Variability of pressure at the pressure garment-scar interface in children after burn: A pilot longitudinal cohort study

Background

Current consensus for the ideal pressure range at the pressure garment to scar interface is 15–25 mmHg. Interface pressure variability has been reported at new pressure garment fitting in children. Pressure reductions up to 25% have been recorded over one month in adults.

Research on medication use in the neonatal intensive care unit

Introduction: Research on medication use aims at assessing how much of current pharmacotherapy is rational. In neonates, this is hampered by extensive off-label drug use and limited knowledge.

Areas covered: We report on medication use research and have conducted a systematic review of observational studies on medication use to provide an updated overview on characteristics, objectives, methods, and patterns in hospitalized neonates. Moreover, a review on aspects of medication use for opioids, anti-epileptics, gastric acid-related disorders and respiratory stimulants with emphasis on trends and impact of interventions is presented, illustrating how research on medication use can contribute to improved neonatal pharmacotherapy and more focused research. Medication use reports describe patterns and provide signals on irrational use, benchmarking, or can guide research priorities. Moreover, this may generate information on how neonatal health topics and their pharmacotherapy are handled over time or across regions.

Expert opinion: Research on medicine utilization is relevant, since it will inform us on aspects like trends, variability, or about the impact and pattern of implementation of guidelines in neonates. Further progress necessitates to merge datasets on medication use with clinical characteristics, and perinatal drug use remains an area in need of additional research.     

The longitudinal validity,reproducibility and responsiveness of the Brisbane Burn Scar Impact Profile (caregiver report for young children version) for measuring health-related quality of life in children with burn scars

BackgroundThe measurement of health-related quality of life (HRQoL) provides information about the perceived burden of the health condition and treatments from a lived experience. The Brisbane Burn Scar Impact Profile (caregiver report for young children, BBSIP^0–8), developed in 2013, is a proxy-report measure of burn scar-specific HRQoL. The aim of this study was to report its psychometric properties in line with an evaluative purpose.MethodsCaregivers of children up to 8 years of age at risk of burn scarring were recruited into a prospective, longitudinal cohort study. Caregivers completed the BBSIP^0–8, Pediatric Quality of Life Inventory and Patient Observer Scar Assessment Scale at baseline (approximately ≥85% of the total body surface area re-epithelialised), 1–2 weeks after baseline and 1-month after baseline. Psychometric properties measured included internal consistency, test–retest reliability, validity and responsiveness.ResultsEighty-six caregivers of mostly male children (55%), of a median age (IQR) of 1 year, 10 months (2 years, 1 month) and total body surface area burn of 1.5% (3.0%) were recruited. Over one third of participants were grafted and 15% had contractures or skin tightness at baseline. Internal consistency of ten item groups ranged from 0.73 to 0.96. Hypothesised correlations of changes in the BBSIP^0–8 items with changes in criterion measures supported longitudinal validity (ρ ranging from ?0.73 to 0.68). The majority of item groups had acceptable reproducibility (ICC = 0.65–0.83). The responsiveness of five item groups was supported (AUC = 0.71–0.90).ConclusionThe psychometric properties tested support the use of the BBSIP^0–8 as an evaluative measure of burn scar-related health-related quality of life for children aged below eight years in the early post-acute period of rehabilitation. Further investigation at longer time period after burn injury is indicated.     

Reduction of silver complexes: towards an ever more elaborated insight in the influence of the type of ligand on the reaction rate

The present work deals with the investigation of the electrochemical reduction of silver thiosulphate (1,2-Ag(S₂O₃)₂^3?), thiocyanate (1,3-Ag(SCN)₃^2?) and 1,8-dihydroxy-3,6-dithiaoctane (1,2-Ag(DTO)₂⁺) complexes. The influence of the ligand type on the charge transfer rate is explained by the changing positions of the density distributions of electronic energy levels of the three complexes. The basics for this approach are the theories of energy band models (EBMs). An experimental methodology is developed to determine the energy density distributions. A Ti/TiO₂ substrate, obtained by galvanostatically anodising Ti, is put forward as an appropriate substrate for this investigation, and its semiconducting properties are determined. On this substrate, charge transfer (CT) controlled currents can be measured in a sufficiently large potential domain for the three systems. A method of pre-plating is optimised such that the overall semiconducting character of the substrate is kept during the monitoring of the (quasi-)stationary current/voltage diagrams. The active surface areas, necessary for the calculation of the current density/potential curves, are calculated. The positions of the energy density distributions, obtained by the derivation of the current density/voltage diagrams, of the three complexes, show that thiosulphate exhibits the smallest density of accepting energy levels in the given potential domain. For potentials above 0.5 V vs. SCE, the DTO complex has the largest density of vacant energy levels, but for lower potentials the situation is reversed.