Senior dental student's attitudes toward older adults and knowledge of geriatric dental care in the Islamic Republic of Iran.

Dental students should have knowledge of geriatric dental care and positive attitudes toward elderly patients. This study assessed senior dental students' knowledge of geriatric dental care and their attitude towards elderly patients. A descriptive cross-sectional questionnaire survey was conducted on volunteer senior students in all dental schools (n = 512) in the Islamic Republic of Iran. The completed questionnaires (n = 464) were analysed. The mean scores of respondents' knowledge and attitudes were 12.7 (SD 2.9) and 48 (SD 6.1) respectively. Female and male students' knowledge did not differ significantly but their attitudes score was different. The majority of dental students had low to moderate levels of knowledge of geriatric dental care and attitudes toward elderly people; therefore, an intervention programme is indicated. We conducted the study to use the findings to incorporate geriatric dental care programmes into dental school curricula in the Islamic Republic of Iran.

Framework for assessing stewardship of the oral health system in Islamic Republic of Iran.

This study designed a framework for assessing the stewardship function of the oral health system in Islamic Republic of Iran. The modified RAND Corporation/University of California Los Angeles (RAND-UCLA) Appropriateness Method was used in a 2-step process that combined literature evidence and the collective judgement of experts. After a comprehensive literature review, policy instruments related to stewardship components were extracted as candidate standards and categorized according to the 6 sub-functions of stewardship (accountability; defining strategic direction; alignment of policy objectives and organizational structure; regulation; intersectoral leadership; and generation of intelligence). Five key informants then rated the appropriateness of the 85 standards on a 5-point Likert scale. The 38 highest ranked standards, including at least 2 standards in each of the 6 sub-functions, formed a set of proposed standards for evaluating the current stewardship of oral health system. Piloting of the instrument will be reported separately.

Patients' attitudes towards the role of dentists in tobacco cessation counselling after a brief and simple intervention.

Dental professionals are in a unique position to promote smoking cessation among their patients. We evaluated the effects of a brief counselling intervention by a dentist on patients' attitude towards the role of dentists in tobacco cessation programmes. In a semi-experimental study in Tehran, Islamic Republic of Iran, 70 eligible smokers were selected and randomly assigned to intervention and control groups. The initial attitudes of the patients regarding tobacco cessation counselling services provided by the dentist were determined using a validated questionnaire. The intervention group received a brief chair-side counselling by a dentist based on the 5 A's approach, while no intervention was provided for the control group. At 8-weeks follow-up, smokers receiving the intervention showed significantly more positive attitudes towards the role of the dentist in advising patients to quit smoking compared with those in the control group. More responsibility could be transferred to dentists for tobacco prevention.

Patients' attitudes towards the role of dentists in tobacco cessation counselling after a brief and simple intervention

Dental professionals are in a unique position to promote smoking cessation among their patients.We evaluated the effects of a brief counselling intervention by a dentist on patients' attitude towards the role of dentists in tobacco cessation programmes.In a semi-experimental study in Tehran, Islamic Republic of Iran, 70 eligible smokers were selected and randomly assigned to intervention and control groups.The initial attitudes of the patients regarding tobacco cessation counselling services provided by the dentist were determined using a validated questionnaire.The intervention group received a brief chair-side counselling by a dentist based on the 5 A's approach, while no intervention was provided for the control group.At 8-weeks follow-up, smokers receiving the intervention showed significantly more positive attitudes towards the role of the dentist in advising patients to quit smoking compared with those in the control group.More responsibility could be transferred to dentists for tobacco prevention

يتمتع أطباء الأسنان بموقع فريد يمكنهم من تعزيز الإقلاع عن التدخين بين مرضاهم. وقد أجرى الباحثون تقييما لأثر التدخلات الوجيزة للمشورة التي يقدمها أطباء الأسنان للمرضى، للتعرف على مواقف المرضى من دور أطباء الأسنان في برامج مكافحة التدخين؛ وهي دراسة شبه تجريبية في طهران، عاصمة جمهورية إيران الإسلامية، ساهم فيها 70 مدخنا مؤهلا تم اختيارهم عشوائيا وقسموا إلى فئتين، فئة للتدخل وفئة للشواهد. واستخدم الباحثون استبيانا تحققوا من سلامته للتعرف على المواقف المبدئية للمرضى تجاه خدمات المشورة حول الإقلاع عن التدخين التي يقدمها أطباء الأسنان. وقد تلقى أفراد فئة التدخل مشورة موجزة أثناء فترة جلوسهم على كرسي طبيب الأسنان، من قبل طبيب الأسنان، باستخدام أسلوب A5، ولم تتلق فئة الشواهد أي تدخل. وبعد متابعة دامت 8 أسابيع، أظهر المدخنون الذين تلقوا التدخل مواقف أكثر إيجابية تجاه دور طبيب الأسنان في تقديم المشورة للمريض حول الإقلاع عن التدخين، بالمقارنة مع فئة الشواهد. مما يدل على أنه يمكن نقل المزيد من المسؤوليات إلى أطباء الأسنان في مجال الوقاية من التدخين

Les professionnels en soins dentaires occupent une position idéale pour promouvoir le sevrage tabagique chez leurs patients.Nous avons évalué les effets d'une brève intervention de conseil par un dentiste sur l'attitude des patients vis-à-vis du rôle des dentistes dans les programmes de sevrage tabagique.Dans une étude semi-expérimentale menée à Téhéran [République islamique d'Iran], 70 fumeurs éligibles ont été sélectionnés puis répartis aléatoirement dans un groupe bénéficiant de l'intervention ou dans un groupe témoin.Les attitudes initiales des patients à l'égard des services de conseil sur le sevrage tabagique fournis par le dentiste ont été déterminées à l'aide d'un questionnaire validé.Les fumeurs du groupe bénéficiant de intervention ont reçu de brefs conseils reposant sur la méthode des 5 A pendant qu'ils étaient allongés sur le fauteuil et que le dentiste se tenait à côté, tandis que le groupe témoin n'a bénéficié d'aucune intervention.A la huitième semaine de suivi, les fumeurs ayant bénéficié de l'intervention avaient des attitudes nettement plus positives vis-à-vis du rôle de conseil du dentiste en matière de sevrage tabagique par rapport à ceux du groupe témoin.Des responsabilités supplémentaires pourraient être transférées aux dentistes en matière de prévention tabagique

Framework for assessing stewardship of the oral health system in Islamic Republic of Iran

This study designed a framework for assessing the stewardship function of the oral health system in Islamic Republic of Iran.The modified RAND Corporation/University of California Los Angeles [RAND-UCLA]Appropriateness Method was used in a 2-step process that combined literature evidence and the collective judgement of experts.After a comprehensive literature review, policy instruments related to stewardship components were extracted as candidate standards and categorized according to the 6 sub-functions of stewardship (accountability; defining strategic direction; alignment of policy objectives and organizational structure; regulation; intersectoral leadership; and generation of intelligence). Five key informants then rated the appropriateness of the 85 standards on a 5-point Likert scale.The 38 highest ranked standards, including at least 2 standards in each of the 6 sub-functions, formed a set of proposed standards for evaluating the current stewardship of oral health system.Piloting of the instrument will be reported separately

وضعت هذه الدراسة إطار عمل لتقييم وظيفة القوامة في نظام صحة الفم في جمهورية إيران الإسلامية. وتم استخدام الطريقة المعدلة لمؤسسة البحث والتقييم التابعة لجامعة كاليفورنيا في لوس أنجلوس على خطوتين للربط بين البينات المنشورة والرأي الجماعي للخبراء. وبعد إجراء مراجعة شاملة للنشريات، تم استخلاص النصوص الخاصة بالسياسات المتعلقة بعنصر القوامة كمقاييس مقترحة، وتم تصنيفها وفقا للوظائف الفرعية الست للقوامة [المساءلة، والتوجهات الاستراتيجية المحددة؛ وترتيب أهداف السياسيات؛ والهيكل التنظيمي؛ والتنظيم، والقيادة المشتركة بين القطاعات، وإنتاج المعلومات]. ثم قام خمسة مبلغين رئيسيين بتقييم مدى ملاءمة المعايير البالغ عددها 85 مقياسا وفقا لمقياس ليكرت ذي النقاط الخمس. وقد شكلت المقاييس التي حصلت على أعلى ترتيب والبالغ عددها 38 مقياسا، بما فيها مقياسان على الأقل في كل من الوظائف الفرعية الست، مجموعة من المقاييس المقترحة لتقييم القوامة الحالية لنظام صحة الفم. وسيتم تقديم تقرير عن هذه الأداة بشكل منفصل

La présente étude a conçu un cadre d'évaluation de la fonction de gouvernance du système de santé bucco-dentaire en République islamique d'Iran.La Méthode modifiée de détermination de la pertinence des indications de la Rand Corporation et de l'Université de Californie Los Angeles [Rand/UCIA]a été utilisée, dans un processus en deux étapes, combinant les données probantes de la littérature et le point de vue collectif d'experts.Après un examen exhaustif de la littérature, des instruments de politiques liés aux composantes de gouvernance ont été extraits en tant que normes candidates puis classés en catégories selon les six sous-fonctions de gouvernance [responsabilisation, définition d'une orientation stratégique, harmonisation des objectifs politiques et de la structure organisationnelle, réglementation, direction intersectorielle et production de données]. Cinq informateurs clés ont ensuite attribué une note à la pertinence de 85 normes sur l'échelle de Likert en cinq points.Les 38 normes les mieux notées, dont au moins deux normes dans chacune des six sous-fonctions, ont formé un ensemble propose pour l'évaluation de la gouvernance actuelle du système de santé bucco-dentaire.Le pilotage de l'instrument fera l'objet d'un rapport distinct

Knowledge and attitude of dental faculty members towards evidence-based dentistry in Iran.

INTRODUCTION: Educating dental practitioners is a major component in obtaining evidence-based approach to oral health care, but there is no evidence about knowledge and attitude of dental faculty members towards evidence-based dentistry (EBD) in Iran. MATERIALS AND METHODS: A cross-sectional study was conducted using self-administered questionnaires on dental school faculties in Iran to assess their knowledge and attitude towards basic principles and methods of EBD. A total of eight dental schools were randomly selected of 17 public and two existing private schools. Validated questionnaire with an appropriate reliability (Cronbach's alpha 0.67 - 0.87) was conducted on (n = 505) available dental instructors. The covered dimensions were perceived knowledge on critical appraisal, actual knowledge of EBD concepts, evidence-accessing methods and attitudes about EBD. Correlations were assessed between background characteristics and four main parts of the questionnaire, and multiple linear regression analysis was also used. RESULTS: A total of 377 of 505 dental instructors returned completed questionnaires (response rate 74.65%). The mean perceived knowledge score was 15.32 ± 4.69 on a range of 6-36, and mean actual knowledge was 7.98 ± 2.0 on a range of 0-11 for all respondents with an overall positive attitude towards EBD. CONCLUSIONS: This study suggests that the level of actual knowledge of dental faculties about basic principles of EBD was moderate in Iran. However, faculties' overall interest and positive attitude towards learning EBD is encouraging. Therefore, it is highly recommended that degree/certificate continuing educational programmes be planned by the organising committees.

Developing a policy guidance for financing dental care in Iran using the RAND Appropriateness Method.

OBJECTIVE: This study aimed to provide recommendations on health care financing with special emphasis on dental care. METHODS: The RAND Appropriateness Method was employed to obtain the collective opinion of a multidisciplinary panel of experts on a set of recommendation statements regarding Iranian dental care financing. An initial set of recommendations were identified from a literature review. Panel members, selected purposively and by peer nomination, each rated the appropriateness and necessity of the recommendations in a structured process of two rounds. Each recommendation was classified as inappropriate, uncertain, appropriate but not necessary, or appropriate and necessary according to the median rating score and the level of disagreement among the panellists. RESULTS: Of 28 initial recommendations, 25 were agreed on as appropriate, of which 22 were considered as necessary. Altogether, these recommendations provide a holistic picture of an oral health system's financing in three domains: revenue collection, pooling of revenues and purchasing of dental services. CONCLUSION: The policy guidance recommendations are intended to provide the Iranian oral health authorities with an evidence-base for financing dental care. The recommendations may be transferrable, at least in part, particularly to developing countries with similar hybrid health system structures. Finally, the method used to develop the recommendations can serve as a model for use elsewhere.

Use of the McGill Pain Questionnaire to compare women with vulvar pain, pelvic pain and headaches.

OBJECTIVE: To assess differences between women with three distinct types of chronic pain conditions using a modified McGill Pain Questionnaire. STUDY DESIGN: Data by self-administered questionnaire were collected on patients presenting to the University of Michigan Medical Center with chronic vulvar pain (144 patients), pelvic pain (198 patients) or headaches (130 patients). Data for analysis included: patient demographics, duration of pain and modified McGill Pain Questionnaire scores. Univariate and multivariate analyses were performed. RESULTS: Patients with vulvar pain had more formal education (P < .001), were more likely to be married (P < .001) and were less likely to be African American (P = .003) as compared to those with chronic pelvic pain and headaches. Chronic pelvic pain patients were younger than those in the other two groups (P = .002), and headache patients were likely to have had their chronic pain for a shorter duration than those with vulvar or pelvic pain (P < .001). Patients with vulvar pain had lower total scores on the McGill Pain Questionnaire as well as on the four subsets of variables: affective, sensory, cognitive and miscellaneous indexes (P < .001). They also chose fewer words to describe their symptoms from the 20-word lists (P < .001) and had lower average scores in each of the 20 categories as compared to the other two groups (P < .0001). Controlling for age, ethnicity and marital status did not alter this significance. CONCLUSION: Patients with vulvar pain were a unique groups when compared to other chronic pain populations. Evaluation of the demographics and McGill Pain Questionnaire scores confirmed the distinct qualities of women with vulvar pain.