مجله پرستار و پزشک در رزم
سال ششم شماره 19 (تابستان 1397)

Telemedicine is referred to as a remote health service, and researchers have considered telemedicine as an important factor for agility. An agile hospital should have features that include: speed of operation, adaptability and responsiveness. The purpose of the present study was to investigate the hospitalization of the hospital with telemedicine strategy and the effect of employee productivity adjustment in 523 Army Regional Hospital in Urmia. This study was a descriptive-survey study and a sample of 137 personnel of 523 Army hospitals was selected. Data were collected using a questionnaire and data analysis using structural equation modeling. In this study, the findings of the study showed that telemedicine with a path coefficient of 0.278 on organizational agility, staff productivity with a 0.447 pathway coefficient on agility and employee productivity with a path coefficient of 0/174 had a moderating role in the effect of telemedicine on Engage in agility. The results of the study confirmed the effect of telemedicine on the agility of the hospital and the final model indicates that the factors of employee productivity development (timely payment of claims, provision of facilities, medical equipment, support of doctors, nurses and others), the effect of telemedicine on the agility of the hospital is well adjusted.

Determining the prevalence of occupational stress and its relationship with occupational and personal characteristics in nurses in government hospitals in Borujerd. This was a descriptive-analytic cross-sectional study that carried out on 150 nurses. Demographic information questionnaires, Holmes Rae's social adjustment (stressful life stress), and nurses' job stress standard were completed and the prevalence of occupational stress levels (low, moderate, severe) and its relationship with personal and occupational characteristics of nurses were estimated. After applying the exclusion criteria, 56 people (83.9% of whom were women) were analyzed and 94 were excluded from the final analysis because of severe life stress. The average age was 35.1 ± 6.5 years, 33.9% had over 15 years of experience, and 96% had a cyclic shift. 58.9% of nurses had severe occupational stress and 12.5% had low job stress. Sub-scales of occupational stress findings by gender showed that the mean score of the problem dimensions in relation to the partner (10.72 ± 5.71 versus 7.44 ± 1.33) (P = 0.001) Workload (19.55 ± 8.58 versus 13.13 ± 5.50) and (P = 0.009) discrimination (6.40 ± 3.65 vs. 3.77 ± 2.81) (P = 0.47) Was higher in women than in men. The findings of this study, for the first time in Lorestan province, showed a high prevalence of occupational stress in more than half of nurses working in government centers and indicated, high workload, conflict with colleagues and job discrimination in female nurses are more than men.

Human papillomavirus (HPV) is the most common sexually transmitted virus that is directly related to cervical cancer. There is an increasing number of people infected with human papillomavirus virus worldwide, especially in undeveloped and developing countries. Knowledge, awareness, and attitude of the community in the acceptance of HPV vaccination has a significant effect on controlling the infection to this virus. Evaluating and improving the level of knowledge in medical students and medical staff as pioneers in providing health services can increase the level of attitude and knowledge of individuals to the diseases associated with the virus. For this aim, the researchers designed and conducted this study to evaluate the knowledge and attitude of medical students and other medical staff about HPV vaccination. This cross-sectional study was implemented on 400 medical students and other medical staff of Islamic Azad University during 2016 to 2017. Demographic data of all participants were recorded in the data collection sheet. Then, the attitude of participants about vaccination with HPV vaccine was determined by the questionnaire, and the distribution was evaluated based on age, gender, marital status, and education. Eventually, the relationship between age, sex, marital status and education with the level of information and knowledge of the participants was investigated. Data were analyzed using SPSS statistical software version 21. The significance level was considered P <0.05 in this study. 322 females and 77 males between 20 to 72 years of age (mean age of 27.33 ± 6.78 years) participated in this study. Descriptive data showed that the majority of participants had a moderate to high level of knowledge about HPV infection (about 70%) and vaccination (about 60%). The results showed that increase in age increases the level of knowledge about infection and vaccination of HPV. So that, the increasing trend in HPV vaccination is significant (p-value> 0.05). In general view, statistical data showed that variables such as gender and marital status do not have a significant effect on knowledge of individuals. The findings showed that there is a significant difference in knowledge about HPV vaccination among different groups (P-value <0.05), and gynecologists and infectious specialists have the highest level of knowledge compared to other people. Knowledge and attitude about HPV infection and vaccination was relatively desirable among medical students and personnel in our study. Constant aimed training may be useful in increasing the level of knowledge and attitude of these people.

The aim of this study was to evaluate the role of mediation of self-compassion in the relationship between rumination and depression symptoms in Veterans with Post Traumatic Stress Disorder This research is descriptive and co relational. For analyzing the hypothesized model, the path analysis was used. The research population was all of the veterans with PTSD diagnosis in Tehran who used the services of the military hospitals of the Islamic Republic of Iran. A total of 90 people were selected randomly in a cluster sampling. Beck depression questionnaire, and Neff rumination and self-efficacy questionnaire were used to collect information. The results of the indirect effects test, using Amos software, showed that the degree of indirect effect of rumination variable on depression through the mediatory variable of self-compassion (β=0.51) at a confidence level of 95% was meaningful. Considering the significance of the hypothesized model of research, it can be said that self-compassion can decrease the symptoms of depression in veterans with PTSD by affecting rumination. Therefore, self-compassion interventions in this clinical group can be fruitful.

Vitamin D deficiency is prevalent in different societies. It has a role in calcium and phosphorus homeostasis, growth and mineralization of bones, prevention of endocrine, allergic, and autoimmune diseases, and therefore it is important to identify its deficiency in the community, especially in children that are at the age of growth. The aim of this study was to evaluate the vitamin D3 status in children under 15 years of age admitted to Urmia 523 Hospital. 235 children under the age of 15 years of the patients admitted to the laboratory of 523 Urmia Hospital, from April 1 2017 to March 2018, were enrolled in this study. The results of blood tests including vitamin D, calcium (Ca), phosphorus (P) and alkaline phosphatase (ALP) enzyme were collected and the effects of gender, age and season of sampling were investigated. Regarding the level of vitamin D in blood, 75 children (31.9%) had severe deficiency, 54 one (23%) had mild deficiency and 106 one (45.1%) were in normal status. There was no significant difference between the levels of phosphorus in the three groups, but the calcium level in the normal group (10.0±1.1) was significantly higher than two deficiency groups (9.7±0.5 and 9.9 ±0.4). The level of alkaline phosphatase in the severe vitamin D deficiency group was significantly higher than the other two groups. There was no significant difference between male and female patients in terms of vitamin D levels. Considering age groups, the level of vitamin D in the toddler group (0-5 years) was higher than that of the child (5-10) and adolescents (11-15), and there was a significant difference between the two groups. In terms of seasonal difference, the highest level of vitamin D was observed in autumn and its lowest level was observed in spring, and this difference was quite significant. (p<0.05). The results of this study demonstrate high prevalence of mild to severe vitamin D deficiency in children under the age of 15 years. Lower levels of calcium and higher levels of ALP enzyme also indicate the effects of vitamin D deficiencies on the metabolic status and health condition in individuals. The seasonal variation of vitamin D in the study population confirms that the amount of exposure to sunlight has a significant effect on the levels of this vitamin in the blood. Therefore, changing the living style to get more sunlight, along with improving the diet, can play a significant role in promoting community health by preventing nutritional deficiency diseases.

Shoulder girdle deformities, in addition to pain and motor limitation, impair the function of the shoulder, neck and back, which affects the function of the shoulder girdle and all upper limb activities. The purpose of this study was assessment of the shoulder girdle corrective and training device soldiers. The device was designed with AutoCAD software and then built on AutoCAD 3D software. In order to determine the effect of this device, 36 soldiers with superficial upper cross syndrome and uneven shoulder, were purposely selected from soldiers of the Military unit. Then, they were randomly divided into three experimental groups (exercise with the device), the second experimental group (selected exercises) and the control group. The subjects of the experimental group 1 and 2 participated in the training sessions for 8 weeks each week, while the control group continued their day-to-day activities. The first group exercises consisted of four movements with the device and the exercises of the selected group included four movements using the Thera band. A flexible ruler was used to measure the kyphosis angle of the subjects, shooting with the camera to measure the forward head and forward shoulder of the subjects, and the Protractor to measure the uneven shoulder of the subjects, and the mean of the pre-test and post-test was calculated. Descriptive and inferential statistics ( t-dependent, independent t-test) were used to analyze the data. The results showed that the comparison of the post-test and pre-test difference between the first and second experimental groups in forward head, forward shoulder, Uneven shoulder and kyphosis anomalies were not significant (p<0.05). Therefore, it can be concluded that the shoulder girdle modifier device is effective in correcting shoulder girdle deformities (forward head, forward shoulder, uneven shoulder, and kyphosis).

Sulfur mustard is a gas warfare that is absorbed through inhalation and direct contact with the skin or through the digestive tract following contaminated food. In human studies, non-hydrolysed mustard in the brain and fat deposits even after many days after exposure. Disposal of this substance occurs through body secretions such as semen, urine, sweat and blood. The effect of mustard is mainly on the level of other toxic materials, ie, fast cell division, and liver cells. In this research, 30 male albino 200g were divided into three groups: normal, solvent group , and sulfur mustard group. For the experimental group, 10 micrograms per kilogram of mustard dissolved in a tyrods buffer was injected intraperitoneally. After 8 weeks, the rats were anesthetized and then slaughtered and described in the hood and sampled from the liver and testis. The sample was placed in a 10% formalin for tissue processing and was applied to the microtome of 5 micron sections. The specimens were studied by light microscopy after hematoxylin-eosin staining. The results were analyzed using SPSS software and T-test. P <0.05 was considered statistically significant. In the mustard group, the liver tissue was solidified and dried, and extensive necrosis areas were observed in the lobules, as well as vacuolating hepatocytes, hepatocyte necrosis, edema of the port, and blood cell infiltration and lymphocytes. The thickness of germinal epithelium in the mustard group decreased, and the adluminal cells were isolated and discontinuous. The number of seminiferous tubule in the microscopic section was reduced in the mustard group and interstitial edema was seen, and leydig cells also became smaller in the mustard group. The results of this study have shown that changes in the appearance of the liver, necrosis in the hepatocyte, as well as the destruction of the liver cells, dilatation and hypertension of the sinuses, the formation of fatty vacuoles in the hepatocyte cytoplasm, swelling and Picnotic hepatocytes as well as blood cell infiltration were observed in sinusoids, central vein of the lobule and port in the liver. In the testis, loss of the integrity of the testicular tissue, increased space between the seminiferous tubule and interstitial edema, reduced thickness of germ epithelium, and the presence of necrotic forms of spermatocyte cells and reduced its number, decreased the volume and number of Leydig cells. In conclusion, it can be concluded that Mustard can cause spermatogenesis in years after exposure, leading to infertility and changes in the level of liver enzymes and their function.

The purpose of this study was to determine the relationship between personality factors and happiness in the couples’s adaptation to the counseling centers in District 1 of Tehran. This descriptive study was a correlation type. The sample size of this study included 260 couples (130 women and 130 men) who were referred to counseling center in district 4 of Tehran and were selected by available sampling method. The research tools were five-factor questionnaire of Neo character, Oxford Happiness and Enrique's marital adjustment. Data were analyzed using SPSS 21 software and multivariate analysis of variance (MANOVA). The results of regression test show that there is a significant and significant relationship between marital adjustment and happiness in the level of 0.05. There is a significant and significant relationship between marital adjustment and spiritual intelligence at the level of 0.01.