ZANKO JOURNAL OF MEDICAL SCIENCES
Year:2018 | Volume:18 | Issue:59 |Papers Count:8

Background and Aim: Leadership style is one of the effective factors which increase theeffectiveness, quality and productivity of organizations. This study was conducted todetermine the relationship between hospital leadership and their efficiency in TehranUniversity of Medical Science hospitals in 2016. Material and Method: In this descriptive cross-sectional study, Vroom & Yettonquestionnaire (2001) used for collecting management style datas in 2016 and, because ofsmall managers’ population (24 managers of 24 hospitals) the questionnaire distributedamong all managers. Finally, 22 questionnaires were collected. The hospitals efficiencyindexes were achieved from the statistical unit of University and Hospitals. Data wasanalyzed by SPSS 21, DEA, EXCEL, Activity Based Analyzing (ABS) and Frontiersoftware. Results: Participatory management was the predominant style among managers. Farabi andHashemi hospitals, in spite of having low resource, have a high efficiency. Imam and HazrateRasool hospitals have lower efficiency than resources. One bed unit cost, in Farabi andBahrami hospitals is lowest among all hospitals. Hospitals of Farabi, Bahrami and Ziaeanhave a same efficiency as well as hospitals of Imam Khomeni and Hashemi have a sameamount of efficiency, even though hospital of Hashemi needs more resources to reach thefrontier efficiency level, and finally among all hospitals, Ziaean needs the lowest resource toreach the efficiency frontier level. A bed cost was not the performance's predictor and, therewas no relationship between them. Conclusion: Participatory style is able to change the efficiency of hospital and it's better tochange their management style toward participatory style. Increasing in resources is notnecessarily means of consume much efficiency, but to consume in right ways and places toreach the efficiency frontier. Efficiency is not predicted by cost per bed and managers haveto find and change the other factors which needs more examine.

Background and Aim: Oral squamous cell carcinoma (OSCC) develops through a series ofprecancerous stages manifested at the microscopic level as epithelial dysplasia and Ki-67gene may play an important role in this course. The aim of this study was to comparativeinvestigation of Ki67 expression in oral epithelial dysplasia and OSCC byimmunohistochemistery technique. Materials and methods: Ki67 expression was evaluated in paraffin blocks of 15epithelialhyperplasia with no dysplasia (A group), 15 epithelial dysplasia (B group) including 7 mildepithelial dysplasia (B1subgroup) and 8 sever epithelial dysplasia (B2 subgroup), 15 OSCC(C group) including 7 well differentiated OSCC (C1 subgroup) and 8 poorly diffrentiatedOSCC (C2 subgroup). Results: There was a significant difference in Ki67 expression based on quantitative andsmiquantitative analysis between the three groups and Ki67-positive cells were significantlyhigher in C group than B group. A positive significant difference was observed betweenKi67-positive cells and increasing grade of dysplasia (P<0/001). However, Ki67 expressionwas not significant different between histopathological grades of OSCC ( p=0/064). Conclusion: Ki-67 may represent a significant marker to recognize evolution ofprecancerous diseases in the oral cavity, a reliable marker to improve identification of thedegree of dysplasia and for the prediction of malignant change in these lesions.

Background and Aim: In our country, Wright test is used to detect brucellosis. Due to the lowsensitivity of this test, false negative cases are reported. In this study, the results of Wrightand ELISA tests were compared in suspected cases of brucellosis. Material and Method: In this cross-sectional descriptive study, blood samples of 304suspected cases of brucellosis with clinical symptoms, were taken and the results of Rapid testand Wright Tube test and determination of IgG, IgM classes against Brucella were evaluatedby ELISA method. Results: Of the 304 suspected cases in the control group, 134 people (44. 1%) were male and170 people (55. 9%) were female. In this study, using rapid Wright test, to screen 304 samplesfrom the control group, 193 patients (63. 5%) were reported Negative for Brucellosis And 111Samples were positive (36. 5%). Also, using the Wright Tube test, 189 patients (62. 2%) werereported negative for brucellosis and 115 patients (37. 8%) were positive. For all people inaddition to the Wright test, Antibody Tests against Brucella, IgG and IgM classes, wereperformed. In this study, using IgG test for screening 304 samples from the control group, 185 patients (60. 9%) were reported Negative for Brucellosis and by using IgM test forscreening 304 samples, 261 patients (85. 9%) were reported Negative for Brucellosis. Conclusion: Due to the lack of compatibility of the results of Wright and ELISA tests andwith regard to availability, High sensitivity and determining the type of antibody class in theELISA method, this method emphasizes the diagnosis of brucellosis.

Background andAim: Workplace aggression is an alarming and critical issue for bothindividuals and organizations, and nursing profession is one of those professions which ismostly exposed to aggression; therefore, this study aimed to investigate the frequency ofviolence among patients and relatives against nurses and their related factors. Material and Method: The present study is an Analytical-descriptive type which has beenparticipated by 203 nurses working in different sections of Hafte-Tir Medical ResearchTraining Center via the census method. Data gathering instrument was the standardizedquestionnaire of workplace aggression in healthcare centers. The questionnaire includes 6parts(demographic data, threat, physical, verbal, racial and sexual aggression) which were filledby the nurses. Spss22 software has been applied in order to analyze the data via analyticaldescriptiveand statistical tests. Results: 74. 1% (123 people) of nurses had been exposed to violence during their workperiod. Verbal abuse and threat were respectively 95. 1% (117 people) and 42. 3% (52 people)with the highest incidence and physical, sexual and racial violence respectively were (8. 9%11 people), 4. 1% (5 people) and 3. 2% (4 people) and had the least violence against nurses. Also there was a meaningful relation between nurses’ ethnicity and verbal abuse (p=0. 0092)and between marital status and threat (p=0. 0134), In a way that Fars nurses were exposed toverbal abuse more than other races and married nurses were threatened more than singles. Conclusion: The results confirm the high prevalence of workplace violence against nurses, so this issue necessitates special attention. Therefore in order to decrease risks and threats ofaggression in hospitals precautionary, preventive and cooperative approach in addition tosuitable methods of report of aggression and its pursuit and public education is effective andadvantageous.

Background and Aim: The ability to communicate and creation of social relations are one ofthe most important skills for managers. The aim of this study was to survey oncommunication skills of Head-nurses and its relationship with their demographiccharacteristics. Material and Method: This is a Cross-sectional Analytical Descriptive study which wasconducted on 51 Head-nurses who were selected through census method from different wardsin Sanandaj educational hospitals. Data were collected by a two part questionnairecontaining demographic information and Queendom Communication Skills inventory that Itsvalidity is 0. 71 and its reliability was done by Cronbach 's alpha (alpha= 0. 69). We useddescriptive statistics (Mean and SD) and inferential statistics (independent t-test and Pearsoncorrelation coefficient) to analyze the data by SPSS version 16. Results: The mean total score of communication skills in the studied Head-nurses was112. 39 ± 8. 19, which was above the average. Communication skills, including the ability toreceive and send messages, emotional control, listening and insight into the communicativeprocess were higher than the average value. There was not a significant relationship betweenthe mean score of communication skills in the Head-nurses and their demographiccharacteristics. Conclusion: As the level of communication skills in this study was higher than the average, except communication skills combined with the certainty, and there was no significantrelationship between demographic characteristics and communication skills of Head-nurses, acorrect planning for the development of communication skills and managerial competencesof Head nurses will improve their communication skills.

Background and Aims: The purpose of this study was investigation of effectiveness ofinducing positive affect on autobiographical memory of patients with mild depression. Materials and Methods: The study was quasi-experimental by pretest and post-test andwith control group. For this purpose based on inclusion criteria, 30 patients with milddepression were selected by convenience sampling method 15 patients randomized into twogroups: experimental and control. Both groups were investigated by using Beck Depressioninventory (1996, BDI-II) and autobiographical memory test (1996, ATM-T). Questionnaire inthe pre-test were evaluated. Then the experimental group underwent five session of emotionalimages international (center for the study of emotion and attention at the university ofFlorida) induced positive affect. In control group matched with experimental group viewingnatural images. After the end of intervention, was taken post test. Results: the results showed induction of positive affect was significant effect onautobiographical memory (p<0. 059). Conclusion: The results show induction of positive affect can help persons recover morememories that are emotionally charged positive.

Background and Aims: Marital relations quality is a multidimensional concept that includesvarious aspects of couples’ communications such as compliance, satisfaction, happiness, solidarity and commitment. The aim of this study was to determine the effect of EmotionallyFocused Couples Therapy on improving the marital relationship quality and increasing themarital intimacy. Materials and Method: This research is a quasi-experimental study with pretest-posttestdesign and a control group. The study population comprised of couples with marital problemsthat referred to the mental health care center of Kosar in Karaj in the second half of2014. Based on preliminary interview and entry and exit criteria for the study, 20 coupleswere selected through convenience sampling method and assigned to two experimental andcontrol groups (each group of 10 couples). The marital status of Golumberg-Rustquestionnaire and marital intimacy scale of Thompson and Walker were filled out by thesubjects in the two groups in the pre-test and post-test phases. Emotionally Focused CouplesTherapy sessions for experimental group were held 10 weekly sessions of an hour and a half. Participants in the control group did not receive intervention. Data were analysed bymultivariate analysis of covariance using SPSSV20. Results: The results of analysis of covariance showed that Emotionally Focused CouplesTherapy improved the quality of marital relationships (F = 66. 98) and increased intimacy (F= 56. 37) in the couples of experimental group compared with the control group (p < 0. 01). Conclusion: Results of this study showed that Emotionally Focused Couples Therapy waseffective in improving the quality of marital relationships and increasing marital intimacy. Itis recommended to apply this method of couple therapy in family counseling centers andworkshops in order to solve the problems and marital conflicts of couples.

Background and Aims: Stress and anxiety during pregnancy are two of the major challengesand factors affecting the health of mothers and children. The purpose of this study was toinvestigate the invariance of the causal model of mothers’ awareness about infants care, stressand anxiety during pregnancy based on mothers’ educational level. Materials and Method: The design of this research was descriptive-correlation and moreprecisely it was path analysis. The statistical population of the study was pregnant womenreferred to Bojnourd health centers in the summer of 2017. A total of 292 women wereselected through multi-stage sampling during a three-month period. Data were collected usingdemographic questionnaire, Mothers’ Awareness about Infants Care Test (Bagheri, 2013) andDepression, Anxiety, Stress Scale (DASS-21). Data analysis was performed using SPSSv16and AMOSv20. Results: Path analysis showed that the prediction model of anxiety and stress in pregnantwomen, according to their awareness of infant care, has a good fit ( 2/df=1. 32, GFI=. 99, AGFI=. 98, CFI=. 99, NFI=. 99, RMSEA=. 033) and the awareness of infant care is anegative and significant predictor of stress and anxiety during pregnancy (P≤ 0. 01). Theresults of path analysis in the two groups of mothers with and without university educationshowed variability in terms of educational level (P=0. 018). Conclusion: The mothers’ awareness about infants care can affect their anxiety and stressduring pregnancy. Mothers' education also affects their awareness of how to care for theinfants. Accordingly, it is possible to provide necessary instructions for pregnant women asone of the ways to reduce anxiety and stress during pregnancy.