Effect of Fluoride Gel on Microhardness of Flowable Composites: An In Vitro Study

Objective: Adequate knowledge about restorative materials particularly flowable composite resins with favorable physical properties like optimal microhardness and resistance to environmental factors is a big concern for many dentists. Flowable composites have several applications for fissure sealant therapy and preventive resin restorations (PRR); which are common treatments in pediatric dentistry.  Acidulated Phosphor Fluoride (APF) topical gels can cause surface degradation and  weight loss in composite resins and decrease their wear resistance. This study aimed to assess the effect of APF gel on the microhardness of flowable composites.Methods: This experimental in vitro study was conducted on 60 specimens measuring 2mm in thickness and 6mm in diameter fabricated of Tetric N-Flow (Ivoclar-Vivadent), PermaFlo  (Ultradent) and Denfil (Vericom) flowable composites (n=20 for each group). Specimens were stored in artificial saliva at room temperature for one week. The 20 specimens in each group were randomly divided into 2 subgroups of test and control (n=10). Microhardness was measured using Vickers microhardness tester. In the control groups, 3 indentations were made on each disc on the periphery of a circle with at least 1mm distance from one another and from the specimen margin.  The mean microhardness value was then calculated. The mean of all measurements was calculated  as well. Test specimens were subjected to (Sultan) 1.23% APF gel for 4min and then rinsed and air- dried. Their microhardness was measured again as described above. Two-way ANOVA was used to compare the effect of APF gel and type of composite on the microhardness of different flowable composites.Results: Based on the results, the microhardness of Denfil, PermaFlo and Tetric N-Flow was 16.5 (1.32), 37.36 (2.13) and 20.39 (0.52) before and 16.46 (2.20), 35.04 (2.43) and 19.13 (2.20) after theapplication of APF gel, respectively. The difference between the before and after values for each composite was significant (p=0.193) while the difference between different composites was statistically significant in this regard (p<0.001).Conclusion: Exposure of Denfil, PermaFlo and Tetric N-Flow flowable composites to APF gel for 4min had no effect on their microhardness

Factors hindering the adherence to clinical practice guideline for diabetes mellitus in the Palestinian primary healthcare clinics: a qualitative study

Objective Despite a high number of the internationally produced and implemented clinical guidelines, the adherence with them is still low in healthcare. This study aimed at exploring the perspectives and experiences of senior doctors and nurses towards the barriers of adherence to diabetes guideline. Setting The Palestinian Primary Health Care-Ministry of Health (PHC-MoH) and Primary Health Care-United Nations Relief and Works Agency for Palestine Refugees in the Near East (PHC- UNRWA) in Gaza Strip. Participants Individual face-to-face in-depth interviews were conducted with 20 senior doctors and nurses who were purposefully selected. Methods Qualitative design was employed using the theoretical framework by Cabana et al to develop an interview guide. Semi-structural and audio-recorded interviews were conducted. Data were transcribed verbatim and thematically analysed. Results The key theme

Prevention and control of health care–associated infections in Iran: A qualitative study to explore challenges and barriers

Background: Globally, the health and economic burden posed by health care–associated infections (HAIs) remains wide and severe. To curb the burden associated with HAIs, countries, including Iran, aim at HAI prevention and control. This study explores the challenges faced by the Iranian health system in addressing the issues associated with the prevention and control of HAIs. Methods: A qualitative research method was adopted in exploring the phenomenon. We used the purposive sampling approach in reaching 24 key informants at the national and subnational levels. The thematic framework analysis was conducted for analyzing the interviews. Results: Five main themes emerged from our study demonstrating the obstacles toward the prevention and control of HAIs. They include governance and stewardship, resources, safety culture, monitoring and surveillance systems, and inappropriate prescription of antibiotics. Conclusions: Strengthening of reporting and surveillance systems for HAIs coupled with proper governance and stewardship are crucial in order to improve the health and safety of patients. However, the availability of resources, through an intersectoral approach, is essential to achieve sustained output. © 2016 Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control an

Predictors of Transition in Different Stages of Smoking: A Longitudinal Study

Abstract We investigated longitudinally the prevalence of smoking according to three stages of smoking (never smoking, experimenting the smoking, and regular smoking), the rates of transition from one stage to another one, and determinant predictors of transition through these stages of smoking. Of all 10th grade students in Tabriz, 1785 students were randomly selected and assessed twice, with a 12-month interval, with respect to the changes of stage. The predictor variables were measured when the students were in the 10th grade. Logistic regression and principal component analysis were used to analysis data at grade 11. Of 1785 students, 14.3% (CI 95%: 12.3-16.4) and 2.8% (CI 95%: 2.0-4.0) of the never smokers became experimenters and regular smokers, respectively and 16.5% (CI 95%: 12.4-21.7) of the experimenters became regular smokers. Among never smokers, participating in smoker groups (OR = 1.24), having smoker friends (OR = 1.85) and a positive attitude towards smoking (OR = 1.22) predicted experimentation; and participating in smokers groups (OR = 1.35) and a lower socioeconomic class (OR = 0.36) predicted regular smoking. Among experimenters, students having general high risk behaviors (OR = 2.56) and participating in smoker groups (OR = 2.58) were distinguished as those who progressed to regular smoking in follow-up. Programs aimed at smoking prevention and intervention should incorporate plans which focus on predictors of transition through smoking stages, and targeting participation in smoker groups

Appraising the methodological quality of the clinical practice guideline for diabetes mellitus using the AGREE II instrument: a methodological evaluation

Objectives To evaluate the methodological quality of the Palestinian Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. Design Methodological evaluation. A cross-cultural adaptation framework was followed to translate and develop a standardised Translated Arabic Version of the AGREE II. Setting Palestinian Primary Healthcare Centres. Participants Sixteen appraisers independently evaluated the Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. Main outcome measures Methodological quality of diabetic guideline. Results The Translated Arabic Version of the AGREE II showed an acceptable reliability and validity. Internal consistency ranged between 0.67 and 0.88 (Cronbach’s α). Intra-class coefficient among appraisers ranged between 0.56 and 0.88. The quality of this guideline is low. Both domains ‘Scope and

Psychometric properties of an Arabic safety attitude questionnaire (short form 2006)

Objectives There is a widespread interest in exploring healthcare providers’ attitudes and perceptions about patient safety culture. This study was done to determine the reliability and validity of the Arabic version of Safety Attitude Questionnaire (SAQ) in Palestinian hospitals. Methods This was a methodological study and the SAQ was translated into Arabic using the forward-backward translation technique. Four Ministry of Health hospitals in the Gaza Strip were randomly selected, and proportionate systematic sampling was followed to select the participants. Questionnaires were distributed to 370 physicians and nurses. Face and content validity were tested, and the content validity index was determined using the average approach. Internal consistency was assessed with Cronbach’s alpha, split-half reliability, and intercorrelation between the questionnaire scales. Construct validity was assessed through exploratory

Predictors of Transition in Different Stages of Smoking: A Longitudinal Study

AbstractBackground: We investigated longitudinally the prevalence of smoking according to three stages of smoking (never smoking, experimenting the smoking, and regular smoking), the rates of transition from one stage to another one, and determinant predictors of transition through these stages of smoking.Methods: Of all 10th grade students in Tabriz, 1785 students were randomly selected and assessed twice, with a 12-month interval, with respect to the changes of stage. The predictor variables were measured when the students were in the 10th grade. Logistic regression and principal component analysis were used to analysis data at grade 11.Findings: Of 1785 students, 14.3% (CI 95%: 12.3-16.4) and 2.8% (CI 95%: 2.0-4.0) of the never smokers became experimenters and regular smokers, respectively and 16.5% (CI 95%: 12.4-21.7) of the experimenters became regular smokers. Among never smokers, participating in smoker groups (OR = 1.24), having smoker friends (OR = 1.85) and a positive attitude towards smoking (OR = 1.22) predicted experimentation; and participating in smokers groups (OR = 1.35) and a lower socioeconomic class (OR = 0.36) predicted regular smoking. Among experimenters, students having general high risk behaviors (OR = 2.56) and participating in smoker groups (OR = 2.58) were distinguished as those who progressed to regular smoking in follow-up.Conclusion:Programs aimed at smoking prevention and intervention should incorporate plans which focus on predictors of transition through smoking stages, and targeting participation in smoker groups.Keyword: Smoking, Students, Risk-Taking, Longitudinal Studies, Peer Group, Epidemiology, Prevalence, Risk factor

Convergent Validity and Reliability of the Persian Version of the Bay Area Functional Performance Evaluation-Task-Oriented Assessment in People with Severe Psychiatric Disorders

Background: Functional performance plays an important role in the independence and participation of people with severe psychiatric disorders. The Bay Area Functional Performance Evaluation-Task-Oriented Assessment (BaFPE-TOA) is a tool that evaluates functional performance. The present study aimed to assess the convergent validity and inter-rater reliability of the BaFPE-TOA tool using the classic test theory. Methods: In this psychometric study, the population comprised people with severe psychiatric disorders. Participants were selected according to the inclusion criteria and convenience sampling. Consent to participate in the study was given by all participants. To examine the convergent validity, two tests, the BaFPE-TOA test and Kohlman Evaluation of Living Skills (KELS) test, were performed for 55 patients. To assess the inter-rater reliability, two examiners (occupational therapists) performed the BaFPE-TOA test for 26 patients simultaneously. Then, the Pearson correlation coefficient was used to examine convergent validity, and the intraclass correlation coefficient was used to assess inter-rater reliability. Results: Participants in this study comprised 44 men (81.8%) and 10 women (18.2%). The age of participants ranged from 22 to 69 years with a mean of 41.5 years (SD = 10.5). The Pearson correlation coefficient between the BaFPE-TOA and the KELS was good (r=0.74, p -value <.001). The Intraclass correlation coefficient and Pearson correlation coefficient between the two examiners showed a good relation (r= 0.75, p -value <0.001). Conclusion: The results showed that the Persian version of the BaFPE-TOA has acceptable convergent validity with KELS and inter-rater reliability that represents the suitability of this tool for use in the healthcare environment

An Ecological Study of the Association between Opiate Use and Incidence of Cancers

Background: Cancer is the second leading cause of death after cardiovascular disease. In recent years it has been hypothesized that opiate use could be a risk factor for cancer. This study aimed to evaluate a possible association between opiate use and common cancers using ecological statistics from around the world.Methods: To investigate the association we used ordinary linear regression models. The log10-transformed age-standardized incidence rate (ASR) of cancers was used as dependent variables in the models. We adjusted for smoking, alcohol use per capita, human development index (HDI), and body mass index (BMI) as confounding variables. We extracted these variables from different data sources including the GLOBOCAN 2012, the United Nations Office on Drugs and Crime (UNODC) annual reports, World Health Organization database, the United Nations Development Program (UNDP) report 2012, and published literature. We estimated two separate models for each cancer, one for males and the other for both sexes.Findings: Opiate prevalence ranged from 0.01% to 2.65% and its median was 0.20%. In the multiple regression models for both sexes, opiate use was significantly associated with bladder (β = 0.59), kidney (β = 0.16), oral cavity (β = 0.27), esophagus (β = 0.33), larynx (β = 0.17) and other pharynx (β = 0.36) cancers. In the models based on the male data, the coefficient and the significances were approximately the same for the above cancers but larynx cancer was no longer significantly associated with opiate use.Conclusion: There was a significant association between opiate use and risk of cancers. We suggest that more studies should be conducted, especially in high-risk areas of the world

Nurses exposure to workplace violence in a large teaching hospital in Iran

Background: Workplace violence is one of the factors which can strongly reduce job satisfaction and the quality of working life of nurses. The aim of this study was to measure nurses’ exposure to workplace violence in one of the major teaching hospitals in Tehran in 2010. Methods: We surveyed the nurses in a cross-sectional design in 2010. The questionnaire was adapted from a standardized questionnaire designed collaboratively by the International Labor Office (ILO), the International Health Organization (IHO), the International Council of Nurses (ICN), and the Public Services International (PSI). Finally, in order to analyze the relationships among different variables in the study, T-test and Chi-Square test were used. Results: Three hundred and one nurses responded to the questionnaire (a response rate of 73%). Over 70% of the nurses felt worried about workplace violence. The participants reported exposure to verbal abuse (64% CI: 59-70%), bullying-mobbing (29% CI: 24-34%) and physical violence (12% CI: 9-16%) at least once during the previous year. Relatives of hospital patients were responsible for most of the violence. Nurses working in the emergency department and outpatient clinics were more likely to report having experienced violence. Nurses were unlikely to report violence to hospital managers, and 40% of nurses were unaware of any existing policies within the hospital for reducing violence. Conclusion: We observed a considerable level of nurse exposure to workplace violence. The high rate of reported workplace violence demonstrates that the existing safeguards that aim to protect the staff from abusive patients and relatives are inadequate