Journal of Military Medicine
Year:2017 | Volume:19 | Issue:3 |Papers Count:15

Hospitals are considered one of the most critical places in relation to noise pollution. Hospitals are affected by noise pollution and as a healthcare environment, this can have adverse effect on the health, safety and welfare of patients and staff. In addition to the need for a calm environment for a desirable health service, it is important to pay attention to the comfort of patients during their hospitalization to aid disease improvement. Noise pollution is an environmental stressor with well-known physiological and psychological effects. The body's response to noise pollution is the same as responses to stress and excessive work, and thus can disrupt health. Studies clearly indicate that if a hospital's noise pollution level exceeds recommended levels, complications in patients are likely to increase. What is less known is the effects of hospital noise on physicians and nurses. The purpose of this review is to discuss hospital noise pollution and its effects on patients, physicians and nurses. Because physicians and nurses spend more time in the hospital during their professional life, they experience a higher level of noise pollution.There is a need for physicians and nurses to have a healthy work environment that is quiet and healing for them as well as for patients.

Background and Aim: Health care providers, especially physicians and nurses who have returned from war have valuable insight and tacit knowledge of current and future societies. The aim of this study was to explore pain and suffering experiences of health care professionals in the Iran-Iraq war.Methods: This is a conventional content analysis of documentation available in libraries and electronic resources that was conducted in the years 2014 to 2016. Researchers simultaneously collected and analyzed data.A total of 119 written narratives of the 101 the health care providers during the Iran-Iraq war were collected, using a survey. The principles of conventional content analysis were used to analyze the data.Results: The analysis of the 952 pages of the written narratives of health care staff in the relevant literature led to the emergence 3 main themes. The main themes included “one step away from death”, “emotions”, and “tolerance of many hardships”. Sub-themes of “one step away from death” included injury and/or martyrdom of employees and their families, one step to captivity, one step to death, and feeling of danger. Sub-themes of “emotions” included uncertainty, sadness/discomfort, anxiety, hope, fear and panic, waiting, ambiguity and doubt, stress, anxiety, despair, intuition, and disgust towards the enemy. Sub-themes of “tolerance of many hardships ”were experiencing hard situations, disruption of the normal life process, psychological tension, a gradual normalization of conditions, and return to normal life.Conclusion: During the Iran-Iraq War, health care providers suffered a lot of suffering, from enduring hardship and difficulty in everyday life to feeling death is one step away. Transforming the experience and tacit knowledge of health care providers in the Iran-Iraq war to explicit knowledge can effectively identify and analyze challenges and provide strategies to prevent and manage similar scenarios. These results can produce the knowledge in the field of training of health care providers in unusual and critical situations.

Background and Aim: Nowadays, determining factors affecting employee productivity is considered a necessity in the development of governmental organizations’ human resources. The goal of this study was to identify factors influencing the productivity of human resources in a military health organization.Methods: This descriptive study was performed in a military health organization in 2016. This study included two steps. In the first step, a literature review was conducted to identify factors affecting productivity, and in the second step, to verify the findings of the literature review, the same factors were reassessed by technical experts in different departments of the community headquarters and exploratory factor analysis was performed. Forty technical experts were selected using purposeful sampling for participation in the study. The data collection tool was a questionnaire developed by the investigators. The data was analyzed using SPSS 20.Results: In the first step, we identified 11 factors affecting productivity including motivation, mental intellectual growth, individual health, ability, organizational support, job resolution, environment, management style, education, culture, and performance evaluation. The findings of the second step showed that the exploratory results confirmed the findings of the literature review and were consistent with them. Finally, the components were divided into two distinct dimensions that included individual factors (motivation, mental intellectual growth, individual health, ability) and organizational environmental factors (organizational support, job clarity, environment, management style, education, culture, and performance evaluation).Conclusion: Employee productivity is affected by individual and organizational factors. Therefore, strengthening these factors will increase the productivity of employees. Special attention should be paid to motivation and organizational support.

Background and Aim: The effect of prolonged and intense endurance exercise, and the effect of cinnamon in secretion and function of male sex hormones are controversial subjects. The purpose of this study was to investigate the effect of a period of intense endurance training and the consumption of cinnamon powder on the levels of male sex hormones in young trained cyclists.Methods: Sixteen elite cyclists aged 17 to 23 years participated in this study. The subjects were randomized to one of two equal groups: training (T, n=8) and training with cinnamon powder (TC, n=8). The TC group were given 5 mg/kg/day cinnamon powder, along with three main meals. The T group received an equivalent amount of placebo at the same time. Subjects in both groups cycled 80-120 km per day (75-85 % maximum heart rate).Subjects trained 6 times per a week for 4 weeks. Blood samples were collected 24 h before and 24 h after the intervention. Serum levels of testosterone, LH and FSH were measured by ELISA kits. The independent t-test was used to assess differences between the two groups. All analyzes were performed using SPSS-19 software.Results: There was a significant increase in the concentration of testosterone hormones (p=0.001), LH (p=0.036) and FSH (p=0.018) in the training group (T) compared with the cinnamon powder (TC) group.Conclusion: Consumption of cinnamon in male athletes with Long-term endurance training can increase sex hormones. So cinnamon can recommend for prevention reduction in sex hormones after intense endurance exercises.

Background and Aim: Medical science education has special characteristics due to the need for diverse learning areas in the wide range of health and disease. This study was conducted with the aim of Environmental analysis and providing effective strategies for the development of medical education at a military medical faculty.Methods: This cross-sectional study was conducted in 2016 which the SWOT model and review of internal factors (strengths and weaknesses) and external factors (opportunities and threats) was used. Participants included 42 members of the scientific board, experts and stakeholders of a military medical faculty in Iran with purposive sampling. Data collection was performed by reviewing documents, focus group discussions and standard strategic planning questionnaires. Data was analyzed using content analysis and descriptive statistics in TOWS model.Results: The score of internal and external factors of the faculty was determined by 12 effective strategies for the development of medical education. Strategies included: quantitative and qualitative transformation of educational programs and promotion of the top scientific and educational status in the country and the region; becoming a scientific and educational center in the fields of basic sciences, clinical medicine and military medicine; and development of disciplines and educational levels with new trends and interdisciplinary sciences.Conclusion: Based on the results of the evaluation and environmental analysis of the medical faculty in the field of medical education, the strategic position of the faculty is competitive. Therefore, this faculty needs to make more efforts to achieve a desirable situation through development-driven strategies.

Background and Aim: Early detection can prevent one third of cancer deaths. Recent studies show the effectiveness of mass media in increasing awareness. This study aimed to evaluate a PMT-based media program for cancer early detection (CED).Methods: The media program included three parts, each 20 minutes long. A mixed-method study with embedded design was performed including a quasi-experimental study on two groups (each n=60), and a qualitative content analysis study (n=16). Cluster sampling was used to recruit participants in the quantitative phase, and purposive sampling was used to recruit participants in the qualitative phase. Data were collected by a PMT-based questionnaire designed by the investigator, in addition to Knowledge & CED behaviors questionnaires in the quantitative phase, and by semi-structured depth interview in the qualitative phase. Quantitative data were analyzed using SPSS-16 software.Results: The media program increased all of the main variables including the CED behaviors. During qualitative data analysis, 88 codes were extracted that were classified into six main categories: “knowledge reinforcing”, “motivating and empowering beliefs”, “fear reduction and hope increasing”, “program attraction”, “maintenance of program positive effect” and “conductor timing effect” that supported the quantitative finding of study. The most important strengths of the media program were the availability of sections and pictures and various venues, using popular interviews and patient experiences. Inappropriate program names, lack of information about program broadcasts, and lack of emphasis on family support were among the main weaknesses of the program.Conclusion: Considering the low level of CED behaviors, interventional programs aimed at accelerating early detection with an emphasis on designing theory-based media intervention with coordination of education and media principals and techniques may be beneficial in the future.

Background and Aim: Post-traumatic stress disorder (PTSD) is one of the major problems of war veterans that also impacts on other family members, including spouses. The present study was conducted to study the interactive effect of social economic status and support on life quality and mental happiness of wives of veterans with PTSD in Mashhad.Methods: The current study is a descriptive-correlational study that was conducted on wives of veterans with PTSD in Mashhad in 2014. To this aim, simple sampling was followed and the data were gathered based on PTSD symptoms, Life Quality, Oxford Happiness, and Perceived Social Support Questionnaires. SPSS 16 software and Multivariate Analysis of Variance was used to analyze the data.Results: Hypotheses testing was conducted for 302 samples. Veterans’ average age was 43.4 years. Wives ‘average age was 36.3 years old. The results of Multivariate Analysis of Variance indicated that the severity of PTSDsymptoms, the rate of wives’ perceived social support, the level of veterans’ education, the level of their wives’ education, and the family’s economical level simultaneously explain 0.71 of the changes of mental happiness and life quality of Veterans’ wives.Conclusion: It was concluded that wives’ perceived social support, the severity of PTSD, and their economic and educational level play an important role in Veterans’ wives mental happiness and life quality.

Background and Aim: Suicides are reported at a higher level in soldiers compared with the general public, due to the stressful nature of the military. The purpose of the present study was to determine and compare emotion regulation, positive and negative effect, and emotional ambivalence in soldiers with and without suicide attempts and normal people.Methods: This retrospective study included 20 soldiers with suicide attempts in army ground forces in Hamadan city, Iran in 2016. Soldiers with suicide attempts were selected through purposive sampling and matched with 20 soldiers without suicide attempts who worked in the military environment. All study participants provided informed consent. Data were collected using a cognitive emotion regulation strategies questionnaire, positive and negative effect, and emotional ambivalence questionnaires. Data were analyzed using descriptive indicators and univariate analysis of variance.Results: Emotion regulation strategies and levels of positive and negative effect in soldiers with suicide attempts were significantly different compared with soldiers without suicide attempts. The soldiers with suicide attempts reported a high level of negative effect and low levels of positive effect, compared with soldiers without suicide attempts.Conclusion: Results showed that levels of affect and poor emotional regulation can provide predisposing conditions for suicidal behavior. Suicidal behavior itself may make soldiers more susceptible to psychological damage. Interventions are required in order to reduce the risk of psychological damage, including appropriate emotion regulation education.

Background and Aim: Chemicals are widely used in the workplace and educational life so written control procedures are necessary. In this regard it is important to identify chemical risks. In this study, we evaluated the risk of exposure to toxic substances in a chemistry research laboratory using CHEM-SAM model and a semi quantitative risk assessment method.Methods: This cross-sectional study was conducted in a chemistry research laboratory. The study included several stages: preparation of a chemicals list, separating solids and liquids, collecting data on exposure time, frequency of exposure, ventilation system performance, laboratory hoods review, risk assessment methods with CHEM–SAM model for toxic solids and liquids, solids and liquids risk assessment methods with SQRA, and comparison of the two risk assessment methods.Results: Risk assessment for toxic liquids showed the highest risk level for the CHEM-SAM model and a moderate risk level for the SQRA method. Solid risk assessment with SQRA and CHEM-SAM showed the risk level was low and very low, respectively. Results showed no significant differences between the two methods (pvalue> 0.05).Conclusion: The SQRA method and CHEM-SAM model showed similar results. Both methods are simple and require no special equipment so can be used to assess the risk of exposure to toxic substances.

Background and Aim: Personal satisfaction is one of the most important elements of evaluation of service quality in health centers. In this study, we examined the patients’ satisfaction in an urban health center affiliated with a military unit.Methods: In a cross-sectional study, 387 clients were examined in an urban health center in Bojnord, Iran in 2015. Participants were military employees and their families that with convenience sampling were examined over a 2-week period. For data collecting, a demographic questionnaire and a validated investigator-developed satisfaction questionnaire related to various sectors of the clinic such as general and specialized clinics, the laboratory and the dentist clinic were used. Results were analyzed by SPSS 16.Results: A total of 387 cases were assessed. Of these, 53.7% of patients were males and 56.4% of patients were soldiers. Overall 74.42 % of the patients were satisfied with healthcare services. Satisfaction in general and specialized clinics was 77.42 %, in the laboratory, 86.77 % and in the dentist clinic, 68%. The highest percentage of satisfaction was in retirees (72.91%) and the lowest satisfaction was in families of staff (66.99%).Conclusion: Satisfaction with general and specialized clinics and Para-clinical was relatively good.Satisfaction with the dental clinic was average. Satisfaction may be increased with a modified admission process, by providing on time and high-quality service with specialist healthcare professionals, improving effective communication and on time and clear information, fulfilling obligations and raising the level of public services.

Background and Aim: Physical and mental fatigue leads to weakening of the performance of tasks of staff, high annual economic costs, and chronic medical conditions. The aim of this study was to determine the relationship between breakdown of family cohesion and incidence of physical and mental fatigue of family members.Methods: This study conducted with a descriptive and survey design. Data were collected from 100 families (100 male and 100 female) of Yazd province police, Iran in 2014. Families were selected by using multi-phase cluster random sampling. Instruments of data gathering were Fatigue Scale (FS) and Family Cohesion Evaluation Scale (FCES). Data were analyzed by using multivariate analysis of variance (MANOVA).Results: Prevalence rate of breakdown of family cohesion was 32% and prevalence rate of general fatigue (physical and mental) among families was 42%. There was a significant relationship between families with four levels of cohesion; disengaged, separate, connected and enmeshed regarding general fatigue (p<0.01), physical fatigue (p<0.01) and mental fatigue (p<0.01). Therefore, the relationship between breakdown in family cohesion and the prevalence of fatigue was confirmed.Conclusion: Deficiency of family cohesion is one of the main risk factors concerning incidence of fatigue among family members. Individuals with different levels of family cohesion have different levels of physical and mental fatigue. Therefore, social and behavioral interventions to strengthen the cohesion of the family of police seem necessary.