Sepsis and multi-organ failure are the most frequently reported causes of death in burn injuries. Their early identification allows therapies and resources to be targeted in a more effective and efficient way. Due to its frequent antibiotic drug resistance Acinetobacter baumannii (MRAB) is increasingly causing a problem in burns units. New strategies need to be found to combat infection and sepsis in the burn ICU. This study examines the potential of the Albumin Creatinine Ratio, a marker of systemic endothelial dysfunction in predicting outcomes, sepsis and multi-organ failure; the role of Acinetobacter in causing organ failure; and explores for the presence of the cathelicidin, LL-37 in the burn wound and examines it potential utility for treating infection and sepsis. It was found that ACR on admission and at 48 hours is predictive of patient outcomes and the development of sepsis, and may be of use predicting multi-organ failure. Multi-organ failure occurs more frequently in MRAB patients compared to those patients with drug sensitive Acinetobacter baumannii. The number of agency nursing staff and work intensity are possible contributing factors in MRAB acquisition. LL-37 has been found in both acute burn wounds as well as in the grafted healing burn wound and is active against drug resistant Acinetobacter baumannii. ACR can therefore identify those patients at risk of sepsis and may have a role in predicting multi-organ failure. MRAB acquisition in the burns intensive care unit is a significant cause for concern as patients are more likely to suffer from multi-organ failure as well as prolonging their hospital stay and resulting in poorer outcomes. LL-37 has many functions and importantly plays a role in the body’s innate immune system. In the era of increasing antibiotic resistance it may provide a novel therapeutic role in treating MRAB infection.

Burn injury impacts the lives of over 1.1 million people within the United States annually (Centers for Disease Control & Prevention, 2011). Taking into account current advancements in burn trauma care, approximately 95 percent of those hospitalized will survive their injuries. With increased survival rates, greater attention is being focused on the psycho-social aspect of burn treatment and rehabilitation. There is an opportunity for health educators to affect the long-term wellness outcomes of adult burn survivors and to support their growth beyond survival status. This may not constitute recovery to their preinjury lives, but rather recovery to lives closer to optimal health/wellness as opposed to mere acceptance of their current situation. Utilizing a phenomenological qualitative design, this study explored the burn-related experiences and underlying factors of resilience among burn survivors living in the Midwestern United States. After conducting single, semi-structured interviews focused on eight burn survivors' dimensions of health, the themes that emerged through data analysis were "How it Feels," "Somehow I'm Still Me," and "Yet, I'm Better." The findings of this study support the presence of innate resilient protective factors within participants' journey toward recovery and health. Through the experiences of the participants within this study, there is an opportunity for health educators to increase their understanding of the experiences of burn trauma and the impact of resilience on positive recovery outcomes.

Magister Scientiae (Physiotherapy) - MSc(Physio) / Millions of patients with burns require medical attention each year. Impairments, disabilities and handicap due to burn injuries among children are increasing. One possible reason could be that burn injury prevention were not given as much attention as infectious diseases such as leprosy, and tuberculosis (TB). The purpose of the study was to compile a profile of burn injuries among children aged 0-12 years, who were treated at the Black Lion Hospital (BLH) between 1996 and 2001 in Ethiopia. A retrospective, quantitative study design was chosen. Data was collected from the hospital records of 250 children seen with burn injuries. Clinical data, such as the cause and severity of the burn, and socio-demographic data such as the age of the child and his or her caregivers, their socio-economic status and educational levels, were captured. Descriptive and inferential statistical analyses of the data were carried out between socio-demographic variables and the burn injuries. The Chi-squared statistical test was used to identify associations and differences between selected variables. The major causes of thermal burns were hot liquids (63.4%) and flames (36.6%). The highest prevalence of burn injuries occurred in those children in the care of illiterate caregivers (p<0.01). The highest risk environment for burn accidents was identified as the kitchen (p<0.05). Most of the burns (64%) occurred in the children below the age of five years old. This finding was not statistically significant but it is of great clinical importance. Health and safety promotion programmes aimed at carers to minimize the risk of childhood disabilities due to burn injuries are recommended. Caregivers and school children have to be taught to use simple fire prevention procedures to avoid thermal burn injuries. Although the results of this study cannot be generalized, it provides a glimpse of the burn status and causes of thermal burn at BLH. However, in order to get more comprehensive information it is important to obtain information from more hospitals in the country through prospective studies.

<p>Accurate assessment of burn injuries is critical for the correct management of such wounds. Depending on the total body surface area affected by the burn, and the severity of the injury, the optimal treatment and the surgical requirements are selected. However, such assessment is considered a clinical challenge. In this thesis, to address this challenge, an automatic framework to segment the burn using RGB images, and classify the injury based on the severity using ultrasound images is proposed and implemented. With the use this framework, the conventional assessment approach, which relies exclusively on a physical and visual examination of the injury performed by medical practitioners, could be complemented and supported, yielding accurate results. The ultrasound data enables the assessment of internal structures of the body, which can provide complementary and useful information. It is a noninvasive imaging modality that provides access to internal body structures that are not visible during the typical physical examination of the burn. The semantic segmentation module of the proposed approach was evaluated through one experiment. Similarly, the classification module was evaluated through two experiments. The second experiment assessed the effects of incorporating texture features as extra features for the classification task. Experimental results and evaluation metrics demonstrated the satisfactory results obtained with the proposed framework for the segmentation and classification problem. Therefore, this work acts as a first step towards the creation of a Computer-Aided Diagnosis and Detection system for burn injury assessment.</p>