مجله پیاورد سلامت
سال نهم شماره 6 (بهمن و اسفند 1394)

Learning is essential in healthcare environments, where knowledge and skills are quickly outdated due to continuous advances in medical science. Organizational learning is a dynamic process that enables learning organizations to be campatible with change in good time. The aim of this study was to determine the status of organizational learning in an Iranian healthcare organization in Tehran, and to assess the extent to which this organization could be considered as a learning organization.
In this cross-sectional and descriptive study, 200 nurses were selected in an Iranian healthcare organization. Dimension Learning Organizational Questionnaire (DLOQ) was used to collect data to be analyzed using descriptive statistics methods by frequency, percentage, mean, and standard deviation.
The mean overall score for organizational learning was 3.36±0.69. Among the various dimension of organizational learning, continuous learning had the highest average (3.44±0.39), and the empowerment had lowest amount (2.72±0.06).
The findings from this study provide useful information for these organization's managers regarding the areas where there is a need for improvement in OL and to make it a more LO.

In medical centers, after obtaining visceral clinical samples in suitable containers under certain circumstances, they are sent to mycology laboratory. Since sometimes it is impossible to test specimens immediately, therefore, they should be kept in the refrigerator. Thus, possibility of keeping samples, the confidently time of samples keeping in a refrigerator and the appropriate guidelines for the maintenance of visceral samples for clinical centers have a particular importance for practical purposes and are the aim of this study.
At first, the specimen was examined by KOH direct microscopic examination for detection of fungal elements. After primary culture of visceral samples on the Sabouraud dextrose agar with chloramphenicol (SC) medium, the samples were sequentially placed in a refrigerator at temperature 2-8 ºc for 1, 2, 24 and 48 hs and each sample with the specific mentioned time culturing was performed on the Sabouraud dextrose agar (S) and SC media. Then the results of growth were recorded.
From 100 samples, 79 samples had grown, 20 samples with lack of growth and in 1 sample reduced growth were observed.
After 48 hours of cold temperatures (2-8 ºc) visceral fungal clinical samples are able to grow in culture media. So samples which were not tested immediately, could be stored at temperatures 2-8 ºc in the refrigerator.

Job rotation is one of the management policies in human resource management. If these policies are done with proper planning, they can impress job satisfaction and job burnout of the employees. Present survey has been conducted in order to find relationship between job rotation with job satisfaction and job burnout.
A descriptive analytical methodology was used in 2013. The statistical community included all personnel with job rotation at the deputy of development in Tehran University of Medical Sciences (n=200). A researcher-constructed questionnaire was used to collect data. The data was analyzed by SPSS.
The mean job rotation and job burnout among men were more than women. A direct and significant relationship exists between job rotation and job burnout among the women. Job rotation and job burnout were inversely and significantly correlated.
Job rotation can have influence on increasing employees’ incentives and satisfactions and reduce Job burnout. Thus, the managers need to create an environment which contributes to knowledge transactions within an organizational framework together with promotion of encouraging their mentalities and with designing a good incentive system for teamwork, through the movement of workers in different occupations.

Nowadays, hospitals believe that applying the principles of management improve quality, and enhance competition and development. One of the ways to achieve these goals is the use of 5S. This study is aimed to determine and compare supporting departments of Amir Alam Hospital before and after the implementation of 5S.
This descriptive analytical and cross-sectional study was conducted within three departments: Kitchen, laundry and the maintenance & repairs departments of Amir Alam Hospital. Five checklists were designed for collecting information before and after the implementation of 5S within each department. Data analyses was performed using Wilcoxon test and SPSS version 19.
Average rating after running 5S was more than before within the kitchen Section. However, there was a significant relationship before and after running 5S in only stage one and five. Within maintenance & repair and the Laundry departments, average rating after implementation of 5S was higher than using it before. In addition, all purposes with the exception of employees’ adornment, were statistically significant in all of five stages.
Implementation of 5S systems will contribute to increase in employees & patients’ efficiency and satisfaction, which in turn will lead to achieving higher productivity and economic growth. Therefore, we recommend other hospitals and departments to apply the concept of 5S.

Different regulation processes have an effect on osteoblastic differentiation of mesenchymal stem cells (MSCs), and among them Wnt signaling pathway is particularly desirable. In Wnt signaling pathway, Adenomatous Polyposis Coli (APC) bind to β-catenin and induce its degradation, thereby acting as a negative regulator of canonical Wnt pathway. In this study, gene expression and DNA methylation of APC gene during osteoblastic differentiation were determined.

In this experimental study, after the isolation of MSCs, the induction of osteoblastic differentiation was done. To confirm osteoblastic differentiation, alizarin red staining together with the expression of Alkaline Phosphatase (ALP) and osteocalcin as specific osteoblastic markers was performed. APC gene methylation status by MSP (Methylation Specific PCR) and gene expression status of APC gene using Real-Time PCR technique during different times were evaluated.

The results of alizarin red staining and the expression of ALP and osteocalcin confirmed osteoblastic differentiation. In addition, the results showed a significant decrease in the expression of APC gene on the 7th day of osteoblastic differentiation (P

It seems that the decreased expression APC gene will play an important role in Wnt signaling pathway regulation in different stages during osteoblastic differentiation of bone marrow-derived MSC. Also, according to the results, APC gene promoter methylation will play an important role in controlling gene expression.

Diagnosis of preeclampsia has an essential role in applying appropriate treatment plan for the patients. The aim of this study was to design an expert system in order to diagnos preeclampsia in order to assist the clinicians.

This was a cross-sectional study which resulted in developing a new system. The study population consisted of all patients admitted to three Maternity hospitals affliated to Tehran University of Medical Sciences (TUMS). Sample size included 215 medical records which were randomly selected. The results obtained were compared with the diagnosis from experts by kappa test using SPSS software.

First of all, input parameters fuzzificated and entered into inference engine. Outputs were categorized in two groups as patients and healthy, with the final diagnosis and clinical explanation. The results obtained from system evaluation showed that accuracy, specificity and sensitivity of the system were 98.2 percent, 100 percent and 96.4 percent respectively.

Based on evaluation results, it could be concluded that fuzzy logic is an efficient method for designing of expert systems in the field of obstetrics and gynecology. Also, due to the similarity of the logic used in the proposed system with workflow and medical decision making, it will be accepted by the physicians.

The analysis of patients’ safety clinical indicators is considered as one of the safety improvement instruments. Therefore, the present study is aimed to analyze the indices of safety clinical services in selected hospitals of Tehran University of Medical Sciences (TUMS).
The present descriptive-analytical study was conducted in 11 TUMS hospitals in 2013. The study tool was the patient safety evaluation protocol of the World Health Organization (WHO). A checklist was completed following interviews, observations, and documentation reviews. The data were analyzed with descriptive and analytical tests, and SPSS software version 13.
The average scores of the studied hospitals were 96.6, 85.6 and 66 for the required, basic and advanced indices, respectively. The figure was not acceptable in required standards, but it was acceptable in basic and advanced ones. In the studied hospitals, numbers 7, 2, 4, 11, and 9 enjoyed the highest amount of conformity with standard, and were placed in rank 2 according to the ranking protocol. Finally, there was no meaningful statistical difference among hospitals in their observance of standards.
Conformity with necessary standards was low in 6 studied hospitals, but in 5 hospitals, it was acceptable in basic and advanced standards. Hospitals need enhancement programs in statements of information management system, drugs management system, infection reduction system, and effective clinical system.

Today, customer perception assessment as a way to measure satisfaction and expectations has an important role in improving the quality of services and organizational excellence. This study aims to measure customers’ perception at the Health Deputy of Iran’s Ministry of Health and Medical Education (MOHME).
This cross-sectional study was performed in 2012-2013. The population comprised the health deputies of medical universities, among which 13 of the universities were randomly selected. As the main customers of MOHME health deputy, these universities’ managers and experts were asked questions like a census. The data collection device was the national award standard questionnaire consisting of 2 sections and 26 questions. The data were analyzed by SPSS 18 with AWT IMAGE level.
Of the 267 managers and experts, 147 (56.1%) were male. Many of them (57.3%) had a bachelor's degree. Most of them (91.6%) were employed in technical units. The average perceived level of managers and experts regarding their reputation and image was 3.3±0.7, production and service 3.1±0.7, support while and after providing services 3.0±0.7, and loyalty and honesty 3.3±0.8 out of a maximum 5 points, respectively. There was no significant relationship between administrators and experts’ perception level on the one hand, and individual and organizational factors on the other (P>0.05).
The study showed that customers’ perception of indices related to the quality of relationships, services and measures was at a moderate level. Therefore, it is recommended that the department of health should design and implement an appropriate intervention program for organizational excellence.