Social Determinants of Health

Background: The purpose of the present study was to examine how Moodle, a learning management system, influences students' motivation and attitudes toward online learning, both with and without the use of Eitaa as a learning platform, and how this influences the promotion of personal health.

Methods: This research was semi-experimental in nature. Four groups of totally 101 female students from the Shahid Bahonar University of Hamedan, affiliated with Farhangian University, were chosen at random. The first group was trained online for two months using Moodle, while the second group was trained through the Eitaa virtual network. The third group was trained in a combination of Moodle and Eitaa, and the fourth group was trained in the traditional way (lecture). Students' attitudes were assessed in the pre- and post-exam stages using Levin's attitude questionnaire, and their motivation was measured using Papi's questionnaire. The research instruments were examined and confirmed in terms of reliability and validity in a preliminary study.

Results: After 2 months of online training with Moodle as a Learning Management System (LMS), students' attitude and motivation to promote their personal health increased significantly compared to traditional education. Students in the Eitaa group scored greater on attitude and motivation than those in the conventional group. The attitudes and motivations of students in the combined LMS-Eitaa group and the conventional education group did not significantly differ from one another.

Conclusion: To improve students' attitude and motivation, online training by the Moodel should be used as an LMS. This successful educational approach will lead to the improvement of a healthy lifestyle by promotion of the level of personal health.

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: 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: 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: Ethical managers provide mutual trust in the organization by increasing the authority to act, which increases interest in work. This study was conducted with the aim of investigating the Ethical leadership status and performance health of Education workers.

Methods: This study was applied, descriptive and by survey method on 341 Education workers in Kerman province, in which the samples were selected by stratified random method and included in the study. Data collection was done on 46 questions and job performance questionnaire including 28 questions. 30 specialists used the Delphi technique to assess the components' dependability, and AMOS software was installed. A Cronbach's alpha coefficient greater than 0.7 revealed the items' internal consistency and verified their dependability. Software called SPSS-22 was utilized to analyze the data.

Results: The results show that the status of ethical leadership and its components are favorable among employees, and the status of job performance and its task dimension are not favorable, and this variable was favorable only in the contextual dimension. The components of job enthusiasm (behavioral, cognitive and emotional) which are considered as predictors of job performance, have a significant difference in which there is a relationship between job enthusiasm and ethical leadership of healthcare workers.

Conclusion: The results of job enthusiasm with the mediation of moral leadership show the strengthening of employees' performance health. By identifying the influencing factors related to job performance and work enthusiasm, managers can help to better understand the nature of employees' performance and work enthusiasm.

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.

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: 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.

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: 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: Names can potentially carry pertinent information regarding cultural background and familial socioeconomic and educational status. This study was performed to utilize first names as a measure of cultural diversity, and in addition, describe the frequency and distribution of women and international medical graduates in radiology residency in the United States.

Methods: The websites of all 181 ACGME accredited diagnostic radiology residency programs were evaluated to extract the first name, gender, and medical school (US medical graduate or international medical graduate) of residents. These names were compared with the 100 most common names for girls and boys from each decade from 1940 through 2000 from the Social Security website.

Results: The websites from 151 programs included information for a total of 4083 residents. Female residents constituted 25.0% of all radiology residents. International medical graduates constituted 11.7%. Overall 37.5% of the residents had uncommon names, including 32.0% of US medical graduates. There was no significant association between having a female program director with a higher number of female residents (p=0.153). In addition, there was no significant correlation between program directors with uncommon names and residents with uncommon names (p=0.691). International medical graduates were more prevalent in the Northeast and Midwest, corresponding to the higher overall percentage of non-common names. However, uncommon names were also higher in the same regions after excluding international medical graduates. Female radiology residents demonstrated higher percentages in the West, Southwest, and East.

Conclusion: Names may represent an index of cultural diversity. Further investigation may prove useful.

Background: The success of government organizations depends on the ability of employees and managers to provide optimal services. The present study was undertaken with the objective of formulating and understanding the servant leadership model on mental health and creating motivation for public service in the employees of Kerman municipality.

Methods: This study used the intentional snowball sample technique, wherein individuals were deliberately chosen by the researcher using the snowball method, which is a non-probability sampling method, was used to identify other experts. This sampling continued with maximum fluctuation until reaching theoretical adequacy, i.e. until adding data did not change the final pattern. The statistical population was the employees of Kerman Municipality with the number of 154 people. The tools used include standard questionnaires with reliability above 0.8 and Smart PLS3 software was used for data analysis.

Results: A major factor in enhancing mental health and fostering public service motivation is servant leadership, which has a favorable impact on both things. This leadership style strengthens the motivation by improving and growing mutual trust between the leader and the employees and makes the employees able to provide better services while maintaining their mental health.

Conclusion: Considering the importance of the servant leadership style as one of the influencing factors on public service motivation, it is necessary to pay attention to this issue in motivating municipal employees in micro and macro management planning.

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: One of the most important factors that can affect auditors' understanding of ethical issues is the environmental factor of the threat to personal interests. The objective of this research was to examine the impact of ethical constraints and personal interest threats on professional judgment and doubt.

Methods: The use of field research and documentation has been made to apply the goal of this study and the descriptive-correlation approach. To determine the research pattern and the criteria extracted from the theoretical bases has been done with the help of 30 experts using the method based on the Delphi technique. The statistical population of this research was the auditors working in member institutions of the official accountants' society at different levels. Factor load, path coefficients, Cronbach's alpha coefficient and composite reliability coefficient were stimated. All statistical analyses were done using SPSS and Amos software.

Results: In every instance, the T value and the standardized factor loading between the variables and the questions were more than 1.96 and 0.4, respectively. Consequently, the findings demonstrated that the questions were appropriately included in the model and study based on the data gathered, and no more questions in the questionnaire needed to be added or altered. Ethical pressures and the threat of personal interests have a significant effect on auditors' judgment and auditors' professional skepticism. Also, the threat of personal interests has a significant effect on professional doubt. Average variance extracted showed that the appropriateness of convergent validity because the average variance retrieved from the elements. Factor loading coefficients showed that the self-interest item had the highest coefficient.

Conclusion: Moral pressures and the threat of personal interests are important factors in auditors' judgments and their professional doubts, which are effective from the cultural resources of the society. Therefore, adjusting each of these factors will improve the conditions of auditors.

Background: Human resources at all levels of the organization are the main force behind building the foundation, which plays a role in providing good services with ability, clearer vision, and greater awareness. The aim of study was to model the structural equations of human resource management training in the medical sector in crisis conditions based on the experiences of COVID-19.

Methods: This study was cross-sectional and using the structural equation modeling on higher education institutions. The statistical population included 202 experts from higher education institutions. The sample size was 127 people using Morgan's table, who were selected among 202 people by stratified random sampling. Data was analyzed using Smart PLS software.

Result: A total of 6 dimensions can be useful for teaching human resource management in crisis situations. The findings demonstrated that the Cronbach's alpha coefficient was greater than 0.70 and that the total dependability of all constructs was strong. According to the path analysis, the training route for human resource management has the most effects when it comes to strengthening transformational decision-making and handling crisis circumstances. The benchmark values for mild, medium, and strong were 0.19, 0.33, and 0.67, respectively. The coefficient of determination of innovative thinking has a weak, interaction to create coherence, emotion management and capacity building for resilience has a moderate, and deepening transformative decision-making and reactive organizational development has a strong.

Conclusion: The results showed that human resource training has an active role in human resource participation and crisis management and planning to solve it.

Background: Addressing the evolving dynamics of family structures, the parent-employment conflict (PEC) emerges as a significant conundrum of the current century. This article seeks to delve into the intricate factors influencing PEC among employed parents in Tehran, Iran.

Methods: This study employed a stratified random sampling method across various regions within Tehran province, in 2017. A structured questionnaire, encompassing demographic details, the history of fertility, and attitudes towards childbearing, alongside the delineation of conflicts between professional responsibilities and parental duties used to collect 449 employed parents. Since PEC was an ordinal variable with three categories of low (6-12), middle (12-18), and high (18-30), an ordinal regression method was applied to some selected covariates.

Results: The findings suggest that women comparing to men, those with “secondary and high school” and “diploma” comparing to “master degree and PhD” educational levels, governmental employees comparing to free-lance employees, and those employees working 45 hours and more comparing to employees working less than 40 hours in a week had higher PEC.

Conclusion: In general, unless socialization norms and policymakers’ views adopt social realities, PEC will not reduce. Policymakers should pay more attention to institutionalize of social supports and implement family supportive policies.

Background: Regarding the effect of early maladaptive schemas (EMSs) on the psychological distress (PD) of diabetic patients, various factors can play a mediating role. This study was to examine the associations between EMSs, PD, and coping strategies in people with diabetes.

Methods: This descriptive correlational study was carried out on people with type 2 diabetes (T2D) referred to the diabetes clinic of Shariati Hospital in Tehran, in 2021. Here, 200 patients were included in the research and the selection method of people was convenient. Research tools included Kessler's Psychological Distress Scale, Young Schema Questionnaire (YSQ-SF) and Coping Strategies Inventory (CSI).  Data analysis was performed by SPSS 25 software and Smart-PLS 3, and structural equation method (SEM).

Results: The findings revealed that EMSs have a significant and direct association with PD. Coping strategies had a mediating role in relation to EMSs and PD in people with T2D. As a result, 37% of PD was explained by EMSs and coping strategies.

Conclusion: According to the results, in order to reduce the level of PD in people with T2D should be use of techniques aimed at enhancing EMSs and coping strategies.

The modern world and the world of technology claim order and regularity in several aspects of life. However, the disruption of the balance in the global power structure, the existing disorder, and the ringing of the bell of war by the violent people make the daily life of human societies a system of disorder and chaos. The media plays an effective and significant role both in formulating and developing women's legal literature in international relations and global communications and the development of the women’s health system. This study has criticized the performance of the media from the viewpoint of providing the right to women's health by analyzing and describing the news published about women in the recent wars. The evidence suggests that female combatants experience war in the same way as male ones, but the experience after the war has not been pleasant for them and has brought many psychological consequences for them, and their emotional health has been affected. The media's approach to the role, position, and contribution of women during the recent war indicates the impact of the power institution and authoritarian structures, which is necessary for the media, health, and legal system of the country, to develop a legal-media system for empowering female combatants and not limiting their right to health in times of war and peace considering the ethnic, cultural, religious commonalities.

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.