soheil saadat

 Dyslipidemia is among the leading risk factors for cardiovascular diseases (CVDs), with an increasing global burden, especially in developing countries. We investigated the prevalence of dyslipidemia and abnormal lipid profiles in Tehran.

 We used data from 8072 individuals aged≥35 from the Tehran Cohort Study (TeCS) recruitment phase. Fasting serum total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), and triglyceride were measured. Dyslipidemia was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria, and high LDL/HDL was defined as a ratio>2.5. The age-sex standardized prevalence rates were calculated based on the 2016 national census. Furthermore, the geographical distribution of dyslipidemia and lipid abnormalities was investigated across Tehran’s zip code districts.

 The age-sex standardized prevalence was 82.7% (95% CI: 80.1%, 85.0%) for dyslipidemia, 36.9% (95% CI: 33.8%, 40.1%) for hypertriglyceridemia, 22.5% (95% CI: 19.9%, 25.4%) for hypercholesterolemia, 29.0% (95% CI: 26.1%, 32.1%) for high LDL-C, 55.9% (95% CI: 52.6%, 59.2%) for low HDL-C, and 54.1% (95% CI: 50.9%, 57.3%) for high LDL/HDL ratio in the Tehran adult population. The prevalence of dyslipidemia, low HDL-C, and high LDL/HDL ratio was higher in the northern regions, hypercholesterolemia was higher in the southern half, and high LDL-C was more prevalent in the middle-northern and southern areas of Tehran.

 We found a high prevalence of dyslipidemia, mainly high LDL/HDL in the Tehran adult population. This dyslipidemia profiling provides important information for public health policy to improve preventive interventions and reduce dyslipidemiarelated morbidity and mortality in the future.

Prisoners of war (POWs) are usually at risk of suicide due to problems such as torture, social and emotional deprivation, etc. The present study aimed to investigate suicide cases among Iranian prisoners of war (POWs) over ten years of their presence in the camps in Iraq (1980-1990).

Data required in this study were collected in two ways: 1-Iranian ex-POWs' death certificate by the Iraqi army clinic setting; 2-we interviewed 19 Iranian ex-POWs with sufficient information from detention camps and their events. The collected data wereage, sex, duration of captivity, date of death, the suicide, and places of suicide (camp name).

During eight years of the Iraq-Iran war, about 40000 Iranian soldiers captured by Iraqi soldiers. Ofthem, at least 11 persons (0.0275%) lost their lives due to suicide. The rate of suicideamong Iranian ex-POWsin Iraq was variable from zero to 28 per 100000 people. Nine (82%) of deceased were among registered prisoners of war, andthree (%27.3) were civilians. The highest rate was among prisoners that spent seven years of captivity. The most common method of suicide was hanging and burning, with 45.5% (5/11) and 18.2% (2/11), respectively.

Social support and providing suitable treatment for chronic and incurable diseases or creating situations for returning such patients to their home could be essential for suicide prevention. Transferring them to a third country (under the supervision of international groups such as International Committee of the Red Cross (ICRC) could be another way to reduce the amount of psychological stressand will also be helpful in their treatment.

The aim of the present study is to investigate a possible relation between Moon cycle and Trauma deaths registered in Tehran cemetery organization (Behesht Zahra), for a 10 years period (March 1992 to March 2002). From 28,208 traumatic deaths were registered in Tehran cemetery, 22828 (80.9%) meet our conclusion criteria. There were 17,056 (74.7%) males and 5,772 (25.3%) females. There was not an increase in trauma deaths in the full moon and new moon days. A similar pattern was observed for the sex of death cases and intentional deaths. The mean age of deceased cases showed a significant increase in full moon days. Different factors could affect the frequency of trauma deaths. Hence, if there is any role for Full Moon on the occurrence of trauma and its deaths, it is not so strong that can be identified.Keywords: Trauma, Death, Full Moon, New Moon, Tehran.Level of evidence: VI

Idiopathic granulomatous mastitis (IGM) is a rare inflammatory disease of the breast with unknown etiology. Clinico-radiologic findings can mimic breast cancer. Further pathologic evaluation to rule out malignancy is mandatory. Recognizing the severity of the disease is crucial to choosing the most effective therapeutic modality. The aim of this study is to evaluate clinical and radio-pathologic features of IGM, and the treatment outcome in a large series of IGM patients in Iran.

The retrospective charts of 243 patients suspicious of IGM, between December 2007 and September 2017 were reviewed. Patients with confirmed diagnosis of IGM were classified into four grades of severity. Demographic information, clinical and radio-pathologic findings, severity and treatment outcomes were collected.

Overall, 224 patients were confirmed to have IGM. Breast mass and erythema were the most common clinical findings. Mammographic findings mimicked malignancy in 34%. Lobulo-centric non-caseating granulomas were the most common pathologic finding. Also, 61.5% of the patients had mild to moderate symptoms and 49.5% of them recovered completely by observation. In addition, 53 (25.9%) patients had severe symptoms and 30.8% of them were resistant to treatment.

IGM is a diagnostic challenge. Its diagnosis is based on exclusion and a close cooperation between the clinician, the radiologist and the pathologist. Mild to moderate cases can be managed conservatively; however, severe cases may need further aggressive medical or surgical treatments.

Trauma is one of the major non-communicable diseases of this century and one of the main problems threatening public health. Trauma injuries are the leading cause of disability and mortality in all countries. This study aimed to explore and understand the challenges of early rehabilitation care in multiple trauma patients from the experience of a multidisciplinary care team using a qualitative research method.  This study was conducted with the qualitative research approach using qualitative content analysis. Participants were seven nurses, two doctors, three physiotherapies, and two occupational therapists in inpatient wards and outpatient trauma were interviewed. Data were collected through semi-structured interviews with a purposive sampling continued until data saturation. Analysis of data collected concurrently with data for comparison was done. First, for depth descriptions of the participant statements, 800 codes were extracted and finally, for the analysis, and constant comparison, two main themes of the lack of holistic care and support structure were extracted. The results showed that comprehensive and rehabilitation-based care was essential to achieve important care goals in this group of patients. Understanding the challenges of early rehabilitation care in multiple trauma patients will help health policymakers that solve these problems and help improve the health of this group.

Child Abuse and Neglect (CAN) is a major health problem with serious consequences. Since health care professionals play an important role in identification, management, and reporting CAN cases, they should have precise knowledge on this subject. The aim of this study is to investigate the level of knowledge, attitude and practice of the pediatricians, pediatric residents, and nurses regarding CAN issues as well as their possible needs for any educational programs in this regard.
130 pediatric nurses and physicians working at two pediatric tertiary centers, in Tehran, Iran participated in this descriptive cross-sectional study. An anonymous validated and standardized self-report questionnaire was used as the study instrument. The questionnaire consisted of five sections on demographic information, knowledge, attitude, practice and needs assessment. Analytical statistical tests including t-test, Kruskal–Wallis and Mann-Whitney tests were used to analyze the data.
The level of the participants’ knowledge was moderate (mean score: 16.6±3.17) and their attitude towards child abuse and neglect was at a good level (mean score: 45.72 ±4.25). The results of this study revealed that the overall performance of the participants in dealing with a suspicious case of child abuse and neglect was moderate. Almost all participants (95.5%) indicated the need for educational programs on child abuse both for nurses and physicians.
Results of our study revealed that the overall knowledge, attitude, and practice of the health care professionals in the field of pediatrics regarding child abuse and neglect are not satisfactory and training programs on this issue are mandatory for pediatricians, pediatric residents, and nurses due to their serious role in caring for children.

As part of its Next Accreditation System, the Accreditation Council for Graduate Medical Education and the American Board of Emergency Medicine describe 6 competencies containing 23 sub-competencies graded by milestones ranging from level 1 (expected of an incoming intern) to level 5 (demonstrates abilities of an attending) that are used to track resident training progression. To the best of our knowledge, there have been no studies introducing a milestones-based curriculum to medical students prior to their introduction to the wards, so we sought to determine the effects that a pre-clinical Emergency Medicine Interest Group (EMIG) Milestones Elective would have on preparing the students interested in Emergency Medicine (EM) as a specialty to meet thelevel 1 milestones prior to their intern year.

The elective hosted 15 events throughout the academic year, and pre- and post-curriculum surveys were administered. Thirteen first- and second-year medical students at our institution who completed the elective self-reported their perception of preparedness for each level 1 milestone in the 19 sub-competencies. A repeated measures design was used through identical pre- and post-curriculum surveys to determine any changes in self-reported preparedness for meeting level 1 milestones after completing the elective using Wilcoxon Signed Ranks Test.

There was a significant increase in the median scoring from 1 to 2 (P=0.027) in overall self-reported preparedness for meeting the level 1 milestones included in the elective, as well as significant increases in subcategories across competencies 1-4 outlined by the ACGME. There was no significant increase in preparedness for professionalism or interpersonal communicationcompetencies. There was no significant increase in interest in EM as a result of the elective.

Implementing a milestones-based curriculum during the pre-clinical years shows improved self-reported preparedness of students interested in pursuing EM for meeting level 1 milestones prior to residency. Additionally, a specialtybased elective such as this one offered through EMIG may further increase interest in the field during pre-clinical years.

Well-functioning health systems and effective preventive measures require registering the exact number and valid data of fatal injuries. The present study aimed to determine the completeness of fatal injuries reported by LMO with the use of the capture-recapture method and finding the reasons for those unregistered fatal injuries in Hamedan County.

This cross-sectional study was conducted in Hamadan County from 22 August 2015 to 21 August 2016. The completeness of fatal injuries reported by LMO, as the main source of fatal injuries was estimated with the employ of the capture-recapture method including Health Department and Police. Log-linear modeling was used for statistical analysis. The number of fatal injuries that probably had not been detected in any three sources was estimated by using the GENLOG command.

A total of 451 fatal injuries were registered in LMO for one year. The registries were included different amounts of detailed information from at least five variables in the Emergency Medical System (EMS) up to all detailed information in the LMO and Health Department. More fatal injuries occurred in males than females at all ages and the two-sex difference spectrum was wider between about 20 to 45 years old. Among cases of LMO, we found 29 unreported deaths. Therefore, the completeness of reported fatal injuries by LMO was estimated to be 86.9%.

Fatal injuries are under-reported by the main source of this type of death in Iran. Identification of fundamental causes, integrated death registry system, and using a standard cause of death classification are needed to promote the registration of fatal injuries

Appendicitis is one of the most preventable causes of death worldwide. We aimed to determine the trend of mortality due to appendicitis by sex and age at national and provincial levels in Iran during 26 years.

Data were collected from Iran Death Registration System (DRS), cemetery databanks in Tehran and Esfahan, and the national population and housing censuses of Iran. The estimated population was determined for each group from 1990 to 2015 using a growth model. Incompleteness, misalignment, and misclassification in the DRS were addressed and multiple imputation methods were used for dealing with missing data. ICD-10 codes were converted to Global Burden of Disease (GBD) codes to allow comparison of the results with the GBD study. A Spatio-Temporal model and Gaussian Process Regression were used to predict the levels and trends in child and adult mortality rates, as well as cause fractions.

From 1990 to 2015, 6,982 deaths due to appendicitis were estimated in Iran. The age-standardized mortality rate per 100 000 decreased from 0.72 (95% UI: 0.46–1.12) in 1990 to 0.11 (0.07–0.16) in 2015, a reduction of 84.72% over the course of 26 years. The male: female ratio was 1.13 during the 26 years of the study with an average annual percent change of -2.31% for women and -2.63% for men. Among men and women, appendicitis mortality rate had the highest magnitude of decline in the province of Zanjan and the lowest in the province of Hormozgan. In 1990, the lowest age-standardized appendicitis-related mortality was observed in both women and men in the province of Alborz and the highest mortality rate among men were observed in the province of Lorestan. In 2015, the lowest mortality rates in women and men were in the province of Tehran. The highest mortality rates in women were in Hormozgan, and in men were in Golestan province.

The mortality rate due to appendicitis has declined at national and provincial levels in Iran. Understanding the causes of differences across provinces and the trend over years can be useful in priority setting for policy makers to inform preventive actions to further decrease mortality from appendicitis.

Sleep deprivation leads to fatigue and sleepiness among health care workers and can result in road traffic collisions (RTC) after their shift. Planned napping is one of the main solutions proposed to avoid this problem.

The present study aimed at assessing the effect of two nap times during the night shift on psychomotor driving skills among night shift nurses.

A cohort study was conducted on 19 night shift nurses. The nurses completed the eight tests of the validated traffic psychological assessment battery of Vienna test system (VTS) before the night shift at 6 PM, and they repeated the same set of tests after the night shift at 7 AM. Data were compared based on nap times (00:00 - 03:00 AM versus 03:00 - 06:00 AM), which were chosen by the night shift nurses.

Nurses aged 23 to 36 years old participated in this study. Their driving experience was 6.1  3.4 years, and 34% reported RTCs in the previous year. The nurses who chose to take naps from 00:00 to 03:00 showed a significantly improved time-movement anticipation ability in driving compared to those who napped from 03:00 AM to 06:00 AM (P value = 0.005).

With respect to the time-movement anticipation test, napping during 00:00 to 03:00 AM provided better

compared to napping at 03:00 to 06:00 AM. Anticipation is a highly important psychomotor ability for safe driving.

Some disasters, such as earthquake and flood make the majority of affected people homeless. Theaccommodation of these people in temporary shelters and camps requires some specific ethical issues. The aim of thepresent study was to discuss ethical issues regarding living in camps following natural disasters. This study is conducted utilizinga qualitative content analysis approach. The required data were collectedfrom four Focus Group Discussions (FGDs). Subsequently, 11 in-depth interviews were completed using the individualswho had the experience of receiving care following natural disasters and continued until data saturation. Data wereanalyzed using Graham content analysis method. According to the results obtained from affected people’s views, the most important ethical issues that are notconsidered important in temporary shelters and camps include:1) the violation of privacy,2) the shortage of basic needs(e.g., food, water, and sanitation) and type and quality of services rendered,3) lack of attention to cultural and religiousviews of the affected people, 4) cause of evacuation, 5)lack of co-operation among disaster managers, 6)respecting theproperties of the affected people, 7)conditions and geographic location of camps, 8)property care, and 9)communitybasedcare. Without paying attention to ethical issues, living in temporary shelters (i.e., camps) violates the dignity ofaffected people and then the affected people will not have appropriate cooperation with the managers. All these issuesexpose them to more harm than before.Level of evidence: VI

The Cumberland Ankle Instability Tool (CAIT) is a valid instrument for determining the presence and severity of functional ankle instability. This questionnaire was recently cross-culturally adapted into Persian; however, the reliability of the Persian version has not been examined in athletes. CAIT has also been used with various independently-selected cut-off scores to determine instability. The present study was conducted to evaluate the psychometric properties of the Persian version of CAIT and to determine its optimal cut-off score in athletic populations. One-hundred and sixteen athletes (volleyball, basketball and track and field players) over 18 years old both with and without ankle instability completed the Persian version of the CAIT. The internal consistency, test-retest reliability and discriminative ability of the tool were assessed. A receiver operating characteristic (ROC) curve was drawn to confirm the cut-off point of the Persian version of CAIT using the Youden index. The average CAIT score was 25.14±4.98 for the right and 25.76±4.94 for the left ankle. The Persian version of CAIT had a good internal consistency (Cronbach's α of 0.78 for the right ankle and 0.79 for the left ankle) and substantial reliability (ICC2, 1 = 0.88; 95% CI: 0.86 – 0.90) in athletes. No ceiling or floor effects were observed. The optimal cut-off score for discriminating between athletes with and without FAI was 24. The Persian version of CAIT was shown to be a reliable tool for assessing functional ankle instability among Iranian athletes.

This study was aimed to determine the prevalence, predictors and cost of CAM practitioner use among traumatic patients in Iran. This cross-sectional household survey of a nationally representative sample of Iranians 15 to 64 yr old was conducted in 2011, using a three-stage cluster sampling. Short Form Injury Questionnaire 7 (SFIQ7) was utilized through face-to-face interviews and data on demographics, history of injuries, mechanism, site and type of injury, type and place of the treatment were attained. Via telephone calls, service use and costs of treatment were also collected. The prevalence of CAM practitioner use in injured people and victims seeking medical care was 0.7% and 4.1%, respectively in 3-month interval in 2011. There were no significant sociodemographic differences between victims who seek unconventional settings and those who seek conventional treatment. The most common injury description treated by CAM providers was as follows: fracture (type of injury), upper limb (site of injury), fall (mechanism of injury) and cast, splint, and physiotherapy (type of treatment). The average medical cost of CAM practitioner was US$14.7 while this amount in the conventional setting was US$195.5. Use of CAM is not very common among injured people in Iran. However, due to lack of formal training, CAM usage has possible side effects.

This study was aimed to determine the prevalence, predictors and cost of CAM practitioner use among traumatic patients in Iran. This cross-sectional household survey of a nationally representative sample of Iranians 15 to 64 yr old was conducted in 2011, using a three-stage cluster sampling. Short Form Injury Questionnaire 7 (SFIQ7) was utilized through face-to-face interviews and data on demographics, history of injuries, mechanism, site and type of injury, type and place of the treatment were attained. Via telephone calls, service use and costs of treatment were also collected. The prevalence of CAM practitioner use in injured people and victims seeking medical care was 0.7% and 4.1%, respectively in 3-month interval in 2011. There were no significant sociodemographic differences between victims who seek unconventional settings and those who seek conventional treatment. The most common injury description treated by CAM providers was as follows: fracture (type of injury), upper limb (site of injury), fall (mechanism of injury) and cast, splint, and physiotherapy (type of treatment). The average medical cost of CAM practitioner was US$14.7 while this amount in the conventional setting was US$195.5. Use of CAM is not very common among injured people in Iran. However, due to lack of formal training, CAM usage has possible side effects.

Industrialization could bring risk of Technological Disaster (TD) such as happened in Chernobyl, Bhopal and Fukushima crisis. little has been discussed about its related ethical issues. In this study, we aimed to investigate ethical issues have been stated for technological disasters.
Material and A systematic search was conducted on the main international literature databases including Pubmed, Embase, Scopus and ISI (Jan 1, 2000 to March 30, 2014). From 64 articles were eligible for investigation of ethical issues in Natural disaster, 6 was related to Technological Disaster. The articles were in English language.
Our result show that there are six articles discussing ethical issues during Technological disaster. All of them are related to nuclear crisis in Fukushima resulting from Japan tsunami 2011. These articles discussed mainly three ethical issues in providing medical care to victims of Technological Disasters as follow: 1- Duty of care 2- Mandatory evacuation and Resource Allocation.
Victim health is the main factor for making decision and implementation of any programs during response to disasters. Mandatory Evacuation for reasons other than providing health to people (such as: maintain public order) and if bring health risk to people will be unjustified. Duty of health workers for providing care is based on General beneficence meanwhile it is necessary to provide facilities to protect them from dangers that treat them in the field. For act ethically, Health workers must have adequate preparedness for response to T-D meanwhile it is necessary to provide guidelines for individuals that participation in relief operation. It is necessary to discuss more about Technological Disaster Ethics especially in industrial countries and where there is especial industrial with potential of huge crises.

Impairment of alertness, attention and performance associated with sleepiness and fatigue in nurses occur in night and long-term shifts that in the end of night shift reach to the maximum level can lead to traffic accidents when they returning home. The purpose of this study was to determine the effect of night shift on psychomotor abilities of driving in nurses after shiftwork.
Material and A cohort study was carried out on 23 night shift and 24 day shift female nurses aged 20 to 40 at Sina Hospital in Tehran city, using the Vienna Test System (VTS). The concentration and selective attention, reaction time, pheriperal perception, and coordination before and after night and day shifts were measured. A multiple linear regression model and Backward stepwise selection method was used for analyses.
In the concentration and selective attention test, sum hits (p = 0.038) and in the visual perception test , divided attention (p =0.006) and visual field (p =0.019), and in the reaction time test the mean motor time (p =0.034) showed a significant adverse relationship with working in night shift, but the visomotor coordination variables did not show any significant correlation.
The results showed that the concentration and selective attention, peripheral perception, and reaction time of psychomotor ability of driving were significantly adversely impaired in nurses after night shift. These results in evidence of the mechanism of increasing traffic accidents after night shift among nurses added to the previous studies in this subject.

Despite being a frequent plastic surgery complaint, the causes and predisposing factors for breast ptosis have not been studied profoundly. Studying ptosis causative factors will improve prevention, patient select and education, surgical outcome, and patient education. The present study aims to demonstrate the potential predisposing factors for breast ptosis.
In a 6-month study was conducted at the research department of Kaviani Breast Diseases Institute, Tehran, Iran, all female patients referring to the breast clinic were assessed. Patients with a background of severe comorbidities, history of breast surgery, and breast cancer were excluded. Data on demographic characteristics, current and past medical history, physical examination, and ptosis presence grade were collected.
A total number of 141 patients, with the mean age of 35.8 years, were included. About 72% of the patients had varying grades of breast ptosis. Patients with ptosis tended to be of older age, weight, BMI, and brassiere size, were more likely to be menopausal, and had begun wearing brassiere at younger ages. The ordinal model revealed an association between ptosis and age, age at wearing brassiere, current breast size, and smaller cup size in patients.
We suggest age and breast size as the predisposing factors for breast ptosis. In our study, there was no relation between breast ptosis and history of lactation or the number of pregnancies. The effects of hormonal and menstrual status, as well as drinking and smoking habits, need to be investigated further.

In the last decade, great attention has been paid to endovascular treatment and now it is considered as a treatment of choice in aortoiliac occlusive disease.
To report our 2-year follow-up experience in this field.
Patients and A retrospective review was conducted on patients who underwent aortoiliac angioplasty with or without stenting from September 2013 to March 2015. Medical profile, clinical signs and symptoms, and technical variables of angioplasty were recorded. Technical success rate and primary patency rate were the main outcome measures.
Fifty eight patients (m:f = 53:5) with the mean age of 64.28 ± 10.88 years and the most common initial presentation of intermittent claudication (37.9%) were evaluated. The technical success rate was 100% in each transatlantic inter-society consensus (TASC) subtypes. The mean time of hospital stay was 9.45 ± 7.96 days. The mean follow up period was 14.01 ± 5.87 months (6-27months). The Kaplan-Meier analysis estimated a primary patency rate of TASC subtypes A-D at 1 year as 96.3%, 100%, 66.7%, and 96.3%, respectively. Two years primary patency rates were 96.3%, 100%, 66.7%, and 81.6% for A-D TASC subtypes, respectively. There was no complication or death in the study group.
Endovascular treatment for different TASC II subtypes is associated with considerable technical success rate and primary patency rate even in TASC D, which has been previously indicated to be treated with open surgical procedures.

Hands-free cell phone conversation (HFCC) while driving is a common practice among drivers. Several studies have revealed that HFCC, while driving, is no safer than hand-held cell phone conversations (HHCC). This study was conducted to explore the influence of HFCC on the psychomotor performance of drivers.
In this quasi-experimental study, the participants were randomly allocated into 2 groups. Participants in group1 passed the traffic psychological battery of the Vienna test system (VTS) once without being engaged in any phone conversation and again while making a HFCC. The order of testing in the 2nd group was reversed. All participants shifted their group and passed the tests in a reverse order after 7 to 10 days. The tests included peripheral perception, perceptual speed, general intelligence, visuomotor coordination, and time anticipation. The mixed model analysis was used to assess the association of HFCC with every test.
A total of 24 students, with a mean age of 27.1 ± 5.3 years, were included in the study. HFCC had a significant negative influence on the overall mean duration (P value = 0.015), overall percent error duration (P value These findings provided further evidence of the adverse effects of HFCC during driving. Even though drivers can perceive an obstacle while talking on a hands-free cell phone, they are highly likely to react incorrectly due to impairment of visuomotor coordination, time anticipation, divided attention, and fluid intelligence.

Resilience is defined as skills, abilities, knowledge, and insight that people gain over time to overcome problems and hardships and cope with challenges.
Due to the lack of a gold standard to measure resilience, the current study aimed at designing and validating a resilience scale in Patients with cardiovascular and respiratory diseases.
The current methodological study was conducted in 2016 in 3 consequential phases. In the first phase, the concept of resilience was defined and analyzed in patients with chronic physical diseases using hybrid concept analysis. In the second phase, based on the findings obtained in the phase 1, the item pool was generated. In the third phase, in order to evaluate the psychometric properties of the tools, 375 patients in public places of Tehran, Iran, were selected using the multistage cluster sampling method to complete the scales.
Based on the results of the content analysis, the primary item pool included 142 items, which was reduced to 57 items by excluding the repetitive and combining the overlapping ones. After administering face validity, content validity, and item analysis, a total of 30 items remained. The exploratory factor analysis, by eliminating 1 item, indicated five 5, explaining 65% of the total variance, and the Kaiser - Meyer - Olkin (KMO) index was 0.949, showing a significant difference (P = 0.0001). Discriminant validity showed that patients with higher education were more resilient. Cronbach’s alpha coefficient of the final version of the 29 - item scale was 0.943.
The 29 - item resilience scale was a simple, valid, and reliable tool to measure resilience in patients with cardiovascular and respiratory diseases.

Conversation over the cell phone while driving is a known risk factor for road traffic crash. Using hands-free to talk on the cell phone may remove visual and manual distraction yet not the cognitive distraction.
The purpose of this study was to better understand the mechanisms of cognitive distraction due to hands-free cell phone conversation (HFPC) while driving.
Twelve male and 12 female University students in Tehran, Iran, were selected via the consecutive convenient sampling method, and randomly assigned to one of the following administrations of cross-over quasi-experimental study design, during year 2016: Administration 1, participants performed the tests while involved in HFPC, took rest for 60 minute, and then performed the tests another time without HFPC; Administration 2, participants performed the tests without HFPC, took rest, and then performed the tests another time with HFPC. Each participant moved to the other administration after 7 to 10 days. The Vienna test system (VTS) was used to measure simple and choice reaction time, selective attention, visual orientation, and visual memory. Linear regression analysis was used to study the change in test scores due to HFPC.
The mean age of participants was 27.1 ± 5.3 years. A history of road traffic crash (regardless of severity) was reported among 9 (37.5%) participants in the previous year. Hands-free cell phone conversation while driving was directly associated with mean time correct rejection score (P Using hands-free devices to converse during driving, impaired reaction time, selective attention, visual orientation and visual memory, which are essential for safe driving. Thus, the use of these devices does not preclude cognitive distraction and should be restricted.

Epidemiological researches indicated smokers are overrepresented in road traffic crashes. This study aimed to measure the influence of cigarette smoking on reaction time and selective attention required for safe driving (psychomotor performance of driving).
This semi-experimental study was carried out in laboratory of Sina Trauma Research Center of Tehran University of Medical Sciences in 2017. Twenty-twenty male university students aged 20-40 years from Tehran universities who had smoked occasionally participated voluntarily. Data collection tools consisted of two tests of the traffic psychological pack of Vienna Test System (VTS) and two questionnaires including nicotine dependency (Fagerstrom), individual characteristics and their views on cigarette smoking. Mixed model analysis was used to survey the change in the test scores due to cigarette smoking.
The mean ± standard deviation of age and nicotine dependency score (Fagerstrom) was 25.6 ± 3 years and 1.1 ± 1.4 respectively. Based on the results, 45.5% of participants believed that driving performance will be worse and little worse with cigarette smoking. But in this study, eye- hand and Hand-hand coordination and perceptual speed from psychomotor skills of driving did not show any significant association with the one cigarette smoking. (P≤0.05).
The results showed that the use of one cigarette in people who smoke occasionally does not change the score of eye-hand and Hand-hand coordination and perceptual speed significantly that is required for driving safety. A study on permanent smokers with a variety of addiction scores of nicotine is recommended.

Burden of injuries is an important public health problem, especially in developing countries. However, a national standard tool for data collection of trauma registry has not been developed in Iran yet.
The present study aimed to describe the steps undertaken in the development of the minimum dataset (MDS) and define the inclusion and exclusion criteria for a case of trauma registry by the national trauma registry of Iran (NTRI).
The working group consists of sixteen elected expert representatives from seven established countrywide active trauma research centers. Following a structured extensive review of the literature, the working party identified the data variables that included key registry goals for pre-hospital and hospital, outcome and quality assurance information. We used data variables from three trauma registry centers: National trauma data standard questionnaire, European trauma care (UT stein version), and Sina trauma and surgery research center. Then, we performed two email surveys and three focus group discussions and adapted, modified and finally developed the optimized MDS in order to prepare the quality care registry for injured patients.
The finalized MDS consisted of 109 data variables including demographic information (n = 24), injury information (n = 19), prehospital information (n = 26), emergency department information (n = 25), hospital procedures (n = 2), diagnosis (n = 2), injury severity (n = 3), outcomes (n = 5), financial (n = 2), and quality assurance (n = 1). For a patient sustained one or more traumatic injury in a defined diagnostic ICD-10 codes, the inclusion criteria considered as one of the followings: If the patient stayed > 24 hours in the hospital, any death after hospital arrival, any transfer from another hospital during the first 24 hours from injury.
This study presents how we developed the MDS in order to uniform data reporting in the NTRI and define our inclusion and exclusion criteria for trauma registry. Applying the MDS and the case definition in pilot studies are needed in next steps.

Today, trauma is considered as a major cause of temporary or permanent disabilities for millions of people. Any loss of ability has considerable effects on the quality of life. One of the most important causes of disability is limb trauma. However, the quality of life with limb trauma is relatively unexplored.

The objective of this study was to explore the quality of life following limb trauma.

In this qualitative study a thematic analysis and purposive sample method was used to recruit 11 patients with a disability in the upper or lower limbs and a history of hospitalization caused by a traffic accident 6 months to 2 years earlier. Data were collected through semi-structured interviews continued until reaching saturation. The data analysis approach in this study was thematic analysis, which consists of a vigorous process of data familiarization, data coding, and theme development and revision. The trustworthiness of the results was ensured through constant comparisons, triangulation, member checks, and peer review.

Based on the participants’ experiences, three themes were conceptualized: existing with limitations, empowerment approaches in encountering disabilities, and seeking support.

The experience of living with limb disability was a limiting experience, and other person’s activities and relations could aid participants in achieving empowerment through strengthening and seeking compensatory mechanisms. More attention to the problems of patients, and more research is recommended.