Evaluation of an undergraduate occupational health program in Iran based on alumni perceptions: a structural equation model / 보건의료교육평가

PURPOSE: Evaluating educational programs can improve the quality of education. The present study evaluated the undergraduate occupational health program at the Semnan University of Medical Sciences in Semnan, Iran, with a focus on the associations between alumni perceptions of the learning environment and the outcomes of the occupational health program. METHODS: A cross-sectional questionnaire survey was conducted among alumni of the undergraduate occupational health program. We asked alumni to rate their perceptions of the items using a 4-point Likert scale. The associations between alumni perceptions of the educational program and curriculum, faculty, institutional resources, and learning outcomes were modeled and described using structural equation modeling procedures. RESULTS: A descriptive analysis of alumni perceptions indicated low evaluations for the administrative system, practical and research-based courses, and the number of faculty members. We found that a structural model of the evaluation variables of curriculum, faculty qualifications, and institutional resources significantly predicted undergraduate educational outcomes. The curriculum had direct and indirect effects on learning outcomes, mediated by faculty. CONCLUSION: The findings of our study highlight the usefulness of the structural equation modeling approach for examining links between variables related to the learning process and learning outcomes. Surveys of alumni can provide data for reassessing the learning environment in the light of the professional competencies needed for occupational health graduates.

[Age estimation from pulp/tooth area ratio using digital panoramic radiography]

To estimate the age in forensic identification, when none of the methods is satisfactory, the teeth are used. The aim of the present study was to estimate the age from pulp/tooth area ratio [AR] by digital panoramic radiography in patients referred to a radiography clinic. In this diagnostic study, digital panoramic radiographs of 120 cases were assessed. The chronological age was calculated by subtracting the date of birth from the date of radiographs and the pulp/tooth AR was calculated with "AutoCad" software. Using the regression model, the age was estimated. In this study, the role of sex was also assessed. The mean difference between the chronological and estimated age was 0.11 years in male group. The correlation coefficient was -0,180 and the correlation between age and AR was not statistically significant [p=0.169]. The mean difference between the chronological and estimated age was 0.36 years in female group. Correlation coefficient was -0.336 and the correlation between age and AR was significant [p=0.004]. Negative correlation indicates that by advanced age, pulp/tooth AR decreases. According to the results of this study, AR alone cannot be used for age estimation alone, but it can be used as combined index with other indices for this purpose

The efficacy of the reverse contrast mode in digital radiography for the detection of proximal dentinal caries

PURPOSE: This study evaluated the diagnostic accuracy of the reverse contrast mode in intraoral digital radiography for the detection of proximal dentinal caries, in comparison with the original digital radiographs. MATERIALS AND METHODS: Eighty extracted premolars with no clinically apparent caries were selected, and digital radiographs of them were taken separately in standard conditions. Four observers examined the original radiographs and the same radiographs in the reverse contrast mode with the goal of identifying proximal dentinal caries. Microscopic sections 5 microm in thickness were prepared from the teeth in the mesiodistal direction. Four slides prepared from each sample used as the diagnostic gold standard. The data were analyzed using SPSS (alpha=0.05). RESULTS: Our results showed that the original radiographs in order to identify proximal dentinal caries had the following values for sensitivity, specificity, positive predictive value, negative predictive value, and accuracy, respectively: 72.5%, 90%, 87.2%, 76.5%, and 80.9%. For the reverse contrast mode, however, the corresponding values were 63.1%, 89.4%, 87.1%, 73.5%, and 78.8%, respectively. The sensitivity of original digital radiograph for detecting proximal dentinal caries was significantly higher than that of reverse contrast mode (p0.05). CONCLUSION: The sensitivity of the original digital radiograph for detecting proximal dentinal caries was significantly higher than that of the reversed contrast images. However, no statistically significant differences were found between these techniques regarding specificity, positive predictive value, negative predictive value, or accuracy.

[Diagnostic accuracy of digital phosphor plates using pseudo-color enhancement for detection of horizontal root fractures in single-rooted teeth]

If root fractures remain undetected, pulp necrosis will occur in 25% of cases leading to eventual tooth loss. The purpose of this study was to evaluate the diagnostic accuracy of digital phosphor plates using pseudo-color enhancement for detection of horizontal root fractures in single-rooted teeth. Eighty-two human single-rooted teeth were evaluated [41 with no horizontal fracture and 41 with horizontal fractures]. Digital intraoral imaging plate system. [Digora[registered sign] Optime PSP System, Soredex] was used to obtain 16-bit gray scale images. Five 16-bit images were obtained from each specimen and saved [one original and four with pseudo-color enhancement]. Four observers evaluated the images twice with a 2- week interval. Accuracy, positive predictive value [PPV], negative predictive value [NPV], specificity and sensitivity for each observer and each image group were calculated. The diagnostic sensitivities were not significantly different among the five images [P absolute=0.125, P complete=0.170]. But, statistically significant differences were found in the diagnostic specificity [P absolute=0.019, P complete=0.016] among the five views. Cool and Summer views had higher diagnostic specificity than Bone, Copper and Original views [P=0.025]. Kappa and Weighted Kappa values showed statistically significant differences for intra- and inter-observer reliability in the five views [P=0.032]. Both Cool and Summer views were suitable for detection of horizontal root fractures and had statistically significant differences with the original view

[Accuracy of reverse contrast option of digital radiography in detection of horizontal root fracture.[in vitro]]

Background and Aim: Detection of Horizontal root fracture is completely related to radiography and application of new methods is indispensable .The aim of this study was to compare the diagnostic accuracy of reverse contrast option of digital radiography with original images for detection of horizontal root fracture

Materials and methods: In this diagnostic study, digital radiographs were taken from 40 maxillary anterior teeth mounted in a dry alveolar socket with vertical angles of 0[degree sign]and 15 [degree sign] .Root fractures were created in the horizontal plane on each root and after relocating root fragments radiographs were repeated in a same position. Images were processed with reverse contrast option and assessed by observers. Data were analyzed with proportion test and Cochran's Q test

Results: There was no significant difference in sensitivity, specificity, PPV[Positive Predictive value] and NPV [Negative Predictive Value] between 0[degree sign]and 15[degree sign]radiographs in original and reverse contrast images. In either image groups, when fractures were certainly diagnosed by observers, 0[degree sign]radiographs obtained higher sensitivities [P=0.014] Also when fractures were likely diagnosed , sensitivity and NPV were significantly higher for 0[degree sign]radiographs [P=0.035] ,[P=0.023]respectively

Conclusion: The diagnostic accuracy of reverse contrast option of digital images are equal to original images, although 0[degree sign]radiographs are more appropriate

Assessment of right ventricular function in children with congenital heart disease Doppler tissue imaging

To assess right ventricular dysfunction in children with congenital heart disease [CHD] by measurement of tricuspid annular diastolic velocity Aa/Ea ratio by doppler tissue imaging [DTI]. A case-control study was performed on 141 children with CHD who were referred to Aliasghar Hospital of Zahedan, Iran for cardiac catheterization from April 2004 to December 2005. Tricuspid inflow velocity [A/E ratio] and Aa/Ea ratio was measured by DTI. Patients were catheterized afterwards. Cumulative data were analyzed by Statistical Package for Social Sciences and evaluated using t-test and correlation. There was significant correlation between Aa/Ea ratio by DTI, and hemodynamic criteria derived at catheterization. It was also diagnosed that 77 patients of 141 had right ventricular dysfunction by DTI, whereas 74 of them showed this problem at catheterization. The sensitivity of this method for evaluation of right ventricular dysfunction was 95%, and specificity was 98%. The positive predictive value 95%, and negative predictive value 98% were assessed. Finding of this study showed that we can use DTI for diagnosis of right ventricular dysfunction in children with CHD, and it can be used instead of catheterization especially in unstable patients

Ellis - van - Creveld syndrome: a case report

Ellis - van Creveld syndrome [EVC] or chondroectodermal dysplasia, a rare autosomal recessive disorder, is a tetrad of chondrodysplasia, ectodermal dysplasia, polydactly, and congenital heart disease, that frequently presents with the single atrium defect. Chondrodystrophy of the tubular bones is the most common feature, while central nervous system [CNS] and urinary tract anomalies are very rare. The reported case is a 2800 gr female neonate with polydactyly of fingers, short limbs, deformed chest, single atrium and cystic kidney