Awareness and Attitudes toward the Safety of Motorcyclists: A Training Approach, 2016

Introduction: Due to the high level of vulnerability, motorcyclists are considered a priority for research and intervention. Therefore, this study aimed to improve the society’s awareness and attitudes toward motorcycle traffic safety. Method: This study involved a randomized clinical trial conducted in 2016 among trauma patients and their caregivers in Shahid Rajaee hospital, Shiraz. Block randomization was used to divided the patients into study and control groups. Data collection was done using a researcher-made questionnaire called “Awareness & Attitude associated with Motorcycle Traffic Safety”; the questionnaire was found reliable with a Cronbach’s alpha of 78%. We made use of a pairwise T-test to make our intergroup comparisons; in cases of non-normal data, a non-parametric alternative was employed. The one-way analysis of variance (ANOVA) wasused to study the inter-variable relationships. Results: Participants included 276 patients, 138 in each group. Generally, 72.7% of the population consisted of males and the rest were females. The participants had a mean age of 31.38±10.46 years. Our pairwise T-test in the case group revealed a significant difference in attitudes and awareness of the subjects before and after the intervention (P<0.001). The oneway ANOVA indicated the influence of marital status on the level of awareness after training. Furthermore, training had the highest impact on the age-group of 47-62 years old. Conclusion: Training would lead to increased awareness and improved attitudes in society toward motorcycle traffic safety, and would indirectly be an effective step toward improvement of traffic culture and reduction of road traffic accidents (RTA)

Investigation of Fall Accidents among Children and Adolescents and Determination of the Time Indices of Emergency 115 Service Provision in Shiraz, 2017

سابقه و هدف: سقوط دومین علت شایع مرگ‌ومیر ناشی از جراحت پس از حوادث ترافیکی است و مراقبت‌های اورژانس به‌ویژه نوع پیش بیمارستانی از مهم‌ترین رکن مراقبت‌های درمانی می‌باشد. مطالعه حاضر باهدف بررسی سقوط کودکان و نوجوانان و تعیین شاخص‌های زمانی ارائه خدمات اورژانس 115 طراحی و اجرا گردید. روش‌ بررسی: مطالعه‌ای مقطعی در سال 1396 با شرکت 3622 نفر بر اساس اطلاعات ثبت‌شده در مرکز اورژانس انجام شد و متغیرهای دموگرافیک و شاخص‌های زمانی مورد تجزیه‌وتحلیل قرار گرفتند. جامعه پژوهش شامل مصدومانی بود که با اورژانس 115 تماس گرفته بودند. جهت توصیف و تحلیل تک متغیره‌ها از آزمون‌ کای اسکوئر و جهت تحلیل چند متغیره‌ از مدل رگرسیون لجستیک برای آنالیز داده‌ها استفاده شد. نتایج: نتایج این مطالعه نشان داد که از مجموع 3622 نفر 1228 (33.9%) نفر زن و 2394 (66.1%) نفرمرد بودند. میانگین سن مصدومان 4.27 ± 11.35 بود. شیوع سقوط در گروه سنی 18-13 سال بیشترین (99.6) و در گروه سنی زیر 6 سال کمترین (72.1) به ازای هر ده هزار نفر بود. ارتباط بین جنس مرد، سن 18-13 سال و ارتفاع بیش از دو متر با GCS معنی‌دار شد (0.001 p&lt;). میانگین زمان پاسخ‌گویی برابر 7.5 دقیقه به دست آمد. نتیجه‌گیری: بر طبق نتایج مطالعه 28.9 درصد موارد تماس با اورژانس به علت سقوط می‌باشد و جنس، سن، ارتفاع و مکان از عوامل خطر تأثیرگذار بر شیوع سقوط می‌باشند بنابراین توصیه می‌گردد با طراحی دقیق و مناسب محیط زندگی افراد شرایط امنی برای آن‌ها، به‌ویژه کودکان فراهم گردد و با افزایش ارتقاء ایمنی افراد جامعه میزان حوادث سقوط را کاهش داد. How to cite this article: Yadollahi M, Norouzi M, Moradian MJ. Investigation of Fall Accidents among Children and Adolescents and Determination of the Time Indices of Emergency 115 Service Provision in Shiraz, 2017. J Saf Promot Inj Prev. 2021; 9(1):18-26.Background &amp; Objectives: Falling is the second leading cause of fatalities after road traffic accidents. Emergency care, particularly prehospital emergency care, is amongst the most important bases of therapeutic care. The present study aimed to assess the falling of children and adolescents and determining the time indices of the emergency115 service provider. Materials and Methods: A cross-sectional study was conducted on3622 individuals based on the data recorded in the emergency care center dated 2017. The target population includes the injured people who had contacted the emergency115service. Demographic variables and time indices were evaluated. Univariate analysis was done using the chi-square test and multivariate analysis was carried out via a logistic regression model. Results: The results indicated that out of the 3622 participants, 1228(33.9%) were female and 2394 (66.1%) were male. The mean age of the injured people was 11.35+4.27 years. The highest and lowest prevalence rates of falling belonged to the13-18-years (99.6 per10000 population) and &lt;6 years(72.1per10000 population)age groups, respectively. The results revealed a significant relationship between the consciousness level based on Glasgow Coma Scale(GCS)and male sex,13-18-years age group, and height above two meters (p&lt;0.001).The mean response time was found to be7.5 minutes. Conclusion: The study results demonstrated that 28.9% of the contacts to the emergency115 service were due to fall accidents. Besides, sex, age, height, and location were the effective risk factors in the prevalence of fall accidents. Therefore, individuals’ living places should be designed appropriately and accurately for providing safe conditions specifically for children. Increasing individuals’ safety can, in turn, reduce the rate of fall accidents in society. &nbsp; How to cite this article: Yadollahi M, Norouzi M, Moradian MJ. Investigation of Fall Accidents among Children and Adolescents and Determination of the Time Indices of Emergency 115 Service Provision in Shiraz, 2017. J Saf Promot Inj Prev. 2021; 9(1):18-26. &nbsp

The Accuracy of GAP and MGAP Scoring Systems in Predicting Mortality in Trauma; a Diagnostic Accuracy Study

Introduction: Trauma scoring systems help physicians and nurses to be informed of injuries to a patient and assist their decision making in the cases of trauma and importantly prediction of their outcome and prognosis.&nbsp;Objective: This study aimed to compare the accuracy of GAP and MGAP scoring systems as predictors of mortality in trauma patients.&nbsp;Methods: This diagnostic accuracy study was conducted amongst 1861 trauma patients admitted to Rajaee Hospital in Shiraz, Iran, during 2017. The data on demographic features were extracted from the patients’ records. Then, trauma scoring systems including injury severity score (ISS), GAP, MGAP, and Glasgow coma&nbsp;scale (GCS) were compared to evaluate their accuracy in predicting mortality. Area under the receiver operating characteristic (ROC) curve was used to evaluate the accuracy of different trauma scoring systems and detect the sensitivity and specificity in order to predict status of discharge after 24 hours.&nbsp;Results: Based on the results, the area under the ROC curve was 0.8 for GCS. Moreover, Area Under Curve (AUC) of GAP was 0.91 and amongst different values, GAP value of ≤18 was selected as the cut-off point, since it exhibited the best sensitivity and specificity (72.99 and 95.52, respectively). In addition, the area under the ROC curve was 0.9 for MGAP, and value of ≤23 was selected as the cut-off point because it showed the best sensitivity and specificity (81.04 and 87.70, respectively). Additionally, AUC of ISS was 0.88.&nbsp;Conclusion: Both GAP and MGAP methods were able to appropriately predict mortality and were not significantly different; hence, both can be used for the right triage of patients and to predict the severity of injuries and subsequent mortality. Moreover, GAP and ISS had the best specificity and sensitivity, respectively

Comparison of Blood Glucose Levels, Physical Activity and Blood Pressure between Medical Sciences University Employees and General Population

Background: Diabetes is the 5th cause of mortality among women and the 16th cause of mortality among men. Therefore, the present study aimed to investigate and comparison of blood glucose levels, physical activity and blood pressure between medical sciences university employees and general population. Methods: In across-sectional study using clustered sampling method, 238 subjects were enrolled, while 150 were Shiraz University of Medical Sciences employees and 88 were general population. A detailed standardized form was completed for all participants including demographic data, anthropometric measurements, systolic and diastolic blood pressure, fasting blood glucose, diabetes and hypertension history and medication, physical activity, dietary habits, and nutrition. Results: The employees’ abdominal circumference was 90.68±9.52 centimeter and that of general population was 78.18±26.9 centimeter (P<0.001). The systolic blood pressure of employees and general population were respectively 11.75±1.72 mmHg and 12.73±1.87 mm Hg and their diastolic blood pressure were 7.43±1.1 mmHg and 8.39±1.22 mmHg, respectively (P<0.001). Diabetes frequency in employees and general population was 9.9% and 41.8%, respectively (P<0.001). Conclusion: The frequency of diabetes in medical personnel was less than general population which may reflect the impact of various factors on the physical activity; personal and social differences in different societies could explain the differences in the prevalence of physical inactivity and also proper control of blood glucose as well as appropriate and regular monitoring of blood glucose by medical staff

The Accuracy of GAP and MGAP Scoring Systems in Predicting Mortality in Trauma; a Diagnostic Accuracy Study

Introduction: Trauma scoring systems help physicians and nurses to be informed of injuries to a patient and assist their decision making in the cases of trauma and importantly prediction of their outcome and prognosis.&nbsp;Objective: This study aimed to compare the accuracy of GAP and MGAP scoring systems as predictors of mortality in trauma patients.&nbsp;Methods: This diagnostic accuracy study was conducted amongst 1861 trauma patients admitted to Rajaee Hospital in Shiraz, Iran, during 2017. The data on demographic features were extracted from the patients’ records. Then, trauma scoring systems including injury severity score (ISS), GAP, MGAP, and Glasgow coma&nbsp;scale (GCS) were compared to evaluate their accuracy in predicting mortality. Area under the receiver operating characteristic (ROC) curve was used to evaluate the accuracy of different trauma scoring systems and detect the sensitivity and specificity in order to predict status of discharge after 24 hours.&nbsp;Results: Based on the results, the area under the ROC curve was 0.8 for GCS. Moreover, Area Under Curve (AUC) of GAP was 0.91 and amongst different values, GAP value of ≤18 was selected as the cut-off point, since it exhibited the best sensitivity and specificity (72.99 and 95.52, respectively). In addition, the area under the ROC curve was 0.9 for MGAP, and value of ≤23 was selected as the cut-off point because it showed the best sensitivity and specificity (81.04 and 87.70, respectively). Additionally, AUC of ISS was 0.88.&nbsp;Conclusion: Both GAP and MGAP methods were able to appropriately predict mortality and were not significantly different; hence, both can be used for the right triage of patients and to predict the severity of injuries and subsequent mortality. Moreover, GAP and ISS had the best specificity and sensitivity, respectively

Risk Factors Affecting Death from Hospital-Acquired Infections in Trauma Patients: Association Rule Mining

Introduction: Trauma patients are potentially at high risk of acquiring infections in hospitals,which is the main cause of in-hospital mortality. The aim of this study was to identify the riskfactors contributing to death from hospital-acquired infections in trauma patients by datamining techniques.Methods: This is a cohort study. A total of 549 trauma patients with nosocomial infectionwho were admitted to Shiraz trauma hospital between 2017 and 2018 were studied. Sex,age, mechanism of injury, body region injured, injury severity score, length of stay, typeof intervention, infection day after admission, microorganism cause of infections, andthe outcomes were collected. Association rule mining techniques were applied to extractknowledge from the data set. The IBM SPSS Modeler data mining software version 18.0 wasused as a tool for data mining of the trauma patients with hospital queried infections database.Results: The age older than 65, surgical site infection skin, bloodstream infection, mechanisminjury of car accident, invasive intervention of tracheal intubation, injury severity score higherthan 16, and multiple injuries with higher than 71 percent confidence level were associatedwith in-hospital mortality. The relationship between those predicators and death amonghospital-acquired infection was strong (Lift value >1).Conclusion: Factors such as increasing age, tracheal intubation, mechanical ventilator,surgical site infection skin, upper respiratory infection are associated with death fromhospital-acquired infections in trauma patients by data mining

Potential Risk Factors of Death in Multiple Trauma Patients

Introduction: Trauma has been recognized as one of the leading causes of death in many countries for decades. Reduction in mortality and morbidity rate of trauma cases is one of the most important attitudes in this field. Evaluation of different risk factors have been considered as the main goal of some studies. The purpose of this study was determining potential risk factors of death in trauma patients. Method: In a retrograde study, data of 740 patients admitted during three years (2009-2011) were studied. Demographic data (sex and age), clinical factors (blood pressure, pulse rate, respiratory rate, Glasgow coma scale (GCS)), trauma characteristics (location, type of injury, etc.), as well as outcome of patients were evaluated. Data analyses was done using SPSS 18.0. Stepwise multivariate regression analysis was used for recognition of independent predictive factors of death in multiple trauma patients. Results: Of those admitted, majority of patients were male (81.4%), 68% between 18 to 60 years, and 11.2% of them died during the course of treatment. Age; type of trauma; abnormal respiration rate, pulse rate, blood pressure; total GCS ≤8; abnormal pupil size; and head and neck; vertebral, and extremities fractures were obtained as significant predictive factor of death. GCS≤8, head and neck fracture, and abnormal pulse rate were independent death predictors. Conclusion: We identified GCS≤8, head and neck fracture, and abnormal pulse rate as predictive factors of mortality after trauma, which remained independent in the presence of all other factors and potentially treatable

The Effect of Radiation on Secondary Sex Ratio among Radiologists in Shiraz, Iran

Environmental and occupational exposure may play a role in gender offspring. This study aimed to investigate the effect of radiation on gender ratio in the offspring of radiologists and technicians. This cross-sectional study was conducted on 262 participants with a total of 354 children. A data collection form including age, years spent in radiology practice, number of children, sex of each child, observance of radiation protection principles, and intensity of exposure based on International Commission Radiological Protection was completed. Male to female ratio was calculated 0.85 in fathers and 0.75 in mothers in comparison to this ratio estimated in Iran demographic statistics sex ratio which is 1.03. Highly-exposed parents (Prevalence ratio [PR]: 1.67, 95% confidence interval [CI]: 1.67, 95% confidence interval [CI: 1.11-2.52), as well as fathers (PR: 2.72, 95%CI: 1.56-4.72), had a significant propensity to have female offspring. However, this criterion in female radiologists was not found to be significant (P= 0.57). Moreover, in fathers a significant relationship was found between the years spent in radiology field up to the time of the child’s birth or age of the parents’ at child’s conception with offspring gender (4-6 year: PR: 2.07, 95% CI: 1.15-3.72; ≥7 year: PR:1.81, 95%CI: 1.18-2.78). Highly-exposed radiology male personnel, as well as those exposed to radiation 4 years or more before the offspring’s birth, were more likely to have daughters than sons. Although no exact mechanism has been identified for this preponderance, further animal studies are required to evaluate whether x ray is an influential factor in offspring gender

Epidemiologic Study of Trauma Patients Admitted to Shahid Rajaee Hospital of Shiraz, Iran on National, Religious, and Cultural Occasions within 2009-2014

Introduction and purpose: Trauma is one of the major cause of mortality and&nbsp;disability in communities and annually leads to the death of millions of people&nbsp;worldwide. Based on the evidence, car accident injuries (especially on religious&nbsp;and cultural events) are at an impressive level in Iran. Regarding this, the aim of the&nbsp;present study was to investigate the prevalence of trauma patients admitted to Shahid&nbsp;Rajai Hospital, and its relationship with religious, cultural, and national occasions,&nbsp;such as Ramadan, Tasua and Ashura, and so forth.&nbsp;Methods: This descriptive, cross-sectional study was conducted on the trauma&nbsp;patients admitted to Shahid Rajai Hospital in Shiraz, Iran, on religious, cultural, and&nbsp;national occasions during 2009-2014. The data were collected through a checklist,&nbsp;including the demographic data, some questions about the mechanism of the&nbsp;accident (i.e., car and motorcycle accidents, pedestrian injuries, assault, as well as&nbsp;gun and knife attacks), and religious occasions of the admission day (e.g., holidays,&nbsp;Wednesday Feast, Yalda, Tasua and Ashura, and Ramadan). The data were analyzed&nbsp;in SPSS version 17 using the descriptive statistics and the frequency distribution table.Results: According to the results, on the celebrations and birthdays, the highest&nbsp;number of trauma patient admission was recorded. In addition, the mean number&nbsp;of hospitalized men was significantly higher than that of the women. There was no&nbsp;significant difference in the mean number of the admissions between the first and&nbsp;second half of Nowruz and between the Martyrs&rsquo; Days and birthdays regarding the&nbsp;accident mechanisms of the car accident, motorcycle accident, assaults, falls, and&nbsp;unexpected events.&nbsp;Conclusion: As the findings of the present study indicated, the highest number of&nbsp;the admissinos occurred on the birthdays and celebrations, especially among the&nbsp;males. Therefore, it is suggested that measures be taken to minimize the number&nbsp;of traumatic accidents, especially on holydays, and deliver more care for the&nbsp;pedestrians, motorcyclists, and car drivers in this regard

Effect of COVID-19 pneumonia infection control protocols on nosocomial infection incidence in trauma patients

Purpose: Nosocomial infection is a major threat to the health care system and patient welfare. After the pandemic, new protocols were established in hospitals and communities to protect against the transmission of COVID-19, which may have changed the incidence of nosocomial transmission. This study was conducted to compare the incidence of nosocomial infection before and after the COVID-19 pandemic. Methods: This was a retrospective cohort study performed on trauma patients who were admitted, from May 22, 2018 to November 22, 2021, to the largest level-1 trauma center in Shiraz, Iran (Shahid Rajaei Trauma Hospital). All the trauma patients over 15 years old admitted during the study time were included in this study. Individuals who were declared dead upon arrival were excluded. Patients were evaluated in 2 periods: before the pandemic (May 22, 2018 – February 19, 2020) and after the pandemic (February 19, 2020 – November 22, 2021). Patients were assessed based on demographic information (age, gender, length of hospital stay, and patient outcome), the occurrence of hospital infection, and the type of infection. The analysis was done using SPSS version 25. Results: Overall, 60,561 patients were admitted, with a mean age of 40 years. Nosocomial infection was diagnosed in 4.00% (n = 2423) of all admitted patients. The incidence rate of post-COVID-19 hospital-acquired infections decreased by 16.28% (p < 0.001) when compared to before the pandemic; in contrast, surgical site infection (p < 0.001) and urinary tract infection (p = 0.043) were responsible for this change, while hospital-acquired pneumonia (p = 0.568) and bloodstream infection (p = 0.156) were not significantly different. Overall mortality was 1.79%, while 28.52% of all patients with nosocomial infections died. During the pandemic, there was a 25.78% increase (p < 0.001) in the overall incidence rate of mortality, which was also observed among patients with nosocomial infections (17.84%). Conclusion: The incidence of nosocomial infection has decreased during the pandemic, possibly due to the use of more personal protective equipment and modified protocols after the outbreak. This also explains the difference in the change in incidence rates of nosocomial infection subtypes