Journal of injury & violence research最新文献

Background: The research was done to evaluate the value of the visual evoked potentials test in the assessment of visual pathways function in cases with head trauma and minimal findings on routine testing.

Methods: A prospective case series evaluating use of visual evoked potentials testing in patients with a history of head trauma and suffering from visual symptoms with no significant clinical and neuroimaging findings, referred for further work up.

Results: Thirty-four patients with a history of head trauma and subsequent visual complaints were included. 27 cases (79.4%) were male and 7 cases (20.6%) were female. The mean elapsed time after the trauma was 47.6 weeks (range: 3.5 to 320 weeks). Twenty-five cases had unilateral and 9 cases had bilateral visual complaints. History of coma with mean duration of 12 days was present in 4 cases. The best-corrected visual acuity was less than 1 Log MAR (legally blind) in 21 eyes. In 4 eyes (12%) the relative afferent papillary defect test was positive. Mild to moderate optic disc pallor was present bilaterally in 4 cases and unilaterally in 3 cases. Hemorrhagic patches were reported on MRI in 2 cases; no other cases had pathologic MRI findings. In unilateral cases, there was a statistically significant difference between the involved eye-sided lobe and the sound eye-sided lobe implicit time and amplitude. In patients with bilateral complaints, by testing each eye, the VEP amplitudes of both eyes showed significant differences with the International Society for Clinical Electrophysiology of Vision standards, whereas the implicit times showed not-statistically significant differences.

Conclusions: The visual evoked potentials test shows not only additional diagnostic value, not seen on routine clinical and neuroimaging testing, but also rather a high validity in tracing visual disability in traumatic brain injury.

Background: The aim of this study was to identify the characteristics of suicidal ideation (SI), suicidal plan (SP), and suicide attempt (SA) in patients who had survived suicide attempts.

Methods: In a one-year cross-sectional design in Khorasan Razavi province, all suicide attempters who were referred to urban and rural health care centers, hospital's emergency rooms and agreed to participate in the study were included. The previous twelve-month SI, SP and lifelong SA (prior to the current suicide attempt) were obtained.

Results: The mean age of 856 included individuals was 24.2±8.3 years. The majority (652,76.4%) were females. Half of them were first-time suicide attempters. The mean age of first SI was 22±7.7; SP 22±7.9; and SA 22.2±8 years. The twelve-month prevalence of SI and SP prior to the current suicide attempt was 30% and 26.7%, respectively. Males, unlettered, wedded, and employees were significantly older at their first time SI, SP, and SA (all p less than 0.001). SI (25,44.6%), SP(25,47.2%) and SA(34,75.6%) were more prevalent in widow/divorced individuals(all p-values less than 0.02). SI (OR=53.4,CI95%=33.6-85) increased the risk of SP, and SP(OR=6.7,CI95%=4.5-9.9) increased the risk of SA.

Conclusions: SI seems to be a more important predictor of suicide compared to SP, however, the fact that a significant number of attempters had not any previous detectable suicidal ideation or plan, indicates particular clinical considerations. We need to have some presuppositions about the factors leading to unplanned and unthoughtful suicide attempts.

Background: Over 95% of unintentional injury-related childhood deaths globally occur in low- and middle-income countries, such as Uganda. Risks for injury in settings like rural Uganda are vastly understudied despite differing patterns of child injury risk. The present study investigated the prevalence and type of hazards in children's environments in rural Uganda, as well as the relationship between hazard exposure and parent attitudes and perceptions regarding unintentional injury.

Methods: Our sample included 152 primary caregivers in Eastern Rural Uganda who had children in either 1st or 6th grade. All parents/guardians completed caregiver surveys following verbal instructions. Surveys assessed demographic information, child hazard exposure, and parent beliefs regarding child injury.

Results: Almost all parents (98.5%) reported daily exposure for their children to at least one of the hazards assessed. Caregiver's perceived likelihood of child injury was positively related to hazard exposure (r = .21, p less than .05). This relationship remained significant when controlling for family demographics, child grade level, and child injury history (F (7, 126) = 2.25, p less than .05).

Conclusions: Our results suggest that Ugandan parents are aware of the risks of children's exposure to hazards, but may lack the tools to address it. Development of injury prevention interventions focusing on behavioral change techniques may help reduce childhood injury and injury-related deaths in Uganda.

Background: According to official statistics in Iran, there were 17000 fatalities in road traffic crashes in 2018 that 25% of all crash fatalities belong to pedestrians. In most of the researches related to pedestrians' safety, one aspect of the traffic crash (e.g. the injury or crash severity) is almost considered for the investigation. In order to perform a complete study of the crash, accident size can be utilized which involves different aspects of the crash. Accident size is described in terms of the number of fatalities and injured individuals and the number of damaged and involved vehicles in a crash.

Methods: According to the fact that accident size has multiple indicators and it is not measured directly, traditional methodologies cannot be applied. So, in the present study the effective factors on the accident size of pedestrian crashes are investigated through structural equation modeling. For the purpose of this study, 3718 pedestrian-involved crash data occurred in Isfahan province is used for the modeling. The independent variables are weather conditions, road surface conditions, time, horizontal and vertical alignments, road type and location, driver's gender and age, vehicle type, pedestrian's age, gender and clothing color.

Results: The results indicated that highways, the pedestrians' invisibility, female and old-aged pedestrians, heavy vehicles, old-aged and female drivers are related to the increase of the accident size in pedestrian crashes. These results denote that the mentioned variables are associated with the higher number of injuries, fatalities, the higher number of involved and damaged vehicles in a crash.

Conclusions: Present study shows the importance of considering safety improvement measures in highways, educating the people in the society about the traffic safety, the separation of pedestrian and motor vehicle traffic flow and considering the old people in policies and programs for mitigating the accident size.

Background: Over 90% of morbidity and mortality associated with traumatic brain injury (TBI) occurs in low- and middle-income countries. Lack of reliable, high-quality data regarding TBI prevention and care hinders the ability to reduce TBI burden. We sought to identify current TBI data collection practices and capacity in Georgia, focusing on pre-hospital, hospital, and rehabilitation treatment.

Methods: The eight level I and two level II Trauma Hospitals in Georgia with the highest number of TBI admissions in 2017 were selected for study. A semi-structured survey about various aspects of TBI care was designed and semi-structured interviews of healthcare providers treating TBI patients (e.g. neurologists, neurosurgeons) were conducted based on this survey.

Results: Pre-hospital triage protocols were not routinely used to match patient treatment needs with hospital capacity. All hospitals provided specialist care for TBI 24 hours/day. MRI was available at only three (30%) centers, and in-hospital rehabilitation units were available in only one (10%). No center used a defined protocol for treating TBI patients and no national protocol exists.

Conclusions: Even among the largest, most highly specialized hospitals in Georgia, TBI care varies in terms of diagnostic and treatment protocols. While TBI specialists are available, diagnostic equipment often is not. Gaps in pre-hospital coordination and access to rehabilitation services exist and provide areas of focus for future investment in reducing TBI burden.

Background: Road traffic injuries (RTIs) pose a disproportionate public health burden in the low and middle-income countries (LMICs) like Uganda, with 85% of all the fatalities and 90% of all disability-adjusted life years lost reported worldwide. Of all RTIs which are recorded in Uganda, 50% of cases happen in Kampala -the capital city of Uganda and the nearby cities. Identifying the RTI prone-areas and their associated risk factors can help to inform road safety and prevention measures aimed at reducing RTIs, particularly in emerging cities such as Kampala.

Methods: This study was based on a retrospective cross-sectional design to analyze a five year (2011 - 2015) traffic crash data of the Uganda Police Force.

Results: Accordingly, 60 RTI prone-areas were identified to exist across the Kampala. They were ranked as low and high risk areas; 41 and 19, respectively and with the majority of the latter based in the main city center. The bivariate analysis showed a significant association between identified prone-areas and population flow (OR: 4.89, P-value: 0.01) and traffic flow time (OR: 9.06, P-value: 0.01). On the other hand, the multivariate regression analysis only showed traffic flow time as the significant predictor (OR: 6.27, P-value: 0.02) at identified RTI prone-areas.

Conclusions: The measures devised to mitigate RTI in an emerging city like Kampala should study thoroughly the patterns of traffic and population flow to help to optimize the use of available resources for effective road safety planning, injury prevention and sustainable transport systems.

Background: Although very few studies have investigated the association of narcissistic symptoms and aggressive driving, very little is known about association of narcissism and serious traffic outcomes such as crash and serious violation of traffic laws. The aim of this study was to determine whether there is an association between the narcissistic symptoms of professional bus drivers and high risk driving records or crash.

Methods: A total of 200 outer-city bus drivers were enrolled in 2018 from Tehran origin of trips. The narcissistic symptoms of drivers were assessed using the Narcissistic Personality Inventory-16 (NPI-16). The traffic police databases were searched for records of crashes or recorded negative traffic scores during a 3-year period prior to time of interviews. Data were analyzed using Stata 14 statistical software package.

Results: Mean age of the participants was 44.4 years with a standard deviation of 9.3 years. Fourteen drivers (7%) had a crash history over the past three years. Mean normalized narcissism score was 22.3 among those without a crash history over the past three years versus 18.8 among those with a crash history without statistical significance. Forty-four drivers (22%) had a negative traffic scoring record due to high risk traffic violations registered in police database over the past three years. Mean normalized narcissism score was 22 among those without negative score record over the past three years versus 22.3 among those with a negative score history. However, the difference was not found to be statistically significant.

Conclusions: The findings of present study does not support an association between crash risk or being a recorded high risk driver and narcissism levels. However, considering the complex risk profile of road traffic crashes, much larger studies are needed to rule it out.

Background: Injury has become the leading cause of death among adolescents. This study aimed to understand the prevalence of risk-taking behaviors and exposures and injuries among vocational school students and to provide guidance for further injury intervention.

Methods: A cluster sampling method was used to conduct a questionnaire survey of all grade one and grade two students in a vocational school in Jiangsu Province in April 2018. A self-administered questionnaire was designed to investigate information on basic demographic information, risk-taking behaviors and exposures, and injuries.

Results: A total of 1079 students were investigated, 490(45.41%) were boys; the mean age was 16.80±0.80 years; 560(51.90%) were grade one students. There were 57 injuries in the past 12 months. The overall injury incidence was 5.28%. The total proportions of risk behaviors ranged from 1.4% for playing on the street to 68.6% for not wearing reflective devices while walking at night. Behaviors of not using traffic safety protection devices were highly prevalent, including not using seat-belts in the back seat of cars (19.7%), not wearing helmet while taking/ riding an electric car (15.8%/13.0%), not wearing reflective devices while walking/riding at night (68.6% for pedestrians and 62.8% for two-wheelers riders). Girls generally had more negative mood exposures compared to boys. Boys generally had more traffic risk behaviors and bullying and violence experiences compared with girls. The average number of risk-taking behaviors and exposures was 8.73±8.06. The number of risk-taking behaviors and exposures was positively associated with injury, with OR of 1.07(1.04-1.10).

Conclusions: Risk-taking behaviors and exposures were prevalent among vocational school students and increased the risk of injury. Traffic safety, bullying and violence, and sports safety were the aspects need more attention. The intervention of such risk behaviors should aim at the characteristics of the population and their special behavior problems.

Background: Road Traffic Injuries (RTIs) impose a worldwide burden on public health and economy. RTIs result in a wide range of immediate and long-term consequences. However, little is known about post-discharge consequences of RTIs at national levels. In addition, reliable and producing valid data mostly through prospective studies is fundamentally required to address the issue. The aim of this paper was to describe the research protocol for development and psychometric evaluation of post-discharge consequences of road traffic injuries as part of the Persian Traffic Cohort (PTC) and complementary to the Iranian Integrated Road Traffic Injury Registry (IRTIR).

Methods: Literature review and expert's opinion were used to develop data collection tools. Registry timeframe was designed based on experts' opinion. Reliability of tools will be assessed using intra- and inter-rater reliability. The pilot phase of the Phone interviews on Post-discharge Consequences of Road Traffic Injuries (PCRTI) will be conducted in Tabriz in 2019.

Results: The PCRTI is designed to be applied at three different time points: one, six and twelve months after the crash. The PCRTI tools' main domains are: demographic, psychological, medical, social and financial which will be assessed through PC-PTSD, PHQ2, WHODAS, SES-Iran, EQ-5D-3L and Economic assessment standardized tools. The descriptive outcomes will be reported to the Ministry of Health and Medical Education of Iran.

Conclusions: The protocol satisfies the requirements of developing valid data collection tools for PCRTI.

Background: Due to a lack of effective registry system for road traffic deaths, some international organizations like the World Health Organization provide the estimated number of road traffic deaths. It was shown that there are differences in the number of road traffic deaths between the WHO estimates and national reports even in High-Income Countries. This study aimed to an investigation of reasons for differences between the national reports and world health organization estimates about road traffic deaths.

Methods: This study focus to investigate the World Health Organization reports of Global Status Report for Road Safety in years of 2009, 2013, 2015 and 2018 and related articles about the estimates of deaths related to road traffic crashes and the observed differences between the WHO estimates and national reports.

Results: The findings showed that the observed differences between the WHO estimates and national reports could be due to errors in the road traffic death registration system, errors in the regression model which was used for estimation, proposed variables for estimations, or all of them.

Conclusions: The estimations of WHO about road traffic deaths can be useful for countries especially for those which don't have the road traffic registry system or the registry system does not meet the quality criteria. These estimates may not be sufficiently robust if disregard for spatial differences, the epidemiological pattern of risk factors among the countries, and the type of regression model which was used for estimation.