Self-reported cycling behavior and previous history of traffic accidents of cyclists.

BACKGROUND: Cyclists are vulnerable traffic users and studying the cycling behavior of professional and elite cyclists, their previous history of traffic accidents combined with the current knowledge on high-risk behaviors of this group can be a useful basis for further studies on ordinary cyclists. This study aimed to determine the relationship between cycling behavior and the previous history of traffic accidents among members of the Cycling Federation of Guilan province in 2022. METHODS: A descriptive-analytical study was performed in which the Bicycle Rider Behavior Questionnaire (BRBQ) constructed in the Porsline platform was distributed using the WhatsApp social network. All participants were asked to self-report their cycling behavior. The final analysis was performed by using STATA software (version 14). RESULTS: The study subjects included a total of 109 cyclists with a mean age of 38.62 ± 10.94 years and a mean cycling experience of 13.75 ± 11.08 years. Using the logistic regression model, the relationship between gender (P = 0.039), years of cycling experience (P = 0.000), and education level (P ≤ 0.00), with previous traffic accidents, was found significant. There was also a significant relationship between stunts and distractions (P = 0.005), signaling violation (P = 0.000), and control error (P = 0.011) with previous traffic accidents. A significant association existed between stunts and distractions (P = 0.001) and signaling violation (P = 0.001) with a previous history of traffic injury within the last 3 years. CONCLUSIONS: The findings of this study can be used to establish cyclist safety and preventative planning in society. In behavior change intervention programs, it is best to target male cyclists with higher-level education. In addition, the behavior of the cyclists whose predominant term of signaling violations must be corrected should be targeted. It is necessary to shape information campaigns and educational programs aimed for cyclists with common high-risk behaviors, especially signaling violations.

Fatigue in taxi drivers and its relationship with traffic accident history and experiences: a cross-sectional study in the north of Iran.

BACKGROUND: The monotonous nature of work, long driving duration, and working overload hours cause frequent fatigue in taxi drivers. A high prevalence of fatigue is associated with traffic accidents. However, the risk factors associated with taxi driver fatigue are unclear. Therefore, the present study aims to determine the rate of fatigue in taxi drivers and its relationship to their traffic accident experience. METHODS: In this descriptive-analytical study, 400 taxi drivers in the city of Rasht were registered in Taxi association selected through random sampling and entered into the study based on inclusion criteria. Data was collected through a researcher-made questionnaire reliable and valid by two medical students. The statistical analysis used ordinal data and a Poisson regression model with SPSS software version 21, with a significance level set at 5%. RESULTS: The driver fatigue self-reported was directly and significantly related to alcohol consumption (OR = 3.43, 95% CI 1.01-11.62) and had a significant and inverse relationship with smoking (OR = 0.50, 95% CI 0.32-0.76), being married (OR = 0.08, 95% CI 0.01-0.40) and driving experience there was (OR = 0.96, 95% CI 0.94-0.98). Drivers' sense of quality of life (QOL) was directly and significantly related to smoking (IRR = 1.43, 95% CI 1.28-1.59), education level under diploma (IRR = 2.41, 95% CI 1.43-4.06) diploma (IRR = 2.06, 95% CI 1.21-3.48) and bachelor (IRR = 2.42, 95% CI 1.36-4.29) and there was a significant and inverse relationship with age (IRR = 0.98, 95%CI 0.98-0.99). There was a significant relationship between the number of traffic accidents in the past year with the level of bachelor's degree (IRR = 3.10, 95% CI 1.43-6.76) and driving experience (IRR = 1.03, 95% CI 1.02-1.04 and inverse relationship between the number of traffic accidents in the past year and the QOL sense (IRR = 0.96, 95% CI 0.93-0.99) and the working hours (IRR = 0.96, 95% CI 0.94-0.99). CONCLUSION: Legislators and policymakers should pay more attention to fatigue in single and inexperienced taxi drivers. Regarding the QOL, pay attention to drivers with high education and older. To reduce the number of crashes, pay more attention to drivers with a bachelor's degree and less driving experience and improve the feeling of QOL.

Return to work after traumatic spinal fractures and spinal cord injuries: a retrospective cohort study.

This study aimed to determine the factors associated with return to work (RTW) after traumatic spinal fracture and spinal cord injury. It provided a predictive model for RTW among patients with spinal fractures and spinal cord injury and determined important factors influencing the time to RTW after injury. A retrospective cohort study was conducted in Poursina Tertiary Hospital, Guilan, Iran between May 2017 and May 2020. Patients aged 18 to 65 who were hospitalized with traumatic spinal fractures and spinal cord injuries were included. Demographic and clinical data were collected from the National Spinal Column/Cord Injury Registry of Iran (NSCIR-IR). A researcher-administered questionnaire was used through a telephone interview to obtain complementary data on social and occupational variables. Kaplan-Meier survival analysis was used to estimate the average time to RTW and the predictors of RTW were determined by multivariate Cox regression model. Of the 300 patients included, 78.6% returned to work and the average time to RTW was about 7 months. The mean age of the participants was 45.63 ± 14.76 years old. Among the study variables, having a Bachelor's degree (HR 2.59; 95% CI 1.16-5.77; P = 0.019), complications after injury (HR 0.47; 95% CI 0.35-0.62; P = 0.0001), full coverage health insurance (HR 1.73; 95% CI 1.10-2.72; P = 0.016), opium use (HR 0.48; 95% CI 0.26-0.90; P = 0.023), number of vertebral fractures (HR 0.82; 95% CI 0.67-0.99; P = 0.046), and length of hospital stay (HR 0.95; 95% CI 0.93-0.98; P = 0.001) were found to be significant in predicting RTW in Cox regression analysis. Our analysis showed that wealthier people and those with high job mobility returned to work later.

Epidemiology of head injuries in pedestrian-motor vehicle accidents.

Despite efforts of many countries to improve pedestrian safety, international reports show an upward trend in pedestrian-motor vehicle accidents. Although the most common cause of death of pedestrians is head injuries, there is a lack of knowledge on the epidemiology and characteristics of head injury in terms of the Glasgow Outcome Scale to be used for prevention. However, this study aimed to determine the epidemiology of pedestrian-motor vehicle accidents, the characteristics of head injury, and differences in the Glasgow Outcome Scale in terms of gender. In this retrospective analytical study, the data of 917 eligible injured pedestrians were obtained from the two databases of the Trauma System and the Hospital Information System. The data were analyzed using SPSS software (Version 21). The mean age of all 917 injured pedestrians was 47.55 ± 19.47 years. Most of the injured pedestrians (42.10%) were in the age range of 41-69 years and 81.31% were male. Moreover, 83.07% did not have any acute lesions on the CT scan. The most common brain lesion was brain contusion (n = 33, 3.60%), subarachnoid hemorrhage (n = 33, 3.60%), and skull fracture (n = 29, 3.16%). Among all concurrent injuries, lower extremity/pelvic injuries were observed in 216 patients (23.56%). Outpatient treatment (n = 782, 85.27%), airway control/endotracheal intubation (n = 57, 6.22%), and resuscitation (n = 35, 3.82%) were the most applied treatments respectively. There were significant differences in the Glasgow Outcome Scale between men and women (P- value = 0. 012). The high rate of mortalities, disability, head injuries, contusion, subarachnoid hemorrhage, and skull fractures in pedestrians involved in MVAs emphasizes the need for developing and implementing prevention strategies including appropriate management and risk reduction. Male pedestrians were at higher risk of motor vehicle accidents and worse Glasgow Outcome Scale. The presented data identified the main types of pedestrian injuries and suggested the importance of adopting appropriate preventive strategies to achieve the most effective interventions for creating a safer community.

Helmet Use and Jaw and Tooth Injuries in Motorcyclists Admitted to a Referral Hospital.

Background and Aim: The use of helmets has been reported to reduce the incidence and severity of head injuries in motorcyclists. However, there remains a significant gap in knowledge regarding the effectiveness of helmets, especially in preventing jaw and tooth injuries. Patients and Methods: In this retrospective analytical study record, all traffic accidents that occurred continuously from 2017 to 2019 in which the motorcyclists were on at least one side of the collision based on inclusion criteria. Data from injury variables in medical records were merged with data related to helmet use in the trauma registration system in Excel software. Then, the final analysis was performed with STATA software version 14 at a significance level of < 0.05. Results: In total, 1807 people participated in the study, and 160 (9.37) people used helmets. The incidence rate of jaw and tooth injuries was 86 (5.04%). Logistic regression implied that the odds ratio for helmet use was 0.7, which considering the p value of 0.419, shows no significant relationship between wearing helmets and jaw and tooth injuries. Conclusion: Helmets alone cannot prevent jaw and tooth injuries, and designers should design helmets that protect the head and the jaw and tooth. In prevention programs and campaigns for motorcyclists, every age, gender, job, grade group and marital status are target groups.

Investigating the behavior of pedestrians and related factors in northern Iran in 2021.

Among all road users, pedestrian behavior is most unpredictable, and our knowledge of pedestrian behavior and compliance in northern Iran is limited. The aim of the study was to determine the self-reporting behavior of pedestrians and related factors in northern Iran in 2021. This cross-sectional study's research tool included demographic characteristics, social characteristics, and a pedestrian behavior questionnaire (PBS - 43 questions). Data collection was randomly performed in 30 different passages around Rasht (a city in the north of Iran). We used the Poisson regression model and statistical software STATA version 15 for data analysis. With increasing age, pedestrians showed better crossing behavior (p < 0.001, ß = 0.202), and the behavior of female pedestrians was better than that of male pedestrians (p < 0.001, ß -4.79). As pedestrians, those with private jobs had worse crossing behavior than others (p < 0.045, ß = 9.380), and those pedestrians who mentioned they were motorcyclists before had worse crossing behavior than others (p < 0.045, ß = 9.380). The findings of this study can be used to establish pedestrian safety and preventative planning. In behavior change intervention programs, it is best to target young male pedestrians aiming to walk to their workplace, a private business. In addition, the behavior of pedestrians whose predominant means of transportation is the motorcycle must be corrected. It is necessary to conduct information campaigns and educational programs for pedestrians with common high-risk behaviors, especially errors and violations.

Psychiatric symptoms and pain in maxillofacial injury following motor vehicle accidents: A comparative study.

BACKGROUND/AIM: Post-traumatic stress disorders, depression, and pain are rarely discussed in the literature on maxillofacial injuries, and psychiatric symptoms and pain are not identified and managed in such patients. The aim of this study was to determine the symptoms of post-traumatic stress disorders, depression, and pain in people with maxillofacial injuries following motor vehicle accidents. MATERIAL AND METHODS: In this cross-sectional study, people injured in motor vehicle accidents from March to September 2015 who were referred to a medical educational center in the northern part of Iran for treatment follow-up were sampled. The existing symptoms of post-traumatic stress disorder by PSS, depression by BDI-II, and pain by NRS were assessed. SPSS software version 21 was used for analysis. RESULTS: Maxillofacial injured patients had significant differences in terms of post-traumatic stress disorder (p = .006), depression (p = .001), pain (p = .001), and length of hospital stay (p = .002) than patients without maxillofacial injuries. CONCLUSIONS: Motor vehicle accident victims with maxillofacial injuries suffered significantly more from post-traumatic stress disorders and depression, pain and length of hospital stay than patients with other injuries.

A study of students' use of restraint systems in school transportation services in primary and secondary schools in northern Iran: an observational study.

BACKGROUND: Traffic accidents are one of the leading causes of death and severe injury among child occupants of vehicles in most countries. This has led to the consideration of how to use restraint systems for students in school buses. The purpose of the present study was to determine the percentage of students' use of restraint systems in school transportation services in 2020. METHODS: In the present cross-sectional observational study, seatbelt use was assessed in 400 students in school transport vehicles using a checklist. The observation team sat at their vehicle, at the nearest location on one of the three sides of the school's entrance: they had by manually registering the variable in the checklist. They focused on exactly the first vehicle parked next to the school entrance. There were two other observers to validate the observations. Data were analyzed by SPSS software (version 21). RESULTS: The rate of using restraint systems was 11.3%, use of restraint systems in the Sport Utility Vehicles (SUVs) was significantly higher (P < 0.03), in areas with medium income (P < 0.009) and low income (p < 0.012) as well as when the students were sitting in the rear seats, using the seatbelt were significantly lower (P < 0.001). Seatbelt use in students was less in services driven by drivers over the age of 40 (P < 0.01) and more in vehicles driven by female drivers (P < 0.003) and newer vehicles (p < 0.001). CONCLUSION: School authorities must enforce traffic safety rules for school transportation services. These rules should be taught to drivers, families, and students. A restraint system must be mandatory for all students. School officials must equip their buses with seatbelts and employ school bus assistants to encourage wearing seatbelts and prevent students from standing.

Effect of Text Messaging-based Psychiatric Nursing Program on Quality of Life in Veterans with Post-Traumatic Stress Disorder: A Randomized Controlled Trial.

BACKGROUND: Recurrent post-traumatic stress disorder (PTSD) can devastate the life of a veteran. Despite the widespread use of mobile learning technology in health care and nursing, few studies have examined its potential in PTSD patients and the effect on quality of life (QoL). The present study aimed to investigate the effect of a text messaging-based psychiatric nursing program on QoL in veterans with PTSD symptoms. METHODS: A single-blinded, randomized, controlled trial was conducted at the outpatient clinic of Sadr Hospital in Tehran (Iran) from January 2014 to October 2015. A total of 98 veterans with PTSD who referred to the outpatient clinic of the hospital were initially assessed for eligibility to participate in the study. Based on the inclusion criteria, 66 veterans were recruited in the study and randomly allocated to a control group (n=33) and an intervention group (n=33). Due to the lost to follow-up, 9 participants (control=4, intervention=5) were excluded from the analysis phase. The intervention group received psychiatric support via short text messages for 6 months, whereas the control group received the routine hospital care. The self-rating scale for PTSD (SRS-PTSD) and the short form 36 (SF-36) were used to evaluate the severity of symptoms and the QoL, respectively. The results were analyzed using the SPSS software (version 18.0) with the Chi-square test, Fisher's exact test, independent sample t test, and paired sample t test. P<0.05 was considered statistically significant. RESULTS: A significant improvement in PTSD (P=0.001) and QoL (P=0.001) was observed in the intervention group compared to the control group. Moreover, the recurrence frequency in the intervention group was significantly lower (P=0.03). CONCLUSION: The text messaging-based psychiatric nursing program reduced the severity of symptoms in veterans with PTSD and improved their QoL. Trial Registration Number: IRCT2013101214983N1.

Predictors of Post-Traumatic Stress Disorder among Victims of Serious Motor Vehicle Accidents.

BACKGROUND: Compelling evidence has shown that motor vehicle accidents have an enormous impact on mental health. Post-traumatic Stress Disorder (PTSD) is one of the most common psychological consequences in adult survivors of accidents, so it is important to understand the prevalence and predictors of this issue since delay causes damage to crucial daily functioning. This study aimed at investigating the prevalence and predictors of PTSD after motor vehicle accident. METHODS: This cross-sectional study was conducted on 528 injured patients six weeks to six months after motor vehicle accident in Imam Reza Clinic of Poursina hospital, Rasht in 2015. Data collection tools were three questionnaires including post-traumatic stress-self report (PSS), Beck Depression Inventory (BDI-II), and the Numeric Rating Scale (NRS) for pain. The data were analyzed in SPSS (Version 19) using Chi-square, Fischer's exact test and multivariate logistic regression. Significance level was considered P≤0.05. RESULTS: The prevalence of PTSD and depression was 30.49% and 19.89% in participants, respectively. Chi-square test indicated a significant relationship among age (P=0.02), sex (P<0.001), education level (P<0.001), work status (P<0.001) and PTSD. Participants who reported pain (P<0.001) and depression (P<0.001) were more likely to have high score of PTSD than the others. Multivariate logistic regression showed this significance in sex, depression, age, educational status and pain, as constant risk factors in developing PTSD after accident. CONCLUSION: This study suggests that primary care setting should be readily prompted for diagnosis of these disorders in non-treatment seeking individuals in the community.

Psycho-social and Mental Variables and Post-Traumatic Stress Disorder in Traffic Accident Survivors in Northern Iran.

OBJECTIVE: To assess the psycho-social and mental variables associated with post-traumatic stress disorder (PTSD) in a series of Iranian patients. METHODS: A total of 528 eligible accident survivors in pre-sampling of a randomized controlled trial targeting PTSD were included in this cross-sectional study. Psycho-social characteristics associated to PTSD were explored in these survivors in an outpatient clinic. They completed the questionnaires via interview between six weeks to six months after accident. Data collection tools were PSS (DSM-V version) for PTSD and BDI-II for depression and a researcher-made questionnaire for psycho-social variables. RESULTS: There was a significant association between PTSD and the following variables; family communication, current depression, return to work, history of death of relatives, witnessed the death, length of amnesia, hospitalization, injured situation, and accident severity. Multivariate logistic regression indicated that some variables were associated with PTSD such as accident severity, (p<0.001), injured situation, (p<0.001), current depression, (p<0.001), RTW (p<0.001), and family communication (p=0.01). CONCLUSION: Psychiatric nursing prevention efforts is best directed toward motorcycle depressed drivers with severe accident and poor family communication who do not return to work. Thus, routine assessment of PTSD, depression and psycho-social variables after traffic accidents must be taken into account.