Journalism : a new dimension

Raymond M. Solomon, memorial lecture.Journalism Week, May 8, 1964. Journalism Series, 160

Efficacy of acupuncture in treating scars following tissue trauma

Introduction: Anecdotally, acupuncture is used in the treatment of scar tissue in order to improve scar quality and reduce symptoms of pain and pruritus. Unlike conditions such as lower back pain, knee osteoarthritis and migraines, there are no systematic reviews to confirm treatment efficacy. This systematic literature review aims to assess the current level of evidence for the use of acupuncture for treating abnormal scars such as hypertrophic or other symptomatic scars. Methods: A comprehensive database search was performed followed by reviewing reference lists, grey literature databases and Google Scholar. Study quality was assessed using the Oregon CONSORT STRICTA instrument (OCSI) for clinical trials and the Joanna Briggs Institute (JBI) checklist for case reports. Results:The search strategy discovered five case studies, one retrospective cohort study, one cohort study and three clinical trials that investigated the use of acupuncture for scars. Studies rated as low to moderate quality (26–50%) on the OCSI checklist due to lack of detailed reporting, use of non-validated outcome measures and heterogeneity of participant cohorts. Three case studies rated as moderate quality (5–6/8) and two as low quality (\u3c2/8) on the JBI checklist. Discussion: All studies reported positive outcomes for the use of acupuncture for scar symptoms; however, treatment frequency, duration, number of treatments and points used varied between studies. Conclusion: Acupuncture for the treatment of abnormal scars has a low level of evidence thus requiring further well-designed, controlled trials to be performed. Recommended treatment protocols for future studies have been provided

Grip and muscle strength dynamometry in acute burn injury: Evaluation of an updated assessment protocol

External stabilization is reported to improve reliability of hand held dynamometry, yet this has not been tested in burns. We aimed to assess the reliability of dynamometry using an external system of stabilization in people with moderate burn injury and explore construct validity of strength assessment using dynamometry. Participants were assessed on muscle and grip strength three times on each side. Assessment occurred three times per week for up to four weeks. Within session reliability was assessed using intraclass correlations calculated for within session data grouped prior to surgery, immediately after surgery and in the sub-acute phase of injury. Minimum detectable differences were also calculated. In the same timeframe categories, construct validity was explored using regression analysis incorporating burn severity and demographic characteristics. Thirty-eight participants with total burn surface area 5 – 40% were recruited. Reliability was determined to be clinically applicable for the assessment method (intraclass correlation coefficient \u3e0.75) at all phases after injury. Muscle strength was associated with sex and burn location during injury and wound healing. Burn size in the immediate period after surgery and age in the sub-acute phase of injury were also associated with muscle strength assessment results. Hand held dynamometry is a reliable assessment tool for evaluating within session muscle strength in the acute and sub-acute phase of injury in burns up to 40% total burn surface area. External stabilization may assist to eliminate reliability issues related to patient and assessor strength

Increased burn healing time is associated with higher Vancouver Scar Scale score

Increased burn wound healing time has been shown to influence abnormal scarring. This study hypothesized that scar severity increases commensurate to the increase in time to healing (TTH) of the wound. Wound healing and scar data from burn patients treated by the Burn Service of Western Australia at Royal Perth Hospital were examined. The relationship between TTH and scar severity, as assessed by the modified Vancouver Scar Scale (mVSS), was modelled using regression analysis. Interaction terms evaluated the effect of surgery and total body surface area – burn (TBSA) on the main relationship. Maximum likelihood estimation was used to account for potential bias from missing independent variable data. The sample had a median age of 34 years, TTH of 24 days, TBSA of 3% and length of stay of five days, 70% were men and 71% had burn surgery. For each additional day of TTH, the mVSS score increased by 0.11 points (P ⩽ 0.001) per day in the first 21 days and 0.02 points per day thereafter (P = 0.004). The relationship remained stable in spite of TBSA or surgical intervention. Investigation of the effect of missing data revealed the primary model underestimated the strength of the association. An increase in TTH within 21 days of injury is associated with an increase in mVSS or reduced scar quality. The results confirm that efforts should be directed toward healing burn wounds as early as possible

The Effect of Various Chelates and Chelated Cations on the Availability of Phosphorus to Tomato Plants

Shortly after the discovery of the usefulness of chelating compounds by agriculturists, whereby metallic cations are supplied in available form to plants, another use was proposed. This paper is dedicated to this resulting use, namely, that certain chelates appear to have value in keeping phosphate compounds from becoming “fixed” or “tied-up” in the soil

Low-temperature heat capacities and thermodynamic properties of zinc ferrites--II : Effect of thermal history and metallic additives

The heat capacities of annealed and quenched samples of Li0.005Zn0.90Fe2.05O4, and of quenched ZnFe2O4 have been determined over the range 5-350[delta]K. Addition of lithium to zinc ferrite lowers the temperature of the co-operative thermal anomaly associated with antiferromagnetic ordering transition in accord with theory, and quenching of either material results in nearly complete disappearance of the [lambda]-anomaly but modifies the pronounced high-temperature tail less significantly. The effects on the thermal properties are interpreted in terms of sublattice populations.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32485/1/0000571.pd

Low temperature heat capacity and thermodynamic properties of zinc ferrite

The heat capacity of zinc ferrite (ZnFe2O4) has been determined over the range 5 to 350[deg]K. Molal values of Cp,S0, and H0-H00 computed from the thermal data are 32.99+/-0.03 cal/deg., 36[middle dot]01 +/-0[middle dot]03 cal/deg., and 18[middle dot]00+/-0[middle dot]02 cal, respectively, at 298.15[deg]K. A co-operative thermal anomaly associated with antiferromagnetic ordering occurs at 9.5[deg] and extends toward higher temperatures probably as a consequence of persisting short range order.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32505/1/0000595.pd

Increased risk of blood transfusion in patients with diabetes mellitus sustaining non-major burn injury

Background: Due to the increased mortality and morbidity associated with blood transfusion, identifying modifiable predictors of transfusion are vital to prevent or minimise blood use. We hypothesised that burn patients with diabetes mellitus were more likely to be prescribed a transfusion. These patients tend to have increased age, number of comorbidities, infection risk and need for surgery which are all factors reported previously to be associated with blood use. Objective: To determine whether patients with diabetes mellitus who have sustained a burn ≤20% total body surface area (TBSA) are at higher risk of receiving red blood cell transfusion compared to those without diabetes mellitus. Method: This was a retrospective cohort study including patients admitted to the major Burns Unit in Western Australia for management of a burn injury. Only the first hospital admission between May 2008 to February 2017 were included. Results: Among 2,101 patients with burn injuries ≤20% TBSA, 48 (2.3%) received packed red blood cells and 169 (8.0%) had diabetes. There were 13 (7.7%) diabetic patients that were transfused versus 35 (1.8%) non-diabetic patients. Patients with diabetes were 5.2 (p=0.034) times more likely to receive packed red blood cells after adjusting for percentage TBSA, haemoglobin at admission or prior to transfusion, number of surgeries, total comorbid burden and incidence of infection. As percentage TBSA increases, the probability of packed red blood cell transfusion increases at a higher rate in DM patients. Conclusions: This study showed that diabetic patients with burn injuries ≤20% TBSA have a higher probability of receiving packed red blood cell transfusion compared to patients without diabetes. This effect was compounded in burns with higher percentage TBSA

Resistance training for rehabilitation after burn injury: A systematic literature review and meta-analysis

Background/aim: Resistance training is beneficial for rehabilitation in many clinical conditions, though this has not been systematically reviewed in burns. The objective was to determine the effectiveness of resistance training on muscle strength, lean mass, function, quality of life and pain, in children and adults after burn injury. Methods: Medline & EMBASE, PubMed, CINAHL and CENTRAL were searched from inception to October 2016. Studies were identified that implemented resistance training in rehabilitation. Data were combined and included in meta-analyses for muscle strength and lean mass. Otherwise, narrative analysis was completed. The quality of evidence for each outcome was summarised and rated using the GRADE framework. Results: Eleven studies matched our inclusion criteria. Primary analysis did not demonstrate significant improvements for increasing muscle strength (SMD 0.74, 95% CI _0.02 to 1.50, p=0.06). Sensitivity analysis to correct an apparent anomaly in published data suggested a positive effect (SMD 0.37, 95% CI 0.08–0.65, p=0.01). Psychological quality of life demonstrated benefit from training (MD=25.3, 95% CI 3.94–49.7). All studies were rated as having high risk of bias. The quality of the evidence was rated as low or very low. Conclusion: Further research with robust methodology is recommended to assess the potential benefit suggested in this review