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Background and aim:Driving after a night shift imposes a risk on health care professionals and other road users. The aim of this study was to measure psychomotor performance of driving of night shift nurses compared to day-shift nurses. Methods:Forty-seven volunteer female nurses working at Sina hospital in Tehran, Iran, with a call in all departments of hospital, participated in this study (23 night shift and 24 day shift nurses) in 2016. The tests included RT for simple reaction time, ATAVT for perceptual speed, LVT for visual orientation and ZBA for time anticipation. Data collection tools were individual characteristics, 11-item circadian type inventory (CTI), Stanford sleepiness scale (SSS), and Swedish occupational fatigue inventory (SOFI-20) questionnaires. Psychomotor driving performance was assessed using validated computerized traffic psychological battery of Vienna Test System (VTS), before and after the shifts. Data analysis was performed using paired-samples t-test and Linear Regression. Results:The mean age of day and night-shift nurses were 31.4±5.6 and 28.7±3.9 years respectively, no significant difference between two groups. Thirty percent of night shift and 16.7% of day shift nurses reported traffic accidents in the past year. The results revealed that, scores based on viewing times in visual orientation test (p=0.005), and median reaction time score in choice reaction time and reactive stress tolerance test (p=0.045), had a significant association with a 12-hour night shift with a 3-hour nap. Conclusions:Twelve-hour night shift work impairs choice reaction time and visual orientation in nurses, even though they take a 3- hour nap during the shift. These skills are required for safe driving.

AbstractThe significant burden of home injuries has become a growing concern that affect thousands of people every year across Canada. This study examined the relationship between neighbourhood deprivation and unintentional injuries occurring at home leading to hospitalizations in British Columbia (BC) between 2015 and 2019. This study used de-identified hospitalization data on unintentional home-related injuries from the Discharge Abstract Database (DAD) and population data for each dissemination area from Statistics Canada’s 2016 Census Profiles. Hospitalization rates were computed for unintentional home-related injuries across four dimensions specified in the Canadian Index of Multiple Deprivation (CIMD) for BC. For three CIMD dimensions (situational vulnerability, economic dependency, and residential instability), unintentional home injury rates were higher in areas with higher deprivation, while the inverse was observed for ethno-cultural diversity. Understanding socio-economic disparities within neighbourhoods enables injury prevention partners to identify vulnerable populations and prioritize the development and implementation of evidence-based injury prevention interventions. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic's impact on older adults (55+) living at the mid-point of the shelter-care continuum, in seniors housing (SH) and assisted living (AL), remains largely unexplored. This study compares survey responses of SH and AL residents with those of age peers living in private conventional community-based dwellings (CD) in British Columbia, Canada. Despite more SH/AL residents reporting feelings of isolation and changes to social support access, the pandemic appears to have had a greater negative impact on the routines of CD older adults. AL residents were more likely to engage in advance care planning discussions before and since the COVID-19 outbreak. These data are important for improving response to current and future disasters across the shelter-care continuum, particularly in ways to reduce the psychosocial effects of isolation or routine disruption, and strategies to increase advance care planning engagement. [ABSTRACT FROM AUTHOR]

【Abstract】Objective: The high burden of injuries in Iran necessitates the establishment of a comprehensive trauma care system. The purpose of this paper is to de- scribe the current status of trauma system regarding the components and function. Methods: The current status of trauma system in all components of a trauma system was described through ex- pert panels and semi-structured interviews with trauma spe- cialists and policy makers. Results: Currently, various organizations are involved in prevention, management and rehabilitation of injuries, but an integrative system approach to trauma is rather deficient. There has been ongoing progress in areas of pub- lic education through media, traffic regulation reinforcement, hospital care and prehospital services. Meanwhile, there are gaps regarding financing, legislations and education of high risk groups. The issues on education and training stan- dards of the front line medical team and continuing educa- tion and evaluation are yet to be addressed. Trauma regis- try has been piloted in some provinces, but as it needs the well-developed infrastructure (regarding staff, maintenance, financial resources), it is not yet established in our system of trauma care. Conclusions: It seems that one of the problems with trauma care in Iran is lack of coordination among trauma system organizations. Although the clinical management of trauma patients has improved in our country in the recent decade, decreasing the burden of injuries necessitates an organized approach to prevention and management of trauma in the context of a trauma system. Key words: Emergency medical services; Trauma centers; Wounds and injuries

Background: The use of oral corticosteroids to treat idiopathic granulomatous mastitis (IGM) has been a point of controversy for a long time. In addition, a wide diversity of combinations with other therapies have been reported so far. This study aims to review the usage of oral corticosteroids and their combinations in the published literature. Methods: PubMed and Scopus were searched using the key word "granulomatous mastitis." Citations were filtered in two stages, considering the titles/abstracts and full texts. Papers reporting the treatment of IGM with corticosteroids with/without other treatments were included. Results: Fifty-eight citations were included in this study, 31 of which had at least a group of patients treated only with systemic corticosteroids. Combination therapy of systemic steroids with immunosuppressants, surgical interventions, and antibiotics were used in 6, 12, and 13 studies, respectively. Conclusion: Considering the inconsistency of studies in reporting the severity of the disease, administered treatments, outcome of treatment, side effects, and follow-up, our study failed to provide solid evidence for using corticosteroids as the first step in the management of idiopathic granulomatous mastitis. There is still a need for further studies emphasizing the homogenization of such reports. In this regard, preparing a questionnaire to help homogenize future reports on IGM is highly recommended. [ABSTRACT FROM AUTHOR]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2006.12.014 Byline: Mojgan Karbakhsh, Negar Salehian Zandi Keywords: Overdose; Poisoning; Opium; Narcotics; Heroin Abstract: The global epidemic of opiate use continues to spread and is an increasing burden especially in developing countries. Acute opiate overdose (AOO) is one of the most dramatic complications of drug abuse. The purpose of this study is to examine the epidemiology of acute opiate overdose in a poisoning center in Tehran. Author Affiliation: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran

ABSTRACT OBJECTIVE: The purpose of this study was to investigate an ancient hypothesis; the moon effect might increase incidence of injuries and hence admission of patients with trauma to Emergency [...]

Objectives: Although Gross hematuria in patients receiving anticoagulants is not very common, it is one of the most common reasons of consulting with urologists. It is recommended to investigate urinary tract malignancies but simultaneous approach to anticoagulation and hematuria so as the optimum balance could be attained, is not clearly defined in the literature yet. We aim to answer pitfalls of hematuria management in anticoagulant receiving patients in this manuscript. Materials and methods: In a prospective case control study during 2017–2019, we observed and collected the data of patients receiving anticoagulant therapy and suffered from gross hematuria with coagulation parameters in prophylactic or therapeutic range in an academic hospital affiliated to Tehran University of Medical Sciences. SPSS 24th version was used for descriptive analysis of collected data. Results: Sixty-six patients encountered hematuria while receiving anticoagulant therapy. Although hematuria was more common in male patients, its recurrence was higher in female patients. It started mostly in first 72 h of therapy and was anticoagulant-dose dependent. Degree of hematuria was mostly mild or moderate by visual estimation and controlled easily by holding the anticoagulant therapy for less than 2 days. Anti-platelet therapy, urinary catheterization and patient's activity did not have any effect on re-bleeding rate. Conclusion: Considering the fact that ruling out the urinary tract malignancy is mandatory in these patients, moderate and severe hematuria can be controlled simply by short term holding the anticoagulant therapy while continuing antiplatelet therapy albeit there is possibility to continue them in mild cases. Removing urinary catheters and decreasing the patient's mobility are not recommended. In order to decrease the recurrence of hematuria, re-establishing anticoagulation with LMWH and non-Vitamin D dependent oral agents rather than continuing Heparin and Warfarin might be helpful. [ABSTRACT FROM AUTHOR]

Background: Evidence concerning the impact of long-term exposure to fine Particulate Matter ≤2.5 μm (PM2.5) on Cardio-Vascular Diseases (CVDs) for those people subject to ambient air pollution in developing countries remains relatively scant. This study assessed the relationship of 15-year PM2.5 exposure with cardiovascular incidence and mortality rate in Isfahan province, Iran.Methods: The cohort comprised 3081 participants over 35 years old who were free of CVDs. They were selected through multi-stage cluster sampling in Isfahan, Iran. PM2.5 exposure was determined separately for each individual via satellite-based spatiotemporal estimates according to their residential addresses. In this context, CVD is defined as either fatal and non-fatal Acute Myocardial Infarctions (AMI) or stroke and sudden cardiac death. The incidence risk for CVD and the ensuing mortality was calculated based on the average PM2.5 exposure within a study period of 15 years using the Cox proportional hazards frailty model upon adjusting individual risk factors. The mean annual rate of PM2.5 and the follow-up data of each residential area were combined.Results: Mean three-year PM2·5 exposure for the cohort was measured at 45.28 μg/m3, ranging from 20.01 to 69.80 μg/m3. The median time period for conducting necessary follow-ups was 12.3 years for the whole population. Notably, 105 cardiovascular and 241 all-cause deaths occurred among 393,786 person-months (27 and 61 per 100,000 person-months, respectively). In well-adjusted models, 10 μg/m3 increase in PM2.5 corresponded to a 3% increase in the incidence rate of CVDs [0.95 CI = 1.016, 1.036] (in case of p = 0.000001 per 10 μg/m3 increase in PM2.5, the Hazard Ratio (HR) for AMI and Ischemic Heart Disease (IHD) was 1.031 [0.95 CI = 1.005, 1.057] and 1.028 [0.95 CI = 1.017, 1.039]), respectively. No consistent association was observed between PM2.5 concentration and fatal CVD (fatal AMI, fatal stroke, SCD (Sudden Cardiac Death)) and all-cause mortality.Conclusions: Results from analyses suggest that the effect of PM2.5 on cardiovascular disease occurrence was stronger in the case of older people, smokers, and those with high blood pressure and diabetes. The final results revealed that long-term exposure to ambient PM2.5 with high concentrations positively correlated with IHD incidence and its major subtypes, except for mortality. The outcome accentuates the need for better air quality in many countries. [ABSTRACT FROM AUTHOR]