Experts' perspectives on the application of public-private partnership policy in prevention of road traffic injuries / 中华创伤杂志(英文版)

PURPOSE@#Successful application experiences on public-private partnership (PPP) in different countries, suggest that PPP could be an option in road traffic injury (RTI) prevention. The present study aims at investigating the applicability of PPP policy in RTI prevention in Iran based on the experts' perspectives.@*METHODS@#This is a qualitative study with grounded theory approach which has been conducted in Tabriz University of Medical Sciences, Iran in 2018. The participants were 22 experts in the field of RTIs selected using purposive sampling method. Data were collected by semi-structured interviews and analyzed with content-analysis method.@*RESULTS@#The results were classified under 5 main themes (applicability, scopes and services, challenges, advantages, and strategies) for applying PPP policy and 37 sub-themes. Due to the prevalence of RTIs, the present challenges in public sector, existence of qualified private sector, and successful experiences in other areas, there are opportunities for private sector partnership in prevention of RTIs. Private sector could participate in different scopes and services regarding RTI prevention, including road construction and maintenance, maintenance and provision of vehicles safety and public education. The main challenges including legislation issues, ambiguities in collaboration, political and organizational unsustainability, government's financial hardship and lack of experienced experts in the field of RTI. However, there are significant advantages including high efficiency in program implementation, covering the weaknesses of public sector, effective and efficient management on application of PPP in RTI prevention. The strategies include identifying and prioritizing the assignable activities, identifying the qualified private sector, developing PPP policies and legal frameworks, creating a common language between public and private parties, trying to meet the expectations of the private sector by public sector, developing a comprehensive and sound contract, and cultivating public culture to accept private sector in the field of RTI prevention.@*CONCLUSION@#This study sought to determine whether PPP could be used as strategy to reduce the burden of RTIs in Iran. But it requires a lot of preliminary studies to provide the context and conditions for applying this policy.

Effectiveness of interventions for prevention of road traffic injuries in Iran and some methodological issues: a systematic review

Objective: To review the effectiveness of Road Traffic Injuries [RTIs] interventions implemented for prevention of RTIs in Iran and to introduce some methodological issues

Methods: Required data in this systematic review study were collected through searching the following key words: "Road Traffic Injuries", "Road Traffic accidents", "Road Traffic crashes", "prevention", and Iran in PubMed, Cochrane Library electronic databases, Google Scholar, Scopus, MagIran, SID and IranMedex. Some of the relevant journals and web sites searched manually. Reference lists of the selected articles were also checked. Gray literature search and expert contact was also conducted

Results: Out of 569 retrieved articles, finally 8 articles included. Among the included studies the effectiveness of 10 interventions were assessed containing: seat belt, enforcements of laws and legislations, educational program, wearing helmet, Antilock Braking System [ABS], motorcyclists' penalty enforcement, pupil liaisons' education, provisional driver licensing, Road bumps and traffic improvement's plans. In 7 studies [9 interventions] reduction of RTIs rate were reported. Decreased rate of mortality from RTIs were reported in three studies. Only one study had mentioned financial issue [Anti-lock Brake System intervention]. Inadequate data sources, inappropriate selection of statistical index and not mention about the control of Confounding Variables [CV], the most common methodological issues were

Conclusion: The results of most interventional studies conducted in Iran supported the effect of the interventions on reduction of RTIs. However due to some methodological or reporting shortcoming the results of these studies should be interpreted cautiously

Epidemiology of road traffic Iijuries among elderly people; A systematic review and meta-analysis

Objective: To systematically review the epidemiological patterns and interventions for prevention of road traffic injuries [RTIs] among elderly

Methods: Searching keywords including: accident, trauma, road injury, road traffic injuries, aging, old, elder, strategy, intervention, road traffic crash prevention and traffic accident in databases including, Google scholar, SID, IranMedex, PubMed and Scopus. English and non-Persian articles, articles presented in congresses, articles that considered elderly people to have age under than 60 years were excluded. The reporting quality of articles was assessed by two experts using Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] check list

Results: RTIs compromised 23.6% of total injuries among elderly. The most frequent injuries were about car accidents [51.4%]. Pedestrian injuries composed 48.1% of the RTIs. Head and neck [32.1%] were most injured body parts. There was a significant difference between elderly and non-elderly people in terms of RTIs associated mortality [Odd=2.57 [1.2-5.4 CI 95%]]. Overall 25 main domains of intervention and 73 subordinate domains were extracted in five categories [human, road and environment, tools and cars, medical, legal and political issues]

Conclusion: According to the notable prevalence and fatality of RTIs, lack of sufficient studies and valid evidence of the present study can provide an appropriate evidence for better interventions for RTIs prevention among elderly

Prevalence and causes of cesarean section in Iran: systematic review and meta-analysis

Unfortunately, the prevalence of cesarean section has increased in recent years. Whereas awareness of the prevalence and causes is inevitable for planning and effective interventions, so aim of this study has designed and conducted for reviewing of systematic Prevalence and caesarean causes in Iran. In this meta-analysis, the required information have been collected using several keywords which are Cesarean section rate, Cesarean section prevalence, delivery, childhood, childbirth, relative causes, relative frequency, Iran and their Persian equivalents have been collected from databases such as CINAHL, Science Direct, PubMed, Magiran, SID, Iranmedex. Finally, we found 706 related articles and selected 34 articles among them for studying of cesarean Prevalence. We used CMA software with random model for Meta-Analysis. The prevalence of Cesarean was estimated48%. Using content analysis, Factors influencing the incidence of cesarean section were divided to 3 categories including social and demographic factors, obstetric-medical causes and non-obstetric-medical causes. Maternal education and grand multiparity in the field of demographic and social factors, previous cesarean in the field of obstetric-medical causes and fear of normal-vaginal delivery [NVD] and doctor's suggestion in the field of non-obstetric-medical causes were major causes of Cesarean. According to the high prevalence of caesarean section and it upward development, it seems to be essential designing and implementing of programs and interventions effectiveness including providing of Possibility of painless childbirth and education and psychological interventions, increasing of quality of natural delivery services, proper culture and prohibiting of doctors from Personal opinions and profit

[Evidence-based care in Iran: a systematic review]

Background and Aim: Evidence-based care is defined as combining research findings with caring skills. The current study aimed at a systematic review of obstructions, facilitators, awareness, knowledge, function, perception, and results of interventions in evidence-based care in Iran

Materials and Methods: In the present survey different data base searching methods and manual search were applied using the key words of "evidence-based", "evidence-based medical", "evidence-based nursing", "evidence-based practice", "evidence-based care", "evidence-based activity", "evidence-based education", "applying research results", "research application", and their combinations with the key words of "obstructions", "facilitators", "awareness", "knowledge"," function", "perception", and" Iran" and their English synonyms in data bases of PubMed, Medlib, Magiran, SID, CINAHL, Google Scholar, and Iranmedex to collect articles

Results: Out of 819 articles, finally 25 articls were used for this study. The most important barriers of evidence-based practice were lack of facilities, lack of time, and lack of expertise in research methods. The rate of familiarity with evidence-based practice specific terms was low [44.22%]. Reference books were considered as the most important information sources. Awareness, knowledge, function, and usage of evidence-based practice was low [<50%]. Main concepts of evidence-based practice from providers' point of views were scientific and professional care, patient-oriented and considering service quality. Interventional studies had a positive effect on the improvement of evidence-based practice

Conclusion: Weak knowledge, weak attitude, and time shortage are among the most significant barriers of evidence-based care in Iran. These problems require more accurate planning and more favorable policies on the part of medical science authorities

Quality of life in cardiovascular patients in Iran and factors affecting it: a systematic review

Cardiovascular diseases are always one of the major causes of mortality in the world affecting all aspects of patients' lives. Therefore, this study was conducted to summarize and provide a clear view of quality of life in these patients in Iran through a systematic review on the results of previously conducted studies. In a systematic review, required information was collected by searching keywords of Iran, quality of life, heart failure, cardiac, heart, and their Persian equivalents in databases of Science Direct, Pubmed, IRAN doc, SID, Medlib and Magiran. The selected time period for searching articles was since 2000 to 2012. Inclusion criteria were: releasing of article during 2000 to 2012, articles reporting patients' quality of life in any domains of heart diseases, and articles published in Persian and English. Extracted results first were summarized in Extraction Table, and then analyzed manually. Finally 18 of 1592 found articles were included in the study. A total of 3,797 cardiac patients' quality of life was measured using six different tools, the most important one of which was SF36 questionnaire. Among eight dimensions of SF36 questionnaire, the highest mean was for social role functioning with average score of 58.37 and the lowest for physical limitation [physical role functioning] with score of 42.95. Overall, mean of eight dimensions was 53.19. Among 4 general domains of quality of life, physical activity had the lowest average of 43.63 and average of general dimensions of quality of life was 47.65. The most important factors affecting quality of life were sex, age, education, marital status, occupational status, suffering duration, number of hospitalizations etc. The results of the studies showed relatively low quality of life of cardiovascular patients in general. Therefore, according to the introduced effective factors in this study, it is necessary to consider regular programs for improving quality of life in these patients and providing suitable and qualitative services