PURPOSE: Traffic accidents are one of the main causes of death and disability, causing annual deaths of 1.23 million and tens of millions injured people worldwide. Meanwhile, a significant proportion of the deaths and injuries caused by traffic accidents occur among motorcyclists. According to the world health organization's 2015 report, about 25% of deaths from traffic accidents occur in motorists. In Iran, a significant proportion of deaths and injuries result from traffic accidents among motorcyclists, especially in passages within the cities. According to traffic police, about 25% of deaths and 50% of injuries in traffic accidents of Tehran are reported among motorcyclists. Therefore, due to the importance of this issue, the spatial factors influencing the incidence of motorcycle-related accidents in Tehran were investigated using the geographic information system. METHODS: The present work was a cross-sectional and descriptive analysis study. The data necessary for the study were extracted from Tehran traffic police as well as municipality databases. Zoning maps were used to display the distribution of events. In the analytical investigation, Moran index was used to determine the distribution pattern of the events, while Getis-Ord G * statistics were applied to analyze hot spots. To investigate the role of regional and environmental factors in the frequency of traffic accidents related to motorcyclists in geographic units (Tehran 22 districts), Poisson regression and negative binomial models were used. The geographically weighted regression (GWR) model was used to analyze the relationship between environmental factors and the location of these events. Statistical analyses were performed using SPSS, STATA, ARC-GIS and GWR software. RESULTS: The southern and eastern margins of Tehran are the most vulnerable areas in terms of deaths related to traffic accidents of motorcyclists. Highways are considered the location of most traffic accidents which lead to death of motorcyclists. Getis-Ord General G * (p < 0.04) indicates that the distribution of high-risk points is statistically significant. The final model showed that in Tehran, the association of different variables including demographic characteristics, pathways network and type of land use with the number of accidents in geographic units was statistically significant. The spatial distribution of traffic accidents leading to deaths of motorcyclists in the center of Tehran varies considerably with changes in population density, length of highways, volume of traffic, and land use in different parts. CONCLUSION Most of the traffic accidents leading to deaths of motorcyclists occur in highways. Various environmental variables play a role in determining the distribution pattern of these types of events. Through proper traffic management, controlling environmental risk factors and training people the safety of motorcyclists in Tehran can be improved.
Accidents, Traffic ; prevention & control ; statistics & numerical data ; Automobile Driving ; statistics & numerical data ; Cross-Sectional Studies ; Environment ; Geographic Information Systems ; Geography ; Humans ; Incidence ; Iran ; epidemiology ; Motorcycles ; statistics & numerical data ; Regression Analysis ; Risk Factors ; Wounds and Injuries ; epidemiology ; etiology ; mortality ; prevention & control

This paper purports to identify and analyze the medical information of the frontline soldiers in the Northwest borderland provinces of Han Dynasty, especially Juyan and Dunhuang region, through an heuristic reading of the Juyan Bamboo Slips and the Dunhuang Bamboo Slips of the Han Dynasty. My findings are as follows. The most frequent disease found in the bamboo slips was the external injury. The injury of the frontline soldiers mainly occurred from the quarrels among armed soldiers using weapons. The bamboo slips also demonstrate that the quarrels usually arose due to the fierce tension caused by the frontier line service such as heavy guard activity and labour duty. Undernourishment and chronic stress the soldiers suffered might be another reasons. The second most common disease harassing the soldiers was exogenous febrile disease. In most cases reviewed in this paper, the exogenous febrile disease was usually concurrent with complex symptoms such as chills, fever, headache, etc. The bamboo slips show that the exogenous febrile disease was related to the harsh climate of the Northwest provinces, featuring extremely dry weather and the large magnitude of diurnal temperature fluctuations. In addition, the annual temperature range in the Northwest province was huge, fluctuating between very cold and dry winter and very hot and dry summer. The third most common disease this study identified was the disorder of the digestive system and respiratory system. However, these two types of disease were virtually indistinguishable in the bamboo slips, because the ancient Chinese chroniclers did not distinguish them, usually dubbing both diseases simply 'abdominal pain.' It should be mentioned that a few slips mention contagious disease such as dysentery and dermatolosis, and sudden death, as well. Overall, the bamboo slips demonstrate extremely poor status of the soldiers' heath condition and poor medical environment surrounding the soldiers stationing in the Northwest borderland military camps. The records also show that acupuncture, applying a plaster, drugs were the most common medical treatment. Drugs among them was the most frequently used. Whereas Acupuncture, applying a plaster were very rarely used. Medication has been used in three ways: powdered medicine, medicinal decoction and pill. Medicinal decoction was the most commonly used way.
China/epidemiology ; Climate ; Communicable Disease Control/history ; Communicable Diseases/epidemiology/etiology/history ; Digestive System Diseases/epidemiology/etiology/history/prevention & control ; History, Ancient ; Humans ; Military Medicine/*history/statistics & numerical data ; Military Personnel/*history ; Wounds and Injuries/epidemiology/etiology/history/prevention & control

When treating trauma patients with severe hemorrhage, massive transfusions are often needed. Damage control resuscitation strategies can be used for such patients, but an adequate fresh frozen plasma: packed red blood cell (FFP:PRBC) administration ratio must be established. We retrospectively reviewed the medical records of 100 trauma patients treated with massive transfusions from March 2010 to October 2012. We divided the patients into 2 groups according to the FFP:PRBC ratio: a high-ratio (> or =0.5) and a low-ratio group (<0.5). The patient demographics, fluid and transfusion quantities, laboratory values, complications, and outcomes were analyzed and compared. There were 68 patients in the high-ratio and 32 in the low-ratio group. There were statistically significant differences between groups in the quantities of FFP, FFP:PRBC, platelets, and crystalloids administered, as well as the initial diastolic blood pressure. Bloodstream infections were noted only in the high-ratio group, and the difference was statistically significant (P=0.028). Kaplan-Meier plots revealed that the 24-hr survival rate was significantly higher in the high-ratio group (71.9% vs. 97.1%, P<0.001). In severe hemorrhagic trauma, raising the FFP:PRBC ratio to 0.5 or higher may increase the chances of survival. Efforts to minimize bloodstream infections during the resuscitation must be increased.
Acute Lung Injury/epidemiology/etiology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bacterial Infections/epidemiology ; *Blood Transfusion/adverse effects ; *Erythrocyte Transfusion/adverse effects ; Female ; Hemorrhage/etiology/*prevention & control ; Hospital Mortality ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Patients ; Respiratory Distress Syndrome, Adult/epidemiology/etiology ; Resuscitation ; Retrospective Studies ; Wounds and Injuries/complications/mortality/*therapy ; Young Adult

PURPOSE: This study was performed to compare the effects of standardized peristomal skin care (SPSC) and crusting technique (CT) on the peristomal skin of ostomates. SPSC was developed by a consensus among the expert group based on a comprehensive review of the relevant literature and hospital protocols. METHODS: A randomized controlled pilot trial with 2 parallel arms was used. A total of 81 ostomates, who were recruited from a tertiary hospital, completed the baseline, 1-month, 2-month, and 3-month follow-up (SPSC group, n=45; CT group, n=36). SPSC consisted of water cleansing and direct application of ostomy appliances. CT involved crusting hydrocolloid powder and patting with water sponge or protective barrier liquid film. The outcomes of the study were assessed by skin problems, such as discoloration, erosion and tissue overgrowth; the domains of the evaluation tool used in examining the peristomal skin. A generalized estimating equation model was used to examine the effects according to time and group. RESULTS: In both SPSC and CT groups, the likelihood of occurrence of discoloration (OR, 1.99; 95% CI, 1.61-2.46), erosion (OR, 1.87; 95% CI, 1.55-2.25) and tissue enlargement (OR, 1.94; 95% CI, 1.36-2.77) increased with time. There was no significant difference in discoloration between the groups, whereas the probability of erosion (OR, 0.38; 95% CI, 0.16-0.89) and tissue overgrowth (OR, 0.09; 95% CI, 0.02-0.55) was lower in the SPSC group than in CT group. CONCLUSION: SPSC was sufficient in preventing peristomal skin problems of ostomates compared to the CT.
Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms/surgery ; Female ; Follow-Up Studies ; Humans ; Inflammatory Bowel Diseases/surgery ; Male ; Middle Aged ; Odds Ratio ; Ostomy/*nursing ; Skin Care/instrumentation/*methods/standards ; Wounds and Injuries/etiology/prevention & control

OBJECTIVETo evaluate the clinical effect of Xuefu Zhuyu Decoction (XFZYD) on the incidence of complications of rib fracture in patients with blunt chest injury.

METHODSOne hundred and twenty patients with rib fracture stratified according to the AIS scale in three layers (1-3) were equally assigned to two groups, the treated group and the control group, all received conventional treatment, but XFZYD was administered to patients in the treated group additionally. The incidence of complications in patients, including atelectasis, pleural effusion, pulmonary contusion, pleurocentesis and closed thoracic drainage, were observed.

RESULTSThe incidence of pleural effusion in patients of AIS-1 and -2 in the treated group was 20% and 45% respectively, which was remarkable lower than that in the control group (55% and 85%) respectively (P < 0.05); in the treated group, 10% patients of AIS-3, for whom close thoracic drainage was applied, while in the control group, the percentage reached 60%, showing significant difference between groups (P < 0.05).

CONCLUSIONXFZYD could reduce the incidence of pleural effusion in patients with blunt chest injured rib fracture of AIS-1 or -2, and reduce the utilization of close thoracic drainage in those of AIS-3, so it is good for clinical practice.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Pleural Effusion ; etiology ; prevention & control ; Rib Fractures ; complications ; drug therapy ; Thoracic Injuries ; complications ; Wounds, Nonpenetrating ; complications

Adult ; Bronchoscopy ; Female ; Humans ; Intubation, Intratracheal ; adverse effects ; methods ; Laryngostenosis ; etiology ; prevention & control ; Larynx ; injuries ; Male ; Wounds and Injuries ; surgery ; Young Adult

OBJECTIVETo explore the risk factors of road traffic injury (RTI), and to provide evidence for stretagy development on the prevention and control of RTI.

METHODSCase-crossover study was used. 402 drivers were face to face interviewed by specially designed questionnaire including the items as drinking alcohol before driving, onset anger scale (OAS), anxiety/irritation, Stanford sleepiness scale (SSS), vehicle breakdown, carelessness, violating the rules on right of way and traffic signs when driving. Tables related to case-control study on 1:1 matching was used for single factor analysis, and conditional logistic regression was used for multifactor analysis.

RESULTSThe risk factors that were associated with RTI including high OAS (OAS = 5-7, OR = 114.88, 95% CI:4.29-3074.86), violating the rules on right of way (OR = 46.96, 95% CI:12.74-173.11), violating traffic signs when driving(OR = 24.57, 95% CI: 8.69-69.45), carelessness (OR = 14. 54,95% CI: 6.85-30.86), unsafe distance between vehicles( OR = 14.30,95% CI: 3.68-55.60), wrong judgement (OR = 14.67,95% CI:4.88-44.10), vehicle breakdown (OR = 8.57, 95% CI: 1.38- 53.27) and improper measure ( OR = 8.46, 95% CI: 2.46-29.14) etc.

CONCLUSIONImproper driving behaviors, abnormal psychological status and driving skills of drivers were related to RTI, suggesting that it was necessary to carry out continous traffic security education to the drivers.

Accidents, Traffic ; statistics & numerical data ; Adult ; Cross-Over Studies ; Demography ; Female ; Humans ; Logistic Models ; Male ; Multivariate Analysis ; Risk Factors ; Surveys and Questionnaires ; Wounds and Injuries ; epidemiology ; etiology ; prevention & control

OBJECTIVETo probe into the effects of familial factors on injury-related behaviors in children.

METHODSInjury-related behaviors and familial factors of 6884 children were investigated with Family Questionnaire and Child Behavior Checklist. Multi-nominal logistic regression analysis was performed.

RESULTSThere were 1670 (24.26%) children having serious injury-related behaviors and 3683 (53.50%) children having moderate injury-related behaviors. Factors contributing to children's injury-related behaviors would include punishment or indifference as well as the mode of parents' education; reintegral type of family; the level of parents' cognition on injuries; unfit location of medicine at home and careless attitudes of parents.

CONCLUSIONThere was close relationship between children's injury-related behaviors and familial factors. To avoid injury-related behaviors and to prevent injury occurrence, the importance of familial factors must be stressed.

Child ; Child Behavior ; psychology ; Family ; psychology ; Female ; Humans ; Logistic Models ; Male ; Surveys and Questionnaires ; Wounds and Injuries ; etiology ; prevention & control ; psychology

China ; epidemiology ; Disease Notification ; standards ; Epidemiologic Methods ; Humans ; Models, Statistical ; Occupational Diseases ; epidemiology ; prevention & control ; Occupational Health Services ; statistics & numerical data ; Registries ; Wounds and Injuries ; epidemiology ; etiology ; prevention & control

OBJECTIVETo study psychologic features of accidentally injured children to provide basis for application of psychologic intervening measures.

METHODSEysenck personality questionnaire (EPQ) and Achenback child behavior capacity list (CBCL) (list for parents) were used to test accidentally injured children 7 - 11 years of age who were hospitalized (injury group) and healthy children (control group). Each group was composed of 81 cases.

RESULTS(1) Scores of P, E and N branch capacity lists in EPQ of injury group were all higher than those of control group (P < 0.05 or < 0.001). But the score of L branch capacity of control group was higher than that of injury group (P < 0.001). (2) Boys of injury group in seven factors of restlessness, violation of discipline, attack, harmful contact, schizoid anxiety, depression and body complaint and girls of injury group in seven factors of restlessness, cruelty, attack, depression, body complaint, social flinching and violation of discipline had higher scores than those in control group did (P < 0.01). (3) Detectable rate of behavior problems of injury group was 32.09% (26/81), higher than that of control group [11.11% (9/81), P < 0.001]. The odds ratio (OR) was 3.78, 95% CI was 1.66 approximately 8.59 (P < 0.01). The behavior factor had a lower sensitivity (32.1%) and a higher specificity (88.9%) and lower positive result value (74.3%). (4) Average CBCL score of boys in injury group (39.84 +/- 10.99) was higher than that of girl in injury group (34.26 +/- 10.43, P < 0.05). Boys in two factors of violation of discipline and attack, girls in factor of depression factor M had higher score than the opposite sex subjects did (P < 0.05 or 0.01). (5) Average CBCL score (37.62 +/- 11.03) of injury group was higher than that of control group (17.77 +/- 12.12, P < 0.001). Logistic multiple factor analysis showed that boys' accidentally injured factors were attack, restlessness, violation of discipline, and girls' accidentally injured factors were attack, violation of discipline and depression.

CONCLUSIONAccidentally injured children have more psychologic problems in character and behavior. Psychologic education should be given to reduce incidence of accidental injury to children.

Accident Prevention ; Case-Control Studies ; Child ; Child Behavior ; psychology ; Female ; Humans ; Male ; Personality Inventory ; Psychology, Child ; Risk Factors ; Sex Factors ; Surveys and Questionnaires ; Wounds and Injuries ; etiology ; psychology