مجله طب نظامی
سال بیست و چهارم شماره 7 (پیاپی 116، مهر و آبان 1401)

Green Hospital is a concept that protects the environment from destructive human actions. It has emerged to achieve the goals of sustainable development, following the world wars, the industrial revolution, and the increment of environmental destruction. Further, Hospitals have moved towards the implementation of green hospital criteria according to their social responsibilities. This study aimed to investigate the challenges of achieving green hospital indicators.

The present study was conducted as a Mixed Method (quantitative and qualitative) in a military, educational, and selected reference hospital in Tehran in 2016. The first phase was quantitative which was performed based on collected information through translated checklists and initial hospital statistics. In the second phase, qualitative information was obtained by using semi-structured interviews with 10 hospital employees working in the fields related to the green hospital, Finally. the data were analyzed with EXCEL and ATLAS.ti software (Version 7) by utilizing central criteria (quantitative) and conventional content analysis (qualitative).

Based on quantitative findings of the checklist, the rate of compliance with the Green Hospital criteria was 56.8 percent. In the qualitative phase, the main challenges of the hospital were divided into two main categories (Internal and External factors) and 7 sub-categories, including the challenges of human resources, organizational and managerial, technical, financial, laws and foreign issues, cultural, and factors related to the organization's clients.

Based on the identified challenges, hospitals should work with external collaboration on educating and cultivating the clients and staff, amending government laws, modifying management thinking against environmental issues, and prioritizing these issues to pave the way for achieving green hospital criteria.

Considering the nature of post-traumatic stress disorder (PTSD) in the military profession, challenges in the effectiveness of psychological interventions on the symptoms of the disorder and sustainable recovery have been reported among the military population. The present research aims to identify effective psychological interventions for PTSD symptoms and compare their effectiveness as first-line therapy (trauma-focused) and second-line therapy (non-trauma-focused).

The systematic review method has been performed in the present research. Related studies from 2010-2022 were reviewed and 41 qualifying studies were selected. The database included Elmnet, Magiran, Google Scholar, Pubmed, Science Direct, PsycINFO, and SID.

Focused first-line interventions included therapies based on mindfulness, cognitive-behavioral, long-term exposure, cognitive processing, and eye movement desensitization and reprocessing (EMDR), which were applied in clinical trials. Other non-trauma-focused therapies had a significant effect on improving PTSD symptoms compared to the wait group. The risk of bias was low in clinical trials and higher in non-trauma-focused therapies. Nevertheless, when the conventional therapies and second-line therapies were performed on the control group, the effectiveness was often equal or with insignificant differences. Including continuous and intensive individual, written, online, and home-based sessions, particularly the integration of non-trauma-focused therapies played a special part in the effectiveness of interventions and reducing the dropout rate.

The first-line interventions to treat PTSD also have their pros and cons. Changes can be made to resolve these challenges, including the homogenization of subjects, shorter intervals between sessions, integration of the conventional and non-trauma focused therapies, using writing tools and smart phones, personalized interventions, and trust in second-line therapies in terms of clinical trials

Employees in power plants are exposed to noise due to working with booster pumps, condensers, fans, boilers, steam valves, and other equipment. Noise, as a common detrimental factor, has devastating effects on human health. Today, infertility is one of the problems observed in different societies, and it is possible that noise, as a job stressor, affects fertility factors. The aim of this study is to investigate the relationship between occupational exposure to noise and the levels of some reproductive hormones in men working in power plants.

A descriptive-analytical study was conducted among the employees of different sections of the selected power plant around Tehran, in 2019. One hundred and twenty-two men working in the power plant were selected based on the age of 20-50 years, no history of infertility, and no use of bodybuilding supplements and steroids. They completed the Smoking and Petersburg Sleep Quality Index (PSQI) questionnaires, and their height and weight were measured to calculate Body Mass Index (BMI). Noise exposure was measured using the sound meter (SLM). Regarding the duration of each job task, the equivalent sound pressure level for individuals was calculated. Serum levels were determined for free testosterone, luteinizing hormone (LH), and follicle stimulating hormone (FSH). The data were analyzed using SPSS version 25 statistical software.

There was no statistically significant relationship between demographic factors (marital status, work shift, education, sleep quality, and smoking) with serum levels of free testosterone, LH, and FSH. With increasing age (r=-0.25, P=0.005) and work experience, serum levels of LH decreased significantly (r=-0.203, P=0.025). In the study of the relationship between BMI and hormone levels, despite a decrease in the level of reproductive hormones with weight gain, no significant relationship was observed (P>0.05). There was no significant relationship between noise exposure and serum levels of free testosterone, LH, and FSH (P>0/05).

There was no relationship between noise exposure and demographic factors with the levels of free reproductive hormones, testosterone, LH, and FSH. However, it is not possible to make a definite statement in this regard without using more accurate methods to estimate male fertility performance and using a stronger study method.

The aim of this study was to discover and explain factors affecting the health-oriented sport of the Iranian Armed Forces. Sports policy-making will not be possible without a comprehensive investigation of all the effective factors and their importance.

Semi-structured interviews were conducted with 20 elites of the Armed Forces of the Islamic Republic of Iran, including 12 managers, commanders, and eight academic elites. Data were analyzed through a three-step coding based on grounded theory. Researchers sought to identify the factors influencing the sports policies of the Armed Forces of the Islamic Republic of Iran by coding in three steps (open codes, themes, and categories).

After data analysis, 1316 open codes were categorized into five primary interventions, including legal interventions (767 codes, 58.3%), social environment interventions (269 codes, 20.4%), sports interventions (162 codes, 12.3%), physical environment interventions (110 codes, 8.4%) and technological interventions (8 codes, 0.6%).

Analysis revealed that sports intervention was considered one of the independent interventions in sports policy emphasizing health because the armed forces are not a specific organization with a sports mission. Also, technological interventions were not considered one of the primary interventions in physical activity and sports-based health. It indicated that technology-based alterations are still not considered an effective intervention in Iran's armed forces culture. Generally, the factors influencing the sports policy of the Islamic Republic of Iran included legal intervention, social environment, physical and sports environment, and legal intervention affected the highest impact in comparison with other interventions.

One of the best radiotherapy methods that have been suggested for the treatment of cancers such as brain, head and neck, skin, and recently liver is boron neutron capture therapy. Therefore, neutron shielding in the treatment room is important because the absorption of neutrons in the shield may lead to the production of gamma rays, which can have destructive effects. While an increase in density of the elements used in the shield is generally sufficient for gamma radiation shielding, protection against neutrons is more complicated. It is due to variations in neutron interactions with the matter based on their kinetic energy and reaction cross-sections with the shield component atoms.

In this paper, it will be developed a neutron shield that is a proper shield against ionizing radiation, will be accomplished via the use of experiment-based optimization of materials backed by Monte Carlo simulations. Also, the neutron shielding characteristics of conventional and heavy-weight shields modified with epoxy resin and gadolinium oxide were investigated. The shielding effectiveness against neutrons was initially modeled using the MCNP code. In the end, the comparison of MCNP simulated results and the real experiment was presented.

Gadolinium is an efficient additive for weakening low-energy neutrons, but it does not have a good effect in terms of shielding against fast neutrons. Also, Epoxy resin improves the shielding property of the composite against neutron radiation.

The results show that the addition of the polymers used in composite shielding and the proposed method for developing the neutron shield can improve the shielding characteristics for neutron beams.

In World War I, sulfur mustard or mustard gas was used as a chemical weapon for the first time. Years later, during the imposed war (eight years of holy defense) against the Islamic Republic of Iran, Iraq used this poisonous gas against the soldiers and people of Iranian cities. Many years after the war, many chemical veterans still suffer from its effects. Mustard gas is a strong alkylating substance with cytotoxic and mutagenic properties, which causes blisters in mucous membranes and skin when it comes in contact with the skin. It is usually a colorless or amber-yellow oily liquid. In high concentrations, it has a disgusting smell similar to horseradish, onion, or garlic, which is mostly due to contamination with ethyl sulfide and other byproducts of its synthesis. Various studies have proven that long-term exposure to this toxic gas can lead to respiratory disorders and lung cancer. Considering the drug resistance and special conditions of chemical veterans with lung cancer, one of the new methods proposed for their treatment is the use of oncolytic viruses. The purpose of this study is to review the therapeutic potential of oncolytic viruses in the treatment of lung cancer caused by chemical warfare agents.