مجله علوم پیراپزشکی و بهداشت نظامی
سال شانزدهم شماره 4 (پیاپی 42، زمستان 1400)

Musculoskeletal disorders (MSDs) are the most common type of occupational disease and injuries in the workplace that lead to reduced productivity, efficiency, and disability of individuals especially among military personnel. This study aimed to determine the prevalence of MSDs among the administrative staff of a military center and to identify ergonomic risk factors in the occurrence of these disorders.

 In the present cross-sectional study, 53 administrative staff of a military center located in Karaj city in 1400 that was selected by census method. Data collection tools included demographic information form, the Nordic Musculoskeletal Questionnaire (NMQ) to estimate the prevalence of MSDs, and the ROSA method to evaluate posture. Data were analyzed through descriptive statistics, T-test, and Fisher’s exact test using SPSS software version 26.

All subjects were male and the mean age of the administrative staff of the military center was 41/43±6/564. The highest prevalence of these disorders was 56.8% in the knees, 54.1% in the shoulders, and 40.5% in the neck and upper back. The final score risk level of the ROSA rapid office stress assessment method includes 32.5% (n = 12) at the safe level with a score of less than 3, 62.1% (n = 23) in the alert area with scores between 3 to 5 and 5.4% (2 people) are in the area of need for ergonomic intervention with a score above 5.

According to the average ROSA score, employees were in the warning area in terms of ergonomic risk factors. Discomfort and pain in the knees and shoulders are the most common postural abnormalities and MSDs in the administrative staff of this military center respectively. Taking corrective measures in workstations, reducing the duration of using electronic devices, increasing the rate of sports and stretching activities during working hours, and increasing the level of knowledge and awareness of employees by providing organizational training can be mentioned to reduce and prevent the prevalence of MSDs in the study group.

The Covid-19 virus affects the hemostasis system in infected people by causing thrombosis and it increases the level of D_dimer. This study was designed and conducted for the evaluation of correlation between D-dimer levels with disease severity in patients with Covid-19 referred to Hamedan Besat hospital.

 366 patients with Covid-19 referred to Besat Hospital in Hamadan were randomly selected in this cross-sectional and retrospective study. The severity of the disease was assessed as level 1 that is the need for intensive care and level 2 which means the need for hospital care. The collected data were analyzed through Pearson correlation and independent t-test using SPSS software version 24.

The mean level of D-dimer in patients was 1.18 ± 1.01 microgram per milliliter. Disease severity was observed in 179 patients (47.3%) at level 1 and it was observed in 187 patients (52.7%) at level 2. Furthermore, the mean level of D-dimer in patients with level 1 was significantly higher than patients in level 2 (P value: 0.0001). There was a significant direct relationship between D-dimer level and hospitalization time and D-dimer level with ICU admission time (P value: 0.0001).

D-dimer level is more correlates with disease severity and it impacts on duration of hospitalization and ICU hospitalization.

The spread of corona virus and its psychological consequences is one of the most important human social events in the 21 century. Sailors are vulnerable to the virus and they have severe psychological consequences. Therefore, the aim of this study was to predict Covid-19 anxiety based on coping strategies and emotion regulation in Iranian sailors.

The present research is a descriptive cross-sectional correlation study. The statistical population of the present study includes all Iranian sailors in 2020-2021, whose total number was estimated to be over 500 people. According to Cochran’s table, 150 people were selected by available sampling method from sailors in Nowshahr city of Mazandaran province. Moreover, Lazarus and Folkman coping strategies questionnaires, John and Gross (2003) Emotion Regulation and Corona Virus Anxiety Scale in Cyberspace has been responded by those seafarers who were willing to cooperate in the study.

Out of 150 male sailors participating in the study, their age range was from 25 to 54 years and their mean and standard deviation was 38.79 ± 7.738. Among the components of coping strategies, problem-oriented and emotion-oriented coping strategies were achieved with mean and standard deviation of 52.26 ± 3.12 and 68.55 ± 3.47 respectively, emotion regulation components including emotional repression and emotional re-evaluation were achieved with mean and standard deviation of 23.43 ± 5.64 and 19.45 ± 4.22 respectively. In addition, components of corona virus anxiety including psychological and physical symptoms were obtained with mean and standard deviation of 32.67 ± 5.47 and 17.39 ± 2.89 respectively. The results also showed that the regression model used was significant (F = 14.39) and this model with a coefficient of determination of 0.32 had the ability to explain the relationship between variables. Multiple correlation between variables was 0.41 (R = 0.41) (P <0.05).

According to the research findings, it can be said that coping strategies and emotion regulation are effective factors related to corona virus anxiety, which can be considered in maritime centers and sailors.

The professional ethics is the integral part of all dimensions of providing health care services. In recent years, promotion of the professional ethics among medical sciences students becomes very important particularly the ones which are directly in contact with patients. This study aimed to define the relationship between clinical experiences of the operating theater students and the level of adherence to professional ethics.

The descriptive-analytical study was carried out among 87 undergraduate students of operating theater. The sampling was done by census and included all of the 4th, 6th and 8th semester undergraduate students of operating theater which met the criteria to involve in the study. The data were collected by the standard questionnaire of professional ethics and the demographic information questionnaire. Then, they were analyzed by SPSS software version 21.

87 students were participated in this descriptive-analytical study. 35 of them were men (40.2%) and 51 of them were women (58.6%). In this research, the average age was estimated as 22.51 years. The results indicated that there was a significant relationship between the semester, and as its consequence, the clinical experience of the students and professional ethics (p = 0.011). The results also showed the significant relationship between age and professional ethics (p = 0.020).There was no relationship between ethnicity, average mark, sex and professional ethics.

The results of this study showed that increasing students clinical experience and their involvement with issues and problems in OR along with theoretical and practical training in the clinical environment enhance the level of professional ethics among students and later as staff in the clinical environment.

In the past years, workplace violence in the area of health has been reported with an upward trend. This study aimed to evaluate the prevalence of workplace violence of emergency medical staff and relevant factors in Chaharmahal-Bakhtyari province in 2020.

 This descriptive, analytical, and cross-sectional research was conducted in the emergency medical centers of Chaharmahal-Bakhtyari province in 2020. Census method was applied and 125 staff of these centers was selected considering the limited research population. Data were collected through a self-report questionnaire. In addition, data analysis was performed using Chi-square and Fisher’s exact tests in SPSS version 19.

In this research, 88% of the participants had an experience of workplace violence in the past year. 36% of which has been physical, 54.4% of them were verbal violence and 9.6% of them were cultural violence. In addition, 62.4% (N=78) of the staff has reported to be the companions of patients as the source of violence. Moreover, 84% of the participants believed that there is no proper procedure to report workplace violence. There were no significant relationships between workplace violence in the emergency medical staff and variables of age, marital status and work experience.

Emergency medical personnel are exposed to high levels of violence. Special training should be provided to emergency medical personnel in controlling violence and educating the media to improve public health and reduce job burnout.

The rapid spread of covid-19 and its unknownness has caused public fear and concern and it has affected almost all important economic, political and social aspects of the country.The aim of this study was to determine the relationship between anxiety caused by coronavirus pandemic and psychological well-being of hospital staff.

This descriptive cross-sectional study was conducted in May 2016. For this purpose, a sample of 200 men and women related to the medical staff in hospitals of Birjand was selected by available sampling method. Moreover, the standard questions of Reef (2002) Psychological Welfare Questionnaire including 54 questions and Coronary Anxiety Scale (CDAS) in the Iranian sample that contained 18 questions were answered by participants. Statistical analyzes were performed using SPSS software.

The results showed that there was no significant relationship between psychological well-being and anxiety at the level of 0.5. Examining the relationship between psychological well-being and corona virus anxiety in different sections, the results showed that the relationship between psychological well-being and corona virus anxiety in health workers was R = 0.98 (P = 0.002) and 96% of health workers’ anxiety changes were due to psychological well-being changes. Furthermore, 98% of the changes in pharmacy staff anxiety were due to changes in their psychological well-being (R = 0.988 and P = 0.12). There was no significant relationship between psychological well-being and corona virus anxiety among male and female employees and the mean of psychological well-being was significantly different between men and women.

Based on the findings, the relationship between psychological well-being and anxiety status was not significant at the 0.5 level. Although there was no significant relationship between corona virus anxiety and psychological well-being, this issue is significant in some areas such as health and pharmacy staff. Additionally, this relationship should not be ignored but it should be acknowledged and considered by the relevant authorities.

Surgical site infection (SSI) is the most significant postoperative complication. The sources of microorganisms that cause SSIs in healthcare facilities are multifactorial in origin and they may be endogenous (e.g. patient’s own normal skin flora) or exogenous (e.g. airborne bacteria-carrying particles [ABCPs]). The skin flora of patients is the direct source of contamination in only 2% of cases and remaining 98% of cases connected to ABCPs. Therefore, the current study tried to provide useful information for surgical team about the roleof ABCPs in contamination of sterile surfaces in the operating room (OR); moreover, this study provided strategies to deal with it.

The present research was a descriptive study performed by review method. Data were collected by searching various databases including Science Direct, PubMed, Scopus, and Google scholar search engine.

Surgical wound contamination (SWC) and SSI prevention depends on minimization of ABCPs. Hence, maintaining clear air in the OR by using the efficient ventilation systems, limiting traffic and opening doors and using of non-woven fabric instead of cotton fabric can maintain low ABCPs in the OR environment and they reduce the chances of infections by ABCPs transmission.

Everyone on the surgical team is responsible for establishing and maintaining a sterile field by using sterile techniques to prevent SWC and SSI. The results of this review suggests that OR staff should be educated about routes of sterile field contamination by ABCPs to be able to prevent risk of SWC and incidence of SSI.

Physical fitness is one of the most effective factors in optimal military missions’ performance. Doing exercises to increase fitness is associated with musculoskeletal injuries, which besides reducing the quality of performed tasks, it costs a lot for the health care system. This study aimed to investigate the prevalence and type of musculoskeletal injuries due to military training education and its risk factors. Finally it provides suitable solutions to reduce them.

This narrative review study has been performed by searching military, injury prevention, and skeletal muscle keywords in various databases such as PubMed, Scopus, Science Direct databases, Google Scholar search engine and Persian articles.

The findings indicate a high prevalence of musculoskeletal injuries during military training. The most common injuries are overuse, stress fracture, muscle strain and sprains, especially in the lower extremities. The prevalence, type and area of injuries are different dueto differences in the type of military task. For example, Stress fracture and overuse and infantry Stress fracture are common in the Marines. In general, injury risk factors are divided into intrinsic and extrinsic types. Internal risk factors include age, sex, physical activity and fitness, body mass index, fatigue, and body structure. Extrinsic risk factors include heavy loads carriage, footwear, running surface, type of exercise, malnutrition and insomnia. Many solutions have been recommended to reduce these risk factors. For example, designing exercise according to the level of fitness and physical structure of soldiers, using new training methods that are associated with less damage, adequate nutrition and rest, training of instructor and medical staff and optimization military equipment such as footwear and backpacks.

It seems that successful modifying of these risk factors can be effective in reducing injury and improving military training.