an emerging option to treat severe P. aeruginosa infections. It involves using natural viruses called bacteriophages, which have the ability to infect, replicate, and, theoretically, destroy the P. aeruginosa population in an infected patient. We report here the case of a severely burned patient who experienced relapsing ventilator-associated pneumonia associated with skin graft infection and bacteremia due to extensively drug-resistant P. aeruginosa. The patient was successfully treated with personalized nebulized and intravenous phage therapy in combination with immunostimulation (interferon-γ) and last-resort antimicrobial therapy (imipenem-relebactam). [ABSTRACT FROM AUTHOR]

Background and Aims: Burn and scald injuries are the fourth most common type of trauma. Pediatric burns account for a high proportion of the total number of burn patients and impose a high burden on public health. Understanding the epidemiology of pediatric burns can help improve science education and reduce the incidence of burn injuries. Methods: This study is a single‐center retrospective study. One thousand five hundred and twenty‐seven pediatric burn patients admitted to our burn center from January 2016 to December 2020 were included. Demographic and epidemiological data of included patients were extracted and analyzed. The correlations of categorical data were tested by the Chi‐square tests, and differences of continuous data were tested by the Kruskal–Wallis tests. A p‐value of less than 0.05 was considered to be statistically significant. Results: The results showed that children under 3 years of age were most susceptible to burn and scald injuries. Burn injuries were most likely to occur in the season of winter and at the place of home. 56.6% of included patients did receive first aid measures, while 1.8% received gold‐standard first aid. Clinical variables related to the severity of injuries were statistically different between patients with and without cooling measures in first aid. Linear regression models showed that emergency treatment of burns in children and adolescents was associated with outcome indicators, including number of operations, total operation duration per total burn surface area (TBSA), cost per TBSA, and length of stay per TBSA. Conclusions: This study summarized the epidemiology and outcomes of pediatric burn patients admitted to a burn center in northern China. Adopting cooling measures in first aid can reduce the severity of injuries and reduce the burden on the medical system. Education on burn prevention and first aid measures to caregivers of children, especially preschool children, should be strengthened. Key points: Understanding the epidemiology of pediatric burns can help improve science education and reduce the incidence of burn injuries.This study aimed to analyze epidemiological and clinical variables of pediatric burn patients in a burn center in northern China.Children under 3 years of age were most susceptible to burn and scald injuries.Burn injuries in pediatric patients were most likely to occur in the season of winter and at the place of home.Adopting cooling measures in first aid can reduce the severity of burn injuries. [ABSTRACT FROM AUTHOR]

Rehabilitative care for burn patients in developing countries is often wrought with several issues. Post-discharge support is equally challenging as there is often limited rehabilitative care as the burn survivors and their families transition. To inform practice, this study sought to explore the perspectives of adult burn survivors and burn care staff regarding transitioning from the burn unit and the development of a transitional rehabilitation programme. We employed interpretive description for this study. Semi-structured face-to-face interviews were conducted with adult burn survivors and burn care staff across two tertiary healthcare facilities in Lanzhou, Gansu Province of China, and Ghana. The thematic analytical approach was employed to analyse the data. Forty-six participants comprising 26 adult burn survivors and 20 burn care staff participated in this study. Two themes and five subthemes emerged from the data. Transitioning from the burn unit to the home was described as complex with varied biopsychosocial needs emerging. However, available support was not comprehensive to resolve these needs. Existing pre-discharge support is limited across both settings. Burn survivors expressed interest in taking on an active role in the rehabilitation process and being able to self-manage their post-burn symptoms following discharge. Transitional rehabilitative support should include an active follow-up system, ensure patient- and family-centred support, and offer a bundle of comprehensive rehabilitative services using locally available items which do not financially burden burn survivors and their families. In conclusion, transitioning from the burn unit is filled with varied health needs. Transitional rehabilitative care is required to bridge the pre-discharge and post-discharge periods. [ABSTRACT FROM AUTHOR]

Background: Visual evaluation is the most common method of evaluating burn wounds. Its subjective nature can lead to inaccurate diagnoses and inappropriate burn center referrals. Machine learning may provide an objective solution. The objective of this study is to summarize the literature on ML in burn wound evaluation.Methods: A systematic review of articles published between January 2000 and January 2021 was performed using PubMed and MEDLINE (OVID). Articles reporting on ML or automation to evaluate burn wounds were included. Keywords included burns, machine/deep learning, artificial intelligence, burn classification technology, and mobile applications. Data were extracted on study design, method of data acquisition, machine learning techniques, and machine learning accuracy.Results: Thirty articles were included. Nine studies used machine learning and automation to estimate percent total body surface area (%TBSA) burned, 4 calculated fluid estimations, 19 estimated burn depth, 5 estimated need for surgery, and 2 evaluated scarring. Models calculating %TBSA burned demonstrated accuracies comparable to or better than paper methods. Burn depth classification models achieved accuracies of >83%.Conclusion: Machine learning provides an objective adjunct that may improve diagnostic accuracy in evaluating burn wound severity. Existing models remain in the early stages with future studies needed to assess their clinical feasibility. [ABSTRACT FROM AUTHOR]

Background: Burns occur disproportionately within low-socioeconomic populations. The Western Cape Province of South Africa represents a middle-income setting with a high rate of burns, few specialists and few burn centres, yet a well-developed pre-hospital system. This paper describes the burn cases from a viewpoint of operational factors important to pre-hospital emergency medical services. Methods: A retrospective, cross-sectional study of administrative and patient records was conducted. Data were captured for all pre-hospital burn patients treated by public Emergency Medical Services over a continuous 12-month period. Data were captured separately at each site using a standardised data collection tool. Described categories included location (rural or urban), transport decision (transported or remained on scene), age (child or adult) and urgency (triage colour). Results: EMS treated 1198 patients with confirmed burns representing 0.6% of the total EMS caseload; an additional 819 potential burn cases could not be confirmed. Of the confirmed cases, 625 (52.2%) were located outside the City of Cape Town and 1058 (88.3%) were transported to a medical facility. Patients from urban areas had longer mission times. Children accounted for 37.5% ( n = 449) of all burns. The majority of transported patients that were triaged were yellow ( n = 238, 41.6% rural and n = 182, 37.4% urban). Conclusions: Burns make up a small portion of the EMS caseload. More burns occurred in areas far from urban hospitals and burn centres. The majority of burn cases met the burn centre referral criteria. [ABSTRACT FROM AUTHOR]

Improving patient care through enhanced electronic communication among health care providers is aimed at reducing the number of medication and medical errors. The American Reinvestment and Recovery Act (ARRA) was signed into law in 2009, supporting the federal government's commitment to the improvement of health care quality, safety, and efficiency through requirements to implement an electronic health record by October 2015 or hospitals and eligible providers potentially realizing penalties or reduced reimbursement rates. In addition to ARRA, Congress presented another initiative to further advance the delivery of high-quality health care, the Health Information Technology for Economic and Clinical Health Act (HITECH), leading to the authorization of $27 billion to encourage health care providers to achieve meaningful use of the electronic health record. However, the conversion of the paper medical records to an electronic version has been challenging, particularly in specialty departments. The burn unit of a tertiary hospital located in the Pittsburgh area experienced such challenges. A project plan, developed in 2009 prior to the electronic medical record going live, involved a multidisciplinary team, consisting of providers, nurses, and information system builders who came together to determine how to capture the totality of the burn unit documentation. The goal of the project was to develop an electronic documentation tool and provide a system to accurately and efficiently evaluate documentation compliance with the staff. The Lund Browder documentation tool, used with the paper medical record, was the selected tool for the electronic conversion. This tool has been regarded by most health care organizations as being the most accurate in measuring the extent and degree of the burn. With the paper documentation tool, the staff was, on average, 74% compliant with the Lund Browder tool. The electronic version and availability of the tool increased compliance to 100% in the fourth quarter of 2015. [ABSTRACT FROM AUTHOR]

This study aims to build on the small body of evidence in previously published study exploring professional attitudes toward deliberate self-harm (DSH) patients from a predominantly burns and plastic surgery perspective. The authors distributed a short paper-based questionnaire within the burns and plastics department at the Queen Elizabeth Hospital, Birmingham, where the authors gathered a mixture of qualitative and quantitative data surrounding this issue. Professionals generally agree that DSH patients require input from multiple services and that surgery is not always the best option. The most common frustration among healthcare professionals regarding the care of DSH patients includes inconsistencies in care, lack of training/understanding, and the need for a policy to guide and standardize treatment. Improving training in line with UK National Institute of Health and Care Excellence (NICE) guidance along with introducing guidelines for the care of DSH patients may help smooth out inconsistencies in care and reduce frustrations among staff members. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The study aimed to determine the factors which influence clinician behaviour and adherence to best practice when clinicians provide the initial care for paediatric burn patients admitted to a burns unit.Background: Optimal initial care of burn patients influences morbidity and mortality. Non-burn specialist clinician adherence to best practice is influenced by previously unexplored factors.Design: General inductive qualitative methods were used to explore factors which influenced clinicians providing acute pre-admission burn care for children in Western Australia.Methods: Interviews of nineteen clinicians using standardised open-ended questions based on the Gilbert Behaviour Engineering Model were used to collect data.Results: The main influencing factors identified were the telehealth service which supported practice, whilst IT issues provided challenges to clinicians.Conclusion: Telehealth services support clinicians when providing burn care, however IT issues are an major barrier to both best practice and accessing the telehealth service and should be optimised to support clinical care IMPACT STATEMENT: What does this paper contribute to the wider global community? It provides burn clinicians with an insight into the factors which facilitate optimal care for patients prior to transfer to burn units, as well as the barriers faced by non-burn specialist clinicians when patients initially present for care. Models of care which acknowledge these factors can help facilitate optimal patient care. [ABSTRACT FROM AUTHOR]

Copyright of Plastic Surgery & Burns / Chirurgia Plastyczna i Oparzenia is the property of Evereth Publishing Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)