Burns : journal of the International Society for Burn Injuries
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Burns and their associated wound care procedures evoke significant stress and anxiety, particularly for children. Little is known about the body's physiological stress reactions throughout the stages of re-epithelialization following an acute burn injury. Previously, serum and urinary cortisol have been used to measure stress in burn patients, however these measures are not suitable for a pediatric burn outpatient setting. ⋯ Factors which support the use of sAA over salivary cortisol to assess stress during morning acute burn wound care procedures include; sensitivity, morning clinic times relative to cortisol's diurnal peaks, and relative cost.
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About 90% of the global burden of burns occurs in the low and middle income countries. In Africa it is estimated that between 17,000 and 30,000 children under five die each year due to burns. In Tanzania there are no specialized burn centers. Burn patients are often managed in the general surgical wards in most hospitals. Kilimanjaro Christian Medical Centre is one of the four tertiary referral hospitals in Tanzania. ⋯ Children under five are the worst affected by burns. Most patients had second degree burn wounds. Inappropriate management of the burn wound started just after injury and continued even in hospital. Mortality and complication rates are high.
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A growing awareness of psychological and functional impairment due to burns have led to the development of specific instruments to evaluate Quality of Life in this population, such as the Burn Specific Health Scale - Brief (BSHS-B), whose psychometric properties have been consistently verified. The aim of this study was to translate the BSHS-B into Italian and to investigate its reliability and validity. ⋯ The Italian translation of BSHS-B has shown satisfactory internal consistency, criterion validity, and convergent validity, supporting its application in routine clinical practice as well as in international studies.
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Comparative Study
Differences between intentional and non-intentional burns in India: Implications for prevention.
Non-intentional and deliberate burns in India and other developing countries present particular challenges of prevention and treatment. This exploratory study sought improved understanding of burns in order to inform treatment and prevention. ⋯ Analysis indicated that: (1) the conditions that facilitate intentional and non-intentional burns are similar, but intentional burns involve additional contributory factors; (2) a high proportion of patients subjected to burns are young women in domestic situations; and (3) a higher proportion of their TBSA was burned, with consequent higher mortality than for men. It was concluded that: (1) Haddon's matrix and the situational crime prevention framework of criminology assist in understanding the etiology of intentional burns and in identifying preventive measures; (2) social service and criminal justice agencies have important roles in dealing with victims of intentional burns during and after treatment; (3) full account should be taken of gender-related physical, psychological and family factors in planning treatment; and (4) maintaining careful records of burns cases is vital for estimating the prevalence and incidence of intentional injuries.
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Burn care and research have significantly improved over the past years. However, insurance coverage of such treatments does not reflect the improvements in this multi-disciplinary field. ⋯ Using case studies from both countries, we have analyzed both the institutional and policy approach to pediatric burn treatment coverage. Subsequently, by presenting the Shriners burn care model, we offer a policy recommendation to both the Swiss and the American governments to better their present legislation and infrastructure on pediatric burn coverage.