Journal of Injury and Violence Research <p>The Journal of Injury and Violence Research (JIVR) is a peer-reviewed open-access medical journal covering all aspects of traumatology includes quantitative and qualitative studies in the field of clinical and basic sciences about trauma, burns, drowning, falls, occupational/road/ sport safety, youth violence, child/elder abuse, child/elder injuries, intimate partner abuse/sexual violence, self-harm, suicide, patient safety, safe communities, consumer safety, disaster management, terrorism, surveillance/burden of injury and all other intentional and unintentional injuries.</p> en-US <p>Copyright.&nbsp; In accordance with Bethesda Statement on Open Access Publishing (released June 20, 2003, available from:, all works published in JIVR are open access and are immediately available to anyone on the website of the journal without cost. JIVR is an open-access journal distributed under the terms of the Creative Commons Attribution 3.0 License (<a href="" target="_blank"></a>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p> (Journal of Injury and Violence Research (JIVR)) (Tayebeh Najafi) Sat, 15 Aug 2020 00:00:00 +0000 OJS 60 Comparison of pre-hospital emergency services time intervals in patients with heart attack in Iran <p><strong>Background</strong><strong> and Goal</strong>: After cardiac arrest, the possibility of death or irreversible complications will highly increase in the absence of cardiac resuscitation within 4 to 6 minutes. Accordingly, measuring the pre-hospital service time intervals is important for better management of service delivery. The purpose of this study then was to investigate pre-hospital time intervals for patients with heart attack in Arak city in 2017, based on location and time variables.</p> <p><strong>Materials and Methods:</strong> This is a cross-sectional study of which, registered at the Arak emergency medical services (EMS) in 2017 related to time intervals of heart attack patients. Data were analyzed by SPSS version 13.</p> <p><strong>Results:</strong> In total, 51% of patients were males. Six percent of patients were under 25 and about 49 percent were between 46 and 65 years old. The average of activation, response, crash scene, transportation, recovery and total time intervals were 3:30, 7:56, 15:15, 13:34, 11:07, 12:11, and 41:25, respectively. In the city area, the shortest and longest average of response time interval was in spring and winter, respectively. In out of the city area, the shortest average of response time interval was in summer and the longest in autumn. The shortest and longest average response time interval in the city was in June and March, respectively, and in out of the city area, the shortest average response time interval was in June and the longest in April.</p> <p><strong>Conclusion: </strong>The shorter response time interval and delivery time interval compare to the other studies may indicate improvement in the provision of EMS. Special attention should be paid to the facilities and equipment of vehicles during cold seasons in order to be in the shortest possible time. Also, more training and informing staff about the code of cardiac patients along with general public education can help improve these intervals.</p> ََAbed Khanizad, Davoud Khorasani-Zavareh, Soheila Khodakarim, Mohammad Palesh Copyright (c) 2021 Journal of Injury and Violence Research Wed, 20 Jan 2021 00:00:00 +0000 A new approach in analyzing the accident severity of pedestrian crashes using structural equation modeling <table width="651"> <tbody> <tr> <td width="501"> <p><strong> </strong></p> <p><strong>Abstract:</strong></p> <p><strong>Background:</strong> According to official statistics in Iran, there were 17000 fatalities in road traffic crashes in 2018 that 25% of all crash fatalities belong to pedestrians. In most of the researches related to pedestrians’ safety, one aspect of the traffic crash (e.g. the injury or crash severity) is almost considered for the investigation. In order to perform a complete study of the crash, accident size can be utilized which involves different aspects of the crash. Accident size is described in terms of the number of fatalities and injured individuals and the number of damaged and involved vehicles in a crash.</p> <p><strong>Method:</strong> According to the fact that accident size has multiple indicators and it is not measured directly, traditional methodologies cannot be applied. So, in the present study the effective factors on the accident size of pedestrian crashes are investigated through structural equation modeling. For the purpose of this study, 3718 pedestrian-involved crash data occurred in Isfahan province is used for the modeling. The independent variables are weather conditions, road surface conditions, time, horizontal and vertical alignments, road type and location, driver’s gender and age, vehicle type, pedestrian’s age, gender and clothing color.</p> <p><strong>Results:</strong> The results indicated that highways, the pedestrians’ invisibility, female and old-aged pedestrians, heavy vehicles, old-aged and female drivers are related to the increase of the accident size in pedestrian crashes. These results denote that the mentioned variables are associated with the higher number of injuries, fatalities, the higher number of involved and damaged vehicles in a crash.</p> <p><strong>Conclusion:</strong> Present study shows the importance of considering safety improvement measures in highways, educating the people in the society about the traffic safety, the separation of pedestrian and motor vehicle traffic flow and considering the old people in policies and programs for mitigating the accident size.</p> </td> </tr> </tbody> </table> Ali Tavakoli Kashani , Mahsa Jafari, Moslem Azizi Bondarabadi Copyright (c) 2020 Journal of Injury and Violence Research Sun, 22 Nov 2020 00:00:00 +0000 The value of the visual evoked potentials test in the assessment of the visual pathway in head trauma <p><strong>Background:</strong> The research was done to evaluate the value of the visual evoked potentials test in the assessment of visual pathways function in cases with head trauma and minimal findings on routine testing.</p> <p><strong>Materials and Methods:</strong> A prospective case series evaluating use of visual evoked potentials testing in patients with a history of head trauma and suffering from visual symptoms with no significant clinical and neuroimaging findings, referred for further work up.</p> <p><strong>Results:</strong> Thirty-four patients with a history of head trauma and subsequent visual complaints were included.&nbsp; 27 cases (79.4%) were male and 7 cases (20.6%) were female. The mean elapsed time after the trauma was 47.6 weeks (range:&nbsp; 3.5 to 320 weeks). Twenty-five cases had unilateral and 9 cases had bilateral visual complaints. History of coma with mean duration of 12 days was present in 4 cases. The best-corrected visual acuity was less than 1 Log MAR (legally blind) in 21 eyes. In 4 eyes (12%) the relative afferent papillary defect test was positive. Mild to moderate optic disc pallor was present bilaterally in 4 cases and unilaterally in 3 cases. Hemorrhagic patches were reported on MRI in 2 cases; no other cases had pathologic MRI findings. In unilateral cases, there was a statistically significant difference between the involved eye-sided lobe and the sound eye-sided lobe implicit time and amplitude. In patients with bilateral complaints, by testing each eye, the VEP amplitudes of both eyes showed significant differences with the International Society for Clinical Electrophysiology of Vision standards, whereas the implicit times showed not-statistically significant differences.</p> <p><strong>Conclusion:</strong> The visual evoked potentials test shows not only additional diagnostic value, not seen on routine clinical and neuroimaging testing, but also rather a high validity in tracing visual disability in traumatic brain injury.</p> Pejvak Azadi, Morteza Movassat, Mohammad Hosein Khosravi Copyright (c) 2020 Journal of Injury and Violence Research Sat, 15 Aug 2020 00:00:00 +0000 Evaluating implementation of WHO Trauma Care Checklist vs. modified WHO checklist in improving trauma patient clinical outcomes and satisfaction <p><strong>Background:</strong> Use of checklist in evaluation of trauma patients has been a critical component of improving the care process and reducing medical errors and increasing patient's quality of life. We aim to assess the impact of the modified World Health Organization Trauma Care Checklist (WHO TCC) on the management of pain, complications, mortality and patient satisfaction in trauma patients.</p> <p><strong>Methods: </strong>This was a randomized control trial (RTC). Trauma patients referred to the trauma center and met the eligibility criteria were randomly assigned into three study groups. Group 1 were patients who received trauma care without using the WHO checklist, and only by the standard of care. Group 2 were patients who received trauma care according to the WHO's checklist, and group 3 were patients received trauma care according to the WHO's modified checklist. We used independent t-test and chi-square tests to assess the association between the study variables with checklist groups. The significance level of tests was set for p-value less than 0.05.</p> <p><strong>Results: </strong>We observed patients’ level of pain, Injury Severity Score (ISS), Glasgow Coma Criterion (GCS) and patient satisfaction significantly improved across the checklist groups, but more so in the modified checklist group (P less than 0.001). Similarly, findings reveal significant relationships between all clinical characteristics of the patients and checklist groups, except for a CT Scan of the spinal cord. We were unable to establish any significant associations between the checklist groups and the majority of the selected trauma care process measures, except for missed injury (p = 0.001).</p> <p><strong>Conclusions: </strong>Both the WHO TCC and the WHO modified checklist, in the initial assessment and during the treatment and care processes, enhance patients’ clinical outcomes. However, patients in the modified checklist compared to WHO TCC reported a higher level of satisfaction. Implications and future directions are discussed.</p> Shahram Bidhendi, Alireza Ahmadi, Mona Fouladinejad, Shahrzad Bazargan-Hejazi Copyright (c) 2020 Journal of Injury and Violence Research Sun, 16 Aug 2020 00:00:00 +0000 Risk factors associated with road traffic injuries at the prone-areas in Kampala city: a retrospective cross-sectional study <p><strong>Background:</strong> Road traffic injuries (RTIs) pose a disproportionate public health burden in the low and middle-income countries (LMICs) like Uganda, with 85% of all the fatalities and 90% of all disability-adjusted life years lost reported worldwide. Of all RTIs which are recorded in Uganda, 50% of cases happen in Kampala —the capital city of Uganda and the nearby cities. Identifying the RTI prone-areas and their associated risk factors can help to inform road safety and prevention measures aimed at reducing RTIs, particularly in emerging cities such as Kampala.</p> <p><strong>Methods:</strong> This study was based on a retrospective cross-sectional design to analyze a five year (2011 – 2015) traffic crash data of the Uganda Police Force.</p> <p><strong>Results:</strong> Accordingly, 60 RTI prone-areas were identified to exist across the Kampala. They were ranked as low and high risk areas; 41 and 19, respectively and with the majority of the latter based in the main city center. The bivariate analysis showed a significant association between identified prone-areas and population flow (OR: 4.89, P–value: 0.01) and traffic flow time (OR: 9.06, P–value: 0.01). On the other hand, the multivariate regression analysis only showed traffic flow time as the significant predictor (OR: 6.27, P–value: 0.02) at identified RTI prone-areas.</p> <p><strong>Conclusions:</strong> The measures devised to mitigate RTI in an emerging city like Kampala should study thoroughly the patterns of traffic and population flow to help to optimize the use of available resources for effective road safety planning, injury prevention and sustainable transport systems.</p> Joseph Kimuli Balikuddembe, Ali Ardalan, Kasiima M. Stephen, Owais Raza, Davoud Khorasani-Zavareh Copyright (c) 2020 Journal of Injury and Violence Research Tue, 29 Sep 2020 00:00:00 +0000 Is driver education contributing towards road safety? a systematic review of systematic reviews <p><strong>Background:</strong> There is a vast amount of literature on the effects of driver education. However, the evidence has become somewhat fragmented, making it challenging to understand driver education's effectiveness for improving road safety. The current study aimed to provide the efficacy of pre-LDE and post-LDE interventions aimed at improving the safety of drivers (includes crashes, injuries, or secondary outcomes).</p> <p><strong>Methods:</strong> The following online databases were searched up to the 21st of February 2020: Web of Science (WOS), Scopus, PubMed, Cochrane library, and other relevant databases. Systematic reviews (SR) and meta-analyses were selected to investigate the efficacy of driving education in reducing crashes, injuries, or secondary outcomes. Two investigators independently conducted the data extraction and used the assessment of multiple systematic reviews (AMSTAR) tool to conduct a quality assessment of each SR identified.</p> <p><strong>Results:</strong> Out of the 229 potential articles, seven SRs were eligible for the current overview of systematic reviews and meta-analyses. This overview showed that pre-and post-license education by people of all ages led to improvements in secondary outcomes, such as performance, self-perceived driving abilities, behind-the-wheel driving performance, and even a small decrease in traffic offenses. However, education was not effective in reducing crashes or injuries, either at the individual or community level.</p> <p><strong>Conclusion:</strong> There was no evidence that driver education is an effective approach to reducing crashes or injuries. This negative result might be due to ineffective teaching methods. To improve road safety, it appears necessary to change the method or content of driving education since the current approaches to driving education do not reduce traffic crashes or injuries.</p> Maryam Akbari, Kamran B. Lankarani, Seyed Taghi Heydari, Seyed Abbas Motevalian, Reza Tabrizi, Mark J.M.Sullman Copyright (c) 2021 Journal of Injury and Violence Research Mon, 18 Jan 2021 00:00:00 +0000 Non-communicable diseases in disasters: a protocol for a systematic review <p><strong>Background:</strong> NCDs require an ongoing management for optimal outcomes, which is challenging in emergency settings, because natural disasters increase the risk of acute NCD exacerbations and lead to health systems’ inability to respond. This study aims to develop a protocol for a systematic review on non-communicable diseases in natural disaster settings.</p> <p><strong>Methods:</strong> This systematic review protocol is submitted to the International Prospective Register of Systematic Reviews (Registration No. CRD42020164032). The electronic databases to be used in this study include: Medline, Scopus, Web of Science, Clinical Key, CINAHL, EBSCO, Ovid, EMBASE, ProQuest, Google Scholar, Cochrane Library (Cochrane database of systematic reviews; Cochrane central Register of controlled Trials). Records from 1997 to 2019 are subject to this investigation. Three independent researchers will review the titles, abstracts, and full texts of articles eligible for inclusion, and if not matched, they will be reviewed by a final fourth reviewer. The proposed systematic review will be reported in accordance with the reporting guideline provided in the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) statement. We select studies based on: PICOs (Participants, Interventions, Comparators, and Outcomes).</p> <p><strong>Results:</strong> This systematic review identifies any impacts of natural disasters on patients with NCDs in three stages i.e. before, during and in the aftermath of natural disasters.</p> <p><strong>Conclusion:</strong> A comprehensive response to NCD management in natural disasters is an important but neglected aspect of non-communicable disease control and humanitarian response, which can significantly reduce the potential risk of morbidity and mortality associated with natural disasters.</p> Elham Ghazanchaei, Iraj Mohebbi, Fatemeh Nouri, Javad Aghazadeh-Attari, Davoud Khorasani-Zavareh Copyright (c) 2021 Journal of Injury and Violence Research Mon, 18 Jan 2021 00:00:00 +0000