Laurel University

Abstract Introduction Burn injuries are a major public health concern, leading to about 500,000 emergency department (ED) visits annually in the U.S. Many smaller facilities without specialized burn care often refer these patients to burn centers. Although the number of burn injuries is on the rise in recent years, they remain relatively rare, resulting in limited experience among providers at non-burn centers. This lack of experience often leads to over-triaging, unnecessary transfers, higher costs, and resource strain. Recent studies have explored the use of telemedicine and photography to improve triage and reduce unnecessary transfers. By sharing patient history and images of burns, referring providers can make more informed decisions about whether to transfer a patient. The purpose of this study was to evaluate the effectiveness of an image-sharing app in increasing the appropriateness of transfers to a burn center. Methods A burn image-sharing app is being piloted at selected referring facilities to facilitate transfers to a regional burn center. To assess its effectiveness, data from the burn center’s burn registry were analyzed. The study compared two referring hospitals—one using the app and one not—chosen for their similar patient and hospital profiles. The data analyzed included consultation times for transfer decisions, total burn surface area (TBSA), length of hospital stay, and patient age group. Institution A does not have access to the app, but Institution B does at this time. Results Forty patients were included, 20 from Institution A (not using the app) and 20 from Institution B (using the app). The average transfer time at Institution A was 37.7 minutes compared to 84.3 minutes (p=0.2000) at Institution B. The average TBSA for Institution A was 6.7% versus 3.5% at Institution B (p=0.1200). Length of stay was similar: 5.25 days at Institution A and 4.26 days at Institution B (p=0.6248). Age group analysis revealed that geriatric patients at Institution A had a higher TBSA (14.1% vs. 4.8%) and longer evaluation times (61.8 vs. 22 minutes), possibly due to the complexity of assessing burns in older patients. Qualitative reviews by burn advanced practice providers indicated that burn image information augmented their transfer decisions but was not always the dominant factor in the decision. Conclusions This study suggests that burn image-sharing apps can improve the efficiency of transfer decisions. The differences noted between the two institutions, while not significant, were likely due to the small N in our preliminary study and suggest the need for additional data. Applicability of Research to Practice This study highlights the potential of telemedicine to enhance burn care and reduce unnecessary transfers. Further data collection is needed to refine the app and assess additional parameters that could streamline the transfer process more effectively. Funding for the Study N/A

Click to increase image sizeClick to decrease image size ACKNOWLEDGMENTSSome of the text is from my article about Johannes Keilmann that appeared in the Mineralogical Record (White 2010 White, J. S. 2010. The heart of the Munich Show: Johannes Keilmann. Mineralogical Record 41 (5): 441–50. [Google Scholar]), and I thank Wendell E. Wilson for granting permission to use it here. William Besse prepared the map.Additional informationNotes on contributorsJohn S. WhiteJohn S. White, a consulting editor of Rocks & Minerals, operates Kustos, a museum/collector consulting business. Now retired, he is the former curator-in-charge of the National Mineral and Gem Collection at the Smithsonian Institution.

Click to increase image sizeClick to decrease image size ACKNOWLEDGMENTSI am debted to Kendal Martyn for sharing with me his great knowledge of these curious objects, as well as his photographs. Also sharing important information and highly valued photographs were Yves Masson, Peter G. Seroka, Mark Mauthner, and Terry Huizing, to whom I am most grateful. George Venable contributed one of the photographs. Drs. Robert Cook and John Rakovan reviewed the text and made helpful suggestions.Additional informationNotes on contributorsJohn S. WhiteJohn S. White, a consulting editor of Rocks & Minerals, operates Kustos, a museum/collector consulting business. Now retired, he is the former curator-in-charge of the National Mineral and Gem collection at the Smithsonian Institution.

The purpose of this paper is to explore the meaning — the metaphysics, in the sense of the ultimate status in being — of human life as it is discerned from a consideration of the human body as expressive. The meaning of body here is that of the lived body as associated mainly with Husserl and Merleau-Ponty, even though a case can be made that Max Scheler was the first to focus on the distinction between the body as an object Korper (thing-body) and the Leib — the body as lived — the body as experienced in the first person (le corps vecu, le corps propre) one’s own body.1

84 majors in elementary education were divided into three groups, one control group and two experimental groups. The control group received no instruction in skill analysis while the experimental groups were instructed via videotape in either the instep kick in soccer or in throwing, catching, and striking skills. All three groups were given a skill-analysis test composed of throwing, catching, and striking skills. Statistical analysis yielded significant effect for those who viewed the throwing, catching, and striking videotape. No effect was found for the control group or the group who viewed the soccer-instep videotape. The results suggest specificity may be as important in skill analysis as in acquisition.