Journal of

Background and Aim: Foodstuffs additives are a general term for materials that are added to the foodstuffs in order to increase durability and to improve the appearance, composition, taste and food nutritional value. Colors are classified in this group and are added to foodstuffs in order to increase their attraction. The aim of this survey was to analyze status of added colors to the juice of black cherry and juice of barberry which are produced in Tehran City, capital of Iran.

Materials and Methods: Three haundred thirty six samples of dried sweets were randomly collected and analyzed from different areas of Tehran. First, the samples were de-colored by Clorhidric Acid, and then were analyzed after refining by Thin Layer Chromatography (T.L.C) method.

Results: Eighty nine percent from the total samples contained colors. Among chromatic samples, 62 samples (18.5%) out the total samples, contained artificial, non-edible colors and 237 samples (70.5%) from the total samples contained artificial and edible colors (for Industrial Producers) and 37 samples (11%), contained natural colors. Carmoisine color was detected more than added colors in juice of black cherry and juice of barberry.

Conclusion: Low costs, stability, Ph and similarity of artificial dyes with natural dyes motivate the producers for high utilization of these dyes without considering their possible hazards and/or their edible quality aspects.

 Background and Aim: Considering the information needs of users improves the quality of care . We aimed to Survey the Compliance Rate of Surgical Information Systems with The Information Needs of surgeons.

Materials and Methods: This was a descriptive and original study. Statistical Society consisted of two groups. First was the hospital information systems in hospitals of Tehran University of Medical Sciences and Shahid Beheshti were the first group. The Second group were 982 surgeons. Hospitals that had the highest number of surgeries were the research sample. Researcher gathered data in two steps. First by questionnaire and then checklist was used to collect the data by interviewing the technicians’ of systems . All data has been analyzed by descriptive analysis.

Results: In Rasul and Emam hospitals surgical information systems in scheduling section(50%) had highest conformity with surgeons needs. In flexibility section in all hospitals except of Shariati, they had 50% conformity with information needs of surgeons.

Conclusion: From surgeons view flexibility capability, scheduling and accessing data had highest priority although systems from display capability had not the conformity with the user needs. In designing the surgical information systems in future it is better to consider these capabilities.

Background and Aim: Clinical laboratories, due to their succeptibility to potential risks, are priorities in all activities concerning safety issues in hospitals.
Total Quality Management (TQM) is a model considered by WHO for clinical laboratories safety development. This study aimed to assess how safety standards were followed at the clinical laboratories of hospitals affiliated with Tehran University of Medical Sciences (TUMS) based on TQM safety regulations.

Materials and Methods: This descriptive study was conducted on a research population including TUMS hospitals clinical laboratories in 2012. For data collection, census was applied and sampling was not considered. The data gathering instrument was a checklist measuring seven safety components based on TQM. The validity of the instrument was determined through content validation, and Cronbach alpha was calculated to be 0.82. For the analysis of the results, descriptive statistics including frequency percentage of scores was employed.

Results: The safety of research population turned out to be suitable in terms of four factors: designing, existence of general safety items, conducting standard safety activities, and safe disposal of laboratory wastes. Besides, implementation of safety programs and increase in employees’ knowledge to cope with accidents were relatively acceptable. The emergency evacuation program, however, was estimated as poor.

Conclusion: The studied laboratories enjoy relatively safe conditions, but imperfect implementation of safety protocols can endanger safety conditions. Therefore, it is necessary to take the required correcting measures to ensure full safety in clinical labs.

Background and Aim: Analysis of functions enables organizations to identify their special capabilities and weak points accurately and thus they can enhance capabilities and reduce impacts of threats and obstacles through such analysis. The main goal of this work is investigation of status of Weisbord Model's variables (6 variables) as functional dimensions of management in hospitals of Tehran University of Medical Sciences.

Materials and Methods: This was a descriptive - analytical study. The study population consisted of 384 staffs from hospitals of Tehran University of Medical Sciences. Standardized questionnaire for organization recognition was used for data collection. Descriptive statistics (frequency distribution, frequency percentage) and inferential statistics (Pearson correlation coefficient and significance level) were used for statistical analysis and data analysis was run using SPSS software.

Results: The results showed that there is a significant difference (p=0.0001) in hospitals in terms of the internal situation. Internal situation of all hospitals in the study was evaluated as favorable condition by obtaining 94.5 score out of 125. Among the hospitals, Hashemi-Nejad Hospital with highest score (113) showed the better condition and Rasoul Hospital had the lowest score (87) and lower condition as compared to other hospitals.

Conclusion: Necessity of systematic perspective in designing and development of fair compensation mechanism with presence of representatives of employees is an action which can considerably influence improvement of current situation in the hospitals and facilitates achieving predetermined goals of the organization

Background and Aim: Cutaneous leishmaniasis (CL) is prevalent in most tropical and subtropical countries of the world and leads to adverse economic consequences. This study was performed to estimate the cost of healthcare services delivered to CL patients in Qom Province.

Materials and Methods: Based on the data from 638 CL patients, this cross-sectional study was performed in Qom during 2009-2011. First, using researcher-made forms and based on the accounting documents, the direct and overhead costs of health services in the studied areas were calculated. Then, the out-of-pocket costs per patient were obtained. Finally, the gathered data were calculated using the excel software.

Results: In total, more than 1,600 million rials was spent on providing health services to 638 patients with cutaneous leishmaniasis in endemic foci of Qom. The direct healthcare cost was estimated to be about a thousand million and the overhead cost about 600 million rials. Besides, the state cost per patient was estimated to be over 2,520 thousand and the out-of-pocket cost per patient about 240 thousand rials. Moreover, the average total cost per patient was calculated to be 2,760,772 in the studied period.

Conclusion : Based on results, considerable costs are spent for CL diagnosis and treatment in Qom. Therefore, health planners should give priority to the prevention of this disease in their programs.

Background and Aim: Having a preparedness program for earthquake in hospital, with regard to its function for victims of accidents, is very important. The main objective of this study was evaluation of effective factors on the rate of preparedness of Tehran University of Medical Sciences’ teaching hospitals, to deal with earthquake danger of earthquake .

Materials and Methods: This cross-sectional analytical survey was performed in the follow ing hospitals: Sina, Farabi, Roozbeh, and Razi. Data was collected by checklists and questionnaire. Data analysis was performed using statistical software (SPSS19) and Pearson correlation , ANOVA, t-test statistical tests.

Results: The most and the least preparedness against earthquake was in disaster management and construction mitigation plan fields respectively. Relationship between the field of hospital curriculums with construction mitigation plan (p= 0/045 and r=0/644) and hospital environmental health action plan (p=0/048 and r=0/636), was significant.

Conclusion : Average of Hospitals preparation against earthquake was evaluated in an intermediate level (51.81percent). Due to the significant relationship between education and other fields that are listed above it is suggested that in addition to short-term training programs, non-structural retrofitting of hospitals should be considered as a priority.

Background and Aim: Despite all inherent advantages of information technology in health sector, its implementation still faces many problems. One of the most important barriers is people’s resistance. This study was carried out to survey the factors affecting the acceptance of information technology by Health Information Management (HIM) staff of Tehran University of Medical Sciences (TUMS) hospitals based on Technology Acceptance Model (TAM) in 2011.

Materials and Methods: It is a descriptive-analytical survey. The population of the study consisted of the HIM staff (363 members) of TUMS hospitals. As the sample, 123 employees were selected. The data gathering tool was a questionnaire the validity and reliability of which were confirmed. The data were collected and analyzed by SPSS software, descriptive statistical methods and Spearman Test.

Results: The results showed that there was a positive direct relationship between perceived ease of use (PEOU) on the one hand and the staff’s attitude and their application of IT on the other hand (R=0.14, P= 0.05 R=0.36, P=0.05). Also, perceived usefulness (PU) had a significant direct effect on the staff’s attitude and their application of IT (R=0.22, P= 0.05 R=0.37, P=0.05).

Conclusion : Perceived ease of use (PEOU) and perceived usefulness (PU) are the factors affecting the acceptance of information technology by the HIM staff of TUMS hospitals. Therefore, it is suggested that the above two principles be considered when designing and implementing the IT systems.

Background and Aim : Nurses' perception of spirituality can affect the way they behave and communicate with patients in line with spiritual care provision. The present study aims to investigate nurses' perception , capability, and adequacy of training about spirituality and spiritual care in Genaveh hospitals affiliated to Bushehr University of Medical Sciences (BUMS) .

Materials and Methods: A cross-sectional descriptive study was performed among 111 nurses working in BUMS hospitals in 2013. The spirituality and spiritual care scale (SSCRS) was used for data collection, which explores nine aspects of spirituality and spiritual care. Descriptive statistics were used to analyze the data. 

Results: The overall spirituality and spiritual care was 3.86 (out of 5). Among the nine aspects of need for spirituality, belief in God had the highest mean score, and beliefs and values had the least mean values. About 78.7 % of the participants were confronted with the patients' spiritual needs. Meanwhile, 74.6 % of them noted that the current training about spiritual care was not sufficient .

Conclusion: Although most participants were able to meet the patients' spiritual needs, most of the nurses did not know enough about the issues related to spiritual care. Therefore, inclusion of spiritual care in nursing curriculum and holding workshops and training courses in this area can be useful.

Background and Aim: Obesity is now considered as one of the main risk factors of certain known diseases such as cardio-vascular diseases, non- insulin-dependent diabetes, and common cancers. Moreover, the increase of white fat tissue is known as a main factor in the obesity process, in terms of physiology and pathology. Therefore, the understanding of adipocytes differentiation processes is crucial.

Materials and Methods: In this study, mesenchymal stem cells (MSCs) were isolated from human bone marrow by ficol-gradient, and then, their surface markers were confirmed by flow cytometry. Osteoblastic and adipocytes differentiation were done by dexamethasone protocol and confirmed by staining. Then qualitative and quantitative expressions of PPARgamma (PPAR-γ) gene as an important transcription factor in the differentiation of fat were studied by RT-PCR and REAL TIME PCR before and after differentiation into adipocytes. For statistical analysis, paired t-test was performed, using pfaffl and graph pad software.

Results: PPAR-gamma gene expression showed a significant increase after differentiation of human bone marrow mesenchymal stem cells into adipocytes (p<0/05).

Conclusion: According to the results, the PPAR-γ gene acts as one of the important factors in the differentiation of MSCs into adipocytes. In brief, the inhibition of this gene's expression to prevent obesity is suggested as an idea for treatment in the future.

Background and Aim: Medication errors make up a large portion of medical errors that mostly happen in hospitals. To prevent medication errors, it is essential to reach an appropriate understanding regarding with their causes and reporting especially among nurses. The purpose of this study was to determine the reasons of medication errors and the causes of not error reporting from nurses’ viewpoints. 

Materials and Methods: This is a descriptive analytical cross-sectional study conducted in year 2013. The study population were nurses working in different working shifts in special and sub-special pediatric hospitals in Tehran. A sample of 294 nurses recruited using a stratified non randomized sampling approach. The corrected Gladstone questionnaire with appropriate validity and reliability was used. The data were analyzed by descriptive (frequency, mean and standard deviation) and analytical statistics (Mann-Whitney and Kruskal-Wallis) using SPSS version 16.

Results: The most important reasons of medication errors were tiredness of nurses, wrong dose prescription by the physicians and illegible prescriptions. Fear of the nursing manager's reaction was the main obstacle to reporting medication errors in the view of 74.9% of nurses. The nurses estimated that only 42.52% of all the medicinal errors were reported.

Conclusion: Raising awareness regarding with the types and causes of medication errors and their reporting and implementing the relevant intervention to address these causes should be established in hospitals in particular in pediatrics wards.

Background and Aim: In a severely inflationary environment with unemployment, social problems increase and, therefore, high health care expenses are imposed on the society.

Materials and Methods: This was a correlational study. Panel data model and EVeiws 6 software were used in this study. The data were collected from the World Bank website. The required pre-tests, including F-Limer and Hauseman tests, were given to check the appropriateness of data and to determine a appropriate model. Following the pre-tests, the results were estimated in the form of a regression model.

Results: The results indicated that F-test and t-statistic were significant, and that R² statistic was high. In the three models, R² was 99%, 99% and 98%, respectively. Moreover, it can be said that employment is positively related with life expectancy, but negatively related with infant mortality and total fertility rate. Also, inflation is negatively related with life expectancy, but positively related with infant mortality, and total fertility rate. Finally, Gross Domestic Product (GDP) is negatively related with total fertility rate and life expectancy, but has no meaningful relationship with infant mortality (p = 0.31).

Conclusion: Employment, inflation and GDP are the variables that have the greatest impact on health indicators. however, life expectancy is more sensitive to explanatory variables.

Background and Aim: 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.

Materials and Methods: 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.

Results: 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.

Conclusion: 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.

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.

Background and Aim: Organizational productivity and efficiency depends on staff members’ job satisfaction and performance. Without the participation of staff members, hospitals cannot play an important role in promoting the society’s health. This study aimed to determine staff’s job satisfaction in a teaching hospital of Tehran university of Medical Sciences (TUMS).
Materials and Methods: This descriptive, analytical cross-sectional research was conducted on 172 staff members of a teaching hospital, who had been selected through random sampling. The data-collection tool was a researcher-made questionnaire. The validity of the questionnaire was confirmed by the clinical governance department members and Cronbach’s alpha reliability estimate turned out to be 0.88. 
Results: Para-clinical and service employees getting the mean scores of 72.55 and 70.71 demonstrated desired job satisfaction; nursing and administrative-financial staff members, however, showed a relatively desired job satisfaction with mean scores of 60.04 and 53.52, respectively; and the difference between job groups was significant (p=0.02) regarding job satisfaction. The highest job satisfaction figure was related to job success and the lowest pertained to the nature of the job. There was a meaningful relationship between job satisfaction on the one hand and staff members’ gender, marital status, and type of employment on the other.
Conclusion: Staff’s job satisfaction in the studied hospital has increased due to the establishment of Iran’s Healthcare Reform Plan at the beginning of 2014. However, compared with other job groups, nurses are less satisfied; therefore, it is necessary to improve nursing job satisfaction through timely payments based on job performance and difficulty level.

Background and Aim: The aim of this study was structural monitoring of the articles in knowledge and information science field in five Iranian journals. Today, the publication of papers constitutes one of the written scope among scientific broad cost productions.
Materials and Methods: The research method was analytical-survey. The articles were analyzed by the variables such as author distribution by sex, field of study, scientific notation, types of articles by original papers or translated papers, individual or group articles and their publication dates, and by statistical methods used in the articles in two periods from 2002-2006 and 2007-2011.
Results: The results showed that most of the articles were written as original. International cooperation between authors was minimal. Using qualitative research methods among the articles were low. Majority of the authors had masters degree. There was a significant relationship between the authors’ grades, number of authors and journals, and used statistical methods.
Conclusion: The written articles in the field of knowledge and information, followed by special patterns. The journals policies in publication of articles process is the most important issue. Also, lack of international cooperation between Iranian with foreign authors, type and format of the articles were similar according to mentioned variations.

Background and Aim: Safety is an important component in the quality of health care that lack of attention to it leads to harmful results. This study was conducted to estimate the safety management status in selected hospitals affiliated with Tehran University of Medical Sciences. 
Materials and Methods: This analytical-descriptive cross-sectional study was conducted in four selected hospitals affiliated to Tehran University of Medical Science in 2012. Data collection was performed through a valid and reliable questionnaire (Safety management) involved 112 questions in 3 parts: organization, safety and event committee’s management, investigation of organization and hospital’s structure and evaluation standards for surgery rooms by safety management views, in 5 options of Likert criteria. SPSS software frequency, mean and standard deviation and Kruskal–Wallis were used for statistical analysis of data’s.
Results: In the evaluation of the hospital organization factor and its structure from safety management approach, each hospital’s organizational structure form safety management view was in a suitable condition (72.50). The result also showed that in respect to evaluation of surgery rooms for safety management, the highest average of calculated score was for hospitals number 1 (90.00) and the lowest was related to hospital number 4 (69.09). 
Conclusion: According to the results, safety in hospital was in an acceptable level. But it seems that continuous monitoring and safety management training courses is essential.

Background and Aim: Heterogeneous insertion of Organizational affiliations can cause loss of ranking points in the national and international levels. So, we decided to investigate the different affiliations of Shahid Beheshti University of Medical Sciences in scientific publications that indexed in Web of Science and their effect on the result of research activities evaluation in the year 2012.
Materials and Methods: Methodology of this study is bibliometric approach with descriptive survey. The study included 1139 scientific production of Shahid Beheshti University of Medical Sciences that indexed in Web of Science in the first one in April 2011 to April 2012. 
Results: 1139 articles indexed in the Web of Science, 94/38% in the evaluation of the research activities of the ministry of health have been scored and 5/61% failed. Among the unsuccessful papers 1/01%, had been inserted affiliation incorrectly. One-sample t-test showed that the mean score of 1/01% has no significant statistical impact on the total average rating of products indexed in Web of Science.
Conclusion: Investigation showed that standard insertion of affiliation has impact on enterprise University Ranked and University status at the international level.

Background and Aim: Early diagnosis is a tenet in oncology and enables early treatment with the expectation of improved outcome. The aim of this study was to determine the factors associated with personal characteristics and clinical signs in patients with breast cancer.
Materials and Methods: This research was a descriptive analytic that 
cross-sectionally assessed 232 patients with definite breast cancer diagnosis that referred to Razi hospital located in Rasht using a researcher designed questionnaire including demographic and clinical signs. Collected data (mammography, tumor size, pathological stage of tumor) were obtained from medical records of patients. Gathered data analysis was accomplished with SPSS V.19 and for description of data from average and standard deviation for inference statics fisher test with a 
P value of 0.05 were used.
Results: Mean age of subject was (49.80+10.27). 44 individuals (14%) had a precedent regular mammography before disease. Hundred and four (44.8%) in first appointment were referred to a general surgeon. Hundred and thirty six (58%) women were in stage III of the disease. Hundred and twenty nine (60%) patients had a tumor size more than 5 cm and 106 (46%) had a lymph node metastasis at the time of diagnosis. Patients referring with advanced stage of breast cancer had a low education (P=0.04) and income level (P=0.01).
Conclusions: Recognizing associated personal and clinical factors with early diagnosis can provide essential information for planning health education, screening and presenting appropriate solutions to overcome barriers to treatment and care in health system planning in this provinc

Background and Aim: In the recent years the number of science research health journals has increased in Iran. These journals should be based on the standards and criteria required in international indexing database. The aim of this study was to determine the adaptation rate of structural requirements on the Iranian medical journals with the criteria of indexing based on Scopus indexing database.     
Materials and Methods: This study was a descriptive-applied study done using bibliometric methods. The statistical population was all of the science research journals in health ministry on 2014. The data collection tool was the inventory control extracted from Scopus database. The data was collected and analyzed by SPSS20 software and descriptive statistics methods.
Results: The results showed that more than half of the biomedical journals were not based on the international editing statements and also, participation of the members of international editing committee was very low. The mean of international editing committee members was 83.3% and all of them were in Iran besides, participation of non Iranian authors was very low in these journals, with a participation rate of only 5.79%.
Conclusion: The Iranian medical journals did not follow the expected criteria in Scopus indexing database in a satisfaction level. Adaptation to the expected criteria can facilitate the entering and indexing procedures for these health journals in Scopus indexing database.