Burn injuries are a pervasive clinical problem. Extensive thermal trauma can be life-threatening or result in long-lasting complications, generating a significant impact on quality of life for patients as well as a cost burden to the healthcare system. The importance of addressing global or systemic issues such as resuscitation and management of inhalation injuries is not disputed but is beyond the scope of this review, which focuses on cutaneous pathophysiologic mechanisms for current treatments, both in the acute and long-term settings. Pathophysiological mechanisms of burn progression and wound healing are mediated by highly complex cascades of cellular and biochemical events, which become dysregulated in slow-healing wounds such as burns. Burns can result in fibroproliferative scarring, skin contractures, or chronic wounds that take weeks or months to heal. Burn injuries are highly individualized owing to wound-specific differences such as burn depth and surface area, in addition to patient-specific factors including genetics, immune competency, and age. Other extrinsic complications such as microbial infection can complicate wound healing, resulting in prolonged inflammation and delayed re-epithelialization. Although mortality is decreasing with advancements in burn care, morbidity from postburn deformities continues to be a challenge. Optimizing specialized acute care and late burn outcome intervention on a patient-by-patient basis is critical for successful management of burn wounds and the associated pathological scar outcome. Understanding the fundamentals of integument physiology and the cellular processes involved in wound healing is essential for designing effective treatment strategies for burn wound care as well as development of future therapies. Published 2018. Compr Physiol 8:371-405, 2018.
The decline of traditional pensions and the rise of individualized retirement accounts such as 401(k)s can be read as a neoliberal program of transferring risk and responsibility for providing retirement income from employers to workers. Subsequent to this shift, American workers are facing a “retirement savings crisis.” While the stagnation of incomes in the United States has certainly contributed to this crisis, I argue that the specific temporality of 401(k) investing also plays a role. Drawing on the work of John Clarke, E. P. Thompson, and Paul Virilio, I argue that the neoliberal temporality of 401(k) investing conditions a new “time-sense” in workers-turned-employee-investors that privileges the present over the future. This present-focused time-sense contradicts the future orientation required for retirement investing.
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