Analysis of the Quality of Logistics Supply Chain Process Using Six Sigma Scale: A Case Study in One of the Teaching Hospitals in Kerman, 2014

Background: In the present competitive era, organizations need to use a suitable model such as supply chain management in order to earn and keep a suitable place in the national arena and gain competitive advantage. The aim of this study was to analyze the quality of logistics supply chain process in a teaching hospital of Kerman. Methods: This is a qualitative research, in which the phenomenological approach was used. Data were collected through semi-structured interviews with the personnel of the Procurement Unit who were selected purposively and a random review of 20 product request forms. Finally, data were analyzed using framework analysis, and the process quality was analyzed using the six sigma scale. Results: Errors identified in the supply chain included 9 main themes and 29 subthemes among which, inadequate monitoring of the accuracy of the product request forms, inattention to the point of ordering, purchase regardless of the quality, inappropriate archive, inappropriate selection of supplier, and non-compliance with standard time of purchase and delivery of goods were the main errors identified. The quality of supply chain process according to Six Sigma scale was moderate. Conclusion: Weakness in the information system of the procurement unit and lack of suitable relationship between this unit and other units of the hospital lead to incidence of errors in the supply chain process that can be significantly reduced through implementing an office automation system and electronic procurement system

The Competitive Analysis of the Private Hospital Industry Using Porter's Competitive Diamond Model: A Case Study in Kerman 2014

Introduction: Changes in diseases pattern and increase in demand have necessitated private hospitals’ involvement in the health system. The purpose of this study was to analyze the private hospital industry in order to identify its strengths and weaknesses. Method: This qualitative study was carried out through phenomenological approach. The study participants consisted of 17 experts and chief managers of private hospitals and were selected through purposive and snowball sampling. Data collection was conducted through semi-structured interviews. The data were analyzed using framework analysis method. Results: The challenges of the private hospital industry, in the format of Porter’s diamond model, included 4 main themes and 21 minor themes. The most important challenges of private hospitals were shortage of medical equipment and facilities, old hospital building and physical environment, nursing shortage, lack of job security, and poor of management skills. The strengths of private hospitals were patient satisfaction with welfare services, good relationship between healthcare personnel and patients, and observance of the patient rights charter. Conclusion: Dominance of profit on the private sector's management viewpoint, lack of state financial support, limitations on signing contracts with a variety of supplemental insurances, and poor government monitoring are the major causes of problems in private hospitals. The realization of private-public cooperation in community health improvement can be expected through increased government support and the improvement of the quality and quantity of human, informational, and physical resources. Keywords: Private hospitals, Competition, Porter's diamond model

The Effect of Root Coating with Titanium on Prevention of Root Resorption in Avulsed Teeth; An Animal Study

Introduction: Tooth avulsion is a real dental emergency. If immediate replantation is not performed, the avulsed tooth may be lost due to inflammatory or replacement resorption. This animal study aimed to evaluate the bone response to the titanium coating of the root surface as an artificial barrier, and prevention of resorption of avulsed teeth. Methods and Materials: This experimental study was conducted on four male dogs. The dogs were randomly divided into two groups for assessment at two and eight weeks. Four teeth were extracted in each animal. The root surfaces of the test group were coated with a titanium layer using the Electron Beam Deposition system. After 24 h, replantation of the teeth was performed. Two animals were sacrificed after two weeks and the remaining dogs were killed after eight weeks. The presence of inflammation, inflammatory resorption, replacement resorption, periodontal regeneration, periapical granuloma and ankylosis were evaluated through histological analyses. Results: Inflammatory root resorption was not present in any tooth except one tooth in the coated group after eight weeks. Replacement resorption was noted just in three of the non-coated teeth after two weeks and two teeth after eight weeks. The McNemar's test revealed that the frequency of replacement resorption in the non-coated group was significantly higher than the coated group (P=0.031). Conclusion: Based on the results of this study, it seems that coating the root surfaces of avulsed teeth with titanium may control the replacement root resorption.Keywords: Avulsion; Root Resorption; Titanium Coatin

Effective Factors in Hospitalization Costs of the Public Hospitals: A Qualitative Study

Introduction:Hospitals are the most expensive health care organizations. In this study, identifying factors influencing hospitalization costs based on the three aspects of the health system including patients, health care providers, and insurance organizations were considered. Methods:This was a qualitative and phenomenological study. In this study, 12 experts in the field of management and controlling hospital’s costs were selected through purposive and snowball sampling method. Data were collected using focused group discussion. Framework analysis was used for data analysis. Results:The factors affecting hospitalization costs were classified into three codes including patients, health care providers, and insurance organizations. Lack of knowledge and awareness and neglecting self-care were the main patient-related factors, and weak management and supervision, lack of medical guidelines, long-term recovery period, lack of implementation of family physician and weak commitments and structural problems of insurance organizations were the main factors related to the health care providers and insurance organizations. Conclusion:The results showed that by increasing and improving self- care programs, providing health-oriented services, implementation of family physician program, specializing the hospital management, improving the quantity and quality of supervisions and reforming expert structure of insurance organizations, the hospitalization costs can be managed. Key¬words:Hospitalization Costs, Patients, Health Care Providers, Insurance Organizations, Public Hospital, Qualitative Study. Citation:Jafari M, Lashkari M,Mahmoudi F, Dehnavi R, NooriHekmat S, Izadi A.Effective Factors in Hospitalization Costs of the Public Hospitals: A Qualitative Study. Journal of Health Based Research 2016; 2(1): 39-54

Investigating Knowledge Management Status among Faculty Members of Kerman University of Medical Sciences based on the Nonaka Model in 2015

systematic exploitation of available knowledge and information. Therefore, it is necessary to investigate the knowledge management status in an education system by considering the function of faculty members in creation and dissemination of knowledge. This study was conducted to investigate the knowledge management status among faculty members of the Kerman University of Medical Sciences based on the Nonaka and Takeuchi models in 2015. Methods: This was a descriptive-analytical and cross-sectional study. It was conducted on 165 faculty members at the Kerman University of Medical Sciences, who were selected from seven faculties as weighted using a random stratified sampling method. The Nonaka and Takeuchi knowledge management questionnaire consists of 26 questions in four dimensions of socialization, externalization, internalization, and combination. Scoring of questions was conducted using the five-point Likert scale. To analyze data, independent t-test, one-way ANOVA, Pearson correlation coefficients, and the Kruskal-Wallis test were employed. Results: The four dimensions in the Nonaka and Takeuchi model are based on optimal indicators (3.5), dimensions of combination, and externalization with an average of 3.3 were found in higher ranks and internalization and socialization had averages of 3.1 and 3. According to the findings of this study, the average knowledge management among faculty members of the Kerman University of Medical Sciences was estimated to be 3.1, with a bit difference compared to the average. According to the results of t-tests, there was no significant relationship between gender and various dimensions of knowledge management (p>0.05). The findings of Kruskal-Wallis showed that there is no significant relationship between variables of age, academic rank, and type of faculty with regard to dimensions of knowledge management (p>0.05). In addition, according to the results of Pearson tests, there is no significant relation between employment history and dimensions of knowledge management (p>0.05). Conclusion: Considering the function and importance of knowledge management in education and research organizations including universities, it is recommended to pay comprehensive attention to establishment of knowledge management and knowledge sharing in universities and provide the required background to from research teams and communication networks inside and outside universities

Investigating Knowledge Management Status among Faculty Members of Kerman University of Medical Sciences based on the Nonaka Model in 2015

Introduction: Education and research are two major functions of universities, which require proper and systematic exploitation of available knowledge and information. Therefore, it is necessary to investigate the knowledge management status in an education system by considering the function of faculty members in creation and dissemination of knowledge. This study was conducted to investigate the knowledge management status among faculty members of the Kerman University of Medical Sciences based on the Nonaka and Takeuchi models in 2015. Methods: This was a descriptive-analytical and cross-sectional study. It was conducted on 165 faculty members at the Kerman University of Medical Sciences, who were selected from seven faculties as weighted using a random stratified sampling method. The Nonaka and Takeuchi knowledge management questionnaire consists of 26 questions in four dimensions of socialization, externalization, internalization, and combination. Scoring of questions was conducted using the five-point Likert scale. To analyze data, independent t-test, one-way ANOVA, Pearson correlation coefficients, and the Kruskal-Wallis test were employed. Results: The four dimensions in the Nonaka and Takeuchi model are based on optimal indicators (3.5), dimensions of combination, and externalization with an average of 3.3 were found in higher ranks and internalization and socialization had averages of 3.1 and 3. According to the findings of this study, the average knowledge management among faculty members of the Kerman University of Medical Sciences was estimated to be 3.1, with a bit difference compared to the average. According to the results of t-tests, there was no significant relationship between gender and various dimensions of knowledge management (p>0.05). The findings of Kruskal-Wallis showed that there is no significant relationship between variables of age, academic rank, and type of faculty with regard to dimensions of knowledge management (p>0.05). In addition, according to the results of Pearson tests, there is no significant relation between employment history and dimensions of knowledge management (p>0.05). Conclusion: Considering the function and importance of knowledge management in education and research organizations including universities, it is recommended to pay comprehensive attention to establishment of knowledge management and knowledge sharing in universities and provide the required background to from research teams and communication networks inside and outside universities

Mutation analysis of androgen receptor gene: Multiple uses for a single test

Androgen receptor gene mutations are one of the leading causes of disorders of sex development (DSD) exhibited by sexual ambiguity or sex reversal. In this study, 2 families with patients whom diagnosed clinically as androgen insensitivity syndrome (AIS) were physically and genetically examined. This evaluation carried out by cytogenetic and molecular analysis including karyotype and sequencing of SRY and AR genes. In family 1, two brothers and their mother were hemizygous and heterozygous respectively for c.2522G. >. A variant, while one of their healthy brother was a completely normal hemizygote. Family 2 assessment demonstrated the c.639G. >. A (rs6152) mutation in two siblings who were reared as girls. The SRY gene was intact in all of the study's participants.Our findings in family 1 could be a further proof for the pathogenicity of the c.2522G. >. A variant. Given the importance of AR mutations in development of problems such as sex assignment in AIS patients, definitive diagnosis and phenotype-genotype correlation could be achieved by molecular genetic tests that in turn could have promising impacts in clinical management and also in prenatal diagnosis of prospect offspring.In this regard, phenotype-genotype correlation could be helpful and achieved by molecular genetic tests. This could influence the clinical management of the patients as well as prenatal diagnosis for the prospective offspring. © 2014 Elsevier B.V