Search

Background: Previous analyses have revealed that the human factor is significant in causing traffic accidents. Antisocial driving behaviors have led to a phenomenon called driving violence, which poses a significant risk to other road users. Accordingly, this study aimed to explore the concept of antisocial driving behavior and its various types.Methods: This qualitative study was carried out using a content analysis approach and involved 12 participants selected through the purposive sampling method. In-depth semi-structured interviews were conducted from June to September 2019 in Tehran, Iran. Data were analyzed using Graneheim’s approach.Results: The study identified a total of 419 primary codes, 10 subcategories, and 5 main categories including culture, violation of laws, reduced traffic safety, reduced social welfare, and risk-taking behaviors.Conclusion: Antisocial behaviors in driving are context-based and pose a potential risk to other road users. They often violate citizenship rights and driving laws while being related to the prevailing culture of the community. Therefore, appropriate interventions and policies should be adopted to reduce these behaviors.

Abstract Background Training plays a role in reducing traffic accidents, and evaluating the effectiveness of training programs in managers’ decision-making for training continuation is important. Thus, the present study aimed to evaluate the cost-effectiveness of a single-credit traffic safety course based on the four levels of the Kirkpatrick model in all Iranian universities. Methods This interventional study aimed to evaluate the cost-effectiveness of a single-credit traffic safety course based on the Kirkpatrick model from 2016 to 2020 in Iran. The data were collected in three stages: (1) calculating the costs of offering traffic safety courses, (2) determining the effectiveness of providing such courses based on the levels of the Kirkpatrick model, and (3) evaluating the cost-effectiveness of administering traffic safety courses. Data were collected through researcher-made and standardized questionnaires. The research population included traffic safety course instructors and university students who could take this course. Finally, the data were analyzed with SPSS v. 23 and also calculations related to ICER, which shows the cost effectiveness of providing single credit course. Results Scores of the students’ reaction level to the traffic safety course was 41.8% before the course; this score was estimated at 67% after the course. At the level of learning, students’ knowledge was 43.6% before the training course, which reached 73% after the course. At the level of behavior, the state of students’ desirable traffic behaviors was 54% before the course, which reached 66.1% after the course. The educational effectiveness of the course presentation at the level of results was 58.2% before and 74.8% after the course. While assuming that the weights of all model levels were constant, the cost of a 1% increase in the overall educational effectiveness by using the Kirkpatrick model, compared to not providing the course (not administering the intervention) was 486.46 USD. Conclusion The results showcased the effectiveness of the traffic safety course in all four levels of The Kirkpatrick model. Therefore, policy-makers and officials in charge of delivering this program should strengthen it and resolve its deficiencies to realize all its educational goals at the highest level.

Objective: To determine the causal relationship between aging and nighttime driving and the odds of injuryamong elderly drivers.Methods: In this cross-sectional study, 5460 car accidents were investigated from 2015 to 2016. The data wereextracted from the Iranian Integrated Road Traffic Injury Registry System. Pedestrian accidents, motorcyclecrashes, and fatalities were excluded from the study. To account for major confounders, Bayesian-LASSO, andtreatment-effect cutting-edge approaches were used.Results: Overall, 801 injuries (14.67%) were evaluated. The results of the univariable analysis indicated thataging and nighttime had adverse effects on the odds of road traffic injuries (RTIs), even after adjusting forthe effect of other variables, these effects remained statistically significant. According to a newly developedapproach, the overall effects of aging and nighttime were significantly and directly correlated with the odds ofbeing injured for older adults (both p

Objective(s): Organizing the rapid response team is one of the strategic mechanisms that have been used to control the COVID-19 epidemic. This study aimed to compare the COVID-19 epidemic control before and after the implementation of rapid response program in southeast Iran. Methods: This cross-sectional study was carried out in Sistan and Baluchestan province in summer of 2021. The rapid response team has been settled in the region for 3 weeks since 3 July, and rapid response program including mass vaccination with a community-based approach has been implemented in catchment populations of three universities of medical sciences including Zaheadn, Iranshahr and Zabon. Data were collected from June 5, until September 23, 2021 and analyzed using descriptive statistics in Excel software. Results: During the study period, a total of 2,514,911 people were admitted and 2,125,389 people (84.5%) were discharged. 58,441 (2.3%) of the cases were hospitalized. The total number of tests taken during the study period was 310,741 (111,978 tests per million population). This rate decreased about 15% after the implementation (36% versus 21.7%). The total number of positive death cases was estimated at 0.9 per 1000 population. After the implementation, the mean number of hospitalized cases (59 patients per day), the mean difference of positive laboratory cases (400 cases per day), and the mean difference in the number of deaths (confirmed cases) decreased to eight cases per day. Conclusion: The findings showed that the implementation of rapid response program with community-based approach in was successful in controlling the COVID-19 epidemic.

Background & Aims: Nowadays, traffic accidents are one of the major causes of death worldwide. Therefore, it is essential to determine the modifiable risk factors in order to reduce traffic accidents. This study aimed to investigate the relationship between the psychological factors, the spiritual health, and the drivers' behavior of the employees of Shahid Beheshti University of Medical Sciences. Materials & Methods: This cross-sectional study examined the data on 3245 participants in the Health Cohort Study of Shahid Beheshti University of Medical Sciences. The required information was collected using general health questionnaire (GHQ-28), Manchester driving behavior questionnaire (MDBQ), spiritual health questionnaire (SHEL), aggression questionnaire (AGQ), and Beck's anxiety and depression questionnaires. The data were analyzed with the help of structural equation modeling using SPSS 25 and Amos 24 software. Results: The study used the information on 1386 people. Moreover, 754 of these people were men. All of the correction indices highlighted the good fit of the hypothesized model (CMIN/DF=3.3, GFI=0.96, AGFI=0.94, CFI=0.97, TLI=0.97, IFI=0.97, NFI=0.95, SRMR=0.03, RMSEA=0.04). According to the model, aggression (β=0.45, p

Introduction Despite the emphasis on empowerment in interventions supporting women against domestic violence and ending spousal abuse, there is still no standard and accurate instrument to evaluate women’s empowerment in this field. This study proposes a protocol to fill this gap by developing and psychometrically testing a standardised instrument for assessing women’s empowerment in dealing with domestic violence (WEDDV).Methods and analysis This study will be conducted in Iran in a mixed method with a sequential exploratory design (qualitative–quantitative). In the first phase, qualitative methods will be used to generate items, rank and identify essential items for WEDDV conceptualisation. The data collection method in this phase includes semistructured face-to-face interviews with married women, a review of related literature, and a fuzzy Delphi method with participants with work experience and expertise about violence against women. Qualitative data analysis will be done using a content analysis strategy and MAXQDA 2020 software. In the second phase of the study, the psychometric properties of the instrument, including face, content and construct validity, and the instrument’s reliability will be evaluated. Also, the psychometric features of the COSMIN checklist will be used in the design of this instrument.Ethics and dissemination This study protocol has been approved by the Research Ethics Committee of Shahid Beheshti University of Medical Sciences with code (IR.SBMU.PHNS.REC.1400.011). The findings will be published in prestigious journals and presented at national and international conferences. We hope that these results can provide a practical framework for planning and organising domestic violence interventions for policy-makers, researchers and women’s health and counselling service providers.

Background and Aims. Upper body fat distribution is more related to cardiometabolic diseases than central obesity. Neck circumference (NC) and neck-to-height ratio (NHtR) are two indicators of upper body obesity that are affordable, easy to obtain, highly reproducible, and more practical in the crowded health centers than the classic anthropometric indices. Methods. 18–65-year-old individuals with no past medical history were included. After obtaining written informed consent, they were screened for hypertension, high blood glucose, and other abnormal laboratory results. Data were analyzed using SPSS and Mann–Whitney U test, Chi square test, Spearman’s correlation coefficient, and ROC curve. Results. In our 2,812 participants, NC had the lowest area under the curve (AUC) in both male and female obese and overweight subjects. NHtR and hip circumference (HC) had the highest AUC in men and women with obesity, respectively. The highest sensitivity for overweight men and women belonged to waist circumference (WC) and waist-to-height ratio (WHtR), respectively, and for both males and females with obesity, NHtR had the highest sensitivity. The cutoff point of NHtR had the same value for males and females. HC and NHtR had the highest positive likelihood ratio (PLR) for obesity in men. In addition, HC and WC had the highest PLR for obesity in women. Conclusion. In this study, we revealed that NC had the lowest and NHtR and HC had the highest predictive value for obesity. Furthermore, for both males and females with obesity, NHtR had the highest sensitivity. HC had the highest PLR for obesity in both genders. Our results warrant prospective studies to evaluate the role of NHtR and other novel anthropometric indices in the risk of cardiometabolic diseases.

Background: This study assesses the effect of blood lipid indices and lipid ratios on cardiovascular diseases (CVDs) using inverse probability-of-exposure weighted estimation of marginal structural models (MSMs). Methods: A pooled dataset of two US representative cohort studies, including 16736 participants aged 42–84 years with complete information at baseline, was used. The effect of each lipid index, including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), ratios of TC/HDL-C, LDL-C/HDL-C, and TG/HDL-C on coronary heart disease (CHD) and stroke were estimated using weighted Cox regression. Results: There were 1638 cases of CHD and 1017 cases of stroke during a median follow-up of 17.1 years (interquartile range: 8.5 to 25.7). Compared to optimal levels, the risk of CVD outcomes increased substantially in high levels of TC, LDL-C, TC/HDL-C, and LDL-C/HDL-C. If everyone had always had high levels of TC (≥240 mg/dL), risk of CHD would have been 2.15 times higher, and risk of stroke 1.35 times higher than if they had always had optimal levels (

Abstract Background Understanding the distinct patterns (trajectories) of variation in blood lipid levels before diagnosing cardiovascular disease (CVD) might carry important implications for improving disease prevention or treatment. Methods We investigated 14,373 participants (45.5% men) aged 45–84 from two large US prospective cohort studies with a median of 23 years follow-up. First, we jointly estimated developmental trajectories of lipid indices, including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) concentrations using group-based multi-trajectory modeling. Then, the association of identified multi-trajectories with incident CVD, heart failure, and all-cause mortality were examined using Cox proportional hazard model. Results Seven distinct multi-trajectories were identified. The majority of participants (approximately 80%) exhibited decreasing LDL-C but rising TG levels and relatively stable HDL-C levels. Compared to the individuals with healthy and stable LDL-C, HDL-C, and TG levels, those in other groups were at significant risk of incident CVD after adjusting for other conventional risk factors. Individuals with the highest but decreasing LDL-C and borderline high and rising TG levels over time were at the highest risk than those in other groups with a 2.22-fold risk of CVD. Also, those with the highest and increased triglyceride levels over time, over optimal and decreasing LDL-C levels, and the lowest HDL-C profile had a nearly 1.84 times CVD risk. Even individuals in the multi-trajectory group with the highest HDL-C, optimal LDL-C, and optimal TG levels had a significant risk (HR, 1.45; 95% CI 1.02–2.08). Furthermore, only those with the highest HDL-C profile increased the risk of heart failure by 1.5-fold (95% CI 1.07–2.06). Conclusions The trajectories and risk of CVD identified in this study demonstrated that despite a decline in LDL-C over time, a significant amount of residual risk for CVD remains. These findings suggest the impact of the increasing trend of TG on CVD risk and emphasize the importance of assessing the lipid levels at each visit and undertaking potential interventions that lower triglyceride concentrations to reduce the residual risk of CVD, even among those with the optimal LDL-C level.

Background: Road traffic crashes’ (RTCs) multidimensional nature has piqued the interest of officials all around the world for many years. Vision Zero is one of the most innovative approaches to road safety. Vision Zero is a government initiative aimed at reducing RTC-related deaths and serious injuries. To effectively apply this approach in Iran, it is required to first identify the obstacles to execution. Therefore, the purpose of this study was to examine the obstacles to Vision Zero implementation in Iran.Methods: The qualitative content analysis method was used in this investigation. The participants were chosen using purposive, snowball, and maximum variety sampling methods. Data were collected through face-to-face interviews. Graneheim and Lundman’s method was used to analyze data using the content analysis method.Results: There were 16 interviews with 14 participants in this study. The data were organized into four main categories and 13 sub-categories to determine the obstacles to implementing Vision Zero. Managerial and administrative obstacles, as well as supportive, cultural, and social, and transportation design and development challenges, were the main categories.Conclusion: In Iran, implementing Vision Zero necessitates the establishment of a lead agency that considers administrative and managerial, supportive and logistic, socio-cultural, transportation design and development, and infrastructure components. In addition, Vision Zero implementation and road safety improvement would require political commitment and support from the government and society. Vision Zero implementation and road safety management must take into account the ethics and value of human life.

Background and purpose: Job burnout is one of the major reasons for frequent job changes that creates physical and mental problems and reduces efficiency and at workplace. This study aimed to investigate the relationship between the quality of working life and job burnout in a large sample of health workers. Materials and methods: The present study was part of the first stage of Health Cohort of Staff in Shahid Beheshti University of Medical Sciences, performed in 1274 participants. The WHOQOL-BREF and the Maslach Job Burnout Inventory (1985) were administered. Data were analyzed using STATA applying Shapiro Wilk, Spearman correlation coefficient, and Linear Regression Analysis. Results: There was a significant inverse relationship between the quality of working life and job burnout (r = -0.234, P= 0.001). Among the dimensions of quality of life, only t corresponding to the beta of physical health (r= -0.260) was found to be significant at the error level of less than 5% (P=0.026). Significant inverse relationship were seen between quality of life, emotional fatigue, and depersonalization (r= -0.117, P= 0.001 and r= -0.080, P= 0.004, respectively) and a significant direct relationship was observed between quality of life and individual performance (r= 0.116, P= 0.001). Conclusion: According to the inverse relationship between job burnout and quality of life, authorities should aim at identifying the factors associated with lower quality of working life, and especially improve physical health to prevent job burnout and ultimately increase productivity.

Objective: To explore the factors affecting unsafe antisocial behaviors of drivers in the context of Iran.Methods: The interviews were conducted from June to November 2019. A number of 19 participants were selected using purposive sampling method. The data were collected using face to face in-depth semi-structured interviews. Content analysis using Granheim’s approach was applied for data analysis.Results: Seven categories and 14 sub-categories were extracted from the data. The categories included cultural factors, educational and training factors, laws, imitating, substance abuse, awareness and attitude, and psychological problems.Conclusion: Based on the findings, various cultural, legal, educational, individual and psychological factors affect the unsafe antisocial behavior in driving. Seemingly, such behaviors could increase the chance of death or injury caused by road traffic crashes among the road users and affect social welfare of the citizens and road user’s safety.

Objective (s): This study aimed to investigate the pattern, prevalence, behavioral and socio-economic factors that relate to tooth loss among Shahid-Beheshti University of Medical Sciences employees. Methods: The data used for this was derived from a cohort study of Shahid-Beheshti University of Medical Sciences employees. The study was assessed tooth loss among 1381 participants using ordinal regression modeling . Additionally data from self-administered questionnaire were used. Results: Prevalence of tooth loss and edentulous in both genders was 68.1% and 1.8% respectively. In general tooth loss among women were lower than men (P

Background: This study aimed to determine the environmental factors affecting the frequency of accidents leading to injury and death related to pedestrians in 31 provinces of Iran. Methods: Data necessary for the study were extracted from databases of traffic police, statistics center, ministry of roads and urban development, and Iran meteorological organization. Hot spots analysis was used based on Getis-Ord G statistics in geographically weighted regression models. Goodness of fit of models was evaluated using the Bayesian information criterion, Akaike's information criterion and Deviance statistics. Results: In this study, 49,409 incidents were investigated. Of these, 48,382 (98%) cases were injuries and 1027 (2%) cases were fatal accidents. The incidence of fatal accidents does not follow a specific pattern; however, the incidence of accidents leading to injuries is higher in the central and the northeastern provinces of the country and lower in the southern and southeast provinces of the country. The final models showed that the relationship between different variables, including demographic characteristics, road network, and distance from the capital, traffic volume, and rainfall with dependent variables (number of accidents in geographic units), was statistically significant. Conclusion: In order to better design preventive plans for traffic accidents and promote the safety of passageways for pedestrians inside and outside the cities, these factors need to be considered more carefully, and practical solutions should be developed and implemented for their correction.

Introduction: A national road safety strategic plan (NRSSP) is considered as one of the main road safety management issues in different countries. Such a plan not only determines the vision and relevant strategies but also causes the implementation of appropriate interventions to be coordinated and strengthened to achieve the goals set by partner organizations. The present study mainly aims to report Iran's NRSSP 2021–2031 development protocol. Methods: According to a schedule, the study protocol consists of ten sections: (1) Determining a core planning center, (2) Establishment of a steering committee, (3) Stakeholder identification, (4) Identification and development of Goals and Strategies, (5) Vision development, (6) Establishment of committees, (7) Integration of Goals and Strategies, (8) Goals and Strategies assessment, (9) Action plans development, (10) Monitoring and evaluation. An appropriate study method is performed for each of the concerned steps. Conclusion: The road safety strategy plan is a critical component to promote the effectiveness of activities and achieve the goals determined for road safety purposes. The Decade of Action for Road Safety is just being closed to its end; hence, reviewing and drawing up a road safety document concerning authentic scientific models and evidence is of paramount importance in Iran. The present study takes over the mission to address this gap.

Background and aims: This study was conducted to determine the economic, social, and cultural factors influencing the consumption of drugs by drivers of public vehicles in 2013. Materials and Methods: The capture-recapture method was employed to determine drug use, its type, and the time of consumption among drivers of public transport. At the capture stage, 384 of the samples were surveyed and then (15 days later) at the recapture stage, 1176 drivers were randomly selected. All drivers who crossed the boundaries of Hormozgan, Khuzestan, Khorasan Razavi, West and East Azarbaijan, Sistan and Baluchestan, and Gilan during the defined time were randomly selected. The sample size was 196 drivers for each boundary based on the traffic volume of each boundary and type of vehicle. Results: The mean age of the addicted and non-addicted subjects was 41.65 ± 3.41 years and 39.63 ± 2.11 years, respectively, with a significant difference (P = 0.01). There were significant differences between addicted and non-addicted subjects with respect to some of the socioeconomic variables such as monthly income (P = 0.001), owning home (P = 0.001), owning car (P = 0.001), ethnicity (P = 0.016), and education (P = 0.01). There were significant differences in the economic and cultural factors affecting addictive drug use between non-addicted and addicted subjects (P = 0.001). Conclusion: A significant difference in economic and cultural factors, ethnicity, and levels of education was observed between non-addicted and addicted subjects.

Background: There are few studies on the association between bullying types and psychosomatic issues in pupils. The current study aimed to examine the association of verbal, relational, physical, and cyber bullying with psychosomatic problems among students. Methods: This was a cross-sectional study conducted in northern Iran on 834 participants, which were in 8th and 9th grades in 2014. Bullying and psychosomatic problems were measured by the Iranian-version of the Olweus Bullying and the Health and Illness Questionnaires. Descriptive statistics and multilevel logistic regression analysis were used for data analysis. Results: Findings revealed that bad temper was the most prevalent psychosomatic problem and the prevalence of headache (P=0.021), feeling low (P=0.009), bad temperedness (P=0.004), nervousness (P Conclusions: The results showed the different psychological and somatic burdens associated with various types of bullying. Therefore, it is necessary to implement preventive and interventional programs so as to reduce bullying behaviors in Iran. Implications of these findings for health care professionals, educational systems, and parents were further discussed.

Mists of water-based metalworking fluids (MWFs) as a kind of lubricants mineral oil are reported as a respiratory irritant with having carcinogenic compounds such as formaldehyde. Due to the widespread exposure of Iranian metal machining workers to water-based MWFs and limitations of advanced analytical balance in Iran, which is required by the National Institute of Occupational Safety and Health (NIOSH) conventional method No5524, the purpose of this study was set to develop a new analytical method using Fourier-transform infrared (FTIR) spectrometry instead. In this study, the spiked standards in the range of 0.96 to 960 µg/sample were dried and extracted with carbon tetrachloride and scanned by FTIR in the range of 2700 to 3200cm-1 for the best absorption. FTIR and Gas chromatography analysis of formaldehyde as a toxic ingredient of MWFs was examined and its presence was confirmed. For establishing the validation, the merits of the analysis of the FTIR and NIOSH method No.5524, such as precision, accuracy, LOD, LOQ, and bias were obtained that were 1.49%, 103%, 0.0004, 0.0014 µg/sample, -3%, and 10.87%, 111%, 14.9, 49.1µg/sample and 11% respectively. Regression coefficients (r2) of the calibration line with the spiked standards (0.96-960µg/sample) were in the range of 0.997 to 0.999. Since the merits of the analysis of the FT-IR method for water-based MWFs were comparable to the respective NIOSH method, the developed method could be very useful in monitoring lathe workers, especially in developing countries. However, collaborative examination for full validation of the method is recommended.

For downloading the full-text of this article please click here. In the history of Islam, knowledge about health has received a lot of attention. In Islam, health is an advantage and a prelude to perfection. On the other hand, the impact of religion on health, especially spiritual and mental health, has been emphasized several times and the importance of health, sanitation, and their impact on the life in this world and afterlife has been frequently mentioned. It should be noted that the purpose of materialistic and spiritual health is not the health itself. Rather, there is a much sublime objective; that is, all dimensions of health should be used to move toward divine satisfaction.For downloading the full-text of this article please click here. Please cite this article as: Soori H. A quick review of studies on religion and health. J Res Relig Health. 2019; 5(3): 1- 4. doi: https://doi.org/10.22037/jrrh.v5i3. 26728.

Background and purpose: This review study and meta-analysis aimed at providing evidence on helmet use and its efficacy on death and various types of head injuries caused by motorcycle crashes in different countries. Methods & Materials: Relevant databanks such as PubMed, Scopus, Web of Science, Science Direct, Embase and some relevant websites were searched for suitable studies. Two authors independently performed article selection, quality assessment and data extraction. Data analysis was done in Stata Software V14 applying random effects model. Results: Overall, 107 studies -with different qualities- were entered into the current systematic review and 100 studies were entered into our meta-analysis. Total rate of helmet use in motorcycle riders and occupants were 63% (95%CI: 56-69%) and 41% (95%CI: 33-48), respectively. The studies that examined the effectiveness of helmet use in reducing head, face and neck injuries, (while controlling the confounders) showed that wearing helmet could reduce the risk of death by 45% (OR= 0.55, 95%CI: 0.41-0.68) and the risk of head and face injuries by 57% (OR=0.43, 95% CI: 0.36-0.50). But it was found that helmet may not considerably reduce the risk of neck injury. Conclusion: In spite of the efficacy of helmet use on reducing the rate of deaths and head injuries among motorcyclists after a traffic collision, its use is still low and varies in different countries. But, the findings suggest that more use of helmets can facilitate global efforts to reduce road traffic injuries.

Background: In many developed and developing countries, a significant proportion of deaths from road traffic accidents occur in the passages within cities. Considering the importance of this issue, this study was conducted to determine the environmental factors affecting the frequency of deaths in 22 areas of Tehran. Materials and Methods: In this study, the statistical population consisted of traumatic traffic incidents during the period of 2014–2016, all of which were studied. The data necessary for conducting the study were extracted from the traffic police databases, Tehran Municipality, and the Statistics Center of Iran. In order to analyze the role of regional and environmental factors in the frequency of traffic accidents related to pedestrians in geographic units (22 districts of Tehran), the Poisson regression and geographically weighted regression models were used. The likelihood ratio test was used to compare the models. The goodness-of-fit of models was evaluated using R2, Bayesian information criterion, and Akaike's information criterion statistics. Results: In this study, 519 incidents were studied, 175 of which (33.7%) were related to motorcyclists, 174 (33.5%) related to automobile drivers, and 170 (32.8%) pedestrians. The frequency distribution of the incidents studied varied in Tehran's 22 districts. The incidence of accidents in the central regions of Tehran was lower, while marginal areas located in the north, south, east, and west of Tehran had the highest frequency of fatal accidents. The both final Bayesian Poisson and GWR models showed that the relationship between the length of highways and educational land used with dependent variable was statistically significant. Conclusion: Various demographic and environmental variables play a role in determining the distribution pattern of these types of events. Through regional planning, proper traffic management, controlling environmental risk factors, and training people the pedestrian safety in Tehran can be improved.

Background and Objectives: Road traffic accidents (RTAs) are the second cause of death, the first leading cause of years of life lost due to premature mortality, and the most common source of injury in Iran. According to the World Health Organization estimates, Iran located in the countries that have the highest rates from RTAs. The present study aimed to measure road traffic mortality rates and also to depict a view of the trend for a period of 11 years which started from 2006 to 2016. Materials and Methods: In this cross-sectional study, we collect data on all road traffic deaths in Iran between 2006 and 2016 using records from the Legal Medicine Organization. For doing this research, demographic and epidemiological data of the deceased were extracted using a checklist designed by the forensic experts. Content validity of this form was determined by obtaining comments of professors and scholars in the field. Directly standardized mortality rates were calculated. Finally, the information was analyzed by descriptive statistics. Results: During the 11-year period of this study, 226,514 people in Iran died from RTAs. The age-adjusted mortality rate that caused by road traffic decreased from 41.5/100,000 people in 2006 to 20.4 in 2016 during the study period. There were significant differences in mortality rates between males and females and between outside city and inside city roads. The age-adjusted mortality rate was significantly higher among men than in women. The majority of death has occurred in illiterate young men aged 15–34 years and also in self-employed people. Conclusions: During the 2006–2016, mortality from RTAs decreased from 41.5 to 20.4/100,000 populations. This decreasing trend was observed in both sexes and in outside city and inside city roads. However, this reduction trend in the last years of the study is not suitable. These findings highlighted that training programs and harm reduction approaches for reducing the mortality from traffic accident are still needed.

Background: Identification of risk factors involved in road traffic deaths (RTDs) could help policymakers and road traffic managers to adopt effective strategies and approaches for the prevention and control of these incidents, while the lack of accurate data on the risk factors of RTDs causes the problem to persist. This systematic review aimed at assessing the national studies regarding the risk factors of RTDs in the regions covered by the World Health Organization (WHO). Methods: This review study was conducted during 2008–2018 via searching in databases of PubMed, Science Direct, Scopus, Cochrane, Thomson Reuters, Web of Science, EMBASE, ProQuest, and Trip databases. Initially, a literature review was performed to find similar systematic reviews, followed by another literature review to retrieve the published or registered protocols. At the next stage, PECOTS was developed for the search strategy, followed by the quality assessment. The eligibility criteria in this study were the national-level studies about the risk factors related to RTDs, English-language studies, and studies published during 2008–2018. Results: In total, 169 articles were included in this study, with the highest and lowest number of the published articles in the United States and African countries, respectively. According to the reviewed studies, human factors accounted for the most common risk factors involved in RTDs. In the southeastern regions of Asia, the main road-related risk factor for RTDs was reported to be the type of roads. Furthermore, roadside departure to the right side and long roads were denoted in the national data of the Western Pacific region on the incidence of RTDs. Differences were observed between the six regions covered by the WHO in terms of the time-related risk factors for RTDs. Conclusions: Several risk factors have been reported for RTDs in the countries covered by the WHO, and each risk factor is considered to have various subcategories. Therefore, it could be concluded that there are different epidemiological patterns for road traffic accidents and RTDs.

Sleep quality plays an important role in people's mental health. Until now, the comparison of factors affecting mental health among clinical and non-clinical workers has received less attention. This study aimed to investigate the relationship between sleep quality and mental health and factors affecting mental health in a large working population. The present study was derived from the first phase of a cohort study of Shahid Beheshti University of Medical Sciences staff in 2019. Participants included 2921 employees. Demographic variables and job characteristics, the Pittsburgh Sleep Quality Index (PSQI) and General Health Questionnaire-28 (GHQ-28) were used for data collection. For finding factors affecting mental health, logistic regression was used. Clinical workers had lower mental health (P

Objective: Pedestrians are road users vulnerable to traffic injuries and fatalities. This study aimed to develop and validate a pedestrian behavior questionnaire to be used in Iran.Methods: In this cross-sectional study, the initial questionnaire was designed based on the evaluation of previous studies conducted world-wide or in Iran. The initial pack included 127 items. After the assuring the face validity of the questionnaire, 27 experts’ opinions in the field of traffic was obtained for assessing/improving the content validity. To test the reliability of the questionnaire, the test-retest method and internal consistency assessment were used. To evaluate the structural validity, the Exploratory Factor Analysis (EFA) using the principal component and the Varimax rotation was applied.Results: After completing the face validity and after summarizing the experts’ suggestions, 12 questions were deleted. By calculating the content validity ratio and coefficient, 20 and 17 were removed. Also, the average content validity coefficient regarding relevancy, clarity and overall average were 0.86, 0.88, and 0.87, respectively. The Cronbach’s alpha coefficient was 0.84. In the last stage and according to the results of the factor analysis, five factors violations, distraction, positive behaviors (group1), positive behaviors (group2) and Aggressive behaviors) were identified from the 29-items questionnaire, which explained 98% of the total variance.Conclusion: Considering the necessity of using a verified and validated tool for planning and evaluating effective interventions for pedestrians is inevitable. The tool designed in the study was found to be valid and reliable for use to measure pedestrian’s behavior and planning to modify high-risk behaviors and enhance safe pedestrian behaviors.

Objective: This study investigated the existence of anxiety and depression mediating effect on the relationship between PTSD and aggression in the hope of providing more comprehensive and effective trauma treatment in motor vehicle accident. Methods: The studied population of the study consisted of motor vehicles with posttraumatic stress disorder in Kashan. Three questionnaires of post-traumatic stress disorder, Hospital Anxiety and Depression Scale (HADS) and Aggression Questionnaire (Buss & Perry, 1992) were used for data collection. In order to analyze the mediating effects of anxiety and depression on the relationship between PTSD and aggression, structural equation modeling(SEM) was performed with the maximum likelihoodratio as the method of estimation. Results: Evaluation of the research hypothesis model using fitness indices showed that the hypothetical model fits with the measurement model. NFI=0.96, CFI =0.95, RMSEA=0.06 and the results showed that PTSD had indirect exacerbating effects on aggression. The results also confirmed the mediating role of anxiety and depression in the relationship between post-traumatic stress disorder and aggression in motor vehicle accident. Conclusion: The findings demonstrate that anxiety mediates the relationship between PTSD and aggression. Therefore, this finding can help to prioritize therapeutic goals and determine therapeutic focus for mental health professionals. It is possible to reduce one's aggression by focusing on his anxiety and increasing his/her ability to handle and manage it.

Introduction: Seizure is a common complication of tramadol poisoning and predicting it will help clinicians in preventing seizure and better management of patients. This study aimed to develop and validate a prediction model to assess the risk of seizure in acute tramadol poisoning. Methods: This retrospective observational study was conducted on 909 patients with acute tramadol poisoning in Baharloo Hospital, Tehran, Iran, (2015-2019). Several available demographic, clinical, and para-clinical characteristics were considered as potential predictors of seizure and extracted from clinical records. The data were split into derivation and validation sets (70/30 split) via random sampling. Derivation set was used to develop a multivariable logistic regression model. The model was tested on the validation set and its performance was assessed with receiver operating characteristic (ROC) curve. Results: The mean (standard deviation (SD)) of patients’ age was 23.75 (7.47) years and 683 (75.1%) of them were male. Seizures occurred in 541 (60%) patients. Univariate analysis indicated that sex, pulse rate (PR), arterial blood Carbone dioxide pressure (PCO2), Glasgow Coma Scale (GCS), blood bicarbonate level, pH, and serum sodium level could predict the chance of seizure in acute tramadol poisoning. The final model in derivation set consisted of sex, PR, GCS, pH, and blood bicarbonate level. The model showed good accuracy on the validation set with an area under the ROC curve of 0.77 (95% CI: 0.67–0.87). Conclusion: Representation of this model as a decision tree could help clinicians to identify high-risk patients with tramadol poisoning-induced seizure and in decision-making at triage of emergency departments in hospitals.

OBJECTIVES Cigarette smoking is an established, strong, and modifiable risk factor for coronary heart disease (CHD). However, little research has investigated CHD risk in former smokers who continue to be exposed to others’ cigarette smoke (former & secondhand smokers). METHODS In the Tehran Lipid and Glucose Study, a prospective population-based cohort (n=20,069) was followed up for a median period of 14.6 years. A subset of 8,050 participants of 30 years of age and older was analyzed, with first CHD events as the study outcome. Participants were categorized as never, former, current, secondhand, and former & secondhand smokers. Data on smoking intensity (cigarette/d) were also collected. A Cox proportional hazards regression model was applied to estimate the risk of CHD, taking into account the main potential confounders. RESULTS The mean age of participants was 46.10 ±11.38 years, and they experienced 1,118 first CHD events (with most CHD cases in former smokers) during the follow-up period. The risk of CHD was highest in current smokers, followed in order by former & secondhand, former, and secondhand smokers (hazard ratio [HR], 1.99; 95% confidence interval [CI], 1.65 to 2.39; HR, 1.55; 95% CI, 1.15 to 2.08; HR, 1.39; 95% CI, 1.12 to 1.72; HR, 1.27; 95% CI, 1.07 to 1.51, respectively), compared to never smokers. The risk of CHD increased with smoking intensity, which has been proposed as a preferable measure of smoking, indicating a dose-response pattern. CONCLUSIONS The elevated risk of CHD in former & secondhand smokers was a noteworthy finding, with possible implications for health policy; however, further research is needed.

Background and aims: More than 40 percent of deaths of pedestrians in traffic accidents happen in Tehran. The aim of this study was to determine the impact of human factors was associated with an increased intensity of pedestrian traffic. Methods: In this cross-sectional study, 6323 traffic injuries and 99 traffic deaths resulted from traffic accidents in pedestrian during 2013 in Tehran were investigated. Data was extracted from traffic police databases and in Tehran. In analytical analysis, logistic regression model was used to control for possible confounders Results: In studied accidents, 4070 (63.5%) and 2335 (36.5%) of injured or died pedestrians were male and female, respectively. The mean age of injured pedestrians was 39.15 ± 19.47 years and the mean age of guilty drivers was 34.75 ± 12.38 years. The final model showed that gender, age, pedestrian position and fault, and type of driverchr('39')s license are correlated to the dependent variable. The events leading to the death was significantly higher in men, pedestrians standing next to the roadway, pedestrians fault and drivers with grade 1 of driver license. Conclusion: Human factors had much role in the severity of traffic accidents related to pedestrians in Tehran. These factors have a high correlation with environmental factors, and vehicles. More researches is needed to specifying mechanisms of effect of these factors in traffic accidents related to the pedestrians and designing strategies for promotion of traffic culture and safe behaviors in drivers and pedestrians.

Background:A Based on the World Health Organization’s reporting, over 1.25 million people die annually in traffic accidents worldwide. Traffic accidents are the ninth main cause of death worldwide, with an average age range of victims of 15 to 29. Broadly speaking, 90% of traffic accidents happen in the lowand middle-income countries that comprise 82% of the global population, and these countries account for half of the world’s vehicles. One of the goals of the National Road Traffic Knowledge Development Trustee is to plan and implement training courses (content design, design and implementation and evaluation) for target groups. To achieve this goal and due to the lack of academic programs on traffic safety in Iran, a single-credit course, “Safety and Traffic,” was developed to be run as a compulsory academic course in all universities across the country. Methods: This course was administered as a national pilot study in four phases and in 17 medical universities across the country. All experts and national authorities in the Ministry of Science and the Ministry of Health and Medical Education were requested to provide feedback. Afterwards, the results and comments were forwarded to the Supreme Council of Cultural Revolution for further investigation. Upon approval of the Council, the course will be implemented in all universities across the country. Results: Results from the pre-test showed that the level of students’ knowledge was low before attending the training courses. Surveys also revealed that the two items of “pedestrian safety” and “first aids in RTCs” were the most useful and applicable subjects. The percentage of wrong answers ranged from 61 to 98%. Conclusion: Considering the importance of traffic accidents and people’s role in traffic-related issues, it seems that it is necessary to provide university courses for traffic safety education.

Background and Objectives: Road traffic accident (RTA) is one of the major public health problems. Inequality in this problem and its trend has not been yet investigated in Iran. A better understanding of different contributing factors to RTA like inequalities can be helpful to reduce the negative influence of road crashes. Hence, this study aimed at examining geographical inequality in mortality from RTAs over the previous decades. Materials and Methods: In this cross-sectional study, all people who died from RTAs from March 2006 to February 2015 were selected. The data were taken from Legal Medicine Organization in Iran. The Theil index was used to estimate geographical inequality in mortality from RTA. Data were then analyzed using the Stata software. Results: During the 10-year period of this study, 210,582 people in Iran died due to RTA. The mortality rate that caused by RTAs has decreased during the study. We found a larger reduction in a mortality rate in suburban RTAs. In spite of the reduction in RTAs death, geographical inequality increased during the 10-year study. Conclusions: The findings of this study indicate that there is a geographical inequality in mortality from RTAs in Iran. This implies that effective interventions in reducing the RTAs should be distributed equally among regions of the country. Further research can be performed to investigate the causes of this inequality.

Background: A great proportion of deaths due to traffic crashes occur for pedestrians, both in developing and developed countries. Objectives: The aim of the present study was to determine the spatial factors related to the frequency of traffic crashes on pedestrians in districts of Tehran city. Methods: This was a cross-sectional study. All traffic crashes on pedestrians during 2013–2015 were included in this study. The data were extracted from different sources such as traffic police main office, Tehran municipal office, and Iran statistics center. Poisson and negative binomial regression models were used to analyze the role of environment and district on frequency of traffic crashes. Moreover, the likelihood-ratio test has been used for comparison between models, while assessment of goodness-of-fit has been reported using R2, Akaike information criteria, and Bayesian information criteria. Results: Of 12,090 crashes, 11,895 (98.4%) had led to injuries, while 195 (1.6%) had led to deaths. The frequency of crashes varied substantially in different districts of Tehran. The incidence of injuries did not show any particular pattern, whereas the pattern of incidence of deaths was lower in central districts in comparison to higher incidence in marginal districts (e.g., north, south, west, and east of Tehran). The results of the final model showed a statistically significant association among various variables such as demographics, web of roads, rate of traveling, and land use with the outcome as number of crashes in geographic units. Conclusions: Frequency distribution of traffic crashes leading to injury and/or death is completely different in various districts of Tehran. Demographic as well as spatial characteristics also play an important role in determining this distribution. Regional planning, appropriate traffic management, control measures on spatial risk factors, and educational programs could substantially improve the safety of pedestrians in Tehran.

Background and Objectives: Road traffic accidents (RTAs) were estimated to be the eighth major cause of death worldwide in 2016. Investigation of various factors alone can distort the results. Thus, it is important to consider interactions among the various factors associated with RTAs. Logic regression was used to investigate the important combinations among traffic accident variables. Methods: In this analytical study, the existing 1-year data from the police accident database in 2014 were examined. The Legal Medicine Organization database was also used to correct death after 30 days. Logic regression, a generalized regression model, was used to explore the interactions among different factors of the accident. Results: Cross-validation results showed the best model in the form of three trees and eight leaves. Being a professional driver and exposure to a heavy vehicle on sandy or earthy road double the chance of death. Operating an unsafe car on a road with curve increases the odds of a fatal crash by 1.65 times. Driver error on a nonresidential road without any shoulders adds 90% to the odds of having a deadly crash. Conclusions: The significance of the interactions between the road and driver factors shows that roads with poor design can cause a driver to make mistakes and increase fatal accidents. Therefore, politicians must consider constructing structures alongside nonresidential roads and proper shoulders, install signs at curves, and repair pavement in order to reduce the fatality of accidents. It is also recommended that manufacturers of commercial vehicles install proper safeguards in all heavy vehicles to reduce fatal accidents.

Abstract Background Road traffic Injuries (RTIs) as a health problem imposes governments to implement different interventions. Target achievement in this issue required effective and efficient measures. Efficiency evaluation of traffic police as one of the responsible administrators is necessary for resource management. Therefore, this study conducted to measure Iran’s rural traffic police efficiency. Methods This was an ecological study. To obtain pure efficiency score, three-stage DEA model was conducted with seven inputs and three output variables. At the first stage, crude efficiency score was measured with BCC-O model. Next, to extract the effects of socioeconomic, demographic, traffic count and road infrastructure as the environmental variables and statistical noise, the Stochastic Frontier Analysis (SFA) model was applied and the output values were modified according to similar environment and statistical noise conditions. Then, the pure efficiency score was measured using modified outputs and BCC-O model. Results In total, the efficiency score of 198 police stations from 24 provinces of 31 provinces were measured. The annual means (standard deviation) of damage, injury and fatal accidents were 247.7 (258.4), 184.9 (176.9), and 28.7 (19.5), respectively. Input averages were 5.9 (3.0) patrol teams, 0.5% (0.2) manpower proportions, 7.5 (2.9) patrol cars, 0.5 (1.3) motorcycles, 77,279.1 (46,794.7) penalties, 90.9 (2.8) cultural and educational activity score, 0.7 (2.4) speed cameras. The SFA model showed non-significant differences between police station performances and the most differences attributed to the environmental and random error. One-way main road, by road, traffic count and the number of household owning motorcycle had significant positive relations with inefficiency score. The length of freeway/highway and literacy rate variables had negative relations, significantly. Pure efficiency score was with mean of 0.95 and SD of 0.09. Conclusions Iran’s traffic police has potential opportunity to reduce RTIs. Adjusting police performance with environmental conditions is necessary. Capability of DEA method in setting quantitative targets for every station induces motivation for managers to reduce RTIs. Repetition of this study is recommended, annually.

Objective (s): Pedestrians are one of the most vulnerable and important road users. This study aimed to identify the current situations and present a clear picture of epidemiological pattern of road traffic injuries among pedestrians in Iran in 2014. Methods: This was a secondary analysis study using the traffic police data. Differences of selected variables and type of road traffic injuries were examined. To test the related risk factors for severity of injuries the univariate regression analysis was performed. The injury information extracted from a special form called COM that provided by traffic police of Iran. Results: There were 50518 accidental injuries among Iranian pedestrian in 2014. Qom province with 108.81, Zanjan with 91.21, Golestan with 89.09, and Khorasan Razavi with 87.49 had the highest rates of pedestrian injuries per 100000 populations versus 3.97 in Char-Mahal O Bakhtiari with the lowest rate. Results showed that age, sex, safety facilities for pedestrian for crossing roads, unsafe behaviors and the anatomical site of injury had a statistical significant association with the severity of injuries. Majority of injuries occurred between 3:00 to 6:00 PM (22.9%) and 6:00 to 9:00 PM (24.7%). Conclusion: The great number of pedestrian injuries in Iran in 2014 in this study and other studies shows that pedestrian safety is poor. Scientific approach using descriptive and analytical epidemiological studies might help to implement preventive measures for reducing pedestrian injuries in Iran.

Objectives The aim of this study was to model the avoidable burden of the risk factors of road traffic crashes in Iran and to prioritize interventions to reduce that burden. Methods The prevalence and the effect size of the risk factors were obtained from data documented by the traffic police of Iran in 2013. The effect size was estimated using an ordinal regression model. The potential impact fraction index was applied to calculate the avoidable burden in order to prioritize interventions. This index was calculated for theoretical, plausible, and feasible minimum risk level scenarios. The joint effects of the risk factors were then estimated for all the scenarios. Results The highest avoidable burdens in the theoretical, plausible, and feasible minimum risk level scenarios for the non-use of child restraints on urban roads were 52.25, 28.63, and 46.67, respectively. In contrast, the value of this index for speeding was 76.24, 37.00, and 62.23, respectively, for rural roads. Conclusions On the basis of the different scenarios considered in this research, we suggest focusing on future interventions to decrease the prevalence of speeding, the non-use of child restraints, the use of cell phones while driving, and helmet disuse, and the laws related to these items should be considered seriously.

Objective (s): Given that a significant proportion of traffic accidents deaths in Tehran is related to the pedestrians, this study was conducted to determine high and low risk points leading to pedestrians-related injury in the central area of Tehran, 2014-2015. Methods: This was a cross-sectional study. The study population consisted of all pedestrian-related traffic accidents that had occurred during April 2014-March 2015 in the district 6 of Tehran. We used police and municipal databases. Zoning maps were used to show distribution of traffic crashes events. Moran index and Getis-Ord G were used for determining the distribution pattern of pedestrian-related traffic accidents and the analysis of hot spots (high-risk areas), respectively. Results: In all 514 events were reviewed. The most and least frequent crashes had occurred in May (62 cases) and April (22), respectively. 370 (71.9%) events had happened in the main streets followed by secondary streets (133 events, 25.2%) and in highways (11 events, 2.1%). Although Vali Asr street had most frequent events (67 cases), but most frequent rate of crashes had occurred in the Azadi street between Navab street and Enghelab square (18.11 events in each Km). Moran statistic shows that the distribution of events had cluster pattern (P

Objective (s): According to estimates in 2010, approximately 273000 pedestrian in the world lost their lives due to traffic accidents. Studies have shown that the majority of traffic accidents related to pedestrians, particularly in high-income countries occurred in urban areas and More deaths from traffic accidents in densely populated cities in the world is attributed to pedestrians. Because of the importance of choosing a suitable method for the detailed study of traffic accidents related to pedestrians, this review was conducted to compare different methods and reviews and also determination the strengths and weaknesses of each of these methods. Methods: in this review study we used exist data and evidences based on searching in electronic databases. All studies found entered in endnote software and based on study goals we extract different methods and analysis used to crashes related to the pedestrians. Results: History of traffic accidents related to pedestrians back to the 1980s. During the 1990s, new methods such as GIS and statistical models used in the study of traffic accidents related to pedestrians. During these years, several studies using GIS and statistical models were used. In recent years, due to the advances obtained in various applications, the researchers in the field of traffic accidents related to pedestrians have been studied using modern and advanced methods and by combining various techniques provided the grounds to identify more precisely effective factors on spread and severity of traffic accidents related to pedestrians. Conclusion: there are various methods for the study of pedestrian accidents and injuries and in the recent years, methods for analysis of this type of injuries have had more evolution. In light of recent developments, in terms of methodology and software, problems in identifying the causes of this type of injuries more decreased and events and new insights in this field is obtained.

Objective: Job burnout can cause physical and psychological damage and reduce job efficiency, especially in difficult jobs such as health care fields. This study aimed to assess the association between the level of job burnout and some contributing factors among health care providers in Iran. Method: This study was performed on the data derived from 1807 participants from the first phase of the employees’ health cohort in 2017-2018. The data were collected using as a self-administrated tool utilizing Maslach Burnout Inventory. The questionnaire scores ranged from never to everyday, with 3 levels of burnout as well as burnout itself; then, the scores were categorized as low, moderate, or high. Ordinal logistic regression model was used to adjust ordinal dependent variables. Results: The mean score of the total burnout was 16.5±7.77 and was associated with work experience and age group (p < 0.001). The components of burnout consisted of emotional exhaustion (8.9± 9.0), depersonalization (23± 2.9), and personal accomplishment (34± 8.6). Emotional exhaustion was related to sex (less among males, OR=0.48) and type of job (less among officials compared to health care staff, OR=0.488). Composite burnout was more common among younger staff (OR= 3.85). Depersonalization was associated with duty shift workers (OR=2.42). Conclusion: Job burnout is a major concern, and lack of personal accomplishment, as a component of burnout, was highly prevalent among Iranian health care employees. Being a single woman, health care provider, and having more than 20 years of work experience with a duty shift were contributing factors for burnout experience. Monitoring symptoms of burnout and its associated factors in the workplace and proposing an alternative organizational and behavioral system and sharing it with relevant authorities may help prevent or reduce job burnout and its deleterious effects.

Introduction: The largest proportion of road traffic deaths (RTDs) happen in Low and Middle Income Countries (LMICs). The efforts for decreasing RTDs can be successful if there is precise information about its related risk factors. This study aimed to determine economic, population, road, and vehicle factors with the highest impacts on RTDs in Iran. Methods: This is an ecological study, which has been done using covariates including: the population density, economic growth, urbanization, distance traveled (km) in 100 thousand people, the length of urban roads, the length of rural roads and the Vehicle per 1000 population for each province of Iran in 2015. The covariates considered had been gathered from different sources and to determine which one of the covariates has an effect on RTDs, the Negative Binomial (NB) regression model was used. Results: The mean number of RTDs per 100000 population was 474 ± 70.59 in 2015. The highest and lowest rates of death belonged to Fars and Qom provinces, respectively. The results of the univariate model showed the population density as the only covariate of RTDs (p=0.001). Also, among other covariates, GDP was the only variable with a p-value equal to 0.2. In the multivariate NB model, it was seen that the population density (p=0.001), and GDP (p=0.02) significantly correlated with RTDs. For a unit (Million Rial) increase in the GDP of the province, the number of deaths decreased by as much as 0.0014. In addition, for a unit increase in population density, the number of deaths went up by as much as 30. Conclusion: Population density and GDP had positive and negative effects on the number of fatal road traffic injuries, respectively. By considering these factors in presentational and controlling programs on road traffic injuries, it is possible to decrease the RTDs.  Â

Introduction: The use of antioxidants may reduce the harmful effects of radicals during exercise and extreme sports. The Current study aimed to investigate the effect of this supplement on the lipid profiles in exercise-induced muscle injury. Methods: In this experimental study, 64 Wistar rats were randomly divided into four groups of control, exercise, exercise + Resveratrol (REV) and REV. After a week of adaptation, endurance and acute exercises were conducted in a motor driven treadmill, followed by using a training protocol in which running speed was gradually elevated until 19 weeks of age. Finally, the levels of cholesterol (CHO), triglycerides (TG), low-density lipoproteins (LDL), high-density lipoproteins (HDL), and very low-density lipoproteins (VLDL) were compared between the groups. Results: There was no statistically significant difference in CHO plasma level between the studied groups after acute and endurance exercises. There was a significant increase in the level of TG in the exercise group (p = 0.001) and the exercise + REV (p = 0.004) group after acute and endurance exercises. After the implementation of the endurance and acute exercises none of the studied groups had statistically significant changes in HDL plasma level. There was a significant decrease in LDL plasma levels in the exercise (p = 0.007) and the exercise + REV (p = 0.01) groups. After performing endurance protocol, VLDL plasma levels increased significantly in the exercise (p = 0.001) and the exercise+ REV (p = 0.005) groups in comparison with control group. Conclusions: Based on the findings, there was no difference in the level of CHO and HDL between the training groups, REV and control groups. However, both endurance exercise and acute exercise trainings resulted in an increase in TG and VLDL levels and decrease in LDL level, compared with the control group.

Objective (s): Texting while driving (TWD) is of the dangerous causes of accidents. As such, in order to determine an appropriate instrument to investigate the psychosocial factors related to the issue of (TWD), the reliability and validity of the Farsi-translated questionnaire was explored by utilizing the Theory of Planned Behavior (TPB) model among drivers. Methods: The present study was done among students of 18 years old and above at Tehran Medical Sciences University, Shahid Beheshti University, and The University of Iran in 2014. The study sample included 470 students, 260 males and 210 females, through a several-stage clustering strategy. Results: During the investigation of content validity of the questionnaire, question number 14_related to possessing a cell phone_ and three subcategories of questions number 23, 24, and 25 were omitted due to their similarity in meaning with the other questions. Also, three options were added to the questionnaire so as to guard against ambiguities. The index of Cronbachchr('39')s alpha to investigate internal consistency in two scales of "sending" and "receiving" was 0.79 and 0.71, respectively. The intra class correlation in two scales of "sending" and "receiving" was 0.83 and 0.79, respectively, showing a high degree of test-retest reliability. Conclusion: The Persian translated questionnaire of Texting While Driving (TWD) by using the TPB model is a valid and reliable instrument and could be used in related studies.

Objective (s): This study was conducted to determine the high accident areas and the risk factors of motor vehicle crashes resulting in injury and death in suburban and rural of Tehran province from March 2012 through February 2013. Methods: This was a cross sectional study. The locations of motor vehicle accidents were obtained from police stations. The coordinates of the accidents locations were extracted. The Arc-GIS software was used to overlay the different layers of geographical data and extract the risk map of Tehran province. Results: A total of 1089 motor vehicle accidents were evaluated. 182 accidents (16.7%) resulted in death and 907 accidents (83.3%) resulted in injury. 971(2/89%) of accidents on roads and highways between urban and 118 (8/10%) occurred on rural roads. The West and North West of Tehran province Specially West of Tehran county, north and central of Shahriar county, north and center of Shahre Rey county are the main areas of traffic accidents leading to injury, south of Tehran county, North East and center Shahre Rey county, East and south of Rabat Karim county are the main areas of traffic accidents leading to death. Conclusion: Most fatal traffic accident was due to reversal or fall of vehicles. The severity of traffic accidents was more on freeways, highways, and non-residential areas, at sunrise, horizontal and vertical curves, out-of-band roadway and unstable weathers. It is useful to conduct more studies to better identify these factors considering their importance in traffic accidents.

Introduction: The number of systematic reviews and meta-analyses published in Iran has increased significantly in recent years. Writing these articles based on internationally accepted guidelines is one of the most important factors effective on their structural quality. This study aimed to assess the abstract of Iranian systematic reviews and meta-analyses indexed in Scopus. Methods: This study was an applied, descriptive survey. The study sample included 247 abstracts of Iranian systematic reviews and meta-analyses indexed in Scopus until the end of 2012. In this study, the quality of the abstracts was evaluated using a checklist and organizational affiliation and the articles’ publishing progress were identified through the analysis of Scopus. Results: Compliance with the checklist criteria was generally poor in abstracts. The objective criteria obtained the highest compliance rate (98.8%) and the registration criteria obtained the lowest compliance rate (1.6%). The results showed the growth in quantity of articles in time. Tehran University of Medical Sciences with 131 reviews was the most productive organization and Baqiyatallah University of Medical Sciences and Isfahan University of Medical Sciences with 23 and 22 reviews, respectively, were the next in the ranking. Conclusion: The present study showed that the abstracts’ quality was not desirable. Therefore, training authors on review writing and greater attention by editors and judges during the adjudication process seems essential.

OBJECTIVES We analyzed dietary patterns using reduced rank regression (RRR), and assessed how well the scores extracted by RRR predicted stroke in comparison to the scores produced by partial least squares and principal component regression models. METHODS Dietary data at baseline were used to extract dietary patterns using the 3 methods, along with 4 response variables: body mass index, fibrinogen, interleukin-6, and low-density lipoprotein cholesterol. The analyses were based on 5,468 males and females aged 45-84 years who had no clinical cardiovascular disease, using data from the Multi-Ethnic Study of Atherosclerosis. RESULTS The primary factor derived by RRR was positively associated with stroke incidence in both models. The first model was adjusted for sex and race and the second model was adjusted for the variables in model 1 as well as smoking, physical activity, family and sibling history of stroke, the use of any lipid-lowering medication, the use of any anti-hypertensive medication, hypertension, and history of myocardial infarction (model 1: hazard ratio [HR], 7.49; 95% confidence interval [CI], 1.66 to 33.69; p for trend=0.01; model 2: HR, 6.83; 95% CI, 1.51 to 30.87 for quintile 5 compared with the reference category; p for trend=0.02). CONCLUSIONS Based primarily on RRR, we identified that a dietary pattern high in fats and oils, poultry, non-diet soda, processed meat, tomatoes, legumes, chicken, tuna and egg salad, and fried potatoes and low in dark-yellow and cruciferous vegetables may increase the incidence of ischemic stroke.

Introduction: Despite the importance of perceived barriers against self-care in diabetic patients, the role of this factor is rarely addressed in the improvement of self-care behaviors of Iranian patients. The lack of appropriate instruments that fit demographic properties of Iranian society is one reason. The aim of this study was to develop and validate the scale of perceived barriers to self-care in patients with type 2 diabetes mellitus. Methods: This cross-sectional study conducted on 400 patients with type 2 diabetes who were covered by the health centers in Isfahan (Iran) in 2015. A 22-item, researcher-made instrument was designed; the face and content validities of the instrument were examined through obtaining the opinions of an expert panel before administering the instrument in the study. Also, the exploratory factor analysis was used to investigate the instrument's validity. Cronbach's alpha was employed to measure its internal consistency (reliability). To examine the validity of the final scale, the mean scores of perceived barriers in patients with appropriate and inappropriate self-care behaviors were compared. Results: The research sample was comprised of 240 women (60%) and 160 men (40%). The mean value of the content validity index was 0.84. The results of factor analysis confirmed the validity of the 11 items and 3 factors of the developed scale. The factor loading ranged from 0.46 to 0.78. These three factors together explained 40.28% of the total variance. The overall reliability coefficient of the instrument was 0.79, ranging from 0.82 to 0.93 for three factors. Conclusion: According to the results, the developed scale was a valid and reliable instrument for examining the barriers perceived by the patients. The findings of this research can help health policy makers in planning to facilitate the self-care behaviors as the most vital factor in diabetes control.

Background: Needle-syringe programs (NSP) have been running in Iran since 2002. However, the coverage of such program among the NSP clients at the individual level was not studies yet. This study aimed to determine the client coverage of NSP and its correlation with high injection-related risk behaviors. Methods: A cross-sectional survey was conducted in Kermanshah province, Iran, in 2014. 230 people who inject drugs (PWID) recruited from two drop-in centers (DICs) from April to September 2014, participated in a face-to-face interview to provide information related individual coverage of NSP, demographic characteristics, and injecting behaviors 30 days prior to the interview. Findings: Overall, the average of syringe coverage was 158% [95% confidence interval (CI) = 65.7-205.5], while 56% (95% CI = 40-97) have individual converge less than 100%. Needle/syringe sharing was significantly higher among individual with low NSP coverage [adjusted odds ratio (AOR) = 2.6, 95% CI = 1.3-6.2]. About 85% participants with coverage of less than 100% reported reuse of syringe within the last 30 days (AOR = 3.2, 95% CI = 1.4-7.7). Conclusion: PWID are different regarding their NSP individual-level converges. There are certain clusters of PWID, who do not receive sufficient number of syringes. Given that insufficient individual syringe coverage level is highly associated with injection risk behaviors, reasons for such low converge need to be assessed and addressed carefully.

مقدمه: در ایران، تا زمان انجام این پژوهش، مطالعه‌ی جامع و مبتنی بر جمعیت، برای تعیین الگوی اپیدمیولوژیک سکته‌ی قلبی و به ویژه، تعیین میزان و عوامل مؤثر بر مرگ و میر بیماران در بیمارستان انجام نشده بود. این مطالعه با این هدف انجام گرفت. روش‌ها: این مطالعه‌ی هم‌گروهی آینده‌نگر و مبتنی بر جمعیت، از داده‌های 20750 بیمار جدید مبتلا به سکته‌ی قلبی در سال 1391 در ایران استفاده نمود. از Cox Regression و Logistic Regression برای تحلیل داده‌ها در نرم‌افزار Stata استفاده شد. یافته‌ها: 4/72 درصد بیماران مرد و مابقی زن بودند و میانگین و انحراف معیار سن در آنان 4/13± 2/61 سال بود. میزان کشندگی مرگ بیمارستانی به علت سکته‌ی قلبی برابر 1/12 درصد بود. میزان بروز مرگ بیمارستانی در زنان بیشتر از مردان بود. این میزان در کل کشور 74/6 درصد با حدود اطمینان (CI 95%) 7-4/6 درصد بود. سن بالاتر از 84 سال، جنسیت زن، بی‌سوادی، عدم دریافت درمان ترومبولیتیک، دیابت نوع دو، درد قفسه‌ی سینه قبل از ورود به بیمارستان و درد مقاوم به درمان، انسداد شاخه‌ی راست قلب، تاکی‌کاردی بطنی، فیبریلاسیون دهلیزی، سکته‌ی قلبی با بالارفتن قطعه‌ی ST، نارسایی قلب و دریافت آنژیوبلاستی مهم‌ترین تعیین کننده‌های مرگ بیماران بودند. نتیجه‌گیری: با توجه به نتایج حاصل از این مطالعه، به نظر می‌رسد که سکته‌ی قلبی با بالارفتن قطعه‌ی ST و سن بالاتر از 84 سال بیشترین اثر را بر بروز مرگ بیمارستانی بیماران مبتلا به سکته‌ی قلبی دارد. نتایج این مطالعه برای برنامه‌ریزی در پایش و بهبود مراقبت‌ها و درمان بیماران کمک کننده است.

Background: Despite the implementation of harm reduction program, some injecting drug users (IDU) continue to engage in high-risk behaviors. It seems that there are some social factors that contribute to risk of human immunodeficiency virus (HIV) transmission in IDUs. The aim of this study was to analysis the social network of IDUs and examines the effect of network location on HIV transmission risk using the multiple membership multilevel models. Methods: From October 2013 to March 2014 we conducted face-to-face interviews on 147 IDUs. We asked participants to nominate up to 20 people whom they had more than causal contact with them during the last month and specify if each nominee is drug injector or not. We defined four Network locations as Core and Peripheries of main components. The risk of HIV transmission for each individual was measured based on 7 items scale. We applied Multiple Membership Multilevel Linear Regression analysis to examine the relationship between network location and HIV transmission risk. We used Stata and UCINET software’s for the analysis of data. Findings: The mean age of participants was 37 ± 9.32. Most of the individuals were male, single and educated up to guidance school. Being a core member of the main component as like as being a member of other small components in comparison with Isolates/unlinked significantly increased the HIV Transmission risk. Engagement in methadone maintenance therapies (MMT) was associated with a decrease in HIV transmission score. Conclusion: Network analysis is a useful guide to find the most influential members of IDUs network and may have a complementary role for harm reduction program. The efficacy of interventions programs can be reinforced by addressing them to core individuals within the network. Furthermore, it provides the harm reduction staff to find the broader number of IDUs who are usually hard to reach by routine outreach case-finding tasks.

Background: Myocardial infarction (MI) is a leading cause of mortality and morbidity in Iran. No spatial analysis of MI has been conducted to date. The present study was conducted to determine the pattern of MI incidence and to identify the associated factors in Iran by province. Materials and Methods: This study has two parts. One part is prospective and hospital-based, and the other part is an ecological study. In this study, the data of 20,750 new MI cases registered in Iranian Myocardial Infarction Registry in 2012 were used. For spatial analysis in global and local, spatial autocorrelation, Moran′s I, Getis-Ord, and logistic regression models were used. Data were analyzed by Stata software and ArcGIS 9.3. Results: Based on autocorrelation coefficient, a specific pattern was observed in the distribution of MI incidence in different provinces (Moran′s I: 0.75, P < 0.001). Spatial pattern of incidence was approximately the same in men and women. MI incidence was clustering in six provinces (North Khorasan, Yazd, Kerman, Semnan, Golestan, and Mazandaran). Out of the associated factors with clustered MI in six provinces, temperature, humidity, hypertension, smoking, and body mass index (BMI) could be mentioned. Hypertension, smoking, and BMI contributed to clustering with, respectively, 2.36, 1.31, and 1.31 odds ratio. Conclusion: Addressing the place-based pattern of incidence and clarifying their epidemiologic dimension, including spatial analysis, has not yet been implemented in Iran. Report on MI incidence rate by place and formal borders is useful and is used in the planning and prioritization in different levels of health system.