مجله طب نظامی
سال بیست و دوم شماره 8 (پیاپی 93، آبان 1399)

Disasters are a set of unexpected situations that occur as a result of natural misadventure or human manipulations. Depending on the type, time, and location of the events, the insect population causing vector-borne diseases is affected, which may eventually lead to widespread epidemics. Parasitic diseases such as malaria, leishmaniosis, arboviral diseases such as dengue fever, West Nile encephalitis and Crimean-Congo fever that are transmitted to humans, in disasters by mosquitoes and ticks increased in the foci and may even be able to create new emerge foci. For example, the waters due to heavy rains create favorable larval habitats for Culicidae mosquitoes. Depending on the distribution areas and the presence or absence of pathogens in the area, this situation will lead to rapid reproduction of the mosquitoes of the genera Anopheles, vectors of malaria parasite, Culex, main vectors of West Nile virus and Aedes, vectors of dengue and chikungunya viruses. At the same time, the disruption of current insect control programs in health networks results in the progressive proliferation of insects which are involved in vector-borne diseases such as flies and cockroaches. In order to manage the crisis situation, appropriate arrangements must be involved in advance, and action plans, as well as precautions, should be prepared, including a set of actions crisis, in the early days, and after disasters. The programs should organize medical entomologists, vector control experts, as well as defining their position and role. These actions should also be undertaken to determine the available resources and to provide equipment and means of vector control and personal protection tools, to control arthropods of medical importance, as well as to the endemic centers of the diseases transmitted. Finally, it is also necessary to develop diagnostic protocols and provide operational solutions for practical control appropriate to each regionchr('39')s capabilities. In the present study, changes in vector-borne diseases patterns and vector populations, as well as strategies for their management and control in disaster situations in the Islamic Republic of Iran are discussed.

Police hospitals provide specialized and general care services to staff, soldiers, and the public, according to their main mission, which is to support police missions in different situations. Some clients of these hospitals have rights that need to be considered due to special circumstances. This study aimed to design and validate the evaluation model of service recipient supports in accreditation of police hospitals.

The present study was a mixed-method conducted in three phases in 2020 includes library, qualitative, and Delphi phases. At the first, using the appropriate keywords and a thorough review of the literature in the main databases, including PubMed, Scopus, Web of Science, Science Direct, related military websites, as well as existing documents and instructions, all sources related to the support of the recipient in public and Police hospitals were identified. Also, to identify more structures, infrastructures, and standards, 9 policymakers and officials of the Department of Health, rescue and treatment were interviewed and after analyzing them, the initial questionnaire of the evaluation model of service recipient support in police hospitals was designed. Then the validity of the model was confirmed using the Delphi method and a survey of 45 experts and key informants in police hospitals by descriptive statistics.

The proposed model was presented for evaluating the service recipient supports in police hospitals in four main dimensions include providing the necessary facilities for special services recipients, planning and managing medical councils and medical services, the satisfaction of clients, patients, and their families with services and the charter of patientschr('39') rights to special clients.

This study led to the design of an evaluation model for service recipients in Police hospitals in the form of 4 dimensions and 15 indicators that can be used as a comprehensive tool and complementary to current evaluation methods such as national accreditation standards of Iranian hospitals, evaluates the service recipients in these hospitals.

Healthy diet has an important role in the success of military operations, so the commanders and all forces must understand the relationship between proper diet and the physical ability to perform physical activity. The aim of the current study is to evaluate the nutritional status of the military in order to provide strategies to improve the health status and increase the efficiency of individuals.

This study has been done on 89 navies in the cities of Bandar Abbas and Bandar Lengeh, south of Iran in 2019. Demographic information, IPAQ and FFQ168 questionnaires were used to collect data.

There were 89 navy men with an average age of 32.6 years. The average daily calorie intake was 2973 kcal. The average daily intake of milk and dairy products, vegetables, fruits, cereals and meats were 1.2, 3.15, 3.55, 1.2 and 1.6 units per day, respectively. The highest deficiency of the main groups of the pyramid was related to the dairy group (77.5%). In the evaluation of micronutrient status, deficiency of calcium (48.3%), vitamin A (83%), zinc (52.8%), omega 3 (46.1%) and vitamin C (33.7%) were reported.

This study showed that the navy in the field of food intake, especially in the consumption of dairy products and sources of calcium, vegetables, fruits, protein sources, omega 3 and energy intake needs to intervene to increase access and consumption of food items.

Military Nursing is a new field in Iran; given the emphasis on the crisis management process and dealing with trauma patients in the field, the services of the field seem to be welcomed by those involved in the crisis and events in the country. The study explored the pathology of military nursing based on the hybrid model.

In this study, concept analysis was performed by the hybrid method in three stages. In the theoretical stage, a systematic review using the PRISMA protocol by searching the scientific databases of Pubmed, Scopus, Web of science and some Persian language scientific databases with the keywords of military nursing, pathology, field of study, systematic review and their English equivalent was done until July 2019. Ultimately, five studies were reviewed, evaluated, and analyzed. In the fieldwork stage, interviews were conducted with 11 experts in the field. Interviews recorded and content analysis was done. In the third stage, the results of the two previous stages were merged.   

In the theoretical stage, the review of literature exhibited that some paramount important factors of nursing field pathology were: lack of a unified definition of nursing in the country, lack of care-oriented curriculum, irresponsible curriculum, non-compliance of the curriculum with community needs, lack of evidence-based practice, lack of design of a native model for education nursing in the country, lack of organizational position for nursing instructors in hospitals, resistance to change and lack of motivation of some students were the most important harmful factors in the field of military nursing in Iran. Analyzing data in the field revealed that the pathologic factors of military nursing include three main categories including the nature of the discipline, human factors and managerial factors.

By recognizing the pathologic factors of military nursing in theory and practice, appropriate students will be attracted to the field. By modifying the teaching process and handing over the management of this field to successful and interested people in the field of military nursing, the pathological factors will be neutralized and the development background will be provided.

Caring for veterans with post-traumatic stress disorder (PTSD) has a number of physical and psychological effects that affect their spouses and their quality of life. The aim of this study was to evaluate the effectiveness of group logo-therapy training on the quality of life of spouses of veterans with PTSD.

This was a quasi-experimental pretest-posttest study with a control group. Sixty spouses of veterans with PTSD in Ibn Sina Hospital in Mashhad were divided into two equal groups based on random allocation. Data collection tool was SF-36 quality of life questionnaire which was completed in three stages before the intervention, after and two months after the intervention. The intervention included group training in logo-therapy for 9 sessions.

The mean score of overall quality of life in the intervention group changed from 84.1±8.3 in the pre-intervention stage to 88.4±5.1 in the post-intervention stage and 104.5±3.4 in the follow-up stage two months later. It was significantly more than the control group (p<0.005). In the control group, the mean score of overall quality of life in the post-intervention stage and the follow-up stage two months later significantly decreased compared to the pre- intervention stage (p<0.001).

According to the results of this study, which shows the effect of group logo-therapy on quality of life, it can be used to improve the quality of life of people in the community, especially the families of veterans.

More than 100,000 Iranian veterans suffer from chemical damage caused by mustard gas. The aim of this study was to determine the body composition status of chemical warfare veterans with chronic obstructive pulmonary disease (COPD).

This is a cross-sectional study. 97 chemical warfare veterans with COPD in Karaj, Iran were included in the study. The Patients were divided into two groups low and medium to high disease severity according to spirometry parameters. The body composition parameters were evaluated using the Bioelectrical Impedance Analysis method. 

Mean age, height and weight of patients were 49.19±3.86, 171.85±6.11, 79.24±11.09, respectively. 65.6 % of them were overweight or obese. According to spirometry indexes, 55.7% (n=54) of veterans had low disease severity and 44.3% (n=43) had moderate to high disease severity. There was a significant difference between chemical veterans with low severity of COPD and moderate to high severity of COPD in body fat-free mass (p-value=0.031), body muscle mass (p-value=0.026) and body water (p-value=0.031) indices. All three indices in the group of veterans with moderate to high disease severity had a higher mean than the veterans with low disease severity. But no significant difference was observed in the fat mass index between these two groups (p-value=0.527).

According to the findings of this study, the severity of the disease in chemical veterans with COPD had an increasing effect on fat-free mass and muscle mass body composition.

The health of police staff plays a key role in increasing their productivity to ensure the security of society. Therefore, the present study was conducted to determine the general health status of police and identify some of the factors affecting it.

This cross-sectional study was conducted in 2018 on 354 personnel of Kohgiluyeh and Boyer-Ahmad (Iran) police command who were selected by stratified random sampling. Data were collected using a standard public health questionnaire.

The mean score of general health in the components of physical disorders, anxiety, social disorders and depression were 5.96±0.26, 6.16±0.28, 7.22±0.18 and 3.50±0.29, respectively. In these components, 61%, 53.4%, 45.5% and 79.7% of police were in the healthy category, respectively. There was also a statistically significant difference between the variables of gender, work experience, education degree and age with general health and related components, while there was no significant difference between the total general health score and monthly income, service categories and organizational rank.

Given that police personnel’s health are at risk for the nature of their profession and this affects the quality of their work, it seems that in order to be more productive, plans should be made to improve their health.

An efficient health care system can only fulfill its mission of ensuring the health of the community through the provision of desirable services. Access to patientschr('39') points of view as a reliable source can be considered for evaluating health services. The purpose of this study was to determine patientschr('39') satisfaction with services provided in a Military Hospital.

In this cross-sectional study, 230 patients who were discharged from a military hospital were selected by convenience sampling method in 2019. The data collection tool was a patient satisfaction questionnaire that its validity and reliability were confirmed. The questionnaire assessed patient satisfaction in two health-care sections with 21 questions and three dimensions of hygiene, nursing and physician services, and non-healthcare with 27 questions and six dimensions of admission services, staff treatment, nutrition, welfare and facilities, religious issues and discharge services.

Overall, patientschr('39') satisfaction in the medical and non-medical wards was 81.05% and 78.58%, respectively. Satisfaction in health care services and nurses (excellent satisfaction) was higher than the satisfaction of physicians (good satisfaction) and in non-healthcare services, the highest level of satisfaction was observed in the admission services (excellent) and welfare services had the lowest satisfaction (Good Satisfaction). Among demographic variables, only patient age had a statistically significant relationship with satisfaction (P =0.03). Other demographic variables such as gender, marital status, type of hospitalization and type of insurance had no significant relationship with satisfaction (P =0.23).

Considering the higher patient satisfaction with medical services than non-medical services and higher dissatisfaction rates especially in the welfare services and facilities, the allocation of more welfare facilities to patients, improvement of hospital conditions and equipping of the hospital are the most important issues.

Based on religious beliefs, the Iranian Muslim follow the lifestyle of the Prophet and the Imams. The aim of this study was to comparatively evaluate the spiritual health behaviors of the Iranian Muslim in the COVID-19 pandemic with religious evidence.

This comparative study was conducted in the period from March 1, 2020, to the end of May 2020 in Tehran, Iran. Without intervening in the research samples, the researchers observed, recorded, examined and compared their individual and social behaviors with religious evidence. Data collection methods were semi-structured interviews, observation, taking notes from published papers, website surveys and social networks. Data were analyzed by conventional content analysis.

Religious beliefs, as a moral motivating factor, had a positive effect on the health behaviors and spiritual health of people in the biological crisis of the COVID-19 pandemic. Community adherence to health standards, spiritual self-care, home care, and family participation in health services at prevention levels were consistent with scientific findings and religious evidence. Muslim people avoided doing things that endangered their own health or the health of others.

The adaptation of health behaviors of the research samples with religious evidence shows the effect of adherence to Islamic rules on the individual and social behaviors of Iranian Muslims, which can be recommended for followers of other Abrahamic religions.

The purpose of this study was to investigate the differences and relationships between the amount of time spent in physical activity and abdominal muscle endurance among the cadets and civilian students.

In this study, a total of 191 male participants (19.7±0.9 years; 63.1±7.5 kg; 169.3±4.8 cm) from the National Defense University of Malaysia (NDUM) volunteered to participate including cadets (n=106) and civilian students (n=85) in 2019. Time spent in physical activity was measured by total minutes and total days of engagement in physical activities. A one-minute sit up was used to measure abdominal muscle endurance. The cross-sectional study and open-ended questions were administered for data collection.

The research findings showed that cadets spent more time in physical activity compared to civilian students in days (cadet, 5.47±.81 days; civilian, 3.25±1.41 days) and minutes (cadet, 76.93±21.73 min; civilian, 58.65±22.48 min). The levels of the cadets of abdominal muscle endurance were significantly greater than that of civilian students (cadet, 45.82±5.95 reps; civilian, 34.5±5.94 reps). Based on the t-test cadets showed a statistically significantly greater in total days of doing physical activity [t(189)=13.73, p(.00)<.05], total minutes [t(189)=5.67, p(.00)<.05] and abdominal muscle endurance [t(189)=13.07, p(.00)<.05] compared to civilians. There was also a positive relationship between performing physical activity in days per week (r=.44) and minutes (r =.34) with abdominal muscle endurance in both groups.

In conclusion, the amount of time spent in physical activity had a significant influence on abdominal muscle endurance. The greater time spent in physical activity led to greater physical fitness level.