Association of risky driving behavior with psychiatric disorders among Iranian drivers: A case-control study / 中华创伤杂志(英文版)

PURPOSE@#This study aimed to investigate the possible association between psychological disorders and risky driving behavior (RDB) in Iran.@*METHODS@#This case-control study conducted in Shiraz, Iran in 2021. The case group included drivers with psychological disorders and the control group included those without any disorders. The inclusion criteria for selecting patients were: active driving at the time of the study, being 18 - 65 years old, having a driving license, having a psychological disorder including depression, bipolar disorder, anxiety spectrum disorder, or psychotic disorder spectrum confirmed by a psychiatrist, and completing an informed consent form. The exclusion criterion was the existence of conditions that interfered with answering and understanding the questions. The inclusion criteria for selecting the healthy cases were: active driving at the time of the study, being 18 - 65 years old, having a driving license, lack of any past or present history of psychiatric problems, and completing an informed consent form. The data were gathered using a researcher-made checklist and Manchester driving behavior questionnaire. First, partition around medoids method was used to extract clusters of RDB. Then, backward logistic regression was applied to investigate the association between the independent variables and the clusters of RDB.@*RESULTS@#The sample comprised of 344 (153 with psychological disorder and 191 without confirmed psychological disorder) drivers. Backward elimination logistic regression on total data revealed that share of medical expenditure ≤ 10% of total household expenditure (OR = 3.27, 95% CI: 1.48 - 7.24), psychological disorder (OR = 3.08, 95% CI: 1.67 - 5.70), and substance abuse class (OR = 6.38, 95% CI: 3.55 - 11.48) were associated with high level of RDB.@*CONCLUSION@#Substance abuse, psychological illnesses, and share of medical costs from total household expenditure were found to be main predictors of RDB. Further investigations are necessary to explain the impact of different psychological illnesses on driving behavior.

Burden of traffic accidents among pedestrians of Fars province, southern Iran; estimate of years of life lost in a sample of Iranian population from 2009 to 2013 / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Traffic injuries are among the leading causes of mortality and morbidity worldwide. Pedestrians have been considered as a high-risk group among road users, especially in middle- or low-income communities. This study attempted to determine the burden of pedestrians' fatalities in Fars, the southern province of Iran using years of life lost (YLL) approach.</p><p><b>METHODS</b>The data used in this study were retrieved from Fars Forensic Medicine Organization database on pedestrian traffic accidents. The YLL from 2009 to 2013 was estimated using the method presented by World Health organization. Some epidemiological characteristics of pedestrians' fatalities were analyzed by SPSS.</p><p><b>RESULTS</b>Although YLL among 1000 male pedestrians decreased from 2.5 in 2009 to 1.5 in 2013, it increased from 0.9 to 2.1 among 1000 females during the same period. Higher proportion of death was found in female, illiterate, and married pedestrians (p < 0.001). In addition, mortality was higher in pedestrians living the cities, during daytime, at home, and in hospitals (p < 0.001).</p><p><b>CONCLUSION</b>Consistent with the global trends, burden of pedestrian accidents in Fars was also exceptionally high. Considering the national and cultural aspects of different countries, improving the safety of pedestrians demands a multi-dimensional approach with interventional factors concerning policies, rules, pedestrians, motor vehicles and environmental conditions taken into consideration.</p>

Prevalence and risk factors of alcohol and substance abuse among motorcycle drivers in Fars province, Iran / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>The aim of this present study is to investigate the prevalence of alcohol and substance abuse (ASA) and its relationship with other risky driving behaviors among motorcycle drivers.</p><p><b>METHODS</b>This is a cross sectional study which is performed at Shiraz city of Iran. Data from motorcycle drivers were collected using a standard questionnaire in eight major streets at different times of the day. The data includes consumption of alcohol and other substances two hours before driving and some of the risky behaviors during driving.</p><p><b>RESULTS</b>A total of 414 drivers with a mean ± SD age of (27.0 ± 9.3) years participated in the study. Alcohol or substance consumptions two hours before driving was significantly associated with risky driving behaviors such as using mobile phone during driving, poor maneuvering, and driving over the speed limit (both p < 0.001). It was also associated with carelessness about safety such as driving with technical defects (p < 0.001) and not wearing a crash helmet (p=0.008).</p><p><b>CONCLUSION</b>Screening for alcohol and substance consumption among motorcycle drivers is an efficient way to identify drivers that are at a greater risk for road traffic accidents.</p>

Burden of transportation injuries among children and adolescents of Fars province: analysis of Iran's 20-year trends / 한국역학회지

OBJECTIVES: Transportation injuries are among the top ten causes of burden of disease in all age groups worldwide. The burden of transportation injuries among children and adolescents in Iran is higher than the world average and that of other developing countries. The aims of this study were to investigate the burden of transportation injuries in children and adolescents in the province of Fars in Iran from 2009 to 2013, and to report the burden of these kinds of injuries in children and adolescents in Iran from 1990 to 2010. METHODS: The number of deaths due to transportation injuries and the location of fatal injuries in the province of Fars in Iran from 2009 to 2013 were analyzed using data from the Fars Forensic Medicine Organization. The 20-year trend in the burden of transportation injuries in Iran was analyzed using data from the Institute for Health Metrics and Evaluation. RESULTS: Similarly to the long-term trend in Iran, the burden of transportation injuries among the male population of Fars province was generally higher than in females. Most fatal accident injuries occurred on roads (males: n=4151, 61.51%; females: n=1182, 65.95%) and in urban areas (males: n=1994, 29.54%; females: n=473, 26.40%). CONCLUSIONS: Considering that children and adolescents are high risk groups for transportation injuries, adopting an effective comprehensive multi-sectoral approach, including enacting and enforcing appropriate laws and regulations, developing general knowledge, and facilitating the availability of Personal protective equipment, could be helpful for reducing the burden of these injuries.

Time analysis of fatal traffic accidents in Fars Province of Iran / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To analyze the time factor in road traffic accidents (RTAs) in Fars Province of Iran.</p><p><b>METHODS</b>This study was conducted in Fars Province, Iran from November 22, 2009 to November 21, 2011. Victims'information consisted of age, sex, death toll involving dri- vers or passengers of cars, motorcycles and pedestrians, and site of injury etc. Accidents were analyzed in relation to hour of the day, season of the year, lighting condition including sunrise, sunset, daytime and nighttime.</p><p><b>RESULTS</b>A total of 3 642 deaths (78.3% were males, and the ratio of males to females was about 3.6:1) were studied regarding their autopsy records. There was a steady increase in fatal accidents occurring at midnight to 15:59. The risk of being involved in a fatal traffic accident was higher for those injured between 4:00 to 7:59 than at other times (OR equal to 2.13, 95% CI 1.85-2.44). The greatest number of fatal RTAs took place in summer. Mortalities due to RTA during spring and summer were more pronounced at 20:00 to 23:59 and midnight to 3:59, whereas mortalities in fall and winter were more pronounced from 12:00 to 15:59.</p><p><b>CONCLUSION</b>The high mortality rate of RTA is a major public health problem in Fars Province. Our results indicate that the time is an important factor which contributes to road traffic deaths.</p>

An epidemiologic survey of road traffic accidents in Iran: analysis of driver-related factors / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>Road traffic accident (RTA) and its related injuries contribute to a significant portion of the burden of diseases in Iran. This paper explores the association between driver-related factors and RTA in the country.</p><p><b>METHODS</b>This cross-sectional study was conducted in Iran and all data regarding RTAs from March 20, 2010 to June 10, 2010 were obtained from the Traffic Police Department. We included 538 588 RTA records, which were classified to control for the main confounders: accident type, final cause of accident, time of accident and driver-related factors. Driver-related factors included sex, educational level, license type, type of injury, duration between accident and getting the driving license and driver's error type.</p><p><b>RESULTS</b>A total of 538 588 drivers (91.83% male, sex ratio of almost 13:1) were involved in the RTAs. Among them 423 932 (78.71%) were uninjured; 224 818 (41.74%) had a diploma degree. Grade 2 driving license represented the highest proportion of all driving licenses (290 811, 54.00%). The greatest number of accidents took place at 12:00-13:59 (75 024, 13.93%). The proportion of drivers involved in RTAs decreased from 15.90% in the first year of getting a driving license to 3.13% after 10 years'of driving experience. Neglect of regulations was the commonest cause of traffic crashes (345 589, 64.17%). Non-observance of priority and inattention to the front were the most frequent final causes of death (138 175, 25.66% and 129 352, 24.02%, respectively). We found significant association between type of accident and sex, education, license type, time of accident, final cause of accident, driver's error as well as duration between accident and getting the driving license (all P less than 0.001).</p><p><b>CONCLUSION</b>Our results will improve the traffic law enforcement measures, which will change inappropriate behavior of drivers and protect the least experienced road users.</p>

Fatal motorcycle accidents in Fars Province, Iran: a community-based survey / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To identify the main characteristics of victims of motorcycle accidents in Fars Province, Iran.</p><p><b>METHODS</b>This cross-sectional study was conducted in Fars Province which has the fourth largest population of all 31 provinces in Iran from March 2009 to June 2010. We included data from all 542 recorded cases of fatalities due to motor vehicle accidents. Data were recorded from the forensic medicine registry consisting of demographic and accident-related information. Demographic information consisted of name, age, sex, status of fatal victim (motorcycle driver vs passenger) and educational level.</p><p><b>RESULTS</b>Of the 2 345 autopsy records from the forensic medicine archives, 542 (23.1%) gave the cause of death as motor vehicle accidents. Mean age of these victims was (31.4+/-6.5) years, and the male to female ratio was 28. Head injury was the most common cause of death in these victims, and overall they tended to have a low level of education. Motorcycle accidents frequently involved younger age groups (15-35 years), and head trauma related with non-use of a helmet was the most common cause of death.</p><p><b>CONCLUSIONS</b>Head injury is frequent among victims in the province we studied. This situation may be related to the victims' low socioeconomic status and little education regarding traffic laws leading to speeding and disregard of these laws along with their weak enforcement.</p>

Epidemiological characteristics of fatal pedestrian accidents in Fars Province of Iran: a community-based survey / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To determine the epidemiological characteristics of fatal pedestrian accidents in Fars Province of Iran.</p><p><b>METHODS</b>This cross-sectional study was conducted in Fars Province of Iran during a 29-month period from March 2009 to July 2011. The data were from the Fars Forensic Medicine Registry. In 4 923 recorded road traffic accident fatalities, 971 deaths were due to pedestrian accidents. The demographic and accident-related information were analyzed by SPSS version 11.5. P value less than 0.05 was considered significant.</p><p><b>RESULTS</b>The mean age of decedents was (47.2+/-26.2) years, ranging from 6 months to 103 years old. Males accounted for 69.8% of all deaths. Fatal accidents were most common in September; 56.1% of the fatal injuries occurred on intracity roads and 33.1% on extracity roads. Fatal head injuries were present in 60.54% of cases. Evaluation of the injury site and the cause of death found that they were significantly associated with age, interval between injury and death. Besides, the type of roads played an important role in mortality.</p><p><b>CONCLUSION</b>Although the clinical management of trauma patients has been improved in our country in the recent decade, decreasing the burden of injuries needs coordination among trauma system organizations.</p>

prevalence of high blood pressure and its relationship with anthropometric indicators; a population based study in pars province, IR Iran

The burden of non-communicable diseases is rising globally. The present study was carried out to examine the relationship between different anthropometric indices and blood pressure in the Iranian population. A cross-sectional descriptive study was conducted on 3916 subjects including 1976 males and 1940 females, aged 15-64 years from a healthy population in Shiraz, IR Iran. Anthropometric variables of each person including weight, height, waist circumference [WC], waist to height ratio [WHR] and body mass index [BMI] were calculated along with measuring systolic and diastolic blood pressures [BP]. The relationship between blood pressure and different anthropometric variables was determined in both genders. The mean +/- SD systolic blood pressures were 123.9 +/- 20.0 and 121.2 +/- 17.7 mmHg while the mean diastolic blood pressures were 78.3 +/- 11.9 and 77.4 +/- 12.9 mmHg in men and women respectively [P<0.001]. The prevalence of hypertension in men [23.8%] was significantly more than that of women [21.1%]. Mean systolic and diastolic blood pressures increased with age and BMI in both genders. Anthropometric indices showed a positive association with systolic and diastolic blood pressures. The BMI and WC showed a strong association with systolic and diastolic blood pressure. The suggested lower cut-off values of the anthropometric indicators will cover maximum of the population with higher odds of having hypertension and may help reduce the levels of populations mean blood pressure

Necessity of admissions in selected teaching university affiliated and private hospitals during 2007 in Shiraz, Iran

The use of acute hospital beds is an issue of concern both to policy-makers and practitioners. In most countries attempts are underway to improve efficiency in this sector. One of the most widely used instruments for assessing inappropriate hospital use is the Appropriateness Evaluation Protocol, which consists of a set of standards based on objective criteria relating the condition of the patient to the clinical services received. The aim of this study was to measure inappropriateness of admission and inpatient stays at four major hospitals in Shiraz, Iran. The results showed that 22% of the total admissions in four hospitals were rated as inappropriate. The most as well as the least inappropriate admissions were found in both teaching university affiliated hospitals. Our data has shown that a total of 29.6% [average 6.40%] of the hospital stays in the study population were judged to be inappropriate. The result of the Least Significant Difference Test indicated a significant association between the mean days of inappropriate stay and turn of admission in all hospitals. In the four hospitals, a significant association was observed between the inappropriateness of hospital stay, costs, and length of stay. Considering the findings of this study, in addition to other studies in Iran and other countries, we can conclude that the factors involving inappropriate admission of patients to hospitals are mostly similar. In order to solve this problem we can use strategies such as: improving the performance of the referral system, using standard criteria for an appropriate evaluation protocol by the medical staff, and extending outpatient diagnostic services to reduce inappropriate hospitalization