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   Table of Contents - Current issue
Coverpage
January-March 2020
Volume 9 | Issue 1
Page Nos. 1-46

Online since Friday, March 27, 2020

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EDITORIAL  

The Ukraine airplane shoot-down due to neglecting the sustainable development goals p. 1
Ahmad Fayaz-Bakhsh, Payman Salamati
DOI:10.4103/atr.atr_11_20  
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ORIGINAL ARTICLES Top

Epidemiologic characteristics of injuries among 1–5 year-old children in Hamadan Province: Analysis of 4523 hospitalized children over a 6-year period p. 3
Salman Khazaei, Erfan Ayubi, Zahra Sanaei, Ensiyeh Jenabi, Leyla Khazaei, Jalaleddin Amiri
DOI:10.4103/atr.atr_49_19  
Background: Unintentional injuries are one of the major causes of death in Iranian children. Information on epidemiological pattern of injury among one-to 5-year-old children is limited in Hamadan. The aim of this study was to clarify the person, space and time pattern of injury among 1–5-year-old children in Hamadan Province. Methods: All registered incidence cases of injury among 1–5 year-old children in Hamadan Province from March 2009 to March 2015 were included in this cross-sectional study. We analyzed the data on county, gender, age category, type of injury, season and outcome of injury. Temporal trend was explored using time series regression with accounting autocorrelation, seasonality, and short-term variation. Results: This study included 4523 injury cases. During the studied period, urban residents and boys had a higher number of injuries. Motor vehicle-related injuries were the most common type of injury. A seasonality pattern was found so that most of the cases were occurred in summer months. The lowest and highest incidence rate ratios (IRRs) were occurred in January 2011 (IRR = 0.61 with 95% confidence interval [CI]: 0.31, 1.18) and May 2014 and August 2013 (IRR = 6.78 with 95% CI: 4.38, 10.51), respectively. Conclusion: In Hamadan Province, childhood injury has a variation in person, place, and time pattern, as some groups such as boys and urban residents among 1–5 year-old children are at a higher risk for the incidence of injury. Therefore, it is recommended that health service managers and health policymakers devote more healthcare and resources to the high-risk groups.
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Environmental factors influencing the distribution of pedestrian traffic accidents in Iran p. 8
Amir Kavousi, Ali Moradi, Hamid Soori, Khaled Rahmani
DOI:10.4103/atr.atr_76_19  
Background: This study aimed to determine the environmental factors affecting the frequency of accidents leading to injury and death related to pedestrians in 31 provinces of Iran. Methods: Data necessary for the study were extracted from databases of traffic police, statistics center, ministry of roads and urban development, and Iran meteorological organization. Hot spots analysis was used based on Getis-Ord G statistics in geographically weighted regression models. Goodness of fit of models was evaluated using the Bayesian information criterion, Akaike's information criterion and Deviance statistics. Results: In this study, 49,409 incidents were investigated. Of these, 48,382 (98%) cases were injuries and 1027 (2%) cases were fatal accidents. The incidence of fatal accidents does not follow a specific pattern; however, the incidence of accidents leading to injuries is higher in the central and the northeastern provinces of the country and lower in the southern and southeast provinces of the country. The final models showed that the relationship between different variables, including demographic characteristics, road network, and distance from the capital, traffic volume, and rainfall with dependent variables (number of accidents in geographic units), was statistically significant. Conclusion: In order to better design preventive plans for traffic accidents and promote the safety of passageways for pedestrians inside and outside the cities, these factors need to be considered more carefully, and practical solutions should be developed and implemented for their correction.
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Development of safety improvement method in city zones based on road network characteristics p. 16
Nemat Soltani, Mahmoud Saffarzadeh, Ali Naderan, Milad Abolhasani
DOI:10.4103/atr.atr_44_19  
Background and Objective: Extensive studies have so far been carried out on developing safety models. Despite the extensive efforts made in identifying independent variables and methods for developing models, little research has been carried out in providing amendatory solutions for enhancing the level of safety. Thus, the present study first developed separate accident frequency prediction models by transportation modes, and then in the second phase, a development of safety improvement method (DSIM) was proposed. Materials and Methods: To this end, the data related to 14,903 accidents in 96 traffic analysis zones in Tehran, Iran, were collected. To evaluate the effect of intra-zone correlation, a multilevel model and a negative binomial (NB) model were developed based on both micro- and macro-level independent variables. Next, the DSIM was provided, aiming at causing the least change in the area under study and with attention to the defined constraints and ideal gas molecular movement algorithm. Results: Based on a comparison of the goodness-of-fit measures for the multilevel model with those of the NB model, the multilevel models showed a better performance in explaining the factors affecting accidents. This is due to considering the multilevel structure of the data in such models. The final results were obtained after 200 iterations of the optimization algorithm. Thus, to decrease accidents by 30% and cause the least change in the area under study, the independent variable of “vehicle kilometer traveled per road segment” underwent a considerable change, while little change was observed for the other variables. Conclusions: The final results of the DSIM showed that the ultimate solutions derived from this method can be different from the final solutions derived from the analysis of the results from the safety models. Hence, it is necessary to develop new methods to propose solutions for increasing safety.
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Prevention of occupational traumas by developing an ergonomic design and modifying farmers' postures in walnut gardens of Tuyserkan, Iran p. 24
Hassan Sadeghi Naeini, Zahra Kaviani, Karmegam Karuppiah, Mohammadreza Sadeghi
DOI:10.4103/atr.atr_48_19  
Background and Objectives: Occupational traumas are known as work-related disorders, associating with some sorts of factors such as repetitive tasks, body postures, workstations, and hand tools. These traumas cause various problems for both workers and employers. Due to occupational hygiene considerations, problems such as cumulative trauma disorders, occupational trauma, low back pain (LBP), and work-related musculoskeletal disorders should be controlled. In this regard, ergonomic interventions can have efficient outcomes toward controlling occupational traumas. In this study, the focus was on working at some walnut gardens in the city of Tuyserkan in Iran, to reach an ergonomic analysis base, in which hand tools were assessed. The main objective was to develop a new ergonomic design for workers using hand tools. Subjects and Methods: In this cross-sectional study, 19 workers participated and filled out the Nordic Musculoskeletal Questionnaire (NMQ). Their body postures during harvesting walnuts were evaluated by the Ovako Working Posture Analysis System method. Hand tool analysis was also performed by ergonomic risk assessments. Results: The results showed that 15% of the farmers experienced some sorts of trauma during the harvest while using traditional hand tools. The results also emphasized that 61.5% of the workers' body postures should be modified. In addition, according to the NMQ, the most common problems among workers were wrist disorders, LBP, and knees' and shoulders' disorders. Conclusions: Considering experimental data, a new device was developed in which the weight, adjustability, and form of hand tools were modified under ergonomic considerations. The benefits of the new design were confirmed by SOLIDWORKS software. Since this new device helps farmers to decrease extra force exertion in awkward postures, it is expected to improve farmers' condition while using it.
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Humeral shaft fractures treated by closed retrograde intramedullary Kirschner wire fixation p. 30
H Lalrinchhana, Chandrashekhar Martand Badole, Girish Balasaheb Mote
DOI:10.4103/atr.atr_83_18  
Context: Flexible intramedullary nails have been reported to provide a stable humeral fixation with satisfactory results in terms of union and complications. In this study, Kirschner wire (K-wire) was used to achieve a closed intramedullary fixation of humeral shaft fractures. Subjects and Methods: This study included forty cases of the displaced diaphyseal fracture of the humerus based on inclusion and exclusion criteria. The study was done at Kasturba Hospital, Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sevagram, between the periods January 2003 and November 2006. All the cases were operated after clinical evaluation. The final evaluation of the result was done by Qidwai's clinical and radiological criteria. Results: A total of forty cases were available for the study. K-wire of different sizes was used; the average duration of surgery was 45.3 ± 7.2 min. The average time taken for radiological union was 12.1 ± 1.9 weeks. The patients were analyzed by Qidwai's criteria and had excellent result in 30 (83.3%) cases, good in 4 (11.1%) cases, and poor in 2 (5.6%) cases. Three patients were lost to follow-up, and one patient was died due to medical illness. Conclusion: Intramedullary K-wire fixation is a satisfactory, safe, simple, minimally invasive technique and cost-effective treatment for humeral shaft fractures. It gives elastic mobility and stability.
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A fuzzy analytic hierarchy process-TOPSIS framework for prioritizing emergency in a petrochemical industry p. 35
Marzieh Abbassinia, Omid Kalatpour, Majid Motamedzade, Ali Reza Soltanian, Iraj Mohammadfam
DOI:10.4103/atr.atr_85_19  
Background: Petrochemical industry has experienced a variety of accidents and the number of emergency situation in this industry is high. Therefore, prioritizing these situations is important. The aim of this study was to determine the effective criteria for the selection of emergency scenario and prioritize them for corrective actions. Subjects and Methods: Delphi technique was used to determine and prioritize the appropriate criteria for the selection of high-risk emergency scenarios. Then, the weights of selected criteria were obtained using fuzzy hierarchical analysis and finally, using the fuzzy TOPSIS technique, the criteria for emergency scenarios were prioritized for corrective actions. Results: The most important criteria for the selection of dangerous emergencies included the amount of loss, damage, and probability. According to the weight of these criteria, emergency situations were prioritized. The most important emergencies included fire in the chemical storage, hydrogen leakage at the cylinder fitting in the Alfin unit, and extreme gas leakage in one of the power plant turbines. Conclusions: Using this approach, high-priority emergencies can be identified, and it is suggested that planning for controlling these situations and preventing crises should be prioritized by managers.
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Predicting the quality of life of patients with mild traumatic brain injury: A study based on psychological variables p. 41
Sheida Shirvani, Zahra Khayyer, Peiman Koleini, Esmaeil Fakharian, Gholamabas Mosavi, Abdolah Omidi
DOI:10.4103/atr.atr_67_18  
Background: Recognizing the factors related to psychological disorders such as depression, stress, anxiety, and other related problems in a mild traumatic brain injury (MTBI) can be helpful in designing more effective treatment protocols. This study aimed at examining the effect of some prevalent psychological issues on predicting the quality of life of the MTBI patients. Methods: In this descriptive correlational study, 322 MTBI patients (mean age, 38.8 ± 10.8 years) who had admitted to the emergency and neurosurgery departments of Kashan Shahid Beheshti Hospital during April–July 2017 were selected using the convenient sampling method. Data were collected using the quality of life (WHOQOL-BREF) questionnaire (as a dependent variable), mental fatigue questionnaire, and depression, anxiety and stress scale (DASS-21). Finally, the data were analyzed in SPSS-23 by multiple regression analysis. Results: The results of the study showed that the regression model was significant (P < 0.001), in which 43% of total changes in the quality of life in MTBI patients were predicted by mental fatigue, depression, stress, anxiety, and gender. Conclusion: The findings of this study show that there is a negative relationship between psychological factors and quality of life among the MBTI patients. Thus, it is suggested to design more specific psychological-based rehabilitation programs with regard to gender differences to improve the quality of life among these patients after discharging from the hospital.
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