This study evaluated the feasibility of a drowning intervention package in northern Islamic Republic of Iran. A quasi-experimental design used pre-and post-observations among residents and tourists in waterrecreation beach areas of intervention and control regions by the Caspian Sea and in residents near the Caspian Sea coastline. The fatal drowning rate in the studied resident population in the provinces fell from 4.24 per 100 000 residents at baseline to 3.04 per 100 000 residents at endline. The risk of death from drowning in the intervention areas in the water-recreation area was greater during the pre-intervention (OR = 1.15, 95% CI: 0.66-2.01) than the implementation period (OR = 0.24, 95% CI: 0.15-0.37). The risk of drowning can be reduced by implementing increased supervision and raising community awareness.1 Division of Social Medicine, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden (Correspondence to A. Davoudikiakalayeh: davoudikiakalayeh@gmail.com RÉSUMÉ La présente étude a évalué la faisabilité d'un programme d'intervention contre la noyade dans le nord de la République islamique d'Iran. Un plan quasi-expérimental a été utilisé à partir des observations réalisées avant et après l'intervention auprès de résidents et de touristes dans des zones de plages pour les loisirs aquatiques et des régions témoins près de la mer Caspienne ainsi qu'auprès de résidents à proximité du littoral de la mer Caspienne. Le pourcentage de noyades mortelles au sein de la population résidente étudiée dans les provinces est passé de 4,24 pour 100 000 résidents au début de l'étude à 3,04 pour 100 000 résidents à la fin de l'étude. Le risque de décès par noyade dans les zones d'intervention de loisirs aquatiques était plus élevé avant l'intervention (OR = 1,15, IC 95 % : 0,66-2,01) que pendant la mise en oeuvre (OR = 0,24, IC 95 % : 0,15-0,37). Le risque de noyade peut être réduit en renforçant la surveillance et en faisant de la sensibilisation auprès de la communauté.

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Background Traffic accidents are one of the leading causes of death and severe injury among child occupants of vehicles in most countries. This has led to the consideration of how to use restraint systems for students in school buses. The purpose of the present study was to determine the percentage of students’ use of restraint systems in school transportation services in 2020. Methods In the present cross-sectional observational study, seatbelt use was assessed in 400 students in school transport vehicles using a checklist. The observation team sat at their vehicle, at the nearest location on one of the three sides of the school’s entrance: they had by manually registering the variable in the checklist. They focused on exactly the first vehicle parked next to the school entrance. There were two other observers to validate the observations. Data were analyzed by SPSS software (version 21). Results The rate of using restraint systems was 11.3%, use of restraint systems in the Sport Utility Vehicles (SUVs) was significantly higher (P < 0.03), in areas with medium income (P < 0.009) and low income (p < 0.012) as well as when the students were sitting in the rear seats, using the seatbelt were significantly lower (P < 0.001). Seatbelt use in students was less in services driven by drivers over the age of 40 (P < 0.01) and more in vehicles driven by female drivers (P < 0.003) and newer vehicles (p < 0.001). Conclusion School authorities must enforce traffic safety rules for school transportation services. These rules should be taught to drivers, families, and students. A restraint system must be mandatory for all students. School officials must equip their buses with seatbelts and employ school bus assistants to encourage wearing seatbelts and prevent students from standing.

Objective and Background: This study aimed at determining the predictors of chronic physical and mental quality of life (QOL) in patients with traumatic brain injury (TBI) focusing on neuropsychological functions post trauma. Materials and Methods: This is a longitudinal study in which 257 patients having inclusion criteria were enrolled. Neuropsychological tasks including logical memory, verbal paired associates, visual memory, verbal expression, auditory comprehension, semantic judgment and semantic categories were implemented. The appearance of psychiatric disorder, Agnosia, Apraxia, Dysarthria and pragmatic linguistic disorder post trauma were evaluated at discharge. QOL was studied 6 months after injury by filling SF-36 questionnaire via phone interview with patients. Results: Appearance of some post-traumatic disorders including agnosia, pragmatic linguistic disorder and psychiatric disorder were significantly correlated to poor QOL. The final step of logistic regression model showed that TBI severity, verbal memory, auditory comprehension and semantic acceptability scores were predictors of unfavorable mental QOL as well as TBI severity, injury severity scale (ISS) score and multifocal lesions for unfavorable physical QOL. Discussion: Thus, it is recommended that clinicians choose medical therapeutic priorities to improve the verbal neuropsychological sequela and provide preliminaries for a chronic favorable mental QOL. Furthermore, to prevent of chronic unfavorable physical QOL, early care of organic injuries should be considered especially in patients with severe and multifocal TBI. KeywordsTraumatic Brain Injury; Physical and Mental Quality of Life; Short Form-36 Questionnaire; * Corresponding author. S. Yousefzade-Chabok et al.