مجله طب نظامی
سال بیست و پنجم شماره 6 (پیاپی 124، بهمن و اسفند 1402)

Telehealth is one of the technologies that can help us in the prevention, diagnosis, and treatment of diseases caused by bioterrorism. This research aims to introduce the applications of this tool and examine its strengths, weaknesses, opportunities, and threats in bioterrorist attacks.

We searched in Scopus, PubMed, and Google Scholar from 2001 to 2021. By applying the inclusion and exclusion criteria and checking the title, abstract, and full text, we selected articles to enter the analysis. Finally, we extracted and saved data based on the Excel form.

A total of articles were retrieved through the search, and 15 studies remained for final analysis. Based on the findings, we categorized telehealth applications into four general categories. Tele-consultation, e-learning, tele-prevention, tele-monitoring, and tele-diagnosis were the most common applications. Also, SWOT analysis showed that practical tools in bioterrorism have more strengths than weaknesses. Early identification of bioterrorism attacks and control of their spread is one of the significant strengths of this field. Also, one of its considerable weaknesses is the incompatibility of these systems.

Considering the many applications of telehealth and the positive impact of this tool during bioterrorism incidents, its use is suggested by various organizations, especially the Red Crescent and military organizations. But considering the weaknesses and threats like the lack of appropriate technical, organizational, legal, and insurance infrastructure and security and confidentiality issues, it is necessary to measure to deal with these cases.

Considering the wide range of services of the health system, proper training and distribution of human capital is highly important. It is worth mentioning that any imbalance in the distribution of human resources will result in a shortage or over-recruitment of medical staff. The purpose of this review article is to analyze the workload Indicator Staffing Need and determine the number of human capital required based on the standard of the World Health Organization.

This study is a Narrative review research. The statistical population includes available documents regarding the determination of the workload Indicator Staffing Need from January 2003 to April 2023. The sampling method was determined according to the documents related to the workload Indicator Staffing Need. The validity of the present study was implemented by searching in authoritative Persian and English-language scientific databases, including Google Scholar, IranMedex and Magiran, Scopus, and PubMed. Also, for reliability, a comparative study of documents was used. The search strategy included Human resource planning, Wisn, "Workload" and "Workload Indicator staff need" keywords and their Persian equivalent.

The classification and review of documents related to the subject of the study were examined in the three continents of Asia, Europe, and Africa. The findings indicated that the key success factor in the accurate estimation of the demand and supply of human resources in the health system is correct policy-making at headquarters levels and choosing a timely scientific-executive approach based on the precise definition of job processes. According to the documents and articles and comparison of common factors, and also concerning the World Health Organization Workload Indicator Staffing Need findings of the study were divided into 48 managerial components and 13 technical components, and then the data were.

Many medical sciences universities in Iran do not use a specific model and indicator to estimate the number and calculate the workload of their employees. It can be said that most universities of medical sciences, instead of using a systematic model, still use old and mental models to deal with high workload and estimate the required number of employees. So, it is highly important to pay attention to the implementation of the two-dimensional managerial-policy-making model at the level of senior managers and perform scientific-executive measures according to the conditions and organizational culture.

Ionizing radiation protection is one of the most fundamental research and application fields in reducing the absorbed dose of sensitive internal organs. The presence of lead as the first radiation shield with a series of good features such as high density and having some flexibility and a series of bad features such as toxicity, low physical and chemical stability and high weight, have been thinking about replacing it for a long time. In the mammography section, the lead shields present during mammography cause limitations in the patient's work and are generally not used. As a result, they lose their efficiency. Therefore, it is necessary to propose and design a lead-free shield that can have suitable radiation attenuation in the range of mammography energy up to 60 keV and does not create limitations for the patient compared to the existing shields in this sector.

In this study, the evaluation of X-ray and gamma-ray shielding for nine different proposed compounds was done using a computational code MCNPX based on the Monte Carlo method, in the photon energy range of 15 to 400 keV, which is the energy range used in Covers the mammography section.

Among the selected protective compounds, the combination of Kennertium showed a more suitable protective function than the other compounds. To reach such a result, the mass attenuation coefficient of the Kennertium compound has been calculated in three thicknesses of 0.1, 0.5, and 1.5 cm. In the following, to check the performance of selected shields of ionizing radiation, for the thickness of 1 mm of Kennertium composition, the dose reached the tissues close to the tumoral area located in the patient's left breast, such as the left lung, thyroid, and heart, has been calculated with the presence of such protection.

Quantitative results show that the Kennertium compound completely covers the energy range above 60 keV and as a proposed compound for interacting with X-rays, does not produce secondary particles.

Chronic neuropathic pain is one of the common and debilitating problems of human societies and is a challenge in health care Valerian officinalis has been used in the treatment of pain and anxiety due to its antioxidant effects and multiple mechanisms. Also, the medicinal form of emulsion is studied to increase the bioavailability and absorption of herbal products. The present study was conducted to determine the analgesic and anti-anxiety effects of the oral emulsion of the extract and compare it with the effects of the extract in adult male rats. First, the oral emulsion of the extract was formulated with the help of similar studies and Design Expert software, and the best formulation was selected. Then, neuropathic pain was induced in the animals with the help of a sciatic nerve chronic obstructive lesion (CCI) neuropathy surgical model. The extract and emulsion were given orally (gastric gavage) to the animals for 30 days, after which behavioral tests were performed, to investigate thermal allodynia, and elevated plus maze (EPM), to investigate induced anxiety behaviors, one day before Induction of neuropathy and on days 2, 4, 6, 10, 14, 21, 30 after neuropathy were investigated, and at the end, the effects of oral emulsion gavage of extract and extract on lipid peroxidation of malondialdehyde (MDA) in brain tissue were investigated and compared. Separate administration of valerian extract and emulsion reduced cold allodynia in all days after CCI surgery compared to the neuropathy group (P<0.05). In addition, CCI surgery caused anxiety in rats. Administration of valerian emulsion and its extract were able to significantly reduce anxiety in the behavioral test of the plus-shaped elevated maze. The difference is that this reduction process started earlier with the administration of the extract emulsion (P<0.001). Also, the administration of the extract and emulsion significantly reduced the amount of malondialdehyde in the brain tissue in neuropathic rats compared to the neuropathy group (P<0.001), with the difference that the emulsion of the extract caused a greater decrease in the amount of malondialdehyde compared to the extract. Valerian extract and emulsion have analgesic and anti-anxiety effects. In addition, the administration of valerian emulsion in neuropathic rats has significantly more anti-anxiety and analgesic effects compared to the administration of valerian extract.

The use of new training for improve the learning of beginners in executive skills such as shooting is one of the topics of interest in recent researches. The aim of research was to investigate the effect of a course of resistance training and neurofeedback on improving shooting skills and neural performance of military beginners. For this purpose, 25 people (mean age 20 years and weight 73.8 kg) were randomly selected and using the pre-test-post-test plan, shooting score, and supraspinal nerve function. Using TMS, before and after 12 sessions of resistance training with SMR and Alpha, it was studied in five resistance, resistance-neurofeedback, neurofeedback, Sham, and control groups. Multiple variance analysis in the graphpadprism9 software showed that in intra-group changes, the shooting score in resistance-neurofeedback (P<0.0001), resistance (P = 0.0229), and neurofeedback (P = 0.0241) increased, and the amplitude decreased significantly in the resistance-neurofeedback (P = 0.0115), but latency increased only in resistance training (P>0.05). The follow-up test between groups in the post showed that the changes in the shooting score and the amplitude in the resistance-neurofeedback were not significantly different compared to other groups. Considering the importance of muscle strength and brain functions regarding the proper performance of the shooter and according to the results of this research, it can be said that the use of training methods to strengthen muscles and improve the function of brain waves related to shooting skills, probably at the same time Strengthening the supraspinal nerve function improves part of the learning process and skill implementation in this field.

The Accreditation program has been increasingly expanding around the world. Implementing the Accreditation program directly affects patients' quality and safety. Also increasing the productivity of the manpower to reach the predetermined goals of the organization, is of the utmost importance. As a result, this research was conducted to assess the effect of the Accreditation program on job productivity from the nurse's point of view.

This descriptive-analytical study was conducted cross-sectionally in 2021. A total of 250 nurses working in a military hospital were included in the study and all subjects completed the questionnaire. To collect the data related to the Accreditation program, the Scholarly inquiry created by Jardali was used the validity and reliability of which were assessed and confirmed. The data related to the productivity of the nurses was collected using the Standard Hersey and Goldsmith inquiry (ACHIEVE). Also, the data was analyzed using analytical statistics in the form of Confirmatory Factor Analysis and the path analysis was done using Structural Equation Modeling based on the Partial Least Squares method with the Smart-PLS3 software.

The results show that Accreditation has a meaningful effect on the productivity of nurses. The average score of the total accreditation and productivity was equal to 3.03±0.75 and 2.47±0.64. From all the different accreditation dimensions the highest score belonged to the qualitative results of accreditation (3.23±0.83) and the lowest score they have belonged to the leadership, commitment, and support dimension (2.80±0.96). Also in the productivity dimensions the highest score belonged to the capability (2.77±0.84) and compatibility (2.75±1.12) dimension and the lowest score belonged to the motivation dimension (2.08±0.86).

The accreditation program has had an impact on the productivity of nurses. Hospital managers can increase their productivity by strengthening dimensions such as leadership, commitment, support of nurses, use of production factors and existing technology, and work better towards achieving organizational goals. Managers and policymakers should provide conditions where nurses can participate in determining the strategies and goals of the organization and consider themselves a part of the organization.