مجله طب نظامی
سال نوزدهم شماره 6 (پیاپی 72، بهمن و اسفند 1396)

Soldiers encounter various physical and mental outcomes after military wars which adversely affect different aspects of their quality of life. The aim of the present review was to determine the total score of quality of life in Iranian war veterans.
In current systematic review and meta-analysis, searches were conducted in national and international databases using keywords “war veteran” and “quality of life” and their combinations. Data were analyzed using meta-analysis and random effects model methods. Heterogeneity between the studies was evaluated using the I2 test. Data were analyzed using STATA software version 12.
Analyzing 19 selected studies with a total sample size of 2575 participants showed that the mean scores of the physical and mental aspects of quality of life in Iranian war veterans were 41.6 (confidence interval of 95%: 37.69-47.02) and 42.22 (confidence interval of 95%: 37.04-47.40), respectively. The lowest scores of physical (28.79 with a confidence interval of 95%: 21.92-35.66) and mental (33.86 with a confidence interval of 95%: 25.08-42.64) dimensions of quality of life belonged to chemical war veterans.
Iranian war veterans have a low physical and mental quality of life and providing strategies for improving their quality of life seems necessary.

Service-based learning, as a kind of experiential learning, connects nursing education to the real world. The purpose of the present study was to examine the concept of service-based learning in nursing by Rodgers's Evolutionary Concept Analysis Method.
In this review study, English-language databases including Science Direct, Medline, Cochrane library and CINAHL, and Persian-language databases like Scientific Information database were searched by a three-step searching method from 2005 to 2015. To demonstrate a conceptual model of service-based learning, Rodgers's Evolutionary Concept Analysis Method was used.
Of a total of 6543 articles identified, 165 were included into the second step, of which only 32 were relevant to the field of nursing. Using the given answers to the 9 questions raised in the study, the new approach to the service-based learning model was developed.
According to the growing demands of societies from educational centers on graduate students who are able to work in real social life settings, recommends the necessity of focusing in this new educational approach. For more objective evaluations of this new educational approach, it is advisable to use its specialized check list.

Evidence shows that a considerable percentage of Iranian young men suffer from obesity and being overweight at the onset of military services. This study aimed to investigate the soldier's knowledge, attitude and practice about obesity and overweight management based on the Extended Parallel Processes Model.
This KAP (Knowledge, Attitude and Practice) study was conducted in two military centers in Yazd, Iran (in 2016). Through a multi-step sampling method, 94 subjects were recruited. The knowledge, attitude and practice level of soldiers were measured by valid and reliable researcher-made questionnaires. Data were analyzed by descriptive statistics and the Pearson correlation test using SPSS 18.0 software.
The mean±SD score was 8.30±1.34 for knowledge, 10.70±1.90 for perceived severity, 9.10±1.69 for susceptibility, 10.11±2.30 for response efficacy, 10.28±2.27 for self-efficacy and 19.70±5.84 for practice of obesity and overweight management. There was a significant direct correlation between the soldiers’ knowledge score and perceived severity (p=0.021). However, knowledge and perceived response efficacy had an inverse and significant correlation (p=0.04). Results also showed a direct significant correlation between perceived self-efficacy and practice (p Soldiers did not have ideal knowledge, attitude, and practice towards obesity management. Therefore, it is suggested to use proper educational intervention for improving these variables in soldiers who are overweight or obese during military service.

Knowing the maximum radius of fire, explosion and emission of toxic gases, can play a very important role in the operationalization of urban passive defense requirements in order to reduce vulnerability in accidents. The main objective of this study is modeling the extent of explosion, ignition and gas leakage Consequences in cylinders containing 26.2-liters of liquid gas, with passive defense approach.
In this study, the effective factors on discharge and release of gases are described and ALOHA software has been used as one of the most suitable software for modeling the gas emissions of LPG (Liquefied Petroleum Gas) cylinders. Based on the modeling results, the emergency response program during gas leakage is presented.
When the gas leaks from LPG cylinder with 1-inch vent valve, the cylinder will be empty in one minute and the gas concentration will be 12600 ppm (60% LEL) and 2100 ppm (10% LEL) up to 11 meters and 35 meters from cylinder, respectively. In the case of vapor cloud explosion, the explosive wave pressure will be about 3.5 psi, up to 13 meters from the reservoir which may cause serious damage, and it will be equal to 1 psi, up to 25 meters from the cylinder which has strength of breaking the glass. In case of furious fire, fire flame with eight meters’ length is created, with thermal radiation of about 10 Kw/m2 and 5 Kw/m2 up to 10 meters and 12 meters from the cylinder, respectively which can cause second-degree burns. In the event of BELIEVE, a fireball will occur with a diameter of 14 meters within 2 seconds, with thermal radiation of about 10 Kw/m2 up to 53 meters from the cylinder.
The consequences of flaring and explosion of LPG gas, up to 35 meters from cylinder, are the most serious threat for human health, if gas leaks from a cylinder. Optimal positioning of gas cylinders will have an important role in limiting the harmful effects of hazardous emissions in military barracks.

Today, Pilates and Yoga are particular popular among various groups of society. The aim of this study was to investigate the effect of eight weeks of Pilates and yoga training on the respiratory gas exchange indices of young women at anaerobic threshold moment.
In this semi-experimental study, 36 female volunteers were divided into control, Pilates and yoga groups, each including 12 subjects. The maximum consumed oxygen, anaerobic threshold and anthropometric characteristics of the subjects were measured before and after eight weeks. After the maximal test session, participants in the Pilates and yoga groups had exercise training for 8 weeks, 3 sessions in each week. Each session took 75 minutes until the eighth week and the intensity of activity gradually reached 70-85 percent of the maximum consumed oxygen. During the workout sessions, the control group did not exercise. The considered respiratory indices of the maximum test session were measured before and after eight weeks. Independent one-way ANOVA and dependent t-test were used for statistical analysis.
The results showed that despite changes in respiration indices, changes in the consumed oxygen of the anaerobic threshold moment between the three groups, as well as changes before and after eight weeks of RER in the yoga group have been significant only (p> 0.05); while changes in VT, VE,, EQO2, EQCO2, PETO2, PETCO2 and VE/VCO2 were not significant at the intra- and inert-group levels (p The research results showed that eight weeks of yoga and Pilates activities resulted in positive but insignificant changes in some indicators on the cardiovascular system of active women, such that the volume of consumed oxygen, current volume and moment verge were increased on reaching anaerobic moment. This effect is higher in yoga than Pilates; while indicators related to the efficiency of respiratory system to meet the needs of activity time after regular Pilates practice are more affected.

Patient safety is one of the main components of the quality of healthcare services. Patient safety culture is one of the factors that helps to understand the various aspects of patient safety and factors affecting it. Among these factors is burnout and job satisfaction of healthcare staff in hospitals. Therefore, the aim of this study was to investigate the relationship between burnout, job satisfaction and demographic factors with patient safety culture in the military healthcare staff in Tehran, Iran.
This cross-sectional study was performed on 136 healthcare staff working in a military hospital in Tehran, Iran in 2017, by using stratified sampling. The tools used in this study include Mesteth’s job burnout standard questionnaire, JSS job satisfaction, patient safety culture questionnaire and demographic information form. In this study, the relationship between gender, marital status, type of membership, position, work-shift, age, work record, education, job satisfaction and job burnout variables with patient safety culture were investigated.
This study included 20 (15%) males and 116 (85%) females with a mean age of 36.99±8.63 years old. This study showed that job burnout (r=-0.51, P Considering the effective role of both satisfaction and burnout factors on patient safety culture, one can manage these two variables in the workplaces in order to contribute to the improving patient safety culture.

By improving the level of trust in supply chain management, customer care is improved and mutually improving customer care will in turn lead to increased trust in supply chain management. Therefore, different aspects of customer relationship management and supply chain management affect and promote each other. Meanwhile, information technology plays an important role as a facilitator. The purpose of this study is to examine the effect of customer relationship management on the supply chain considering the mediating role of information technology (case study: supply of medicine in Iran).
This research is a correlational, survey and applied study. The statistical population includes experts and pharmacists, pharmaceutical companies and experts working in the pharmacy of military hospitals, of which 140 were selected by a simple random sampling method, and were evaluated using a researcher-made questionnaire. The researcher-made questionnaire consists of three parts with 27 items and a Likert scale (5 = very large to 1 = very small), respectively. The data were analyzed using SPSS-18 software and LIZREL8 software, and the fitness indices of the model were calculated.
The results indicated that not only customer relationship management has a direct impact on the supply chain, but also the full intermediary effect of information technology is also confirmed. There is also a positive and significant relationship between customer relationship management and supply chain management, customer relationship management and IT, IT and supply chain (P> 0.05).
Military hospital pharmacies can achieve a competitive advantage by integrating a systematic supply chain based on the use of new technologies in the context of information security, and develop and maintain long-term relationships with stakeholders.

Nowadays, with many challenges in organizations such as hospitals, strategic management is considered necessary more than ever. Without strategic management in organizations, even survival is not possible. Given the importance of strategic management on organizational innovation and productivity, especially in hospitals, this study aimed to investigate the relationship between strategic thinking with innovation and productivity in different levels of managers in a military hospital.
In a cross sectional study, all senior, middle and operational managers in a military hospital were entered by the census method in 2017. The data gathering tool included 3 questionnaires; strategic thinking measurement questionnaire based on the Liedtka model, the productivity questionnaire was based on the Hersey - Blanchard Model and Chang-Lee innovation questionnaire. Data analysis was performed using Pearson correlation, using SPSS 18 software.
A total of 17 managers with a mean age of 45 years were included. A significant relationship between strategic thinking and productivity (r=0.59, P=0.013) and also with innovation (r=0.54, P=0.021). In this way, the more strategic thinking among the managers of the organization, the more innovation and productivity in the organization will increase Also, there was not a significant relationship between strategic thinking and age, work experience, management work experience and degree of education (p >0.05).
Considering the meaningful relationship of strategic thinking with productivity and innovation in this study, one can conclude that by reducing strategic thinking, the amount of productivity and innovation in the organization is reduced, leading to stagnation and failure.

Cell phone technology in universities is growing exponentially, while related social research is rare. The purpose of this study was to identify the pathology and provide the conceptual model of cell phone use in military students during 2017.
This study was a qualitative study using thematic content analysis. Semi-structured interviews and literatures were used to collect data. The semi-structured interview was conducted with 11 media and communications experts by a purposeful sampling method. To analyze the data, descriptive coding, interpretive coding and overarching themes were used.
Three functions and three malfunctions of scientific-educational, cultural-social and communication dimensions were identified, and 35 indicators were determined as positive points and negative damages of cell phones in military students. In addition, three intra-personal, environmental and organizational dimensions were developed to enhance the capabilities and address mobile threats, and 15 indicators were identified as strategies to improve the capabilities and address the threats of the cell phone.
Reducing the negative consequences and promoting the positive use of mobile phones in the field of communication, educational and cultural-social in the military university students should be considered. Also, this study can be considered as an exploratory study for using in military students.

During military exercises, lower extremity injuries is very common. However there are limited data about risk factors and predictors of these types of injuries. The purpose of this study was to predict lower extremity injury in Iranian army rangers using the functional performance tests.
This population study included 141 ranger cadets who were selected by convenience sampling from the Isfahan University complex in 2015. All the subjects were evaluated before the beginning of the rangers training. The functional performance tests of Y balance and triple hop test were used for evaluation. Musculoskeletal injuries resulting through a 7-month basic combat training period were recorded prospectively.
During the observation period, 42% of the rangers suffered from at least one musculoskeletal injury. Logistic regression modeling showed that the rangers with Y balance less than 81.5% of their limb length were 2.25 times more likely to have a lower extremity injury. Also, the rangers with a triple-hop distance less than 70% of their height were 2.3-fold more likely to have a lower extremity injury.
It can be concluded that functional performance tests can predict lower extremity injuries during the basic combat training periods. Therefore, it is recommended that these tests be carried out before recruiting the rangers.

Nowadays organizations are in dynamic environments that continuously change in consideration of economics, politics, social factors, and technology. In this condition it is believed that information technology (IT) can increase the capabilities of organizations, as well as reduce the costs. The aim of this study was to investigate the effective factors, their variables and their impact on the application and use of IT in health insurance organizations in Guilan province.
This cross-sectional study was carried out in 2016. The population study included 45 experts in the health insurance industry in Rasht city and 16 other cities of Guilan province, Iran. Data were collected using a researcher-made questionnaire including 6 dimensions of managerial, human source, cultural, environmental, organizational and technological factors. The questionnaires were completed by health insurance industry experts. Then, the collected data were analyzed using the hierarchical analysis process using Expert Choice software version 11.
The findings of the study demonstrated that the ranking of factors (and variables) which affect the optimum use of IT in the health insurance industry from the expert's viewpoints were inclusion of the managerial factor (the variable of motivation and necessary support for managers), the environmental factor (the variable of the existence of an integrated network in the country), organizational factor (the variable of sufficient budget for hardware and software equipment), technological factor (the variable of facilitating the application and use of IT), human source factor (the variable of passing related training courses for staff and reducing staff resistance to change), and cultural factor (the variable of familiarity of people and authorities with IT performance), respectively.
In order to optimize the use of IT in the insurance industry in Guilan province, conducting IT training courses, reducing staff resistance to changes, familiarity with the performance of IT, developing and upgrading hardware and software components are the most important aspects.

Self-harming behaviors are one of the main problems of the military personnel. The aim of the current study was to investigate the role of psychological disorders, personality disorders, occupational and family variables in self-injuring behaviors of the Iranian army force personnel in Shiraz city.
This research was a descriptive-correlational study which was conducted on military staff members living in Shiraz, Iran, in 2016. Availability sampling was the method for choosing subjects. Data were collected using Suicide Behavior Questionnaire- Revised (SBQ-R), Self-Harm Inventory (SHI), Beck Depression Inventory-II (BDI-II), Milon Clinical Multi Axis Inventory-III (MCMI-III), Family Assessment Device (FAD), Maslach Burnout Inventory (MBI), Bery Fild and Roth Job Satisfaction Inventory and Job Stress Questionnaire. Data were analyzed using SPSS-21 software and Structural Equation Modeling (SEM).
The mean age of 215 army personnel was 31.07±4.71 years old. Findings showed that the Measurement Model wasn’t fit, and then some modification was done. Also in the Structural Model with regard to fitness and modification indices some paths (Personality disorders and anxiety disorders) were removed from the model in order to increase the fitness. Moreover, findings showed depression (β=0.79, p It can be concluded that depression, job burnout and family functioning are effective variables on self-injuring behaviors of army force personnel.