Journal of Military Medicine
Year:2020 | Volume:22 | Issue:5|Papers Count:10

Background and Aim: One of the important psychological aspects of prisoners of war (POW) and veterans, which can be neglected in most societies, is their family and marital problems. The aim of this study was to investigate the effectiveness of resilience training on quality of marital life and resiliency of POW families. Methods: This quasi-experimental study was conducted with a pre-test-post-test design and a two-month follow-up with a control group in 2017. 30 POW from Divandere city of Kurdistan province, Iran were selected by simple random sampling method and randomly assigned to two intervention and control groups (15 people in each group). The intervention group received a resilience training program for ten sessions, each session lasting two hours for two months, but the control group did not receive training. The Marital Quality Questionnaire [Revised Dyadic Adjustment Scale (RDAS)] and the Family Resilience Assessment Scale (FRAS) were used to collect data. Results: The mean quality of marital life and resiliency of POW family in the intervention group was higher than the control group in post-test and there was a significant difference (p <0. 01) and this increase was maintained in the follow-up session. Conclusion: Resiliency training can have a lasting and stable impact on improving the quality of marital life and family resiliency in POW.

Background and Aim: The occurrence of chemical events causes a lot of financial, life and environmental damages. The purpose of this study is investigating and analyzing chemical events in Fars province between 2008 and 2017, to provide solutions based on chemical defense for immunization and emergency response to consequences. Methods: This research conducted with practical approach and descriptive method. The study population consists of experts with operational experience in response to chemical events in Fars province (including 29 cities). The study tool was a researcher-made questionnaire which its reliability and validity were confirmed. Analytical Hierarchy Process with Expert Choice software has been used to investigate chemical events in Fars province. Results: 166 chemical events in Fars province during the period from 2009 to 2018 was recorded. Industrial unit fires, road transport accidents, and gas leaks and gas leakage from the gas distribution network were the most significant incidents. The type of chemical that caused the event, human injuries and the location of the event were considered as the main criteria. Capital damage, proximity to residential area, and environmental and natural resources damage were considered as sub-criteria. The most important chemical defense solutions include; preparing a database of all chemical industries and factories, prioritizing chemical facilities from a risk perspective, conducting training programs for emergency teams, conducting medical examinations of people exposed to chemicals, cleaning up contaminated areas, and preventing the spread of contamination. Conclusion: This research has shown that most events were not only preventable, but also severely predictable. One way of immunity and emergency response to events is their timely analysis to identify the causes, most of which are human error and the factors affecting it.

Background and Aim: Attempts to reduce depression, anxiety and stress of home caregivers of mental patients lead to better results of care givers performance and decrease psychological and physical stress in home caregivers. The purpose of this study was to determine the effect of Roy Adaptation Model-Based training on depression, anxiety and stress in caregivers of chronic psychiatric patients. Methods: In this randomized controlled trial, 46 home caregivers of psychiatric patients referred to military hospitals in 2019 were randomly assigned into two intervention and control groups. In both groups, depression, anxiety and stress were assessed using DASS-21 questionnaire in two stages before and after the intervention. Data were analyzed by SPSS-22 software. Results: In the baseline, the mean scores of depression, anxiety and stress were not significantly different between the two groups (P ˃ 0. 05). After the intervention, the mentioned scores increased in the control group and decreased in the intervention group. In this regard there was a significant difference between the two groups (P ˂ 0. 05). Conclusion: Implementation of a Roy Adaptation Model-Based training reduces depression, anxiety and stress of home caregivers of chronic psychiatric patients. Therefore, it is recommended using this model in home caregivers of mental patients.

Background and Aim: Hemorrhage has been a major cause of casualties on the battlefield, which can be prevented in many cases. The aim of this study was to evaluate the results of hemorrhage control methods in prehospital and battlefield conditions. Methods: In this mini-review, search was conducted using different combination of keywords including Hemorrhage control, Hemorrhage blocking agents, new methods of hemorrhage control, pre-hospital care, war scene, battlefield, nurse from the databases like IranMedex, Sid, Scopus, Magiran, PubMed, Google Scholar, Scopus, Pro Quest, CINHAL, Science Direct from 2000 to 2019. The articles were reviewed by three researchers independently. Results: The databases search yielded 42 records. Based on inclusion and exclusion criteria, 13 articles were selected for study purpose. The results obtained from the articles showed that among the major factors controlling hemorrhage, two major factors play more prominent role. The first is combat tourniquets that have an important role in saving people's lives from hemorrahge, and the second category is the novel Hemostatic agents, which are manufactured under different trademarks and in various forms, including powder, bond or gas impregnated with these materials. Conclusion: Tourniquet can be life-saving if used at the right time. The modern blood coagulation factors may not fulfill all expectations in the process of controlling hemorrage on the battlefield. But any blood hemostatic factor with its properties can have a significant impact on controlling bleeding and subsequently saving lives.

Background and Aim: According to the clinical approach of standards of oral health system, designing specific standards is necessary to guarantee health promotion activities in the dental clinic. The aim of this study was to develop the standards of the health promotion dental center and to evaluate the performance status of a military dental clinic based on the standards. Methods: An applied descriptive study of consecutive (qualitative and quantitative) method was conducted in 2019. At the qualitative stage, the standards were collected and analyzed through library study and Delphi method. To obtain expert opinions, the draft of each standard axis including, title and standard definition, target expression; definition of sub-standards and criteria was provided to 11 participants through a Delphi questionnaire. In the quantitative phase for evaluating the studied center, the data were collected using the Health Promotion Dental Standards Checklist tool derived from the qualitative phase. The checklists were completed by the assessment team at the study center and their data were analyzed using SPSS-16 software. Results: The Health Promotion Dentistry Standards consisted of 6 axes of management policy, patient evaluation, patient notices and interventions, promoting a healthy workplace, continuity and collaboration, and 61 criteria were approved by experts by the content and standards of the two Delphi rounds. The quantitative results of the standards assessment were evaluated on the medium level. Among the standards, the highest score was for management policy evaluation, 68. 62% of the total score. Patient evaluation was scored 66. 66% on the axis, followed by patient notices and interventions scored 52. 38% and continuity in treatment and participation scored 48. 80% of the total score. The lowest score was 41. 66% on promoting a healthy workplace. Conclusion: Health promoting standards are necessary for dental centers with a core health mission and to establish a mechanism for evaluating their performance in implementing health promotion programs. In order to improve the quality of oral health services, it is recommended that policymakers and managers of dental centers be effective in improving health-based dental services by establishing coherent policies within the framework of health promotion standards.

Abstract Background and Aim: Coma caused by severe traumatic brain injury, leads to cognitive function disorder, the most frequently affects being on the working memory. Because of the importance and direct impact of working memory on the quality of human life, especially in military skills that require active memory and high attentional power; the present study aimed to investigate the cognitive patterns of patients coma in working memory. Methods: In this causal-comparative study, which was conducted from February 2017 to July 2019, two groups of individuals were selected by available sampling method. 20 comatose patients, aged 30-55 years, who had returned from coma during last year and were admitted to ICU ward of Haft-e-Tir and Baqiyatallah hospitals in Tehran, Iran, were included as the experimental group and 64 healthy individuals with the same age range considered control group. All participants were male and were assessed by Wechsler working memory. The performance of the two groups was compared using multivariate analysis of variance. Results: The difference between the two groups in the visual memory span was statistically significant (p <0. 05) and the difference between the two groups in other subdomains of working memory test were statistically significant (p <0. 01). In general, coma patients showed a poorer performance than the healthy group. Conclusion: Coma caused by severe traumatic brain injury, can disturb executive functions of the brain's prefrontal lobes after one year and impair patients' working memory. Hence, it is strongly suggested that in clinical and legal evaluations of the patients, this issue to be considered and both psychological and medical interventions done simultaneously to facilitate the treatment process and cognitive rehabilitation of the patients and to prevent individual, social and financial consequences and costs associated with a coma.

Background and Aim: Nurses play an important role in responding to natural disasters. The aim of this study was to describe the functional dimensions and professional competencies of military nurses in disasters and emergencies. Methods: This study is a systematic review. In order to review and explain the professional competency of military nurses in disasters and emergencies, 100 published papers during January 2000 to July 2019 were selected through searching in the scientific databases such as Scopus, Elsevier, PubMed, ISI Web of Science, Cochrane Library, ProQuest, Google Scholar and SID, using the keywords emergence or disaster preparedness and core competency of nurses in disaster or emergence, and nursing and nurses military nursing or military nurses and the role of military nursing. After considering the inclusion and exclusion criteria, a total of 13 articles related to the research topic were studied and reviewed. Results: Nurses' roles can be categorized into three areas: professional competence, leadership, and operations. These roles including care based on professional competencies, organizational competencies, leadership and management of medical teams, vital and special care in difficult conditions, safe transfer and evacuation of injured, care of injured in disaster (Chemical, biological, radiological, nuclear and explosive), protecting oneself and others (personal protection), battlefield triage, moral resilience and psychological support, caring for vulnerable and high-risk individuals and out-of-scope nursing roles. Although some of these roles overlap with the civilian nurses, others emphasize the special and unique roles of military nurses. Conclusion: Considering the necessity of providing high quality and safe services at the highest possible level of injuries in various areas, especially in times of crisis and disasters, and the effective presence of military nurses in all stages of a disaster incidents. It is required that all military nurses benefit from the training and development of useful knowledge in order to implement long-term medical care programs for injured people in crisis situations.

Today, with the development of microbiology, biotechnology, and cellular and molecular genetics, human knowledge of microorganisms has increased and the possibility of making biological weapons with pervasive effects has increased. On the other hand, bioterrorist events and the construction of laboratories and sites for the production of biological weapons in many developed and developing countries emphasize the need for rapid identification and determination of these bio-threatening agents. Accurate identification of such agents is important not only for the validation of a bioterrorism operation, but also for the timely implementation of appropriate measures for the biological agent to protect public health. As mentioned above, the biotheroism agents are very diverse and wide-ranging, hence it is always difficult and complex to identify these agents. Various methods have been introduced for detecting them. Some methods have been used for years, but some are still develoing. There are many problems in identifying and diagnosing bioterrorism agents, some of them are specific to one method, but some are common to all commonly used methods and developing methods. Therefore, this study aimed to investigate and review studies on the new methods of identifying microorganisms with bioterrorism potential from 2000 to 2020 as a review study.

Background and Aim: Chemical warfare can endanger the security of any country. The present study examined the chlorine gas emission scenario on the outskirts of the Bushehr nuclear power plant over a 24-hour period, so that the study results can be utilized in an emergency response program. Methods: In order to access the data, the area of Bushehr nuclear power plant was investigated in person and then, in order to assess the worst scenario, chlorine was selected due to its extremely high toxicity. From among the existing scenarios, the catastrophic explosion (immediate release) was selected and finally the risk intervals of this scenario were determined to evaluate the impact of chlorine gas on the target population with the use of ERPGs, IDLH and STEL. PHAST 6. 7 software has been used for this purpose. Results: Based on the criteria for evaluating the effects of exposure to toxic substances, the results of the present study showed that it is not possible to define an emergency planning area at close distances to the explosion origin by using IDLH and STEL criteria. However, based on ERPG concentrations, the chlorine gas passes shorter distances from 06: 00 to 10: 00 in the morning to reach the values of ERPG2-3 at 2811 and 1040 meters compared to other time periods studied. Conversely, at night, these distances have the largest risk area based on the values of the above mentioned concentrations at 5212 and 1459 meters, respectively. Conclusion: In order to reduce the vulnerability in accidents, modeling weather conditions based on time periods (morning, noon, evening and night) can be an important tool for planning emergency conditions. Accordingly, it was suggested that the highest risk distance is obtained based on the ERPG1 criterion, i. e. the risk distance based on the lowest concentration of the chemical in the ambient air which does not even make unpleasant odors to be sensed by the residents in the safe areas, especially in similar study zones.

Background and Aim: Since pin cutter is used in surgical operations involving screw and orthopedic plating and this is one of the most sensitive surgeries, saving time is very important along with reducing infection rate. The purpose of design the Mini-Pin Cutter is to replace a smaller, lighter, more efficient device than conventional and traditional cutters, which ultimately results in a comfortable, clean, and faster shear, resulting in shorter operating time. Methods: This is a descriptive study with design and manufacturing approach. This means that before preparing and assembling the components of the system, first, using force engineering software (ABAQUS and CATIA), the force analysis was done (design approach). Then, after modeling the mechanical parts, the desired parts were prepared for manufacturing and assembly (manufacturing approach). To collect the required data, the subject literature has been used in conjunction with the design team's experiences. Results: The device was designed and built based on the results of orthopedic specialists. It includes an electronic circuit and orthopedic pin cutting blades with high reaction capability in critical situations, which is very useful for speeding up surgery and preventing infection in operating room environments. The designed device is portable with a weight of 1600 grams. Conclusions: The device introduced in this study is a mechanical and automatic system in which tried to eliminate the shortcomings of current and conventional tools. The device is smaller, lighter and safer than existing tools. On the other hand, its’ packing and disinfecting is very easy. The most important advantage of this device compared to old ones is the increasing the cutting speed of orthopedic pins, which reduce surgery time, which is very important in times of crisis and the military.