Domestic injuries and suicide among women of reproductive age in Iran

Using the Modified Delphi Method to Propose and Validate Components of a Child Injury Surveillance System for Iran

BACKGROUND

Child injuries are a worldwide public health concern. An injury surveillance system (ISS) has a beneficial impact on child injury prevention, but an evidence-based consensus on frameworks is necessary to establish a child ISS.

OBJECTIVES

To investigate key components of a child ISS and to propose a framework for implementation.

METHODS

Data were gathered through interview with experts using unstructured questions to identify child ISS functional components. Qualitative data was analyzed using content analysis method. Then, the Modified Delphi method was used to validate functional components. Based on the outcomes of the content analysis, a questionnaire with closed questions was developed to be presented to a group of experts. Consensus was achieved in two rounds.

DISCUSSION

In round I, 117 items reached consensus. In round II, five items reached consensus and were incorporated into the final framework. Consensus was reached for 122 items comprising the final framework and representing seven key components: goals of the system, data sources, data set, coalition of stakeholders, data collection, data analysis, and data distribution. Each component consisted of several sub-components and respective elements.

CONCLUSION

This agreed framework will assist to standardize data collection, analysis, and distribution to detect child injury problem and provide evidence for preventive measures.

Suicide by self-immolation in southern Iran: an epidemiological study

Background

Self-immolation, as a method of suicide, is one of the most violent and extreme ways which is usually attempted by the ignition of inflammable materials, with more than 70% fatality rate. In the literature, Iran has been reported to have a high rate of self-immolation; therefore, this study aimed to evaluate the prevalence and epidemiological features of self-immolated patients.

Methods

In this retrospective cross-sectional multicenter study, data from burn patients from 2007 till 2017 due to self-immolation and suicide were enrolled in our study.

Results

Based on our data, 657 out of 3530 burn patients (18.6%) with a mean age of 31.15 (SD = 0.452) were documented as suicidal attempts; the majority were female (63.2%) and married (66.3%). Most of the patients were from rural areas (58.3%) with an education level of under diploma (63.2%). Of the patients in our study, 22 (8.7%) had comorbid systemic diseases and 115 (50.5%) had psychiatric disorders.

Conclusion

Due to the high prevalence of suicide by self-immolation among the Iranian population, further studies to evaluate the risk factors and clarify the high-risk group for more targeted approaches are recommended.

Using modified Delphi method to propose and validate the components of a child injury surveillance system for Iran

PURPOSE

Child injuries are a public health concern globally. Injury surveillance systems (ISSs) have beneficial impact on child injury prevention. There is a need for evidence-based consensus on frameworks to establish child ISSs. This research aims to investigate the key components of a child ISS for Iran and to propose a framework for implementation.

METHODS

Data were gathered through interview with experts using unstructured questions from January 2017 to December 2018 to identify child ISS functional components. Qualitative data were analyzed using content analysis method. Then, modified Delphi method was used to validate the functional components. Based on the outcomes of the content analysis, a questionnaire with closed questions was developed and presented to a group of experts. Consensus was achieved in two rounds.

RESULTS

In round I, 117 items reached consensus. In round II, 5 items reached consensus and were incorporated into final framework. Consensus was reached for 122 items comprising the final framework and representing 7 key components: goals of the system, data sources, data set, coalition of stakeholders, data collection, data analysis and data distribution. Each component consisted of several sub-components and respective elements.

CONCLUSION

This agreed framework will assist in standardizing data collection, analysis and distribution, which help to detect child injury problems and provide evidence for preventive measures.

Self-immolation in Iran: Systematic Review and Meta-analysis

OBJECTIVE

To perform a systematic review and meta-analysis of self-immolation epidemiology and characteristics in Iran.

METHODS

This was a systematic review and meta-analysis study. PubMed, Scopus, Web of science and Science Direct were searched for English literature and SID and Magiran for Persian in the time period of 2000 to 2016. The retrieved studies were screened and reviewed then quality assessed. Random Effect model was applied for meta-analysis. The qualitative data were analyzed by content analysis method.

RESULTS

After literature screening, 39 studies included in the analysis. Women were subject to self-immolation more than men. The rate of self-immolation estimated to be 4.5 cases in every 100,000 populations and it was the reason of 16% of hospitalized burns. The average length of hospital stay calculated to be 12.24 (95% CI: 8.85-15.59) days. The total burnt surface area was 65.3% (95% CI: 56.71-73.89). Death due to self-immolation was 62.1%. The major risk factors of self-immolation were having mental health issues, family problems and characteristics and problems in relation/communication with spouses.

CONCLUSION

Despite the low rate of self-immolation in Iran, it comprises one sixth of the hospitalized burns. The mortality rate of self-immolation also is high and this highlights the importance of providing special care. Psychological consultations and mental health screening in the primary health care would help to prevent the self-immolation.

Domestic Injuries among Children Under 7 Years of Age in Iran; The Baseline Results from the Iranian First Registry

Objective

To investigate epidemiological aspects of injuries among Iranian children under 7 years of age using obtained data from a national registry.

Methods

Injury data were derived from a national-based injury supervision system during 2000-2002. This registry involved all of home-related injuries for children less than 7 years of age that treated in health or emergency centers. The study population included 25% of Iranian people. The descriptive statistical methods were used for representing the distribution of the variables like age, sex, injury mechanisms, types of injuries, etc. Data were presented as mean ± SD and proportions as appropriate.

Results

Of the total 307,064 domestic injuries registered during 2000-2002, 77,500 cases (25.2%) were children. 70% of these children (54581 cases) were in age group of 1-5 years. The large fraction (58.8%) of injuries among children under 7 years of age went back to burn injuries. Cuts and lacerations were at the second level with 17.4%. 51% of injuries had contact with hot liquids. Of all children under 7 years of age injuries, 282 died, 86 were disabled, while the rest improved or being under treatment when recording data.

Conclusion

Injuries, particularly burns (especially those who had contact with hot liquids that led into scald), are major public health problem that children under 7 years of age encounter. Therefore, it seems necessary to provide adequate plans to promote children under 7 years of age safety issues.

Domestic Injuries among Children Under 7 Years of Age in Iran; The Baseline Results from the Iranian First Registry

OBJECTIVE

To investigate epidemiological aspects of injuries among Iranian children under 7 years of age using obtained data from a national registry.

METHODS

Injury data were derived from a national-based injury supervision system during 2000-2002. This registry involved all of home-related injuries for children less than 7 years of age that treated in health or emergency centers. The study population included 25% of Iranian people. The descriptive statistical methods were used for representing the distribution of the variables like age, sex, injury mechanisms, types of injuries, etc. Data were presented as mean ± SD and proportions as appropriate.

RESULTS

Of the total 307,064 domestic injuries registered during 2000-2002, 77,500 cases (25.2%) were children. 70% of these children (54581 cases) were in age group of 1-5 years. The large fraction (58.8%) of injuries among children under 7 years of age went back to burn injuries. Cuts and lacerations were at the second level with 17.4%. 51% of injuries had contact with hot liquids. Of all children under 7 years of age injuries, 282 died, 86 were disabled, while the rest improved or being under treatment when recording data.

CONCLUSION

Injuries, particularly burns (especially those who had contact with hot liquids that led into scald), are major public health problem that children under 7 years of age encounter. Therefore, it seems necessary to provide adequate plans to promote children under 7 years of age safety issues.

Trauma-related Therapeutic Procedures at Shohada Trauma Center in Tabriz

Background

To decrease the burden of injuries it is essential to have an overview of trauma patterns and its management at regional trauma centers.

Objectives

The aim of this study was to investigate some patterns of trauma and trauma-related therapeutic interventions at our trauma center.

Materials and Methods

In a cross-sectional study, 19530 trauma cases admitted to the emergency department and hospital wards of Shohada University Hospital during 2007-2008 were assessed.

Results

Of the 19530 trauma cases, 14960(76.7%) were males. Mean (SD) of age was 31(19.9) years. The elderly aged 65 and above, comprised 10% (1953) of the participants; while 44 were infants. Falls and traffic injuries were the most common cause of injuries among trauma patients. Most of the mortalities were men comprising 74% of the 57 deaths. Reduction of fractures and dislocations were the most common types of operations among trauma patients.

Conclusions

Young men form the target group for possible interventions to decrease the burden of trauma following falls and traffic accidents.

Burn injury-specific home safety assessment: a cross-sectional study in Iran

Background

The aim of this study was to assess the feasibility of injury specific home safety investigation and to examine the home safety status focused on burn related safety in a rural population in the North-West of Iran.

Methods

A cross-sectional study was conducted on 265 rural households of rural Meshkinshahr, Iran. Cluster sampling method was used in 38 clusters with 7 households in each cluster. Clusters were selected on a probability proportional to size (PPS) basis using the available health census database called D-Tarh. Data were analyzed using the statistical software package STATA 8.

Results

Possible risks were explored in fields of house structure; cooking and eating attitudes and behaviors; cooking appliances, specific appliances such as picnic gas burners, valors (traditional heaters), samovars (traditional water boilers), and air-heating appliances. Many safety concerns were explored needing to draw the attention of researchers and public health policy makers.

Conclusion

Injury specific home safety surveys are useful and may provide useful information for safety promotion interventions.