Epidemiology of burn patients admitted in the Netherlands:: a nationwide registry study investigating incidence rates and hospital admission from 2014 to 2018

PURPOSE: The aim of this study was to gain insight into the epidemiology of burn patients admitted to a hospital without a burn center or referred to a burn center. METHODS: This retrospective, nationwide, cohort study included patients with burns or inhalation trauma, admitted between 2014 and 2018, from a national trauma registry. The primary outcome measure was admission to a hospital with or without a burn center. Secondary outcome measures were patient and injury characteristics, Intensive Care Unit (ICU) admission and length of stay, and hospital length of stay (HLOS). RESULTS: Of the 5524 included patients, 2787 (50.4%) were treated at a non-burn center, 1745 (31.6%) were subsequently transferred to a burn center, and 992 (18.0%) were primarily presented and treated at a burn center. The annual number of patients decreased from 1199 to 1055 (− 12.4%). At all admission locations, a clear incidence peak was observed in children ≤ 4 years and in patients of ≥ 80 years. The number of ICU admissions for the entire population increased from 201 to 233 (33.0%). The mean HLOS for the entire population was 8 (SD 14) days per patient. This number remained stable over the years in all groups. CONCLUSION: Half of all burn patients were admitted in a non-burn center and the other half in a burn center. The number and incidence rate of patients admitted with burns or inhalation trauma decreased over time. An increased incidence rate was found in children and elderly. The number of patients admitted to the ICU increased, whereas mean hospital length of stay remained stable. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00068-021-01777-y

Elements of care that matter:Perspectives of families with multiple problems

The severe and often persistent problems of families with multiple problems (FMP) call for better understanding of how interventions can improve outcomes in these families. Perspectives of FMP on the crucial elements of interventions may strongly support improvement by providing cues on how to realize positive change. We therefore explored the views of parents and children in FMP regarding helpful and less helpful elements of various interventions. We interviewed 24 parents and 4 children about their perspectives, using a semi-structured interview guide comprising themes that were chosen by the target group. Participants reported 11 elements that contribute to the effectiveness of care, categorized under three main themes: the characteristics of the practitioner, the content of interventions, and the structure of interventions. The perspectives of FMP show the following activities to be promising: routine reflection on the non-judgmental and positive approach of practitioners, more direct focus on children, focus on the underlying cause of behavior, activation of families’ social network, the school and other professionals around the family, and creation of more possibilities for long-term and flexible support. Perspectives of FMP on the content and provision of care should be better embedded in interventions. This may help to tailor interventions to their wishes and needs, which in turn can contribute to more positive outcomes of care

Can we predict the clinical outcome of arthroscopic partial meniscectomy? A systematic review

NHS-Prospero registration number 42016048592 Objective In order to make a more evidence-based selection of patients who would benefit the most from arthroscopic partial meniscectomy (APM), knowledge of prognostic factors is essential. We conducted a systematic review of predictors for the clinical outcome following APM. Design Systematic review Data sources Medline, Embase, Cochrane Central Register, Web of Science, SPORTDiscus, PubMed Publisher, Google Scholar Inclusion criteria Report an association between factor(s) and clinical outcome; validated questionnaire; follow-up >1 year. Exclusion criteria 1 year) are associated with worse clinical outcome following APM. In addition, resecting >50% of meniscal tissue and leaving a non-intact meniscal rim after meniscectomy are intra-articular predictive factors for worse clinical outcome. Moderate evidence was found that sex, onset of symptoms (acute or chronic), tear type or preoperative sport level are not predictors for clinical outcome. Conflicting evidence was found for the prognostic value of age, perioperative chondral damage, body mass index and leg alignment. Summary/conclusion Long duration of symptoms (>1 year), radiological knee osteoarthritis and resecting >50% of meniscus are associated with a worse clinical outcome following APM. These prognostic factors should be considered in clinical decision making for patients with meniscal tears

Using delta channel width to estimate paleodischarge in the rock record: geometric scaling and practical sampling criteria

Quantifying paleodischarge from geological field observations remains a key research challenge. Several scaling relationships between paleodischarge and channel morphology (width; depth) have been developed for rivers and river deltas. Previous paleodischarge scaling relationships were based on discharge-catchment area scaling and an empirical flow velocity estimate (e.g. Chézy, Manning formulae) multiplied by channel cross-sectional area to derive discharge. In deltas, where marine (wave, tide) energy causes bidirectional flow within distributary channels, the available paleodischarge scaling relationships are not applicable due to their unidirectional flow assumption. Here, the spatial variability of distributary channel widths from a database of 114 global modern river deltas is assessed to understand the limit of marine influence on distributary channel widths. Using 6213 distributary channel width measurements, the median channel widths of distributary channels for each delta were correlated with bankfull discharge for river-, tide- and wave-dominated deltas, the latter two including the effect of bidirectional flow. Statistically significant width-discharge scaling relationships are derived for river- and wave-dominated deltas, with no significant relationships identified for tide-dominated deltas. By reverse bootstrapping the channel widths measured from modern deltas, the minimum number of width measurements needed to apply width-discharge scaling relationships to ancient deltaic deposits is estimated as 3 and 4 for the upstream parts of river- and wave-dominated deltas, respectively, increasing to 30 in the downstream parts of river-dominated deltas. These estimates will guide sedimentological studies that often have limited numbers of distributary channel widths exposed in the rock record. To test the reliability of these alternative width-discharge scaling relationships in the rock record, paleodischarges were estimated for the well-studied Cretaceous lower Mesa Rica Sandstone Formation, USA . Comparison of these results with the more complex Chézy-derived method suggests that these new scaling relationships are accurate. Hence, it is proposed that the scaling relationships obtained from modern deltas can be applied to the rock record, requiring fewer, and easier to measure, data inputs than previously published methods

Adsorption and two-body recombination of atomic hydrogen on 3^3He-4^4He mixture films

We present the first systematic measurement of the binding energy $E_a$ of hydrogen atoms to the surface of saturated $^3$He-$^4$He mixture films. $E_a$ is found to decrease almost linearly from 1.14(1) K down to 0.39(1) K, when the population of the ground surface state of $^3$He grows from zero to $6\times10^{14}$ cm$^{-2}$, yielding the value $1.2(1)\times 10^{-15}$ K cm$^2$ for the mean-field parameter of H-$^3$He interaction in 2D. The experiments were carried out with overall $^3$He concentrations ranging from 0.1 ppm to 5 % as well as with commercial and isotopically purified $^4$He at temperatures 70...400 mK. Measuring by ESR the rate constants $K_{aa}$ and $K_{ab}$ for second-order recombination of hydrogen atoms in hyperfine states $a$ and $b$ we find the ratio $K_{ab}/K_{aa}$ to be independent of the $^3$He content and to grow with temperature.Comment: 4 pages, 4 figures, all zipped in a sigle file. Submitted to Phys. Rev. Let

Content and Quality of Motor Initiatives in the Support of People With Profound Intellectual and Multiple Disabilities

Motor activation is rarely integrated into the support of people with profound intellectual and multiple disabilities (PIMD), which might be the result of the limited evidence‐based knowledge in this field. Practitioners have recently been developing several motor initiatives for people with PIMD, but it remains unclear about what core elements the motor initiatives actually consist of and to what level of quality it is implemented in practice. This study aims to offer an overview and analysis of the content and quality of motor initiatives actually in use for people with PIMD. Motor initiatives were explored by asking practitioners to complete an online inventory form. Documents, expert knowledge, and observations were used to collect data about the characteristics of the motor initiatives. The quality of the motor initiatives which met our eligibility criteria, was analyzed on the basis of the level of evidence for their effectiveness. The inventory yielded 118 motor initiatives of which 17 met the eligibility criteria. We identified four motor initiatives reflecting an approach to motorically activate people with PIMD within various activities, three including power‐assisted exercises, three with aquatic exercises, two frameworks which integrated motor activities into their daily programs, two methods which included small‐scale activities, two rhythmic movement therapies, and one program including gross motor activities. We found limited indications for descriptive evidence from 17 initiatives, limited or no indications for theoretical evidence from 12 and five initiatives respectively, and none of the initiatives provided a causal level of evidence for effectiveness. A wide variety of motor initiatives is used in current practice to activate persons with PIMD, although their effectiveness is actually unproven. Science and practice should cooperate to develop an evidence‐based understanding to ensure more evidence‐based support for the motor activation of people with PIMD in the future

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