This study illustrates that there are potential benefits owing to the positive influence of workplace spirituality on OCB and affective commitment among nurses. Managers of nursing services should consider workplace spirituality and its positive influence on nurses' outcomes in order to improve their performance and, subsequently, the healthcare system.

Intercostals neural blockade may safely be used to reduce the postoperative pain after laparoscopic cholecystectomy.

AIM:To evaluate the impact of a preoperative "triple non-invasive diagnostic test" for diagnosis and/or exclusion of common bile duct stones. METHODS:All patients with symptomatic gallstone disease, operated on by laparoscopic cholecystectomy f r o m M a r c h 2 0 0 4 t o M a r c h 2 0 0 6 w e r e s t u d i e d retrospectively. Two hundred patients were included and reviewed by using a triple diagnostic test including: patient's medical history, routine liver function tests and routine ultrasonography. All patients were followed up 2-24 mo after surgery to evaluate the impact of triple diagnostic test.

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Introduction:Despite a global increase in conservative treatment of blunt liver injuries, the number of surgically treated traumas in one major trauma center in Iran has increased. The aim of this study was to unveil the reasons behind this increase in operative management by studying 228 consecutive patients at this regional center.Hypothesis:The increased number of liver injuries operated upon is due to the lack of a solid, well-defined trauma system.Methods:A retrospective review of all patients admitted for liver trauma at Bahonar Hospital, Kerman, Iran, from March 2001 until March 2006 was conducted. Patient data were collected, studied and statistically processed with regard to demographics, clinical and laboratory findings, surgical procedures, complications, and mortality.Results:All patients who were admitted between 30–360 minutes after injury were included. Twelve hemodynamically stable patients were treated conservatively in an ordinary surgical ward.The remaining 216 patients, 153 of whom had blunt injuries, were hemodynamically unstable. A total of 70 patients were in hemorrhagic shock at the time of arrival. Hemodynamically unstable patients with either the suspicion of associated injuries and/or who displayed clinical deterioration and could not be observed in an ordinary surgical ward were treated surgically. The majority of patients who were operated upon in this series had a grade-II liver injury. The total mortality rate in surgically treated patients was 18.1%. None of the patients treated conservatively died.Conclusions:Despite the low grade of their liver injuries, the high number of surgically treated patients in this series was due to the absence of a valid trauma system. This result should encourage the authorities to review current trauma systems and trauma surgical guidelines.