JOURNAL OF MILITARY MEDICINE
Year:2008 | Volume:10 | Issue:3 (37)|Papers Count:14

Introduction: FMEA is a systemic and preventive tool, completely conceptual, based on a team work. It is included identification, assessment, prevention, controlling or removing main factors and potentially effects relating to a plan or a service. It is necessarily risk preventor done by experts who are familiar to use the method so, selecting the team and planning the plan is an important factor to run the program taking defined steps and paying attention to some rules is necessary for doing the method this study is going to introduce FMEA as a suitable tool and applying it to analyze some probable systemic risks by health personnel.Materials and methods: this study is a descriptive one using a cross – sectional method on a field emergency center in sepah. First, the emergency center was visited once it was defined. During this visit, current situation, weakness and strengths of the center were recorded. Second, in team work meetings the most important duties of the center, based on its mission, including helpings, triage, transportation, treatment, medication health and support, were determined. In next step, each phase and its probable risks or mistakes have been analyzed. Then, in another step, factors producing risks, and their effects on consumers, scorings the severity of mistake, scoring mistake accordance determining current controls for identification or removing mistake were followed. Then, according to collected information and given scores, RPN (Risk probable score) for any risk, has been assessed. These scores were sorted and analyzed to introduce the priorities. Delivering suggested programs to prevent those risks or hazards was the next important activity.Results: the most important problems in helping and transportation phase (with RPN score of 192-567), was skill related ones. In treatment and medication phase, (with RPN score of 192-576), skilled factors and man-mistaks, were reported weaknesses in monitoring and following activities. Were move in important in health sector (with RPN 175-630). Finally, in providation area with RPN192-567, lack and improper man-power, space, and facilities were introduced as more important problems. Inspite of being high RPN for some risks, their priorities in accurance severity curve, were low, in contrast, some risks with low RPN have a higher priority in the curve. Practical solutions were suggested for these problems.Conclusion: In helping transportation phase, skill promotion in man-power got spcial attention along with providing related needs. Reducing man-power mistakes and promoting skills was more important to attention in the treatment medication area. In health domain, attention paid more to monitoring, following activities and solving the problems of the man-power. Finally, in provocation phase, along with solving man-power problems (providing practical scientific, education, motivation) promoting working-space, safety and facilities, received special attention.

Introduction: Job stress is one of the most important factors in reduces of productivity in organizations and involves physical and mental signs in personals. Because of nurse’s job stress as a important part of health care system has a great effect on quality of patient care, so, this research accomplished to determine relationship between job stress and quality of work life among nurses in military selected hospitals.Materials and methods: This research is a cross sectional and descriptive – correlation study that was conducted among 200 nurses who were selected via probable multistage sampling. Data collecting method was questionnaire which consisted of three parts: demographic characteristics, Walton quality of work life questionnaire and Osipow job stress questionnaire. Gathered data were analyzed by SPSS software and descriptive and inferential statistics (such as Pearson, chi square ,fisher, s exact test ,ANOVA) Results: The finding showed that job stress level of nurses majority (%90) was normal and existed meaningful statistical relation to sex, married status and negative correlation with age and positive correlation with work hours in week (p < 0.01). Quality of work life (QWL) level of nurses majority (%81) was moderate and only existed meaningful statistical relation to married status and negative correlation with work hours in week (p < 0.01). Nurses were dissatisfied with income and balance between work and family. The results showed negative correlation between job stress and QWL in nurses (r=- 0.637 p<0.001) and positive correlation between dimensions of QWL (p < 0.01).Conclusion: With due to finding that nurses with high QWL tend to have lower job stress, therefore suggested education for hospital, s managers on job stress and QWL issues are planned in order to develop strategies to address and improve the QWL conditions and to decrease level of job stress for nurses life for example employee participation, supervisor supports, decrease overload and conflict and ambiguity and also psychological intervention for increase cope with job environment.

Introduction: Amputation as a defect would result in personal disability which is widely affected by social and rehabilitative cares; in case of insufficient social supports and services, it will finally lead to personal handicap.Materials and methods: During a focused 3 day program, of total 140 bilateral upper limb amputees, 103 patients were visited by an expert psychiatrist. Demographic data (sex, age, level and date of injury) along with comprehensive psychiatric examination (appearance, mood, affect, speech, perception, form and content of thought, memory, orientation …) were documented. Final diagnosis of patients’ psychiatric status and their functional score (0-100) were also recorded.Results: Except one, all of the visited amputees were men and had been injured 2.4 to 25.9 years before follow up (mean: 17.1 years). The mean age of the subjects at follow up was 37.5 y/o (15-82 y/o). 44.7% of the amputees reported a history of outpatient visit of a psychiatrist while 3 subjects had already been hospitalized due to psychiatric problems. Our visit revealed that 41.7% of the amputees had abnormal mood; the most frequent was a depressive one (29.1%). Limited affect found in 16.3% and short term memory impairment reported in 45.6%. Axis I of psychiatric status examination showed that 50.5% of bilateral upper limb amputees suffer from psychiatric problems including mood disorders (33.9%) and anxiety disorders (30.1%). 42.5% of the patients had a functional score more than 90. Statistical analysis showed no relation between psychiatric disorders and level of amputation (p> 0.05).Conclusion: Depression and anxiety, as a reflection of their interpersonal problem and physical disabilities, may lead to social isolation and handicap of bilateral upper imb mputees. A well organized psychiatric and social support is strongly recommended.

Introduction: Operational Rations are packed items provided to feed troops participating in military operations and maneuvers. One significant responsibility of the head of logistic divisions in all armies around the world is to provide required individual and group rations and evaluate their quality and quantity after consumption in order to optimize them. Aim of this study is to evaluate quality and quantity of five ration types used in “The Great Messenger” maneuver.Materials and Methods: In this cross-sectional study, a questionnaire was prepared by the researcher and issued by the number of 150 ones in order to put in each ration pack. All questionnaire sheets were gathered after ration consumption and obtained data was evaluated and analyzed.Results: About 85.24% (±7.02) and 87.63% (±4.50) of participating troops were satisfied with quantity and quality (palatability, organoleptic features, packing and ration safety) respectively, while the percentage of (palatability, organoleptic features, proper packing and ration safety were 72.01 % (±8.50), 85.14% (±8.96), 95.18 % (±2.35) and 95.02% (±11.11) with respect.Among all tested rations, the no. 4 ration 90.81% (±8.74) for its quantity and the no. 1 ration 91.53 % (±14.07) for its quality were the best. The ration no. 3 had the lowest satisfactory both for its quantity 74.11% (±12.37) and its quality 76.47% (±14.46).Among breakfast meal items, sesame pudding (100%), wheat and meat porridge powder (86.7%) and in lunch meal ones, barley soup (100%), chicken meal with bean (95.2%) and between dinner items, peanut and pistachio (95.7% and 95.1% respectively) showed the highest satisfaction level among troops while among all meals, vegetable soup powder (14.3%) and onion soup powder (31.8%) had the lowest ones.Among used mid-meals, those related to rations no. 5 and 1 (processed fig and compacted date) showed the highest satisfaction for both their quality and quantity.Conclusion: As the studied rations were used for the first time in a maneuver, they would have some weak points which should be removed. Omitting or revising some of these rations (especially rations no. 3 and 2), more food variety and considering food habits of military forces are of prime importance in production and optimization of military food rations.

Introduction: Hydrogen fluoride is used in a wide range of industries such as glass making and silicon cleaning, manufacturing florescent lamps, ceramic objects, as catalyst for several different processes in the petroleum industry and in separation uranium isotopes. While the corrosive nature of HF is well-known, it can also inflict disorder like eye, nose, throat and mucus membranes irritation. The main purpose of this study was to determine HF in worker's breath and introducing an easy and cost effective method of HF analysis.Material and methods: Having employed NIOSH 7902 method, 22 air samples were obtained from worker's breathing zones and compared to standards.Air samples were also analyzed with both spectrophotometery (using zirconium eriochrome cyanine R) and ion specific electrode method simultaneously. The results of analysis were then compared with each other.Results: The mean fluoride concentration in air samples from worker's breathing zone by ion specific electrode and spectrophotometery were 0.172 and 0.176 ppm. Comparing this to the standard level (3ppm), a significant difference was emerged (p<0.001). Mean of fluoride concentration, obtained from both methods of analysis were not significantly different (p=0.55).Pearson correlation test indicated a strong, positive and direct correlation between results from both methods of analysis as well. (r=0.994, p<0.001)discussion: The results of this study showed that mean comparison of fluoride concentration in air samples of worker's breathing zone is significantly less than standard level proposed by NIOSH (p<0.001). This confirms the fact that there are appropriate controlling measures present in the workplace. T paired comparison test displayed no significant between two methods of analysis, (p=0.55), which in other words shows no consistency between two applied methods.

Introduction: Application of nuclear technology is developed in various fields such as industry, basic and medical sciences. So that, the nuclear incidents and nuclear injuries is inevitable. In this report, educational needs of hospital personnel for effective medical management and response to nuclear injuries are investigated. Materials and methods: In this investigation, the educational needs of six hospitals were studied by using of designed questionnaire. 137 of volunteer responders among hospital managers, medical emergency department, nuclear medicine and radiology sections were participated in this study.Results: In an actual nuclear event, key hospital personnel including responders in this study would be called on to focus medical responses. Unfortunately, the obtained results showed that they did not pass suitable courses and training for responding to nuclear injuries. Also, based on this result, in some fields such as personnel protection and medical syndrome of ionization radiation the information of responders were acceptable, but some other fields such as medical management protocols for nuclear injuries, radiation detectors and biodosimetry, their knowledge were insufficient.Discussion: Because of deployment of nuclear technology, training and preparing of hospital personnel for medical management and response to nuclear injuries is necessary. Notwithstanding some shortcomings, because of enthusiastic and scientific background among responders, creation and development of preparedness among responders is completely conceivable.

Introduction: This is a summary of an extended research on sociological study of influential factors on war veteran disabled persons’ attitude toward narcotic drugs in Mazandaran Province. The main focus of the study has been to identify and analyze the social correlates of war veteran disabled persons’ attitude toward narcotic drugs.Materials and Methods: The researcher has been designed on the base of response to this question "what are the causes of influential factors on war veteran disabled persons’ attitude toward narcotic drugs in Mazandaran province?" The research unit of analysis is individual. The research method of study was survey, based on collected data though questionnaire. Results: Totally, theoretical model variables explain 21 percent of variation in dependent variableDiscussion: It is an established fact that war veteran disabled person's drug addiction has been increased in Mazandaran province in the recent years. Path analysis results indicate that family attachment, belief, self-esteem and occupation variables are the most important variables for explanation of dependent variable, respectively.

Introduction: One of the basic problems in many of organizations and institutes is that, there are not enough information about personals knowledge and awareness. Knowledge management includes the most important means for resolving this problem by focusing on the alternatives for organizing, human forces and technology knowing the nature and importance of the knowledge and knowledge management in the organization completely to plan a knowledge management system or promoting its level in an organization is necessary. Also its necessary organizations success basic and approach for making balance among these items are attended specially by recognizing items and their functions indirect of accessing basic advantages in result of using knowledge management in the organization. So far 26 models about knowledge management were presented by different scientist sand institutes that most of them are similar to each other in terms of content but they include different orders in the words and phrases. Nonaka and takouchi model is one of the best models among these models interms of explaining how producing knowledge that is was selected Materials and Methods:this study is Cross-sectional. For Analyzing challenges and blocks in the organization. At first nonaka model were divided sports for making questions for question air according to the studies and Analyzing main concepts in the structure of knowledge management and also studying suggested models. Then possible important parameters for promoting knowledge level in that part were made and finally selected parameters and alternatives were changed to the questions for questionnaire that its result was producing and questionnaires for each part. Questionnaires were given managers and people who were known as elits and specialist by the researching society for Analyzing their validity, so they were analyzed for resolving problems and matching with suggested model. Finally the questions in the questionnaire were evaluated by kokran test suitably and samely. Then the questionnaires were distributed among selected center personals and determining their views about the present center situation (according likert spectrum) were asked them. (in fact determining the value of the questions were asked them). In next step explaining the effect of these questions on promoting knowledge level of the center were asked them (in fact determining the value of the questions). Then the average value of each question was accounted and standardized after accounting the number (advantage) of the center and each level of nonaka model divisions, the value of the questions in the questionnaire are determined for accepting and determining the level of center knowledge suitably with each part of the model.Discussion: Analyzing data (the answers of the questions in the questionnaire) shows that the advantage of the center related to the knowledge management is 2.77 in other ward the general center situation interms of centralizing knowledge and profiting the capital of the knowledge is less than average (between middle and weak). Finally, they were sent again to the professional and people who have a hand in the society for Analyzing validity of the results and determining distinction about produced challenges and problems in order of their level of importance were asked them and these people’s views were analyzed by using (feridman) test. According to the obtained advantages by the organization and the list of the tabled problems in the organization, it seems that the organization needs to do some projects and knowledge under structures in the organization basically. These under structures include both human sources as the most important part and technologic equipments. On the other the organization should include suitable cultural programs for younger and in experienced people to recognize the importance of the knowledge factors as unimportant organizational capital. Also the organization manager’s mind should be focused on the importance of organization knowledge capital more than before by making culture.