[ efficacy of CBCT for diagnosis and treatment of oral and maxillofacial disorders: a systematic review]

Cone Beam Computed Tomography [CBCT] has the ability to accomplish rapid volumetric image acquisition by its cone-shaped beam. The aim of this study was to evaluate the safety and efficacy of this imaging modality A standard systematic review was performed. Medline [December 2012] and The Cochrane Library [Issue 3 2012] were searched to identify evidence about the performance [sensitivity, specificity and safety] of CBCT compared with other standard diagnostic methods. The results of the included studies were analyzed using a qualitative method Thirty-one articles were included in the study; the majority of them were diagnostic studies with a small sample size [n<10]. There was limited evidence about the effectiveness of this technology and the available evidence was scattered and sometimes controversial. At present, CBCT technology has greatly advanced and its image quality in terms of resolution is higher than that of MOCT. However, its contrast resolution is still lower than that of MOCT. Therefore, MOCT is preferred for soft tissue imaging. For evaluation of hard tissue in the maxillofacial region, a more clear image with higher resolution can be obtained by CBCT. CBCT technology is now commonly used in developed countries for obtaining detailed information regarding the oral and maxillofacial region and can greatly help clinicians in diagnosis and treatment of maxillofacial disorders

[Quality of working life and its relation with productivity of nurses' performance in Shahid Beheshti University of Medical Sciences hospitals]

The quality of working life is a very important variable in connection with human resources. Therefore, it should be taken into consideration by managers if they aim to improve the capabilities and efficiency of their staff, which will, in turn, lead to improved productivity and economic growth. Productivity is an important factor in the success of hospital nurses too. The objective of this study was to determine the association between the quality of working life and productivity of nurses. Knowledge of this relationship can help plan to improve the nurses' quality of working life and, subsequently, improve their productivity and, ultimately, productivity of a hospital. This was a cross-sectional correlation study conducted in 2011. The study population was nurses of the Shahid-Beheshti University of Medical Sciences hospitals in Tehran, Iran. Using the randomized stratified multistage sampling method, 380 nurses were selected as the study sample. Data on the nurses' quality of working life and productivity were collected using two questionnaires and analyzed using SPSS-17, the statistical tests being Chi-2, ANOVA, T-test, and the Pearson correlation test. The findings showed that nurses' quality of work life and productivity were at the middle level, with a mean of 2.47 and 3.07, respectively. A very small number [1.55%] of the nurses reported that their quality of work life was at a high level, while the majority [82.4%] believed their quality of work life to be at a moderate level. The Pearson correlation test showed a significant positive relationship between the quality of work life and productivity of the nurses [r = 0.66, p-value = 0.001]. Only a low proportion of the nurses report their quality of working life and productivity to be at a high level. Therefore, bearing in mind that a statistically significant relationship exists between the quality of working life and productivity, authorities should a tempt to promote the nurses' quality of work life in order to increase their productivity

[Estimation of the costs of MRI 3 Tesla and MRI 1.5 Tesla in Iran, for the purpose of comparison]

The aim of this study was to estimate and compare the costs of MRI3Tesla and MRI1/5 Tesla in Iran in order to offer recommendations to the health system policymakers and hospital administrators in regard to the use of MRI 3 Tesla and its costs in Iran. This was an economic evaluation study which was performed by reviewing articles and economic modeling. Data were obtained from internet and the main suppliers of this technology and their representatives in Iran and also hospitals using these technologies. We divided the costs into three categories: capital costs including buildings and machinery depreciation, staff costs and other costs [costs of consumable materials, running costs and maintenance]. For 1500 tests per year, the unit cost was estimated at 4,500,000 Rials per test for MRI 3 Tesla and 3,500,000 Rials for 1.5 Tesla. If the number of tests per year was 3000, the unit cost would be 2,400,000 Rials for 3 Tesla and1,900,000 Rials for 1.5 Tesla. For 6000 tests per year, the unit cost would be was 1,350,000 Rials for 3 Tesla and 1,050,000 Rials for 1.5 Tesla. For 12,000 tests per year, the unit cost would be 710,000 Rials for 3 Tesla and 560,000 Rials for 1.5 Tesla. For 24000 tests per year, the unit cost would be 373000 Rials and 300,000 Rials for 3 Tesla and 1.5 Tesla respectively. For 1500 to 24000 tests per year the cost of each test with MRI 3 Tesla system in Iran, will vary between 373000 to 4527000 Rials. It is recommended that this technology be used in the centers with sufficient number of patients otherwise it may give rise to extra costs

[Job burnout and some of its risk factors on the health workers (Behvarz) in Koohrang County, I.R.Iran, in 2010]

Emotional exhaustion, depersonalization and lack of personal accomplishment are three dimensions of job burnout. Symptoms occur when employees' abilities and skills are not match with job demands. In a health care organization, staffs are exposed to physical, mental and emotional stresses and predisposed to job burnout. In this survey we studied Job burnout and some of its risk factors among Koohrang county Rural Health Workers [RHW or Behvarz] in 2010. This descriptive-analytical study designed to assess job burnout dimensions in RHW of Koohrang county in 2010. Total koohrang county RHW [n=81] entered to the study. Two types of questionnaires were used for data collection: 1] Demographic data questionnaire include of age, sex, marriage status, level of education, type of employment and working years. 2] Maslach Burnout Inventory [MBI] as a common valid questionnaire for assessment of job burnout. The reliability and internal validity of MBI questionnaire had been proved in previous studies. Data were analyzed by SPSS using ANOVA, spearman correlation and simple t tests. In different dimensions of job burnout, frequency of high lack of accomplishment, high emotional exhaustion and high depersonalization were 24.5%, 4.6% and 2.7% respectively but severity of emotional exhaustion and depersonalization were 6.7% and 1.3%. None of them reported severe lack of personal accomplishment. The relation between demographic factors and job burnout was not statistically significant [P>0.05]. There were significant correlation between emotional exhaustion and depersonalization and between personal accomplishment and emotional exhaustion [P<0.001]. The study shows that frequency and severity of job burnout in different dimensions are low. It could be explained by their appropriate socioeconomic status, short distance to workplace as one of its advantages, job security, low level of life expectations accompanying with nice climate

Quality of working life on residents working in hospitals

Residents play an important role in the delivery of hospital care. They regularly work overnight, in emergency situations and with workload and stress which can affect their performance and quality of working life [QWL]. This study explores the QWL and its contributory factors in residents working at hospitals affiliated with Tehran University of Medical Sciences [TUMS], Tehran, Iran. Medline was searched to identify questionnaires for measuring QWL in healthcare professionals and these questionnaires were used to design a comprehensive questionnaire for measuring residents QWL. Face and content validity of the questionnaire were examined by 7 experts. The questionnaire then was completed twice with one-week interval by 14 residents to assess the intera-rater reliability. Then 310 questionnaires were distributed among residents working at different specialties in 7 hospitals affiliated to TUMS including a large general hospital, two medium general hospitals and four small single specialty hospitals. Statistical analyses were performed by SPSS. Totally, 263 residents [84%] completed the questionnaire. The quality of working life was very well in 18%, well in 32%, moderate in 31%, low in 14% and very low in 5% of residents. Pediatric residents had the highest and urology and internal medicine residents had the lowest quality of working life. The QWL is high in the majority of residents, but the QWL is still not desirable in a significant proportion of them. The questionnaire used in this study is reliable and valid. The residents' QWL still need improvement

Estimating the frequency and rate of first 50 common types of invasive procedures in Iran healthcare system

The aim of this study was to estimate the frequency and rate of the first 50 common types of invasive procedures in Iran. Data about the number of all invasive procedures and each type of procedure that were conducted in Iran in 2010 were collected using the main insurance organizations database. These numbers were sorted in an excel database, and the first 50 invasive procedures with the most common frequency were selected. Then according to the population covered by the given insurance organizations, and based on the total population of Iran in 2011, we estimated the number and rate of each invasive procedure for the selective procedures. It was estimated that a total of 769,500 [1,026 per 100,000 population] natural vaginal delivery [NYD] was performed in Iran in 2011, followed by 416,790 cataract operation [556 per 100,000 population], 401,436 cesarean delivery [535 per 100,000 population], 260,514 coronary angiography disease [347 per 100,000 population], 181,836 varicocele [242 per 100,000 population], 144,918 appendectomy [193 per 100,000 population], 134,766 rhinoplasty [180 per 100,000 population] and 105,912 pilomdal cyst [141 per l00,000 population]. The result could be used to identify and select the most frequent invasive procedures in Iran, to calculate the average cost of each procedure and to use these costs to estimate hospital budget and improve policy-making

Unresolved issues in medical tariffs: Challenges and respective solutions to improve tariff system in Iranian health sectors

Medical tariff is one of the most important tools for health policy making in a country that influences equity, efficiency, quality and accountability of service deliveries. If relative values for different services are not determined correctly, it may have negative consequences on availability and sustainability of care. This study was designed to assess the challenges and respective solutions of the tariff system in Iranian health sectors. This is a qualitative study, involving nine face to face interviews with health managers, policy makers and researchers at the Ministry of Health and Medical Education and relevant organizations, as well as public and private institutions and service providers who had experiences in medical tariff. We used the thematic framework method for analyzing qualitative data. The problems and respective solutions were classified into stewardship power, policy making and surveillance for tariff setting, structural organization of medical tariff system, methods and principles of setting the tariffs, medical costs recording systems and other concepts related to the medical tariff system in the health sector. To improve medical tariffs system in the country, one need to have a deep understanding of the current challenges and potential solutions in different levels. It is advisable to follow a clear model based on focus on policy-making and stewardship of medical tariffs system as an important cornerstone of any effort to rectify the current situation