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      Implementation of the World Health Organization Global Burn Registry: Lessons Learned

      research-article
      , BSc, MSc 1 , 2 , , MD, MPH 3 , , MD, PhD 4 , 5 , 6 , , BA(Hons), PhD, CPsychol, AFBPsS, FHEA 1 , 7 , , MBChB, FRCS (Ed), FRCS (Plast, DA (UK), DTM&H 1 , 7
      Annals of Global Health
      Ubiquity Press

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          Abstract

          Burn injuries are a major cause of death and disability globally; however, the true epidemiologic burden is underestimated given the limited and fragmented availability of high-quality burn injury data from many regions. To address this gap, the World Health Organization (WHO) Global Burn Registry (GBR)—a minimum dataset aligned with a centralized registry—was officially launched in 2018 to facilitate hospital-level collection of key prevention, care, and outcome data from burn-injured patients around the world in a standardized manner. However, uptake and use of GBR has been low and inconsistent. Therefore, we aimed to identify and understand the barriers and facilitators to the implementation of the GBR to inform the development of a web-based GBR implementation guide through the Centre for Global Burn Injury Policy and Research and Interburns. We designed and conducted web-based surveys with “GBR users” and “GBR non-users” using purposive sampling. Themes of identified barriers and facilitators focused on awareness of the GBR, stakeholder buy-in, resource constraints, process management, and utility of the registry. The lessons learned could support current and future GBR users to promote and maximize the use of the GBR. To achieve the GBR’s full potential in global burn injury prevention and care, engagement with the GBR should be enhanced through education and promotion, development of a community of practice, tools for data utilization and quality improvement, and periodic re-evaluation.

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          Most cited references16

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          The qualitative content analysis process.

          This paper is a description of inductive and deductive content analysis. Content analysis is a method that may be used with either qualitative or quantitative data and in an inductive or deductive way. Qualitative content analysis is commonly used in nursing studies but little has been published on the analysis process and many research books generally only provide a short description of this method. When using content analysis, the aim was to build a model to describe the phenomenon in a conceptual form. Both inductive and deductive analysis processes are represented as three main phases: preparation, organizing and reporting. The preparation phase is similar in both approaches. The concepts are derived from the data in inductive content analysis. Deductive content analysis is used when the structure of analysis is operationalized on the basis of previous knowledge. Inductive content analysis is used in cases where there are no previous studies dealing with the phenomenon or when it is fragmented. A deductive approach is useful if the general aim was to test a previous theory in a different situation or to compare categories at different time periods.
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            Epidemiology of burns throughout the world. Part I: Distribution and risk factors.

            M Peck (2011)
            Globally in 2004, the incidence of burns severe enough to require medical attention was nearly 11 million people and ranked fourth in all injuries, higher than the combined incidence of tuberculosis and HIV infections. Fortunately, although burns and fires account for over 300,000 deaths each year throughout the world, the vast majority of burns are not fatal. Nonetheless, fire-related burns are also among the leading causes of disability-adjusted life years (DALYs) lost in low- and middle-income countries (LMIC). Morbidity and mortality due to fire and flames has declined worldwide in the past decades. However, 90% of burn deaths occur in LMIC, where prevention programs are uncommon and the quality of acute care is inconsistent. Even in high-income countries, burns occur disproportionately to racial and ethnic minorities such that socioeconomic status--more than cultural or educational factors--account for most of the increased burn susceptibility. Risk factors for burns include those related to socioeconomic status, race and ethnicity, age, and gender, as well as those factors pertaining to region of residence, intent of injury, and comorbidity. Both the epidemiology and risk factors of burns injuries worldwide are reviewed in this paper. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.
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              Epidemiology of injuries from fire, heat and hot substances: global, regional and national morbidity and mortality estimates from the Global Burden of Disease 2017 study

              Background Past research has shown how fires, heat and hot substances are important causes of health loss globally. Detailed estimates of the morbidity and mortality from these injuries could help drive preventative measures and improved access to care. Methods We used the Global Burden of Disease 2017 framework to produce three main results. First, we produced results on incidence, prevalence, years lived with disability, deaths, years of life lost and disability-adjusted life years from 1990 to 2017 for 195 countries and territories. Second, we analysed these results to measure mortality-to-incidence ratios by location. Third, we reported the measures above in terms of the cause of fire, heat and hot substances and the types of bodily injuries that result. Results Globally, there were 8 991 468 (7 481 218 to 10 740 897) new fire, heat and hot substance injuries in 2017 with 120 632 (101 630 to 129 383) deaths. At the global level, the age-standardised mortality caused by fire, heat and hot substances significantly declined from 1990 to 2017, but regionally there was variability in age-standardised incidence with some regions experiencing an increase (eg, Southern Latin America) and others experiencing a significant decrease (eg, High-income North America). Conclusions The incidence and mortality of injuries that result from fire, heat and hot substances affect every region of the world but are most concentrated in middle and lower income areas. More resources should be invested in measuring these injuries as well as in improving infrastructure, advancing safety measures and ensuring access to care.
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                Author and article information

                Contributors
                Journal
                Ann Glob Health
                Ann Glob Health
                2214-9996
                Annals of Global Health
                Ubiquity Press
                2214-9996
                18 May 2022
                2022
                : 88
                : 1
                : 34
                Affiliations
                [1 ]Centre for Global Burn Injury Policy and Research, Swansea University, Wales, UK
                [2 ]Interburns, Swansea, UK
                [3 ]Department of Surgery, University of Washington, Seattle, WA, USA
                [4 ]Division of Trauma, Burn, and Critical Care Surgery, Department of Surgery, University of Washington
                [5 ]UW Medicine Regional Burn Center, Seattle, WA
                [6 ]Harborview Injury Prevention & Research Center, Seattle, WA, USA
                [7 ]Interburns, Cardiff, UK
                Author notes
                CORRESPONDING AUTHOR: Kajal Mehta, MD MPH University of Washington, Department of Surgery, 1959 NE Pacific Street, Seattle WA, USA kajalm@ 123456uw.edu
                Author information
                https://orcid.org/0000-0002-3907-4301
                https://orcid.org/0000-0003-1674-3493
                https://orcid.org/0000-0002-8099-9218
                https://orcid.org/0000-0003-3767-0131
                https://orcid.org/0000-0001-9282-8128
                Article
                10.5334/aogh.3669
                9122007
                35646613
                fdc3fcfb-f3dd-4a1f-8b0b-0139de43bb91
                Copyright: © 2022 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.

                History
                Funding
                Funded by: National Institute for Health Research (NIHR), doi open-funder-registry10.13039/open_funder_registry10.13039/100006662;
                Award ID: 16/137/110
                Funded by: Fogarty International Center, doi open-funder-registry10.13039/open_funder_registry10.13039/100000061;
                Award ID: R25-TW009345
                Funded by: US National Institutes of Health (NIH), doi open-funder-registry10.13039/open_funder_registry10.13039/100000002;
                This study was funded by the National Institute for Health Research (NIHR), NIHR Global health Research Group on Burn Trauma, Grant Reference 16/137/110. supported by R25-TW009345 from the Fogarty International Center, US National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIHR, NIH, UK Department of Health and Social Care, or WHO.
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