مجله پیاورد سلامت
سال نهم شماره 5 (آذر و دی 1394)

The study of human resources flexibility impact on hospitals performance indicators can be effective on hospitals performance improvements. The main purpose of this research is to investigate the relationship between human resources flexibility and hospitals’ performance indicators of Islamic Azad University.

The present research was a descriptive-analytical research that has been induced cross-sectionally in 2013. The statistical sampling has been selected randomly, and class assignment among 108 nurses, and supportive employees in five hospitals of Islamic Azad University. Data collection tools was hospital’s performance indicator forms, and flexibility questionnaire based on Right and Esnel. The process of data analysis has been done using SPSS software and by descriptive statistical indicators and correlation tests.

The studied employees had low flexibility. The total studied hospitals were in undesirable situation from the perspective view of bed occupying and bed rotation ratio. Finally, there were not any meaningful relationship between human resources flexibility and hospitals performance indicators.

According to low flexibility of human resources of Islamic Azad University hospitals, the policies should be made in order to coordinate human resources process with human resources flexibility strategies. Furthermore, human resource for the purpose of creating flexibility and hospital subsidiaries of Islamic Azad University performance improvements could be clearly effective in such hospitals situation promotion.

The postoperative shivering is one of the common complications of anesthesia, which can cause increased systemic blood pressure, oxygen consumption, intra optical pressure and heart rate in patients. It is necessary to choose an effective intravenous and the inhaled drugs to reduce postoperative shivering, therefore the aim of this study was to compare Isoflurane and Propofol on shivering among patients undergoing Vitrectomy Surgery.
In a double-blind clinical trial, 112 patients aged 16 to 75 (ASA class I-III) who underwent the Vitrectomy surgery were randomly classified into two groups of 56 cases. The occurrence of postoperative shivering in recovery were registered in both groups. Findings were analyzed employing the t-test and Chi-square. Statistical significance was accepted for P values of There was no significant difference between the two groups in terms of age, sex, Weigh¡ duration of surgery and duration of anesthesia. The incidence of shivering in recipients of Isoflurane and in recipients of propofol was 12.5% and 32.1% respectively.
Using Isoflurane is better than Propofol to reduce the postoperative shivering in patients undergoing the vitrectomy surgery.

Scientific and technological developments have promoted the status of organizational learning as a reasonable way to deal with the present changing circumstances. The development of organizational learning improves the performance of employees, and makes them feel satisfied. The aim of this study is to investigate the relationship between job satisfaction and organizational learning capabilities among the employees of Tehran hospitals.
Materials and Methods This descriptive, analytical study was conducted among 290 employees in 2014 in Tehran hospitals. For data collection, a three-part questionnaire (including demographic characteristics, Gomez`s Organizational Learning Capability Questionnaire and Minnesota Job Satisfaction Questionnaire) was given to 290 employees. Data were analyzed using the SPSS-20 software with Spearman test.
Mean scores of organizational learning capability and job satisfaction were (3.03± 0.61) and (2.8± 0.61), respectively. Among the dimensions of organizational learning capability, the highest score pertained to systematic perspective (3.29± 0.78); regarding job satisfaction, the highest score was related to organizational climate (3.23± 0.1). The results showed that there was a significant correlation between the dimensions of organizational learning capability and job satisfaction. Also, a significant correlation was observed between organizational learning capabilities and job satisfaction.
Organizational learning improves the performance of employees and is positively correlated with their satisfaction. Also, employee satisfaction is one of the factors affecting their performance. Therefore, managers can make employees satisfied and develop their organization through improving organizational learning.

In recent years, the family physician plan has been implemented as a main strategy of the health system in Iran. Therefore, the necessity to reform organizational structure based on new goals and strategies is felt more than before. The aim of this study is to review and summarize all cases about Iran’s organizational structure and its challenges in primary healthcare system.
This study is a systematic review. All relevant databases, bibliography of related papers, and laws were searched using appropriate search strategies and keywords. To evaluate the quality of selected papers, CASP tool was applied by two experts, and their choices were discussed to reach a final decision.
Fourteen final cases were categorized in two groups: papers and upstream policies and laws. The results revealed the ineffectiveness of current organizational structure at different levels. The majority of the findings suggested proper reforms in the system. Centralization and delegation processes were the main dimensions studied.
Due to fundamental changes in goals and strategies, certain reforms in the organizational structure of health system in Iran are indispensable, especially at peripheral levels.

Lung cancer is the most common cancer among men around the world. The aim of this study was to determine the expression levels of CK19 mRNA marker in the affected patients’ peripheral blood.

Thirty patients with lung cancer (NSCLC type) were compared with 30 healthy controls. After taking peripheral blood samples and extracting total RNA, cDNA was synthesized and examined by Real-time RT-PCR technique. Then, the CEA antigen was measured by ELISA.

The CK19mRNA was positive in 7 out of 30 lung cancer patients. Hence, its sensitivity was determined to be 23.3 %. The serum level of CEA antigen was positive in 11 out of 30 lung cancer patients. The mean serum level of CEA antigen markers was higher in patients than in controls; the difference was statistically significant (P

This study showed that the sensitivity of CK19 mRNA in peripheral blood was low, but it had a high specificity for the diagnosis of primary lung cancer. Also, it was found that CEA antigen could be the specific marker for the early detection of lung cancer in patients’ peripheral blood.

Chronic lymphocytic leukemia (CLL) is a lymphoprolifrative disorder, which is very heterogeneous in prognosis. Therefore, the analysis of the prognostic factors should be very helpful in diagnosing patients with a poor prognosis. The aim of this study was to determine the relationship between circulating Endothelial cells number with VWF levels along with the other hematological findings in CLL.
Peripheral blood samples were obtained from 30 CLL patients admitted to the hematology department of Firozgar hospital and 30 healthy subjects. The levels of CEC were measured by the presence of CD34 and VWF markers, and absence of CD45 marker, using flow cytometry. VWF levels was evaluated by ELISA.
The CEC levels were significantly higher in blood of the CLL patients (0.64%), when compared to the controls (0.12%, P=0.002). The levels of plasma VWF were higher among high grade patients, when compared to controls and patients in lower grades. There was a negative correlation between CEC levels, and Hb concentration in the patients group (r=-0.47, P=0.01).
Although the levels of both CEC count and plasma VWF in patient with high grade CLL were increased when compared to patients with low grade, there was no significant correlation between these two parameters.

Employees are an organization's greatest assets and organizational performance is dependent to employee’s performance. Presence of inefficient employees can make other employees to be less productive. To improve inefficient employees to high performance level, it is necessary to analyze the performance of employees. This study aims to identify and determine poor performance dimensions and cluster inefficient staffs.
This study was an analytical and descriptive research. The research made questionnaire developed for data collection and Principal Component Analysis (PCA) and Cluster Analysis (CA) techniques in SPSS used to analyze the research data.
The PCA results showed that six poor performance dimensions were behavioral problems, low results, lack of self-efficacy and creativity, sabotage, postponing, and individualism. The CA results declared that poor performers can be classified to five clusters include poor behavior, lazy, jobber, poor ability, marginal, managers believed that root of employees’ in inefficiency attributed jobber, poor ability, and lazy employees to internal causes, and attributed bad behavior and marginal employees to external causes.
The type of inefficiency and its dimensions should be identified in order to make effective decisions for inefficient employees. Employees clustering propose a new attitude toward inefficiency differentiation comparing to literature, and this five group clustering based on empirical data expected to be more applicable in practice.

Nurses’ main tasks include the provision of healthcare services at the highest levels of quality and quantity standards, and based on the findings of scientific research. The aim of the present study is to identify and determine the barriers of evidence-based practice among nurses of Qazvin hospitals, in Iran, at 2013.
The present cross-sectional research was a descriptive- analytic study conducted among 260 nurses practicing in six hospitals of Qazvin in 2013. The barriers scale questionnaire developed by Funk, et al. was used to examine the four dimensions of evidence-based practice (EBP) barriers including adopter, organization, innovation and communication characteristics. To analyze the data, descriptive and analytic statistics were used.
The mean score of EBP barriers among subjects was 3.07 out of 4. Among the barriers, "organization" and "adopter" dimensions had the highest and lowest mean scores, respectively. There was no significant statistical relationship between gender and EBP performance, But a significant relationship was observed between organizational dimension with age, employment type and work experience.
Since “organization” was found to be the main barrier to the use of research in nursing performance, policy-makers and administrators should pay attention to the use of research in performance, the establishment of a research culture in organization, the creation of appropriate infrastructures, and the allocation of sufficient time to the nursing personnel to have access to evidences.