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Background: In recent years, electronic cigarettes (ECs) have been heavily advertised as an alternative smoking device as well as a possible cessation method. We aimed to review all published scientific literature pertaining to ECs and to present a simple conclusion about their effects for quitting smoking and respiratory health. Methods: This was a cross-sectional study with a search of PubMed, limited to English publications upto September 2014. The total number of papers which had ECs in its title and their conclusions positive or negative regarding ECs effects were computed. The number of negative papers was subtracted from the number of positive ones to make a score. Results: Of the 149 articles, 137 (91.9%) were accessible, of which 68 did not have inclusion criteria. In the 69 remaining articles, 24 studies supported ECs and 45 considered these to be harmful. Finally, based on this evidence, the score of ECs (computed result with positive minus negative) was −21. Conclusion: Evidence to suggest that ECs may be effective and advisable for quitting smoking or a safe alternative for smoking is lacking and may instead harm the respiratory system. However, further studies are needed.

Background Dentists may take part in smoking cessation counseling of dental patients by using the time they are engaged in dental procedures and by emphasizing on oral manifestations of smoking. The present study aimed to evaluate the effects of smoking cessation counseling by a dentist on preparation for change to quit smoking in smoker patients. Methods This study was performed on 150 smoking patients admitted to Dental School of Shahid Beheshti University of Medical sciences, Tehran, Iran. The patients were randomly divided into two groups of 75 patients. The intervention group received smoking cessation counseling by a single senior dental student. A self-administered questionnaire containing questions regarding the position of the individual in change cycle stages was completed by both intervention and control group at baseline and at one-month follow up. For statistical analysis, paired t-tests, Mann-Whitney U and multivariate linear regression models was used with a significance level of P

Aims: Patients’ expectations are essential part of healthcare delivery system. This would definitely relate to patient satisfaction and consequently would provide a guideline for promotion of community health level. This study illustrates the non-clinical expectations of patients referred to a dental school clinic. Study Design: This is a Qualitative study. Place and Duration of Study: This study was performed in dental school of Shahid Beheshti University of Medical Sciences, for a period of three months from May to July 2015. Methodology: In this qualitative study, seventeen patients aged 18 years and older were interviewed. These patients were selected by convenient sampling method from a dental school in

Health care is becoming more patient-centered and, as a result, patients' experiences of care and assessment of satisfaction are taken more seriously. Patient satisfaction influences treatment cooperation, and better cooperation leads to healthier patients in the long term. This generalization clearly applies in the dental school clinic setting. Furthermore, dental school clinics' administrators and clinicians should know about the dimensions of their patient satisfaction in order to provide the highest quality of care. The aim of this study was to review studies published between 1980 and March 2014 to identify the dimensions used to measure patients' satisfaction when they receive services in dental school clinics. The PubMed database was used to access published studies using patient satisfaction surveys in dental school clinics, and the dimensions used in these surveys were then categorized. Through several stages of searching in PubMed, the authors selected 41 articles from a total of 730; after further critical appraisal, nine articles were retained. Five dimensions included in patient surveys were identified: quality, interaction, access, environment, and cost. Determining the dimensions used in patient satisfaction surveys in dental school clinics can assist academic dental institutions in providing the highest quality of care.

Research Motivation: Despite improvement of the trends in levels and experiences of dental caries in developed countries, it remains prevalent and is increasing in some developing countries. In this study we assessed the relationship between dietary regimens and dental caries in 9-year-old students in Tehran, Iran. Research Design/Methodology: The sample was selected by using multi-stage sampling from all the public primary schools in Tehran. 560 students were assessed using WHO questionnaires and dental examinations according to WHO criteria by indices of dmft and DMFT. The frequency of nutritional snacks consumed was determined in the following week on each individual. The acquired data were described according to abundance charts and indices of means and standard deviations. A linear regression test also was used. Main findings and implications: The mean dmft and DMFT of the students were 3.93 and 0.79 respectively. The study showed that the use of snacks such as cream-filled biscuits (P=0.030), plain cakes (P=0.048), cookies (P=0.008), caramel cream (P=0.009), milk-based ice creams (P=0.017), hard candies (P=0.003), popcorn (P=0.013), cheesy snacks (P=0.000), and bananas (P=0.002) significantly increased dmft in the study group. Furthermore, the use of snacks such as pistachios (P=0.036), cookies (P=0.03), caramel cream (P=0.048) and sugar-based chewing gums (P=0.008) showed a consequential relationship with the increase in DMFT. According to the results, the variety of the consumed snacks was high among 9-year-old students. The dietary habits including Oranges, Pies and Caramel Cream affected the incidence of the dental caries in both deciduous and permanent teeth.

Background: Many continuing professional development (CPD) Web-based programs are not explicit about underlying theory and fail to demonstrate impact. Objective: The aim of this study was to develop and apply an aggregate mixed-methods evaluation model to describe the paradigm, theoretical framework, and methodological approaches used to evaluate a CPD course in tobacco dependence treatment, the Training Enhancement in Applied Cessation Counseling and Health (TEACH) project. Methods: We evaluated the effectiveness of the 5-week TEACH Web-based Core Course in October 2015. The model of evaluation was derived using a critical realist lens to incorporate a dimension of utilitarian to intuitionist approaches. In addition, we mapped our findings to models described by Fitzpatrick et al, Moore et al, and Kirkpatrick. We used inductive and deductive approaches for thematic analysis of qualitative feedback and dependent samples t tests for quantitative analysis. Results: A total of 59 participants registered for the course, and 48/59 participants (81%) completed all course requirements. Quantitative analysis indicated that TEACH participants reported (1) high ratings (4.55/5, where 5=best/excellent) for instructional content and overall satisfaction of the course (expertise and consumer-oriented approach), (2) a significant increase (P ˂.001) in knowledge and skills (objective-oriented approach), and (3) high motivation (78.90% of participants) to change and sustain practice change (management-oriented approach). Through the intuitionist lens, inductive and deductive qualitative thematic analysis highlighted three central themes focused on (1) knowledge acquisition, (2) recommendations to enhance learning for future participants, and (3) plans for practice change in the formative assessment, and five major themes emerged from the summative assessment: (1) learning objectives, (2) interprofessional collaboration, (3) future topics of relevance, (4) overall modification, and (5) overall satisfaction. Conclusions: In the current aggregate model to evaluate CPD Web-based training, evaluators have been influenced by different paradigms, theoretical lenses, methodological approaches, and data collection methods to address and respond to different needs of stakeholders impacted by the training outcomes. [JMIR Med Educ 2017;3(2):e19]

Objectives: The current study assessed Iranian dentists' practice, knowledge, perceived barriers, and attitudes toward helping patients to quit. We hypothesized that Iranian dentists would have limited knowledge and awareness of tobacco cessation methods or of their important role in encouraging patients to quit. We expected the combination of quantitative and qualitative research to yield important insights regarding effective methods of engaging Iranian dentists in tobacco intervention. Methods: From a list of registered dentists following an initial screening, we randomly selected a total of 1,000 dental practices in 10 randomly selected provinces. Following an initial letter describing the study, we mailed a questionnaire. For the qualitative part of the study, we used a convenience purposeful sampling of 16 dentists. Results: Despite repeated contacts, only 35 percent of those contacted returned completed surveys. Key findings not only included generally positive attitudes toward tobacco cessation programs, but also identification of major barriers including concerns about patient resistance, lack of supportive organization, and opportunities for training. Dentists were far more likely to ask patients about smoking than to provide actual cessation support. Female dentists were more likely to ask patients. The qualitative interviews shed further light on barriers to intervention. Conclusions: Interpretation of the findings is limited by the relatively low response rate. However, despite identified barriers to intervention, we are encouraged by dentists' overall knowledge and interest in tobacco cessation services. We plan to use the current findings to inform development of continuing education programs and incorporation of tobacco cessation counseling into dental school curricula in Iran.

Background: One of the core responsibilities of health system is to treat tobacco dependence. This treatment includes different methods such as simple medical consultation, medication, and telephone counseling. To assess physicians′ opinions towards quality and result of different quit smoking methods provided in tobacco cessation services centers in Iran. Methods: In this cross-sectional and descriptive study, random sampling of all quit centers at country level was used to obtain a representative sample size of 100 physicians. Physicians completed a self-administered questionnaire which contained 10 questions regarding the quality, cost, effect, side effects, and the results of quitting methods using a 5-point Likert-type scale. Percentages, frequencies, mean, T-test, and variance analyses were computed for all study variables. Results: Most experts preferred to use combination quit smoking methods and then Nicotine Replacement Therapy (NRT) with 26 and 23, respectively. The least used methods were quit line and some methods without medication with 3 cases. The method which gained the maximum scores were telephone consultation, acupuncture, Willpower, Champix, combined method, and Interactive Voice Response (IVR) with the mean of 23.3, 23, 22.5, 22, 21.7 and 21.3, respectively. The minimum scores were related to e-cigarette, some methods without medication, and non-NRT medication with the mean of 12.3, 15.8 and 16.2, respectively. There were no significant differences in the mean of scores based on different cities (P = 0.256). Analysis of variance in mean scores showed significant differences in the means scores of different methods (P < 0.000). Conclusions: According to physicians acupuncture, personal methods and Champix are the most effective methods and these methods could be much more feasible and cost effective than other methods.

Health care is becoming more patient-centered and, as a result, patients' experiences of care and assessment of satisfaction are taken more seriously. Patient satisfaction influences treatment cooperation, and better cooperation leads to healthier patients in the long term. This generalization clearly applies in the dental school clinic setting. Furthermore, dental school clinics' administrators and clinicians should know about the dimensions of their patient satisfaction in order to provide the highest quality of care. The aim of this study was to review studies published between 1980 and March 2014 to identify the dimensions used to measure patients' satisfaction when they receive services in dental school clinics. The PubMed database was used to access published studies using patient satisfaction surveys in dental school clinics, and the dimensions used in these surveys were then categorized. Through several stages of searching in PubMed, the authors selected 41 articles from a total of 730; after further critical appraisal, nine articles were retained. Five dimensions included in patient surveys were identified: quality, interaction, access, environment, and cost. Determining the dimensions used in patient satisfaction surveys in dental school clinics can assist academic dental institutions in providing the highest quality of care.

The present study assessed dental students' perceived barriers to geriatric dental care provision.Out of 512 dental students in Iranian dental schools were participated in the study 464 were completed the questionnaire. The mean age of the dental students was 25.5 ± 2.8 years; 67% were women.Most of the participants (79%) did not have any training focused on geriatric dental care, and the vast majority (more than 83%) had no experience with geriatric dental care. The primary barriers to provide dental care to the elderly that dental student mentioned included insufficient knowledge of geriatric dental care and perceived lack of communication skills and self-confidence in managing elderly patients.Increased emphasis on geriatric dental education in the undergraduate dental curriculums needed to minimize the barriers and improving dental students' willingness to serve older people.

The aim of this study is to determine the dental caries and oral health behavior status of urban adolescents in Iran. Also it assesses the influence of the socioeconomic background on their oral health outcomes.A cross-sectional study was conducted in the students living in the city of Isfahan, Iran. 597 adolescents by 13 to 17 years old participated in the study. The asset-based wealth index, household income and parents' educational history were the indicators of socioeconomic status. Data on tooth brushing frequency and smoking experience were collected, and the adolescents were examined for their dental health status. The index of DMFT was recorded by two calibrated examiners considering the criteria of World Health Organization. Bivariate analysis and multivariate regressions were employed to explore the association between dental caries status and socioeconomic variables.The DMFT mean (SD) of the study population was 2.79(2.7) with attributable 50, 4 and 46 percent to D, M and F components and 26% caries- free prevalence. Nearly 19% of the students presented twice daily brushing and 3% of respondents had smoking experience. Dental caries did not show any linear relationship with the social indicators when the DMFT was modeled by the wealth index, parents' educational level and family income adjusted for age and gender. Without adjustment, lower income has increased the chance of untreated tooth decay, 2.5 times among the students.Despite the supporting findings on inequalities in oral health, this study did not show a direct association between socio economic backgrounds of the adolescents with their dental health/disease. The hypothesized balanced risk exposure is considered to justify the results, but it needs to be studied by further comprehensive analysis.

Following MPOWER's 2011 report, a study was conducted to quantify the implementation of MPOWER tobacco control policies in the Eastern Mediterranean Region (EMR) in 2013 to assess any possible change during the last two years. In this cross sectional study, based on 10 categories mentioned in MPOWER 2013, a checklist was designed and its scoring was agreed upon by Iranian and international tobacco control specialists. Seven questions were scored from 0 - 4 and 3 from 0 - 3. The 22 countries were ranked by their total score on a scale of 0 to 37. Among the 22 countries in the EMR, Iran, Kuwait, Egypt, Lebanon, Gaza and West bank and Jordan were scored 31, 28, 28, 26, 25 and 25 respectively. 14 countries scored more than 50%, a small improvement; 5 countries have seen their scores fall, and three countries received the same score as last time. The highest overall improvement was attributed to the warning label, and the sharpest decline was observed in the consumption category.There has been a slight overall improvement in tobacco control planning, although the desired levels have yet to be reached and some countries in the region have fared worse.

Evidence from the USA and elsewhere has linked smoking depictions in movies with youth smoking initiation. Prior research has not focused on depictions in films produced in the Middle East, however.We reviewed the 10 most commercially successful Iranian films released each year over three decades (1982-2011) to determine trends in depictions of tobacco use over time.Each movie was reviewed in its entirety, and depictions of smoking were recorded and classified as direct (characters holding or using tobacco products) and indirect (tobacco products appearing in the frame, but not being used). Time trends in average duration of direct, indirect and total smoking depictions were analysed using linear regression and Cohen's κ coefficient.The mean duration of tobacco depictions in the most commercially successful Iranian films fluctuated yearly over the 3 decades, but with an overall significant upward trend (p0.005). The proportion of movies depicting tobacco consumption during the three decades was 36% (1982-1991), 60% (1992-2001) and 74% (2002-2011), respectively. The average proportion of total movie time for these depictions (0.75%, 1.41%, 2.08%) increased significantly (p0.005) over the 3 decades as did the average duration of smoking depictions,(39.1, 67 and 99.3 s, respectively, p0.005).The significant increase in the proportion of movies depicting tobacco consumption and in the duration of smoking depictions over the past 30 years underscores the need for increased regulation of the Iranian film industry to minimise this important source of influence on tobacco initiation in young people.

The term 'authentic assessment' has recently gained widespread use in education. A five-dimensional questionnaire for authentic assessment was translated into Farsi. The questionnaire which comprises 29 items, divided into 5 subscales (task, physical context, social context, result/form and criteria) was developed in English by Dr. Gulikers and her colleagues in the Netherlands. The questionnaire was translated using a forward-backward method and was pilot tested in terms of translation clarity and applicability. The psychometric properties of the Persian version of the questionnaire were evaluated in terms of face, content, and construct validity in addition to test-retest reliability. A convenience sample of 230 dental students (70 males and 160 females) studying in four dental schools in Tehran city was recruited to evaluate the reliability and construct validity of the Persian version. The quality rating of the translations was favorable, suggesting a high quality of both forward and backward translations. The Content Validity Index (CVI) and Ratio (CVR) for the final Farsi version of the questionnaire were found to be acceptable. Cronbach alpha coefficients for all subscales ranged from 0.78-0.91. These preliminary results suggest that a five dimensional questionnaire in its Farsi version may be a valuable tool in dental education assessment and studies.

In this study, we assess the strengths, challenges and opportunities regarding the oral health system stewardship in Iran.A mixed methodology was used, comprised of a quantitative questionnaire using the functional standards, semi structured interviews with key stakeholders and document review. The level of current attainments of each standard was determined based on a Likert-type scale. Literature review was completed to find official documents of national organizations.The responsibility of policy development of oral health care at the national level mostly falls on the Oral Health Bureau. This office has formulated a strategic plan for its policy-making and has considered the required capacity to implement them. However, the Bureau has some problems in enforcing its regulatory framework, especially in the private sector. There are rigorous problems in managing information and using them for evidence-based decision making. Setting and allocation of operational budgets for implementing the policies is only partially attained, as is monitoring and evaluating the performance.While the Ministry of Health and Medical Education has achieved some stewardship measures, it still needs further improvements in the oral health system. It needs to strengthen its information system and its executive capacity to implement the proposed regulations. The Ministry must improve accountability in the oral health system, especially the provider accountability.

To evaluate the psychometric properties of an oral-health related quality of life (OHRQoL) instrument for application in the population of Iranian adolescents and to assess the discriminate and convergent validity and reliability of the Persian version of the Child Oral Health Impact Profile (COHIP) in a representative sample of this population.Using multistage stratified sampling, 597 schoolchildren aged from 13 to 18 years living in the city of Isfahan were recruited to complete the Persian COHIP questionnaire. They were also examined for dental caries and malocclusion by two trained, calibrated examiners.Overall COHIP scores ranged from 15 to 135 (mean ± SD: 103.6 ± 18). Sixty-six percent of the students experienced at least one frequent oral health-related impact over the past three months. The Cronbach alpha coefficient was 0.89 for the overall score. Discriminate validity was supported by the significant difference between COHIP scores in the caries-free group and the others (P = 0.01). In addition, the questionnaire was able to differentiate among the groups by various degrees of need for orthodontic treatment (P0.01). Convergent validity was confirmed by significant association between the quality of life scores, the self-perceived health and oral health ratings and the self-perceived treatment need (r = 0.36, 0.57, -0.40).The Persian COHIP demonstrated acceptable psychometric properties for the descriptive purposes. Some discrepancies observed between the clinical data and quality of life status were confirmed by the perceptual identity of such indices influenced by several overt and covert variables.

To develop an instrument to measure socioeconomic status (SES) in order to assess SES-related inequalities in oral health in a developing country.In order to develop a SES measurement tool, an expert panel generated a primary item pool from which the items were revised after validity and reliability testing. The final instrument was used in a 1100-sample survey in Tehran. SES was calculated using the weights produced by both principal component analysis (PCA) and expert panel two-stage paired comparisons (TSPC) methods.The final instrument contained 10 items. Standardised SES scores derived from TSPC and PCA methods were significantly correlated (r = 0.749, P0.001). Five-level SES stratification by the two methods revealed a correlation coefficient of 0.701 (P0.001) for SES class.The newly developed SES index was appropriate to be used in exploring oral health inequalities in the studied sample of the Iranian population. When formulating SES, domestic experts' opinions could help the researchers explore and weight sub-construct factors.

The current study assessed Iranian dentists' practice, knowledge, perceived barriers, and attitudes toward helping patients to quit. We hypothesized that Iranian dentists would have limited knowledge and awareness of tobacco cessation methods or of their important role in encouraging patients to quit. We expected the combination of quantitative and qualitative research to yield important insights regarding effective methods of engaging Iranian dentists in tobacco intervention.From a list of registered dentists following an initial screening, we randomly selected a total of 1,000 dental practices in 10 randomly selected provinces. Following an initial letter describing the study, we mailed a questionnaire. For the qualitative part of the study, we used a convenience purposeful sampling of 16 dentists.Despite repeated contacts, only 35 percent of those contacted returned completed surveys. Key findings not only included generally positive attitudes toward tobacco cessation programs, but also identification of major barriers including concerns about patient resistance, lack of supportive organization, and opportunities for training. Dentists were far more likely to ask patients about smoking than to provide actual cessation support. Female dentists were more likely to ask patients. The qualitative interviews shed further light on barriers to intervention.Interpretation of the findings is limited by the relatively low response rate. However, despite identified barriers to intervention, we are encouraged by dentists' overall knowledge and interest in tobacco cessation services. We plan to use the current findings to inform development of continuing education programs and incorporation of tobacco cessation counseling into dental school curricula in Iran.

Objective: Tobacco use is prevalent in Iran, especially among men. The aim was to assess cessation practices and identify perceived barriers to delivery of tobacco cessation services by Iranian senior dental students. Design: Descriptive, cross-sectional study. Setting: Iran, Schools of Dentistry, 2009–2010. Participants: 370 (response rate 82%) officially registered senior dental students selected through stratified random sampling. Intervention: Students at 11 dental schools throughout the country completed the survey. Main outcome measure: Students’ practice of the US Clinical Practice Guideline 5 As (ask, advise, assess, assist, arrange); interest in training; intention and barriers addressing tobacco use in dental settings. Results and Conclusions: Respondents were primarily female (67.8%). The students were far more likely to be actively involved in asking, advising and assessing patients to quit than in assisting and arranging. Most respondents (68.5%) agreed that it is within the scope of dental practice to help smokers quit. The most important barriers to providing cessation services included perceived patient resistance (44%) and lack of a supportive organisation (36%). This was the first assessment of approaches to tobacco users by dental students in Iran. Although there clearly is room for improvement, the interest of the students toward tobacco cessation is encouraging.

The implementation of 5 of the 6 WHO MPOWER program in Iran is satisfactory; the only notable shortcoming is the lack of tobacco taxation increases. This study was designed to increase key policy makers' awareness of tobacco taxation effectiveness through a sensitization program in Iran. This analytical and semi-experimental study in 2014 included 110 tobacco control key policy makers, who were trained and received educational materials on the importance of tobacco taxation. A valid and reliable questionnaire was completed before and three months after intervention. Data were analyzed using mean (SD), t-Test and analysis of variance. The mean (SD) scores at pre- and post-test were 2.7 ± 3 and 8.8 ± 1 out of 10, respectively. Paired t-tests demonstrated a significant difference in the pre- post-test knowledge scores. Increasing knowledge and promoting favorable attitudes of policy makers can lead to greater attention which could in turn change tobacco taxation policies.