مجله علوم پزشکی صدرا
سال یکم شماره 2 (بهار 1392)

Nowadays, hospitals play a critical role in maintaining and promoting human health. Therefore, review of employee's deviant behavior at work would receive much research attention. This study aims to investigate the influence of managerial and organizational factors on workplace deviant behavior among employees working at Zahedan Imam-Ali Hospital.
A descriptive-analytic design was used; the sample size using technique of random sampling was 400 employees, who were working at Zahedan, Imam-Ali Hospital during the study. To collecting data used of two designed, self-reported questionnaires. the first questionnaire for measuring deviance work behaviors, second questionnaire for measuring four managerial and organizational affecting factor on deviance work behaviors (Organizational rules, organizational culture, reward structures and interactive equity). Data was analyzed using statistical test such as Spearman correlation coefficient, T test and one way-ANOVA.
Employees’ deviant workplace behaviour score (36.5 ±8.5) was considerably lower than the mean value of 70. Moreover, the deviant workplace behaviours in nursing and services personnel were higher than physician and administrative personnel. The score of organizational rules, organizational culture and reward structures were down than criteria score but the score of interactive equity was higher than criteria. Subsequently, there was relationship between work deviance behavior and education, job and personnel income (p The frequency of employees’ deviant behavior was lower than the mean value; however, it is observed that some of the study variables including employees’ educational attainment and income level played important roles in workplace deviant behavior. Hospital manager should pay more attention to their staff level of education and income if they are to reduce workplace deviance.

Burnout is a psychological syndrome in nursing due to prolonged close contact with other people. Social support is one of the major factors inhibiting the negative effects of stress. This study was performed in order to determine the burnout and the social support for nurses and also the relationship between these variables.
This cross-sectional study was performed on 114 nurses working in hospitals of Shiraz University of Medical Sciences. For collecting the data, valid and reliable questionnaires of social support McCain and Marklyn and Burnout Inventory Maslach and Jackson were used. The data was analyzed using SPSS version 17 and Chi-square test.
86% of nurses stated that they had been received the average social support from their colleagues, head nurses and their supervisors. 67.5% of them had a burnout. 34.2% of them expressed levels of burnout in emotional exhaustion in the moderate level, and more than half of the nurses reported low levels of depersonalization and inadequacy. There was a statistically significant relationship between social support and burnout (p=0.01).
Due to high levels of burnout in nurses and not being ideal the amount of social support received from colleagues and a positive impact that this support could have on the performance of nurses, it is necessary to consider arrangements to reduce the burnout and increase the receiving of social support.

Scapular position has a critical role in exposure of humeral head to the acromion. Any change in scapular positioning may lead to shoulder dysfunctions such as shoulder impingement syndrome and instabilities. Imbalances in muscles surrounding scapula may deviate scapula from natural position. Among these muscles, lower trapezius is more prone to weakness. Taping of this muscle may facilitate it through stimulating proprioceptive receptors. The aim of this study was to verify the effect of lower trapezius taping on scapular positioning measured by virtue of kibler index.
It was a clinical trial study that was done in the two healthy groups of people. Thirty healthy men (15 non-athletes and 15 overhead athletes) within non-random sampling participated into this study. The angle made by medial border of the scapula and spine measured before and after lower trapezius taping in three different positions: zero degree (arms beside the body), 45 ° (hands on the iliac crest) and 90 ° (hands to cross).
There was a significant difference between kibler index and scapular rotation angle with different degrees of shoulder abduction in the both groups (P0.05). The comparison between the two groups demonstrated significant difference in 90° shoulder abduction without taping in kibler index and after taping in scapula rotation (P There is a significant decrease in kibler index after taping in athletes. Scapular rotation angle increased significantly in this group. Taping has no effect in scapular static position in either group.

The main objective of all organizations is to improve the efficiency and effectiveness of the personnel’s performance and this partly depends on effective management. Managers are valuable assets and studying their behavior and personality dimensions may provide important guide for effectiveness and efficiency improvement. In this connection the aim of this study was to determine the association between organizational effectiveness and position of control in managers of staff in Shiraz University of Medical Sciences.
The present study was a cross-sectional study. Statistical societies of this study include all personnel and managers of staff in Shiraz University of Medical Sciences. 168 subjects of 8 departments were selected through randomize-stratified sampling and the data for the managers of these departments were also collected. The data were collected using 2 questionnaires of organizational effectiveness and Ratter's position of control. Finally, the data were analyzed using SPSS 15 and Kruskal-Wallis and Mann-Whitney Tests.
The results indicated that there was a significant association between organizational effectiveness and its dimension with manager's position of control (p0.05. Moreover, the relationship between manager's position of control with gender, managerial experience and manager’s educational level was not significant (p>0.05).
Since, internal managers are more effective than external ones; it is suggested that individuals with internal control position used for management of organization. In addition, the programs training could be used to change the manager external position of control to the internal.

In the absence of sugar-containing fluids in fluid therapy during anesthesia of prolonged surgeries, the amount of blood sugar before and after the surgery has a significant difference. Regarding the lack of sugar in the fluids infused during anesthesia and the duration of NPO and the surgery, there is an increased risk of hypoglycemia during and after the surgery. The aim of this study was to evaluate the blood sugar changes before and after elective surgeries that use the usual fluid therapy (no sugar).
It was a descriptive-analytic design study. One hundred patients with an ASA class and an elective surgery with less than 2 hours duration randomly participated into the study. The patients divided into male and female groups with NPO duration of 8-10 h, 10-12 h and more than 12 h and two age groups of 15-30 and 30-45 years old. The blood sugar was measured 15 minutes prior to the onset of surgery and 15 minutes after the end of the operation. Data was analyzed by SPSS using Paired and Independent Samples T-test.
The blood sugar at the end of the surgery was significantly higher than its amount before the onset of the operation and even without using dextrose-containing fluids during anesthesia and patients NPO condition, hypoglycemia was not observed. In this study, age, gender and NPO duration did not have a significant effect on blood sugar before and after the surgery.
Using dextrose-containing fluids during fluid therapy of elective surgeries is unnecessary and only monitoring the blood sugar during prolonged surgeries is recommended in order to prevent hypoglycemia and its complications.

Tooth avulsion is defined as the complete displacement of the tooth from its normal position which causes damage to the periodontal ligament structure, cementum, alveolar bone, gingiva, and dental pulp. Since, the milk is storage medium for the short-term storage of avulsed teeth, the purpose of this study was to determine the ability of the new storage media (symphytum Mihan long-life milks) in keeping the Periodontal Ligament (PDL) cells viability.
Following atraumatic extraction of healthy human premolars, the PDL cells were cultured. A certain number of the cells was seeded in each well of a 96-well plate and treated with Mihan long-life milks, Hank’s Balanced Salt Solution (HBSS), composition media (symphytum Mihan long-life milks), and Apada fresh milk for 1, 3, 6, and 24 hours. Dulbecco’s Modified Eagle Medium (DMEM) and dry medium were considered as positive control and negative control media, respectively. Cell viability was determined by using the MTT assay. Moreover One Way-ANOVA and post Hoc (LSD) test were used for comparing the study groups.
After 24 hours, the cell's viability in composition media was significantly better than Apada fresh milk medium (P=0. 03). Moreover, the results of One-way ANOVA showed that the PDL cell's viability in composition media was higher than the HBSS medium after 24 hours. At this time point, the mean of viable cells in composition media, Mihan long-life milk medium, and HBSS was 135%, 64%, and 35%, respectively.
According to the study results, composition media (symphytum Mihan long-life milks) are considered as desirable storage media which are comparable to HBSS. This media are not only able to keep more cells viability after 24 hours time period compared to the expensive commercial solutions, but they can also be easily accessed and used.

In recent years, the skill of critical thinking has become an essential component of education. The aim of this study was review the literature on critical thinking; determine the dimensions of critical thinking; investigate issues relating to the critical-thinking skills; determine instrument to measure it; and examine the different critical thinking strategies for increasing critical thinking.
The authors examined research and theoretical literature related to five key topic areas: critical thinking, education, strategies for increasing critical thinking, instrument to measure it and issues relating to the critical-thinking. CINAHL, EBESCO and Medline databases were searched.
the result of this study indicated that critical thinking has been expressed in several ways. It is defined as a purposeful, self-regulatory judgment, which results in interpretation, analysis, evaluation and inference as well as the explanation of the evidential, conceptual, methodological, contextual consideration upon. The dimensions of critical thinking consist of both cognitive skills and affective dispositions. Factors such as personality, culture, fair-mindedness and moral development, communication and interpersonal skills, maturity, self-confidence and so on effects on critical thinking. Instrument such as California Critical Thinking Skills Test Stone, California Critical Thinking Disposition Inventory, Watson & Glaser critical Thinking appraisal, Crnell Critical Thinking Tests and Ennis & Weir Thinking Essay Test and so on can be used to measure the critical thinking. Some strategies such as written and oral assignments, multiple choice examinations, case studies, clinical logs, faculty role model, problem-based learning and simulated clinical experiences facilitate and promote active learning, and encourage the development of critical thinking skills.
While critical thinking ability is an important outcome of education, the literature demonstrate that there were various definitions and instrument to measure critical thinking. There is a need for more research and ongoing development of valid and reliable instruments to measure critical thinking in student to guide learning strategies that effectively facilitate it among students.