Journal of

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Background and Aim : Creation of knowledge management (KM) and efforts to use it in the university research programs shows the university society activity to enhance intellectual qualities and improve this effectiveness of the universities on the development and advancement in the countries. The objective of present study was to evaluate the status of organizational culture and structure for implantation of KM in the central libraries of the medical science universities in Iran.

Materials and Methods:The present work is an applied research and descriptive-analytic study.  The survey population consisted of 80 people who were directors or managers of 29 central libraries in medical science universities. Data collection method was used based on the questionnaire.  The validity was checked by researchers and reliability Cronbach's alpha (>0.7). The data & information were analyzed with descriptive statistics and independent t-test by SPSS software package ver. 15.

Results: The findings showed that the status of "organizational structure" of KM in these libraries was intermediate, whereas "organizational culture" was in the suitable status. Also in the libraries in which decentralization, revision in knowledge sharing process and Internal Network for knowledge sharing is adopted, higher organizational culture as compared with  other libraries, and have significant differences in them (p<0.05).

Conclusions: The result of present work is a proof for willingness and propensity of the Iranian librarians and their managers in the process of knowledge sharing and utilization of KM is at the proper level. Therefore, the authorities should provide the necessary structures and other complementary backgrounds for the utilization of KM in Iranian university libraries.

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Background & Aim: Unified Medical Language System (UMLS) is an extensive ontology of biomedical knowledge developed and maintained by U.S. National Library of Medicine (NLM). Traditional Iranian Medicine (TIM) does not have any position in the structure of metathesaurus of UMLS. The main aim of this study was designing a scheme of TIM cluster's crotch mapping in the structure of metathesaurus of UMLS. Moreover, the TIM position and its proportion in the domain of vocabulary and concepts of universal medical knowledge was another aim of this study.

Materials and Methods: System analysis was the method of this study. To investigate structure of UMLS metathesaurus, and to survey lacking of TIM cluster's crotch, we applied UMLS Knowledge Source (KS) by using inductive, deductive, inductive-deductive approaches. 

Results: One Concept Unique Identifier (CUI) two synonym terms with Lexical Unique Identifier (LUI), L0025131 and L6330122 two ancestor and parent concept nine concepts which with TIM crotch were the child concepts of two ancestor and parent eighteen sibling concepts six narrower and five other related found concepts were identified for the proposal TIM crotch mapping in metathesaurus of UMLS. In addition, we found the "Biomedical Occupation or Discipline" semantic type assigned to it.

Conclusions: Current domain of metathesaurus of UMLS does not represent complete and formal domain and position of TIM. Therefore, this metathesaurus needs to depict a domain and position for TIM.

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Background And Aim: Nowadays university websites are very important in information services. There fore university has designed website for categorizing and availability of mass of information . This study accomplish to purpose evaluated of Tehran university of medicine sciences website base on webometrics criteria on 2008 .

Materials and Methods: This survey have been used link analysis methods by four criteria : visibility , size , rich file and google scholar . The situation of Tehran university of medicine sciences website has surveyed . Data gathering tools at webometrics survey are search engines . Data are gathering at google , yahoo, live search and exalead search engine . For data analysis used Excel software.

Results: Findings showed that , visibility of Tehran university of medicine sciences website with 9562 inlinks are weak , nevertheless published research at google scholar with 12100 articles , have suitable ranked in region and world. also size of university website depended to indexing of search engine , web of university often indexing at google and yahoo , less than at live search and exalead .10813 pages published at Rich files format on google , website of university tend to publish rich files as format of .pdf and then .Doc and .ppt . Average load time for tums with 4.2 second is not desirable.

Discussion and Conclusion: Number of papers and citations for tums domain at google scholar is very good at world and middle east. Number of pages recovered from Google, Yahoo in Persian language are optimum but pages from Live Search and Exalead in English language is not favorable . The total number of unique external links received to tums website from Iranian university website is good but from international and information institution is low .

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Background and Aim: Citation could be considered as basis of scientific researches. Each researcher will use citation to prove his scientific findings either to be in correspondence with truth or to familiarize readers with more references. Maintenance and continuation of informational link by citation is essential. Theses are not exceptional for this subject. This study was done to review the accuracy of cited articles of specialized theses (Tehran University of Medical Sciences in 1386) and the rate of correspondence with Vancouver style.

Materials and Methods: Citation analysis is used as study approach. By systematic sampling and Morgan table 357 cited articles were selected to review for accuracy of citation and their correspondence with Vancouver style. Six studied factors are as following: Name of author(s), title of article, title of journal, year of Publishing, volume number, number of pages. Citation errors are divided in to two main groups: 1-Minor errors 2-Major errors. Method of sampling is direct observation. Data was entered in a check list, based on Taylor division. SPSS(11.0) software was used to analysis.

Results: Out of all 357 reviewed cited articles, totally 111.4% citation errors were observed and only 136 (38.09%) of citations had no error and 221(62%) citations had errors. 9.8% of citations fully corresponded with Vancouver style.

Discussion and Conclusions: Main reasons of dissatisfying results of citation errors and rate of correspondence with Vancouver style are as follows: Student's unawareness of importance of scientific researches consistence Laxity of students about citification produce, inaccessibility to original references and copy of other sources. Teacher's less emphasis on accuracy of citation, carelessness of educational universities about accuracy of citation in thesis, not use of experts and specialized librarians for consultation, being not familiar with reference management software.

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Background and Aim: Development and evaluation of rehabilitation services as a section of health system, which plays an important role in the improvement of the quality of life, needs a mechanism for information management as well as other healthcare levels. The effectiveness of information management has been assured through standardization & ongoing evaluation of rehabilitation centers. There is no standardization on rehabilitation information management processes in Iran, Therefore we surveyed the standards of information management at Commission on Accreditation for Rehabilitation Facilities and compared them to same English & Australian rehabilitation services evaluation & standardization organizations. At the end, we present a framework for necessary standards for this field.

Materials and Methods: In this literature review article CARF standards in axis of information management infrastructural standards, data gathering, content of records, documentation principles, information reveal for confidentiality policies of standard classification has been investigated. We used reliable electronic references in this article.

Discussion and Conclusion: The CARF information management standards are included a standardized outcome-oriented program evaluation & management systems as a fundamental & infrastructural requirement, data gathering standards, internal content of patient records, the framework for complete documentation and maintenance of information confidentiality. Therefore CARF standards in term of information management are the most complete model and have enough details in compare to the others. The results indicate that CARF standards can be a proper model for standardization activities and evaluation rehabilitation centers.

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Background and Aim: The major tasks of libraries is collecting information resources in appropriate shapes for clients needs and organize resources for making them available. This study has been done to review this status in school and hospital libraries of Tehran University of Medical Sciences.

Materials and Methods: This is survey descriptive research. Method statistical population consisted of all college and hospital libraries of Tehran University of Medical Sciences. Intrument data collection was a questionnaire that its resiability and validity was measured Setting tables and getting percentages is performed as the Average measures in Excel spss version 12 programes.

Results: The highest rate of bachelores and masteres in libraries organized sector (more than 62 percent) belong to the libraries professionals. Staffes of 7 libraries (32 percent)are familiar with abstract and indexing services and staff is of more than 45 percent of libraries (more than 10 libraries) are familiar with a variety of subject headings and thesauri .

Conclusion: Low percentage of the average organization also show little attention in organizing some non-book materials. Low percentage of librarians orientation with abstracting and indexing services and also thesauri (45%) are the reason for this little attention.

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Background and Aim: Annually, large amounts of fees that paid by hospitals will not be reimbursed as deductions by health insurances and takes irreparable financial losses to hospitals. The purpose of this study was to determine the amount of deductions imposed on hospital bills of Tehran University of Medical Sciences and their causes related to documentation.

Materials and Methods: The present research was a cross-sectional and descriptive study performed in year 2009 on educational hospitals of Tehran University of Medical Sciences. All deductions reports related to Medical Services and Social Insurance related to year 2008 was collected from Income Unit of hospitals. The amount of deduction of each hospital was extracted and organized in the form of comparative tables. Data was analysed by descriptive statistics and Excel application. Then, the amount, type and causes of annually deduction of each hospital was determined.

Results: Most deductions imposed on inpatient bills have been related to the tests, appliances, medicine, residency, surgeon commission, and anesthesia and for outpatient bills have been related to visit, tests and medicine which most of them have been created due to documentation deficiencies.

Conclusion: Most of deductions are due to unfamiliarity of care staff with documentation requirements of insurance organizations. Therefore it is necessary to use a multi-aspect mechanism including education of documentation principles to staff, supervision on record control in the Medical Record Unit and establishment of a committee by university for related activities.

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Background and Aim: The international book fair is an opportunity for school libraries. This study was conducted to determine the role of the Tehran international book fair to provide books for school libraries.

Materials and Methods: The study is a descriptive survey. Employees and authorities worked in libraries affiliated to Tehran and Beheshti Medical Sciences Universities consisted the study population. Sample size included 41 individuals(26 staff and 15 officials). For data analysis descriptive statistics by using one sample t- test, chi square, ANOVA and correlation were used.

Results: The highest average score dedicated to choose books in school libraries was a scale of a 3/35± 0/89. With an average score of 3/06±0/07, the role of International book fair in supplying books for school libraries was moderate. Correlation test showed that problems of school libraries had the highest correlation(r=0/36) while the lowest correlation was related to the possibility of book supply(r =0/067).

Conclusion: The international book fair does not have an effective role in supplying books for school libraries. It is necessary to use new approaches to supply books for academic libraries.

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Background and Aim: Pityriasis versicolor is a fungal disease with causative agent Malassezia species which is an opportunistic and lipophilic yeast .With regard to liphophilic nature of the yeast, this study was carried out for evaluation of relationship between pityriasis versicolor and triglyceride and cholesterol levels.

Materials and Methods: This cross - sectional study was performed on 1500 subjects ranging from 10 to 50 years old in Isfahan province. Of total subjects, 105 had pityriasis versicolor. Disease confirmation was based on direct examination, inoculation and culture on Dixon media. Measurement of total cholesterol and triglyceride of patients and control groups in fasting manner was done by Auto analyzer RA 1000. Data of patients including age, education level and job was gathered by questionnaire and analysis of results was done by t student, chi square and Pearson correlation tests.

Results: Prevalence of infection was 7% in the test group. Maximum frequent rates of infection was %3.13 in age group 20- 30 years and minimum in age group 30-40 years(% 0.87). The highest rate of total cholesterol levels was seen in age group 40-50 years (mean 215 mg/dL) and the lowest was in age group 10-20 years(mean 205 mg/dL).

Conclusion: Total cholesterol and triglyceride levels in patients were higher than the control group but the difference was not significant(P<0.05). No correlation was seen between pityriasis versicolor and increase in the total cholesterol and triglyceride levels in patients and control groups.

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Background and Aim: Citation is one of the journals ranking factors. Self-Citation rates regarding journals `performance, especially in international databases, is important. The aim of this study is to examine the effect of Journal self-Citation on Impact Factor of Iranian English medical journals indexed in the Web of Science and Islamic World Science Citation Center.

Materials and Methods: The Impact Factor of 12 journals in WoS and 26 in ISC were studied during years 2006-2009 using citation analysis and Journal self-Citation. Self-Citation rate were calculated using cited journals and citing journals tables in ISC. Wilcoxon test and Mann-whiteny test were used for comparison of self-citation rate between two databases. In order to determine any correlation between journal self-citation and IF in WoS, Pearson test was used. In ISC, Spearman test was performed. For comparison of two correlations test, Covariance test was used.

Results: No significant difference between Journal self-citation rates in two databases was noted(p>0.05).There was a significant correlation between Journal self-citation and Impact Factor in WoS(p=0.007, r=0.64). The correlation was not statistically significant in ISC(p>0.05, rsp =0.23). There was not any significant difference between the relations of Journal self-citation and impact factor in two databases(p=0.526).

Conclusion: Attention to the Journal self-citation rates for comparison of Journal Impact Factor in WoS is more important than attention to the comparison of these journals between two Databases.

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Background and Aim: Motivation and satisfaction of manpower are the most important variables in the field of organizational behavior and because of the strong relationship between these two variables with the job and organization productivity, it’s necessary to look job characteristics as increasing factor of employee satisfaction and performance in redesigning jobs. The objective of this study was determining motivating potential score (MPS) of the jobs and survey the relation between MPS and job satisfaction in staff employees of educational and research deputy of TUMS (Tehran University of Medical Science).

Materials and Methods: This was a cross-sectional and descriptive-analytical study. The research context was to staff employee of education and research deputy of TUMS. Sampling frame of the study was simple random sampling. Data collection method was a questionnaire. Reliability of the questionnaire was ascertained with pilot study with and confirm with Cranach's Alpha. T-test and Pearson correlation were the analytical methods.

Results: The results showed the jobs of the study population have skill variety, task identity, task significance and potential motivation but haven't job authority and feedback. The findings showed there was significant relation between motivating potential power and its dimensions with the job satisfaction ( P<0.05 ).

Conclusion : The job characteristic have great impact on the job satisfaction so this model can be used for redesigning the jobs to increase job satisfaction.

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Background and Aim: Accreditation is one of the evaluating health care organization tools especially in hospitals and is also one of the priorities of Ministry of Health in Iran. The aim of this study was to examine the impact of accreditation on health service delivery in hospitals from perspective views of experts.

Materials and Methods: This qualitative study was conducted by semi-structured interviews and opinions of 12 experts at Isfahan University of Medical Science in the field of hospital accreditation in 2012. After transcription of each interview, content analyses was used to minimize and structuring qualitative data.

Results: According to this study, 10 main theme and 72 sub- themes were identified. Main themes included: Necessity, implementations priorities and mechanisms of Accreditation effect, accreditation impact on service quality and organizational performance, patient satisfaction, commitment and job satisfaction of staff, reducing factors the impact of accreditation, confounder factors the effect of accreditation and the executive proposals in order to implement accreditation program in Iran.

Conclusion : Accreditation could be properly implemented through setting Conditions, selecting the appropriate accreditation model, justify stakeholders about the necessity of accreditation, monitoring, establishment of appropriate information systems, information transparency and changing the general attitude of the organization. It would take positive effects to achieve hospital goals and improve the quality of services.

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 Background and Aim: Defensive medicine is a potential social problem which can bring about consequences for public health regarding the quality of personal care and wastage of limited health resources. In this study, the frequency of positive and negative defensive medicine behaviors was examined among general practitioners of Kerman city.

 Materials and Methods: This cross-sectional study was conducted among general practitioners in the city of Kerman. As data collection instrument, a questionnaire was given to a sample of 100 subjects. The obtained data were entered into SPSS 20 and analyzed using such descriptive statistics as frequency percentage and mean, and applying analytical tests such as chi-square and t-test.

 Results: In this research, 100 general practitioners were studied. The frequency of positive and negative defensive medicine behavior was 99% and 47%, respectively. Besides, the positive defensive medicine behavior in men was more than that in women (100% vs. 97.2%) on the contrary, the negative defensive medicine behavior in women was more than that in men (52.8% vs. 43.8%). Explaining in more detail about taking medicines properly and on time and avoiding the prescription of risky behaviors which might be useful to patients had the highest frequency among positive and negative defensive medicine behaviors, respectively.

 Conclusion : The present study showed that the frequency of defensive medicine was high in the studied population and that the application of factors related to this phenomenon by the participants of the present study was prevalent.

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 Background and Aim: In order to better design an electronic health record system in the country, determining standardized data elements for creating an integrated information system is important. In this study, the minimum data set of radiology reporting system is determined.

 Materials and Methods: In this descriptive cross-sectional study, 13 radiologists, 3 anesthesiologists, 3 general practitioners and 3 insurance experts working in the Imaging Center of Imam Khomeini hospital in Tehran were chosen. The research tool was a questionnaire having 11 parts. Content validity and test-retest method were used to measure the validity and reliability of the questionnaire, respectively. Data analysis was performed using the SPSS software.

 Results: The highest means reported were radiologists' written explanations and suggestions (9.6), image interpretation (9.5), the name of contrast material (9.4), the name of imaging procedure (9.3) type and date of previous measures (9.1), and the final diagnosis (9) and the lowest averages belonged to referring physician's address (4.8), relationship between patients and the primary individual insured (4.3), and religion (2.2).

 Conclusion: In an electronic health record system, due to the importance of radiology reports for the diagnosis and future management of a patient's clinical problems, it is necessary to pay attention to the minimum set of data related to these reports such as administrative, insurance, patient identity, and clinical data, and the results of radiological examinations for exchanging with electronic health record system.

 

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Background and Aim: One of the perennial questions for hospitals and insurance organizations are the real cost of g lobal surgery. The aim of this study was to compare the cost of global surgery bills with approved tariffs in hospitals affiliated to Tehran University of Medical Sciences Medical Sciences .

Materials and Methods: This was a cross – sectional study . The study population included all hospitalized patient bills eligible for global tariff at nine selected hospitals (include: Imam Khomeini, Shariati, Arash, Fatemeh Alzahra, Zanan, Cancer Institute and Razi) affiliated to Tehran University of Medical Sciences in 2012. Checklist was used for data collection. Data about the real costs of surgical procedures were collected from the patients' bills . Data were analyzed using descriptive statistics in SPSS version 16 software .

Results: The results showed that a total of 90 included global tariff surgical, 68 surgical procedures were performed in nine selected hospitals. Except seven surgical procedures in other cases (61 cases), the real costs of surgical procedures average 3 -312 percent more than approved global tariff. The surgical procedure "Septoplasty" had the most difference with global tariff.

Conclusion: The results showed that surgical global tariff are not real, and lead to the hospitals financial loss. Therefore, it is recommended that to prevent the hospital financial loss in the calculation of the g lobal t ariff factors such as patient age , presence or absence of comorbidity and complication, disease severity, length of stay and inflation rates in country to be considered .

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Background and Aim: Today universities admit International Students as well as national students. Tehran University of Medical Sciences has been also started admitting International Students in regards of its Internationalization aims. Student’s satisfaction is of high importance in order to gain the given goals. The purpose of this study was to evaluate the satisfaction of International students of TUMS.

Materials and Methods: This was a descriptive study. The target group was international students of TUMS, the participants were selected through availability sampling. The research instrument was researcher-made questionnaire which the reliability calculated as 0.97 by Chronbach’s alpha. The data was analysied by Microsoft Excell version 2010.

Results: The overall satisfaction of the students was 70% (satisfied and completely satisfied) while the overall dissatisfaction was 10% (dissatisfied and completely dissatisfied).

Conclusion: Given satisfaction of more than half of the International students, TUMS has performed reasonably. Based on the results obtained in this research the university may pay attention to the fields reported as dissatisfied.

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Background and Aim: Online submission and peer review systems are formal channels of communication among authors, journal editorial boards, and reviewers. The review process starts after authors submit their manuscripts. The aim of this study is to examine the online article submission and peer review systems in terms of the capability in medical journals of Iranian Ministry of Health, and Medical Education. Materials and Methods: In this descriptive survey study, 199 approved Iranian medical journals were examined so that the characteristics of online submission and peer review systems could be investigated. To study author role features, a checklist was developed by the researcher. The data were analyzed by SPSS 18 and Microsoft Excel 2007. Results: The online submission and peer review systems considered in this study had most (84%) of the features of the author role. Among the systems reviewed, Kowsar system had the highest number of features. Conclusion: The results show that the studied systems consider some, but not all, of the required features. To meet the maximum required features of the author role, it seems necessary to take all standard research criteria into account

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Background and Aim: Nurses’ knowledge and awareness about religious orders is undoubtedly so important in their relationship with patients in hospitals. So, the aim of this study is to compare the knowledge and attitude of nurses before and after their participation in religious orders workshop. Materials and Methods: In this cross-sectional study, religious knowledge and attitude of 480 nurses working in the hospitals of Tehran University of Medical Sciences (TUMS) were evaluated. The research tool was a questionnaire and such factors as nurses’ age, sex, educational level, and type of employment were considered. The data were collected by a questionnaire and analyzed by SPSS software version 19. Results: Nurses demonstrated a higher level of knowledge and attitude in hospitals where Islamic orders workshop was held than the ones in other hospitals. In total, there was no significant difference among nurses regarding their age, sex, educational level, and type of employment however, nurses working in surgical wards and those with a postgraduate degree showed a higher level of knowledge and attitude than others. Conclusion: It is necessary to provide nurses with knowledge about religious orders because such knowledge may increase patients' satisfaction with the care they receive.

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Background and Aim: 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.

Materials and Methods: 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.

Results: 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 7^th day of osteoblastic differentiation (P<0.05). Also, the results revealed hypermethylation status of APC gene promoter during osteoblastic differentiation.

Conclusion: 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.

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Background and Aim: Requisite to achieve a correct understanding of the meaning and purpose traditions In addition to the general regulations of understanding human speech, the application of certain rules and regulations "Methodology of  understand traditions" can be interpreted. The Principle of methodology of understand those traditions at odds with the theory (philosophical hermeneutics) who believe that the text should not be understood to mean the process of achieving text through the systematic understand. But, the interpreter has always been faced with a prior grasp with text and following the disclosure of the before understanding had about the text.

Materials and Methods: This was a review study that induced by library texts and search engines in order to identify and analysis of the related different references.

Results: Refer readers to specific individuals by the Ahl al-Bayt to achieve the correct meaning and intent and lawful of traditions the best evidence of systematic understanding of the traditions and the traditions of medicine.

Conclusion: Proof the above principle as the basis to understand the traditions must have a hand in self- traditions, both internal and external characteristics including "there are different levels of meaning", "similarity", "manuscripts", "application" and other characteristics have to searched. On the other hand, return to the traditional reasons that to explicitly methodology of understand of these religious texts were approved. Traditions indicating the logic of understanding that is includes traditions such as "supply of mutashabihat on the mhkmat", "supply of traditions on the verses and certain of traditions". The narrative implies the use of Ahl al-Bayt from the principles of common sense is the some of these reasons.