JOURNAL OF MILITARY MEDICINE
Year:2019 | Volume:21 | Issue:|Papers Count:16

Background and Aim The burden of non-communicable disease (NCD) such as cancers and diabetic is increasing. The purpose of the current study was to perform an epidemiological survey for pattern recognition of the most prevalent cancers، type 1 diabetes، type 2 diabetes، and multiple sclerosis among the Iranian military community from 2001 to 2017. Methods In this cross-sectional study all registered cancers، type 1 diabetes، type 2 diabetes and multiple sclerosis in the Iranian military community between 2001? 2017 were collected. Simple proportions and the Spearman correlation coefficient were used for data analysis. Results The total number of registered cancers during 2001? 2017 was about 31675 cases in the Iranian military community. A total of 15413 (48. 66%) were females and 16262 (51. 34%) were males. The most prevalent cancers in this group were: breast، prostate، colon and gastric cancers respectively. The incidence of colon and gastric cancers among males was more than females. The trend of cancers among the Iranian military community was increasing. There was a positive and significant association between the incidence of cancers with type 1 diabetes، type 2 diabetes and multiple sclerosis in the Iranian military community. Conclusion Considering the increasing trend of cancers and the presence of the positive association between cancers and other NCDs such as different types of diabetes and multiple sclerosis، the diagnosis and control of common risk factors can be an important approach for disease prevention and reduction.

Background and Aim In addition to the physical and psychological consequences for veterans، war has adverse effects on their wives. The purpose of this study was to investigate the effect of treatment of mindfulness-based stress reduction (MBSR) on marital adjustment، sense of coherence and psychological flexibility of veteran's wives. Methods This is a quasi-experimental study with pre-test، post-test and follow-up with a control group. The statistical population was all wives of veterans who were covered by the Foundation of Martyrs and Veterans Affairs of Kermanshah city in 2019. A total of 28 women were selected by the available sampling method and randomly assigned to two experimental and control groups (experimental groups، n=14; control group: n=14). At baseline، the Locke-Wallace marital adjustment Questionnaire (1959)، Antonovsky's sense of coherence Questionnaire (1987)، and the Acceptance and Action Questionnaire-II (AAQ-II; Bond et al.، 2007) were completed by both groups. This was followed by a MBSR intervention that was performed for 8 sessions of 90 minutes for 2 months for the treatment group، while the control group did not receive any treatment. After completing the intervention، post-tests were performed for both groups، and three months later، follow up was performed using the same questionnaires for both groups. Results The mean age (± SD) was 48. 85 ± 3. 37 years of the experimental group and 49. 64 ± 2. 92 years for the control group. Repeated Measures Analysis of Variance showed that MBSR intervention had a significant effect on marital adjustment، psychological flexibility (p<0. 05) and sense of coherence (p<0. 001) in the experimental group. These results were recorded at the follow-up stage. Conclusion The MBSR intervention is an effective treatment program for promoting marital adjustment، sense of coherence and psychological flexibility of veterans' wives. In order to increase the quality of life of veterans' spouses، it is necessary to provide an interventional program for reducing mental health problems.

Background and Aim The effects of war-related injuries and psychological pressures on the family، especially on the wives of injured people، continue after the war. The aim of this study was to investigate the effectiveness of quality of life therapy on psychological well-being، resiliency، and marital satisfaction on the wives of veterans. Methods This is a quasi-experimental study with a pretest-posttest design with a control group. The statistical population consisted of all wives of veterans who were covered by the Foundation of Martyrs and Veterans Affairs of Khorram Abad city in 2018. A total of thirty women were entered by a convenience sampling method and were randomly assigned into two experimental and control groups (15 patients in each group). For the pre-test، the Connor-Davidson Resilience scale (CD-RISC)، Keiers and Makiramo Psychological Wellbeing Questionnaire and Enrich Marital Satisfaction Scale (EMS) were completed by both groups. Quality of life therapy was performed in 8 sessions (each session lasted 1 hour) over 2 months for the experimental group; the control group did not receive any therapy. After 2 months، the post-test was performed on the two groups by completing same questionnaire. Results The two groups were matched for age and education. Quality of life therapy in the experimental group had a significant effect on increasing the level of resiliency (F=88. 33)، psychological well-being (F=-0. 49) and marital satisfaction (F=22. 22) compared to the control group (p<0/001). Conclusion According to the results of this study، quality of life therapy can be used to increase the resilience، subjective well-being and marital satisfaction of the wives of veterans. Therefore، this treatment may be used in specialty psychiatric care clinics to help psychological problems and improve resilience in wives of veterans.

Background and Aim Coping with stress is a concern for many people. The main purpose of this study was to design and then normalize the stress assessment questionnaires، which were presented in two different versions of self-reporting and other reports focusing on physical، behavioral and motion characteristics، and، objective indications. Method The research population was the staff of a military university in Tehran. The sample consisted of 30 people in the pilot phase and 300 in the main stage of the research. The self-report stress questionnaire، other-report stress questionnaire were used along with the perceived stress questionnaire. To assess the psychometric properties of these questionnaires، SPSS23 and AMOS23 software were used. The correlation coefficient، factor analysis and content validity index were used to examine the validity of these questionnaires. Results The items of the self-report stress questionnaire and other-report stress questionnaire، based on the opinion of experts، had a content validity of over 0. 7. Exploratory factor analysis showed that each of these questionnaires had three physical، motion and behavioral factors. Confirmatory factor analysis also showed the fitting of a correlated three-factor model. The validity coefficients for the self-report stress questionnaire and other-report stress questionnaire، calculated by measuring the perceived stress questionnaire were 0. 44 and 0. 28، respectively (p <0. 01). The internal consistency coefficients for the self-report stress questionnaire and other-report stress questionnaire were 0. 70 and 0. 69، respectively. The two half-tests also showed the reliability of both questionnaires at the level of p <0. 01. The cut-off points for the total score of self-report stress questionnaire and other-report stress questionnaire were 90 and 114، respectively. Conclusions According to the results، both designed questionnaires have appropriate validity and reliability. The questionnaires can be used to measure the stress and screening of people with traumatic stress and are considered as an objective and subjective indicator of stress measurement.

Background and Aim Irritable bowel syndrome (IBS) is a common and costly clinical disorder، and affects quality of life in patients. The purpose of the study was to evaluate the effectiveness of acceptance and commitment therapy on the severity of symptoms and quality of life in soldiers with IBS. Methods This is a semi-experimental study. The population study was 30 soldiers with IBS who were treated by physicians of Isfahan Shahid Babaei Military base. They had Rome-III diagnostic criteria and consented to enroll in the study. Soldiers randomly assigned to two groups (control group، n=15; experimental group، n=15). Initially، both groups completed the demographic checklist، the frequency and severity of IBS symptoms checklist، and the quality of life questionnaire for patients with irritable bowel syndrome (IBS-QOL-34). Then، the experimental group received 8 sessions of acceptance and commitment therapy، while the control group did not receive any psychological treatment. Post-test، the same questionnaires were completed by soldiers. Data were analyzed by SPSS version 18 and covariance analysis. Results The two groups were matched in terms of age and smoking. Acceptance and commitment therapy significantly reduced the frequency and severity of IBS symptoms and increased the quality of life of soldiers (P=0. 001). Conclusion According to the relationship between IBS and psychological factors، and also the stressful nature of military service، acceptance and commitment therapy can effectively reduce IBS symptoms and subsequently improve quality of life in soldiers.

Background and Aim Coagulase enzyme is one of the most important virulence factors of Staphylococcus aureus (S. aureus)، which could be used for differentiation of S. aureus from other Staphylococcal species. The relationship between the genotype of coagulase and the enterotoxigenic strain of S. aureus is unknown. The purpose of this study was to investigate coa gene typing in enterotoxigenic strain of S. aureus. Methods A total of 21 enterotoxigenic S. aureus strains were assayed. A specific pair primer for coa gene amplification was selected. Gene extraction from the bacterial strain was carried out separately. Then، the coa gene amplification by PCR was performed. Using the bioinformatics methods in Silico and comparing PCR products with reference samples in silico، the search for AluI restriction enzyme digestion sites was determined. Results The results of coa gene amplification showed that only 20 S. aureus strains have this genetic element and consist of eight classes of coa gene based on their size، ranging from 352 to 1200 bp amplicons. All amplified fragments have fragments restriction enzyme AluI site action except fragment 352 bp which prone to genotyped. The frequency of the coa genotype in this study was type I (42. 85%)، type IV (19%)، type II (9. 5%) and others (4. 76%) respectively. The results of alignment coa gene types with enterotoxigenicity showed that the potent enterotoxin producer was related to coa gene type II and VI. Conclusion The study results indicated that the coa gene by primer pairs could have an amplified different size fragment. The comparison finding with references is a simple and accurate method for genotyping of the S. aureus isolate and it would be able to determine the type of enterotoxins produced.

Background and Aim Missed nursing care is a significant problem in care units in hospitals. Teamwork is an important element in assuring patient safety and quality of care. Therefore، the aim of this study was to investigate the relationship between missed nursing care and teamwork. Methods This study includes 196 nurses from 11 care units، including intensive، general، rehabilitation، and medical-surgical care units in a military hospital in Tehran. Sampling was done using the census method. Data were collected using standard questionnaires formissed nursing care and teamwork. Results Regarding nurses، average teamwork among nurses and the average amount of missed nursing care is significantly different in intensive، general، rehabilitation، and medical-surgical care units (P < 0. 05). The results of correlation analysis indicate that there is a reverse significant relationship among missed nursing care with teamwork and its subscales– including mutual trust، team orientation، backup، shared mental models، and team leadership (P < 0. 05). The estimated regression، considering the personality traits of the nurses، indicates that in effective teamwork explains 12. 6% of missed nursing care. Additionally، with more teamwork، the less missed nursing care is reported. Conclusion The results of this study show that care units require investment to increase teamwork among nurses. When there is more teamwork، less missed nursing care has been reported

Background and Aim Promoting factors associated with physical fitness and improving performance through new methods of training for soldiers is also important. The purpose of this study was to compare the three methods of resistance exercise (RE) with blood flow restriction (BFR) on functional factors in Iranian army soldiers. Methods Eighteen Iranian soldiers with a mean age of 22. 4± 2. 2 years، body mass index of 22. 3± 1. 1 and a history of military services of 10. 4± 3. 3 months were included. A total of 18 soldiers were randomly categorized in to three groups of resistance exercise with variable blood flow (R + BFRV، n=6)، resistance exercise with variable intensities and constant blood flow restriction (R V + BFR، n=6) and resistance exercise with variable intensities and blood flow restriction (C، n=6). A total of 18 soldiers performed resistance training with BFR at the same training volume three days a week for four weeks. Results Significant variations were only observed in the upper endurance muscle variables (P=0. 01) while there was no significant difference between other factors (P>0. 05). The highest variations in cardiovascular endurance variables، upper and lower trunk muscular endurance and the mean anaerobic power occurred in the R+ BFRV group (P≤ 0. 05)، and the highest variations in upper and lower trunk muscular endurance occurred in R V + BFR group (P≤ 0. 05). Group C showed the highest improvement in agility، and the same variations were observed in the balance in the three groups (P≤ 0. 05). Conclusion According to the results of this study، the resistance exercise with constant intensities was suitable for the increase in cardiovascular and muscular endurance and mean anaerobic power، the resistance exercise with variable intensities and constant blood flow restriction (R+ BFRV) was suitable for the increase in strength and balance، and the combined method was recommended for the increase in agility.

Background and Aim Job burnout is a state of physical or emotional exhaustion that leads to reduced accomplishment in the workplace. The aim of this study was to investigatee job burnout and its dimensions in the personnel of selected military clinics in Tehran in 2018 Methods In this descriptive-analytic study، all healthcare staff working in the military clinics in Tehran، Iran in 2018 was surveyed usingthe “ Maslach Burnout Inventory” (MBI) questionnaire. Maslach's questionnaire has two parts: frequency and severity; and three dimensions: emotional exhaustion، depersonalization and personal accomplishment. Results This study included 193 people with an average age of 31. 82 years. A total of 152 (78. 7%) were male and 41 (21. 3%) were female. Scores in the severity of burnout dimensions were: emotional exhaustion: 47. 15%، depersonalization: 54. 93%)، personal accomplishment: 50. 27%; all were considered a high level. There was a significant relationship between burnout dimensions and both work experience and marital status. There was a significant relationship between emotional exhaustion and job interest، education and marital status. There was a significant relationship between personal accomplishment and both age and work experience. In the emotional exhaustion dimension، education variable and in the personal accomplishment dimension، the work experience variable and in job burnout، work experience variable had the highest effects. Conclusion Generally، job burnout and its dimensions are at a high level in staff in military clinics. Therefore، for reducing job burnout and providing quality services، we need to support and provide regular programs for military staff.

Background and Aim Schema therapy is a psychological treatment available for divorcing women. The present research was carried out with the purpose of studying the effectiveness of schema therapy-based group counseling on the quality of marital relationships، differentiation and hardiness among divorced women of veteran families. Methods This was a quasi-experimental study with a pre-test and post-test design that included a control group. The statistical population of the study consisted of all women seeking divorce whose fathers were war veterans and referred to the consulting center affiliated to the Foundation of Martyrs and Veterans Affairs in Neyshabur in the winter of 2018. Thirty women were enrolled using the available sampling method and then randomly assigned to either an experimental (n=15) or control (n=15) group. Counseling sessions were conducted for 11 sessions for the experimental group (2 hours، one weekly) and the control group did not received any intervention. The women then completed the quality of marriage questionnaire by Bassby، Cran، Larsson، and Kristensen (1995)، self-differentiation Scouron and Friedlander (1999) and hardiness (1998). Results Women applicants for divorce were matched in terms of demographic variables، such as age and length of marriage. Group counseling based on schema therapy had significant effects on differentiation and hardiness of divorced women (P<0. 05). However، group counseling with schema therapy had no effect on the marital quality of divorced women (P>0. 05). The effects of treatment were maintained after one month (p <0. 05). Conclusion Group counseling with the schema therapy procedure led to improved differentiation and hardiness of divorced women، and may be useful as a therapeutic intervention to improve the psychosocial situation of female applicants for divorce in relevant settings.

Background and Aim Daily care in emergency department may lead to diagnosis of serious conditions in patients. A simple and accessible method for daily care of such patients may be beneficial for their diagnosis. The aim of this study was to investigate the effect of ultrasonography on the daily care of patients undergoing mechanical ventilation in the emergency department. Methods In this cross-sectional study، 57 adult patients under mechanical ventilation in the emergency department of Imam Hossein Hospital، Tehran، Iran were selected for study. Patient demographic and clinical data were recorded in the checklist. The findings of daily sonography were compared with routine care in patients under mechanical ventilation in the emergency department. Results The mean age of the 57 adult patients included in this study was 65. 2 ± 5. 5 years. A total of 32 (56. 1%) patients were male and 25 (43. 9%) were female. The average length of stay was 3. 47± 1. 1 days. The use of ultrasound in daily care for detecting the location of the tracheal tube، pneumothorax، consolidation، pleural effusion، echocardiography، deep vein thrombosis، subcutaneous edema، and ascites examination was effective and useful. Ultrasound was also effective in detecting 10. 5% of abnormalities. Conclusion Based on the findings of this study، the use of ultrasound in daily care in the emergency department is useful and also can be effective in diagnosing abnormal conditions in patients undergoing mechanical ventilation. More clinical studies are required in this field.