Journal of Military Medicine
Year:2017 | Volume:19 | Issue:4|Papers Count:14

Background and Aim: The most common type of injuries which occurr during the military training are physical injuries most of which are musculoskeletal ones. The propuse of conducting the present research was to determine the musculoskeletal disorders related to physical activities of the military training course and presenting a preventive ergonomic solution for them.Methods: In this review study, at first articles which had studied on previous researches on Musculoskeletal disorders related to physical activities of the military training course were extracted from five national and international databases including: Google Scholar, Pubmed, Scopus, Magiran and scientific information database without time range limitations. Then, the collected materials were summarized and discussed in two topics: 1. Epidemiology of physical disorders related to the military training course, 2. Preventive ergonomic solution.Results: The results of the other studies in this field indicated that musculoskeletal injuries are the most common type of physical damages caused by military exercises during military training courses. Meanwhile, the most injuries occur in the lower extremities due to the lack of soft beds and a bumper on military boots as well as the nature and type of these trainings, especially during marching and running. As it has been proven, the usefulness of using in-shoe insoles in preventing injuries from lower limb dysfunction in various randomized clinical trials for soldiers, athletes, and people whose nature of work involve long standing periods and walking long distances. Therefore, the use of these insoles inside the shoes can be considered as one of the most inexpensive but optimal ergonomic solutions.Conclusion: It is suggested that the Military Services and policy maker organizations consider using insole shoes along with other equipment and supplies for the soldiers right at the beginning of the it training period. This can be affective on financial issues and also on the efficiency of human resources which are considered as the most important capital in every society.

Acute myocardial infarction is the most serious and deadliest form of coronary artery disease. In spite of advances in diagnosis and treatment, acute myocardial infarction is a major health problem in the world and is significantly rising in developing countries. Evidence suggests that physical activity-based rehabilitation programs after cardiovascular events have an important role in reducing mortality and morbidity and improving living conditions in these patients. Cardiac rehabilitation is an essential component of the care program for patients with myocardial infarction. One of the non-pharmacological methods for reducing these symptoms is the progressive muscle relaxation technique, which emphasizes on the reduction of muscle tone in the body. In this technique, the muscle of the body contracts and then relaxes. This relaxation method follows the psycho-neuro-immunological theory and, by using the psycho-endocrine system and activating the sympathetic and parasympathetic system, controls the side effects of stress. The positive effects of this technique on some diseases have been confirmed. It has been shown that it can be helpful in reducing stress, anxiety, nausea, vomiting and pain. The present review study introduces the progressive muscle relaxation technique and its effects on the outcomes of acute myocardial infarction.

Background and Aim: Several factors can affect an individual’s level of death anxiety, but very few studies have investigated the role of spiritual intelligence and spiritual well-being. There is also limited research investigating death anxiety in the veterans of wars. Therefore, the purpose of the present study was to determine the relationship between spiritual intelligence, spiritual well-being and death anxiety in Iranian veterans.Methods: In this descriptive cross sectional study (in 2014), veterans completed the King’s spiritual intelligence scale, Paloutzian and Ellison's spiritual well-being scale and Templar’s death anxiety scale-extended. The data were analyzed using multiple linear regression and two way analysis of variance by SPSS-16.Results: The findings showed that the average age of 211 veterans was 48.9±4.6 years. The results revealed no significant difference between the demographic variables and the level of death anxiety reported by veterans (p>0.05). However, spiritual intelligence and spiritual well-being had a significant and negative relationship with death anxiety. The higher the reported spiritual intelligence and spiritual well-being, the lower the death anxiety (p< 0.05).Conclusion: The findings from this study show that spiritual intelligence and spiritual health can reduce the level of death anxiety among veterans. Given that death anxiety is a common nursing diagnosis, the use of spirituality should be considered within a clinical context to harness the psychological health and coping strategies of veterans.

Background and Aim: Due to the limitations of financial resources in medical centers in the country, considering the utilization of beds and hospital bed occupancy rate are considered extremely important. This study was conducted in order to determine the affecting factors of bed occupation index using Multiple Criteria Decision Making approach in a military hospital.Methods: This research was a descriptive study, which was conducted during 2015. The statistical population consisted of the chief executive manager, top manager, training supervisor and the heads of all the inpatient wards. Eighteen subjects were selected in the study through the census method. The gathering data tool was the comparisons questionnaire for factors affecting bed occupation, which its face and content validity were confirmed using experts' opinions. Data analysis were done using the Expert Choice software V11.Results: Eighteen subjects participated as samples in this study which consisted of 2 managers, 10 nurses and nursing directors, and 6 healthcare management experts. Six main criteria were defined for determining the affecting factors of bed occupation index including: clinic activation, Physician staff, financial access, the type of hospital and its services, the disease in the region and an active emergency. Among the main criteria, financial access had the highest geometric mean or priority (0.214) and clinic activation had the lowest geometric mean or priority (0.129).Conclusion: According to the 6 criteria mentioned as the affecting factors in the bed occupancy rate, In addition to providing high -quality services and enough insurance coverage, hospitals must pay more attention to more active clinics and emergencies as the input of patients to hospitals.

Background and Aims: Events for domestic and foreign customers any concern on the one hand and on the other hand concern management staff and loss of capital and economic society. Hence, the necessity of analyzing events to determine root causes in order to prevent their re repetition is important. Human factors also have an important role. This study root causes of errors in order to improve safety, quality and service satisfaction makers fundamental analysis with a focus on human factors analysis and classification system is discussed.Methods: This retrospective study of quality in 2014 was carried out. Place of Imam Khomeini Felavarjan city of Isfahan. Data collection tools and semi- structured interviews with people involved in the discovery. In the first step the causes, time and place of the incident was obtained by Root Cause Analysis. Then, an analysis of accident was done based on HFACS model.Results: In this study, 5 reports of accident in Imam Khomeini hospital were analyzed by HFACS technique.This analysis showed that most of the human errors were: in the first level was Violation of the principles and clinical standards, in the second to the Poor mental state, in the third level to the inadequate supervision and failure or malfunction of a correct understanding of the problem and in the fourth level to the process of the organization.Conclusion: The study and analysis of past events and uses Human Factors Analysis and Classification System, The agreement of action plans can be developed with policies, Training of personnel, boosting the morale of responsibility, to encourage teamwork and collaboration between the part, the implementation of monitoring activities and attention to human resources as the most important strategic factors Reducing errors in repeated use of accidents and the factors that cause it to be prevented.

Background and Aim: The aim of this study is to compare the efficiency of styrene removal with using of Iranian natural zeolite and modified natural zeolite by coating TiO2 nanoparticles as a catalyst.Methods: Natural zeolite with a diameter of 1 to 2 mm was used. Natural zeolite was modified with 1 normalchloridric acid. The surface and volume of the pores of the bed were determined by the BET method. Surface structure was determined by electron microscopy. Continuous air flow and styrene with a concentration of 100 to450 ppm was passed from a zeolite bed coated with titanium dioxide photocatalytic by gamma radiation and removed styrene vapors. The setting temperature was about 25oc and relative humidity was 33%.Results: The results of measuring the level of zeolite with BET showed an increase in zeolite levels. SEM images show that titanium dioxide nanoparticles have been stabilized on zeolite. The surface analysis with XRF and XRD determined that the structure of zeolite after fixation by chloride acid is still fixed and 1.5% titaniumdioxide is increased in zeolite crystals. The highest removal efficiency (95%) was related to modified zeolite bypassing styrene at a concentration of 100 to 450 ppm from both natural and modified zeolite bed.Conclusion: Increasing levels can increase the removal of styrene and gamma rays can activate photocatalyst. Acid-modified zeolite and TIO2 coating can increase the amount of styrene removal.

Background and Aim: Currently, there are no clear or complete guidelines for the distribution and dispatch of physicians. Therefore, it is necessary and inevitable to implement a mobile job program for physicians. This program will be applicable to all physicians by considering a set of effective factors. This research has surveyed the effective factors in the mobility of physicians’ service plan.Methods: A deep interview was held out with physicians working in the armed forces. The viewpoints of 100 of them were gathered by a semi-Delphi method. Based on this, a questionnaire was prepared and, after fitting the results with experts' choice, in order to determine the factors affecting the mobility of physicians, the questionnaire was sent by email to them and their feedbacks were studied.Results: A total of 54 factors were used for grading scale analysis. Among the 54 factors, 9 factors were identified by experts as the most important factors affecting the physician's mobility.Conclusion: Due to the factors involved, the relevant centers can provide the physicians’ mobility instructions. It is suggested that this study be conducted by investigating the influence of job rotation on geographical and environmental factors and individual tendencies and talents.

Background and Aim: Organizational health indicators are of particular importance in military centers and institutions. The purpose of this study was to determine the indicators of organizational behavior health in a military organization.Methods: This research was a descriptive qualitative study conducted during 2016. The population consisted of professionals and experts in the field of organizational behavior inside and outside a military organization. A total of 20 experts and professionals in the field of organizational behavior were selected by purposeful method using Delphi technique and a researcher-made questionnaire designed for organizational behavioral health. Kendall consensus coordination coefficient, Chi-square test, and Friedman variance analysis test for ranking components were analyzed by SPSS.16 software.Results: Recruitment (98%) and financial conditions (98%) as input parameters; long-term vision of the organization (92%), integrity (98%), technology level (100%), the level of innovation (100%), organizational culture (96%), learning capacity (94%) as indicators of process, and human resources developed with alternative power (96%) as output indicators of the health of organizational behavior were obtained. Conclusion: The results indicate that among the health indicators of organizational behavior, the average rating from the highest rank to the lowest rank are: the level of technology, innovation and recruitment levels which are more important than the other indices.

Background and Aim: Healing Medullary Thyroid Carcinoma (MTC) heavily relies on its early detection. Since the current genetic procedures for diagnosis takes reasonable cost and time, studies to find and introduce biochemical biomarkers have been conducting. In this study, the measurement of serum katacalcin (PDN-21) as a biochemical biomarker has been conducted in patients with moderate thyroid cancer and has been compared to healthy people.Methods: This is a case-control study, which patients with modular thyroid carcinoma who have not yet been treated have been invited to participate as a case group as well as healthy subjects as the control group. Demographic and anthropometric data including age, sex, marital status, smoking, history of disease and druguse, height and weight of patients and healthy subjects were recorded. Subsequently, all participants received 5ml of blood for measuring serum katacalcin by using an ELISA kit and data were compared with appropriates tatistical tests.Results: Ninety subjects with MTC in the case group and 90 healthy subjects in the control group were evaluated. Demographic and anthropometric data were matched between the case and control groups (P<0.05). The MTC group consisted of 39 men (43.3%) and 51 women (56.7%) with a mean age of 29.7±12.8 years, and the healthy group included 42 (46.7%) men and 48 (53.3%) women with a mean age of 30.5±11.2 years. The results of ELISA test showed that the mean serum level of katacalcin in patients was 80.76±7.45 mg/L and in the healthy subjects was 17.87±0.87 mg/L. Significant differences were observed between the serum concentration of katacalcin in the control and MTC groups (p=0.001).Conclusion: In the current study, the serum levels of katacalcin had significantly increased in patients with moderate thyroid carcinoma compared to the healthy subjects. These preliminary findings suggest that katacalcincan be associated with medullary carcinoma of thyroid, and further studies are needed in this area for more accurate examination.

Background and Aim: Nowadays, providing the high quality service and reducing costs, have converted health care industry into a challenging environment for the managers. One of the ways to achieve these goals given the importance of productivity and systems’ efficiency, is to optimize the number of facilities. In this regard, the present study aimed at optimizing the bed number of different wards of a military hospital.Methods: This research is a study which utilizes the operations research and mathematical modeling techniques. In This matter firstly, a model assuming no interaction between various wards has been designed and then in the next step another model has been developed without this assumption. To evaluate the models the real life data of a military hospital has been used and ultimately the developed model has been coded and solved in GAMS.24.5.6 software.Results: The results of implementation of first and second models showed that annual costs of the hospital is equal to 372,984,500,0 and 352,984,500,0 Rials respectively, whereas the value for the current situation is 408,408,000,0 Rials per year. Based on importance of reducing costs models have shown the proper efficiency. Conclusion: In general, using mathematical programming for capacity planning has shown high performance capability at any previous studies. It is recommended to apply the models for specialized and general hospitals to allocate the beds into their wards optimally.

Background and Aim: Police force requires a model whose factors are in line with organizational excellence. The improvement of these factors can lead the organization to excellence. This study aimed to predict the productivity of NAJA employees based on perceived organizational justice, job satisfaction and citizenship behavior.Methods: This research is a descriptive study and is considered as a predictive correlation type. The statistical population of the study consisted of all employees of the police force of Bushehr province, of whom, 608 people were selected using a multi-stage sampling method with a mean and standard deviation of 34.60 ± 4.2 years. For data collection, Productivity Measurement Scale (ACHIEVE model), Civil Behavior Questionnaire, Organizational Justice Questionnaire, and Job Satisfaction Questionnaire were used. For data analysis, multivariate regression was used with SPSS 16.Results: The findings showed that the perceived organizational justice is lower than the conceptual mean for NAJA employees. However, job satisfaction, civil behavior and job productivity are higher than the conceptual mean. The results of multivariable regression analysis indicated that job satisfaction, masculinity and forgiveness, altruism, perceived distributive justice, economic status, and civic virtue are the best predictors of productivity in terms of importance from the NAJA employees’ viewpoints.Conclusion: This study showed that 50% of variance of productivity can be explained by variables of job satisfaction, chivalry and forgiveness (negatively), altruism, perceived distributive justice, economic status, and civic virtue.