Journal of Archives in Military Medicine

In Collaboration with Aja University of Medical Sciences


The “Journal of Archives in Military Medicine(JAMM) is an international, peer-reviewed, open-access journal that focuses on basic and clinical studies in military medicine, including etiology, pathogenesis, epidemiology, diagnosis, screening, monitoring, treatment, rehabilitation and clinical practice guidelines for a better care of military forces, veterans and their families. The journal is characterized by the applied multidisciplinary research for improvement in the level of knowledge, practice, and technologies in military medicine, emergency care, disaster medicine, and related subjects. Furthermore, international experience in the “military health system” is of particular interest in this journal. Additionally, we encourage high quality and evidence-based research in variously armed forces health aspects including policy development, economic analysis, and system management as well as patients’ perspective about military health services. JAAM also welcomes articles in military medical education. The editorial board of the journal appreciates novel and innovative studies and offers special priority for these works.


Recent Submissions

Now showing 1 - 20 of 257
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    COVID-19 in Continental Africa
    (Brieflands, 2022-06-30) Leila Moradi
    Background: In late December 2019, the emerging disease of COVID- 19 was first diagnosed in China. It was caused by a coronavirus and caused limitations in most parts of the world. Objectives: We investigated the epidemiology of COVID-19 in continental Africa. Methods: This ecological study described the epidemiological features of COVID-19 in Africa. We extracted the data related to identified definitive cases and deaths due to this disease and other information from the reports released by the World Health Organization and transferred the data to the SPSS 24 software. Also, the fatality rate was separately determined for each country. Results: The highest number of cases diagnosed with COVID-19 was in South Africa with 2907619 cases, and the highest number of deaths due to COVID19 was found in South Africa with 87922 cases. The highest case fatality rate was in Liberia, with 4.93%. Conclusions: Prevention of COVID-19 transmission is possible by vaccinating most age groups in the community and observing social distance. Upgrading diagnostic equipment and identifying healthy and quarantined carriers is also effective in reducing COVID- 19 transmission. The cooperation of health officials and volunteers is effective in more fully identifying patients and enforcing quarantine rules. The World Health Organization provides financial support, diagnostic equipment, and vaccines for low- and middle-income countries in all parts of the world, especially in Africa. Financial support from charitable groups to provide insurance services and medical and pharmaceutical equipment is an effective help in reducing the damage of COVID- 19.
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    A Comparison of Three Research Methods: Logistic Regression, Decision Tree, and Random Forest to Reveal Association of Type 2 Diabetes with Risk Factors and Classify Subjects in a Military Population
    (Brieflands, 2022-06-30) Mohammad Sahebhonar; Mehrzad Gholampour Dehaki; Mohammad Hassan Kazemi-Galougahi; Saeed Soleiman-Meigooni
    Background: Type 2 diabetes mellitus (T2DM) is one of the major non-communicable diseases, causing morbidity and mortality worldwide. There is no study on T2DM status in Iran Army Forces. Objectives: We aimed to measure the prevalence of T2DM in this population and identify variables associated with T2DM risk in order to classify individuals. Methods: Data from 3661 Iran Army Ground Forces were employed. Characteristics of the subjects with and without T2DM were compared. We examined the classification ability of logistic regression with two tree-based supervised learning algorithms, decision tree and random forest (RF). The ethical committee of AJA University of Medical Sciences approved this study by the approval code 995685. Results: The prevalence of T2DM was 3% less than in the general population. Our results showed that the incidence of T2DM increases as subjects become older. The proportions of staff members with T2DM were more than the other military ranks. T2DM is more common in obese and overweight groups. The highest prevalence of T2DM is in the subjects with high levels of lipid profile. The areas below the receiver operating characteristic curve for logistic regression, decision tree, and RF were 73.8%, 77.1%, and 97.1%, respectively. Conclusions: Age, body mass index, total cholesterol, low-density lipoprotein cholesterol, and triglyceride are associated with T2DM risk. The RF has superior classification performance in comparison with logistic regression and decision tree.
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    Effects of Type and Intensity of Voluntary Contractions With Different Recovery Periods on Anaerobic Power and Maximum Torque in Young Trained Girls
    (Brieflands, 2020-06-30) Fariba Momeni Sheykheh; Amirabbas Monazzami
    Background: Implementing the post-activation potentiation phenomenon before a competition in the warm-up section may be better than performing the usual warm-up. Objectives: Therefore, the purpose of this study was to determine the effects of type and intensity of muscle contraction with different recovery periods on anaerobic power and peak torque in young trained girls. Methods: Twelve female subjects (age: 22 ± 2.95 years; height: 165.42 ± 5.35 cm; weight: 57.33 ± 9.15 kg) who had at least two years of continuous training experience were randomly selected. The subjects performed the contraction protocols (isometric (3×70/7s), concentric (3 × 90/4), and eccentric (3 × 110/5)) or control conditions in eight sessions with at least 48 hours intervals between the sessions. In this study, the countermovement jump test and Biodex isokinetic device (60°.S-1) model (ISO-1) were used for measuring anaerobic power and maximum peak torque, respectively. Two-way repeated-measures ANOVA and one-way independent ANOVA were used for analyzing the data (P < 0.05). Results: The between-group comparisons showed that the highest anaerobic power and peak torque values in immediate and three-minute recovery periods were seen in the concentric protocol, and the highest values in seven-minute recovery periods were seen in the eccentric protocol (P < 0.05). These variables were also significant in concentric and eccentric contractions in within-group comparisons (P < 0.05). Conclusions: Eccentric contraction, similar to other contractions, can produce PAP. It seems that eccentric contractions due to a higher intensity of contractions can maintain more consistency of PAP than do other contractions.
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    Calculation of the Cost of Training Medical Students in One of the AJA Universities of Medical Sciences Using Time-Driven Activity-Based Costing Method
    (Brieflands, 2023-12-31) Amir Rezaei; Mahmoud Zamandi; Armin Zareiyan; Fardin Mohammadi
    Background: Estimating the total cost of services is crucial for utilizing available resources more efficiently and effectively. By employing the time-driven activity-based costing (TDABC) method, not only can costs be calculated, but also the efficiency and unused capacity of resources can be assessed. Objectives: This study aimed to calculate the cost of education for each medical student at one of the AJA Medical sciences Universities in 2022 using the TDABC method. Methods: This quantitative study was conducted cross-sectionally and retrospectively in a descriptive-analytical manner. The data were collected and analyzed through interviews and observations. To analyze and allocate costs, administrative and educational departments were categorized into three levels: Overhead, intermediate, and final activity centers. Then, using the TDABC approach in Microsoft Excel 2013 software costs from the overhead and intermediate activity centers to the final activity center and students. Results: The study estimated the average cost of educating each medical student to be approximately IRR 6 267 568 065. Additionally, the unused capacity of resources in overhead and intermediate centers was observed to be 30% (range: 4 - 44%) and 33% (range: 26 - 43%), respectively. Conclusions: The findings indicated that the cost per student is somewhat reasonable; however, there is a high level of unused capacity in the university and faculty activity centers. The effective management of human resources and equipment is necessary to enhance service delivery processes, increase productivity, and reduce unused capacity.
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    Comparison of Diltiazem Ointment and Safflower Oil in Reducing the Necrosis of Accidental Flap of Rat
    (Brieflands, 2023-06-30) Amir Hossein Golmohammadi Khameneh; Siamak Rakei Isfahani; Mehdi Salehi; Abolfazl Mohtarami; Alireza Kamali
    Background: This study aimed to compare diltiazem-ointment and safflower oil in reducing the necrosis of accidental rat flaps. Method: We divide 40 mice into four groups. We created a 10 × 3 random flap on the back of rats after washing with ketamine intraperitoneal. The flap was used for these four groups of ointments from two days before surgery to five days after surgery. We used diltiazem ointment in the first group, safflower essential oil in the second group and vaseline in the third group. The fourth group was for control Results: The mean necrosis of the flap was observed in 49% of the vaseline group, 52% of the diltiazem group, 53% safflower essential oil group, and 47% of the control group. The P-value with the independent groups' test was more than 0.05 and confirmed no significant difference between Wistar rat groups. Vaseline, diltiazem, and safflower essential oil did not increase blood flow to the random flap in mice. Conclusions: Diltiazem and safflower did not improve blood flow to the flap. Since this drug has not been used for flaps, it is suggested that further studies be conducted in this field.
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    Evaluating the Quality of Work Life Among Nurses: A Systematic Review
    (Brieflands, 2022-03-31) Abbas Ebadi; Zeinab Tabanejad
    Introduction: Quality of work life among nurses can affect organizational productivity and quality of care. This study aimed to review the outcome of research conducted in this field. Methods: In this study, five major databases, including Google Scholar, PubMed, ScienceDirect, Scopus, and Web of Science were searched for relevant papers published between 2000 and October 2020 using the following keywords: ‘nurse’, ‘nursing work life’, ‘quality of work life’, ‘nurses' quality of work life’, and ‘scale’. Finally, ten relevant studies were included in the study and the tools introduced in the selected articles were assessed according to the COSMIN checklist. Results: Out of 298 retrieved articles, nine related studies were analyzed based on the COSMIN checklist. None of these tools had all the features listed in COSMIN checklist. However, all tools had acceptable internal consistency and construct validity. Conclusions: Designing a valid and special tool to measure the quality of work life among the nurses is necessary to improve the quality of mental and physical conditions, prevent leaving the nursing job, increase motivation and willingness to work as a nurse, and increase productivity for nurses and organizations.
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    Sickle Cell Disease and COVID-19
    (Brieflands, 2020-06-30) Leila Moradi
    Context: The COVID-19 pandemic emerged in China and spread to the majority of countries worldwide, causing numerous health problems and restrictions on the people’s lifestyles. The complications of this disease can be much more severe in patients who have a weakened immune system or a chronic disease. Sickle cell disease is a genetic disorder in which the immune system is impaired. Exposure to COVID-19 will have severe consequences in the sickle cell disease patients. In this study aimed to investigate the relationship between this disease with the COVID-19 pandemic. Evidence Acquisition: Embase, Scopus, Pub Med databases were reviewed. Keywords were combined as (“COVID19” OR “Coronavirus” AND “Anemia sickle Cell” OR “Sickle cell disease”). The results of related articles were used. Results: At the time of the COVID-19 pandemic, chronic patients and those with weakened immune systems need to be more socially inclined to be less exposed to the COVID-19 virus. Conclusions: When producing the COVID vaccine, high-risk groups such as sickle cell anemia patients should be given priority.
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    A Review of COVID-19 Diagnostic Methods
    (Brieflands, 2019-12-31) Reyhaneh Yaghobzadeh; Seyyed Reza Kamel; Koresh Shirazi
    The new coronavirus disease 2019 (COVID-19) has recently emerged as an acute respiratory syndrome. The virus has spread throughout the world since the primary outbreak of the disease reported in Wuhan, China. The pandemic has led to increased mortality as the most important threat of the disease in specific populations across the world. Furthermore, COVID-19 has caused significant economic problems in several countries. The early diagnosis of COVID-19 is currently an important concern for physicians and communities. The present study aimed to review the published articles regarding the diagnosis of COVID-19 until the end of February 2020. According to the results we show that deep learning and machine learning algorithms can be effectively used to the scope of the disease.
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    Gluteal Hidradenitis Suppurativa: A Case for Collaboration
    (Brieflands, 2023-06-30) Ranjan Kumar; Loknandini Sharma; Niyor Das
    Hidradenitis suppurativa is a chronic inflammatory disease of the apocrine gland, characterized by the formation of abscess, sinus tract, and scarring. The common sites affected by the disease are the axilla and groin, while gluteal region involvement is rare. There are multiple modalities of management available depending on the stage of the disease and associated complications.
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    The Frequency of Knee-Joint Injuries Caused by Sports Activities Among the Armed Forces Personnel
    (Brieflands, 2016-11-01) Zahra Rezasoltani; Faeze Dehghan; Ali Azizan; Afsaneh Dadarkhah; Farhad Yadegarian
    Background: Doing hard physical exercises help empowering military forces to carry out their duties and missions. However, blindly following this aim may cause physical damages which lead to their temporary or permanent disability. Objectives: The current study aimed to investigate the prevalence of knee injuries resulting from sports activities among the armed forces personnel in 2010. Methods: It was a descriptive and retrospective study. All the armed forces personnel (n = 4203) covered by Kosar insurance in 2010 participated in the study. Data were analyzed using Excel and SPSS version 18 at the significant level of P ≤ 0.05. Results: The most frequent injuries were observed in the lower limbs (73% )and ankles (38.7%), respectively. The third most common injury was observed in knees (13.4%). Among the knee injuries, anterior cruciate ligament (ACL) (77.82%) and meniscus (63.8%) were most prevalent. Also, posterior cruciate ligament (PCL) (6.6%) and medial collateral ligament (3.8%), the lateral collateral ligament (2.3%) and other injuries, including chondromalacia, osteoarthritis, etc. were reported. Conclusions: The prevalence of injuries in lower limbs is more frequent than other limbs. Ligament injury is high among the armed forces personnel. Among the ligament injuries, the most frequently observed case was anterior cruciate ligament (ACL). Most knee injuries in this research were observed in the dominant leg and the muscle injuries in the dominant leg can be reduced through appropriate strength training program and muscle balancing to opposemuscles.
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    Electromyographic and Cardiorespiratory Responses of Load Carriage at Different High Altitudes with Varying Gradients
    (Brieflands, 2017-04-30) Tirthankar Chatterjee; Debojyoti Bhattacharyya; Anilendu Pramanik; Madhu Sudan Pal; Dhurjati Majumdar
    Manual load carriage is performed by Indian Army soldiers at different high altitudes (HA) in day to day operation. Such task puts extra stress on cardiorespiratory and skeletomuscular systems. A study was designed to find out the effect of electromyographic and cardiorespiratory responses of load carriage at different high altitudes with varying gradients. Eight healthy Indian infantrymen (mean (± SD) age of 27.2 (± 3.9) years, height of 171.1 (± 2.5) cm, and weight of 66.8 (± 6.7) kg) participated in the study. They were acclimatized at two heights (3550 and 4300 m). On completion of their acclimatization each participant was checked for healthy cardiorespiratory signs and subsequently they walked on a motorized treadmill at a speed of 3.5 and 0% and 10% gradients under three different experimental load carrying conditions (0, 10.7 and 21.4 kg). Continuous electromyography of three pairs of leg muscles i.e. vastus medialis, gastrocnemius, and tebialis anterior and breath-by-breath recording of oxygen consumption (VO2) and heart rate (HR) were recorded during the experiments. Relative work load (RWL) was calculated from maximum aerobic capacity at respective high altitudes. High altitude had significant effects on the responses of gastrocnemius and vastus medialis muscles as well as on VO2 and RWL. Increased responses of VO2 and leg muscle could be attributed to withstanding the stress of HA and strain of load carriage at steep slopes.
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    Prevalence of Loneliness and Associated Factors Among Iranian College Students During 2015
    (Brieflands, 2017-04-30) Mehri Alaviani; Reza Parvan; Fattaneh Karimi; Saeid Safiri; Nader Mahdavi
    Background: University students are the developers of their nations’ future and make up a significant number of young people. The number of students is increasing as universities and higher education centers develop. Hence, paying attention to student’s physical and mental health is among the most important issues. The aim of the present analytical cross-sectional study was to determine the epidemiological pattern of loneliness and related factors among Maragheh University of Medical Sciences students. Methods: The research was an analytical cross-sectional study, in which 323 Maragheh University of Medical Sciences students were selected by means of applying the inclusion criteria with a convenience sampling method. Then, the required data were collected through demographic profile questionnaire and Russell’s revised UCLA loneliness scale. The data were analyzed using the Chi square test. Results: The prevalence of moderate and severe loneliness was reported to be 50.5% and 31.6%, respectively. Furthermore, there was a significant relationship between loneliness of the participants and their gender (P < 0.001), birth order (P = 0.004), birth place (P < 0.001), and semester of study (P = 0.001). Conclusions: The results of the present study accentuate the necessity of paying attention to the state of loneliness in students, exploring situations and reasons that intensify the feeling in this age group, and identifying intervention plans that could reduce it.
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    Structure-Based Virtual Screening: Identification of Novel Quorum-Sensing Inhibitors to Interfere with the Formation of Pseudomonas aeruginosa Biofilm
    (Brieflands, 2017-04-30) Majid Jafari-Sabet; Ali Baratian
    Background: Drug-resistant Pseudomonas aeruginosa (P. aeruginosa) is among the most important opportunistic human pathogens that may infect military personnel during war by generating a broad range of virulence factors, the expression rates of which are firmly arranged by cell density-dependent cell-to-cell signaling called quorum sensing (QS). Objectives: This study aimed at identifying putative inhibitors of LasR by structure-based virtual screening on ZINC database, testing prospective candidates on pqsE with computer aided inhibition studies followed by structure analysis, and examining the extension of specific drugs with potential anti-virulence properties for the treatment of infections induced by drug-resistant P. aeruginosa. Methods: Structure-based virtual screening in ZINC database was used through Autodock Vina in order to assess putative inhibitors of LasR. Prospective candidates’ inhibitory efficiency on pqsE was examined by means of computer aided inhibition studies followed by structure analysis. Results: Twenty possible quorum sensing inhibitors were introduced that could be used in different conditions to inhibit quorum sensing and thus reduce bacterial resistance and pathogenicity. A software was also designed to provide graphical user interface to vina and to automate the process of virtual screening. Conclusions: This study provided a perspective for development of specific drugs with potential anti virulence properties in military medicine for the treatment of infections induced by drug-resistant P. aeruginosa
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    Hospital Information Systems in Iranian Military Hospitals: A Multiple Case Analysis
    (Brieflands, 2014-11-30) Ramin Hamidi Farahani; Mohammad Sharifi; Masarat Ayat; Nader Markazi Moghaddam
    Background: Hospitals are regarded as the most important part of each healthcare system. At present, all hospitals are using hospital information system (HIS) as an infrastructure in recording, retrieval, and transmission of data, facilitation of decision-making processes, and other healthcare-related domains. However, its position, maturity, and boarder of its coverage are not quite clear. The hospitals affiliated with military healthcare in Iran are facing the same challenges. On the other hand, Electronic Medical Record Adoption Model (EMRAM) is a worldwide-recognized stage-based model that is used to assess the maturity of HISs in the hospitals. Objectives: This study aimed to assess the maturity and applicability of HISs in Iranian hospitals. Materials and Methods: Two Iranian military hospitals were selected for HIS maturity assessment. Data were collected through interviewing related experts and the use of some software and documentation analysis. Then the data were compared with the EMRAM. Results: The results revealed that the HISs in these military hospitals had reached different stages of EMRAM while they could reach upper HIS maturity stages. Conclusions: The maturity of HISs in Iranian military hospitals was almost the same as that of Iranian nonmilitary hospitals. The HISs in these hospitals did not utilize full potentials advantages of HIS and were placed at up to third stages of EMRAM.
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    Hidden Unicameral Bone Cyst of the Calcaneus: A Case Report of Military Soldier with Chronic Ankle Pain
    (Brieflands, 2017-06-30) Zaheer Ahmed Gill; Saeed Bin Ayaz; Nadeem Ahmad; Ali Raza Qureshi
    Bone cysts are benign bone lesions that are quite uncommon in the calcaneus. Calcaneal cysts generally remain asymptomatic in most patients and are discovered incidentally but in some, they may cause localized bone pain that is progressive in intensity. If not picked on the conventional radiographs, the diagnosis is delayed and the patient remains distressed and dispirited. We, here, report a military soldier with calcaneal cyst who remained misdiagnosed for six months and had been treated as a case of ankle sprain. After correct diagnosis, his problems were finally settled following surgical intervention. The physicians should keep a high degree of suspicion of an alternative diagnosis in all cases where usual management is not beneficial in commonly expected pathologies.
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    Professionalism of Healthcare Jobs in the War
    (Brieflands, 2017-04-30) Zahra Farsi
    Background: Professionalism is an important characteristic of professional jobs including nursing and medicine. Many professional values during the crisis are glaring. Objectives: This study was conducted to explain the role of the Iran-Iraq war in the professionalism of healthcare disciplines based on the documented experiences of medical staff. Methods: This is part of a qualitative study which used the conventional content analysis in 2014 - 2016. The researcher collected and analyzed 119 memories of the healthcare providers about the Iran-Iraq war, simultaneously. Results: Professionalism was one of the main categories emerged from the analysis of data. This theme included six sub-themes, “promotion of personal and professional empowerment”, “compliance with laws and regulations”, “holistic care”, “expression of good traits”, “interpersonal relationships”, and “sublimation of spirit”. Conclusions: Experiences of healthcare providers in the war can be applied in peacetime and future crisis through broadening their perception of nursing and medicine professions and improving their sense of professionalism.
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    Toxoplasmosis Among Patients with Immunocompromising Conditions: A Snapshot
    (Brieflands, 2016-11-01) Amir Abdoli; Mohammad Barati; Abdolhossein Dalimi; Majid Pirestani; Seyyed Javad Hoseini Shokouh
    This article does not have an abstract.
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    Medical Experiences of the Turkish Armed Forces in Afghanistan
    (Brieflands, 2015-02-28) Pelin Ozmen; Mehmet Cetin
    The Turkish Armed Forces have played a key role in the International Security Assistance Force (ISAF) in Afghanistan since 2002. Medical services provided in Afghanistan are structured as a multinational health care operation so as maximize the efficient use of resources. The medical services provided by the Turkish Armed Forces in Afghanistan are at Role 2 and are for the benefit of the Afghan people as well as of ISAF personnel. This article sets out the medical experiences of the Turkish Armed Forces and the projects during 2008 and 2009.
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    Prevalence of Dyslipidemia in Military Police Officers Operating in a Special Operations Group
    (Brieflands, 2022-03-31) Thomaz Talarico Neto; Higino Carlos Hahns Júnior; Maria Clara Santos Minelli; José Mauricio Magraner Paixão dos Santos; Marcos Corrêa Junior; Yanesko Fernandes Bella; Fernanda Galante; Cesar Baraldi Gonella; Leandro Ferreira; Carlos Eduardo Martinelli Junior; Hugo Tourinho Filho
    Background: Dyslipidemia is a disorder caused by alterations in the plasma concentrations of one or more lipids/lipoproteins. It is considered a metabolic disease that exposes the body to various harmful and even fatal events, one of which is the increased risk for cardiovascular diseases. Military police officers, in turn, are exposed to high physical and psychological risks and may suffer from cardiovascular diseases more than other professions. Objectives: In this sense, the objective of the present study was to evaluate the lipid profile of military police officers working in a special operations group to identify the prevalence of dyslipidemia among the subjects. Methods: In total, 65 volunteers participated in the study, members of a special operations battalion (37.26 ± 5.77 years of age). Blood collection was performed after 12 hours of fasting to analyze the following variables: Total cholesterol, triglycerides, LDL-c, and HDL-c. Results: The total cholesterol value presented the highest variation, since 77% of those evaluated showed altered values. Regarding the values of HLD, LDL, and triglycerides, most subjects (89%, 72%, and 80%, respectively) presented results within normal values Conclusions: It can be concluded that most participants presented regular values for most of the analyzed lipid fractions, which could contribute to their demands during their work activities. It is believed that the positive results seen in this group, which is heterogeneous with respect to age, are due to an extremely rigorous selection process and a training program that elevates the individuals to the rank of elite soldiers within the Brazilian military police.
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    Profile of Steroid Hormones and sex Hormone-Binding Globulin of Elite Soldiers
    (Brieflands, 2020-09-30) Thomaz Talarico Neto; Higino Carlos Hahns Júnior; Maria Clara Santos Minelli; José Mauricio Magraner Paixão dos Santos; Marcos Corrêa Junior; Yanesko Fernandes Bella; Fernanda Galante; Cesar Baraldi Gonella; Leandro Ferreira; Carlos Eduardo Martinelli Junior; Hugo Tourinho Filho
    Background: Military police training should characterize the necessary abilities to conduct their activities with excellence. Biochemical parameters have a significant role in the performance of individuals and, therefore, are of crucial importance when trying to improve the teamwork of police officers, particularly for special operations groups. Hence, the use of laboratory analysis in activities that cause great physiological stress is of paramount importance. Objectives: The present study aimed to evaluate the profile of steroid hormones and the sex hormone-binding-globulin of soldiers belonging to a special operations force. Methods: In this cross-sectional study, blood samples of 75 volunteers collected after 12 hours of fasting are analyzed. Data were analyzed using descriptive statistics (i.e., mean and standard deviation) and compared to the reference values for each biomarker, referencing each individual in their age group. Results: Most of the participants presented adequate concentrations for their respective ages in relation to the data analyzed. Even the inclusion of individuals from different age groups did not change the good results found in the group. Conclusions: The positive results found in such a heterogeneous group with respect to age group can be attributed to an extremely rigorous selection process and a training program that elevates them to the rank of elite soldiers of the military police.