مجله طب نظامی
سال بیست و سوم شماره 7 (پیاپی 104، مهر 1400)

Achieving the optimum levels of combat readiness, its assessment and maintenance have great priority in countries' military forces. This research was carried out with the aim of assessing the combat physical fitness of the military forces army center.

In the cross-sectional descriptive study, 50 volunteers aged 27.5 years, 176.7 cm height; 73.2 kg body weight and 23.5 body mass index were selected non-randomly and intentionally as study samples and voluntarily take part in the study. After familiarization the main test session including 23-meter-two-speed movements, J-Hook scrolls, 23 meters of crawling, 69 meters causality drag, 69 meters carrying two ammunition boxes, a grenade launcher + Swedish push-up and running 600 meters accomplished. Statistical analysis of data carried out with SPSS version 24 using descriptive statistics (mean, standard deviation, standard score).

Results showed that at the total test time and 600-meter endurance running test participants gained 3.01 min and 1.43 min respectively. In addition, subjects have a record of 17.9 seconds in carrying two ammunition boxes, 26.77 seconds in causality drag, 4.97 seconds in 23 meters and 17.56 seconds in crawling.

Based on the optimum results of the total test time, endurance running, subjects’ records in strength endurance tests. It could be concluded that in cardiovascular and muscular endurance components of combat physical fitness studied armies were in optimum levels but in other elements such as in strength endurance and speed they had suboptimum performance. It suggested that greater emphasis should be focused on strength endurance or speed training in the comprehensive planning of army physical training.

Transcranial Direct Current Electric Stimulation (tDCS) is a non-invasive treatment. The purpose of the current study was to compare the effectiveness of Transcranial Direct Current Stimulation (tDCS), Eye Movement Desensitization and Reprocessing (EMDR) on PTSD symptoms.

This was a double-blind, controlled randomized with pretest-posttest design. The statistical population included patients with PTSD in Atieh clinical neuroscience center and Baqiyatallah University of Medical Science (1396 to 1397), in which 44 subjects were selected using a purposive sampling method and then randomly divided into two experimental (EMDR=14, tDCS=15) and one control (n=15). Active and sham tDCS groups received bilateral active and sham stimulation (2mA) on dorsolateral prefrontal cortex (DLPFC) during 10 sessions. The EMDR group also received 5 sessions of EMDR treatment. The research tool was included the PTSD-Checklist for DSM-5 (PCL-5). The data were analyzed by multivariate analysis of covariance (MANCOVA).

Symptoms of PTSD were significantly reduced in the experimental groups compared to the control group in the post-test and follow-up periods (P<0.05) While there was no significant difference between the two experimental groups in the post-test and follow-up stages (P>0.05).

The tDCS method can be used as a non-invasive treatment to reduce the symptoms of PTSD.

Early and early detection of psychological distress and ensuring the psychological health levels of military personnel using screening tools is of great importance in increasing the performance and combat capability of the armed forces. Therefore, the purpose of this study was to investigate the psychometric properties of the Iranian version of the Mental Health Inventory (MHI-38) in military personnel and to compile a lie detector scale for it.

The present study was a descriptive and correlational psychometric design. The statistical population included all the employees of the Army of the Islamic Republic of Iran, from which 420 people were selected by cluster sampling. The Mental Health Inventory (MHI-38), the Beck Anxiety Scale (BAI), the Beck Depression Inventory (BDA-II) and the General Health Questionnaire (GHQ-28) were used to collect data. Face validity and internal consistency were assessed using qualitative method and Cronbach's alpha coefficient, respectively. Pearson correlation coefficient was also used to evaluate the reliability of retest, concurrent validity, divergent validity and convergent validity.

The internal consistency values of the Cronbach's alpha mental health checklist for well-being and psychological distress and the whole scale were 0.79, 0.80 and 0.81, respectively. Also, the reliability coefficient of the retest was calculated to be 0.79, 0.76 and 0.75, respectively. Simultaneous validity of the mental health inventory was -0.55 for psychological well-being and 0.65 for psychological helplessness. Also, divergent validity for well-being and psychological helplessness was -0.59 and -0.64, respectively, and convergent validity was 0.65 and 0.51, respectively. All coefficients were significant at the level of P<0.01.

Based on the results of this study, it can be said that the mental health inventory has good reliability and validity and can be used for research and clinical purposes in the field of mental health of the military.

Due to the nature of tasks, nursing is a job with a high prevalence of skeletal and muscular disorders, which increased skeletal muscle pain and fatigue. The aim of this study was to determine the effect of foot reflexology on the severity of skeletal and muscular pain and fatigue of nursing staff.

In this clinical trial study, all nurses in NEZAJA in the southwest of Iran (60 nurses) were selected between August and January 2017 according to the entry criteria and then randomly assigned to two groups of intervention and control. For the intervention group, according to the location of the pain, the foot reflexology protocol was administered during 9 sessions for 3 weeks and 3 sessions of 30 minutes per week. Data collection tools included a demographic information questionnaire, Nordic Musculoskeletal Questionnaire, numerical scale of pain intensity and fatigue.

The results of our study also showed that out of 9 parts of the body, the intensity of pain in the neck (P=<0.001), back (P=0.003), knees (P=0.010), feet (P=0.002), thigh (P=<0.001) and hand (P=<0.001) after reflexology was significantly reduced in the intervention group compared to the control group. Reflexology also reduced fatigue in the intervention group, but this reduction was not statistically significant compared to the control group (P=0.129).

The results showed that reflexology reduced the severity of musculoskeletal pain in some parts of the body and reduced fatigue. Therefore, it is recommended that foot reflexology be used as a simple and cost-effective method to reduce the severity of skeletal and muscular pain in nurses.

After the World Health Organization (WHO)'s 2000 report, views shifted in that direction of strategic purchasing in medical services. WHO stated that adequate funding for health is an important issue, but financial resources alone cannot lead to universal health coverage. WHO defines "Strategic purchasing" as a measure to maximize the efficiency of countries' health systems to answer these questions: what to buy / from whom to buy/how to buy and for whom to buy.

This study was conducted in four main stages, including identifying the concept of "strategic purchasing" in the health system using the critical method and review resources, review of strategic purchasing policies in the Iran Armed Forces Health Insurance Organization, identifying the main policy factors of strategic purchasing by insurance from the perspective of experts in this field and finally evaluation of strategic purchasing in insurance and providing solutions and suggestions for its implementation. A validated questionnaire was developed and the Likert technique was used to score the results.

The results were presented in sub-categories, which included identifying the concept of "strategic purchasing" in the health system and the Iran Armed Forces Health Insurance Organization, effectiveness and contracting for the supply of medicine with the lowest price and quality of the product is a top priority for policymakers. In response to the four basic questions of strategic procurement, various factors and their contributions were measured.

Strategic procurement of health services is very necessary for health insurance organizations. Therefore, it is better to take steps to implement it as soon as possible. In addition to the findings of this study, including determining the factors for the strategic drug purchasing process, one of the most important policy findings of this study in interviews and discussions with experts was that theoretically, we all know what strategic purchasing is and what are the steps involved, but in practice, there is not any plan to implement it or we do not have the ability to implement it due to the existing infrastructure and policies. So, in addition to raising awareness, a proper understanding of the process must be established so that policy-making and implementation can follow, which requires integrated decisions.

Human resources are the most important resource in any organization. Therefore, it is very important to pay attention to the quality of their working life, since it covers a large part of the employees' lives. The aim of this study was to study the role of quality of work-life on staff performance in a military university.

This research is a quantitative research and is applied in terms of purpose. In terms of strategy, it is a descriptive survey and causal research. The statistical population included the staff of a military university in Tehran, 262 people were selected as a sample using the available sampling method. In the proposed model, the quality of work-life was considered as an effective variable that has 8 dimensions of fair and adequate payment, safe and healthy work environment, providing opportunities for growth and continuous security, legalism in the labor organization, social dependence of working life, general space Life, integration and cohesion in the organization was the development of human capabilities and also job performance was considered as an influential variable that had three dimensions of skill and knowledge, quality, responsibility. Variables were assessed using a questionnaire with three sections: demographic questions, quality of work-life questions and employee performance questions.

The research findings showed that fair payment with a coefficient of 0.81, provision of growth opportunity with a coefficient of 0.76, legalism with a coefficient of 0.74, development of human capability with a coefficient of 0.69, safe work environment with a coefficient of 64. 0, integration and cohesion with a coefficient of 0.6, social dependence with a coefficient of 0.59 and the overall living space with a coefficient of 0.57 affect the performance of employees.

Universities are the scientific driving force of the country in the national and international arenas and the dynamism and promotion of its staff can have positive results in the national arena. However, improving the performance of staff depends on the quality of their working life. The results of this study showed that fair payment, growth opportunity and legalism as dimensions of quality of working life have the greatest impact on employee performance, respectively, and more attention should be paid to them. The results also show a positive and significant relationship between other dimensions of quality of work-life and employee performance.