Improved and standardized method for assessing years lived with disability after burns and its application to estimate the non-fatal burden of disease of burn injuries in Australia, New Zealand and the Netherlands

Background: Burden of disease estimates are an important resource in public health. Currently, robust estimates are not available for the burn population. Our objectives are to adapt a refined methodology (INTEGRIS method) to burns and to apply this new INTEGRIS-burns method to estimate, and compare, the burden of disease of burn injuries in Australia, New Zealand and the Netherlands. Methods: Existing European and Western-Australian health-related quality of life (HRQL) datasets were combined to derive disability weights for three homogenous burn injury groups based on percentage total body surface area (%TBSA) burned. Subsequently, incidence data from Australia, New Zealand, and the Netherlands from 2010 to 2017 were used to compute annual non-fatal burden of disease estimates for each of these three countries. Non-fatal burden of disease was measured by years lived with disability (YLD). Results: The combined dataset included 7159 HRQL (EQ-5D-3 L) outcomes from 3401 patients. Disability weights ranged from 0.046 (subgroup  24 months post-burn) to 0.497 (subgroup > 20% TBSA burned 0–1 months post-burn). In 2017 the non-fatal burden of disease of burns for the three countries (YLDs/100,000 inhabitants) was 281 for Australia, 279 for New Zealand and 133 for the Netherlands. Conclusions: This project established a method for more precise estimates of the YLDs of burns, as it is the only method adapted to the nature of burn injuries and their recovery. Compared to previous used methods, the INTEGRIS-burns method includes improved disability weights based on severity categorization of burn patients; a better substantiated proportion of patients with lifelong disability based; and, the application of burn specific recovery timeframes. Information derived from the adapted method can be used as input for health decision making at both the national and international level. Future studies should investigate whether the application is valid in low- and middle- income countries

Определение оператора поворота вектора в квадриплексном пространстве

Рассмотрен один метод определения оператора поворота вектора в квадриплексном пространстве до совмещения с направлением, заданным другим вектором. Метод базируется на изоморфизме квадриплексных и бикомплексных чисел.Розглянуто один метод визначення оператора повороту вектора в квадриплексному просторі до суміщення з напрямком, який задано іншим вектором. Метод базується на ізоморфізмові квадриплексних та бікомплексних чисел.A method of determination of an operator of vector rotational displacement in quadruplex space before overlapping with a direction given by other vectors is considered. The method is founded on the isomorphism of quadruplex and bicomplex numbers

Improved and standardized method for assessing years lived with disability after burns and its application to estimate the non-fatal burden of disease of burn injuries in Australia, New Zealand and the Netherlands

Background: Burden of disease estimates are an important resource in public health. Currently, robust estimates are not available for the burn population. Our objectives are to adapt a refined methodology (INTEGRIS method) to burns and to apply this new INTEGRIS-burns method to estimate, and compare, the burden of disease of burn injuries in Australia, New Zealand and the Netherlands. Methods: Existing European and Western-Australian health-related quality of life (HRQL) datasets were combined to derive disability weights for three homogenous burn injury groups based on percentage total body surface area (%TBSA) burned. Subsequently, incidence data from Australia, New Zealand, and the Netherlands from 2010 to 2017 were used to compute annual non-fatal burden of disease estimates for each of these three countries. Non-fatal burden of disease was measured by years lived w

Feasibility of Mindfulness for Burn Survivors and Parents of Children with Burns

Burn survivors, spouses, and parents of children with burns may experience psychological distress for a prolonged period. Mindfulness-Based Stress Reduction (MBSR) is an intervention that can improve psychological well-being. This study aimed to examine the effectiveness of an MBSR group intervention in a convenience sample. An MBSR group intervention was conducted for burn survivors (n = 8) and parents of children with burns (n = 9), each comprising eight sessions. The participants completed the Beck Depression Inventory-II-NL, PTSS Checklist DSM-5, Five Facet Mindfulness Questionnaire-Short Form, Self-Compassion Scale-Short form, and evaluation questions at baseline, immediately after, and three months post-intervention. All participants completed the intervention. The intervention was rated very useful (M = 8.8), and the participants were very satisfied (M = 8.8). The highest effect was observed in the parents’ group on mindfulness skills and self-compassion. For both groups, there was an increase in personal goal scores immediately after the intervention. Qualitative data show that the participants in both groups experienced more inner peace, more awareness of thoughts and emotions, and more self-compassion. This exploratory study suggests that a mindfulness intervention is feasible and can be effective in improving mindfulness skills and self-compassion, particularly in parents of children with burns

Aspects of Clinical Utility of the Distress Thermometer and Problem List after Burns

Burn survivors may benefit from screening for a broad area of problems to improve communication and inform referral needs. Therefore, the aim of this study was to investigate clinical utility aspects such as appropriateness and acceptability to clinicians and completers of an existing, frequently used screening instrument in oncological populations, the Distress Thermometer and Problem List (DT and PL). Methods: Paediatric and adult patients visiting the outpatient clinic after admission to the burn centre were invited to complete the instrument. The DT and (problem domains of) the PL were related and compared to the need to discuss the reported problems. Results: A total of 160 patients were invited to complete the DT and PL, of which 139 agreed. The study shows evidence for appropriateness and high acceptability to clinicians and completers, although the effectiveness of the PL may be lower compared to the DT and needs adaptation to better meet the burn survivors’ situation. Discussion: The use of a screening instrument in the outpatient clinic environment has shown to be appropriate and acceptable and informs clinical practice to identify supportive needs in patients with burns. However, the PL needs to be adapted to the situation of the burn survivors

Posttraumatic Stress Symptoms after Exposure to Two Fire Disasters : Comparative Study

This study investigated traumatic stress symptoms in severely burned survivors of two fire disasters and two comparison groups of patients with "non-disaster" burn injuries, as well as risk factors associated with acute and chronic stress symptoms. Patients were admitted to one out of eight burn centers in the Netherlands or Belgium. The Impact of Event Scale (IES) was administered to 61 and 33 survivors respectively of two fire disasters and 54 and 57 patients with "nondisaster" burn etiologies at 2 weeks, 3, 6, 12 and 24 months after the event. We used latent growth modeling (LGM) analyses to investigate the stress trajectories and predictors in the two disaster and two comparison groups. The results showed that initial traumatic stress reactions in disaster survivors with severe burns are more intense and prolonged during several months relative to survivors of "non-disaster" burn injuries. Excluding the industrial fire group, all participants' symptoms on average decreased over the two year period. Burn severity, peritraumatic anxiety and dissociation predicted the long-term negative outcomes only in the industrial fire group. In conclusion, fire disaster survivors appear to experience higher levels of traumatic stress symptoms on the short term, but the long-term outcome appears dependent on factors different from the first response. Likely, the younger age, and several beneficial post-disaster factors such as psychosocial aftercare and social support, along with swift judicial procedures, contributed to the positive outcome in one disaster cohort