A function-based cost model for early cost advice on new-build schools projects

Establishing a reliable budget estimate based on limited information at the briefing stage of a construction project is a challenge for any client and design team. Unreliable estimates based on ill defined client needs and wants are all too frequent in practice (Newton 1991; Akintoye & Fitzgerald, 2000; Longmaid, 2003; Sonmez, 2004; Elahg et al., 2005 and Aibinu & Pasco, 2008). A review of the literature revealed a lack of accuracy of current cost estimation methods as a consequence of limited design information available at the conceptual stage. The focus of the investigation was newbuild school projects and, though much published design guidance on schools is available, there is little or no specific construction cost estimation guidance. Previous studies have not considered how the richness of information that is available at the briefing stage might inform cost estimates. The main purpose of the study, therefore, was to develop a function-based cost model for application at the briefing stage of school projects to estimate cost prior to the technical design phase. Exploring the current briefing practices and available design guidance breadth of school projects and consulting the various UK council representatives revealed eighty eight design and engineering requirements as the initial basis of the cost model. The model developed uses the identified functional requirements to prepare a cost estimate that does not rely on technical design information. The research approach adopted was a mixed methodology combining qualitative and quantitative data collection. Initially, a qualitative survey of the various UK councils involved in the delivery of new-build school projects was conducted to investigate the current practices of briefing and costing new school projects. A quantitative study was then undertaken to determine the various general design and engineering requirements asked by the school clients. Finally, another quantitative survey was employed to establish the various levels of performances which the existing UK school buildings achieve for the distilled requirements. Regression analysis was used to develop the proposed cost model using all the information which would be available at the briefing stage. The study showed that clearly identifying all client requirements, determined at the briefing stage in predicting the project cost, would enhance the accuracy level of the model. Conversely, neglecting any part of briefing information would reduce the reliability and accuracy of estimates. The function-based cost model was developed and iii validated within the school projects sector. The cost model would estimate the cost of new-build projects accurately relying only on clients’ design and engineering requirements sought at the briefing stage. The cost model provides a decision aid for the client which, if developed and applied, could be used at the briefing and technical design stage of school projects in evaluating the affordability of alternative options

A Survey of Clinical Governance Success in University Hospitals in Tehran

Background & Objectives: Clinical Governance (CG) is an organizational strategy for maintaining and improving the quality and safety of patient care and increasing employees’ and managers’ responsiveness and accountability through developing an appropriate organizational structure and culture as well as developing, implementing and monitoring clinical guidelines, pathways and standards. This study aimed to examine the success of CG implementation in university hospitals, in Tehran, Iran. Methods: In this descriptive analytic study, a researcher-made questionnaire was filled out by managers and CG executive managers of 39 university hospitals in Tehran/ Iran. Data analysis was done through SPSS software and using Pearson, Spearman and logistic regression. Results: Clinical Governance was moderately successful in Tehran university hospitals (58%). The most success was achieved in patient involvement and risk management dimensions and the least success was observed in clinical effectiveness and clinical audit dimensions. Management and leadership and clinical audit had the most effect on CG success. The involvement and commitment of managers and employees in implementing CG were moderate and physicians’ involvement and commitment was poor. The length of CG implementation time had significant relationship with managers’ and employees’ commitment and CG success. Conclusion: Clinical governance was not successful in Tehran university hospitals. Active involvement and commitment of top managers, staff empowering, patient centeredness, evidence-based practice, and clinical audit are necessary for successful CG implementation. Key­words: Quality management, Clinical governance, Hospital, Critical success factors ­Citation: Mosadeghrad AM, Arab M, Shahidi Sadeghi N. A Survey of Clinical Governance Success in University Hospitals in Tehran. Journal of Health Based Research 2019; 5(1): 101-16. [In Persian

Study of Conflict Management Styles in Tehran University Affiliated Hospitals

Study of Conflict Management Styles in Tehran University Affiliated Hospitals Mosadeghrad Ali Mohammad1, Arab Mohammad2, Mojbafan Arezoo3* Received: 10. 02. 2016 Revised: 25. 05. 2016 Accepted: 31. 05. 2016 Abstract Introduction:Conflicts in hospitals, in addition to reducing Employee’s productivity and satisfaction, and also increasing hospital’s costs, has a negative effect on the treatment process. Therefore, acquiring necessary knowledge and skills for conflict management are essential for hospital managers. The present study aimed to investigate the conflict management strategies used by managers of hospitals affiliated with Tehran University of Medical Sciences (TUMS). Method:This is a descriptive – analytic study conducted as a cross-sectional one in 2015. The sample consisted of 563 managers of three levels of management including senior, middle, and executive managers in hospitals affiliated with TUMS. Using a high valid and reliable self-made questionnaire based on Thomas and Kilman’s model, the data was collected. Data analysis was performed by SPSS software 19, and using descriptive (Mean, Standard Deviation, Frequency and Percentage) and inferential statistics (Regression, Spearman and ANOVA). Results:The results show that collaborating style was the dominant style used by hospital managers. Compromising and accommodating styles were the next management strategies in order. There were significant statistical relationship between management style and management level (P=-0.038), age (P=0.016), manager’s work experience (P=0.019), management experience (P= 0.021) and conflict management training courses (P=0.001). Conclusion:The nature of healthcare organizations requires that managers use collaborating, compromising and accommodating styles in order to interact with various stakeholders. Holding suitable training course in the field of conflict management has a significant role in reducing devastate effects of conflict in the hospitals. Key¬words:Conflict Management, Senior Managers, Middle Managers, Executives, Teaching Hospitals Citation:Mosadeghrad AM, Arab M, Mojbafan A.Study of Conflict Management Styles in Tehran University Affiliated Hospitals. Journal of Health Based Research 2016; 2(1):1-13. 1.Assistant Professor, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 2.Professor, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 3. MSc, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. *Correspondence: Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences Tel: 021-42933006 Email: [email protected]

Social Values in Health Prioritizing: the analysis of national documents of Iran

Background: Health system, as a part of the wider social system, should consider social values in decisions for health prioritizing. This study was aimed at identifying social values considered in the health-related national documents. Methods: This qualitative study was conducted based on the Clark-Weale framework to identify the social values in health related national documents. Identification of health-related basic documents (11 documents) was performed purposefully. Documents included Iran's Constitution Law, the 5-year development plan, national health insurance law, urban family physician program, health sector development map, Health Ministry foundation law and Health Ministry structure and organizational law. Each value was analyzed based on qualitative content analysis. Results: Different approaches toward considering social values were observed. While some documents had explicitly considered social values, some others had implicitly considered them. The health Road Map was the most comprehensive document in terms of considering social values. Equity was the most repeated value in documents and clinical effectiveness was not mentioned in any of the documents. Conclusion: Although, the importance of social values has been increased in national documents during the recent years, it dose not have the same trend in different documents and each of them have emphasized on different social values. It seems that using national documents, as a practical guide, can be effective in achieving health system goals

Which Solution is better for the prevention and even treatment of diabetes in Iran?

The present article was written under the pretext of World Health Day 2016 to attract the attention of society and health policy makers toward this issue. Due to the importance of this issue, WHO is marking World Health Day, April 7th, by calling for action on beating diabetes. Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. Hyperglycemia, or raised blood sugar, is a common effect of uncontrolled diabetes and, over time, leads to serious damage to many of the body's systems, especially the nerves and blood vessels (1). In 2014, 8.5% of adults aged 18 years and older had diabetes. In 2012, diabetes was reported to be the direct cause of 1.5 million deaths and high blood glucose was the cause of another 2.2 million deaths (2)

Studying Psychological and Organizational Factors’ Roles on Occupational Accidents among Nurses and Nursing Aids in Qom, Iran

It is clear that safety in healthcare centres in both fields of staffs and patients is under influence of various factors and needs considering organizational and psychological variables. This study aimed to find the effects of organizational citizenship behaviour (OCB), patient safety climate (PSC) and fatalism on occupational accidents among nurses and nursing aids in one of the non-governmental hospitals in Qom, 2017. Two hundred people from the study population were selected by simple random sampling method and entered the study. A researcher-made demographics questionnaire, Williamson et al. questionnaire for fatalism and valid questionnaires for PSC and OCB were tools to gather data. The relationship between the variables was analyzed using ANOVA and T-test through SPSS V20 and structural equation was done by AMOS V8.8. One hundred and seventy-seven questionnaires out of 200 ones were entered into the analysis phase. Women with 104 (58.8%) were the most frequent and 71.8% of participants were married. Participants had an average age of 34.2(±9.37) years. Reliability of the questionnaires was acceptable. Analysis depicted effects of fatalism on occupational accidents (β=0.15), the patient safety climate on OCB (β=0.13), and OCB on occupational accidents (β=-0.13) (

Effect of immobilization stress on scratching behavior in male rat

زمینه و هدف: استرس یکی از بزرگترین مشکلات روانی بوده و زمینه ساز بسیاری از مشکلات سلامتی از جمله بیماری های عروقی قلب، مغز، سرطان ها و تضعیف ایمنی می باشد. از آنجا که بین استرس و التهاب پوست از یک طرف و التهاب پوست و خارش از طرف دیگر رابطه وجود دارد، در این مطالعه اثر استرس بر خارش پوست بررسی گردید. روش بررسی: در این مطالعه تجربی 26 سر موش نر صحرایی به صورت تصادفی به دو گروه شاهد و مورد تقسیم شدند. استرس روزی دو ساعت و به مدت 5 روز به گروه مورد القا شد. میزان خارش پس از هر دوره استرس به مدت 1 ساعت شمارش و ثبت گردید. 24 ساعت پس از آخرین استرس میزان خارش نیز ثبت و نمونه خون به منظور شمارش گلبول های سفید از موش ها گرفته شد. وزن موش ها قبل و پس از القا استرس اندازه گیری و ثبت شد. داده ها به کمک آزمون آماری t تجزیه و تحلیل شد. یافته ها: در مقایسه با گروه کنترل، میانگین دفعات خارش در گروه مورد در روزهای سوم (05/0

Production of Rosuvastatin Calcium Nanoparticles Using Gas Antisolvent Technique: Experimental and Optimization

The activity of pharmaceutical substances crucially depends on the bioavailability of the substances. The bioavailability of drugs in body and their rate of dissolution in the biological fluids are increased if the particle size is decreased. In the present paper, the Gas Anti-Solvent (GAS) method was used to lower the size of rosuvastatin particles. The effects of temperature (313–338 K), pressure (105–180 bar) and initial solute concentration (20–60 mg/ml) were evaluated by Response Surface Methodology (RSM). The optimum initial solute concentration, temperature and pressure were found to be 20 mg/ml, 313 K and 180 bar, respectively which resulted in the minimum particle size. Furthermore, the particles were characterized by Differential Scanning Calorimetry (DSC), Dynamic Light Scattering (DLS), Fourier Transform Infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), and X-Ray Diffraction (XRD). The analyses showed that the rosuvastatin particles (60.3 nm) precipitated by GAS process become significantly smaller than the initial particles (45.8 µm)