Payavard Salamat
Year:2012 | Volume:6 | Issue:4|Papers Count:9

Background and Aim: Accountability is a process by which all service organizations including hospitals are required to legitimize their activities. This research aims to study the seven aspects of accountability in Iran’s teaching hospitals.Materials and Methods: This is a cross-sectional analytic study performed in the second half of 1390 in five major medical-educational hospitals in 5 points of the country. A research-made questionnaire with seven dimensions (ethical, cultural, financial, operational, legal, informational, and structural) was used. The collected data were analyzed using descriptive and inferential statistics.Results: The total number of subjects was 454, of whom 45.6% were males and the rest were females (n=247). They were mostly (40.1%) in the age group of 21-to 29-year-olds, and the least figure (6.8%) pertained to those older than 50 years of age. The average mean of structure turned out to be the highest (3.54±0.97) and the informational dimension had the lowest (3.45±0.97). The average accountability score was the highest in Rasht hospital (99.3±0.61) and the lowest in Tehran hospital (3.02±0.67). The correlations between all dimensions were confirmed. Moreover, accountability as evaluated in the studied educational hospitals was above average.Conclusion: Patients' attitude towards accountability in Iran’s teaching hospitals was assessed to be above average. The findings show that an office or a unit for accountability, validation, and continuous audit of its dimensions is essential to advance the high goals of the hospitals.

Background and Aim: Learning may be the only sustainable competitive advantage for all organizations. A learning organization is an organisation where people continually expand their capacity to create results they truly desire; new and expansive patterns of thinking are nurtured; collective aspirations are set free; people are continually learning from what others have learned. The aim of this research is to study whether a learning organization and its subsystems are established in Shahrekord University of Medical Sciences (SKUMS).Materials and Methods: This descriptive-survey study was conducted in 2012. Marquardt’s standard questionnaire was used to measure learning organization based on Likert’s scale with a Cronbach’s Alpha coefficient of 0.946. The research sample consisted of 177 staff members (bachelor’s degree holders and bove) in seven vice-chancellorships of SKUMS, selected through simple random sampling.Results: The findings of the study are twofold. (1) According to the results of  one-sample t-test with a 95% confidence interval, the mean scores in learningorganization and sub-systems of learning dynamics, people empowerment, knowledge management and technology application subsysems were higher than the assumed mean of 3; however, the figure turned out to be equal to the assumed mean for the organization transformation subsystem, and (2) Based on Freidman Test, there was a significant difference between the means of at least 2 learning organization subsystems.Conclusion: According to the research findings, more attention should be paid to the subsystems of learning organization establishment and balanced development of these subsystems.  

Background and Aim: A vast majority of clinical specimens are contaminated with Klebsiella species. The drug resistance among Klebsiella species is increasing day by day; therefore, antibiotic senility test is necessary before prescribing antibiotics. The aim of this research was to determine the antibiotics resistance patterns of Klebsiella species isolated from clinical specimens of patients using the standard Kirby-Bauer method.Materials and Methods: The present research was performed on 300 specimens of Klebsiella collected from Imam Khomeini hospital. After identification, drug resistance was investigated through the standard CLSI procedure. The drug sensitivity test was determined for all of the 12 antibiotics using standards of disk diffusion in agar Kirby-Bauer.Results: The frequency rates of the isolated Klebsiella species were: pneumonia (94%), oxytoca (4%), ozaenae (1%), and rhinoscleromatis (1%). Moreover, in terms of source of infection, the collected samples in order of frequency were: urine, sputum, vagina, scar, stool, and blood, respectively. Altogether, the percentage rates of resistance were as follows: Ampicillin (97%), Amoxycillin (97%), Cefalotin (39%), Gentamicin (30%), Colistin (55%), Nalidixic acid (2%), Chloramphenicol (26%), Kanamycin (17%), Tetracycline (28%), Nitrofuration (44%), Ceftazidime (2%), and Amikacin (0%).Conclusion: The results showed that the lowest resistance rate obtained was related to Amikacin in all tested Klebsiella; therefore, it can be recommended as the most effective antibiotic.

Background and Aim: Chronic myelogenous leukemia is characterized by Philadelphia (Ph) chromosome, the presence of BCR-ABL fusion gene and constitutive activation of the ABL1 tyrosine kinase. Despite an excellent result of target therapy by imatinib, some patients develop resistance to imatinib. In this study Efficacy of HESA-A on proliferation and apoptosis of K562 cell line was assessed.Materials and Methods: In this study doubling time of K562 cell line was calculated. The cells were affected by various concentrations of HESA-A (1,2,4 and 8 mg/ml respectively). Cytotoxicity and IC50 dose of HESA-A were detected by MTT and trypan blue exclusion assay. Apoptosis was assessed by flowcytometry after 48 h cell treatment in the presence of IC50 dose.Results: Doubling time of K562 cells was 24 hours. HESA-A reduced the number of viable K562 cells in a concentration dependent manner.IC50 dose was 3.5 mg/ml. In flowcytometry analysis of apoptosis, 19.22% of the treated cells were located in the position of the necrotic cells.Conclusion: The results of MTT and trypan blue exclusion assay suggest that HESA-A inhibits the growth of k562 cells in a concentration dependent manner and induces necrosis in K562 cells.

Background and Aim: Human Giardisis infection is caused by the flagellate protozoa. Giardia lamblia, which lives in the small intestine, causing damage and may also cause gastrointestinal symptoms. This parasitic disease has a worldwide distribution and prevalence varies from 5% to 30%. The role of both humeral and cellular immune response in the host defense against parasites has proven. Since an immune response is directly affected by cytokine, study of cytokines changes in patients with giardiosis is of particular importance.Materials and Methods: In this study the serum levels of IL-2-4-6 to 17 and 23 in patients and healthy subjects were measured and compared. Fasting blood samples were taken from the volunteers, ELISA was performed to measure cytokines.Results: In this study, the amount of IL-2 and IL-6 in infected patients was significantly more than the controls, but IL-4 levels were significantly lower in infected individuals (P=0.0001). Also for the first time in people with giardiasis IL-17 and IL-23 was measured and there was a significant aifference in these cytokines between the infected patients healthy controls(respectively P=0.044 and P=0.03).Conclusion: Host defense response against parasitic infections, is directly and affected by cytokines. Increased interleukin 2, 6, 17 and 23 in patients with Giardiosis was probably caused by immune response and local intestinal inflammation.

Background and Aim: In many countries, hospitals have triple ownership (governmental or public, for-profit, and not-for-profit). Numerous studies have been performed in order to investigate the differences among these hospitals in accordance to expenditures, presentation of uncompensated therapeutic services, number of outgoing patients and other measurement devices of hospital performance. The aim of this research was to investigate the role of ownership on total Factors Productivity changes in Qazvin’s selected hospitals.Materials and Methods: Descriptive-analytic study was conducted in three periods of time from 2005 to 2007 in 8 selected hospitals of Qazvin. Inclusion criteria included the active beds and the value of intermediate consumptions in hospitals. The exclusion criteria included the total number of inpatient and surgical operations. Data collection tool, was researcher-designed checklist. Data were analyzed using DEAP 2.1 software and ANOVA, HSD and TUKEY tests.Results: There was a significant difference between the mean productivity of three hospital groups due to the existence of various ownership (p=%012), Also a significant difference was observed between the mean of technological efficiency of the three groups of hospitals (p=%006), No significant differences was found between the mean of technical efficiency of the three groups of hospitals (p=%23).Conclusion: Cause of the variation in total factor productivity in private hospitals, is due to their suitable production technology which is always improved. But in respect to their efficiency promotion and optimization of production and products, there was no distinguishing difference with other hospitals.

Background and Aim: Staff satisfaction is one of the basic and important indicators for assessment of contract management. The aim of this study was to survey relationship between contract management and staff satisfaction in hospitals affiliated to the Tehran University of Medical Sciences in 2011.Materials and Methods: This research was a cross-sectional and descriptive study. Six hospitals which were deployed a contract management system in recent years were chosen. A questionnaire with Likert scale was designed to measure the satisfaction.One hundered and twenty three employees filled the questionnaire. The data analysis was performed using descriptive statistics and paired t test.Results: The average staff satisfaction score before implementing contract management system was 3.04 (out of 5) and after implementation was 2.86. The correlation of satisfaction among workers before and after the out sourcing was significant (P<0.005). It was clear that satisfaction was reduced after the transfer.Conclusion: The average staff satisfaction score before implementing contract management system was 3.04 (out of 5) and after implementation was 2.86. The correlation of satisfaction among workers before and after the out sourcing was significant (P<0.005). It was clear that satisfaction was reduced after the transfer.

Background and Aim: Nowadays, Information conduct health care system and its substantiation depend on available correct data and reliable information. This study was performed to determine the accuracy rate of statistical indicators in Kashan educational hospitals.Materials and Methods: This was a cross-sectional descriptive study carried out in March2009-August 2010. Data (the items that need for evaluate of each indicator) were gathered with self-designed checklist. The accuracy of items and hospital indicators were compared with items and indicators that researcher had gathered or calculated. Data(frequency and percent) was presented with descriptive statistical method.Results: Findings showed that maximum rate of accuracy was found in gross death percentage(68%), and minimum rate was found for the average bed count (24%). The accuracy rates of other indicators were: bed occupancy percentage (39%), bed turn over rate (47%), and bed occupancy average (61%). Net death percentage and bed turn over interval both were (49%). Totally, the accuracy of hospital indicators were 53% which was in a moderate level.Conclusion: The accuracy of hospital indicators is low. Use of monitoring methods for improvement of its accuracy is recommended.