مجله طب نظامی
سال سیزدهم شماره 3 (پیاپی 45، پاییز 1390)

Providing ideal therapeutic services and improving the hospital processes highly depends on staff’s team-work and managers’ leadership styles and leadership styles affects the effectiveness and efficiency. This study was performed with the aim of determining managers’ leadership style from staffs’ viewpoints in one of Tehran’s hospitals and its relationship with hospital indicators. This descriptive-analytical cross-sectional study was done on 394 staffs of a hospital in Tehran who were selected by proportionate and simple random sampling method in 2009. Demographic characteristics’ questionnaire and Likert leadership style questionnaire (after confirming its validity and reliability) were used for data collection and data analysis was done by Chi-square and ANOVA tests using SPSS 16 software. 13.7% of staff state d that their managers’ leadership style was exploitative-authoritative, 56.1% benevolent-authoritative, 28.2% consultative and 2 % of them considered it participative. There was a significant relationship between leadership style of managers and BOR, ALOS, BT and BTI indicators with the significance levels of 0.003, 0.006, 0.003 and 0.002, respectively. Although choosing the authoritative leadership style from the staffs’ viewpoint is not far from mind regarding the organizational environment, use of consultative and participative leadership styles and using training methods for applications of the mentioned styles is suggested in order to improve the organizational efficiency.

Extremely low-frequency electromagnetic fields are identical to the spectrum of human brainwaves and therefore, have more effect on function. Power substation operators are more exposed to these waves compared to other people. The purpose of this study was to assess the risk of power substation workers’ occupational exposure to extremely low-frequency electromagnetic fields. This cross-sectional descriptive study was performed on 67 power substation operators of Kerman who were selected by accessible sampling method in 2010. The electric field intensity and magnetic flux density were measured in different parts of the substations and the amount of occupational exposure of each operator was estimated using the mean intensity of electric field and magnetic flux density in a work shift. Data was analyzed by descriptive statistical methods and one-way variance analysis using SPSS 18 software. Occupational exposure to extremely low-frequency electromagnetic fields was mostly related to 400kv substations and the lowest exposure was related to 132kv substations. Minimum and maximum ranges of the magnetic flux density and electric field intensity varied from 0.11 to 60.8mG and from 0.0008 to 0.13kv/m in the interior equipment and from 0.01 to 790mG and from 0.0008 to 110kv/m in the outdoor equipment. The mean exposure time of operators in a work shift in various substations is lower than standard occupational permissible limits, except for some parts in the outdoor equipment which may have resulted from their proximity to transformators’ earth system.

Musculoskeletal disorders are the most common diseases and occupational injuries and the main cause of labors’ disability all over the world. Various studies have shown the relationship between whole body vibration and skeletal disorders. The purpose of this study was to investigate musculoskeletal complaints among motorboat staff. This descriptive-correlative study was done on 149 of motorboat staff of Caspian Sea and Persian Gulf in 2010. Sampling was carried out based on purposive and convenience sampling methods. Data were collected using demographic questionnaire and NMQ (Nordic Musculoskeletal Questionnaire) and analyzed by SPSS 16 software using Kolmogorov-Smirnov, Chi-square and independent T-test. The most complaints were lumbar pain (61.1%) and knee pain (60.4%). There was statistically significant relationship between age, height, weight, total work experience and work experience on motorboats and pain in the lumbar region (p=0.001). There was statistically significant correlation between knee pain and age, total work experience and work experience on motorboats (p=0.03). The most common musculoskeletal complaint of motorboats staff is lumbar region and knee pain. Regarding the high prevalence of lumbar and knee pain among motorboats staff that causes decrease in productivity and performance and increase in treatment costs of early disability, the special attention of relevant authorities is required.

Firemen must have appropriate physical fitness in order to do their tasks perfectly and perform their special function under different and critical conditions with the least mortality. The aim of the present study was to evaluate the correctness and capability of Iranian male firefighters’ functional tests proportionate to their cardiovascular fitness. This descriptive-analytical study was performed in 2010. 25 newly employed firemen with the age range of 23-36 were selected voluntarily by available sampling, from among 90 employment applicants of four firefighting stations of Tehran. Iran and Hong Kong’s index functional tests were held in standard condition and the temperature of 19-21 centigrade degrees. The firefighters’ aerobic power was evaluated by direct method of respiratory gas analysis. Kolmogorov-Smirnov test and linear regression were used for data analysis. Firefighters’ VO2 max had a weak correlation with Index tests of Hong Kong (R=0.23 and SEE=0.03) and Iran (R=0.03 and SEE=0.15) that was not statistically significant (p>0.05). Although having the threshold aerobic power is the desirable level for evaluation of firefighters’ cardiovascular fitness in this hazardous career, the studied population lacks appropriate physical fitness considering the special function in relief missions and firefighting. Revision and editing of the components of firefighters’ functional tests is recommended.

One of the most important changes in the method of payment to the employees of health institutions is to pay for performance. Pay for performance improves employees’ performance in the organization through the promotion of financial incentives. The aim of this study was assessing the impact of per-case payment on performance indicators and satisfaction in a selected military hospital. This observational cross-sectional study was conducted during 2003-2008 in a military hospital of Tehran that had participated in per-case payment plan. Subjects were selected by census sampling method. Data was collected by a researcher-made questionnaire using 5-scale Likert system and checklists. Data was analyzed by the SPSS 16 software using independent t-test, ANOVA and Kruskal-Wallis test. The average of bed occupancy rate increased after implementation of per-case payment method in all wards. The evaluation of employees’ satisfaction showed that 21.3% had high satisfaction, 6.7% were satisfied, 31.5% had moderate satisfaction, 24.7% had low satisfaction and 15.7% were not satisfied at all. As a whole, the employees’ satisfaction rate with this plan was “good” with the average of 3.06 ± 1.34. Wards’ performance has improved in almost all the studied wards and this improvement has occurred through increasing of bed occupancy rate in some wards and reduction of patients’ length of stay and increasing of bed turnaround in some other wards. The level of general satisfaction with the plan is evaluated as “good”.

Training has great importance for the military forces of the country and has various effects on soldiers’ capabilities. This study was conducted to evaluate the effects of general military trainings on the development of soldiers’ personal skills in a military training center. This quasi-experimental study was performed on 230 training soldiers who were dispatched on April 21st 2010 and were selected by random sampling method in one of the military training centers of NEZAJA. Data was collected using pre-test and post-test by a researcher-made questionnaire based on the five-factor model of personality (with making some changes in the model). Personal skills were operationalized based on seven components of personal experiments, self-confidence, programming, influence and perfection seeking, communicational skills, teamwork skills and responsibility. Data was analyzed by descriptive statistical methods and paired T-test using Minitab 15 software. The obtained average of personal skills showed a significant difference in pre-test and post-test (p=0.0001). The component of influence and perfection seeking (19.83%) had the highest change and teamwork skills (6.43%) had the lowest change in mean, between the two tests. General military training courses are effective on the development of soldiers’ personal skills with acceptable significance. The mean age of 25.1 years for the test samples, the briefness of the course and gaining some of these skills during the university education and work experience prior to the military services are considered to serve the most important causes of lower change in the components’ average.

Medical team members, especially nurses can play an active role in prevention and control of nosocomial infections. The aim of this study was evaluating the knowledge, attitude and self-efficacy of nursing staff in controlling nosocomial infections This Cross-sectional study was done in 2010 on 135 nursing staff working in selected hospitals of Mashhad selected by census and purposive method. The data collection tool was a researcher-made questionnaire evaluating knowledge, attitude and self-efficacy in controlling hospital infections. Data was analyzed by SPSS 16 software using descriptive statistical methods and Chi-square and Mann-Whitney tests. 67.9% of the nursing staff had average knowledge and 29.9% had good knowledge about infection control. 90.4% had positive attitude towards the perceived threats of nosocomial infections, 17.2% were agreed with the perceived barriers of infections’ prevention and control and 36.2% were agreed with the perceived benefits of infection control. 25.2% had average self-efficacy and 74.8% had good self-efficacy. There was not significant relationship between knowledge and self-efficacy. In addition, there was no correlation between attitude and efficacy but there was a significant relationship between knowledge and gender (p<0.05). Nurses do not have appropriate knowledge about controlling nosocomial infections based on the findings of this study. Considering the important role of nurses in nosocomial infection control, training is necessary to increase nurses’ knowledge and attitude in order to adopt appropriate health behaviors with positive attitude and more ability.

Organizational changes have consequences and each organization undergoing changes should confront these consequences properly. The purpose of this study was to assess changes’ effects on organization al health indicators and its relationship with organization al effectiveness.

This cross-sectional descriptive study was done in 2010 on 59 military sub-officers who were selected by census sampling method. The data collection tool was a researcher-made questionnaire used in a similar study that was applied after confirming its validity and reliability. The organizational indicators were evaluated before and after the changes and their changes were assessed and the relationship between the organizational effectiveness index and organizational health indicators was evaluated. Data was analyzed using descriptive statistical methods and Kolmogorov-Smirnov test, paired T-test and Spearman correlation by SPSS 18 software.

Healthy work environment 4.7%, organizational effectiveness 6.4%, staff’s mood 6.6% and employees’ participation 16.08% showed a significant reduction (p= 0.041, 0.013, 0.003 and 0.048, respectively). Also organizatio n al effectiveness had a high and significant positive correlation with organization al health indicators.

Organizational changes may affect organizational health indicators and reduce the following indicators: staff’s mood, healthy work environment, organizational effectiveness and employees’ participation. It seems necessary to measure organizational health indicators after organizational changes and remove the shortages.

Energy bars can improve armed forces’ performance during military missions, especially if there would not be enough time for food consuming. The aim of this study was formulating and experimental production of energy bars for emergency conditions such as patrol, cold weather and heights.

After formulation and experimental production of 10 energy bar samples, the optimum formulation was selected by taste panels. Shelf life and also qualitative properties (organoleptic, chemical and microbial) of the selected formulation were evaluated 0, 3 and 6 months after production at 38°C (equal to 0, 18 and 36 months at 27°C).

Although organoleptic properties and moisture content of the samples were decreased negligibly after 6 months of incubation at 38 °C, there was no significant difference) p<0.05 (with those produced at the beginning of the experiment. Even 6 months after incubation at 38°C, microbial properties and peroxide value of the samples were in the standard range.

Shelf life and also qualitative properties of the produced energy bar after are acceptable 6 months of incubation at 38°C (equal to 36 months of incubation at 27°C) and this energy bar can be easily used in emergency conditions.

Hypertension is one of the most important causes of chronic disability in the world and can affect patients’ quality of life in different aspects considering its chronic and progressive nature. The aim of this study was to compare the quality of life in hypertensive military and non-military men. This descriptive cross-sectional study was performed on 200 hypertensive men (100 military and 100 non-military individuals) who were selected by convenience sampling method in 2010 in Tehran. The quality of life was measured using the standard short form (SF-36). Data was analyzed by SPSS 15 software using independent T-test and Chi-square test. Mean age was 43.31 ± 7.35 in the military group and 46.34 ± 9.26 in the non-military group. Mean systolic and diastolic blood pressure was 142.33/90.06 in the military group and 148.84/95.98 in the non-military group. The general score of life quality was significantly higher in the military group compared to the non-military group (p<0.001). Quality of life in at a higher level in military hypertensive patients compared to non-military hypertensive individuals. Therefore, more attention should be paid to the early detection and treatment based on the quality of life in non-military hypertensive individuals.