Objective: To study the epidemiology of car user road traffic fatalities (CURTFs) during eight years, in East Azerbaijan, Iran. Methods: A total of 3051 CURTFs registered in East Azerbaijan forensic medicine organization database, Iran, during 2006-2014, were analyzed using Stata 13 statistical software package. Descriptive statistics (p<0.05) and inferential statistical methods such as Chi-squared test and multivariate logistic regression with p<0.1 were applied. Results: Of the 7818 road traffic injury (RTI) deaths, 3051 (39%) were car users of whom 71% were male (mean age of 36.7±18.5 years). The majority of accident mechanisms were vehicle-vehicle crashes (63.95%), followed by rollover (26.24%). Crash causing vehicle fall increased the pre-hospital death likelihood by 2.34 times. The prominent trauma causing death was head trauma (in 62.5%). In assessing the role of type of counterpart vehicle on pre-hospital mortality, considering the other cars to be the reference group for comparison, deceased victims were 1.83 times more likely to die before hospital when the counterpart vehicle was a truck and 1.66 times more for buses. Conclusion: Decreasing the car users' fatalities using appropriate strategies such as separating the roads for heavy and light vehicles and improving the injury related facilitation may be effective. Male drivers with low education could be prioritized for being trained.

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BackgroundCohort studies play essential roles in assessing causality, appropriate interventions. The study, Post-crash Prospective Epidemiological Research Studies in IrAN Traffic Safety and Health Cohort, aims to investigate the common health consequences of road traffic injuries (RTIs) postcrash through multiple follow-ups.MethodsThis protocol study was designed to analyse human, vehicle and environmental factors as exposures relating to postcrash outcomes (injury, disability, death, property damage, quality of life, etc). Population sources include registered injured people and followed up healthy people in precrash cohort experienced RTIs. It includes four first-year follow-ups, 1 month (phone-based), 3 months (in-person, video/phone call), 6 and 12 months (phone-based) after crash. Then, 24-month and 36-month follow-ups will be conducted triennially. Various questionnaires such as Post-traumatic Stress Disorder Questionnaire, Patient Health Questionnaire, WHO Disability Assessment Schedules, Cost-related Information, etc are completed. Counselling with a psychiatrist and a medical visit by a practitioner are provided accompanied by extra tools (simulator-based driving assessment, and psychophysiological tests). Through preliminary recruitment plan, 5807, 2905, 2247 and 1051 subjects have been enrolled, respectively at the baseline, first, second and third follow-ups by now. At baseline, cars and motorcycles accounted for over 30% and 25% of RTIs. At first follow-up, 27% of participants were pedestrians engaged mostly in car crashes. Around a fourth of injuries were single injuries. Car occupants were injured in 40% of collisions.DiscussionThe study provides an opportunity to investigate physical-psychosocial outcomes of RTIs, predictors and patterns at follow-up phases postinjury through longitudinal assessments, to provide advocates for evidence-based safety national policy-making.

Background Due to limited capability to function in post-injury daily life injury, survivors need to be reliably assessed without need to commute more than necessary. The key action is to determine the level of functioning difficulties. Having the opportunity of conducting a national post-crash traffic safety and health cohort study, we aimed to translate into Persian and assess the psychometric properties of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) through phone surveys six month post injury. Methods First, having World Health Organization permission, we tested the translation validity by forward translation, expert panel evaluation, back-translation, pre-testing and cognitive interviewing, and finalizing the Persian WHODAS. Then, through a psychometric study within a national cohort platform, the validity, reliability and applicability of the 12-item WHODAS was assessed through phone surveys. We included data of 255 road traffic injury patients enrolled from the cohort at six-month follow-up. The psychometric assessment (internal consistency reliability and stability reliability) was conducted on test–retest data of 50 patients with an average 7-day time span. An exploratory factor analysis tested the construct validity using extraction method of principal component factor and oblique rotation on data from 255 patients. Regarding the multiple criteria including an eigenvalue > 0.9, Cattell’s scree test, cumulative variance, and the theoretical basis, the minimum number of factors were retained. Data were analyzed using STATA statistical software package. Results The respondents were mostly male (81%), employed (71%), educated (87%), and with a mean age of 37.7(14.9). The Persian version had high internal consistency reliability (Cronbach’s α = 0.93) and excellent stability reliability (ICC = 0.97, 95% CI: 0.92–0.98). An exploratory factor analysis retained four factors defining 86% of all the variance. Factors of Self-care, Mobility, and Cognition were completely retained. Conclusions The brief Pesrian WHODAS 2.0 was highly reliable and valid to be applied through phone interviews post injury.

:Background:Motorcycling is one of the main causes of injury, and motorcyclists are vulnerable to road traffic injuries. Attention Deficit Hyperactivity Disorder (ADHD) in adults is presumably one of the determinants of road traffic injuries and motorcyclists’ risky behavior. Despite the few studies on the relationship between motorcycle injuries and adult ADHD, their association has not been investigated using standardized instruments. This study aimed to analyze the relationship between motorcyclists’ adult ADHD and risky riding behaviors.Methods:This community-based, cross-sectional study was performed on 340 motorcyclists in Bukan city, west Azerbaijan province, Iran in 2015 and 2016 using a cluster-random sampling in seven areas of the city. According to the city map used by Bukan’s Health Centers, the city was divided into 14 clusters. Then, seven clusters (out of 14) were selected randomly. To reach the anticipated sample size, the data were collected from these seven clusters. In this study, the data collection instruments were: standard Motorcycle Rider Behavior Questionnaire (MRBQ), Conners' Adult ADHD Rating Scales (CAARS) questionnaire and a checklist designed by the researchers. The Stata 13 software package was used to analyze the collected data. Pearson correlation coefficient and multiple linear regression were performed to study the linear relationship between ADHD screening and MRBQ scores.Results:All 340 participants were male and the mean age was 30.2 years (SD=9.1). In addition, 22.1% of motorcyclists had a history of motorcycle crash. Bivariate analysis showed a significant association between risky riding behaviors and age, motorcycling records, and mean of riding hours per day (P-value less than 0.05). Multivariate analysis confirmed the correlation between ADHD and risky riding behaviors in all subscales (A, B, D) (p less than 0.05).Conclusions:Those with a high ADHD screening score are more likely to have risky riding behaviors.

Background: This study aimed to determine the prevalence of and correlates for suicidal behaviors among school attending adolescents in Brunei. Methods: Nationally representative cross-sectional data on (n=2599) adolescents derived from the Global School-based Health Survey in Brunei Darussalam were examined. Data on suicidal behaviors, psychosocial and demographic characteristics were analyzed using multiple logistic regression taking survey design into account.Results: Twelve months prior to being surveyed, the prevalence of suicidal behaviors was 9.3%, 6.5% and 5.9% for suicidal ideation, suicidal plan and suicidal attempt, respectively. Females were overrepresented in attempts (61.2%).Several self-reported characteristics such as suicide ideation (69%), anxiety (28%), and loneliness (30%) were significantly different between the attempters of suicide and non-attempters (p less than 0.05). Also, some suicide-related behaviors such as having planned a suicide (52%), being bullied (21%), involved in a physical fight (29%), serious injury (29%), early sexual debut (8.5%), alcohol use at early age (21%), alcohol use in the past 30-days (12%), and being physically attacked (30%) differed by suicide category (p less than 0.05). Compared to those who did not report attempting suicide, attempters were more likely to have suicide ideation (OR=10.58; 95% CI 5.10, 21.97); have planned suicide (OR=9.82; 95% CI 4.60, 20.96); or sustained serious injury (OR=4.01; 95% CI 2.03, 7.93) within the recall period.Conclusions: This study provided evidence, which overall confirm that the psycho-social environment in school settings modify suicidal behavior. The results, taken together emphasize the importance of the school environment on the development of school attending adolescents. Where possible, the results may provide additional information on which self-reported behaviors represent avenues for potential preventive programming.

Introduction: Action research is one of the important methods in medical education quality improvement. This study aims to improve quality of 'health service management' student’s clerkship course using action research. Methods: This action research study used mix method approach and was conducted in Tabriz University of Medical Science in 2018 year using Simon’s six stage model. Qualitative data was collected through in deapth interviews and focus group discussions (FGDs). Quantitative data was collected through a reliable and validated questionnaire. The participants were 17 health service management students (enrolled in 2015-2016) and the control group were 28 health service management students enrolled in 2014-2015). Qualitative data were analysed using content-analysis and quantitative data were analysed using T-test by SPSS-16 software. Result: Overall, 14 problems were identified and for 11 problems interventions were designed. The most important strengths of clerkship were;a)regular planning, b) appropriate assessment, c)scoring, high level of tutor attendance and d)more attention to management issues. Coordination problems and inappropriate headline of portfolio in some cases were weakness of this action research. The results of quantitative evaluation show that all items of questionnaire were improved. After reseach, %20.6 increase was observed in students' satisfactions level in the intervention groupcompared with the control group (80.7 vs. 60.1) (p>0.05). Conclusion: This action research significantly improved quality of clerkship course, it’s recommended that in future years same studies with aim to more quality improvement implemented.

Background: Due to more limited capability to function in daily life post injury, survivors need to be reliably assessed without extra commute. The key action is to determine the level of functioning difficulties. Having the opportunity of conducting a national post-crash traffic safety and health cohort study, we aimed to translate and assess the psychometric properties of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) through phone surveys six month post injury. Methods: First, having World Health Organization permission, we tested the translation validity by forward translation, expert panel, back-translation, pre-testing and cognitive interviewing, and finalizing the Persian WHODAS. Then, the psychometric study on a national cohort platform assessed the validity, reliability and applicability of 12-item WHODAS through phone surveys. We included data of 255 road traffic injury patients enrolled from the cohort study at six-month follow-up. The psychometric assessment (internal consistency reliability and stability reliability) was conducted on test-retest data of 50 patients with a 7-day time span averagely. An exploratory factor analysis tested the construct validity using extraction method of principal component factor and oblique rotation on 255 patients’ data. Regarding the multiple criteria, scree test, and factors with eigenvalues greater than 0.9 determined the number of factors retained. Data were analyzed using software STATA statistical package. Results: The respondents were mostly male (81%) with mean age (SD) of 37.7(14.9), employed (71%) and educated (87%). The Persian version had high internal consistency reliability (Cronbach’s α=0.93) and excellent stability reliability (ICC=0.97, 95% CI: 0.92-0.98). An exploratory factor analysis retained four factors defining 86% of all variance. Factors of Self-care, Mobility, and Cognition were completely retained.Conclusions: The translated brief WHODAS 2.0 was highly reliable, valid and responsive to be applied through phone interviews post injury.