The Effect of Music Therapy on the Pain and Anxiety Levels of Patients Experiencing Wound Healing by Suturing in the Emergency Wards.

Background: A patient experiences high pain and anxiety during laceration healing. One of the non-pharmacological methods of pain and anxiety relief is using music. Objectives: This study was outlined to examine the impact of music therapy on the pain and anxiety levels of patients experiencing wound healing by suturing in the emergency wards. Methods: The study population for this randomized controlled clinical trial was all patients aged 18 - 65 years who were referred to the Emergency Ward of Imam Khomeini and Buali Sina hospitals, Sari, Iran, to suture the hand or foot. Thirty people were included from each group in the study. In the intervention group, traditional Iranian wordless music (Peyk Sahar track) was played with headphones from when the patient was placed on the bed for suturing to the end, and the duration was recorded. In the control group, sutures were made according to the usual procedure. The pain level was measured by a visual analog scale in two stages before washing and immediately after the anesthetic injection. Moreover, the anxiety level was assessed in three steps, before washing the wound, after the end of the anesthetic injection, and immediately after suturing. Data were analyzed by the SPSS software version 22. Descriptive statistics, including mean and standard deviation, and inferential statistics, such as Exact Fisher's test, Mann-Whitney test, and Wilcoxon, were used to describe and analyze the variables. Results: The mean pain before washing the wound (before music therapy) and after the end of the anesthetic injection was not significantly different between the intervention group (5.38 ± 1.31 and 3.71 ± 1.98, respectively) and the control group (5.31 ± 1.69 and 4.60 ± 2.31, respectively) (P = 0.27 and 0.057, respectively). The mean anxiety before washing the wound, after the end of anesthesia injection, and immediately after finishing the suture was 3.37 ± 0.89, 2.73 ± 1.23, and 1.27 ± 0.52 in the intervention group, and 3.50 ± 0.97, 3.07 ± 1.33, and 2.07 ± 1.14 in the control group, respectively. The mean anxiety at all three times was significantly different between the two groups (P < 0.001). Conclusions: The study results indicated that music therapy lowered pain without a statistically significant difference. However, music therapy significantly reduced anxiety. Therefore, it is recommended to use music therapy to reduce pain and anxiety in patients.

Road safety lead agency challenges of three decades of intervention for road safety in Iran: implications for policy-makers.

BACKGROUND: Road traffic crashes and associated injuries and mortalities are one of the big public health challenges, especially in low/middle-income countries. Road safety lead agency (RSLA) is a vital factor in the sustainable prevention and promotes road safety. In the recent decades, various policy interventions have been conducted for road safety in Iran. This study aimed at exploring the challenges of RSLA from the perspectives of stakeholders at various levels. METHODS: A qualitative study was conducted. In-depth interviews and document reviews were used for data collection. To conduct interviews, different stakeholders at various levels such as policy-makers, senior national authorities, researchers and faculty members were selected. Data collection was conducted between November 2019 and June 2020. Thematic content analysis approach was used for data analysis. RESULTS: The experts' perspectives were analysed and then categorised under five main themes including the role and position of the lead agency, the role and duties of the actors and players, translating policy into practice, intrasectoral and intersectoral cooperation and coordination and evidence production and application and a total of 22 subthemes were identified. The current structure of the RSLA is one of the main challenges emphasised by the research participants. CONCLUSION: To achieve significant improvements in road safety at the national level, a strong management system and leadership body is a critical issue. Organisational reform to establish an effective unique lead agency is proposed to cope with RSLA challenges.

An Approach Towards Reducing Road Traffic Injuries and Improving Public Health Through Big Data Telematics: A Randomised Controlled Trial Protocol.

OBJECTIVE: Deaths due to road traffic accidents (RTAs) are a major public health concern around the world. Developing countries are over-represented in these statistics. Punitive measures are traditionally employed to lower RTA related behavioural risk factors. These are, however, resource intensive and require infrastructure development. This is a randomised controlled study to investigate the effect of non-punitive behavioural intervention through peer-comparison feedback based on driver behaviour data gathered by an in-vehicle telematics device. DESIGN, SETTING, AND PARTICIPANTS: A randomised controlled trial using repeated measures design conducted in Iran on the drivers of 112 public transport taxis in Tehran province and 1309 inter-city busses operating nationwide. Driving data is captured by an in-vehicle telematics device and sent to a centrally located data centre using a mobile network. The telematics device is installed in all vehicles. Participants are males aged above 20 who have had the device operating in their vehicles for at least 3 months prior to the start of the trial. INTERVENTION: The study had three stages: 1- Driver performance was monitored for a 4-week period after which they were randomised into intervention and control groups. 2- Their performance was monitored for a 9-week period. At the end of each week, drivers in the intervention group received a scorecard and a note informing them of their weekly behaviour and ranking within their peer group. Drivers in the control group received no feedback via short messaging service (SMS). 3- Drivers did not receive further feedback and their behaviour was monitored for another 4 weeks. PRIMARY AND SECONDARY OUTCOME MEASURE: Primary outcome was changes in weekly driving score in intervention and control groups during stage 2 of intervention. Taxis and busses were analysed separately using generalised estimating equation analysis. FUNDING AND ETHICAL APPROVAL: This project was funded by the National Institute for Medical Research Development (Grant No.940576) and approved by its ethics committee (Code: IR.NIMAD.REC.1394.016). This trial was registered at www.irct.ir as IRCT20180708040391N1.