ORCID Profile
0000-0002-4989-7272
Current Organisation
University of Sydney School of Public Health
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Publisher: Springer Science and Business Media LLC
Date: 16-10-2022
Publisher: Georg Thieme Verlag KG
Date: 03-2021
Abstract: Objective Orthokeratinized odontogenic cyst is a rare developmental odontogenic cyst of the jaws. It is a less aggressive intraosseous cyst identified by an orthokeratinized epithelium. Case Report A 50-year-old male patient with the chief complaint of swelling in the anterior part of his face, and, intraorally, there was diffuse swelling in the palatal cortex. On panoramic radiography, there was a well-defined unilocular radiolucency on the right side of the maxilla and palatal cortical expansion, and thinning of the buccal and palatal cortexes was observed. The histopathological examination revealed a pathologic cyst that was lined by a thick orthokeratinized epithelium. Therefore, the diagnosis was orthokeratinized odontogenic cyst. Conclusion The orthokeratinized odontogenic cyst displays characteristic clinical, histopathological, and biological features that differ significantly from those of keratocystic odontogenic tumor (KCOT), but it has a better prognosis and lower recurrence rate. Thus, other radiolucent lesions of the jaws, including keratocystic odontogenic tumor (KCOT), must be considered in the differential diagnosis.
Publisher: Medknow
Date: 2021
Publisher: Oxford University Press (OUP)
Date: 09-2020
DOI: 10.1093/EURPUB/CKAA165.206
Abstract: Epidemic COVID-19 in 2020 was one of the crises that confronted the Islamic Republic of Iran's health system as a developing low-income country with many challenges. The purpose of this study is to explain the requirements of similar health systems in facing epidemics such as COVID-19 as well as sharing experiences of Iran. The present study was a qualitative study using content analysis of the Iranian Ministry of Health website (behdasht.gov.ir) during the official onset of COVID-19 in Iran (February 20) to March 7, 2020. To Integrate data, interviews with experts were used. In this regard, 4 national health policymakers and 5 provincial health managers were interviewed. After implementation using 8-step content analysis method, data were analyzed using MAXQDA software by research team members who had no conflict of interest. The findings show that the disease began on February 20, 2020, with two cases of death from COVID-19 in Qom province in central Iran and within two weeks it has widely affected 31 provinces, with 4747 approved cases and 124 deaths. According to the results, the Islamic Republic of Iran's health system faced five major challenges to confronting with COVID-19: 1- Medical consumables supply 2- Hospital beds allocation and intensive care units (ICU) equipment 3-The lack of a comprehensive COVID-19 protocol in the country 4- the lack of a single command authority to deal with the crisis 5- Insufficient public health literacy and information as a result of social anxiety. Experiences of this case indicate that health systems require policy action to prevent and control diseases rather than other implementations. In this regard, training should be given to children and adolescents, at-risk persons and health system staff. In addition, to confront with COVID-19, an integrated policy implementation team should be established in collaboration with the health sector and other relevant bodies. It seems obvious that policy implementation requires to prepare the country for future contingencies. A comprehensive National Prevention Protocol needs to be developed.
Publisher: Medknow
Date: 2020
Publisher: Springer Science and Business Media LLC
Date: 17-08-2021
DOI: 10.1186/S12903-021-01765-Z
Abstract: Improving access to health services is a way towards achieving universal health coverage (UHC) in oral health. The purpose of this review was to map the determinants of access to dental services within a UHC framework. Scoping review methods were adopted for the review. PUBMED, Scopus, ISI Web of Science and ProQuest were searched for academic literature on determinants of access to dental services in OCED countries. Articles published in the last 20 years were included. No restriction was placed on study methods only articles in English language were included. Qualitative synthesis was conducted, along with a trend analysis and mapping exercise. A total of 4320 articles were identified in the initial search 57 articles were included in the qualitative synthesis. The results indicate 7 main themes as the determinants of access to dental services: family condition, cultural factors, health demands, affordability of services, availability of services, socio-environmental factors, geographical distance. Defined determinants of access to dental services, family condition, cultural factors and geographical access to dental services can fill the population axis of the UHC cube. Health demands and affordability of services fill the gap of financial protection as another axis of the UHC cube and finally, availability of dental services and socio-environmental factors are aligned with the appropriateness of services, the third axis of the UHC cube. According to the results, family condition and cultural, health demands, affordability and availability of services, social environment, and geographic factors can affect dental health access and equality. Socio-cultural determinations also need to be considered in applied planning. Addressing these factors to improve access to dental services can pave the way for achieving universal health coverage in oral health and should be considered in different levels of policymaking.
Publisher: Wiley
Date: 19-12-2022
DOI: 10.1111/ADJ.12949
Abstract: This study aims to investigate and compare the major Australian government research funding schemes for oral health science with other disciplines from the burden of disease perspective. Major government research funding scheme outcomes were identified. An innovative index of Fair Research Funding (FRF) was developed to examine the extent to which National Health and Medical Research Council funding is aligned with the disease burden. In addition to comparing different diseases, overall governmental research funding for different areas of oral health sciences was explored. Oral disorders with $15 million NHMRC grant funds (2017–2021) and FRF of 10.7 has the lowest and most inequitable amount of Australian government support in relation to disease burden. The share of oral health science in the Australian Research Council and Medical Research Future Fund was very minimal, with $3.43 and $1.88 million respectively. Governmental research funding for oral health sciences is inequitable according to the disease burden. More dedicated oral health sciences research funding schemes are essential. Funding for prevention‐focused public oral health programmes is a vital requirement towards reducing the inequalities in population oral health.
Publisher: Springer Science and Business Media LLC
Date: 02-02-2021
DOI: 10.1186/S13643-020-01574-5
Abstract: Dental and oral health workers have direct contact with respiratory aerosols of patients during procedures. This study aimed to determine the main concerns of dental and oral health workers globally during COVID-19 outbreaks and the coping strategies that help the resilience of dental and oral healthcare system. This scoping study was conducted in August 2020. After adjusting the search strategy, a systematic search of five databases (PubMed, ISI Web of Science, Scopus, ProQuest and EMBASE) was conducted. Data was extracted using Microsoft Excel and the contents of retrieved articles were analysed through a qualitative thematic analysis applying MAX QDA 10 . Most articles were either editorial/letters to the editor/commentary formats (34%), or literature reviews (26%). About half of the articles belonged to three countries of Italy, China and the USA (each 16% and totally 48%). Thematic analysis of included papers led to the identification of four main global concerns and 19 sub-concerns. Economic, ethical, social and professional concerns are among dental and oral health concerns. Other results indicate on three main themes and 13 sub-themes as the coping strategies including patient management, infection control and virtual strategies. Dental and oral health care workers have many concerns relating to COVID-19 including economic, ethical, social and professional factors. Resolution of concerns may involve enhancing coping strategies relating to patient management and infection control strategies as well as using new technologies for virtual contact with the patient without any risk of infection.
Publisher: Medknow
Date: 2015
Publisher: Springer Science and Business Media LLC
Date: 06-2020
DOI: 10.1186/S12903-020-01148-W
Abstract: As the strategies proposed for oral health improvement in developed countries are not adapted for developing ones, this study aimed to identify the challenges of oral health policy implementation in Iran as a low-income developing country. This qualitative study was conducted in 2019 in Iran as a middle-eastern developing country. The study population consisted of experts who had experience in oral health and were willing to participate in the study. Snowball s ling was used to select 12 participants for semi-structured interviews and saturation was achieved after 16 interviews. Guba and Lincoln criteria including credibility, transferability, confirmability and dependability were used to determine reliability and transparency, and finally a five-step framework analysis method was used to analyze the data. The analysis of the interviews resulted in identification of 7 main themes that were categorized into 5 problems of policy implementation as proposed by the Matus framework. The main themes of executive and preventive challenges to implement oral health policies were categorized as organizational problems, the main themes of educational and resource challenges were situated as material problems, and the main themes of insurance, policy making and trusteeship challenges were considered as legal, policymaking and perspective. The implementation of oral health policies has faced some challenges. It seems that the national coverage of oral health and integration of these services in prevention and serious attention to the private sector can be considered as the most important strategies for achieving improved oral health in Iran.
Publisher: Springer Science and Business Media LLC
Date: 10-08-2021
DOI: 10.1186/S13643-021-01779-2
Abstract: There are many determinants that can affect inequality in oral and dental health. This study is aimed to explore the main determinants of inequality in both utilization and provision of dental services in Organization for Economic Co-operation and Development (OECD) countries. Four databases including PubMed, ISI WOS, Scopus, and ProQuest were searched up to 8 Aug 2020, applying the relevant keywords. Thematic analysis was used for synthesizing and extracting data. Trend analysis was applied to determine the trends of the inequality determinants. Thematic analysis led to 6 main themes, 13 sub-themes, and 53 sub-sub-themes. The main themes represent the main inequality determinants for both utilization and provision of dental services. The streamgraph illustrated that fewer studies have been conducted on social and cultural determinants, and for almost all determinants the trend of published articles has been increasing since 2007, with the exception of health policies. Inequality in the utilization and provision of dental services is addressed by various factors including in idual, social, cultural and economic determinants, health policies, and availability of services. The first four determinants are related to utilization and the last two are related to the provision of services. All these aspects must be considered to reduce inequality in dental services.
Publisher: Springer Science and Business Media LLC
Date: 04-12-2021
DOI: 10.1186/S12913-021-07293-4
Abstract: The provision of dental services for children with special health care needs (CSHCN) needs to be considered by policymakers. This study is aimed to explore the determinant factors affecting dental and oral services provision for this vulnerable group. A review was conducted applying the 9-steps approach. Five scientific databases of PUBMED, SCOPUS, Web of Science and PROQUEST and EMBASE were searched up to 10.07.2021, applying appropriate keywords. Thematic analysis was used to analyse the extracted data, and a conceptual map was developed according to JBI manual for evidence synthesis. From the abstracts of the 136 articles that fulfilled the inclusion criteria, 56 articles were included. Five main themes were identified as determinants affecting the provision of dentistry services for CSHCN, including needs assessment, policy advice, oral health interventions, providers’ perception and access barriers. According to the developed conceptual map, assessing the needs of CSHCN can lead to particular policy advice. Regarding the policies, appropriate oral health interventions can be presented. These interventions, along with providers’ perception about service delivery to CSHCN and the barriers to access them, determine the provision of dentistry services for CSHCN. An effective needs assessment of CSHCN and their parents/carers can lead to evidence-informed policymaking and applicable policy advice according to the needs. Then policymakers should develop interventions to improve the community’s health literacy, as well as support the seeking behaviours for appropriate services. Policymakers should also consider how to limit the barriers to accessing oral and dental health by CSHCN to decrease disparities.
Publisher: SAGE Publications
Date: 20-10-2023
Publisher: Springer Science and Business Media LLC
Date: 18-02-2022
DOI: 10.1186/S13690-022-00826-1
Abstract: This short communication paper aimed to compile the main determinants of inequality in dental services by distinguishing between access, utilisation, and provision of dental services. Recent findings integrated, and a dedicated conceptual framework entitled “Triangle of inequality in dental services” has been suggested. These can contribute a rich knowledge in this area and open a new window for policymakers and researchers to seek applied interventions to decrease inequality and improve access and utilisation in communities. This paper aims to synthesise the available evidence and add value to the scope. It highlights a dedicated concept for inequality in dental services beyond other areas of public health.
Publisher: Wiley
Date: 09-06-2022
DOI: 10.1111/CDOE.12767
Abstract: With elimination of the financial burden of dental services, one can expect an increase in utilization of dental services. This study aimed to investigate the effective mechanisms of financial barriers to the utilization of dental services in an Australian adult population. South Australian survey data from the Dental Care and Oral Health Study (2015) were analysed. Following the flexible mediation approach, the direct effect of income and indirect effect of income through mediators (insurance, concession card and service sector) on the outcomes (visit avoidance and treatment prevention due to the cost) were calculated. Findings showed that around half of the low-income people and one-third of the high-income South Australians experienced a financial burden on receiving a dental visit or service. The indirect effect of income on both outcomes of financial burden was negligible, while the direct effect was significant. By changing the potential outcome distribution to their counterfactual exposure distribution and if the mediators are drawn from their counterfactual exposure (lower/higher income) distribution, the odds of visit avoidance and treatment prevention due to the cost were almost twice (Odds Ratio: 2.13, 95% CI 1.72-2.60) and 98% (Odds Ratio: 1.98, 95% CI 1.67-2.35) than in the lower-income in iduals, respectively. It can be concluded that the level of household income, directly and regardless of insurance status, concession card ownership and whether the service sector was public or private, affected the financial burden on utilization of dental services.
Publisher: Springer Science and Business Media LLC
Date: 31-08-2022
DOI: 10.1186/S13690-022-00960-W
Abstract: Medication adherence among older adults (aged 60 and above), particularly those with chronic conditions who take several medications, is critical, and tele-pharmacy services are a way to improve medication adherence. This study sought to determine the factors influencing medication adherence (MA) in older adults using tele-pharmacy services. The Joana Briggs Institute scoping review methodology was implemented. Searches were conducted in databases PubMed, Scopus, ProQuest, Web of Science, and Embase from 2000 to the present day, to identify both qualitative and quantitative studies focusing on the use of tele-pharmacy by older people. Factors impacting MA were extracted and analyzed into themes using a qualitative approach. A concept map was also designed summarising these factors. Of 7495 articles obtained in the initial search, 52 articles met the inclusion criteria. The analysis resulted in 5 themes and 21 sub-themes representing factors that impacted MA with tele-pharmacy. These themes are ided broadly into technology and user related factors. Technology factors included design of the tele-pharmacy intervention, commercial aspects, and adherence measurement method. User factors included user-health constraints, behaviors and perceptions. Industry, policymakers, and stakeholders should consider using tele-pharmacy services for improving medication adherence among older adults however, ensuring interventions facilitate communication between patients and health care teams, and are accompanied by user training and support, is essential for technology uptake and effectiveness.
Publisher: Springer Science and Business Media LLC
Date: 20-02-2023
DOI: 10.1186/S12889-023-15241-6
Abstract: Socioeconomically disadvantaged children are disproportionately affected by oral disease. Mobile dental services help underserved communities overcome barriers to accessing health care, including time, geography, and trust. The NSW Health Primary School Mobile Dental Program (PSMDP) is designed to provide diagnostic and preventive dental services to children at their schools. The PSMDP is mainly targeted toward high-risk children and priority populations. This study aims to evaluate the program’s performance across five local health districts (LHDs) where the program is being implemented. The evaluation will use routinely collected administrative data, along with other program-specific data sources, from the district public oral health services to conduct a statistical analysis that determines the reach and uptake of the program, its effectiveness, and the associated costs and cost-consequences. The PSMDP evaluation program utilises data from Electronic Dental Records (EDRs) and other data sources, including patient demographics, service mix, general health, oral health clinical data and risk factor information. The overall design includes cross-sectional and longitudinal components. The design combines comprehensive output monitoring across the five participating LHDs and investigates the associations between socio-demographic factors, service patterns and health outcomes. Time series analysis using difference-in-difference estimation will be conducted across the four years of the program, involving services, risk factors, and health outcomes. Comparison groups will be identified via propensity matching across the five participating LHDs. An economic analysis will estimate the costs and cost-consequences for children who participate in the program versus the comparison group. The use of EDRs for oral health services evaluation research is a relatively new approach, and the evaluation works within the limitations and strengths of utilising administrative datasets. The study will also provide avenues to improve the quality of data collected and system-level improvements to better enable future services to be aligned with disease prevalence and population needs.
Publisher: Springer Science and Business Media LLC
Date: 03-02-2020
DOI: 10.1186/S12962-020-0204-5
Abstract: Health Transformation Plan (HTP) was occurred in 2014 to improve access and equity and reduce out of pocket payments in Iranian Health Care System. In this regard the aim of this study is evaluating and ranking the service provider’s infrastructures among the country provinces as an indicator of equity before and after implementation of the HTP. This cross sectional study is conducted in 2017. The study population included 31 provinces of the country. Data related to 4 years from 2012 to 2016 were included from the data bases of Ministry of Health and Medical Education as well as the statistics yearbook of the country. The obtained results of multi-criteria decision-making methods were analyzed as well. SPSS 18 and Excel 2013 software were used for data analysis. Based on the VIKOR method, in 2012, Mazandaran, Tehran and Fars provinces and in 2013, the provinces of Tehran, Fars and Isfahan ranked from first to third respectively. Similarly after HTP, in 2015, the provinces of Tehran, Khorasan Razavi and Fars and in 2016 the provinces of Tehran, Fars and Khorasan Razavi have ranked from first to third respectively. Paramedic, dentist, pharmacist, medical institutions and hospital bed had a significant difference before and after the implementation of Health Transformation Plan, so that the number of these indicators increased after implementation of the HTP ( P value 0.05). According to the results, there are many differences between the provinces and these disparities have not decreased significantly after HTP. Consequently, it is suggested to the health sector policy makers to make regional plans and allocate the budget of HTP, based on the status of the provinces. In addition, responding to these inequalities requires a transparent and systematic approach to provide the budget for allocating to the population, health needs, and the lack of development and geographical isolation of regions.
Publisher: SAGE Publications
Date: 2019
Abstract: Pharmaceutical strategic purchasing is considered as a key to improve access to medicines especially for developing countries. The aim of this scoping review is to determine the most important components affecting pharmaceutical strategic purchasing. Here, we employed a comprehensive search strategy across PubMed, ProQuest, EBSCO, ISI Web of Science, Scopus, ScienceDirect, and Google Scholar for the terms related to medicines strategic purchasing. Among 13 included studies, 7 (53.85%) and 6 (46.15%) studies belonged to the developing and developed countries, respectively. Six main variables were emphasized as the effective variables on medicines strategic purchasing, including purchasing interventions, target group and service users, providers and suppliers of interventions, methods and motivations, price, and finally structure and organization. It seems that the insurance organizations of developing countries can achieve strategic purchasing only through the modification of the pharmaceutical pricing system and payment systems. Furthermore, they should pay attention to the real needs of target groups (demand) and modify the structure and organization as well as purchasing the most effective medicines from the best pharmaceutical providers.
Publisher: Wiley
Date: 28-12-2022
DOI: 10.1111/CDOE.12838
Abstract: The aim of this study was to investigate how education level affects dental service utilization patterns in the Australian adult population. This study tested how education level mediated these service patterns through behavioural mediators such as smoking, tooth brushing and oral health status and investigated these mediation effects in different dental service providers. Following the flexible mediation approach, the direct and indirect effects of education through behavioural mediators on dental service utilization patterns (time of last dental visit, reason for last dental visit and frequency of seeking dental care) were calculated for the South Australian population from the Dental Care and Oral Health Study. Participants with lower educational attainment were 33% (Odds Ratio: 0.67, 95% CI 0.56–0.78) and 38% (Odds Ratio: 0.62, 95% CI 0.53–0.74), less likely than their counterparts with higher education to visit a dentist or to receive dental care in the last 12 months, respectively. Low education was associated with a 23% increase in odds of receiving emergency and treatment services (Odds Ratio: 1.23, 95% CI 1.05–1.43) compared to routine dental check‐ups or examinations. Low education, regardless of oral health behaviours and status, reduces the odds of dental service utilization in terms of frequency of seeking dental care and time of last dental visit. There is more tendency towards receiving emergency and treatment services compared to routine dental check‐ups or examinations in participants with lower educational attainment.
No related grants have been discovered for Arash Ghanbarzadegan.