مجله طب نظامی
سال بیست و دوم شماره 3 (پیاپی 87، خرداد 1399)

This study is an epistemological account of the collective nature of the problem of obesity prevalence among the military personnel that by reflecting on the existing knowledge and current and future paths that lead to obesity in the military personnel, we sought to give a conceptual model policymaking for tackling obesity. The prevalence of obesity is a serious challenge for the Iranian Armed Forces’ mission

We reviewed the following topics with a constructivist approach: 1- Understanding the prevalence of obesity at the individual level; 2- The relationship between military lifestyle and prevalence of obesity; and 3- The effects of obesity prevalence in the society on the combat competence of military organizations.

The prevalence of obesity is the result of an obesity-inducing context, so considering personal responsibility is not enough to resolve it.The imbalance between food intake, consumption of energy and psychological instability that comes with a military profession are the three sides of a triangle that lead to obesity among the military personnel. On the other hand, the prevalence of obesity in society, especially in children, adolescents and young people who are the future conscripts or military personnel, especially among the children of military personnel as the most likely future candidates for military service, threatens the mission and combat competence of the armed forces.

Having a systematic understanding of the nature of obesity; biology and personal choices, the regulatory functions of the military organizations, behavioral context, obesity effects of the policy-making sectors, and the cultural, social, economic and political contexts determine the level of obesity among the military personnel. This can be categorized into five levels for anti-obesity policymaking. Controlling and reversing the prevalence of obesity requires strategic patience, coordinated efforts and participation at all levels of military and national sectors.

Musculoskeletal disorders cause abnormalities and major problems, the most important of which is the inability to perform physical activities and military missions. The aim of this study was to investigate the effect of a course of corrective training on the musculoskeletal disorders of soldiers in a military unit.

The Nordic Questionnaire was distributed among 186 soldiers that randomly selected from the military barracks in Tehran, Iran in 2016. Fifty-six soldiers with at least one musculoskeletal disorder were randomly assigned into two groups of 28 people. The intervention group underwent corrective exercises for eight weeks, and the control group did not perform any specific exercises or activities during this period. The QEC test was used to assess the risk of musculoskeletal disorders.

The results of the Nordic questionnaire reported musculoskeletal disorders 51.78% in the lower back, 46.42% in the knees and ankles, 33.92% in the neck, 21.42% in the back, 14.28% in the thighs and buttocks, 12.50% in the shoulders and 10.71 % in hands and wrists. Risk factors for the tasks include 35.71 % very high, 46.42 % high, 12.50 % moderate and 5.35 % low. Finally, it was observed that corrective exercises had a significant effect on musculoskeletal disorders of the intervention group in the neck area (p=0.051 and 2.271), the lumbar region (p=0.05 and z=3.256), and the shoulder muscle (p<0.05, z=3.045) and the wrist/hand area (p=0.05 and z=3.276). But no change was observed in the control group.

Corrective exercises and physical fitness training reduce musculoskeletal disorders and incorporate corrective exercises into the morning exercise program.

The military personnel face many stressors. This study aimed to identify coping mechanisms in the face of stressors in military personnel.

This is a cross-sectional study and the sample was 384 of staffs affiliated to Iranian Navy Force, who were selected by cluster random sampling. Data collection tools were demographic questionnaire, a military stressors questionnaire developed by Azad Marzabadi and Lazarus-Folkman's coping mechanisms questionnaire. Stressors were evaluated in six areas (factors related to the region of workplace, social, occupational, personal, familial and military-related factors) and coping mechanisms in eight subscales including; confronting coping, distancing, self-controlling, seeking social support, accepting responsibility, escape-avoidance, planful problem solving, and positive reappraisal.

Among the stressors, the highest level of stress was related to the military with an average of 17.95. The most common coping mechanism was positive reappraisal with an average of 10.65. The mean use of problem-oriented mechanisms was significantly higher than emotion-driven mechanisms (P<0.001). There was a direct and positive relationship between most stressors factors and emotion-driven mechanisms and negative and reverse relationship with problem-oriented mechanisms.

The study found that participants were more likely to use problem-oriented mechanisms in coping with stressors. However, it is necessary to take appropriate measures to reduce the use of emotion-based solutions and also to strengthen the use of problem-oriented coping mechanisms.

Even though aging is a natural process but many effective factors such as life style, rest and sleep pattern, stresses and confronting them can affect this process. Identifying the effective factors is necessary for improving retirement quality of life. The purpose of this study was to compare quality of sleep of sleep quality in active and non-active military retirement and its relationship with mental health.

This is a descriptive - correlational study that 80 military retirement (40 active retirement and 40 non active retirement) aged 65 - 70 years, availability selected as statistical sample. In order to collect data needed to assess their sleep quality index of Pittsburgh Sleep Quality Questionnaire (PSQI) and also of mental health, Goldber & healer (GHQ-28) questionnaire were used. In order to compare the mean of the two groups, T-test descriptive statistics and deductive statistics, is used; Also, Stepwise Regression test were used to predict the contribution of sleep quality components to mental health of retirees.

The results showed that active military retirement had better scores in sleep quality and mental health than non-active military retirement (P<0.05). Also the result of step wise regression showed that none of the components of sleep quality couldn’t predict mental health in active and non-active military retirement.

According to the results of the research, there is a significant difference between active and non-active military retirement. According to the findings of this research and other related researches it can be concluded that doing public sports has a positive and significant effect on military retirement Quality of Sleep and mental health.

transcranial direct current stimulation (tDCS) is a potential non-invasive treatment for psychiatry disorders. The aim of this study was to investigate the efficacy of bilateral tDCS on depression, anxiety and rumination of patients with post-traumatic stress disorder (PTSD).

This was a double-blind interventional study with pretest – posttest design and one month follow- up. This study was carried out in 2018 with statistical population of PTSD patients from Tehran, Iran. In present study 20 patients with PTSD symptoms were selected using convenience sampling and randomly divided to interventional (n=10) and control groups (n=10). The interventional group received real 2.0 mA tDCS over dorsolateral prefrontal cortex (DLPFC) lasted 20 min in 10 session and the control group received sham tDCS. In present study, Structured Clinical Interview, the Beck Depression and Anxiety Inventory and Nolen-Hoeksema Ruminative Response Scale were used in pretest, posttest and follow- up. 

Patients demonstrated significant depression and anxiety symptoms reductions in the interventional group compared to the control group. There were significant differences between the two groups in rumination at post-test but there were no significant differences between the interventional and control groups in rumination at follow-up.

tDCS improve depressive and anxiety symptoms in patients with PTSD. However, there was no significant reduction in rumination at follow-up course. Further studies may determine optimal stimulation parameters for maximal mood benefit in patients with PTSD.

With regular exercise, the heart undergoes structural and functional changes. The purpose of this study was to evaluate the right ventricular changes by echocardiography in military personnel participating in endurance or strength training.

This clinical trial was performed on 40 male military students at a military medical university in Tehran, Iran in 2018. Echocardiography was performed for all subjects at the baseline and clinical data were recorded and then the subjects were randomly divided into two groups. For one group endurance training and for the other group strength training was performed professionally for 10 weeks under the supervision of a sports coach. Echocardiography was performed for both groups after the end of the training and clinical data were recorded and changes were evaluated and analyzed.

Mean age and clinical data at baseline were not significantly different between the two groups. At the end of the study, after 10 weeks of exercise, a significant increase in RVAD and E/e 'was observed in either endurance or strength groups. The E/e', SWDT and Relative wall thickness showed a significant increase in the strength group compared to the endurance group. The exercise intervention decreased the RVAS in both groups, which was significant in endurance group. In SWDT and LV mass index, only significant increase was observed in endurance group. PAP only increased significantly in the strength group after exercise and was the only index that was in the abnormal range. In the other measured indices, there was no significant difference between endurance or strength groups before and after 10 weeks of exercise training.

The findings of the present study showed that both types of strength or endurance exercise have an impact on the functional status of the military heart, however, the strength exercise is more effective.

Internet addiction as one of the addictive behaviors is associated with negative Intrapersonal and interpersonal outcomes.The purpose of this study was to investigate the prevalence of Internet addiction and the Status of the use of virtual social networks in Iranian Adolescents and youths.

The statistical population of this cross-sectional study included all Iranian teenagers and youths in spring of 2018. Iran was divided into 5 clusters (north, south, center, east, west) for sampling, then, a province was randomly selected from each cluster and the research tool was distributed voluntarily among teenagers and youths in the center of that province. The sample number in this study was 1491 people that responded to demographic characteristics and Yang’s Internet addiction questionnaires.

The overall prevalence of severe Internet addiction is 2.4 percent, regarding gender; 2.9 percent for boys, 2.2 percent for girls, and regarding age 2.5 percent for teenagers, and 2.3 percent for young people, but the differences were not significant. In the two groups of girls and boys, there is no difference in terms of the average score of Internet addiction, while there is a difference between the two groups of teenagers and young people, and the average Internet addiction in the youth age group is slightly higher than teenagers. Telegram, Instagram and WhatsApp are also popular social media networks, and communication with friends and news awareness are the most important reasons for using virtual social networks. 

There is a small amount of severe internet addiction among teenagers and youths, but the important point in the present study is the high number of teenagers and youths who are involved in mild or moderate internet addiction.

Work-related musculoskeletal disorders are one of the most important health hazards of hospital personnel with the task of patient transfer and is highly prevalent. Therefore, the aim of this study is ergonomic risk assessment of musculoskeletal disorders in hospital personnel with the task of patient transfer working in different sections of selected hospitals affiliated to Shahid Beheshti University of Medical Sciences using DINO and PTAI methods.

This cross-sectional study was performed on 245 hospital personnel with the task of patient transfer in different sections of 4 selected hospitals, affiliated to Shahid Beheshti University of Medical Sciences in Tehran, in 2019. In this study was used two-stage cluster random sampling. Data were collected by using Body map, PTAI and DINO questionnaires.

The mean and standard deviation of age were 37.7 ± 9.6 years. 72.2% (177 people) of the subjects were men and 27.8% (68 people) were women. Results showed 88.6% (217 people) of the subjects had pain in at least one of the body organs during the past 12 months. Low back pain with 71% (174 people) was the most common musculoskeletal discomfort between subjects. The highest PTAI score was 69.8% (171 people) at second level (yellow area) and 27.8% (68 people) in third level (red area). The highest DINO score was 57.6% (141 people) at second level (yellow area: Requires Ergonomic Measures) and 41.6% (102 people) at third level (red area: weak ergonomic surface). Relationship between the results of PTAI and DINO indexes and prevalence of musculoskeletal disorders were not found significant (p>0.05). The results showed there is a significant relationship between different levels of DINO index with PTAI index (p<0.05).

Both PTAI and DINO methods can be a useful tool for evaluating patient displacement. Other risk factors such as inappropriate body postures, prolonged standing and high work pressure in nursing job, indicate that the need of ergonomic interventions and improvement of working conditions is as soon as necessary.

The relatively high prevalence of structural deformities and also the importance of timely detection of these abnormalities, are essential in preventing future injuries to employees in any organization. The aim of this study was to investigation of musculoskeletal deformities prevalence and its correlation with working experience in male nurses in a military medical center in 2019.

This cross-sectional study conducted on 159 male nurses, which they working in different parts of a military medical center in Tehran, Iran in 2019. Purposeful sampling was performed which 104 nurses with forward head position and kyphotic abnormalities were included in study. The tools used in this study were: Personal information questionnaire (Age, Height, Weight, BMI, Work experience, Hours of work, and Workplace center), Flexible ruler and goniometer (for measuring forward head and kyphosis angles). Data were analyzed by SPSS software version 23 at the significant level P≥0.05.

Of the 159 military nurses, 104 nurses were participated with an average age of 35.6±9 years and 14.8±9 years of work experience. The prevalence of forward head position and kyphosis deformities was 28.93% and 36.47%, respectively. The results also showed a positive correlation between work experience with forward head position (P=0.020, r=0.290) and hyper kyphosis (P=0.003, r=0.228).

The results of present study indicate a relatively high prevalence of forward head position and kyphotic deformities among military nurses. Statistically, the prevalence of these deformities was significantly higher in nurses with higher work experience. Therefore, it is necessary in the first place to identify the factors affecting the occurrence of these deformities and then to remove or correct them and in the second to focus on the correction of these deformities.

Unsafe injection is like a plague for the health system, which is a constant threat to patient safety. Therefore, the present study was conducted to determine the effect of educational program using the WhatsApp social network on knowledge and performance of nursing students in regard with safe injection in Shushtar University of Medical Sciences in 2020.

In this quasi-experimental study, 60 nursing students of 5th semester (or higher) were enrolled using census. Demographic questionnaire, researcher-made questionnaire on knowledge and performance checklist were used for data collection. The knowledge questionnaire was completed by nursing students before intervention and their performance (before, during, and after injection) was assessed using inventory checklist. Then, a one-month course on safe injections using the WhatsApp social network was launched for students. Three months after intervention, students’ knowledge and performance were assessed again.

The results showed that before the intervention, the average levels of knowledge and performance were 25.66±4.01 and 12.66±1.11, respectively. After intervention about safe injection, the levels of knowledge and performance increased to 28.65±5.05 and 13.50±1.25, respectively. The greatest effect of education on performance was observed after the injection. In addition, the knowledge and performance respectively in 76% and 66% of students were at an excellent level. There was no statistically significant relationship between knowledge and performance before intervention (P>0.05), but this relationship was significant after the educational intervention (P<0.05).

The findings of this study showed that education based on WhatsApp social network can be associated with the promotion of knowledge and performance of nursing students.