مجله طب نظامی
سال بیست و چهارم شماره 5 (پیاپی 114، امرداد 1401)

Disruption in the physical- psychological- social- spiritual health of patients and the psychological consequences resulting from the biological crisis of the COVID-19 pandemic requires the management of health services. Therefore, this study aimed to investigate the role of spiritual communication in health services management during the biological crisis of COVID-19.

This qualitative study was conducted from April 2020 to July 2021 at Baqiyatallah Military Hospital in Tehran, by using "Strauss and Corbin's grounded systematic theory". To identify the central phenomenon, causal conditions, background factors, intervening factors, strategies, consequences, and their relationships, in-depth interviews with 22 patients and hospital staff, field observations, and a comprehensive review of the report were conducted. The data were analyzed in three stages open, central, and selective coding by using the MAXQDA software.

Spiritual communication had an impact on the health services management. The main strategy of patients and the treatment team in dealing with the biological crisis was the use of medical treatments, along with trust in God and appeal to imams. Safe attachment to God, as a health-giving relationship, by affecting other relationships (with self, people, and nature) optimized the management of health services. Communication with God as a central phenomenon, increases spiritual attitude, spiritual self-awareness, spiritual motivation, resilience, and adaptability. It also strengthens the social relations of the treatment team with patients and families, professional commitment, empathy, cooperation, sacrifice, and courage in the face of crisis. Communication with the environment and people caused socio-spiritual support.

Considering the impact of safe attachment to God on optimizing the health services management in the COVID-19 crisis, it is necessary to provide spiritual health services in Iranian hospitals by trained health system employees.

Pain is one of the most complex processes in the human body, having various physical and psychological dimensions. To date, many preliminary studies have been conducted in the field of pain management in the Intensive Care Unit (ICU), but to our knowledge, no study has been found that summarizes the results in one article. Therefore, the present study aimed to investigate pain reduction management in the ICU via systematic review.

To find studies related to the research objective, the databases SID, MagIran, Embase, PubMed, Scopus, Web of Science (WoS), and Google Scholar were searched using the keywords Therapy, Interventive, Intervention, Therapeutics, Therapies, Treatment, Effect, Management, Intensive Care Units, ICU, and Pain with no time limit until September 2021. A qualitative assessment of articles was performed using the checklist CONSORT.

During the initial search, 7190 studies were found, of which 56 articles were finally included after deleting studies not related to the purpose of the research. According to the studies, it can be concluded that pain medications significantly reduce pain in the ICU, but the effectiveness of different medications varies. In addition to medications, Complementary and traditional medicine methods such as acupuncture, massage therapy, music therapy, cold therapy and the use of lavender can also contribute to pain relief in the ICU. However, further studies are needed on the effects of other therapies, including hypnosis, meditation, and education.

The results of this study show that modern and traditional medicine treatments are complementary. Therefore, in the ICU, they can be used as a supplement to manage patients’ pain.

The military structure of military occupations in comparison with civilian occupations puts employees in a variety of stressful situations related to the work, family, and organizational environment. The aim of this study was to investigate the prevalence and stressful sources of militarism in a group of military personnel.

The present research method was descriptive with a cross-sectional design. The sample studied in this study was 300 active military personnel who were selected by the available sampling method. The instrument used in this study was the scale of Azad and Nedaei's (2020) Military Stress Factors Scale. The research questions were answered through statistical methods of frequency distribution, mean and standard deviation, and t-test.

The results showed that 61.3% of employees are moderately stressed and 19% of them are exposed to severe stress. Also, the result of the t-test indicates a significant difference between the mean stress of the sample group and the mean of the population.

Significant military stressors are ongoing among employees that endanger their mental health. Systematic interventions should be provided to prevent the aggravation of stressors and reduce stress among employees.

Cartilage defects treatment is one of the most common clinical challenges in orthopedics. The current management techniques help to control symptom and joint function. The cell-free approach to cartilage regeneration through paracrine action has been considered to accelerate and facilitate the healing process and the importance of its urgency in the recovery of military personnel. Exosomes, one of these paracrine mediators, are nanoscale extracellular vesicles.

An electronic search was performed on databases at PubMed and EMBASE with keywords such as stem cells, exosome cartilage and reconstructive medicine since 2000 to 2021.

Functional cargos like miRNA and mRNA molecules, peptides, proteins, cytokines and lipids are transferred by exosomes from MSCs to the recipient cells. The use of exosomes as a cell-free method without creating an immune response can be promising in the treatment of joint diseases.

It has been found that exosomes are involved in intercellular communication events and due to their similarity to the plasma membrane, the lack of activation of the immune system and the secretion of large numbers of cells can be an important factor in the healing of damaged tissues and organs. Exosomes can also be used as a safe, high-availability treatment for the treatment of osteoartritis disease.

Telematics, or new electronic health media, is a growing topic that is becoming a major improvement in patients' lives, especially for the elderly, disabled, and chronically ill. In this context, mobile health provides healthcare services and overcomes geographical, time, and even organizational barriers. In this review, we examine the services and applications of mobile health in various diseases and the clinical trials conducted in connection with health-oriented applications, and the challenges ahead.

This systematic review will extract related studies in domestic and foreign databases including PubMed, SID, Science Direct, Scopus, and Magiran with the keywords of disease self-management, e-health, health care, telematics, and mobile health. The period from 1390 to 1400 was conducted with both Persian and English languages based on the search strategy. The articles were included in the study based on the inclusion criteria.

According to the review of the articles, it was found that physical and mental health problems create challenges for army veterans, returning troops, and military family members, including spouses and children. The challenges of meeting physical and mental health needs include improving access and quality of care. Mobile health can help to meet these needs in military and civilian environments.

With the broader participation of members of the healthcare and informatics communities, both from the private and public sectors, regulations related to the use of health applications will become reasonable, provided that these regulations apply to mobile medical applications that pose potential risks to public health. If they do, it should be applied.

Exposure to impact noise (short-term, high intensity) higher than permitted levels results in injury to the auditory system. Armed forces are one of the occupational groups exposed to these types of noises resulting from gunshots. In this study, relevant articles and research on the adverse effects of impact noise, hearing loss, and tinnitus in armed forces and effective control methods are reviewed.

In this review study, the databases of Web of Science, Scopus, PubMed, Science Information Database (SID), Islamic World Science Citation Center (ISC), and Science Direct were searched with the keywords including noise-induced hearing loss, armed forces, impact noise, control and exposure in armed forces and shooting range. Through determining entrance and exit indicators and consultations among writers, from 68 evaluated articles, 42 entered the study, and 26 were removed.

Several studies measured the gunshot noise level and found that exposure to this noise resulted in different auditory complications depending on the frequency and intensity of exposure. Baseline characteristics and lifestyle are parameters involved in developing noise-induced hearing loss. Active and passive noise control methods and the use of hearing protection devices are among the measures adopted to reduce the intensity of exposure and decrease the detrimental effects of noise on the auditory system.

The use of hearing protection with an active noise cancellation has been developing during the past years, however, it is recommended to use both noise control engineering and hearing protection to reduce the highest level of harmful noise possible when firing a weapon. It should be noted that to prevent hearing loss in the military staff, it is necessary to build medical records upon recruitment for hearing monitoring and conduct periodic examinations.