Social Determinants of Health

Background: Laboratory and observational data suggest that hydroxychloroquine (HCQ) has biological activity against SARS-CoV-2, potentially permitting its use for disease prevention. This study aimed to evaluate the hydroxychloroquine effect as prophylaxis for SARS-CoV-2 infection.

Methods: In this double-blind randomized controlled trial,  1000  healthy people without any signs and symptoms of COVID-19 were randomly assigned in a 1:1 ratio to receive either 800 mg hydroxychloroquine or placebo (four 200 mg tablets in two divided doses on day 1 of the first week, followed by 200 mg (in a single dose) weekly for the next 6 weeks).

Results: Among 871 participants who remained and followed within 10 weeks 97(11.1%) became SARS-CoV-2 positive. there were statistically significant differences between infected or non-infected in the hydroxychloroquine (36 of 97 [37.1%]) and placebo (61 of 97 [62.9 %]) groups with a risk ratio of 2.1 (95% confidence interval (CI) 1.01 - 3.21; p = 0.005). The incidence of severe forms of COVID-19 ( hospitalized in the coronavirus ward or the ICU) was 2 of 97 (0.02 %) in participants who received a placebo compared to hydroxychloroquine. The proportion of non-infected people who received hydroxychloroquine prophylaxis was nearly twice higher than that of placebo users (1.87, 95% CI: 1.19 - 2.84, p = 0.05). There were no significant differences between the two groups regarding side effects (1.1% vs. 0.9%), and no severe adverse reactions were observed.

Conclusion: Pre-exposure therapy with hydroxychloroquine appears to prevent moderate and severe illness caused by COVID-19 in asymptomatic persons.

Background: Loyal customers are valuable for organizations; customer loyalty has a positive effect on the profit and income of the organization. Thus, the purpose of this study was to look into the psychological aspects of corporate electronic banking services that have an impact on client retention.

Methods: This research was a descriptive type that conducted by questionnaire method. The statistical population of the research consisted of 37,000 customers of Saderat Bank from Isfahan and Lorestan provinces. 380 of these people were selected as a sample using Cochran's formula. A survey created by the researcher served as the measurement tool. To analyze the data, both descriptive and inferential statistics were applied. Descriptive statistics, inferential statistics (e.g., Kolmogorov Smirnov, or K-S) test for data analysis, and research data processing were used to analyze and process demographic data using SPSS software.

Results: Mental and psychological health and having a positive mindset of the organization's performance, website usability features, information security, proper structure, time-saving benefits and mental norms, all have a direct and significant effect on the number of returning customers.

Conclusion: Considering the psychological health model, in order to save time and improve corporate electronic banking in the conditions of full market competition for banks, the use of systems that provide services using customer data and the services rendered without the availability of customers in the service It is necessary to inform and use electronically.

Backgrounds: Due to the outbreak and pandemic of COVID-19, the following of recommended preventive guidelines and health behaviors in community is important, in order to further control this disease. The present study was conducted among oil industry shift workers, as a high-risk group, to investigate the determinants of prevention behaviors against COVID-19 disease based on Health Belief Model.

Methods: This cross-sectional research was performed among 250 shift workers who were randomly selected from the oil field of Khuzestan province of southern Iran. Data collection tools were a questionnaire that included demographic characteristics, Health Belief Model and prevention behaviors questionnaires and also knowledge questionnaire. Statistical analysis was done using SPSS.

Results: Correlation analysis showed positive correlations between the behavior and the perceived benefit, self-efficacy, perceived severity, perceived susceptibility, and knowledge, while negative correlation was observed between the behavior and perceived barrier. Results determined that Health Belief Model was able to explain 54% of the variance in the COVID-19 prevention behaviors. According to the linear regression analysis, the most predictive variable was perceived benefits, and the second one was self-efficacy.

Conclusion: Designing educational interventions based on Health Belief Model, in future studies, can be considered as a suitable framework to adherence and follow the health behaviors of COVID-19 and also to correct the individuals’ beliefs. Furthermore, health information groups and health educators must highlight the points to overcome the behavior obstacles and consequently to increase self-efficacy, and also must emphasize the benefits of preventive behaviors, especially in high-risk groups.

Background: The speed of advance in medical education, creativity in technology, limit time for new work has created new vision in medical education. Considering the importance of developing Iran's global position in the scientific and technological in Southwest Asia and the importance of improving the quality of learning and education, the present study identifies and examines the current status of mobile learning indicators in medical sciences universities.

Methods: This study was applied in terms of purpose, descriptive-correlation in nature and survey method. The statistical population of the study consists of specialists from different medical groups. Based on Morgan's table, the sample size was estimated to be 200 people who were selected by simple random. Mobile learning components were extracted using text analysis and interviews with experts. In order to comply with the principle of validity in the questionnaire, in addition to the opinions of supervisors and advisors, the validity of factor analysis has been used. Cronbach's alpha coefficient was estimated above 0.7, so the reliability of the questionnaire was confirmed. For data analysis, exploratory factor analysis and univariate analysis were used in Spss23 software.

Results: Four factors (infrastructure, organizational planning, tools and equipment, human resources) and 16 indicators explain about 79.9% of mobile learning variance. Also, according to the obtained results, there were significant differences between the current and desired conditions based on the values (sig<0.05) in all components.

Conclusion: Designers of mobile learning tools should maximize the efficiency of this tool while paying attention to users' preferences.

Background: One of the most effective indicators of human capital and social determinants of health is the number of university graduates. Investigating the variables influencing Iran's desire for higher education was the goal of this study.

Methods: In this cross sectional study, the Autoregressive Distributed Lag (ARDL) method was used. The questionnaire used in this study included a researcher-made questionnaire to collect information on the target variables of the study. The first stage was using the Banerjee, Dolado, and Mastre approaches to find out if the model had a long-term connection before doing the long-term co-integration test. The t-statistics connected to coefficients inside an interval of the dependent variable served as the basis for this test's execution. The dynamic error correction model (ECM) and the ARDL model's long-term coefficients were retrieved. The Gulpak article model and information from the Central Bank of the Islamic Republic of Iran, the Statistics Center, and other sources were utilized to investigate the variables impacting the demand for higher education in Iran.

Results: Factors affecting the demand for higher education include the average free and night tuition, economic growth, employment rate, consumer and producer price indices, government spending on education and the ratio of urban population to the total population. The factors that influence the demand for higher education are government spending in the education sector, consumer price indices, and economic growth indicators.

Conclusion: Given the role that human resources play in the creation of human societies, particularly in the health sector, raising the proportion of government spending on education can spur demand for postsecondary education and advance national development.

Background: The goal of this study was to examine how self-criticism and cognitive flexibility relate to depression, taking into account the moderating effect of emotion control in depressed undergraduate females.

Methods: The present study's statistical population consisted of all female students at Isfahan Azad University in 1402 who exhibited signs of depression. 384 people were chosen using cluster random selection from the study's target population as a sample, using Cochran's formula. The research variables were measured using the Beck Depression Inventory, the Gross & John Emotion Regulation Questionnaire, the Gilbert et al. Self-Criticism Scale, the Dennis & Vander Wal Cognitive Flexibility Inventory, and the questionnaire on demographic characteristics. The acquired data were examined using the regression analysis technique and the statistical program SPSS version 27.

Results: Findings showed that there is a significant relationship between cognitive flexibility and self-criticism with depression, cognitive flexibility and self-criticism with emotion regulation, and also between emotion regulation and depression (p<0.01). Also, the findings indicated that emotion regulation has a moderating role in the relationship between cognitive flexibility and self-criticism with depression (p<0.01).

Conclusion: Based on the findings of this research, it can be concluded that the relationship between cognitive flexibility and self-criticism with depression is not a simple linear relationship and emotion regulation can affect this relationship.

Background: Domestic violence causes the family institution to turn into a tense, stressful, cold and soulless environment. The current study was handled to the aim of predicting domestic violence according to cognitive emotion regulation (CER) and early maladaptive schemas (EMS) in couples.

Methods: The present study was a descriptive correlational Research, which was carried out on couples with domestic violence problems referring to counseling centers in Tehran, 2021. The number of 400 people was selected as samples through convenience sampling among those who were referred to counseling centers. The research tools included the questionnaire of Haj-Yahia violence against women, Garfenski et al.'s cognitive regulation of emotion, and Young's early maladaptive schemas. Data analysis was done using SPSS 21 software, Pearson's correlation coefficient and analysis of regression.

Results: The findings revealed that domestic violence has a significant and inverse correlation with CER, and a direct and significant correlation with EMSs (P < 0.001). Domestic violence was predictable based on CER (B = -0.411, P = 0.001) and EMSs (B =0.372, P = 0.001).

Conclusion: According to the results, CER and EMSs were able to reduce and increase domestic violence in couples, respectively. It is suggested to pay attention to the CER and EMSs of couples and supply the required teaching in this regard.

Background: This study aimed to predict suicide attempts based on behavioral activation and inhibition systems (BAS/BIS) with the mediating role of cognitive emotion regulation (CER) strategies among adolescents of Abyek City.

Methods: The research methodology was descriptive-correlational. The cluster sampling method was used, and the resulting sample included 194 adolescents who responded to the BAS/BIS questionnaire (Carver & White, 1994), CER questionnaire, and Beck scale for suicide ideation. Path analysis was employed to evaluate the proposed model using AMOS 24.0 and SPSS 27 software.

Results: The findings indicate that the proposed model is fitted with the data well. The results of path analysis showed that the BAS/BIS systems explain 27% of the variance of maladaptive CER and 61% of the variance of adaptive CER. In addition, maladaptive CER, BAS, and BIS explain 65% of the variance of suicide attempts.

Conclusion: Low levels of BAS, high levels of BIS, and the use of maladaptive CER skills can be considered risk factors for suicide attempts in adolescents.

Background: There have been several outbreaks of coronaviruses including the present SARS-CoV-2 outbreak. The clinical presentation of COVID-19 infection may mimic febrile phase of dengue fever, typhoid fever, malaria, and several other diseases. During the COVID-19 pandemic, more number of typhoid cases were reported. The goal of this study was to determine the seropositivity of the widal test amongst RT-PCR (Real Time Polymerase Chain Reaction) positive COVID-19 patients.

Methods: A cross-sectional study was done on RT-PCR positive COVID-19 patients at the Department of Microbiology, Guru Teg Bahadur Hospital, a designated COVID-19 hospital in Delhi, India between March 2020 to January 2021 and April 2021 to July 2021.

Results: Out of 136 samples received for widal testing,58 patients showed evidence of recent infection (significant TO titre ≥ 128) and  32 patients (significant titre TH ≥256)  may have been in the convalescent stage of enteric fever. An increased number of female patients showed widalseropositivity as compared to males. In our study, 50 (36.76%) and 26 (19.11%) patients with significant titre (TO ≥128; TH ≥256) were less than 40 years of age.

Conclusion: Documenting the prevalence of typhoid fever, especially during the COVID-19 pandemic, is very difficult. Serological results like widal tests can be misleading, sometimes; due to the cross reacting antigens and the endemicity. Cases of co-infections or false positivity amidst an ongoing pandemic are likely to get unreported unless the clinicians are mindful of the rare occurrence of co-infections by various pathogens. Our study concludes that careful surveillance and interpretation of widal seropositivity in COVID-19 patients is crucial, especially in endemic settings.

Medical misinformation is a complex issue influenced heavily by the concept of health literacy levels and is defined as the claim of health-related fact(s) that does not align with evidence-based scientific consensus. Left unchallenged, it could have devastating outcomes for public health, and may present significant challenges for the implementation of future health prevention and promotion interventions. At present, Ofcom estimates that 40% of adults do not currently possess the necessary digital literacy skills to critically assess online content, and studies have found a positive correlation between the use of social media as an information source and COVID-19 conspiracy beliefs. Additional studies have also found evidence to suggest that vaccine hesitancy is linked with lower levels of overall health literacy. In conclusion, medical misinformation has the capacity to cause undoubted harm to public health if left unchallenged, particularly in the employment of health prevention and promotion interventions. Policy makers should consider the need for legislation combating the dissemination of medical misinformation, per Mamak’s argument for the criminalization of [online] medical fake news. Authors of scientific research should, in good faith, heed the advice of Bergstrom’s “Eight rules to combat medical misinformation” to aid in mitigating the potential for their work to be misrepresented or misinterpreted in the popular media.