مجله علوم پزشکی صدرا
سال پنجم شماره 2 (بهار 1396)

In institutions of technical and vocational training, trainees are asked to operate machinery and engage in high-risk manual activities that may expose them to a wide array of potential risks and safety hazards that are unknown to them. Therefore, Job Safety Analysis (JSA) was used in this study to identify potential hazards in one technical and vocational training institution in Zahedan.
This cross-sectional study was done in one of the technical and vocational training institutions in Zahedan in 2011. In this study, 9 technical or vocational workshop activities including carpentry, metal turnery, installation, milling, smooth, welding of building windows, pipe welding, diesel maintenance, and light vehicle maintenance were assessed based on their importance and frequency. All 53 craft vocations were divided to 210 specific sequence steps and hazards of each step were determined using check list, available documents, observations and interviews. For the purpose of risk identification, MIL-STD-882 E matrix table was used. In the final stage, corrective and controlling measures for all hazards were proposed in the special sheet. Excel 2013 software was used for data analysis and interpretation.
524 hazards were determined by JSA. Although it is always difficult to report with certainty that there is no risk, the overall results of this study indicated that there was no risk involved at an unacceptable level. In general, hazards were found in the following: 65 hazard risks level were found to be serious, 257 hazards risk level were found to be acceptable but needed to be revised and 202 hazard risk level were found to be low. Carpentry, metal turnery and installation with 81, 75, 72 hazards, respectively, were the most hazardous technical working activities.
Considering the fact that carpentry, metal turnery and installation exist in almost any occupational environment, it is crucial to provide advice on preventive and protective measures (i.e. health and safety guidelines and detailed Codes of Practice), and to insist upon on-the-job training for trainees to reduce the level of risk arising from activities performed in the training centers and workplaces.

Trauma is one of the leading causes of mortality and morbidity worldwide. Among different types of injuries, chest trauma is responsible for a vast majority of trauma-related mortality and morbidity.
This descriptive, cross-sectional study included cases of thoracic trauma that underwent thoracotomy at Shiraz Namazi Hospital from March 2008 to March 2010. The collected data from each patient included: demographics (age and sex), type of trauma, type of surgical intervention, volume of hemothorax, number of packed red blood cells transfusions, and the consequent adverse effects.
A total number of 81 patients (mean age= 26.72 years old) were included in this study, of which 74 cases (91.4%) were male and 7 cases (8.6%) were female. Reportedly, the most prevalent type of trauma was penetrating injury (71.6 %); the most used surgical approach was left anterolateral thoracotomy (55.6%); the mean hemothorax volume was 1686.53 cc, and the average number of transfused pack red blood cells was 3.74 units per patient. The mean time of surgery was 161.25 minutes, and the most susceptible organ for injury was the lung with an injury prevalence rate of 55.4%. The mean duration of hospital stay was 8.43 days. 5 patients (6.2%) underwent a second surgery and 15 cases (18.5%) did not survive the surgery.
According to the findings of this study, anterolateral incision was the most used thoracotomy approach in patients with thoracic trauma.

There is an urgent need to identify and apply a diagnostic tool that can assess children’s eating behaviors. This study aimed to assess the validity and reliability of the Persian version of Children’s Eating Behavior Questionnaire (CEBQ) in 1-6 year-old children in Shiraz.
The study participants included 350 children (280 girls and 270 boys) selected through convenience sampling. CEBQ was completed by the children’s mothers. Then, the reliability of the questionnaire was assessed using test-retest and Cronbach’s alpha methods. Its validity was also evaluated using exploratory factor analysis.
The reliability of the questionnaire was assessed using test-retest method with a 2-week interval. Accordingly, test-retest and Cronbach’s alpha coefficients were 0.71 and 0.74, respectively. Additionally, the results of factor analysis revealed 6 subscales, namely desire to feed, desire to drink, emotional under-eating, emotional over-eating, slowness in eating, and variety seeking, which explained 53% of the variance.
The study results showed that CEBQ had appropriate psychometric properties for assessment of nutritional behaviors among 1-6 year-old children. Therefore, this instrument is recommended to be used in laboratory and clinical researches.

Strategic plans in hospitals can be considered an investment to improve their performance. However, managers who intend to use strategic planning to achieve success are faced with barriers against its implementation. This study aimed to investigate the barriers against implementation of strategic plans from managers’ perspectives in teaching hospitals of Shiraz University of Medical Sciences.
This descriptive-analytical, cross-sectional study was performed in 2016. The study population consisted of 40 domestic, administrative, financial and accounting, and nursing managers selected through census. The data were collected using a researcher-made questionnaire including questions about effective barriers against implementation of strategic plans. Then, the data were entered into the SPSS statistical software, version 23 and were analyzed using descriptive statistics, ANOVA, t-test, and Pearson’s correlation coefficient.
The results showed that the barriers against implementation of strategic plans were related to structural (27.12±6.58), human (20.12±4.43), process (16.44±3.99), and institutional (15.85±4.80) factors. There was no significant relationship between demographic variables and barriers against implementing strategic plans in hospitals (p>0.05).
Hospital managers should identify and eliminate the barriers against implementation of strategic plans. Considering the dynamic nature of management processes, training courses are recommended to be held based on the needs and priorities obtained in this research.

Patient safety and quality of health-care delivery depend very much on effective teamwork and interpersonal skills. Moreover, maintaining a positive attitude toward teamwork is vital. Considering the importance of interpersonal skills in an organization, the relationship between individuals’ attitudes toward teamwork and their interpersonal skills is not yet very clear. Therefore, this gap in research triggered the researchers to determine the relationship between interpersonal communication skills and attitudes toward teamwork in nursing students.
This cross-sectional study was conducted in 2016. The sample consisted of 84 nursing students with a mean age of 21.92 ± 2.02 who were selected by census method. Data collection instruments were "Interpersonal Communication Skills Questionnaire" and "Teamwork Attitude Questionnaire". To analyze the data, descriptive statistics, Pearson and Spearman correlation coefficient, independent t-test and Mann-Whitney were run, using SPSS software version 16.
The findings showed that there was a significant positive relationship between the interpersonal communication skills and the total score of attitudes toward teamwork (r = 0.42, P The findings revealed that the interpersonal skills had a positive and moderate correlation with the attitudes toward teamwork, leadership, team structure and communication dimensions. Therefore, in order to improve the attitudes of health care providers toward teamwork, it is recommended to reinforce interpersonal skills in the workplace.

Ethics in medicine is of particular importance in Islamic culture. Physiotherapy is one area of medical sciences, which has grown dramatically in the recent years. Ethical principles of physiotherapy should be developed in accordance with Islamic culture and be provided to physiotherapists. To achieve this goal, it is necessary to define a set of ethical codes that could form physiotherapists’ performance structure and provide strategies for dealing with ethical challenges.
This study aimed to compare the ethical principles presented by World Confederation for Physical Therapy to Islamic ethics.
The results revealed consensus and common principles between the professional ethics of World Confederation for Physical Therapy and Islamic culture.
In metaphysical worldview, God’s existence is the principle. Thus, the centrality of God is considered in all aspects, including individuals’ intentions. In contrast, man and the world are the center of non-divine worldviews. Therefore, this viewpoint towards one’s profession, including physiotherapy, can lead to a gap in spiritual and emotional relationships.