BACKGROUND:Trauma patients recovering from coma face significant physical, psychological, and social challenges after returning home, which may adversely affect their daily lives and well-being. Exploring these experiences can inform care needs and guide tailored post-discharge support. Accordingly, this study aimed to explore post-discharge life experiences in trauma patients recovered from coma. METHODS:This qualitative study was conducted using conventional content analysis. A total of 17 trauma patients who had recovered from coma and had been discharged at least three months prior were selected through purposive sampling. For data collection, 20 face-to-face, semi-structured interviews were conducted until data saturation was achieved. Data analysis followed the Graneheim and Lundman approach. The rigor of the study was ensured using Guba and Lincoln's criteria. RESULTS:The findings revealed that the main theme of post-discharge life experience was characterized as "pleasant freedom with suffering wounds," encompassing three categories: "freedom from captivity of alienation and despair," "dubious pleasure," and "integration of real and imagined disability and helplessness." CONCLUSIONS:The initial perception of post-discharge life among trauma patients who recovered from coma is profoundly shaped by the unpleasant experiences endured during ICU hospitalization. The sufferings experienced at home reflect a combination of real complications and imagined concerns arising from the severity of trauma, often accompanied by a false sense of disability and helplessness. These findings underscore the necessity of softening the ICU environment, implementing comprehensive discharge preparation, and providing effective post-discharge follow-up that addresses not only actual physical and psychological problems but also perceived or imagined sufferings.
BACKGROUND:Adult Attention-Deficit/Hyperactivity Disorder (ADHD) is under-recognized in professional drivers, yet it poses significant safety risks. The Conners' Adult ADHD Rating Scale Short Version (CAARS-S:SV) lacks empirically validated cutoff scores for occupational screening in Iran. This study aimed to assess the psychometric properties of the Persian CAARS-S:SV in taxi drivers and to determine optimal ADHD diagnostic thresholds using both traditional and machine-learning methods. METHODS:A sample of 298 male taxi drivers (mean age 36.8 ± 8.9 years) completed the Persian CAARS-S:SV. Internal consistency was evaluated with Cronbach's α, and construct validity was tested via confirmatory factor analysis (CFA). The dataset was randomly split into training (n = 198) and test (n = 100) subsets. Diagnostic thresholds were derived using receiver operating characteristic (ROC) curve analysis, item response theory (IRT; Terluin et al. method), logistic regression, and Random Forest (RF) modeling. Performance metrics-sensitivity, specificity, positive predictive value, and negative predictive value-were computed on the test set. RESULTS:Cronbach's α coefficients ranged from 0.72 (Subscale A) to 0.89 (total score), and CFA fit indices supported the three-factor structure (χ2/df = 2.40, RMSEA = 0.07; CFI = 0.91). ADHD prevalence was 20.8% (n = 62). ROC and RF methods identified optimal total-score cutoffs yielding sensitivity = 88% and specificity = 86.7%. For Subscale D, ROC achieved sensitivity = 96% and specificity = 76%, while RF achieved sensitivity = 92% and specificity = 85.3%. However, RF resulted in lower error value to diagnose the status of ADHD in the participants. IRT, ROC, and RF matched for subscales A, B, and C but produced an unacceptably low sensitivity (68%) for the total score (threshold = 24), reflecting a violation of IRT's unidimensionality assumption. Logistic regression performed less favorably (sensitivity 16%-60%). CONCLUSIONS:The Persian CAARS-S:SV is a reliable and valid instrument for ADHD screening in Iranian taxi drivers. ROC curve and Random Forest methods yielded the most accurate cutoff scores, particularly for the overall scale and dimension D. These empirically derived thresholds can enhance early identification of adult ADHD in occupational health settings and support the development of data-driven screening protocols.
BACKGROUND:Elder abuse constitutes a significant violation of human rights and is linked to various harmful psychological and physical consequences. This research aimed to investigate these effects by assessing the prevalence of elder abuse and its relationship with resilience and health-related quality of life among older adults who attended the comprehensive health centers in Sanandaj, Iran, in 2023. METHODS:This study employed a cross-sectional design that involved 200 elderly individuals who sought services at comprehensive health centers in Sanandaj city, located in the Kurdistan province of Iran, in 2023. Participants were chosen through a two-stage process. The data collection instruments included a form for recording demographic information, a questionnaire on elder abuse, and the CD-RISC measure. Data were analyzed using univariate and multivariate logistic regression, along with the Pearson Correlation test in STATA12 software, setting the significance level p-value ≤ 0.05. RESULTS:The findings revealed that 57.5% of the participants had encountered some form of abuse, with psychological abuse being the most prevalent at 50%. The examination illustrated a significant relationship between the extent of elder abuse and the average mental health scores (p=0.001), resilience (p=0.001), living situation (p=0.05), and Educational level (p=0.05). Furthermore, there was a statistically significant relationship between resilience scores and mental health (r=0.572, p less than 0.001). CONCLUSIONS:In conclusion, the research indicated that a majority of elderly individuals had faced abuse, with higher occurrences among those who were illiterate and resided in rural settings. The findings also suggested that older adults with greater resilience scores experienced lower levels of elder abuse and reported better mental health.
BACKGROUND:Hearing impairment is a potential consequence of brain trauma and may present as conductive, sensorineural, or mixed hearing loss. METHODS:This descriptive-analytical study included patients who sustained brain trauma between 2018 and 2019 and reported hearing difficulties. All participants were examined by an ENT specialist, and audiometric evaluations were conducted immediately after trauma and again one year later. Based on inclusion criteria, all patients referred to Ayatollah Taleghani medical centers were enrolled, resulting in a sample of 70 cases. Data were analyzed using SPSS version 22, with chi-square tests applied at a significance level of p = 0.05. RESULTS:The mean age of participants was 33 ± 18 years, with males comprising 84% of the sample. A significant correlation was observed between initial and one-year follow-up audiometric findings. Among patients with temporal bone fractures, 60% exhibited sensorineural and conductive hearing loss. CONCLUSIONS:Sensorineural hearing loss was identified as the most prevalent disorder, particularly associated with moderate trauma (GCS scores 9-12). Temporal bone fractures, primarily resulting from accidents, were the most common type of brain injury, with 48.5% of cases showing right-sided involvement.
BACKGROUND:Violence Against Women (VAW) impacts 1 in 3 women worldwide, making it a significant public health problem. Most survivors will seek some form of care at healthcare facilities, often making hospitals a critical point of intervention. Psychosocial support plays a crucial role in the rehabilitation of survivors, helping them navigate the physical, emotional, and psychological consequences of violence. This study sought to assess the experiences of both Healthcare Workers (HCWs) and users of facility-based psychosocial care at a private, not-for-profit hospital in Uganda. METHODS:A qualitative design using in-depth interviews was employed to explore experiences and perspectives of eight survivors and nine healthcare workers at a private not-for-profit hospital in Uganda in 2023. RESULTS:The psychosocial services included screening, medical treatment, mental health support, referrals, and follow-up care. Key challenges identified were: limited Healthcare worker capacity to provide psychosocial care, inadequate infrastructure to provide safe spaces for care; high loss to follow up rate; and poorly formed networks with other service providers. While survivors appreciated care, findings emphasized the need for enhanced staff training, more tailored support for survivors and awareness creation for response services at the facilities. CONCLUSIONS:While survivors value psychosocial services, gaps remain in staff capacity, infrastructure, visibility, and follow-up. A client-centered approach that protects privacy, enhances training, and strengthens referral networks can make care more responsive, comprehensive, and sustainable for women affected by violence.
BACKGROUND:Head trauma is a known cause of seizures, with about 10% of patients with moderate or severe injuries experiencing seizure events. Early prevention and control of seizures are critical to limit secondary brain injuries. This study aimed to evaluate the frequency, type, and timing of seizures in patients with traumatic brain injury. METHODS:This analytical-descriptive study included all patients with post-traumatic seizures. Exclusion criteria were pre-existing brain disorders, prior epilepsy, or anticonvulsant use. Data were collected from hospital records using a structured checklist, with incomplete information supplemented by phone contact. Statistical analysis was performed using SPSS with chi-square, Fisher's exact test, and t-tests, considering p less than 0.05 as significant. RESULTS:Twenty-five patients (mean age 34 years) were studied. Accidents were the most frequent cause in men (54%), while falls predominated in women (100%). Chronic subdural hematoma was the most common brain injury in men, whereas Subarachnoid Hemorrhage (SAH) and SAH with brain contusion were noted in women. Primary seizures were most common in men (63%), while late seizures predominated in women (66%). Tonic-clonic seizures were the most frequent type in both men (95%) and women (66%). Recurrent seizures occurred in 22% of men and 66% of women. A significant association was found between Glasgow Coma Scale (GCS) level and both seizure type and timing (p less than 0.05). CONCLUSIONS:Children and adolescents are more prone to early-onset seizures, whereas adults experience both primary and late seizures. Generalized seizures were predominant (96%), with only 4% being focal. The overall incidence of post-traumatic seizures was 1.26%. These findings high-light the need for targeted monitoring of high-risk patients based on age and consciousness lev-el. Future studies should involve larger multicenter cohorts and explore alternative strategies for preventing both early and late post-traumatic seizures.
BACKGROUND:Suicide remains a critical global health crisis that disproportionately targets young adults, and medical students consistently display higher prevalence rates than their non-medical peers. The main aim of this study was investigation of the mediating roles of three intrapersonal factors-perfectionism, difficulties in emotion regulation, and self-disgust-in the relationship between psychological distress and suicidal ideation within in medical students. METHODS:The present study utilized correlational research design with path analysis. A convenience sample of 404 medical students from Kermanshah University of Medical Sciences (KUMS), Iran was selected in the latter half of the 2024-2025 academic year. Data were collected using structured questionnaires, including the Psychological Distress Scale (PDS), Beck Scale for Suicidal Ideation (BSSI), Difficulties in Emotion Regulation Scale (DERS), Frost Multidimensional Perfectionism Scale (FROST-MPS), and Multidimensional Self-Disgust Scale (MSDS). SPSS software version 26 handled descriptive statistics and assumption checks, whereas Amos software performed the structural modeling. RESULTS:The study found that psychological distress significantly predicted difficulties in emotion regulation (β = 0.370, P less than 0.001), perfectionism (β = 0.426, P less than 0.001), and self-disgust (β = 0.348, P less than 0.001). These variables mediated the relationship between psychological distress and suicidal ideation, with significant indirect effects through perfectionism (indirect effect = 0.094, p less than 0.001), difficulties in emotion regulation (indirect effect = 0.119, P less than 0.001), and self-disgust (indirect effect = 0.096, P less than 0.001). Among the total sample, 148 students (36.6%) were at high risk and 200 (49.5%) at very high risk of suicidal ideation. CONCLUSIONS:There is a strong correlation between suicidal ideation and psychological distress among medical students. The findings highlight the roles of perfectionism, difficulties in emotion regulation, and self-disgust in this relationship. Universities should enhance mental health support and offer interventions targeting these factors to reduce suicide risk.
BACKGROUND:Unintentional injuries are a major contributor to morbidity and healthcare burden in early childhood. While falls and fractures are globally recognized as the most common pediatric injuries, region-specific data from primary care emergency settings in Southeast Europe remain scarce. The objective was to investigate the mechanisms, anatomical distribution, and contextual factors of injuries in children aged 0 to 6 years treated in a primary care pediatric service in Bosnia and Herzegovina. METHODS:This retrospective study included ninety-nine children aged 0 to 6 years who presented with injuries to a primary care service between September 2019 and December 2024. Data were collected from medical records and included age, sex, mechanism of injury, type of injury, anatomical site, supervision, home safety, and treatment outcome. Descriptive statistics and chi-square tests were used to analyze associations between demographic variables and injury characteristics. Logistic regression was also applied to examine predictors of fracture occurrence, adjusting for age group and sex. RESULTS:Falls were the leading cause of injury, accounting for 69.7% of all cases, with the highest number recorded in the 13- to 36-month age group. Fractures were the most frequent injury type, of which 74.4% affected the upper limbs, particularly the radius and humerus. Head injuries were more prevalent among infants, while boys experienced a higher overall injury rate. No statistically significant associations were found between injury occurrence and supervision or home safety, largely due to missing data and limited sample size. CONCLUSIONS:Falls were the predominant cause of injury in early childhood, with upper limb fractures being common, especially among toddlers. While these findings provide important insights for prevention and pediatric emergency care planning in Bosnia and Herzegovina, larger prospective studies are needed to validate and extend these results.
BACKGROUND:A Level I trauma center used machine learning algorithms to identify risk factors and patterns in falls among older adults, which constitute our greatest burden of traumatic admissions. METHODS:A retrospective analysis was conducted on 2,391 ground-level fall trauma admissions from 2017-2022 including variables related to demographics, and weather conditions at admission. Supervised learning models were developed to predict older adult vs younger counterpart falls. In this machine learning modality, we generated a Decision Tree, a Support Vector Machine Classifier Algorithm, and a Logistic Regression Model. Unsupervised learning methods uncover patterns or groupings in the dataset of older adult ground-level falls, which consists of 1,742 records from 2017-2022 trauma admissions including comorbidity variables. Unsupervised learning methods of Principal Components Analysis, Hierarchical Clustering, and Market Basket Analysis were employed. RESULTS:All three supervised models found the female sex as an important variable in predicting older adult falls. Unsupervised learning identified discernible patterns and groupings, revealing that certain weather variables are associated with falls. CONCLUSIONS:These machine learning modalities can shed light on what may be important risk factors for older adult falls and can help to target awareness and outreach.
BACKGROUND:Traumatic spinal fractures is a serious condition with significant morbidity and mortality, commonly caused by falls. However, data on patient characteristics and epidemiological patterns are limited. This study aims to describe the epidemiological features of fall-related traumatic spinal injuries in Markazi Province, in center of Iran. METHODS:A retrospective cohort study was conducted on 337 hospitalized trauma patients diagnosed with spinal injuries due to falls during 2022-2023. The patients' information including demographic and clinical characteristics were gathered. Mechanism of fall was considered low (less than 3 meters) and high height (more than 3 meters). Data analysis was done with SPSS24 software. RESULTS:The mean (SD) age of the patients was 48.59 (SD = 17.73) years, with a range from 1 to 94 years. Among the patients, 240 (71.2%) were male, and 246 (73%) sustained injuries from falls at a low height. The variables of age, sex, length of stay, number of injured vertebrae, ICU hospitalization, surgery, level of injury, presence of spinal cord injury, and occupation all showed a significant relationship with the mechanism of the fall (p less than 0.05). Additionally, the level of injury was associated with age, ICU hospitalization, presence of spinal cord injury, in-hospital mortality, length of stay in ICU, and ASIA classification (p less than 0.05). CONCLUSIONS:Our study identifies distinct patterns in fall-related spinal fractures by age and demographics, with high-energy falls linked to greater severity and low-height falls more common in older adults and women. Findings underscore the need for targeted prevention in occupational and domestic settings and suggest that clinical and demographic factors can aid in early identification of high-energy mechanisms.
BACKGROUND:Timely identification of the need for surgical intervention in traumatic epidural hematoma (tEDH) is critical to optimizing outcomes. This retrospective study aimed to identify predictive factors for surgical intervention in tEDH using machine learning and develop a nomogram to support clinical decision-making. METHODS:In this retrospective study, data from 147 patients with tEDH at a major trauma center in western Iran (2023-2024) were analyzed. Demographic, Clinical, and CT scan data were extracted from medical records. Four machine learning models (Logistic Regression (LR)/ Support Vector Machine (SVM)/ Naive Bayes (NB)/Neural Network (NN)), were developed to predict surgical need. A Random Forest (RF) algorithm identified key predictors, and a nomogram was constructed from the LR model to facilitate individualized risk assessment. Statistical analyses were conducted using R software (version 4.3.2). RESULTS:In this study, 131 (89.1%) of 147 patients with tEDH were male. Of these, 72 (49%) underwent surgery. The cause of brain trauma was a Motor Vehicle Accident (MVA) in 76 (51.7%) of patients and a fall in 50 (34%) of patients. The mean (±Standard Deviation) age of the patients was 31.47 (±18.27). The initial hematoma volume demonstrated the highest discriminatory power, with an AUC of 0.92 (95% CI: 0.83-1.00) and an accuracy of 0.89 (95% CI: 0.76-0.96). The Glasgow Coma Scale (GCS) score also exhibited strong predictive performance, with an AUC of 0.76 (95% CI: 0.62-0.89) and an accuracy of 0.71 (95% CI: 0.56-0.84). The SVM model demonstrated the highest AUC of 0.96 (95% CI: 0.91-1.00), with sensitivity and specificity values above 90%. CONCLUSIONS:In this study, the novel integration of machine learning with a nomogram offers clinicians a precise, user-friendly tool for rapid decision-making, potentially reducing complications. These findings help surgeons to make more informed clinical decisions by accurately assessing these parameters in the early stages and to identify patients at higher risk for surgical intervention more quickly.
BACKGROUND:Bangladesh has experienced a mass uprising that resulted in deaths, injuries, and trauma, ended with the ousting of an autocratic government on 05 August 2024. People from all spheres of life have experienced violence and trauma, including children and adolescents. OBJECTIVES:We aimed to report the socio-demography of 89 children killed in the mass uprising in Bangladesh in July-August 2024. METHODS:We extracted the data of this report from a widely circulated Bangla national daily newspaper. We extracted name, age, occupation, place of death, and district of killing. RESULTS:The mean (SD) age of the deceased was 15.2 (±2.6) years, ranging from 4-17 years. Among the 89 deaths, there were bullet wounds in 79 children, 9 died by burn, and one died by splinter; 56 deaths happened during 18 July- 4 August, and 31 deaths happened after 5 August, 2024; 58 deaths happened in Dhaka, and 31 deaths happened in districts outside Dhaka. Among the adolescents, 42 were students, and 29 were involved in child labor. Deaths happened in 16 districts in Bangladesh. CONCLUSIONS:This analysis revealed that about 90% of the adolescents were killed by bullets, indicating the spectrum of armed conflict. Dhaka was the center of violence that resulted in the killing of adolescents. Local, regional, and international human rights agencies should ensure initiatives to prevent such killings of children during any mass protest elsewhere in the world.
BACKGROUND:Driver-associated factors are significant contributors to road traffic accidents. Conversely, personality traits are the characteristics and qualities that define an individual's consistent patterns of thoughts, feelings, and behaviors. Driving behavior is influenced by a variety of factors. We hypothesized that different personality traits may affect driving behavior. This study aimed to investigate the relationship between various personality traits and involvement in accidents. METHODS:Drivers with a history of accidents resulting in injuries for which they were at fault were classified as cases, and drivers without a history of an accident in the past year were considered as controls. We assessed the Big Five personality traits among all participants using the NEO Five-Factor Inventory (NEO-FFI) test. Additionally, we collected data on potential determinants of high-risk driving, including age, marital status, education, alcohol consumption, smoking, psychiatric disorders, self-assessment of driving skills, and substance abuse. The NEO-FFI test scores were compared between cases and controls. We employed Partitioning Around Medoids (PAM) to create clusters for each personality trait. Logistic regression was utilized to examine the association between the independent variables and the clusters of personality traits, adjusting for potential confounders such as age, marital status, and education level. RESULTS:A total of 662 participants, comprising 393 cases and 269 controls, were recruited for the study. The mean score for neuroticism was significantly higher in the case group, while the mean scores for extroversion, agreeableness, and conscientiousness were substantially lower. The mean score for openness to experience did not show a significant difference. The Personality Assessment Model (PAM) identified two clusters for all personality traits, labeled as high and low. In the logistic regression model, high levels of neuroticism (aOR: 2.75, 95%CI: 1.69-4.45) and low levels of conscientiousness (aOR: 0.50, 95%CI: 0.30-0.84) were associated with an increased likelihood of being involved in a car accident. CONCLUSIONS:Drivers involved in severe accidents tended to exhibit higher levels of neuroticism and lower levels of extraversion, conscientiousness, and agreeableness, as measured by the NEO-FFI. Regression analysis revealed that elevated neuroticism and diminished conscientiousness were significantly associated with high-risk driving behaviors. Although assessing personality traits can aid in predicting risky driving, this association is not definitive, and caution should be exercised when generalizing these findings.
BACKGROUND:Pedestrian injuries killed almost 9000 Americans in 2021. Pedestrian fatality rates have increased annually since 2009. Many factors are associated with pedestrian fatalities, but one poorly-understood risk is the role of climate. We examined two primary sets of associations, those between pedestrian fatality crude rate (deaths per 100,000 population) and air temperatures in each US state (2012-2021) and those between national air temperatures and pedestrian fatality crude rate in each year from 2001-2021. METHODS:Data were obtained from public-facing CDC WISQARSTM and NOAA Climate-at-a-Glance websites. Descriptive and correlational analyses were conducted. RESULTS:Average air temperatures in individual US states correlated with pedestrian fatality crude rates in those states, r = 0.66. National average annual temperatures correlated with annual pedestrian fatality crude rates each year, r = 0.61. Secondary analyses considering correlations between annual pedestrian fatality crude rates and heating degree days, cooling degree days, and grid days over 70° F replicated primary results. Secondary analyses considering change in temperature from the previous year and pedestrian fatality crude rates were null. CONCLUSIONS:US pedestrian fatality crude rates are associated with air temperatures. Causality cannot be assumed, but possible explanations for the association include increased exposure to traffic during daytime walking in cooler climates and increased exposure to risk through more walking at night in warmer climates. If findings were translated into NOAA-estimated climate change scenarios of 1° of temperature change over 30 years, correlational associations from the past two decades maintained unchanged, and population presumed stable, between 430-755 additional pedestrian fatalities could occur annually in the future.
BACKGROUND:Fireworks are widely used worldwide for their visual and auditory appeal. However, they pose significant safety risks, particularly to children and young adults, many of whom sustain serious injuries from exposure to these pyrotechnic devices. Given the preventable nature of such incidents and their associated challenges, this study aims to examine the epidemiological impact of injuries caused by fireworks during the Chaharshanbeh Soori ceremony in Fars Province. METHODS:This cross-sectional study included all individuals who experienced injuries between March 6, 2022, and April 4, 2022. Data were collected by emergency technicians affiliated with Shiraz University of Medical Sciences. Statistical analyses included descriptive statistics (mean ± standard deviation [SD] and frequency [%]) and analytical methods, specifically the chi-square test. RESULTS:A total of 79 individuals were injured, with a mean age of 19.4 ± 11.5 years. The majority of the injured were male (73, 92.4%). Most injuries (66, 83.5%) occurred unintentionally, and 9 patients (11.4%) reported headache as a symptom, while 7 patients (8.9%) experienced visual disorders. Among those who received treatment, eye injuries were the most common (17, 26.2%). A significant difference was observed in recovery based on the injured body part; hand injuries had the highest recovery rate (6, 42.9%), compared to other injuries (p less than 0.029). CONCLUSIONS:The findings indicate that fireworks-related accidents during the Chaharshanbeh Soori ceremony predominantly affect teenagers and young adults, often occurring unintentionally. Given the significant physical, financial, and long-term consequences of these injuries, this study's results can inform policymakers in implementing preventive measures. Additionally, it highlights the need to raise awareness among the public and relevant authorities to ensure safer conduct of such ceremonies in the future.
BACKGROUND:Physical Violence by Firearms (PVF) is a type of violence which is considered a public health challenge in high-income countries. This study is designed to investigate the trend of incidence in these countries among different ages and gender groups, cluster countries based on PVF incidence rates, and analyze changes during the years 1990 to 2019. METHODS:At first, countries were clustered using the K-means algorithm, with the number of clusters determined by the elbow method. The clustering was based on the Euclidean distance of physical violence by Firearms (PVF) incidence rates, and the data were sourced from the Global Burden of Disease (GBD) database. The annual changes in the incidence in each cluster were calculated by means of sex and age groups. A heat map was also used to investigate the trend of firearms violence, and Arc map GIS was employed to provide the geographical incidence distribution of firearms violence by gender in 4-time points of 1990, 2000, 2010 and 2019. RESULTS:The United States, which was placed alone in a cluster, had the highest incidence changes with an increase of 1.44 cases per 100,000 per year. The highest incidence of violence was among American men aged 20-24, which ranged from 150 to 240 cases per 100,000 people between 1990 and 2019. CONCLUSIONS:The study highlights that access to firearms and related laws are key drivers of the increasing trend of PVF in high-income countries. The clustering of countries revealed distinct patterns of PVF incidence, with the USA showing the highest rates. These findings underscore the need for stricter firearm regulations and targeted interventions, particularly for young men aged 20-24, who are most affected by PVF.
BACKGROUND:Maxillofacial injuries are common in emergency departments of hospitals. However, there is limited regional data on facial fracture patterns in rural India. This study examines the etiology and anatomical distribution of facial fractures among adults attending Malda Medical College and Hospital in eastern India. METHODS:This retrospective study included all adult patients (≥18 years) with radiologically confirmed facial fractures from August 2018 to July 2023. Data were collected on demographics, etiology, and fracture location. Patients with isolated soft tissue injuries or dentoalveolar fractures were excluded. Data analysis was performed using Epi Info 7 software. RESULTS:In this study, 387 individuals with 557 facial fractures (averaging 1.43 fractures per person) participated. The average age was 37.56 ± 3.80 years, featuring a higher proportion of males (77.8%). Road traffic accidents (RTAs) accounted for 60.5% of the cases, making them the primary factor. Falls came next at 18.6%, followed by violence (12.1%) and sports injuries (8.8%). The most commonly affected areas were the mandible (33.0%), zygomatic complex (28.2%), and nasal bones (11.8%). Mandibular fractures were primarily caused by RTAs in males, while falls were more common among females. The etiology of fractures varies significantly between males and females (p = 0.000). CONCLUSIONS:RTAs were the main reason for facial fractures in eastern India, predominantly affecting young males.
BACKGROUND:There has been minimal research on drive-by shootings since the 1990s. It was the purpose of this study to investigate the demographics and injury patterns of drive-by shootings across the entire US using a national database. METHODS:The Inter-University Consortium for Political and Social Research Firearm Injury Surveillance Study 1993-2020 (ICPSR 38574) data for 1993 through 2020 was analyzed using statistical analyses accounting for the stratified and weighted nature of the data. RESULTS:There were an estimated 63,882 emergency department visits due to drive-by shootings. The drive-by group was younger compared to the no-drive-by group (average age 24.5 years vs. 28.7 years - p less than 10-4). Patients injured in drive-by shootings were more prevalent in medium and large size hospitals. There was a lower percentage of White (17.9% vs. 42.3%) and a higher percentage of Hispanic (30.1% vs. 13.1%) peoples in the drive-by group compared to the no-drive-by group (p = 0.0009). The head/neck (14.3% vs. 3.5%) and lower extremity (35.5% vs. 25.5%) were more commonly injured in the drive-by group compared to the no-drive by group (p = 0.0008). While those in the drive-by group were admitted to the hospital more often (43.9% vs. 32.7%), there was no difference in the percentage of fatalities between the two groups (4.4% drive-by, 4.9% no-drive-by). CONCLUSIONS:This study encompasses both rural and urban areas, all races, and both sexes. These national estimates give health care providers and health facility administrators important demographic information. While both drive-by and no-drive-by shootings increased from 2014 onward, the average annual increase was much greater for the drive-by group (22.7%) compared to the non-drive-by group (8.6%). This data provides helpful information that could be useful when analyzing prevention strategies and firearm legislation and their impact on drive-by shootings.
BACKGROUND:Firearm suicide ranks among the leading causes of death in the U.S. military, with access to personal firearms significantly elevating the risk of firearm-related injuries and death. In this study, we analyzed perceived risks of firearm access and storage among active-duty military service members and embedded civilians with a firearm at home. METHODS:We conducted an anonymous online survey at a single military installation in the United States. Data were analyzed using logistic regression models across four firearm-related risk factors: suicide, others' suicide, interpersonal violence, and unintentional shootings. RESULTS:Of the 324 participants, 50.5% reported a minimum of one firearm at the home. Respondents with a minimum of one firearm at home (vs. those without) were less likely to agree that there was a risk of suicide for themselves (6.0% vs. 16.6%) or others (7.8% vs. 21.8%), interpersonal violence (16.4% vs. 26.9%), or unintentional shootings (27.9% vs. 42.3%). After adjusting for age, gender, race, ethnicity, and living alone, respondents with a firearm at home (vs. those without) were significantly less likely to agree that firearm access increased the risk of suicide for themselves (odds ratio [OR]: 0.20; 95% CI: 0.10, 0.40; p less than .001) or others (OR 0.19; 95% CI: 0.10, 0.36; p less than .001), interpersonal violence (OR: 0.25; 95% CI: 0.15, 0.43; p less than .001), or unintentional shootings (OR: 0.22; 95% CI: 0.13, 0.38; p less than .001). CONCLUSIONS:Our findings identify opportunities for strengthening messaging to help service members understand and acknowledge risks surrounding a firearm at home and promote secure firearm storage behaviors.
BACKGROUND:Risky driving behavior (RDB), a major contributor to road traffic injuries, is a complex issue with multiple dimensions. This study aimed to explore the experiences and perspectives of drivers who engaged in risky driving behaviors in Shiraz, Iran. METHODS:In 2023, we conducted a qualitative study in Shiraz, Iran, with 35 drivers whose licenses were revoked for traffic violations. Through semi-structured interviews, we examined specific instances of high-risk behaviors, prompting drivers to recall the factors that led to their actions. Additionally, the questions explored the impact of various determinants of risky driving, drawing on participants' personal experiences. The data were analyzed using the conventional content analysis method. RESULTS:The findings revealed that various factors, ranging from individual to structural, contribute to the formation of RDB. We identified four themes: job conditions, personal traits, socio-cultural factors, and infrastructural factors. Economic pressures and employer-imposed time constraints contributed to risky driving, while impulsivity and thrill-seeking tendencies played a role at the individual level. Social norms, peer influence, and perceptions of arbitrary law enforcement were the sociocultural risk factors, and poor quality roads and inadequate traffic monitoring were infrastructural factors that contributed to reckless driving. CONCLUSIONS:This research underscores the interplay of economic challenges, job-related pressures, social dynamics, and personal characteristics in shaping RDB. Additionally, it sheds light on previously underexplored aspects which have implications for policy, traffic authorities, and driver training programs aimed at enhancing road safety in Iran.
