bluuebunny/crossref_metadata_2025 huggingface dataset:
Intravenous Immunoglobulin Does Not Improve Outcome in Toxic Epidermal Necrolysis
Authors: Shortt Rodger , Gomez Manuel , Mittman Nicole , Cartotto Robert
Published: September 2004

Intravenous Immunoglobulin (IVIG) has been proposed as a beneficial therapy for toxic epidermal necrolysis (TEN). However, this has been based on a limited amount of Class 5 evidence. To compare outcomes in TEN patients treated in our burn unit since 1999, when we began to use IVIG (IG group), with TEN patients treated between 1995 and 1999 who did not receive IVIG (control group). Retrospective cohort review of the records of all TEN patients admitted between April 5, 1995 and December 4, 2002. There were 16 patients in the IG group (age 53 ± 21 years, with initial rash involving 65 ± 29% TBSA) and 16 patients in the control group (age 52 ± 20 years, with initial rash involving 65 ± 27% TBSA). The IG group received 0.7 ± 0.2 g/kg/day of IVIG for 4 ± 1 days. There were no significant differences between the groups with respect to the length of stay, duration of mechanical ventilation, severity of systemic inflammatory response syndrome and multiple organ dysfunction syndrome, or the incidence of sepsis. Significant progression of the wound occurred in 13% of the IG patients and in 27% of control patients, whereas no wound progression was observed in 47% of the IG patients and in 18% of the control patients (P = .299). The time to healing did not differ between IG and control groups (11.2 ± 3.6 vs 11.4 ± 2.6 days, respectively). There was no significant difference in the mortality rate between the IG group (25%) and the control group (38%). There were no complications from IVIG aside from one case of hyponatremia from the hypotonic IVIG solution. Although there may have been a trend towards less severe wound progression in patients who received IVIG, this was not associated with any substantial improvement in outcome in our TEN patients. A prospective randomized study with a larger sample size is needed to confirm our findings.
Quantification and Risk Analysis of Occupational Burns: Oregon Workers' Compensation Claims, 1990 to 1997
Authors: Horwitz Irwin B. , McCall Brian P.
Published: September 2004

This study examined all accepted Oregon workers' compensation claims for occupational burn injuries during the period of 1990 to 1997 (N = 3,158). The Current Population Survey was used to derive employee population baselines for establishing rate estimates. It was estimated that the average occupational burn claim rate was 2.89 per 10,000 workers (95% confidence interval [CI] 2.76, 3.02). The majority of claimants (71.7%) were males, the largest proportion (32.6%) was aged 25 years or less, and almost half (48.7%) had less than 1 year of job tenure. The most frequent burn type cited was heat/scald burns (78.9%) followed by chemical burns (19.3%). Costs averaged over $1.6 million annually. The average indemnity period was 16 days. Higher relative risks were found for evening workers (2.97, 95% CI 2.96, 2.98) and night workers (2.13, 95% CI 2.12, 2.13) compared with dayshift workers. Kitchen workers had the highest burn rate of all occupations, with 62.5 claims per 10,000 workers.
Burn Education Awareness Recognition and Support (BEARS): A Community-Based Juvenile Firesetters Assessment and Treatment Program
Authors: Bennett B. K. , Gamelli R. L. , Duchene R. C. , Atkocaitis D. , Plunkett J. A.
Published: September 2004

In response to the continued staggering statistics of fires set by juveniles and the devastating personal and property costs that are associated with these fires, the Burn and Shock Trauma Institute of Loyola University Medical Center, in collaboration with the State Fire Marshal's Office; the Illinois Fire Safety Alliance; and representatives from the firefighting community, law enforcement, emergency medicine and mental health, came together to create the Burn Education Awareness Recognition and Support Program. Through financial grant support from the International Association of Firefighters, the Illinois Fire Safety Alliance, and other private donations, the Burn Education Awareness Recognition and Support Program is able to provide a free resource to anyone who is concerned about a child playing with fire. Specially trained firefighters assess each child using the tool developed by the Federal Emergency Management Agency. In 2002, we assessed 42 children; 29 of those children were referred through the courts. So far, none of the children treated in our program have returned to fire-setting behaviors.
A Review of Keratinocyte Delivery to the Wound Bed
Authors: Chester D. L. , Balderson D. S. , Papini R. P. G.
Published: September 2004

Over the last 20 years, confluent sheets of cultured epithelial autograft have been used for patients with major burns. Problems with the lack of “take” and long-term durability, as well as the time delay to produce such grafts, have led to the development of delivery systems to transfer keratinocytes to the wound bed. This review article describes the problems of using cultured epithelial autograft and the advantages of using preconfluent keratinocytes. Despite the numerous delivery systems that have been reported, most studies are limited to animal wound bed models. There are a few small clinical studies that have demonstrated enhanced healing using mainly subjective methods. There is a need for controlled, randomized clinical trials to prove the efficacy of keratinocyte delivery systems. Proposals for the use of this technology are made.
Serum Levels of Prolactin, Growth Hormone, and Cortisol in Burn Patients: Correlations with Severity of Burn, Serum Cytokine Levels, and Fatality
Authors: Dugan A. L. , Malarkey W. B. , Schwemberger S. , Jauch E. C. , Ogle C. K. , Horseman N. D.
Published: September 2004

In this study, we measured serum prolactin (PRL), cortisol, growth hormone, interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12, and tumor necrosis factor-α in patients admitted with small-to-moderate burn injuries. Serum samples were obtained at the time of admission from 49 adult male burn patients with ages ranging from 18 to 91 years and TBSA ranging from 0.001 to 60%. The levels of serum PRL, IL-8, IL-6, and IL-1β correlated positively with the TBSA, whereas only serum IL-8 levels correlated positively with fatality. Each of these factors were increased at least 2-fold at the higher burn severity. Not surprisingly, there was a large degree of variability in the hormone and cytokine levels in this patient population, which presumably reflects individual levels of stress, as well as other physiological variables. We also studied relationships between serum hormone levels and serum cytokine levels in this context. Linear regression analysis revealed a significant positive correlation between the serum PRL level and the levels of IL-10, IL-6, and IL-8. These results indicate that PRL responds to burn injury at early time points and that a subset of cytokines are involved in the early response to burn injury.
Burns from Illegal Drug Manufacture: Case Series and Management
Authors: Porter C. J. W. , Armstrong J. R.
Published: September 2004

This case series presents our experience with burns sustained while manufacturing illegal drugs. All adult burn admissions in an 18-month period were retrospectively reviewed. All patients suspected of sustaining burns from illegal drug manufacture were contacted. Information regarding the burn mechanism was sought. Nine of the 64 adult burn admissions were caused by explosions during the manufacture of cannabis oil. Young males with hand and face burns were heavily represented. First-aid treatment was often ignored in favor of hiding incriminating evidence. Only two patients gave honest admission histories. Illegal drug manufacture is becoming more common as synthetic drugs become more consumer desirable. Burns sustained may be thermal and/or chemical. Dishonest patient histories negatively influence burn management. A high level of suspicion is required for diagnosing and treating burns from illegal drug manufacture. Public education is unlikely to be effective as the financial rewards outweigh the perceived risks.
Effects of Exogenous Growth Hormone on Resting Pulmonary Function in Children with Thermal Injury
Authors: Suman Oscar E. , Mlcak Ronald P. , Herndon David N.
Published: September 2004

Burned children living beyond the acute phase of injury often have extensive physical functional limitations, such as impaired spirometry pulmonary function (PF). In patients with both lung disease and nutritional compromise, such as cystic fibrosis, studies suggest that growth hormone (GH) therapy improves PF. However, whether GH will improve PF in burned children is presently unknown. We therefore evaluated whether GH administration of 0.05 mg/kg/day for 1 year would improve PF in burned children. Thirty children, aged 7 to 18, with a 40% or more total body surface area burned were randomized into two groups and studied. One group received GH (n = 17) and the other received saline (n = 13). No differences were noted at hospital discharge between groups in age, % total body surface area, height, and weight. At 12 months after burn, both groups had similar height and weight. Baseline PF were below normal in both groups, but no statistical differences were noted between groups. At 1 year, there was a significant increase in PF in both groups; however, this increase in PF was similar in both groups. We conclude that the response in PF in burned children from the administration of GH prescribed for up to 1 year is limited.
Treating Sleep Problems in Patients with Burn Injuries: Practical Considerations
Authors: Jaffe Suzan E. , Patterson David R.
Published: September 2004

Sleep disorders are a frequent but under-addressed complication of burn injuries. Burn injuries can potentially disrupt sleep for a variety of reasons, including the physiological effects of trauma as well as ramifications of treatment (ie, intensive care unit environment, pain, itching, medications). The literature on sleep disorders and burn injuries is reviewed, and suggestions for treatment are provided. Treatment is divided into two major types: nonpharmacologic and pharmacologic. Nonpharmacologic treatment, also referred to as behavioral techniques, may include any one or combination of the following: sleep hygiene, stimulus control, sleep restriction, relaxation techniques, cognitive, and light therapy. Pharmacologic therapies may include hypnotics (benzodiazepine, nonbenzodiazepine, or benzodiazepine receptor agonists), antidepressants, over-the-counter preparations, hormone replacement therapy, herbs, and melatonin.
Hot Beverage Scalds in Australian Children
Authors: Dewar D.J. , Magson C.L. , Fraser J. F. , Crighton L. , Kimble R.M.
Published: September 2004

Our objective was to compile data on the mechanism and severity of injuries associated with hot beverage burns in children. We identified 152 children over a 3-year period who attended a tertiary level burns center, representing 18% of all children treated. Their median age was 17.5 months and median body surface area burned was 4% (range, 0.25% to 32%). Significantly, 52% of children required admission, 18% received a split skin graft, and 26% required long-term scar management. In 70% of all cases, the mechanism of injury was the child pulling the hot beverage over himself or herself. In 80% of incidents, a primary care giver witnessed the injury. These findings indicate that scalding from hot beverages carries significant morbidity and is an important pediatric public health issue. It is clear that further research towards effective education programs for primary caregivers is warranted.
Evaluation of a Pediatric Scald Burn Clinical Pathway
Authors: Taylor Kim O. , Goudie Christine M. , Muller Michael J.
Published: September 2004

Scald burns make up more than 75% of the pediatric burns patients who are admitted to our burns unit. A pediatric scald burn pathway was implemented at our center in November 1999, the aim of which was to improve consistency in the management of the acute phase of injury. This study assessed the effectiveness of the first 18 months of this scald burn pathway. Aspects of the management of pediatric scald burn patients were reviewed. This included all the patients admitted over a 6-month period 1 year before the implementation of the pathway and the first 6 months and between 12 and 18 months after the implementation of the pathway. Data collected included patient demographics, total body surface area burned, and key management guidelines, including nasogastric feeding, intravenous cannulation, analgesia prescription, multidisciplinary referrals, and family education Thirty-seven patients were enrolled in the first 6 months of the pathway's use. Between 12 and 18 months, a further 38 patients were enrolled. The patients within the three groups were similar in age and burn size. A comparison among the groups with respect to compliance with the treatment guidelines is presented graphically. In conclusion, the management of pediatric scald burns in the acute phase is more consistent since the implementation of the clinical pathway.
Personality Characteristics and Perceived Health Problems After Burn Injury
Authors: Kildal Morten , Willebrand Mimmie , Andersson Gerhard , Gerdin Bengt , Ekselius Lisa
Published: September 2004

The relationship between personality traits and the perceived outcome of burn injury 1 to 18 years (mean, 9.2 years) after severe burn injury was evaluated in 166 individuals treated at the Uppsala Burn Unit. The perceived outcome was measured with the Burn Specific Health Scale-Brief (BSHS-B) and was related to personality traits evaluated by means of the Swedish universities Scales of Personality. After controlling for age at inquiry, time since injury, burn area, and sex, a stepwise logistic regression analysis revealed an association between the Swedish universities Scales of Personality domain Neuroticism and Bad outcome in all BSHS-B domains, both psychosocial and physical, and Insufficient outcome in the domains Work, Body image, Affect, and BSHS-B total score. The neurotic traits Somatic trait anxiety, Psychic trait anxiety, Stress susceptibility, Embitterment, and Mistrust each or in different combinations explained the observed relationships. The data suggest that personality is related to health status because it is perceived a long time after severe burn injury and that its effect is not confined only to psychological but also to physical aspects of life.
Treatment of Hydrofluoric Acid Burn to the Face by Carotid Artery Infusion of Calcium Gluconate
Authors: Nguyen Lan T. , Mohr William J. , Ahrenholz David H. , Solem Lynn D.
Published: September 2004

Hydrofluoric acid (HF) is highly corrosive substance often used in industrial processes. HF burns to the skin cause local tissue injury. Systemic hypocalcemia may ensue, with the potential to produce life-threatening arrhythmias. Medical treatment consists of local application of topical calcium gels, subcutaneous injection of calcium gluconate, and intravenous or intra-arterial infusion of calcium gluconate. Calcium gluconate infusions have been used for HF burns on distal extremities and digits. We report a case of HF burn to the face that was treated by the use of calcium gluconate infusion via the external carotid artery.
Firefighter Burn Injuries: A 10-Year Longitudinal Study
Authors: Rabbitts Angela , Alden Nicole E. , O'sullivan Geoffrey , Bauer Gregory J. , Bessey Palmer Q. , Turkowski Joseph R. , Yurt Roger W.
Published: September 2004

Our metropolitan area employs approximately 11,000 firefighters who respond to more than 435,000 fire-related incidents per year. It is inevitable that some of these firefighters will suffer burn injuries. This 10-year retrospective review describes the epidemiology of firefighters with burn injuries who were treated at our burn center. From 1992 to 2002, 987 firefighters were treated at our burn center. The total number of firefighters treated for burn injuries and the number of firefighters who were treated for burn injuries to the lower extremities occurred in a bimodal distribution. Injury prevention efforts will continue to further reduce the incidence of burn injuries in the firefighters of our community.
Grease Fryers: A Significant Danger to Children
Authors: Allen Steven R. , Kagan Richard J.
Published: September 2004

Scald injuries in children often occur as the result of them pulling a container of hot liquid off a countertop or stove. To date, there have been no studies that have specifically examined the impact of the burning agent after this mechanism of injury on the magnitude of injury or the hospital resources consumed in caring for these patients. In this study, we sought to compare the extent and depth of injury, hospital resources consumed, and outcomes of children burned by pulling a container of grease or other liquid onto themselves. We retrospectively reviewed all cases of children who were admitted to our pediatric burn center from January 1995 through December 2001 who sustained scald injuries as the result of pulling a container of hot liquid onto himself or herself. Patients were evaluated for extent TBSA burned, depth of injury, the need for skin grafts, and the number of ventilator, days in the intensive care unit, and total hospital days (length of stay). We identified 196 children admitted with scald injuries caused by this mechanism. Fifty-four (27.6%) were caused by grease or oil, and 142 (72.6%) were caused by other liquids. The mean age of children burned by this mechanism was approximately 3 years, and slightly more than half were males. The mean TBSA and full-thickness burn was 18.3% and 8.1% for the grease group and 14.4% and 4.5% for the no-grease group, respectively (P < .05). Fifty-six percent of those children burned with grease required skin grafting compared with only 34% of those burned by other liquids. Twenty percent of the patients burned by grease required ventilator support compared with only 6.3% of those burned by other liquids (P < .01). Of those burned by grease, 22.2% required care in the intensive care unit compared with only 6.3% of those burned by other liquids (P < .005). Mean length of stay was 16.8 ± 2.5 days and 9.1 ± 1.0 days for the grease and nongrease groups, respectively (P < .001). Scalds caused by children pulling a grease fryer onto themselves result in more extensive and deeper injuries and greater consumption of hospital resources than those from other liquids. These findings support the need for safer product design and more specific warnings in product labeling and instructions as to the danger of severe scald injury to minimize the occurrence of such injuries.
Car Radiator Burns: A Prevention Issue
Authors: Rabbitts Angela , Alden Nicole E. , Conlin Tara , Yurt Roger W.
Published: September 2004

Scald burns continue to be the major cause of injury to patients admitted to the burn center. Scald burns occurring from car radiator fluid comprise a significant subgroup. Although manufacturer warning labels have been placed on car radiators, these burns continue to occur. This retrospective review looks at all patients admitted to our burn center who suffered scald burns from car radiator fluid to assess the extent of this problem. During the study period, 86 patients were identified as having suffered scald burns as a result of contact with car radiator fluid. Seventy-one percent of the burn injuries occurred in the summer months. The areas most commonly burned were the head and upper extremities. Burn prevention efforts have improved greatly over the years; however, this study demonstrates that scald burns from car radiator fluid continue to cause physical, emotional, and financial devastation. The current radiator warning labels alone are not effective. The National Highway Traffic Safety Administration has proposed a new federal motor vehicle safety standard to aid in decreasing the number of scald burns from car radiators. The results of this study were submitted to the United States Department of Transportation for inclusion in a docket for federal legislation supporting these safety measures.
Effectiveness of a Burn Prevention Campaign for Older Adults
Authors: Tan Jensen , Banez Carol , Cheung Yvonne , Gomez Manuel , Nguyen Huy , Banfield Joanne , Medeiros Lina , Lee Ruth , Cartotto Robert , Fish Joel S.
Published: September 2004

Older adults are involved in one fifth of burn injury admissions in the Province of Ontario Canada. Most burn injuries in this population occur at home while cooking, bathing, or smoking. The purpose of this study was to evaluate the effectiveness of an educational campaign to improve burn prevention knowledge in older adults of a major metropolitan city. Changes in participants' burn prevention knowledge were determined using standardized precampaign and postcampaign (4-6 weeks) surveys. Of 209 older adult participants, 126 (60.3%) completed the precampaign and postcampaign surveys. There was a significant increase (P < .05) in burn prevention knowledge postintervention. Age, education level, and living conditions did not influence the change in burn prevention knowledge. This burn prevention campaign for older adults was effective in improving burn prevention knowledge, but it remains unclear as to whether this will ultimately result in a change in burn prevention behavior.
A Survey of Airway and Ventilator Management Strategies in North American Pediatric Burn Units
Authors: Silver Geoffrey M. , Freiburg Carter , Halerz Marcia , Tojong Jonathan , Supple Kathy , Gamelli Richard L.
Published: September 2004

A survey was used to gather information regarding airway management patterns in thermally injured children. North American pediatric burn centers listed by the American Burn Association were sent a survey designed to examine patterns of pediatric airway management in children with acute respiratory failure. The sample population means for the number of patients ventilated more than 48 hours and the number of patients ventilated more than 48 hours with inhalation injury were used to separate centers into large and small pediatric burn centers. Small pediatric burn centers had less than 50 patients who were intubated during a 5-year period. A five-point nominal scale was used to facilitate statistical analysis. Twenty-five pediatric burn centers included in the analysis estimated that 11,494 children were admitted during the 5-year period. There was no statistically dominant ventilator mode being used in the setting of acute respiratory failure identified by this survey. Large pediatric burn centers reported more frequent use of cuffed endotracheal tubes and more frequent change from an uncuffed to a cuffed endotracheal tube in patients who were difficult to ventilate because of an excess leak. Large pediatric burn centers reported a higher prevalence of tracheomalacia then small pediatric burn centers. Steroids were used by most centers before extubation in patients with persistent airway edema. No centers reported complications from steroid use. There is lack of clear consensus regarding the application of various ventilator modes in the setting of acute respiratory failure irrespective of center volume. There were divergent of practice patterns between large and small pediatric burn centers regarding the use of cuffed endotracheal tubes and the timing of tracheostomy. There was agreement between large and small pediatric burn centers in tracheostomy use in children older the age of 7 and the use of steroids as an adjunct to extubation in patients with lingering airway edema. Pediatric burn patients may benefit from clinical trials that clarify the advantages and disadvantages of various ventilator modes, the use of cuffed tubes, and the timing of tracheostomy.
Temperature Threshold for Burn Injury: An Oximeter Safety Study
Authors: Greenhalgh David G. , Lawless Mary Beth , Chew Bradford B. , Crone Willem A. , Fein Michael E. , Palmieri Tina L.
Published: September 2004

Pulse oximeters have become essential devices for evaluating and monitoring patient oxygenation. The probe emits a small amount of heat into the skin in the process of signal detection. Regulations set by the Food and Drug Administration currently limit the maximum allowable temperature of an oximeter probe to 41°C. As a result of the prolonged exposure of extremities to these devices, we sought to determine the actual temperature threshold for burn injury in patients. Eighteen patients undergoing surgery for removal of redundant skin (abdominoplasty, breast reduction) consented to the application of a temperature-controlled custom probe with four light-emitting diodes that had temperatures set randomly at the expected threshold for burn injury (42.5°C, 43°C, 43.5°C, and 44°C). The probe was left in place for 8 hours (or less if significant pain was noted). The sites covered by the probes were then checked for signs of injury. On the next day, the redundant skin was removed as a scheduled procedure, and histopathology was performed to detect the extent of burn injury. The study was approved by the local institutional research board. Two patients were excluded because of technical problems with the probe, one of whom had the probe turned off because of pain. The only observed sign of injury was either erythema or a superficial blister that was usually unobservable or slightly red at operation. These subtle signs of a burn were noted in one patient at 43°C, four at 43.5°C, and nine at 44°C. No burns were noted in two patients. Minimal or no signs of injury frequently were noted by histopathology. Pulse oximeter probes are safe up to a temperature of 43°C for at least 8 hours in well-perfused skin. Above that temperature, there is a risk of burn injury. Performing temperature threshold tests in redundant skin that is planned for excision is a potential method for testing the safety of devices or materials.
Home Treadmill Friction Injuries: A Five-Year Review
Authors: Collier Margaret L. , Ward R Scott , Saffle Jeffrey R. , Edelman Linda S. , Morris Stephen E. , Lundy Cindy
Published: September 2004

Treadmills are popular home fitness machines in American homes. Young children are at risk for friction injuries if they contact moving treadmills. The purpose of this study was to determine the impact of treatment of treadmill friction injuries in children. A review of 1211 pediatric patients younger than 6 years treated at the Intermountain Burn Center between July 1997 and June 2002 was conducted. Forty-eight of these cases (4%) were treadmill friction injuries. The mean TBSA of these burns was 0.5%. The volar surface of the hand was the most common site of injury. Twenty-two (46%) of the 48 identified patients had full-thickness injuries that were treated surgically. Medical costs associated with treadmill friction injuries averaged $2385. The number of treadmill friction accidents resulting in friction injuries to children less than 6 years of age deserves serious attention and increased public awareness.
Use of Joshi External Stabilizing System in Postburn Contractures of the Hand and Wrist: A 20-Year Experience
Authors: Gulati Salil , Joshi Brij B. , Milner Stephen M.
Published: September 2004

Postburn contractures of the hand and wrist can range from a minor cosmetic problem to a crippling condition. The contractures, initially limited to the skin, extend to all the soft-tissue structures over time, often necessitating capsulotomies and tendon lengthening, although they still may not be amenable to total correction. The Joshi External Stabilizing System (JESS) is a versatile, lightweight external fixator consisting of K wires, distractors, and connecting rods (both hinged and nonhinged) along with various link joints. JESS is a dynamic system that allows the lengthening of the contracted tissues via slow distraction, causing minimal surgical insult. This is a retrospective review of 218 cases of postburn contractures of the hand treated with JESS during the last 20 years. Deformities varied from finger contractures to metacarpophalangeal joint and wrist contractures. All cases were of long duration at the time of presentation with the original injury being 4 months to 20 years old. All were assessed for the degree of function and deformity. The patients' activities of daily living were recorded and x-rays taken to evaluate joint configuration. The patients underwent a conservative surgical release followed by application of the appropriate JESS frame for the correction of the residual deformity. After 6 weeks, the frame was removed and hand therapy continued. An analysis is provided of the outcome. The technique produces functional hands with minimal surgical insult.
Methamphetamine-Associated Burn Injuries: A Retrospective Analysis
Authors: Danks Roy R. , Wibbenmeyer Lucy A. , Faucher Lee D. , Sihler Kristen C. , Kealey G Patrick , Chang Phyllis , Amelon Marge , Lewis Robert W.
Published: September 2004

Methamphetamine production and use has increased dramatically during the past 10 years. Methamphetamine production requires combining hazardous and volatile chemicals that expose the manufacturer to burn injuries from explosions and chemical spills. We sought to review the epidemiology of burn injuries in a rural burn center secondary to the use of amphetamine or methamphetamine and/or the manufacture of methamphetamine. Review of the records of 507 patients who were admitted to our burn unit from December 1, 1998, to December 31, 2001, revealed 34 patients who were involved in the use of amphetamines or methamphetamines and/or the manufacture of methamphetamine. Thirty-one patients tested positive for either amphetamine (n = 2) or methamphetamine (n = 29) on routine admission urine drug screens. Twenty of these patients were involved in the manufacture of methamphetamines. Three additional patients were identified as methamphetamine manufacturers but tested negative for the use of methamphetamines. The mean age of the study population was 31.88 ± 7.65 years, with a male:female ratio of 10.3:1. The average burn size was 18.86 ± 20.72, with the majority secondary to flame (n = 26). Patient burn admission histories were vague, and the patient's involvement in the manufacture of methamphetamine was often only later confirmed by media, the fire marshal, family members, or the patient. Fifteen patients showed the usual withdrawal pattern of agitation and hypersomnolence, with seven patients requiring detoxification with benzodiazepines. Two were admitted acutely to the psychiatric ward for uncontrollable agitation. Eighteen patients were offered chemical dependency treatment, and two completed therapy. There was one mortality. The mean cost per person was $77,580 (range, $112–$426,386). The increasing use of and manufacture of methamphetamine presents new challenges for the burn team because these patients can become violent and frequently need assistance with detoxification. Routine drug screens are mandatory in identifying methamphetamine use to alert burn unit personnel to particular management problems and target individuals who may be receptive to drug rehabilitation.
Milk Bottle Burns
Authors: Ali Syed N. , O'toole Greg , Tyler Michael
Published: September 2004

In recent years numerous infants have been treated at Stoke Mandeville Hospital's Burns' Unit for scalds sustained in accidents that occurred during the preparation of warm milk. These were significant burns affecting young children with susceptibly thin skin that often resulted in the injured child requiring a long stay in hospital. Frequently, formal intravenous fluid resuscitation was required as was burn excision and skin grafting. We recommend the use of milk bottle warmer to avoid all the hazards associated with use of different techniques of warming milk bottle.
Stainless steel powder as a protective and decorative pigment for steel structures in organic coating industries
Authors: Selvaraj M.
Published: September 2004

In recent years a new metallic pigment was brought to the attention of paint formulators, namely stainless steel. The stainless steel pigmented coatings show much greater resistance to abrasion than the other metallic pigmented coatings. This pigment is used as a major pigment as well as a component of any multipigment systems for both protective and decorative coatings. Attempts to optimize the pigment in epoxy‐polyamide medium by a polarization method. Evaluates the protective behaviour of optimized coating on mild steel by mechanical, accelerated and electrochemical methods. Studies the surface morphology of the primer by scanning electron microscopy (SCM). The electrochemical behaviour of the coating showed that the coating gave a very high order of resistance for longer duration in sodium chloride solution and also the metallic solution. Finds that the resistances produced by the polarization method and impedance method are well comparable for metallic powder pigmented coatings on steel structure in chloride solution.
Corrosion control of brass in groundwater by interface and interphase inhibitors
Authors: Karpagavalli R. , Rajeswari S.
Published: September 2004

The inhibiting action of 2‐mercaptobenzothiazole (MBT) and cetyl trimethyl ammonium bromided (CTAB) on the corrosion of brass in groundwater have been studied by open circuit potential and potentiodynamic polarization techniques. The results revealed that the inhibition occurred by blocking the reaction sites on the surface of brass via chemisorption of the inhibitors. The adsorption of both the compounds on brass surface in groundwater is found to obey Langmuir isotherm. The results also indicate that MBT functions predominantly as an anodic inhibitor whereas CTAB and the combination of MBT and CTAB (MBT + CTAB) behave as mixed type inhibitors.
People make the difference
Authors: Pickett Les
Published: September 2004

Conference presentations often implore delegates to take human resource development issues seriously – after all, research has clearly shown that people are the key to business success. Moreover, a clear link between business strategy and people management significantly increases the likelihood of this success. This article presents an integrated performance management model that links the future directions of the enterprise with the strategies and competencies required to be effective today and to prepare for the future.
Enhancing flexible business training: learners and enterprises
Authors: Smith Peter J.
Published: September 2004

Although flexible training is widely supported by enterprises and government, there are considerable challenges in ensuring successful training outcomes. The evidence is that business learners, at a vocational training level, are not typically well‐equipped for the self‐directed learning required by flexible training, nor do they prefer to learn from textually presented learning packages. This paper suggests a number of strategies that may be used to prepare both learners and enterprises for successful outcomes from flexible training.
The big issues – part 1
Authors: Nixon Bruce
Published: September 2004

Globalisation is confronting us with big issues. Most of these have been around for a long time but their effect is more dramatic now. Every day, in the media, some new crisis, mistake or tragedy emerges but, equally, every day there is positive news – we learn more and there is some new step forward. High on the agenda are sustainability – in the environment, at work and in our lives; a fair distribution of prosperity, health and opportunity in the world; and the need for corporate and individual citizenship and one world thinking. The good news is that human consciousness and our thinking about organisations, society, communities, work, leadership and how change takes place are transforming. This, the first half of a two‐part article, seeks to raise awareness of the importance to business of the issues and show that there are huge opportunities for companies and individuals who see them.
Learning styles and mentoring
Authors: Mumford Alan
Published: September 2004

Examines the context for mentoring based on a mentor and learner
looking together at work situations, problems and opportunities. Goes on
to describe thinking through tasks, the learning process, the four
learning styles and how these impact on the mentor/learner relationship,
including the possible permutation of the different styles in a
one‐to‐one association of mentor and learner. Finally, debates the
preferred combination of styles in this relationship.
How managers help with development
Authors: Mumford Alan
Published: September 2004

Identifies three major shifts of opinion about how managers learn
to become effective managers, emphasizing that individual managers are
helped to learn by other people. Defines managerial work and examines
the six helpers in management development. Goes on to discuss the three
requirements for effective help – opportunity, learning process,
and helping relationships.
Developing the top team to meet organizational objectives
Authors: Mumford Alan
Published: September 2004

Little has been written about developing directors and even less
about how to integrate learning on a formal programme with learning
through work itself. Reviews new research on learning from experience
and describes the four approaches which were found to have been used by
directors. Gives examples of programmes built on structured workshops
for directors of two major UK companies; illustrates how working on real
projects within such workshops can be integrated with
“normal” learning from experience. Finally, shows how this
form of development improves organizational performance.
Learning in action
Authors: Mumford Alan
Published: September 2004

Action learning was a comparative latecomer to the lexicon of
management development techniques, gaining widespread acceptance only in
the 1970s thanks to the work of Reg Revans. Reviews what we have since
learned about the process, how it holds up against developments like the
competence approach, and how Revans′ theories can be updated to apply in
the business environment of the 1990s.
The application of Piercy and Morgan’s dimensions of marketing planning
Authors: Harris Lloyd C.
Published: September 2004

Reviews and critically evaluates the practical application of Piercy and Morgan’s model of the dimensions of marketing planning. Appraises and elucidates analytical, behavioural and organizational dimensions of planning. In order to demonstrate the usefulness of the model and clarify the concepts, applies each of the dimensions of planning to a case study organization ‐ Company Q. Presents an adjusted form of the model and puts forward theoretical and practical implications. Develops a managerial agenda, presents application questions and suggests action points.
Mineral bioavailability
Authors: Harvey Linda
Published: September 2004

The article discusses mineral bioavailability and the process of absorption in humans. It explains the necessity for obtaining accurate data from human studies in order to make dietary intake recommendations for specific population groups. The importance of iron, selenium and copper is discussed, together with methods for determining absorption. In particular, the use of stable and radioisotope methodologies is discussed.
Catering for young people in schools
Authors: Blades Mabel
Published: September 2004

This article provides a brief overview of what young people eat. Their likes and dislikes are mentioned together with their eating habits. The role of the Local Authority Caterers’ Association (LACA) in the provision of school meals is discussed as well as the findings of a questionnaire on school meals given to members of LACA.
Nutritional status of Brazilian lactating women
Authors: das Graças Tavares do Carmo Maria , Granhen Tavares Colares Luciléia , Sandre‐Pereira Gilza , de Abreu Soares Eliane
Published: September 2004

Dietary intake and anthropometric measurements (body weight and skinfold thickness) of 42 lactating mothers were monitored for six months postpartum. Dietary questionnaires were also applied. Nutrient consumption was compared with the recommended dietary allowances. The corporal weight decreased gradually over the period. The thigh skinfold was the one that reached statistically significant variation. The mean energy intake was 1,911 kcal/day and 2,144 kcal/day during first and sixth months respectively. The daily most consumed foods, within the respective food groups, were: rice, bread, beans, milk, fish, bananas, oranges, fruit juices and oil. The diets were hyperproteic during the studied period. Dietary inadequacies regarding micronutrients were also observed, especially for folate, Zn and calcium. These results indicate that the Brazilian lactating women of low socioeconomic status are at high risk of energy and nutrient inadequacies. This information may be of great value to improve lactating women’s diets.
Faculty‐librarian collaboration: a Mexican experience
Authors: Lau Jesús
Published: September 2004

Collaboration between librarians and faculty is a relative new trend in Mexican academic libraries. Therefore, experiences are scarce and not yet documented. University professors and librarians normally have the usual relationship of patron‐information provider. Although librarians have assumed the role of user information educators, their work tends to occur in isolation. Teamwork is needed so that library instruction can become part of the learning process. Mexican information professionals probably face more library instruction challenges than their colleagues from the more advanced economies, because new students come to the library with hardly any library experience. In this article, the outstanding user education experience at Juarez University is described and assessed.
Civil War Resources on the Internet: An Annotated Bibliography
Authors: Vincenti William , Sielaff McKinley
Published: September 2004

Historians and those interested in Civil War history will not be disappointed in the large number of Internet sites dealing with ths subject. The vast array of primary and secondary resources related to the Civil War includes the full range from the Abolition movement through Reconstruction (1830s to 1890s). Available materials include the full texts of diaries, letters, government documents of all sorts, maps, images, and even online discussion groups for Civil War topics. Many sites contian the texts of rare materials enabling the present‐day historian to travel virtually to many computerized collections regardless of the distances from his or her computer. The resource list in this article is drawn from Rutgers University’s Web page, Civil War Resources on the Internet: Abolitionism to Reconstruction.
Internet: Let the User Beware
Authors: Hahn Susan E.
Published: September 2004

Every librarian knows undergraduate students rarely evaluate the information they find in a print index, much less what comes from a computer screen. This knowledge is compounded by the undergraduate’s belief that anything coming from the Internet is the gospel truth. Is the Internet being integrated into library instruction, taught as another research tool, or taught as something special? Are students being taught to evaluate Internet resources? In this annotated bibliography, Hahn examines journal articles, book chapters, and Web sites that discuss the evaluation of information found through the Internet.
Educating Students for the Information Age: The Role of the Librarian
Authors: Rader Hannelore B.
Published: September 2004

Most countries are facing major challenges in educating students from kindergarten through the university for productive lives in the information age. Governments and business leaders are challenging educators to provide students with skills to live and work effectively in the information age. Cooperative ventures between teachers and librarians in the area of information literacy may provide a solution to these educational challenges. Changing teaching methodology to prepare students for life‐long learning may be another solution. In this article, Rader defines various concepts. She offers suggestions and guidelines to help teacher‐librarian collaborations effectively educate students for the twenty‐first century.
New Word Sources: A Selective Annotated Bibliography
Authors: Isaacson David
Published: September 2004

Reference questions about recently coined words or phrases or new meanings of old words present library users and librarians with a sometimes bewildering maze of information sources that range in quality from the scholarly to the amateur. In this article, Isaacson discusses some of the lexical issues concerning new words and evaluates new information in 1) unabridged dictionaries, 2) collegiate desk dictionaries, 3) new word dictionaries, 4) a journal devoted to new words, 5) a journal column and a magazine column about new words, 6) dictionaries of words that don’t exist, 7) various specialized dictionaries that may contain new and old words, and 8) Internet resources that may be helpful. All sources have to do with the English language; most were published since 1980 and include new words coined since 1960.
The Bloomberg Financial Markets Information Databases: A Simple Introduction to a Complex Financial System
Authors: Meredith Meri
Published: September 2004

In this article, Meredith discusses a financial service that has been available to stockbrokers and investment institutions and is trying to gain acceptance in the academic world. The information system monitors news around the world 24 hours a day, 365 days a year with expert analysts operating its telephone lines in New York 24 hours a day. Financial analysts can perform analyses on this system that are not available on any other system. Performance, valuation, and comparative analysis can be done on companies, indexes, and industries. It monitors the stock and bond markets.
Library Instruction for the Professions: Information Needs and Libraries
Authors: Hammond Carol , Mitchell Eleanor
Published: September 2004

In this article, Hammond and Mitchell report on a survey of practitioners in four professions: accounting, architecture, psychology, and recreation/tourism. The authors sought data on how professionals looked for information to improve instruction programs, with a goal of providing graduates with information skills to use in their careers. Fewer than half of the survey respondents had discipline‐specific library instruction. Practitioners identify a need for information but a low use of electronic resources. Data support the necessity of information skills for those entering the professions; suggest that instruction be information‐centered rather than library‐centered; and show that continuing education for professionals in information finding is needed. The authors provide suggestions for changes in library instruction.
Remote Host Databases: Issues and Content
Authors: Majka David R.
Published: September 2004

The recent introduction of a new generation of electronic information products is a significant advance in the evolution from paper‐based to electronic research. These products combine indexing and abstracting of large numbers of journals in multiple subject fields with full‐text delivery capability, storage on remote hosts, and access via the World Wide Web. Any library contemplating the purchase of a remote host database must address several issues to insure its successful integration into the library’s repertoire of electronic information products. The analytical process is complicated by these databases’ rapid evolution, by their large and ever‐changing journal lists, and by the differing strategies employed by the major vendors in regard to their products’ structures. In this article, Majka attempts to assist librarians with their purchase decisions by identifying vendor product strategies and library implementation issues and by suggesting analytical approaches for the comparison of the contents of remote host indexes and databases.