BACKGROUND:Iran's health care system faces significant challenges in managing the growing burden of non-communicable diseases, and these are exacerbated during the frequent natural disasters. The current study was designed to understand challenges in providing healthcare services to patients with diabetes and chronic respiratory diseases during such crisis periods.METHODS:The conventional content analysis was used in this qualitative study. Participants included 46 patients with diabetes and chronic respiratory diseases, and 36 stakeholders with knowledge and experience in disasters. Data collection was carried out employing semi-structured interviews. Data analysis was performed using Graneheim and Lundman method.RESULTS:Four major challenges in providing care to patients with diabetes and chronic respiratory diseases during natural disasters include integrated management, physical, psychosocial health, health literacy and the behavior and barriers to healthcare delivery.CONCLUSIONS:Developing countermeasures against medical monitoring system shutdown in order to detect medical needs and problems faced by chronic disease patients including those with diabetes and chronic obstructive pulmonary disease (COPD), is essential in preparedness for future disasters. Developing effective solutions may result in improved preparedness and better planning of diabetic and COPD patients for disasters.
BACKGROUND:Mass Casualty Incidents (MCIs) have caused great financial losses. These incidents are referred to a situation in which the number of casualties caused by the accident temporarily increases to such an extent that it is not possible to treat all these patients with the facilities and capacities available in the area. To offer fair and proportionate medical services to all patients, it is necessary to use a process called patient triage. This study aimed to modify the Sort Assess Lifesaving Intervention Treatment/transport (SALT) triage method to simplify the differentiation of patients from green from yellow and gray from red.METHODS:This is a methodological study with a descriptive cross-sectional approach that by studying the SALT triage method and using the criteria defined in the Reference Standard, facilitates the identification of patients with a minor (Outpatient) and fatal injury (Expectant). Then, using two common and modified SALT triage methods, 100 simulated patients were triaged and the obtained data were evaluated and compared in terms of accuracy and speed.RESULTS:The improvement made in the SALT triage method was able to reduce 22% of the total triage error of the first nurse and improved 18% in green, 43% in yellow, 15% in red, and 13% in the gray category. In the second nurse, this method was able to reduce 29% of the errors and in the category of green patients, 41%, yellow 47%, red was unchanged, and gray 38% improvement was observed. Furthermore, the average triage rate was 4 and 5 seconds shorter per patient in the first and second nurses, respectively.CONCLUSIONS:With this modification, the diagnostic power has increased by 22% in the first nurse and 29% in the second nurse. Due to the significant increase in the accuracy of the mSALT (Modified SALT) triage method, this modification can be considered useful and can be used to advance the goals of triage in MCIs.
BACKGROUND:Knowledge about the spiritual rehabilitation of affected people after disasters is scare. The objective of the present study is to identify the factors affecting the spiritual rehabilitation of affected people after natural disasters employing a systematic review study.METHODS:The protocol of this review has been registered in the International Prospective Register of Systematic Review (PROSPERO) with the code CRD42021228552. Using MEDLIN (PubMed), Web of Science, Google Scholar, Embase, ProQuest, Scopus and ISC database as well as studies related to the research topic till the end of 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was used to find articles related to the research objective. Thematic content analysis then was used for concepts extraction.RESULTS:This systematic review identifies factors affecting the spiritual rehabilitation of affected people after natural disasters.CONCLUSIONS:Both systematic review as well as qualitative study are essential in order to explore spiritual rehabilitation of affected people after natural disasters, while the current study was employed systematic review. It is expected that planners and policy-makers can use the extracted factors for improving the spiritual rehabilitation of people affected by natural disasters.
BACKGROUND:This research assessed forms of sexual violence and their associations with suicidal ideation among adults identifying on the asexual identity spectrum.METHODS:A secondary data analysis was conducted among adults, identifying on the asexual spectrum of asexual, gray-asexual, or demisexual, from the 2021 Ace Community Survey (n = 8,715). Multiple logistic regression analyses determined potential associations between sexual violence and suicidal ideation, adjusting for the covariates of age group, gender, education, racial/ethnic minority, employment, and asexual spectrum identity.RESULTS:Demisexual individuals were at statistically greater odds of suicidality compared to gray-asexual and asexual individuals. Sexual violence victims were more likely to be suicidal compared to non-victims. This was especially true for attempted rape and suicidal consideration (OR = 2.10, 95% CI (1.60, 2.75), planning (OR = 1.76, 95% CI (1.32, 2.34), and attempts (OR = 3.15, 95% CI (2.07, 4.81).CONCLUSIONS:Asexual victims of sexual violence were more likely to be suicidal compared to non-victims. Demisexual individuals were more likely to be suicidal compared to asexual individuals. These findings demonstrate the need for additional research on sexual violence and suicide.
BACKGROUND:Very few studies have investigated athletes with disabilities during a long period of competitions, such as a professional league. Also, there are limited findings related to specific mechanisms and risk factors of injury, and prevention strategies in Wheelchair Basketball. Therefore, the objective of this study was to investigate the rate and characteristics of injuries in the 2021-2022 Iran Wheelchair Basketball League and present prevention strategies.METHODS:This retrospective study was conducted after the 2021-2022 (Mar 2021-Sep 2022) competition season. The sample size consists of 36 players, who were randomly selected among 129 players. All the data was processed using SPSS (version 21).RESULTS:111 injuries were registered, equivalent to 132 per 100 players (95% CI: 100-180) and 8.16 Injuries per 1000 hours of athlete exposure (6.2-9.8). Also, 77.8% occurred during training and 22.2% in competitions. Most injuries affected the fingers and hands (35.13%), and shoulders (22.57%). The most common types of injuries were contusions (30.63%), laceration and skin lesion (23.42%), and muscle spasms (13.51%), in which, half of the injuries were slight (0-1 days), 27.8% (mild 4-7 days), and 22.2% moderate (8-28 days). Also, 66.9% of injuries were new, and 33.1% were recurrent. Most situations and actions leading to injury include quick wheelchair pushing (29.72%), the intense ball hitting (17.14%), and sudden stops or changes of direction of the wheelchair (12.63%). A multiple linear regression analysis (Enter method) demonstrated (R2 Adjusted=0.530) Wheelchair inappropriateness (P=0.015), lack of protective equipment (P=0.028), and previous injury (P=0.003) explained close to 55% of the injury rate.CONCLUSIONS:The injury rate during the league period was higher than the amounts reported from Paralympic games. Prevention strategies should be focused on rethinking athletes' pre-season readiness evaluation, return to play assessments and protection equipment technologies.
BACKGROUND:Emotional sadness caused by the experience of the loss of a romantic relationship can lead to love trauma syndrome, which includes a set of psychopathology symptoms. The present study was also conducted to investigate the effectiveness of cognitive emotion regulation training based on the Gross model in improving the love trauma syndrome, hoping and positive affect negative affect among female students with love trauma.METHODS:The research method was experimental (pre-test and post-test with the control group). The statistical population was all the female students with love trauma at the University of Mohaghegh Ardabili and 34 participants (17 participants in each group) were selected by purposive sampling. Also, in order to determine the target sample from the Love Trauma Syndromes Inventory (LTSI-10), to implement the intervention of the cognitive emotion regulation program based on the Gross model, and to measure dependent variables in addition to the LTSI, Positive Affect Negative Affect Scale (PANAS-20) and Miller Hope Scale (MHS-48) were used. Multivariate analysis of covariance (MANCOVA) was also used for data analysis.RESULTS:The results showed that the assumptions (homogeneity of covariances and variances) are maintained. Also, the effect of group membership shows the significant impact of the intervention on the love trauma syndrome (p less than 0.01), negative affect (p less than 0.01), hope (p less than 0.01), and no effect on positive affect (p greater than 0.05).CONCLUSIONS:Therefore, after identifying individuals with love trauma, the intervention of cognitive emotion regulation can be done on them in a group to reduce the symptoms of psychological harms in them and also to cognitive strategies, and to equip them for problem solving or compatibility.
BACKGROUND:the present study aimed to investigate gender difference in the perceived cause (intrinsic or extrinsic) of falls leading to fracture (FLF) and its association with selected social, health, and environmental factors.METHODS:All patients aged 60 years or older who were admitted to two referral hospitals due to FLF from August 1, 2018, to the end of May 2019, were included in the study. An interview-administered questionnaire was used to collect the required data from 300 participants (136 men and 164 women).RESULTS:When compared to men, women were less physical active, were less smoker, had lower education, had more vision problems, used more sedatives, and were more satisfied with their life (P less than 0.05 for all). No statistical difference was observed between men and women about the perceived cause of Fall.CONCLUSIONS:Although women and men were the same in the perceived cause of fall, they had considerably riskier lifestyles and lower health status. These factors include education, vision condition, physical activity, occupation, and taking sleeping pills. On the other hand, men were more smoker and alcohol user.
BACKGROUND:SARS-CoV-2 positive status has been considered a predominantly incidental finding among trauma patients. We sought to examine whether concurrent infection is associated with worse outcomes in a contemporary cohort of injured patients during the COVID-19 pandemic.METHODS:Retrospective cohort analysis of a level I trauma center's institutional registry from May 1, 2020 through June 30, 2021. The prevalence of COVID in the trauma population was compared monthly using prevalence ratios relative to population estimates. Unadjusted cohorts of COVID+ vs COVID- trauma patients were compared. COVID+ patients then were matched on age, mechanism of injury, year, and injury severity score (ISS) with COVID- controls for adjusted analysis with a primary composite outcome of mortality.RESULTS:Out of n=2,783 trauma activations, n=51 (1.8%) were COVID+. Compared to the general population, the trauma population had prevalence ratios for COVID of 5.3 to 79.7 (median=20.8). Compared to COVID- patients, COVID+ patients had worse outcomes, including a higher proportion who were admitted to the ICU, required intubation, underwent a major operation, and had greater total charges and a longer length of stay. However, these differences appeared related to more severe injury patterns in the COVID+ cohort. In the adjusted analysis, no significant differences between groups in any of the outcome variables were observed.CONCLUSIONS:Worse trauma outcomes in COVID+ patients appear to be correlated to the more substantial patterns of injury observed in this group. Trauma patients have substantially higher rates of SARS-CoV-2 positivity than the local population at large. These results reinforce that this population is vulnerable to multiple threats. They will guide the ongoing delivery of care in shaping the needs for testing, PPE for those delivering care, and the capacity and operational needs of trauma systems that must care for a population with such high rates of SARS-CoV-2 infection.
BACKGROUNDPast studies have shown a lack of consensus on the definition and terminology of drowning among experts in the field and relevant organizations. There is a need for a new look at the definition of drowning to improve the understanding of drowning events.METHODSA literature search of seven electronic databases, including PubMed, EMBASE, CINHAL, MEDLINE, Sport Discus, and Social Sciences from 1960 to 2020 was conducted using the MESH search terms "drowning", "near-drowning", "submersion", and "immersion". Cochrane databases were also searched for systematic reviews The items were searched in all fields of publication, including title, abstract, and keyword.RESULTSThe search identified approximately 2500 articles, 230 of which were reviewed. The inclusion criteria were applied to the full text of 230 articles, and 25 articles addressing the different definitions of drowning were assessed. They were reviewed critically by authors using a standard review form. The search identified that there were at least 20 different outcome measures for drowning incidents reported. Definitions of drowning in the literature were found for the following terms: dry versus wet drowning, secondary drowning, drowned and near-drowned, drowning without aspiration and drowning with aspiration, near drowning without aspiration or with aspiration, active drowning, passive drowning, silent drowning, witnessed and unwitnessed, immersion, submersion, death certificate records drowning, unintentional submersion, road traffic injury leading to passenger vehicle drowning, drowning, near drowning, salt or freshwater drowning, and cold water drowning.CONCLUSIONSIn the literature, a lack of consensus was observed but the following terms should not be abandoned; "Non-fatal drowning" which is used to describe death following rescue and life with at least 24 hours of in-hospital survival and the development of one or more complications and "Fatal drowning" which implies death occurring at the scene or 24 h of a submersion incident.
BACKGROUND Sexual violence (SV) is a serious public health problem affecting millions of people each year. The main aim of this article is to provide a large-scale snapshot of the field of knowledge in SV research using a scientometric approach. METHODS Documents were retrieved from the Web of Science database. Then, a scientometric study was carried out on a sample of 65,610 documents. Co-citation and co-occurrence measures have been calculated and related networks have been drawn using Citespace and Biblioshiny software. RESULTS The main findings indicate that research in SV has increased significantly in recent years. On the other hand, the publication of about one-third of these documents by a single author is due to the special nature of this topic and its taboo in many societies. In addition, a large number of multimedia documents demonstrate the role and importance of multimedia resources in SV studies. Despite the attention to SV research by poor or developing countries to research in the field of SV, 95% of the documents have been published by 20 developed countries. Additionally, the general research approach has changed from criminology to psychology. CONCLUSIONS Therefore, it seems that the discussion of psychological disorders in the occurrence of sexual violence reveals a new approach to SV. The concepts related to SV have been linked to broader areas than in the past. This, along with emphasizing prevention topics in the long term, will increase awareness of SV and reduce the possibility of abuse of vulnerable people.
BACKGROUND Pre-hospital emergency has a crucial role in providing timely care for patients. In this system, seconds and minutes mean the difference between life and death. Considering the importance of the role of pre-hospital emergency in providing services to different patients and the necessity of continuous evaluation of this system, the present study was conducted to investigate time indicators in pre-hospital emergency missions. METHODS This cross-sectional study was conducted in 2022 in Qazvin province, Iran. The research population was all the calls made to pre-hospital emergency bases in Qazvin province The required information, including time indicators and demographic characteristics of the patient, was obtained using the electronic registration system (Asayar). Data were Analysis using descriptive statistics and SPSS 20 software. RESULTS Out of the 35,943 patients admitted to the hospital, 20,915 were male while the remaining were female. The mean age of the patients was 44.09 ± 21.82 years. Accidents (29.41%) were the most common reason for contacting the pre-hospital emergency. In all transfer missions, the mean delay time (0:02:23 ± 0:03:33), response time (0:15:02 ± 0:09:42), the time on the scene (0:18:33 ± 0:11:10), total run time (0:54:02 ± 0:25:20), transport time (0:20:25 ± 0:16:49), round trip time (1:32:43 ± 1:08: 43). CONCLUSIONS The findings of the present study provided valuable information about the variety and number of missions in a pre-hospital emergency. The results showed that some indicators are within the standard range and some indicators are far from other regions of the country and the world. Increasing the number of bases, increasing the number of ambulances, and Implementation of continuous training courses for personnel can improve time indicators and increase the quality of service to different types of patients.
Background: Prisoners of war (POWs) are usually at risk of suicide due to problems such as torture, social and emotional deprivation, etc. The present study aimed to investigate suicide cases among Iranian prisoners of war (POWs) over ten years of their presence in the camps in Iraq (1980-1990). Methods: Data required in this study were collected in two ways: 1-Iranian ex-POWs' death certificate by the Iraqi army clinic setting; 2-we interviewed 19 Iranian ex-POWs with sufficient information from detention camps and their events. The collected data were age, sex, duration of captivity, date of death, the suicide, and places of suicide (camp name). Results: During eight years of the Iraq-Iran war, about 40000 Iranian soldiers captured by Iraqi soldiers. Of them, at least 11 persons (0.0275%) lost their lives due to suicide. The rate of suicide among Iranian ex-POWs in Iraq was variable from zero to 28 per 100000 people. Nine (82%) of deceased were among registered prisoners of war, and three (%27.3) were civilians. The highest rate was among prisoners that spent seven years of captivity. The most common method of suicide was hanging and burning, with 45.5% (5/11) and 18.2% (2/11), respectively. Conclusion: Social support and providing suitable treatment for chronic and incurable diseases or creating situations for returning such patients to their home could be essential for suicide prevention. Transferring them to a third country (under the supervision of international groups such as International Committee of the Red Cross (ICRC) could be another way to reduce the amount of psychological stress and will also be helpful in their treatment.
Background: Secondary overtriage (SO) is the unnecessary transfer of traumatic patients between facilities, which causes the waste of the resources of the trauma centers and imposes extra costs on patients and caregivers. This study aimed to determine the frequency of secondary overtriage and patient-level, clinical, and hospital factors leading to secondary overtriage. Methods: This cross-sectional study evaluated the data of all trauma patients who were transferred to a high-level trauma center in Guilan between 2016 and 2020. The patients with SO were characterized as those transported to a trauma center with an injury severity score ≤15 and discharged alive within 48 hours without undergoing surgical procedure. Secondary overtriage and appropriate transmissions were analyzed using descriptive statistics. Multivariate logistic regression was used to identify the relationship between SO and patient-level, clinical, and hospital factors. Results: Out of 3342 transferred trauma patients, 3091(92.49%) had the inclusion criteria. The rate of SO was 25.68 % (794). These patients were younger (median 34 versus 36), with 253 women and 541 men. The highest SO belonged to spine injuries (109, 38.2%) (P less than 0.05). In both secondary overtriaged and appropriately triagedpatients, the main cause of transmission was the shortage of neurosurgeons (741, 93.3% and 1780, 77.5%)(P less than 0.05). At the patient level, sex (OR 0.632, 95%CI 0.480-0.832) and at the clinical level, injured body region (specifically spine injury (OR 2.233, 95%CI 1.472-3.388), the reason for transfer (OR 2.158, 95%CI 1.185-3.927), injury severity score (OR 0.655, 95%CI 0.0615-0.697) and length of stay (OR 0.368, 95%CI 0.317-0.428) had a significant relationship with secondary overtriage. Conclusion: About a quarter of transferred traumatic patients were identified as secondary overtriage. Continuous medical education, recruiting trained staff, improving the transfer protocols, extending collaborations between low-level/non-trauma and high-level trauma centers and using telemedicine can provide medical staff with more efficient guidance on transfer decision.
Background: In countries with evolving prehospital trauma care systems, it is recommended that volunteers especially youth can be trained to perform as first responders to render basic emergency care until care by formally trained health-care personnel’s is available. Based on the theory of planned behavior (TBP), the present study aims to predict intention to help road accident victim among young adults in a fast-urbanizing Indian city. Methods: A cross sectional survey was conducted among 695 college students of Jodhpur, Rajasthan by self-administered questionnaire based on theory of planned behavior (TPB). Predictor of behavioral intention to help an accident victim was assessed through partial least square structural equation model (PLS-SEM). Results:Theory of planned behavior provided a reliable and valid framework for predicting intention of college students towards helping an accident victim. Perceived confidence (β= 0.344, p less than 0.001); attitude (β= 0.323, p less than 0.001) and social norm(β= 0.251, p less than 0.001), all emerged as the significant direct predictor of intention. Perceived confidence also significantly predicted social norm (β= 0.370, p less than 0.001) and attitude (β= 0.281, p less than 0.001). Further, attitude towards helping an accident victim was also influenced by social norm (β= 0.366, p less than 0.001). Conclusions: Based on framework of TPB, role of perceived confidence, social norm and attitude is found to significantly predict intention among college youth towards helping an accident victim. Public health interventions designed towards engaging and training youth as first responders in countries with fragmented pre-hospital trauma care systems need to encompass these aspects by establishing community based training programs for potential first responders and recognition of good Samaritans.
BACKGROUND:Dehumanization is a psychological construct meaning denying a person's humanity. The present study has investigated the process of dehumanization in female victims of intimate partner violence using the grounded theory approach. METHODS:For this purpose, 130 women in Tehran were selected through the convenience sampling method, and after completion of the Revised Conflict Tactics Scales (CTS2), 60 female victims were identified. In-depth interviews started with these women, and the data reached theoretical saturation by interviewing ten victims. RESULTS:The data analysis shows the role of dehumanization in the experiences of female victims of intimate partner violence in the form of two models. The first model showed that from the victim's perspective, dehumanization plays a crucial role in intimate partner violence. The second model showed that dehumanization was experienced by these women and is involved in developing strategies in their response to the violence. The combination of these two models showed that dehumanization and violence in the context of domestic violence have a reciprocal relationship, forming a cycle between cognitions, emotions, and negative behaviors between couples. CONCLUSIONS:Data analysis demonstrated that dehumanization might have a role in experiencing intimate partner violence and contribute to IPV recurrence.
BACKGROUND:Physical and sexual harassment has extensive psychological consequences on people's lives. Therefore, the using of a valid measure to identify this unpleasant experience in people can be useful both in determining the starting point of interventions related to victims and in general screenings in the society. In this regard, due to the lack of native and multidimensional measures to investigate this phenomenon, the aim of this study was to design and validation of the psychosexual harassment questionnaire. METHODS:The research method was applied in terms of purpose and descriptive in terms of nature. The study population included all university students aged 18 to 30 in Hamadan province from 2021-2022. From this population, a sample of 600 participants was selected based on a multi-stage cluster sampling method according to the population of the studied cities. The measures were a 27-item researcher-made psychosexual harassment questionnaire and the Ryff Psychological Well-being Scale. RESULTS:The results showed that the factor load was 27 items appropriate and 2 items inappropriate which were removed from the questionnaire. Finally, four factors including sexual harassment, physical harassment, sexual-virtual harassment, and verbal harassment were identified, in total, four factors could explain 58% of the variance of psychosexual harassment. Based on this, the four identified factors explained 33, 12, 8, and 5 percent of the variance of the structure of the psychosexual harassment construct, respectively. The adequacy of Kaiser-Meyer-Olkin sampling and Bartlett sphericity test (7332.2132) was calculated to be significant at the level of 0.001. The overall reliability of this questionnaire was calculated based on Cronbach's alpha coefficient equal to 0.91 and the reliability of physical, sexual, sexual-virtual and verbal harassment dimensions equal to 0.90, 0.88, 0.81, and 0.82, respectively. CONCLUSIONS:As a result, given the validity and reliability of this measure, researchers can use this measure to determine the level of four cases of abuse expressed. Also, due to having a nominal table and its interaction with each of the four dimensions of the measure, followed by obtaining very accurate and detailed information from the subject, clinicians can use this measure for clients and patients, especially in the category of disorders.
BACKGROUND:The increasing rate of traffic crashes involving motorcyclists have turned into a public health and road safety concern. Furthermore, riding behaviors and their precedent factors have been identified as potential determinants for assessing, intervening, and preventing traffic injuries of motorists. This study aimed to identify the effects of a set of demographic and motorcycle-related variables as potential predictors on collision through riding behavior components. METHODS:The study sample was 1,611 motorcyclists who were selected through time-location sampling method from three cities in Iran. They responded a Motorcycle Rider Behavior Questionnaire (MRBQ) and a general questionnaire including sociodemographic and riding-related items. The chosen method to analyze the data was Structural Equation Modeling (SEM) through Lavaan package version 0.6-8 of R software version 4.1.0. RESULTS:All participants were male (100%) with a mean age of 28.1(SD=8.5) years. About 24.4% of riders experienced at least one crash during the last year and the majority of riders did not hold a motorcycle license (80.1%). The SEM model showed that riding license (0.06) and frequency of riding (0.09) had a direct effect on crash involvement. Some latent variables including speed violation (0.13), stunts (0.11) and traffic violation (0.07) had positive effects and safety violation (-0.07) had a negative effect on crash history. There were indirect effects between age and history of crash mediated by speed violation (-0.04), stunts (-0.04), traffic violation (-0.02) and safety violation (0.01). Also, the indirect effects of riding frequency on crash involvement were mediated by speed violation (0.01), traffic violation (0.006) and safety violation (-0.01). CONCLUSIONS:This study's main finding is that age and riding frequency are the main variables indirectly affecting crash involvement. Therefore, periodic training courses for younger riders is essential in order to decreasing crash involvements.
Background: Road traffic accidents are the leading etiological factor for maxillofacial trauma in India. The incidence of these accidents is impacted by various cultural, socioeconomic, and behavioral factors the understanding of which is paramount in assessing their importance in influencing the incidence of maxillofacial injuries. Methods: Data was collected via a questionnaire from 366 patients who reported with maxillofacial injuries due to Road Traffic Accidents to the casualty and maxillofacial OPD at a tertiary center in the Nalgonda District over a five-year period. Data collected included patient details, type of vehicle involved, speed of the vehicle, type of accident, location of the accident, the seating of the patient, presence of alcohol influence, usage of helmet or seatbelt and the injuries sustained by the patient. Statistical analysis was done using Chi squared test.Results:88.5%of the patients were male and 87.4% of the cases were injured in RTA involving two-wheeler vehicles. (50.3%)of the accidents took place between 6 pm to 12 am. 41.5% of cases reported their speed at the time of the accident as 40-60 kmph. 42% of accidents were reported as skid accidents. 70.29% of accidents on rural roads occurred at night (between 6 pm and 6 am) as opposed to 29.71% during the day. Only 4.37% of cases reported wearing seatbelts or helmets. 51.17% of the participants who were driving reported or were observed as being under the influence of alcohol. Conclusions: The poor conditions of the roads, the lack of use of protective measures while driving, and the high incidence of driving under the influence of alcohol were seen to be the most significant contributing factors to road traffic accidents causing maxillofacial injuries in the Nalgonda population.
BACKGROUND:Pre-hospital emergency care is a critical part of the health care system. Helicopter emergency medical service (HEMS) is a novel part of the medical services of the health care delivery system. The goal of these medical services is to provide appropriate treatments at the right place and time. The pre-hospital emergency is the first line of providing emergency care to patients and injured. To reduce the death and disability of patients, the optimal performance of various pre-hospital emergency branches, such as HEMS, is needed. Thereby, it is essential to pay attention to the importance of hospital wards and patient transfer. However, the HEMS can impose a high cost on the health care system. Due to a lack of evidence, in this study, we will investigate the reasons and consequences of transferring patients by HEMS in Shahid Beheshti Hospital in Qom. METHODS:This study is a cross-sectional descriptive study. In this study, sampling was done by the census, and all patients were transferred by air ambulance during the year 1400 (March 2021 to 2022) using the emergency department of Qom province, and the study of patient health records was performed. RESULTS:A significant percentage of patients (46.8%) were discharged from the emergency department in the first 6 hours. Most of the patients (79%) did not need surgery. 41.1% of the patients were traumatic patients with no pathological findings in their imaging. CONCLUSIONS:Many cases did not necessarily need HEMS to transfer. It is recommended to choose the candidates more carefully for air ambulance transfer to reduce unnecessary costs.
BACKGROUND:Although the impact of adverse childhood experiences (ACEs) on healthy behaviors of adulthood is largely investigated, the role of these adversities in a wide variety of impulsive and risky behaviors (RBs) as well as the role of mediating variables has been rarely studied. Therefore, the present study aimed to investigate the mediating role of positive-negative emotional motivations in the relationship between ACEs and RBs. METHODS:In a cross-sectional study, 401 adults of the general population of Kermanshah (201 individuals) and Kurdistan (200 individuals) were selected and they were assessed using the Risky, Impulsive, & Self-destructive behavior Questionnaire (RISQ) and the Childhood Trauma questionnaire (CTQ). Data were analyzed using latent profile analysis (LPA), the correlation tests and structural equation modeling. RESULTS:The prevalence of ACEs using LPA was estimated 37.7%. There was a significant correlation between all types of child abuse (not child neglect) and RBs. Emotional motivations played a mediating role in the relationship between ACEs and RBs (RMSEA=0.07, SRMR=0.05, CFI=0.92, TFI=0.90). The proposed model could explain about 11% of the variance of emotional motivations and around 70% of the variance of RBs. CONCLUSIONS:Considering the impact of ACEs on emotional motivations and the impact of emotional motivations on RBs, intervention on emotional motivations may help to reduce RBs in people who suffer from ACEs.
