Journal of Military Medicine
Year:2019 | Volume:21 | Issue:4 |Papers Count:15

Background and Aim: In order to providing healthy food and improve food security, it is vital to preserve and protect agricultural products from pest's damage during storage. This is especially crucial for strategic products such as grains and cereals. Inefficient management in this subject would lead to the loss of stored food and will make the country's economic dependence on the other. In passive defense in the agricultural sector, importing agricultural products, regardless of the economic aspect, can pose serious threats to food and health security (agroterrorism and bioterrorism), due to the introduction of pests and pathogens. On this basis, it is necessary to establish basic infrastructures, such as the construction of modern warehouses with the aim of successfully storing food outside the growing season, as well as managing pests in warehouses and borders, relying on new techniques. Food depots at military centers are prone to pest attacks because of their location and construction, and less access to urban infrastructure. Methods: In this review, firstly, we explored on all scientific databases and assessed documents were related to stored-pests. Further, the effective control methods for grains pest management were presented in separate sections, finally, we provide the best control methods in military and non-military warehouses. Results: Our review showed, more than 30 key pests from different animal phylum (arthropods, rodents, birds, etc. ) and pathogenic fungi could enter and establish in food warehouses units. Characteristics such as broad distribution and high reproductive capacity led to economic injury, qualitative and hygienic damage into storedfoods and consumers health, so according to storage facilities and grains condition, we chose to introduce some effective tactics such as inert dusts, safety fumigants, eco-friendly biorationals and biopesticides, for stored-grain pest management program. The findings of this review showed that more than 30 key pests of different animal groups, with high eating, dispersal and reproductive power, can infiltrate military and civilian cereal warehouses and cause quantitative, qualitative, and hygienic damage to products and consumers while breeding. The findings of new research also show that nowadays in the integrated management of storage pests, new and diverse methods, such as the use of neutral powders, low-risk arsenic insecticides, bio-pesticides and biorationals compatible with environments can be adapted to suit the type of product and storage conditions. Conclusion: Development of insecticide resistance, environmental problems caused stored-food pests has become a serious challenge in the military and civilian stockpiles that must be eliminated by choosing the most effective, yet least risky, control method. While eliminating pesticides, it must be guaranteed to address all consumers health risks, including militaries.

Background and Aim: Due to the widespread prevalence of different acute and chronic diseases (ACD), nurses need to know the choices, necessities and abilities of patients. The study purposes were to determine: 1) the effect of family-centered empowerment model (FCEM) on the outcomes of ACD and 2) the sustainability of FCEM on the consequences of ACD in the following-up period. Methods: The review study was conducted in-the-year-2017. The PRISMA guideline was used to retrieve all national and international studies using the FCEM keyword. Results: In the initial search, 644 papers were retrieved, following PRISMA screening guideline, 47 relevant papers were recognized. The final studies were classified and reviewed using the variables: authors, year, type of research with the number of studied groups, the purpose of the research, the sampling method, the characteristics of the research samples in terms of the number of people and the type of disease, the method of data collection and final conclusion. Conclusion: The review of the published studies with the FCEM and the effectiveness of all of those on the different outcomes of the studies, indicates that this indigenous model: 1) corresponds with the culture of Iran; 2) is an effective, simple, efficient and reliable model; 3) can be used in promoting and improving the different aspects of ACD. The quality of conducting intervention studies using the FCEM was relatively good, but the reporting style and quality of the studies are inadequate.

Health is the axis of the social, economic, political and cultural development of all human societies and has particular importance in the development of the infrastructure of different sections of society. The final goal of any country's health care system is to improve the health of its people. Equal access to health services and equitable distribution of health resources is one of the main goals of health sector planners and policymakers in each country. Inequality in the distribution of health sector resources is more severe in developing countries such as Iran than in developed countries. Inadequate and poor budget allocation to the health sector, lack of proper and long-term planning are the main reasons for these inequalities. Reducing inequality between different regions in accessing health resources is one of the most important goals of health policy makers in Iran. One of the main ways to achieve this goal is the balanced distribution of health facilities and resources across different geographical areas according to people's health needs and population levels. In this regard, the first step is awareness of the status of access to health services in different areas. There are numerous measures to bring about justice in the field of health and to expand health services in deprived areas such as: equipping various hospitals with modern facilities, acquiring specialist doctors and providing specialized services, and, especially, improving community nutrition. In recent years, military organizations have also played an influential role in expanding health services in deprived areas. All these efforts have extended health services to the lowest levels of the deprived community and strata for human dignity and increased attention on deprived areas. However, there is still a lack of justice in the health field that requires more careful planning and comprehensive efforts. In the meantime, the realization of health justice and the expansion of health services in deprived areas are effective factors in enhancing the efficiency of the Islamic republic system.

Background and Aim: Knowledge management is a conscious strategy to acquire knowledge in the right time and to help individuals to share their information to improve organizational performance. This study aims to investigate the factors underlying the establishment of knowledge management in Social Security Organization. Methods: This cross-sectional study conducted in 2017. The statistical population is composed of 114 managers and supervisors of Social Security Organization selected through systematic random sampling method. Data collection tool was a researcher-made questionnaire including six sections, consisting of 25 questions. The first section includes demographic data and the next five sections include organizational culture, organizational structure, information technology, strategy, leadership, and staff. Results: The findings showed that organizational culture, employees, information technology, organizational structure, strategy, and leadership affect the establishment of knowledge management. Based on Friedman’ s test, the culture index with 3. 70 has the highest, and the strategy and leadership with 2. 53 have the least priority in terms of factors. Conclusion: Since organizational culture, and employees have the highest priority, and strategy and leadership have the least priority in the knowledge management in Social Security Organization, managers and decision makers can pave the way for team members to pay more attention to knowledge transfer in the organization by providing necessary grounds for employees so as to build trust in work communications, reinforcing the spirit of cooperation, doing participatory tasks and incentives.

Background and Aim: The epidemiologic examination of brucellosis can play an important role in the plan to control the disease in the next years and also in interventional plans and resource allocations. The current study was conducted to determine some of the epidemiologic indices and the trend of human brucellosis throughout the years 2009 to 2016. Methods: This was a cross-sectional study. The statistical population consisted of patients affected with brucellosis and whose diagnoses were made during the years 2009 until 2016 in the Khorasan Razavi province. All potentially or certainly diagnosed cases were found online from all the registered patients at medical centers, hospitals, laboratories, and private clinics in all districts in the Khorasan Razavi province. Then, the data was gathered through epidemiology exploring disease forms based on the national program of standing against Brucellosis. Results: The data relevant to 16255 cases reported in an 8 year period were analyzed. The cumulative percentage of the disease was observed in the 25– 44 (34%) and 16 – 24 (19. 2%) year-old age groups, respectively. In terms of occupation, the highest numbers of female cases throughout the study years were seen in housewives and farmer – ranchers. The cumulative percentage of the disease in rural inhabitants and males were 86. 4% and 57. 4%, respectively. The cumulative percentage based on the history of keeping livestock in one’ s residence was 47. 9%; and 28. 9% and 19. 2%, respectively, based on the history of consuming unpasteurized dairy products such as ‘ milk’ and ‘ milk and cheese’ . The highest incidence rate in the province occurred during 2013, at a rate of 42. 26 per 100000 persons, and the lowest incidence rate occurred during 2009, at a rate of 20. 72 per 100000 persons. The highest incidence during 2009 occurred in Kalat district; during 2010-2011 in Bejestan, 2012-2014 in Khooshab and during 2015-2016 it occurred in Zaveh district. Conclusion: Based on our findings, the incidence rate of the disease had a rising trend until 2013 and a declining trend from 2014 onwards. Nevertheless, a large number of disease cases still exist in the province. Preventive measures should be taken by health policymakers and healthcare providers of the country to reduce the burden of the disease through solutions like public education, which includes providing information on preventing the infection while in contact with the livestock, learning the necessity and method of good hand washing with soap and water, using gloves while in contact with affected livestock, using face masks while cleaning the affected livestock’ s shelter, as well as therapeutic interventions, and screenings during the seasons in which disease transmission is higher.

Background and Aim: AIDS is one of the most dangerous infectious diseases which is spreading among adolescents and young people. Soldiers and military staff are among the target groups in national AIDS prevention program. The purpose of this study was to determine the effectiveness of AIDS prevention education program to reduce the risk factors of this disease with a community-based approach. Methods: This was a quasi-experimental study designed with pre-test and post-test that were conducted in two the military barracks in Khorasan Razavi Province (east of Iran) in 2018. Study samples were selected from two military garrisons as available sampling and based on the list and number of soldiers and guards in each garrison. For each intervention and control group, at least 150 samples were calculated. The International AIDS and Life Skills Questionnaires were used. Based on a community-based approach (Educational needs and the use of key forces of the military barrack), educational contents were provided. In total, seven educational sessions were held in the intervention group, including six educational sessions for soldiers and military staffs (one hour in two weeks) and one educational session for military barrack training authorities. Post-test was performed three months after the final educational session. Results: The two groups were matched for age (P>0. 05). The variables of transmission myths, attitudes and awareness about AIDS (P=0. 001) and the variables of decision making, interpersonal relationships and creative and critical thinking relating life skills (P=0. 001) were significantly increased after intervention. Personal risk perception variables relating AIDS (P=0. 630) and problem solving variable (P=0. 594) did not change significantly after intervention. Conclusion: The results of this study revealed that using a life-skills educational program with a communitybased approach can reduce the risk factors for AIDS in soldiers and military staffs. Thus it is recommended to include life skills education in training program of military barracks as a necessary approach for reducing the risk factors for AIDS in soldiers and military staff.

Background and Aim: The stressful resources have a significant impact on students’ mental health which may cause dysfunction in both educational and professional performances in military students. The purpose of this study was to investigate the relationships between students' stressful factors and psychological problems (stress, anxiety and depression) among Students at a military medical sciences university in Tehran, Iran. Methods: This study was a descriptive cross-sectional study. The sample consisted of 319 subjects from medical, pharmaceutical, nursing and health schools in a Military Medical Sciences University, who were studying at the university during the academic year of 2017-2018. The data gathering tool was a questionnaire. Students Stressors Questionnaire (SSQ) was used to assess the sources of stress in the students and to assess the anxiety, stress and depression, the DASS-21 questionnaire was used. Data were analyzed using descriptive and correlation methods and pathway analysis using SPSS-16 and Amos software. Results: Of the 319 students, 273 (86%) were male and 46 (14%) were female. The mean age of students was 22. 32± 1. 97 years. 22. 64% of students had severe to very severe stress, 34. 27% had severe to very severe anxiety and 35. 65% had severe to very severe depression. Three stressful resources, such as academic conditions, academic environment and graduation stresses had significant relationships (P≤ 0. 05) with stress, anxiety and depression. The stressors of the dormitory environment had a direct relationship with stress and anxiety, but was not found with depression. Conclusion: The existence of direct and indirect relationships between student stressful resources and psychological variables in medical students indicates the importance of controlling the types of psychological stress related resources associated with university education in order to manage mental health of students.

Background and Aim: Depression has a destructive impact on performance of working memory. The purpose of current study was to compare the effectiveness of pharmacotherapy, Transcranial Direct Current Stimulation (TDCS), and combined treatment (pharmacotherapy and TDCS) on reducing major depression symptoms, besides improvement of working memory in veterans with PTSD. Methods: This was a quasi-experimental study with pretest – posttest design and three-month follow-up. This study was carried out in 2018 with statistical population of veterans from Tehran, in which 68 subjects were selected using a purposive sampling method and then randomly divided into three experimental (pharmacotherapy, TDCS, and combined treatment) and one-control groups (each group has 17 subjects). Research tools were included the PTSD-Checklist for DSM-5 (PCL-5), Beck Depression Inventory-II (BDI-II) and Daneman and Carpenter Working Memory Test (WMT). Results: In the posttest and follow-up phase, given the matching of groups, there was a significant difference between experimental (pharmacotherapy, TDCS, and combined treatment) and control groups in BDI-II and WMT mean scores. In the post-test phase, combined treatment, TDCS, and pharmacotherapy groups had the highest efficiency, respectively. In the follow-up phase, combined treatment had the maximum and pharmacotherapy had the minimum persistence of their effect. Conclusion: all three therapeutic methods had significant impact on reducing the symptoms of major depression and improving working memory, but they were different in the amount of their effectiveness and persistence.

Background and Aim: Measurement and evaluation of physical activity and physical fitness are essential because without proper basic data, proper planning can’ t be made to improve and promote physical fitness. Therefore, the aim of this study was to evaluate the level of health and skill-related physical fitness of male students in a military center in order to manage the students' physical fitness. Methods: In this descriptive cross sectional study, the population and the sample of the study were all male students in a military center in 2018 and 2019. After physical and medical examinations, those with a specific illness or problem were excluded from the study. Health and physical activity and medical history questionnaires were completed by the subjects. Then, anthropometric and physical-motor fitness tests were measured by the specialists of this field. The body composition, the muscular endurance of the trunk and the upper body, the flexibility, the cardiovascular endurance, agility and speed were measured. Results: Of the 581 scholarship male students in a military center, the mean of body mass index was 23. 15 kg/m2, the body fat percentage was 13. 19 percent, the muscular endurance of the trunk and the upper muscle endurance was 57 and 30 repetitions, respectively. Their flexibility was 36. 87 cm, their aerobic fitness (VO2max) was 31. 08 ml/kg/min, and their agility and speed were 11. 52 and 9. 21 seconds, respectively. Conclusion: The body mass index of subjects was within the range of normal weight and the body fat percentage was moderate. The status of the muscular endurance of the trunk was good, but the muscular endurance of the upper trunk was very weak. Students' flexibility was normal, while cardio-respiratory endurance and agility were very weak.

Background and Aim: Movie show is a method that can increase the level of nurses’ moral courage by creating situations similar to those that involve professional health workers and observing the other nurses clinical experiences. This study aimed to investigate the effect of motivational ethics program on the moral courage of nurses in Mashhad’ s military hospitals. Methods: This research was a semi-experimental study, done in 2018. Two military hospitals were selected by design and 20 nurses of each hospital were randomly selected. Both the intervention and control group included 20 nurses. Demographic form and Sekerka’ s Moral Courage Questionnaire were completed three times: before, immediately and one month after the intervention by nurses in the two groups. An ethical motivational program – which included teaching the nursing ethics by lecture-group decision method and a movie show to increase their moral courage to deal with ethical issues and decision making-was performed for the intervention group over two consecutive days. There was no intervention for the control group. Results: At baseline, the moral courage score in the intervention group was 68. 05± 11. 99 and in the control group was 65. 50± 15. 74. Before the intervention, both groups had a moderate moral courage score and no significant difference was observed (P=0. 568). The moral courage score in the first post-test was 78. 77± 5. 50 in the intervention group and 65. 05± 15. 43 in the control group (P>0. 001). The intervention group at this stage gained a high moral courage score. The moral courage score in the second posttest in the intervention group was 79. 77± 5. 37, which was a minor increase, and the control group achieved 63. 75± 13. 23 which showed a slight decrease (P<0. 001). The moral courage score and all its dimensions in the three stages in the intervention group were significantly different (P<0. 001) and in the control group there was no significant difference (P=0. 278). Conclusion: The results of this study showed that ethics training increases the amount of nurses’ moral courage. Therefore, the researchers suggest that nursing ethics training sessions be included in nursing education in-service training courses.

Background and Aim: Sleep disorders are many of the most common complications of post-traumatic stress disorder (PTSD) after war that disrupt the quality of life of veterans. Therefore, the current study was aimed to evaluate the effect of the continuous care model on sleep quality in veterans with PTSD. Methods: This was a semi-experimental single-group interventional study with before and after design. It was carried out on a sample of 30 war veterans with PTSD in Alborz province during the year 2019. Six 45-30 minute sessions of the continuous care model were held within 4 weeks. Then the training was repeated and followed up for 2 months by SMS reminder. The Pittsburgh Sleep Quality Standard questionnaire was used for data collection Results: The mean age of the veterans was 53. 96± 5. 4 years. The total score of sleep quality before intervention was 13. 51± 2. 71, immediately after intervention was 11. 26± 2. 81 and two months after the intervention was 7. 96± 2. 28. Significant improvement in sleep quality of veterans was recorded after the intervention Conclusion: Sleep quality improvement training using continuous care model improves the sleep quality of veterans with PTSD. So, using Continuous Care Model is an effective method and is recommended along with other interventions.