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Notes: Often chronic wounds have an increased bacterial burden that can impair healing without the classical clinical signs of infection. Silver dressings may provide an alternative topical method to control bacterial burden.The primary aim of this study was to evaluate the effect of 2–4 weeks therapy with the Silver Containing Hydrofiber® dressing on quantitative bacterial burden and clinical improvement in chronic wounds not healing at the expected rate.This was a single centre, four-armed study which included a total of 30 patients with diabetic foot ulcers, leg ulcers, pressure ulcers and miscellaneous wounds that did not fit into any of the above categories. Patients had a baseline quantitative bacterial biopsy and this was repeated at weeks 2 to 4. The wound size was recorded along with a semi quantitative estimate of exudate and the periwound temperatures. Repeat measurements were performed at the follow-up visits and the decrease in wound size calculated. The underlying cause of the ulceration was be treated and corrected. This was followed by application of silver containing hydrofiber® dressing. There was a significant delay in healing of the leg ulcers associated with increased bacterial burden in the quantitative biopsy bacterial burden results at week 0 and healing at week 2. (p = 0.01). Other subgroups had a similar association that did not reach statistical significance. The presence of an increased exudate in the leg ulcers at week two was associated with delayed healing at week 4 (p = 0.05). There was also a significant increase in skin surface temperature of the surrounding skin with an increased quantitative bacterial biopsy of the deep wound compartment for venous, diabetic neurotrophic foot ulcers and pressure ulcers with p values of 0.05, 0.01 and 0.01 respectively. There was no significant decrease in exudate or increased healing of the wounds with the application of the silver hydrofiber dressing in this difficult to heal population. The population studied in this case series had increased bacterial burden in the deep compartment as measured with increased exudate and or an increased temperature of the periwound skin. These patients have an increased bacterial burden in the deep wound compartment that does not respond to topical ionized silver in the dressing studied.

Notes: Abstract The purpose of this study was to test the hypothesis that in the context of a large health science center heavily committed to scientific activity, there would be a positive relationship between the scientific productivity of faculty members and their effectiveness as teachers. Counts of citations by others and counts of publications were used as indices of scientific productivity. The index of teaching effectiveness was derived from students' perceptions of teaching effectiveness, elicited in a questionnaire that asked students to rate teachers in terms of the presence or absence of a series of behaviors grouped under five headings called the Components of Effective Teaching. The results of this study provide support to the notion that research and teaching are not separate and adversary phenomena each working to the disadvantage of the other, but under certain conditions are interrelated with research activity supportive of effective teaching.