Effect of socio-demographic status on dental caries in pupils by using a multilevel hurdle model

Introduction: Dental caries is the most prevalent chronic disease among schoolchildren. We aimed to investigate the association between dental caries index and socio-demographic status in schoolchildren by using a multilevel hurdle model. Materials and Methods: A cross-sectional epidemiological study was carried out on 906 primary school pupils in Kerman, Iran in 2012. The subjects were selected through a stratified cluster random sampling. At first, the whole target area was stratified according to two geographic areas, the north and south area. Then each area was stratified according to gender. In the next step, several schools were considered as clusters, which were selected randomly in each geographic area and gender strata. All the schoolchildren in these schools were included in this study as samples. Twelve-year-old pupils were examined for dental caries. The dependent variable in this study was the dmft/DMFT index. Eight variables, including socio-demographic information, were collected. Multilevel negative binomial hurdle model was employed for data analysis. Results: The prevalence of caries-free pupils was 30.1% and the mean dmft/DMFT was 3.6 ± 2.2. Negative binomial part of the adjusted model showed that the dmft/DMFT adjusted rate for females was 1.36 (95% CI: 1.10-1.79) times higher than males. Also, the dmft/DMFT adjusted rate for overweight pupils was 0.86 (95% CI: 0.74-0.98) times lower than those with normal weight. Logistic part of the adjusted model showed that the posibility of caries-free state in overweight pupils was 1.95 (95% CI: 1.22-3.11) times higher than those with normal weight. In addition, pupils whose fathers and mothers were workers and housewives, respectively, and those with a high maternal age were at a greater risk for caries experience than others (p < 0.05). Conclusion: BMI, gender, parent’s job and mother’s age at delivery were factors effecting on dental caries in schoolchildren. These pupils need more attention to dental care.

Accreditation Maternity and Obstetric Services (MOS), Based on the Accreditation Standards of the Joint Commission International (JCI)

Background: In recent years various standards have been proposed for assessment and supervision of healthcare systems. One of the most popular of them in health care area is Joint Commission International (JCI) standards of US. This study has been conducted to investigate executive potentials related Accreditation Standards of Maternity and birth services of this commission in hospitals providing maternity and birth services in Ardebil Province. Methods: This is a descriptive-analytic study conducted as cross-sectional on 232 employees of three hospitals in Ardebil including Alavi, Arta and Sabalan who were randomly chosen. This is a multi-stage study that in stage 1, an accreditation tool for maternity and birth services was designed based on JCI standards. Validity and reliability of questionnaire was measured by Alpha Cronbach. In stage 2, score of different dimension of Accreditation Standards of MOS was calculated using data obtained from questionnaires distributed among a sample of 232 hospitals personnel;all of them were working in maternity and birth field. Statistical tests used are one-way analysis of variance (ANOVA), dunnets post hoc and correlation test that all of them were calculated by SPSS V. 18. Results: Result showed that all of the MOS accreditation standards components were capable in selected hospitals. Arta hospital earned the highest score of standards (mean = 149/4) and Alavi hospital received the lowest score (mean = 128/04) of the maximum attainable score (186). Also, significant difference was observed between selected hospitals in total score of MOS standards (F = 50/432, p < 0/00). Conclusion: Based on study findings, there is an inequality between Ardebils hospital in field of MOS accreditation standards. Public hospitals are in more difficult situation compared to private hospitals, therefore Health Care System policy makers must pay attention systematically and specially to implementation of international standards in order to improve health care impacts in public hospitals.