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In this paper, we introduce a first-order integer-valued autoregressive process with zero-modified Poisson-Lindley distributed innovations based on the binomial thinning operator. Some statistical ...

In this paper, we introduce a new stationary first-order integer-valued autoregressive process (INAR) with zero-and-one-inflated geometric innovations that is useful for modeling medical practical data. Basic probabilistic and statistical properties of the model are discussed. Conditional least squares and maximum likelihood estimators are proposed to estimate the model parameters. The performance of the estimation methods is assessed by some Monte Carlo simulation experiments. The zero-and-one-inflated INAR process is subsequently applied to analyze two medical series that include the number of new COVID-19-infected series from Barbados and Poliomyelitis data. The proposed model is compared with other popular competing zero-inflated and zero-and-one-inflated INAR models on the basis of some goodness-of-fit statistics and selection criteria, where it shows to provide better fitting and hence can be considered as another important commendable model in the class of INAR models.

In this paper, a new generalization of alpha-skew-normal distribution is considered. Some properties of this distribution, which is denoted by GASN(α, λ), including moments, maximum likelihood estimation of parameters, and some other properties are studied. Finally, using a real data set, we show that our new distribution is the best-fitted distribution for the used data among normal, skew normal, alpha-skew-normal, and skew-bimodal-normal distributions.

This study was undertaken to determine the effects of transformational leadership (TL) and mediating factors on organizational success (OS) from the administrative, financial, and support employees' perspective in teaching hospitals affiliated with Shiraz University of Medical Sciences using structural equation modeling. Three hundred administrative and financial employees were selected, using stratified sampling proportional to size and simple random sampling. Data were collected using 5 questionnaires and analyzed using SPSS 21.0 and Lisrel 8.5 through Pearson correlation coefficient and path analysis and confirmatory factor analysis methods. Results showed that TL had significant positive effects on the 3 mediating factors, including organizational culture (t = 15.31), organizational citizenship behavior (OCB) (t = 10.06), and social capital (t = 10.25). Also, the organizational culture (t = 2.26), OCB (t = 3.48), and social capital (t = 7.41) had significant positive effects on OS. According to the results, TL had an indirect effect on OS. Therefore, organizations can achieve more success by strengthening organizational culture, OCB, and social capital through using transformational leadership style. Therefore, in order to increase OS, the following recommendations are made: supporting and encouraging new ideas in the organization, promoting teamwork, strengthening intergroup and intragroup relationships, planning to strengthen and enrich the social and organizational culture, considering the promotion of social capital in the employee training, establishing a system to give rewards to the employees performing extra-role activities, providing a suitable environment for creative employees, and so on.

Nurses are the largest group and an important part of the providers in the health care systems that who a key role in hospitals. Any defect and deficiency in their work can result in irreversible outcomes. This study aimed to determine the effect of supervisors' support and mediating factors on the job performance (JOBPER) of 400 nurses working in the teaching hospitals affiliated to Shiraz University of Medical Sciences, using structural equation modeling. The results showed that the supervisor's support had a significant negative effect on work-family conflict (t = -2.57) and a positive effect on organizational commitment (t = 4.03); Work-family conflict had a significant positive effect on job stress (t = 11.24) and a negative effect on organizational commitment (t = -3.35) and JOBPER (t = -2.29). Family-work conflict had a positive effect on job stress (t = 4.48) and a negative effect on organizational commitment (t = -2.54). Finally, job stress had a negative effect (t = -3.30), and organizational commitment showed a positive effect (t = 5.96) on the studied nurses' JOBPER. According to the results, supervisor's support could influence JOBPER through reducing work-family conflict and increasing organizational commitment. Therefore, to improve the nurses' JOBPER in the hospitals, some strategies are recommended.

Childbirth is a great moment in a woman's life and is inevitably influenced by emotional, social, and psychological stress. This study aimed to assess the anxiety and pain level of nulliparous women giving birth using physiological methods (without doula support) during labor and those women supported by a doula at Towhid Hospital of Jam, Bushehr, Iran in 2015. In this interventional study, 150 women were randomly assigned to either an intervention (with doula support) or a control group (with no doula support). The intrapartum, postpartum, and hidden anxiety levels were measured using Spielberger standard questionnaire used for assessing anxiety. The labor pain rate was evaluated using McGill questionnaire. Results showed that the average rate of obvious anxiety during labor was 57.76 ± 9.57 in physiological delivery (without doula) and 48.04 ± 9.61 in doula-supported delivery. The difference between mean scores of obvious anxiety during labor was significant. The mean anxiety of the control group (who did not receive doula support) was higher (P = .000). Also, the difference between the mean labor pain scores of the 2 groups was statistically significant. The results of the study showed that doula's presence has positive significant effects on labor pain and anxiety reduction; also, doula-supported mothers reported considerably lower pain and anxiety compared with those experiencing physiological delivery (without doula). Thus, the increased use of doula in hospitals all over the country is recommended.

Service quality is the most important factor in the success of health care organizations; because of their vital and important services, even very small errors can be followed by great and irreparable harm and damage. This study aimed to assess the quality of services provided in the teaching hospitals affiliated to Shiraz University of Medical Sciences in 2015. This is an applied, cross-sectional, and descriptive-analytical study conducted in 2015 in the teaching hospitals affiliated to Shiraz University of Medical Sciences. A sample of 290 inpatients with at least 2 days of admission to hospital was selected using stratified sampling proportional to size and simple random sampling methods. The results showed that there were significant negative gaps in all dimensions (P > .001), and the highest and lowest means and SD of negative gaps were related to empathy (-1.35 ± 1.4) and assurance (-0.52 ± 0.95). Moreover, the results showed that there was a significant negative correlation between the patients' age and the total mean of the patients' expectations. According to the results, the studied hospitals had not been able to meet the expectations of their patients in any of the service quality dimensions. Therefore, to improve the service quality dimensions, the authors recommend holding training courses on how to interact with patients and meet their needs, providing adequate and proper information about the diseases and their treatment for the patients, having adequate medical staff, and so on.

This cross-sectional and descriptive-analytic study aimed to estimate the demands for the use of dental services by Shirazi inhabitants in Iran from June 2013 to October 2013. Six hundred eighty subjects older than 18 years were selected from among the people living in Shiraz, using a multistage sampling method. The collected data were analyzed using SPSS 16.0 and Stata 11.0. The results showed that the factors affecting the number of referrals to the dental services centers and the use of these services included the age groups of 28 to 37 and 38 to 47 years, household expenses per month, and having supplementary health insurance coverage (P < .05). According to the results, in order to improve access to dental services and increase the probability of utilizing such services by people in need, the researchers recommend that the authorities should design and develop basic and supplementary health insurance plans to cover different types of dental services, allocate subsidies to dental health services, and increase the knowledge of all the people in different age groups about adherence to dental health principles and prevention of oral and dental diseases.

Results: The results showed that the studied employees' empowerment and organizational learning were moderate. In addition, the results of multiple linear regression indicated that only participation (P < 0.001) and competence (P = 0.001) had a positive and significant association with organizational learning. Conclusions: The studied university could promote employees' empowerment and organizational learning using strategies including job enrichment, providing opportunities for innovation and creativity for their employees, giving rewards to individuals and team learning.

Background: Job involvement is a work-related attitude which helps to increase the effectiveness of the organization. On the other hand, individuals corresponding to a specific personality type behave in a certain way and have certain expectations, objectives and needs. Objectives: The aim of the study was to determine the level of nurses' job involvement and its association with their personality traits in teaching hospitals affiliated to Shiraz University of Medical Sciences in 2013. Materials and Methods: This was an applied, cross-sectional and analytical-descriptive study. A sample of 110 nurses was determined using a multi-stage sampling method including cluster sampling, stratified sampling proportional to size, and simple random sampling methods. The required data were collected using two questionnaires that measured nurses' job involvement and their personality traits. Collected data were analyzed using the SPSS16.0 software on the basis of statistical tests including Kolmogorov-Smirnov (KS), ANOVA, independent-samples t-test, Pearson correlation coefficient, and multiple linear regression (Stepwise method). A P < 0.05 was considered statistically significant. Results: The results showed that the studied nurses' personality traits and job involvement were moderate. Moreover, the results of the multiple linear regression indicated that the studied nurses' job involvement had significant and positive associations only with achievement orientation (P < 0.001) and being formal and official nurses (P = 0.034). Conclusions: According to the results of the present study and to increase employees' job involvement, hospital administrators should establish an equitable employee performance system and provide appropriate rewards and incentives, adequate career advancement and job promotion opportunities, opportunities for making mistakes and learning from those mistakes for employees and providing a greater job security for contract employees.

To compare the patients' satisfaction between outpatient and inpatient haemorrhoidectomy.Cross-sectional study.Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran, from January to July 2011.A total of 208 patients were involved in this cross-sectional study. All patients were examined by their specialists and after definite diagnosis of haemorrhoid, they were randomly allocated to two groups: outpatient and inpatient. Data for this study was collected by a satisfaction questionnaire.There was no statistical significant difference between the two groups' satisfaction. Both groups were quite satisfied. Also, there was no statistical significance regarding the variable of time of visit. In addition, there was no association between the patients' satisfaction and with, occupation, and level of education.Based on the results of the study, minor operations such as haemorrhoidectomy are better to be done in clinics since they do not differ from the operating room regarding the patients' satisfaction.

Objective: Improving productivity is one of the most important strategies for social-economic development. Human resources are known as the most important resources in the organizations′ survival and success. Aims: To determine the factors affecting the human resource productivity using the ACHIEVEa model from the nurses′ perspective and then prioritize them from the perspective of head nurses using Analytic Hierarchy Process (AHP) technique. Settings and Design: Iran, Shiraz University of Medical Sciences teaching hospitals in 2012. Materials and Methods: This was an applied, cross-sectional and analytical-descriptive study conducted in two phases. In the first phase, to determine the factors affecting the human resource productivity from nurses′ perspective, 110 nurses were selected using a two-stage cluster sampling method. Required data were collected using the Persian version of Hersey and Goldsmith′s Human Resource Productivity Questionnaire. In the second phase, in order to prioritize the factors affecting human resource productivity based on the ACHIEVE model using AHP technique, pairwise comparisons matrices were given to the 19 randomly selected head nurses to express their opinions about those factors relative priorities or importance. Statistical Analysis Used: Collected data and matrices in two mentioned phases were analyzed using SPSS 15.0 and some statistical tests including Independent-Samples T-Test and Pearson Correlation coefficient, as well as, Super Decisions software (Latest Beta). Results: The human resource productivity had significant relationships with nurses′ sex (P = 0.008), marital status (P < 0.001), education level (P < 0.001), and all questionnaire factors (P < 0.05). Nurses′ productivity from their perspective was below average (44.97 ΁ 7.43). Also, the priorities of factors affecting the productivity of nurses based on the ACHIEVE model from the head nurses′ perspective using AHP technique, from the highest priority to the lowest one, respectively, were: Clarity, Ability, Incentive, Evaluation, Help, Environment and Validity.Conclusions: According to the results and the priorities expressed by the head nurses in order to improve the productivity of nurses, providing the orientation, training and retraining courses for nurses, developing performance-based management systems and fair systems of reward and punishment, holding continuous performance evaluation and review meetings between individual nurses and their heads, increasing funding and improving organizational facilities, delegating authority to staff based on their abilities and capabilities, providing more welfare and recreational services and facilities such as nursery schools, transportation services, etc., for the nurses, esp. women nurses, are suggested.

Objectives: This study aimed to review the effects of perceived organizational justice and its components on organizational commitment of administrative and financial employees of Shiraz University of Medical Sciences general hospitals in 2012. Materials and Methods: This was a cross-sectional, descriptive-analytical study conducted in 2012. The population in study was all administrative and financial staff of Shiraz University of Medical Sciences general hospitals. A sample size of 120 staff was selected using stratified sampling proportional to size and simple random sampling methods. The required data were gathered using two questionnaires: The modified Persian version of the organizational justice questionnaire developed by Niehoff and Moorman and the Persian version of the organizational commitment questionnaire developed by Allen and Meyer. Also, respondents were asked about their demographic profiles. The response rate was 82%. The collected data were analyzed using Statistical Package for Social Sciences 16.0 (SPSS) through some statistical tests such as Independent t-test, analysis of variance (ANOVA), Pearson correlation coefficient and Multiple Linear Regression (Stepwise method). P < 0.05 was considered statistically significant. Results: The mean score of perceived organizational justice and organizational commitment were 72.80 and 75.93, respectively. The results showed that affective and normative commitment, as well as total organizational commitment had significant positive correlations with total organizational justice and its three components, that is, procedural, distributive, and interactional justice (respectively, r = 0.544, r = 0.476, r = 0.463, r = 0.509, and P < 0.001). However, continuance commitment had only a significant positive correlation with procedural justice (r = 0.206, P = 0.042). Stepwise multiple regression analysis also showed that only procedural and interactional justice had statistically significant relationships with total organizational commitment (B = 0.511, B = 0.599, and P < 0.05). Conclusion: Improving organizational justice can continuously increase employees′ commitment. Therefore, hospital administrators should pay more attention to implement and enhance organizational justice and its components especially procedural and interactional justice in the organization, provide opportunities for supervisors to be trained in behaving better towards employees (interactional justice), and develop a fair system for employees′ performance evaluation and their promotions (procedural justice), as well as the provision of rewards (distributive justice) based on related standards.