فصلنامه طب و تزکیه
سال چهاردهم شماره 1 (پیاپی 56، بهار 1384)

The health care industry is a relatively late starter in This no-finish-line quality race, but fortunately There are advantages to not being in The vangaurd: So many precedents have been established that information is readily available from the quality pioneers. In that information, the late starter will find lesson others have learned (some times at considerable expense). The late starter can avoid the pits into which early starter have fallen.It has been observed that the health care industry&aposs interest in quality and principles of total quality management (TQM) parallels the interest evinced by industry itself in the 1 980s, and as health care organizations are merging with each other increasingly to form integrated health systems, so the quality - based strategic planning is required.In economic terms, health care is a good, its value realized through the market-place activity of buyers and sellers. The efficiency of health care markets, like that of other markets, depends on three parameters: The numeric balance of participants (the number of buyers versus the number of sellers), externalities (external factors that impede or skew market functioning), and the availability of information to all participants.Because, at the center of any professional activity is a continuing effort to improve performance, so health care organizations as like as any other organizations have done this in addition philosophy of paying attcr,tion to health care quality is: within health care, problems are being generated faster than we can address them.Patient care is the focus of many clinical disciplines: Medicine, nursing, pharmacy, nutrition, therapies such as respiratory, physical, and occupational, and others. In all disciplines, the quality of clinical decisions depends in part on the quality of information available to the decision-maker. The systems that manage information for patient care are therefore a critical tool.It is recognized that there is an integral relationship between medical decision making, the accumulation of clinical data, health care costs, patient outcomes, and the quality of care.The delivery of quality, cost-effective health care requires efficient decision- support tools based on the medical record system if these end points are to be achieved.Finally, the patient care quality depends on many factors that one of them is health care data quality.However, Higher quality means lower costs.

To study the level of mental health among mental health professionals working in psychiatric centers, we selected a sample composed of 120 professionals including nurses (NURs), psychologists (PSYs), social workers (SWs) and occupational therapists (OTs) and were tested by GHQ-28. Results showed that 34/9% of the sample, got a higher sèore than Iranian population cut of point, for GHQ-28. Rate of mental health problems prevalence in professionals was: 25/7% for PSYs , 35/5% for NURs, 16/7% for OTs and 66/5% for SWs. According to final findings, the highest rate of mental health problems prevalence for SWs, while they had the lowest mean of employment duration (0/9year for SWs, 2/4years for PSYs, 2/3 years for NURs, 2/1 years for OTs) led us to this hypothesis that if there is a correlation between mean of employment duration and getting mental problems in mental health professionals. Results also showed that there was no significant correlation between those two variables (r-0/02 and P < 0/80). But the above lower rate of mental problems for SWs, could be attributed to other causes.

Optimal nutrition for women is based on health and influence by variety of factors. Nutri tion of women is the health them. Nutritional needs and concers of women are based on a varity of determinates such as age, stage of growth and development,socieconomic, and cul tural factors. Furthermore, women's need specific have associated with menstrution, preg nancy, lactation and menopause. The appropriate pattern for women supplies adequate amounts of all nutrients essential for life and optimal function. Optimal nutrition is point of health promotion, prevention and treatment of disease. The aim of this study was determine and com parison dietary pattern, calorie and other nutrients intake in menopause women in rural and urban of Ardebil district. 120 menopause women of rural and urban (60 of rural and 60 urban) of Ardebil distric were select for study. Food frequency and 24 hour recall was use nutritional study. Data ana lyzed with Fp2,Epi6,SPSS andANOVA. The mean of calorie and protein intake in rural menopause women was more than urban menopause women (p<0.05), also intake of vitamin B3 in rural women was more than urban women (p<0.0 1 ). The mean ofiron intake in rural women was more than urban women (p<0.001 ). The mean of vitamin (B2,B6,folacin and A) and minerals (phosphorous,magnesium and sele nium) intake in rural women were less than recommended dietary of WHO (p<0.001). Then mean of calorie, vitamin (A,B2, and folacin) and fiber intake in urban women were less than recommended dietary of WHO (p<0.05). Food frequeney questionnaire was show cereal, par ticularly domestic bread (Lavash), potato, egg, milk, yogurt, cheese, garlic and onion, veg etables oil and butter the most of food intake in menopause women in rural and urban, respec tively. Dietary pattern in menopause women was similar in rural and urban. There was some nutri ents deficiency in food program of menopause women. Therefore,improve of nutritional sta tus effect can promotion of health menopause women in rural and urban.

Since the first part and the last part of the information circle in every therapeutic center is the medical Record Department, and all managerial, educational and research activities are dependent on acquiring the correct information which in its tum is dependent on data collecting, organizing, processing and distributing methods, these objectives are achieved when appropriate systems are run there and the improved and correct implementation of medical Record systems, appropriate management, in time education and pres ence of efficient personnel will definitely improve the society health level. So we decided to study this essential part in at least all educational hospitals of the Tehran Medical Sciences University, both public and specialized ones. A descriptive research of cross sectional kind in different aspects was done, including the personnel's situation, specialized activities methods and presence ofnecessary approaches and it was found out that 50 % of the medical Record officials had specialized academic education at BA level and higher and 7.14 % were at AD level, 35.7 % had diploma and the rest were graduates ofunrelated disciplines. In no studied hospital, there is coordinate and standard guide directions regarding the activities of different units of the medical Recorxd Pepartment and almost all jobs are done based on personal defini tion. For example, the duration of keeping files in different centers has been based on letters sent in different situations by the then officials because there have not been standard forms to be obligatory for them. In no hospital, the officials have done a specific action to update the personnel's' information and clearly there has not been any controlling system to control the incomplete files for doctors and no measure has been taken for evaluation, accompanied by appropriate feedback, aiming improvement. In 25 % of public educational hospitals and 12.5 % of specialized educational hospitals, the files are gotten out in ways other than legitimate ones. Fortunately, in 100 % of educational hospitals and 62.5 % of specialized educational centers, the officials have announced that the medical Record committee has been established but in most of them there is no appropriate feedback for improvement of activities.