نشریه طب انتظامی
سال نهم شماره 3 (پیاپی 34، تابستان 1399)

Previous case reports suggest a relationship between methamphetamine abuse/dependence and aortic dissection. Acute aortic dissection is an uncommon disorder which can have fatal results in the event of treatment delay or misdiagnosis. Methamphetamine is a sympathomimetic amine that affects multiple organ systems. Cardiovascular complications are the second most common cause of death in methamphetamine abusers.

A 51-year-old man presented hospital in Tehran on May 2019 with chest pain following methamphetamine abuse. He was referred to the acute unit in the emergency department with suspicion of acute coronary syndrome. The patient has a 20 year history of methamphetamine abuse and hypertension. He had been prescribed losartan for hypertension. Upon examination, the patient’s blood pressure was 160/90 mmHg, pulse rate was 90 beats per minute, respiratory rate was 17 breaths per minute and his temperature was 37.2°C. A reduced pulse was observed in the left femoral, popliteal and dorsalis pedis arteries. His electrocardiogram revealed only sinus tachycardia without any changes. D-dimer was detected (10000 unit). Urine analysis was positive for methamphetamine. CT angiography was carried out and revealed an aortic dissection (Type A). An emergency heart operation was performed and the patient made a successful recovery.

This case demonstrated the importance of conducting a thorough physical examination and establishing an accurate medical history. Failure to recognize the reduced leg pulse, or history of methamphetamine use or hypertension, could have led to a fatal misdiagnosis.

Death due to violence (Homicide) is a heinous situation for social health. The purpose of the study was to identify the demographic characteristics and geographical distribution of homicide in Iran over the years 2011-2017.

This longitudinal and descriptive study was performed using secondary data analysis. The total mortality data for homicide resulting from the years 2011 to 2017 were extracted from the Civil Registration Organization and based on the international classification of the cause of death (ICD10). The population of each province to calculate the death rate in the population was taken from the general census of population and housing in both 2011 and 2016. All data were by gender, age, season and province. Using homicide death rate the geographic distribution was compared, and sex composition was compared by sex ratio of the rate, and difference of the rate for the changes over time, and [YLL] was used to analyze the age composition and impact of homicide on the population.

Between 2011 and 2017, an average of 1,360 murders was recorded annually in the country. The homicide rate was declining during the period, especially for women. In 2016, the homicide rate for men was 7.7 times that for women. Seasonally, the lowest and highest rates of homicide among young men were in winter and spring, respectively.

Death due to homicide in young men is a threat to social health and leads to years of lost life in the workforce. The high level in low-income provinces with ethnic subcultures requires regional programs to reduce this problem in the country. Special programs need to be implemented to fill young people's leisure time, especially in high-risk areas.

High-risk driving behaviors are of the factors that increase road accidents and casualties, which are very costly for the community and endanger the safety of the community. The aim of this study was to investigate the relationship between mental health components and high-risk driving behaviors among intercity drivers on the Tabriz-Ahar road, Iran.

This study is a correlation-predictive type that was conducted among all drivers of Tabriz-Ahar road who had at least two years of driving experience in 2018. A sample of 100 people from 130 intercity drivers was selected through available sampling method. Data collection tools were the Manchester Driving Behavior Questionnaire with a reliability of 0.96 and a validity of 0.81, and the General Health Questionnaire with a reliability of 0.84 to 0.92 and a validity of 0.55. Data analysis was performed using multiple regression analysis with simultaneous method in the form of SPSS 20 software.

The present study was performed on 100 male drivers with an average age of 38.56±2.80 years. The mean scores of mental health components and high-risk behaviors among drivers were below average, and the findings showed that the relationship between the components of physical symptoms, anxiety, social functioning and depression with high-risk driving behaviors was significant (p<0.05). Mental health components were able to predict high-risk driving behaviors, and these four indicators together explained 69.7% of the variance of the high-risk driving behavior index.

High-risk behaviors can be predicted by physical symptoms, anxiety, depression, and social dysfunction.

Anger rumination is a recurring cognitive process and is one of the internal manifestations of anger that leads to increased and persistent anger in individuals. The aim of this study was to investigate the relationship between emotion regulation and mindfulness with the ruminant anger of perpetrators of violent crimes.

The present study is descriptive and correlational. The statistical population included all male prisoners prisoners aged 18-50 in Ahvaz in 1396 who had committed violent crimes (256 people), of which 150 were selected by available sampling method. Data collection tools were Freiburg's Mindfulness Questionnaires, Cognitive Emotion Search, and Anger. Following the issuance of the necessary permits and the consent of the prison authorities, the objectives of the investigation were presented to all participants and the questionnaires were distributed by the prison staff. Data analysis was performed using Pearson correlation matrix and step-by-step regression analysis in SPSS 26 software.

The age range of the 150 men in the study who committed violent crimes ranged from 18 to over 50 (average 36 years). The results of the correlation coefficient showed that there was a significant correlation between negative emotion regulation strategies and significant negative correlation (p<0.05) and negative anger regulation strategies with anger ruminants (p<0.01). Also, positive emotion regulation strategies were positively and significantly correlated with mindfulness (p<0.01). Although there was a negative relationship between positive emotion regulation strategies and anger rumination, this relationship was not significant. The results of regression analysis also showed that negative emotion regulation strategies could significantly predict rumination.

The results of this study show the importance and necessity of paying attention to rumination as an effective factor in violent crimes. Identifying this psychological structure can be considered an important step in preventing violent crimes.

Addiction is a factor of despair, lack of return to life and a social, cultural and psychological problem in women consumers. The aim of the present study was to investigate the effectiveness of mindfulness-based forgiveness on life expectancy in female drug addicts in Zahedan, Iran.

This semi-experimental study of pre-post experimental type with control group in compulsory residential accommodation centers in Zahedan, Iran was conducted in the summer of 2018. Among these individuals, 30 female addicts who were eligible for study were randomly selected and randomly assigned to two groups of 15 individuals. All participants completed the Schneider Life Hope Questionnaire in the pre-test phase. For the experimental group, the training sessions were held for 6 60-minute sessions and were group-trained for one month based on mindfulness-based forgiveness. In this study, one-way analysis of covariance under SPSS 24 software was used to evaluate the effectiveness of treatment.

The mean age of 15 participants in the experimental and control groups was 33.3±8.3 and 34.0±9.3, respectively. The mean life expectancy scores of the experimental group increased significantly in the post-test (36.67±7.26) compared to the pre-test (30.20±8.60). However, no significant difference was observed in the pretest (30.53±9.05) and post-test (31.33±7.17) control group. There was a significant difference between the mean life expectancy in the experimental and control groups (F=13.716; p<0.001). By eliminating the effect of pre-test scores on the adjusted average life expectancy by group, there was a significant difference in the post-test phase. The averages increased after the pre-test effect was removed after the test, and the adjusted life expectancy averages for the experimental and control groups were 33.77 and 31.22, respectively, indicating the effect of mindfulness-based life expectancy training on pre-test life on adjusted averages.

Mindfulness-based forgiveness training can have a positive effect on life expectancy in female addicts.

Difficulty in emotion regulating is one of the important factors in creating marital conflict. The aim of this study was to compare the effectiveness of reality therapy and schema therapy on emotion regulation in women with marital conflict.

This semi-experimental study was conducted with a pre-test, post-test and one-month follow-up among all women with marital conflict who referred to the Dispute Resolution Council and Counseling Centers of Varamin, Iran in the winter of 2019. Of all the female clients, 120 were selected in the desired time frame. Among the participants, 45 were selected using the targeted sampling method and were randomly divided into two experimental groups and a 15-member control group. Gratz and Roemer's emotion regulation questionnaire was then administered. Members of the first and second experimental groups received two months of reality treatment, and treatment plans, respectively. No intervention was made on the control group. After the course of medical interventions, post-test and follow-up were performed for one month. Data analysis was performed using ANOVA with repeated measure and Bonferroni post hoc test in SPSS 24 software.

The mean emotion regulation of the reality therapy group was 126.07±2.05 for the experimental group, 127.4±4.84 for the treatment and treatment plan group, and 128.13±3.56 control group. The marital adjustment index of women with marital conflict in the group of reality therapy (91.47±4.86) and the treatment plan (90.47±12.43) compared to the control group (126.73±2.93) decreased significantly after the test. (p=0.001). In the follow-up phase, the effect of reality therapy and schema therapy on persistent emotion regulation (p<0.05). The effect of reality therapy and treatment plan on emotion regulation was similar in the post-test and follow-up stages (p<0.05).

Reality therapy and schema therapy are effective in regulating the excitement of women with marital conflict.

In today's society, dissatisfaction with body image has increased dramatically among young people due to the emphasis on the criteria of physical appearance as a criterion for attractiveness and social acceptance. The aim of this study was to determine the mediating role of social support in the relationship between psychological capital and body image in military students.

This descriptive-correlational study was conducted in 2018-19 among all students studying for bachelor and master degrees at the University of Police in Tehran, Iran. Using the available sampling method, 300 people were selected as samples and answered social support questionnaires, psychological capital, and body image. The collected data were analyzed using descriptive statistics, correlation coefficient and path analysis in SPSS 25 software.

The results showed that in psychological capital, the component of self-efficacy had a negative relationship and the components of hope and optimism had a positive and significant relationship with the perception of social support from friends, family and others. Also, psychological capital and social support had a positive and significant relationship with students' satisfaction with body image.

Psychological capital in students plays a decisive role in body image. Also, high social support can have a positive effect on people's attitudes toward themselves.