Vol. 8 (2022)

Original Articles


Background: Spiritual well-being is the fundamental dimension of health that integrates the other dimensions (physical, emotional, social, spiritual, and intellectual) and is dynamically reflected in four domains of self, others, environment, and a superior being. The present study aimed to investigate the mediating role of positive and negative affects in the relationships of moral disengagement and spiritual well-being in university students in Tehran.

Methods: The statistical population of this descriptive correlational study comprised all students of universities in Tehran in the academic year 2020-2021. A sample of 301 students (199 females and 102 males) was selected via convenience sampling. The research instruments included the Spiritual Well Being Scale (SWBS), the Moral Disengagement Questionnaire, and the Positive and Negative Affect Schedule (PANAS). Data were analyzed by the Pearson correlation method and path analysis.

Results: There was a significant correlation between the components of moral disengagement, positive and negative affects, and the components of spiritual well-being (P<0.001). The findings revealed that the path between negative affects and spiritual well-being was significant and negative, and that between positive affects and spiritual well-being was significant and positive (P<0.001).  The total path coefficient between moral disengagement and spiritual well-being was significant and negative, and the indirect path coefficient between moral disengagement and spiritual well-being was significant and negative (P<0.001). Positive and negative affects, therefore, significantly and negatively mediate the relationship between moral disengagement and spiritual well-being (P<0.001).

Conclusion: According to the results, spiritual well-being can thus be promoted through training to prevent moral disengagement both directly and as mediated by positive and negative affects.

The effect of social support on marital adjustment in hospital staff: The mediating role of self-control and resilience

Hamidreza Ishaqi Jardavi, Mahmoud Jajarmi, Hamzeh Akbari

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-10
https://doi.org/10.22037/sdh.v8i1.37041

Background: Marital adjustment is one of the most important factors in determining the stability and permanence of the marital relationship and can leads to feelings of happiness, satisfaction and satisfaction of needs that are mutually met. The aim of this study was to investigate the role of social support on marital adjustment in hospital staff with the mediating role of self-control and resilience.

Methods: The present study was a descriptive correlational study. The statistical population included the staff of Samen Al-Aimeh Hospital in Mashhad with a total of 380 people in 2020, from which a sample of 257 married male and female staff were purposefully selected. Data were collected using questionnaires of social support, marital adjustment, resistance, and self-control. Data analysis was performed using SPSS software version 21 and Pearson correlation (structural equation type).

Results: There was a significant relationship between self-control as a mediating variable and marital adjustment with value (B = 0.700, P <0.001). Also, there was a significant relationship between resilience as a mediating variable and marital adjustment with the amount (B = -0.643, P <0.001). A total of 0.93 variance related to marital adjustment was explained by the variables of social support, resilience and self-control.

Conclusion: The results showed that social support has a positive effect on marital adjustment. It is recommended that in order to improve the marital adjustment of couples, workshops should be held on how to perform and receive social support and promote psychological flexibility in social organizations and institutions.

Adult emergency department performance in the largest teaching hospital in southern Iran: a 1.5-year cross-sectional study

Afsaneh Dehbozorgi, Mostafa Moghaddas, Razieh Sadat Mousavi-Roknabadi, Bizhan Ziaian, Mehrdad Sharifi, Najmeh Zarei Jelyani, Seyedeh Elham Amiri

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-12
https://doi.org/10.22037/sdh.v8i1.36656

Background: Emergency department (ED) is one of the most important hospital departments, with significant effects on public health. The aim of this study was to evaluate the adult ED's performance of the largest teaching hospital in southern Iran.

Methods: In this retrospective cross-sectional study (March 2017-August 2018), the registered data in the Hospital Information System (HIS) were collected, and the ED’s performance was assessed based on the Iranian emergency performance index. The slopes of the trend lines were calculated for each indicator. Moreover, 2 six-month periods were compared.

Results: The data of 104,081 patients were analyzed. The mean (±standard deviation) of visited patients per-month was 5,782.28 (±1258.55). The slope of the trend line was negative for all indicators, except for discharge from ED with personal responsibility. The mean duration of waiting time for the first visit by physician in each triage level slightly decreased. Comparison of the two six-month periods showed a significant difference between the visited patient (P<0.0001). The percentage of patients disposed within six hours (P<0.0001), leaving ED within 12 hours (P<0.0001), as well as the percentage of successful cardiopulmonary resuscitation (P=0.014) in the six-month period of 2018 was significantly lower. The percentage of discharge with personal responsibility significantly increased (P=0.005).

Conclusion: Although the number of patients visited in this ED decreased, all indicators had dropped. However, the percentage of discharge with personal responsibility was increased. Moreover, the mean duration of waiting time for the first visit by physician slightly decreased in each triage level.

Analyzing the behavior of internet customers based on social engineering

Sara Hajighorbani , Changiz Valmohammadi, Kiamars Fathi Hafshejani

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-13
https://doi.org/10.22037/sdh.v8i1.36938

Background: The customers' opinions about the features and experience of using the products are considered as a valuable and reliable source for comparison and decision-making. Thus, the present study was an attempt to analyze the behavior of Internet customers based on social engineering.

Methods: This study is applied research in the area of social networks. The statistical population of this study included Amazon social network users. The data includes XML and txt files brought to the programming environment. To analyze the behavior of Internet customers, a method based on the ensemble learning technique was implemented in MATLAB software. The common criteria that were used in data mining applications such as accuracy, sensitivity, and F-score.

Results: The proposed model compared to other ensemble methods (support vector machines, Naive Bayes, ensemble neural networks, and decision tree ensemble) is in the priority in all three criteria for recognizing real and non-real users and has a better function. This method had high accuracy, precision, sensitivity, and F-criteria compared to other methods and it has a good status in evaluation criteria. The performance of the proposed model was much better than single algorithms and is the priority in terms of data mining evaluation criteria, but the training time for this model was much longer than other methods.

Conclusion: The use of the proposed model in any organization that provides a product or service online, is quite promising and better results can be achieved with more studies.

Background: Wearing high-heeled shoes is associated with injury risk. During the COVID-19 pandemic, changes in work and social behavior may have reduced women’s use of such footwear. The aim of the study was to investigate how the trend in high-heeled shoe related injuries (HHSRIs) among U.S. women may have been affected by the COVID-19 pandemic.

Methods: This used 2016-2020 data from the U.S. Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS) to assess HHSRIs among U.S. women. The study included injuries with the “Footwear” product code and selected those with narratives using words suggesting the involvement of high heels. Analysis is based on frequency of such reports by date.

Results: In 2020 there were an estimated 6,290 high-heel related emergency department visits involving women ages 15-69, down from 16,000 per year in 2016-2019. There were 5.40 HHSRIs per 100,000 women ages 15-69 in 2020 (CI: 3.95 to 6.86), significantly below the peak in 2017. Analysis by date shows the 2020 decline began after the start of the COVID-19 shutdowns on March 15. There was no significant change in the percentage of fractures or hospital admissions.

Conclusion: The COVID-19 pandemic was associated with a decline in reported injuries related to high-heeled shoes among US women. Among these, there was a non-significant increase in more serious injuries, which might suggest pressure to stay away from hospitals for less serious injuries during the pandemic. However, if fewer women wearing such shoes, the result may be fewer injuries in the future.

Effectiveness of cognitive-behavioral therapy on pain perception and metacognitive beliefs in patients with irritable bowel syndrome

Hadi Farzadi, Alireza Heidarei, Fardin Moradimanesh, Farah Naderi

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-9
https://doi.org/10.22037/sdh.v8i1.36923

Background: The most common, costly, and debilitating functional gastrointestinal disorder is irritable bowel syndrome (IBS). This study aimed to determine the effectiveness of cognitive-behavioral therapy on metacognitive beliefs and pain problems in patients with irritable bowel syndrome.

Methods: The study used a quasi-experimental design with pre-test, post-test and a three-month follow-up with the control group. All patients with irritable bowel syndrome at Tehran Shariatee Hospital were included in the statistical population. The sample consisted of 30 patients who were randomly assigned to experimental and control groups using the purposive sampling method. Before the intervention, the pre-test was held, after which the experimental group received cognitive-behavioral therapy in 8 sessions of 90 minutes, but the control group did not receive any intervention. Then, the post-test was administered and after three months of post-test implementation, the follow-up period was performed. The research tools included a metacognitive beliefs questionnaire and pain understanding. Data analysis was performed by SPSS.22 software and univariate variance analysis. 

Results: The experimental group was 33.6 (7.8) years old, while the control group was 35.9 (8.4) years old. Both groups were homogenous in terms of gender, age and marital status. The findings showed that cognitive-behavioral therapy was effective on metacognitive beliefs (P<0.01) and pain affect (P<0.01).

Conclusion: It can be concluded that cognitive-behavioral therapy is effective in treating metacognitive beliefs and pain in patients with irritable bowel syndrome, and that it can be used to help these patients.

Precision of C-reactive protein in the diagnosis of acute appendicitis

Melody Omraninava, Shaghayegh Javan , Ghahraman Mahmodi

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-6
https://doi.org/10.22037/sdh.v8i1.37032

Background: Appendicitis is known as inflammation in the appendix, and its treatment is merely through surgery. There is mistaken diagnosis according to clinical presentations. C-reactive protein is an annular pentameric protein found in blood plasma, whose circulating concentrations rise in response to inflammation. It is an acute-phase protein of hepatic origin. Therefore, the aim of this study was to evaluate the diagnostic effect of C-Reactive Protein (CRP) in the diagnosis of acute appendicitis in patients referring to Valiasr Hospital in Qaemshahr city, Iran in 2017-2018.

Methods: This study was a diagnostic study and blood samples were collected from patients with acute abdomen pain with suspected appendicitis in Qaemshahr Valiasr Hospital. Then CRP results were compared with pathological results as golden standard; then sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of this test were determined based on standardized test (pathologic result).

Results: The sensitivity and specificity of CRP test in diagnosis of acute appendicitis were 71.42% and 60.58%, respectively. In addition, PPV and NPV were 88.88% and 42.85%, respectively.

Conclusion: According to the results of this study, CRP can be considered as one of the predictive tests of acute appendicitis. Evaluation of CRP levels, alongside with other diagnostic approaches, can be used as an adjunctive diagnostic method in the diagnosis of acute appendicitis.

Determinants of the smart purchasing of health products in Tehran: a model with a hybrid approach

Azadeh Rajabi , Hossein Vazifedust, Kambiz Heidarzadeh Hanzaee , Karim Hamdi

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-11
https://doi.org/10.22037/sdh.v8i1.36740

Background: Recent studies recognized the smart customer experience as a sustainable competitive advantage. This study aimed to determine factors affecting the smart experience of purchasing health products.

Methods: This research was a descriptive survey. The statistical population of the first phase consisted of16 People, who were experts in the field of shopping malls with intensity and snowball. The statistical population of the second phase was the customers of shopping malls whose managers were interviewed, which included 298 individuals. Data were collected with a standard questionnaire and were determined by open coding, axial coding, and selective coding in ATLAS.ti software. In phase two, LISREL software was used.

Results: The coefficient of the exogenous variable of customer knowledge (0.83), with T = 0.01, perceived quality (0.22), with T = 8.83, sales promotion policies (47.0), with T = 5.08 on the smart customer experience was significant, while the direct path coefficient of the exogenous variable of the store environment on the smart customer experience (-0.05), with T = -0.20, was insignificant. The effect of smart customer experience on customer satisfaction (0.52), with T = -0.87 and on brand equity (0.22), with T = 0.08, was significant. The effect of customer experience on word of mouth (0.50), with T = 8.83 at P <0.05, was negative and insignificant.

Conclusion: It is essential to create a smart experience for knowledgeable customers to choose between competing companies that provide services with different levels from poor to excellent.

Prediction of Marital Conflicts Based on a Systems Approach with the Mediating Role of Attachment Styles

Fatemeh Dousti, Hassan Mirzahosseini, Majid Zargham Hajebi

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-9
https://doi.org/10.22037/sdh.v8i1.36337

Background: Attachment style is a major variable in the creation and description of marital problems and has received greater attention in recent years. The traits of secure attachment include constructive emotional interactions and intimate marital relationships. The present study aimed to predict marital conflicts using a problem-centered systems approach with the mediating role of attachment styles among conflicting couples.

Methods: In this descriptive correlational study, the statistical population in this study was the total number of conflicted couples in Tehran and Qom in 2020. The sample included 540 men and women with marital conflict selected by convenience sampling. The research instruments included the Experience in Close Relationship Scale (ECR-S), the Marital Conflict Questionnaire (MCQ), and the Family Assessment Device (FAD). Data were analyzed by Pearson correlation method and structural equation modeling using SPSS version 22.0 and LISREL version 8.0 software.

Results: The assessment of the hypothetical model of the research indicated that it was a good fit with the measurement model (CFI>0.90; IFI>0.90; RMSE>0.08). The results demonstrated that the components of the systems approach with the mediating role of attachment styles could explain marital conflicts (P<0.001). These components had an indirect relationship with marital conflicts through attachment styles (β= -0.27, P= 0.01).

Conclusion: Based on the results, the proposed model had a good fit. Overall, the findings verified the marital conflict model based on a systemic approach mediated by attachment styles.

Background: Under-nutrition among the children under the age of five renders them vulnerable to recurrent infections, growth retardation, low efficiency in future and even death. Under-nutrition as a global health problem is indeed of serious concern in tribal community which is a vulnerable sector. Various studies have highlighted the burden of under-nutrition nation-wide among different tribal groups in India. This study is aimed to explore the malnutrition among Irular tribal children in Tamilnadu, India.

Methods: A Community based cross-sectional survey was designed among the 450 tribal mothers and children in Chengam, Tamilnadu, India during January to December 2021. Mothers were interviewed with semi-structured Tamil questionnaire with socio-demographic details, nutrition, health-seeking behavior, Clinical and anthropometric examination of children. Under-nutrition was defined - weight for age (Z-Score) < 2 SD. Median for age and sex-WHO standards. Data was entered in SPSS. Chi Square and Logistic regression were used for analysis. A p<0.05 was considered as statistically significant.

Results: Prevalence of Under-weight was 44%, stunting-28.4%, wasting-37.8% and Severe Acute Malnutrition-8.7%. Majority were females. Overall, the nutritional status was poor. Advancing age, sex, maternal illiteracy, lack of awareness on nutrition, food insecurity and under-utilization of health services were the major underlying determinants.

Conclusion: The burden of under-nutrition is indeed a serious concern in the preschool children in Irular tribes in Tamilnadu, India wherein the socio-cultural, nutritional determinants and health seeking behavior have to addressed at the level of Primary Health care to combat malnutrition and prevent morbidities as well as mortality.

The major matters and events in creating and overcoming transition crises in the family life cycle

Fatemeh Zamani Alavijeh , Omid Ali Ahmadi, Majid Kashani , Fariba Shayegan , Ali Roshanai

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-11
https://doi.org/10.22037/sdh.v8i1.36939

Background: This study aimed to investigate the major matters and events in overcoming transition crises in the family life cycle.

Methods: This study is a qualitative approach and a grounded method. The statistical population included couples living in Karaj in 2020 that 80 of them were selected by purposeful sampling method. They were assigned to 20 people in each period. In the qualitative part, data analysis was performed based on grounded theory by performing three coding steps (open, axial and selective). To describe the data, the usual methods in descriptive and inferential statistics such as preparing frequency tables, calculating statistical indicators were used in SPSS software. Sequential strategy was used to combine quantitative and qualitative data.

Results: 20 indicators and 5 components were identified. Economic and social areas such as the difficulty in dividing family responsibilities between spouses, economic and financial issues were some of the influential factors. Factors affecting family experiences such as social, religious and family factors had a great impact on the challenges of Iranian families.

Conclusion: In the study population, lived experiences of identity in families located at different stages of the family life cycle can be considered as the concerns of families. It seems that the lived experience of individuals in families is affected by economic and social problems that have overshadowed their needs, such as coronary heart disease, family well-being, housing purchase, high cost of living, children's future and start-ups. Business.

Work-life balance in nurses working in hospital: a model with the mediating role of emotional intelligence

Saeed Amini Moghaddam , Alireza Manzari Tavakoli, Sanjar Salajegheh , Samaneh Mehdizadeh , Zahra Shokoh

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-12
https://doi.org/10.22037/sdh.v8i1.37150

Background: The aim of this study was to investigate the balance of work and life with the role of mediation of emotional intelligence in nurses working in hospitals in Kerman University of Medical Sciences.

Methods: This study was a descriptive and correlational research. The method of data collection was a combination of library and field studies and the tools of data collection were a review of documents, interviews and researcher-made questionnaires, including work-life balance factors and emotional intelligence questionnaire. The population included all 2740 nurses, who were working in hospitals of Kerman University of Medical Sciences. 508 people were selected by using a stratified sampling method, SPSS-23 and AMOS-24 software was used to analyze the data.

Results: The research results showed a significant relationship between work-life balance factors and emotional intelligence. It showed that by improving the implementation of work-life balance factors, the conditions for increasing emotional intelligence are provided. Based on the coefficient of determination (R2), 51% of the changes in emotional intelligence were explained by factors related to work-life balance. The rate of direct effect was estimated to be 0.714 and the rate of indirect effect through emotional intelligence was estimated to be 0.333.

Conclusion: The organization should help nurses to achieve the necessary capability and conditions, facilities, and welfare so that the nurses could work in an environment in which a balance between work and family responsibilities is established.

Developing management principles in health centers based on citizenship rights

Ebrahim Mokhtari , Masoud Pourkiani, Saeed Sayadi , Zahra Shokoh , Mahdi Mohammad Bagheri

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-9
https://doi.org/10.22037/sdh.v8i1.37031

Background: Given the importance of citizenship rights and the emphasis of Islamic culture on values of special interest, the purpose of this study is to develop management principles in health centers based on citizenship rights.

Methods: The research was descriptive-correlative. The statistical population consisted of all clients presenting to the Health Insurance Organization southeast of Iran in 2020 as the sample size was 384 people using Cochran's formula with the samples selected via random clustering method. Tools to collect data included a 174-item inventory on citizenship rights and development of Islamic culture-based management principles in health centers, suggesting the validity of 0.915 and reliability of 0.967, respectively. Structural equation modeling was used to analyze the data using AMOS22 software.

Results: The components of the right (life, dignity, equality, security and freedom) had a good and significant load factor of less than 0.05. Considering the values of the fit indices of the final model and the limit of acceptable values mentioned, it can be said that the model presented in this research was acceptable. The regression coefficients of the model showed that the mentioned variables well explain the citizenship rights in the service organizations according to the Islamic culture in the health insurance organization.

Conclusion: Freedom of expression allows citizens to have the right to access their thoughts and ideas in a variety of ways. Freedom of the press, media, speech, and association are examples of citizenship rights.

Students' academic well-being based on the perceived social support and cognitive flexibility: a model with mediating role of psychological hardiness

Azam Vaziri Nasab , Alireza Manzari Tavakoli, Zahra Zeinaddiny Meymand , Mitra Kamyabi

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-7
https://doi.org/10.22037/sdh.v8i1.37258

Background: This study aimed to design a model of students’ academic well-being based on the role of perceived social support and cognitive flexibility mediated by psychological hardiness.

Methods: This study was correlational-descriptive research. The statistical sample studied in the present study was 334 people selected by stratified random sampling method among students of the Islamic Azad University of Kerman in the fiscal year of 2019-2020. The research instruments were the academic Well-being Questionnaire, Psychological Hardiness Questionnaire, Cognitive Flexibility Scale, and Perceived Social Support Scale. The pathway review process was used in Amos and SPSS software version 23 for the analysis of data.

Results: The results of path analysis in the final model showed that the model had a good fit with the data. Psychological hardiness had a significant mediating role in the relationship between cognitive flexibility, social support and academic wellbeing. Results from path analysis revealed that the model has an appropriate fit with the data and psychological hardiness had a vital intermediating function in the correlation concerning cognitive flexibility, social support, and academic well-being. Model fit indicators include: Normalized Chi-square (2.17), Fit-Goodness Index (0.912), Modified Fitness-Goodness Index (0.92), Normalized Fit Index (0.96), Incremental Fit Index (0.97), Tucker-Lewis Index (0.95), Fit Index Adaptive (0.96), root mean square estimation error (0.037) has been stating that the proposed model was appropriate.

 Conclusion: Psychological toughness has an important mediating role between perceived social support and cognitive flexibility with academic well-being; Therefore, efforts to develop scientific protocols to improve students’ academic well-being are suggested.

A model for customer retention in electronic banking market

Ahmad Khosravi , Vahid Nasehifar, Tohfeh Ghobadi Lamuki , Alireza Eslambolchi , Hossein Hajibabaei

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-9
https://doi.org/10.22037/sdh.v8i1.37551

Background: In a difficult competitive environment, timely and organized relationship with customers is the best way to increase customer satisfaction, increase sales and reduce costs.

Methods: In a mixed method, interview was used in qualitative section and questionnaire was used in the quantitative section. The statistical population for the interview was 12 people and the statistical population of the quantitative section included 380 customers of Saderat Bank of Isfahan and Lorestan provinces that their total number was 37000. Measurement tools included a researcher-made questionnaire and an interview form. Data analysis was performed by regression test method in SPSS software.

Results: The website, ease of use, information security, appropriate format, savings in time, and subjective norms were considered as effective variables of electronic banking services. The results indicated that each of the above components have a direct and significant relationship with customer retention. to save time, service offering systems should be used using the data of each customer and the information and the services provided without the need for the customer's presence in electronic services to improve performance of electronic banking as well as provide conditions for full competition in the market for banks to increase the performance of banks.

Conclusion: Given the development pattern of customer retention in banking services, it is necessary to pay special attention to the importance of the effective factors listed by managers and employees.

Background: The implementation of public policy in the presence of social responsibility dimensions is an opportunity to gain the support and trust of citizens. The present study aimed to investigate the external consequences of public policy implementation based on the dimensions of social responsibility in the Universities of Medical Sciences.

Methods: In a mix method research, in the qualitative phase twenty experts were selected by purposive sampling method with snowball approach. In the qualitative part 681 employees of these units were selected by relative sampling method. The data collection tool was a researcher-made questionnaire. Descriptive statistics and structural equation modeling were used when appropriate. MAXQDA11, SPSS and Smart PLS3 software were used for analysis.

Results: In the first phase, 14 categories were finally identified, of which 7 categories were identified as components of social responsibility and 7 categories for the external consequences of implementing public policy in three stages of coding. Findings of the research in the qualitative section, introduced 6 categories as causal factors, pivotal phenomenon, strategy, intervening and contextual factors and consequences of implementing a policy based on social responsibility in the Universities of Medical Sciences. In the quantitative part, the two propositions of balance of social values and public acceptance and motivation as the most effective criterion in promoting social values were selected by the managers.

Conclusion: Public policy implementation with a focus on social responsibility dimensions can help increase the socially sustainable development of the Universities of Medical Sciences.

Background: Marital conflicts are a precursor to the separation of couples and can range from obvious differences in the views of man and woman to serious differences in goals, values ​​and aspirations. The aim of this study was to investigate the relationship between social responsibility and marital conflicts in couples with the mediating role of optimism and self- regulatory.

Methods: The present study was a descriptive-survey and correlational study. The statistical population included couples who referred to Bahar Andisheh Clinic in Mashhad in 2020-2021 and 300 people were selected by convenience sampling. Responsibility, marital conflicts, self-regulation and optimism questionnaires were used to collect data. Data were analyzed using SPSS 23 software and Pearson correlation test (structural equation).

Results: The results revealed that 68% of the variance related to marital conflicts was explained by the social responsibility, optimism, and self-regulation. Responsibility showed a direct and significant relationship with optimism and self-regulation (r= 0.597 and 0.736, respectively and P < 0.001), and had a negative and significant relationship with marital conflicts (P-value < 0.001).

Conclusion: Based on the results, the sense of social responsibility reduces marital conflicts and with increasing optimism and self-regulation, couple's conflicts decrease. It is suggested that educational interventions be held to strengthen and improve the level of responsibility, optimism and self-regulation in order to reduce marital conflicts.

Factors determining the implementation of the cultural policy of Iran Tobacco Company: A model with an environmental responsibility approach

Hossein Kharabi , Hamdollah Manzari Tavakoli, Sanjar Salajegheh , Mohammad Jalal Kamali

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-10
https://doi.org/10.22037/sdh.v8i1.37648

Background: This study aims to investigate the cultural policies of the tobacco company in the framework of social responsibility theory.

Method: This study was a cross-sectional study. The statistical population included the managers of the tobacco company (335 people). The research sample size was determined to be 275 people based on Cochran's formula and by using cluster sampling. Data were collected through a researcher-made questionnaire consisting of 32 questions. The content validity of the questionnaire was confirmed by 22 experts. The Cronbach's alpha coefficient of the variables was obtained higher than 0.7. Data were analyzed by confirmatory factor analysis and path analysis in AMOS software.

Results: The results of the path coefficient between the factors related to the implementation of cultural policies and environmental responsibility were close to 0.80, and the path coefficient between environmental responsibility and cultural policies was equal to 0.18 and less than 0.3, indicating the model weakness.  Most of the factor loads belonged to the indicators of environmental advertising, contextualization, warning against tobacco consumption, information, monitoring system, legal policies, policy implementation, management style, high-quality product and cultural implications.

Conclusion: It seems necessary to have a social and environmental responsibility of the tobacco company with the dimensions of "providing a quality product", "following the policies", "providing cultural messages" and "warning against tobacco consumption" as components of the policy the cultural activities of the tobacco company are considered by policymakers for implementation in three indicators: "information-information", "environmental advertising" and "cultural background".

Resistance economy as a social factor affecting health: a model for evaluating and monitoring the policies of Iranian governmental institutions

Ehsan Mahdavi , Sanjar Salajegheh, Masoud Pourkiani , Saeed Sayadi , Alireza Arabpour

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-12
https://doi.org/10.22037/sdh.v8i1.37875

Background: The present study aimed to provide an efficient evaluation model in the economic field in the context of resistance economics in Iran.

Method: Grounded theory was used as a qualitative method for this study. During the interviews with 10 policy-makers of the policies approved by the Parliament of Iran (representatives of Iran’s parliament in ten periods) and scientific experts, information was collected and the interview data were coded and ultimately provides a pattern of topics and categories and is therefore selected. After conducting the interview, the data obtained through the Document menu of MAXQDA software were entered into the software by selecting the Imported document(s) option, a model was presented by using MAXQDA software,

Results: The model has two parts, enablers and results or consequences. Empowerment includes 5 criteria (strategic management, trust in the ability and plans of policymakers, balanced development of inputs and outputs of the science and technology and factors involved in the implementation of policies and infrastructure) and results (perceived, performance and finance). Factors involved in evaluating the resistance to economic policies have included intra-group and institutional collectivism, independence and attention to the views of the Supreme Leader.

Conclusion: With the emergence of the nuclear issue in the international arena towards Iran and multilateral sanctions, Iranian economists must try to provide a local model called the resistance economy to get out of the current situation.

The higher education management in medical universities during the COVID-19 pandemic

Saeed Lak , Nadergholi Ghourchian, Akhtar Jamali

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-10
https://doi.org/10.22037/sdh.v8i1.37722

Background: The use of electronic technology plays a key role in the change in higher education management. This study aimed to assess the necessity of adaptation of electronic learning systems management during the COVID-19 pandemic.

Methods: The present study was mixed research. Its statistical population in the qualitative section included 50 experts in higher education management of medical universities. The statistical population in the quantitative section included 242 department heads of 65 medical universities selected according to Morgan's table. Purposeful sampling was used in the qualitative section and cluster random in the quantitative section. The interview was used in the qualitative section and a researcher-made questionnaire was used in the quantitative section. Qualitative data analysis was performed with MAXQDA 2019 software and quantitative data analysis was performed with SPSS software.

Results: In the qualitative section, 9 general categories were obtained. In the quantitative section, the results of the one-sample t-test in the dimensions of development of technology and electronic service, expansion of virtual and integrated education, enhancing the quality of learning, expanding research, access to scientific resources, the efficiency of the educational system and optimization of capital and financial affairs of the current status of higher education management in medical universities were determined.

Conclusion: For the development of e-learning at the university level during the COVID-19 pandemic, it is necessary to know the motivating factors and barriers well and use the gained experience to select appropriate strategies to accelerate the development process of e-learning.

Comparing the effect of solution-focused therapy and structural family therapy on marital satisfaction and family function in married women

Iman Seyyedmoharrami, Bahramali Ghanbari HashemAbadi, Mohammad Javad Asghari EbrahimAbad, Anahita Zandi

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-9
https://doi.org/10.22037/sdh.v8i1.36043

Background: Marital satisfaction is a situation in which couples can feel happiness and satisfaction with each other. Recently, various therapy techniques have been developed to solve marital and family problems. The purpose of the study was to comparing the effects of group counseling based on solution-focused therapy and structural family therapy (SFT) on the marital satisfaction and family function among married women.

Material and Methods: This interventional study was performed in three of groups married women (20 people as cases in two groups and 10 people as control group). The research population included of all married females referred to the Faculty of Education and Psychology clinic, at Ferdowsi University of Mashhad in Iran. The instruments for data collection in this study were marital satisfaction scale (MSS) and the family function scale (FFS). Data analysis was done using SPSS 21 software and the analysis of covariance, and LSD post-hoc test were employed.

Results: The findings revealed that there is no meaningful difference among married females who received SFT and solution-focused therapy (p>0.05); However structural family and solution-focused of group counseling compared with the control group had significant difference in the influence on family function and marital satisfaction (P=0.014 and P=0.024, respectively).

Conclusions: Based on the results, solution-focused group counseling had more effective than structural group counseling in improving family function and marital satisfaction.

Background: This study aimed to compare the effectiveness of compassion-focused therapy (CFT) and dialectical behavior therapy (DBT) on state-trait anxiety symptoms and impulsiveness in patients with coronary artery disease.

Methods: This research was a quasi-experimental research method, with pre-test, post-test, and follow-up with a control group. The study population in this study is cardiac patients of Tabriz Madani Hospital. The sample consisted of 60 patients with cardiovascular disease who were selected by voluntary and purposive sampling method and were randomly divided into three groups self-compassion (20 patients), DBT (20), and control group (20). Data were collected using the Bart impulsivity scale (Bart, 1994) and state-trait anxiety log (Spielberger et al., 1970) and analyzed by repeated measure analysis of variance using SPSS software (version 22).

Results:   The results showed that the mean of state-trait anxiety symptoms group (p<0.01, F (df=2) =10.17, Eta= 0.26) and impulsivity (p<0.01, F (df=2) =11.81, Eta= 0.28) in the DBT group at the end of post-test was lower than CFT and the control group. In other words, DBT had the highest effect on state-trait anxiety symptoms and impulsivity (p<0.01).

Conclusion:  It can be concluded that DBT has a greater effect on state anxiety and impulsivity than CFT and both treatments can be used to improve psychological problems in patients with coronary heart disease.

Lock and unlock of the nation during pandemic waves: a cross-sectional study observing the spread of COVID -19 in India

Presthiena Lofi, Prasad A B , Varghese P R , Kuttichira Praveenlal

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-7
https://doi.org/10.22037/sdh.v8i1.36555

Background:  The lockdown policies and pandemic curve in India during the two overlapping waves were different. This study aimed to explore the spread of COVID-19 pandemic transmission during the first and second waves in the context of nationwide lockdown in India.

Methods: The present study was a cross-sectional analysis of the COVID-19 incidence and daily fatalities from March 24, 2020 to July 17, 2021 was done using data retrieved from public domains of governmental websites and COVID-19 dashboards.  The daily number of cases (DNC), and the daily number of deaths were observed in the context of the lock and unlock phases and analyzed using descriptive statistics in Microsoft Excel 2010.

Results: The country was able to effectively handle the first wave in 2020, delaying the peak by up to six months, in which nationwide lock down probably had an effect. During the first pandemic wave in 2020, the DNC increased from 506 cases on March 23 (Lock 1) to a peak of 97,874 cases on September 16 (Unlock 4), before declining to 31,118 cases on November 30 (Unlock 6) as the lockdown came to an end.  With only state-level lockdowns in the second wave, the DNC jumped from 9,121 cases on 15th February 2021 to 414,118 cases on May 6, 2021 and then dropped to 30,093 cases on July 19, 2021. The peak was uncontrollable, with 1,846,806 cases and 236,529 deaths reported across the country in the three months from April 1 to June 30, 2021.

Conclusion: The nationwide lockdown probably had an effect on the control of pandemic during the first wave. The findings highlighted the desirability of national policies, and synchronization of lockdown restrictions across the country during pandemic.

Maternal social determinants of health and birth weight

Shabih Manzar

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-6
https://doi.org/10.22037/sdh.v8i1.37592

Background: Social determinants of health (SDoH) affect health during pregnancy. Previous studies have looked at the association between individual SDoH among pregnant women and neonatal outcome. In this study we looked at the correlation between a cumulative SDoH score and birth weight.

Methods: Information on the social determinants of health (SDoH) among pregnant women was collected by using the electronic questionnaire. By using the color-coded wheel, generated by the electronic record system, we developed a SDoH score, ranging from 0-20. A SDoH color of green indicated no concern, while red indicated severe concern. The corresponding birth weight for the maternal SDoH score was noted after delivery. The data was analyzed using the MS excel program.

Results: A total of 130 women out of 159 (81%) completed the questionnaire during the study period of eight weeks. The mean SDoH score was 3.12 with standard deviation of 2.3 (range 0-13). The mean birth weight was 3048 grams with standard deviation of 563 grams (range 860-4215 grams). A weak negative correlation (r = - 0.14, R² = 0.0217) was noted between the birth weight and SDoH score.

Conclusions: Maternal social determinants of health affect fetal growth. Further studies are needed to validate our findings.

The spiritual experiences of students of Iran University of Medical Sciences in 2020

Nasibeh Zerangian , Abbas Rohani , Mahboobeh Khosravani , Neda Khalili Samani , Marzieh Heydari, Zahra Rahimi Khalifeh Kandi , Morteza Mansourian

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-7
https://doi.org/10.22037/sdh.v8i1.38100

Background: Psychologists consider the acceptance of spirituality as a cultural reality and by acknowledging the positive effects of spirituality on mental health, the World Health Organization also considers the spiritual dimension as the physical, social and emotional dimensions of human existence. Spirituality is a genuine and inner experience that It lies in the nature of every human being. The purpose of this study was to investigate the spiritual experiences of students of Iran University of Medical Sciences in 2020.

Methods: The present study was descriptive-analytical. The sample size of 500 students of Iran University of Medical Sciences in 2020 was estimated. For sampling, a list of students was prepared from the faculty education and the sample was selected by regular random sampling method through random number generation software. The data collection tool was a questionnaire with demographic questions and spiritual experiences. The collected data were analyzed after completion with SPSS 20 software. A significance level of 0.05 was considered.

Results: The mean score of the meaning-finding component in life was obtained at 57.98. There was a significant relationship between spiritual experiences and gender, age and educational level of students, while no significant relationship was found between spiritual experiences and marital status and residence.

Conclusion: In order to ensure the spiritual health of students, it is necessary to plan properly to create a meaningful atmosphere in universities for different age and gender groups.

Background: In Haiti, the prevalence of pregnant adolescents is still high despite joint efforts to reduce it. We are unsure as to how hesitant adolescent girls perceive their experience of pregnancy. This article aims to explore the ambivalent perceptions of pregnancy and motherhood by Haitian adolescent girls.

Methods: To conduct this study, we used a qualitative research design developed from Dewey's social survey. To collect the data, semi-structured interviews were conducted with 33 pregnant adolescents. Thematic analyses were conducted on this data entered into qualitative data analysis software (QDA miner, 6.0.5).

Results: The study showed that adolescent girls have a paradoxical and ambivalent perception of fatness and motherhood. Three themes emerged: pregnancy as a difficult time for some adolescent girls; the perception of the positive changes associated with pregnancy; and a positive vision of the unborn child. These themes were divided into nine sub-themes and 34 codes to describe the perception of pregnant adolescents.

Conclusion: This study highlights the double reality of the experiential experience of pregnancy and motherhood in adolescence in Haiti, either positive or negative.  Pregnancy experiences were not negative for all adolescent girls. Some young pregnant girls have shared the positive changes their pregnancy brings. All adolescent girls expressed a sense of satisfaction with the birth of the unborn child. This discovery informs practitioners and researchers concerning the need to consider the phenomenon of pregnancy adolescents from a holistic perspective.

An optimal model for elitism and relevant factors affecting organizational effectiveness

Moein Mahale Khaloee , Amin Nikpour, Sanjar Salajegheh

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-12
https://doi.org/10.22037/sdh.v8i1.37797

organizational effectiveness and elitism contribute to organizational efficiency; this can increase job satisfaction and income level. This study aimed to find an optimal model for elitism and relevant factors affecting organizational effectiveness.

Method: This research was applied in terms of objective and was survey research in terms of method. The statistical population comprised all employees working in National Iranian Copper Industries Co. (N=9200). The sample size (n=369) was calculated using the Cochran formula and selected through stratified random sampling. The data were collected through factors related to elitism and organizational effectiveness. Data analysis was done using Structural Equation Modeling (SEM) based on path analysis through LISREL 8.8.

Results: major relationship exist between human resource management (0.54), individual (0.66), procedural (0.60), communicational (0.83), organizational (0.97), environmental factors (0.46), and organizational effectiveness. There was a direct correlation between the variables mentioned above.

Conclusion: There was a significant relationship among the factors related to elitism and the organizational effectiveness of National Iranian Copper Industries Co.

A model of sustainable development based on performance management of the health system

Roshanak Chehrazi , Foad Makvandi , Vahid Chenari

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-12
https://doi.org/10.22037/sdh.v8i1.37795

Background: performance management requires evaluation of the economic, environmental and social situations. The purpose of this study is to present one model of the performance management of the organization in the health system.

Methods: This was mix method research. Participants of qualitative phase were experts of universities and health system, which were selected through purposive sampling and snowball method (15 people). The data collection method was semi-structured interview. The statistical population of the qualitative phase was the experts of universities and health system. Cochran's formula was used to determine the sample size and 170 people were selected as a sample by simple random sampling. Data were collected using a researcher-made questionnaire with Cronbach's alpha coefficient of 0.89. The validity of the questionnaire was confirmed by experts. Data analysis was performed using Spss and Smart Pls software. Qualitative data analysis was performed through content analysis and coding of interviews and quantitative data analysis was performed using Smart PLS software and factor load coefficient test.

Result: 26 categories and 5 political, social, environmental, economic and cultural dimensions and 74 indicators were identified. The criteria of total suitability, coefficients of determination and prediction of structural models and measurements are all acceptable and indicated the approval of the model.

Conclusion: Paying attention to all the identified dimensions of sustainable development, in addition to the social dimension in the performance management of universities and health system, makes it possible to achieve the goals of sustainable development.

Background: Hearing impairment, even if mild, can delay linguistic development and negatively affect the language acquisition process. This study designed to investigate the effect of self-determination skills training on academic vitality and optimism in students with hearing loss.

Method: This was a quasi-experimental study with pretest-posttest design and control group.  The sample consisted of 30 students with hearing loss in Shahroud who were selected by available sampling method and randomly and equally assigned to the experimental and control groups (15 people in each group). The experimental group participated in a self-determination skills training program that was conducted in 8 sessions of 40 minutes (one session per week), while the control group did not participate in this program. Participants were assessed using the Academic Vitality Questionnaire and Optimism Questionnaire. Data were analyzed using univariate and multivariate analysis of covariance tests and SPSS-23 software

Results: Considering the differential results of multivariate analysis of covariance for experimental and control groups in the variables of academic vitality (P = 0.001) and academic optimism (P = 0.001), the difference between the experimental and control groups is significant. According to Eta squared, it can be said that in the variables of academic vitality and academic optimism, 33% and 39% of these changes are due to intervention, respectively.

Conclusion: This study emphasizes the role of self-determination interventions in positive academic variables. This method can be used in the educational and rehabilitation program of this group of children.

University entrepreneurship model based on public service motivation

Saeeid Hossein Abadi , Alireza Manzari Tavakoli, Samaneh Mehdizadeh , Mahdi Mohammad Bagheri

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-11
https://doi.org/10.22037/sdh.v8i1.37877

Background: Entrepreneurship is vital in today's modern societies. The purpose of this study was to develop a university entrepreneurship model based on public service motivation.

Methods: The statistical population of this study in qualitative phase was 27 experts. The opinions of 315 employees were used to measure the variables in the studied Azad Universities of District 6. The present study was a descriptive-correlational research conducted by a survey method. It was also a developmental-applied research in terms of aim. Data collection method was a combination of library and field studies.  Data collection tool was a questionnaire. Data analysis was performed using SPSS software version 25 and AMOS version 25. To examine the research questions, statistical methods of one-sample t-test and structural equations were used.

Results: Also, there is a direct relationship between university entrepreneurship and its components including organizational competencies, continuous interaction, university goals and policies, culture and entrepreneurial marketing and good character and temper of administrators. The results also showed that there is a direct relationship between good character and temper of administrators and its components, including courage, patience, honesty, humility, optimism, responsibility of administrators and public service motivation.

Conclusion: Given the importance and positive impact of university entrepreneurship on regional development and the new nature of international competition of universities in the economic development of countries, the results of the present study can be used by administrators and planners.

Background: Mental disorders can cause many problems in students' academic performance and also severely affect their cognitive, emotional, moral and social development. The aim of this study was to evaluate the effectiveness of acceptance and commitment therapy (ACT) on emotional stability and alexithymia in female second-grade high school students.

Methods: The present study was a quasi-experimental with a pretest-posttest design. The statistical population included all girls’ second grade students of the second secondary school in District 8 of Tehran. The sample size consisted of 118 students who were selected by stratified random sampling and assigned to two groups of 59 people as experimental and control groups). Data collection tools were emotional adjustment measure (EAM), Toronto alexithymia scale (TAS-20), and the ACT protocol. Data analysis was done using SPSS V.21 and multivariate analysis of covariance, and significance level was considered ≤ 0.05.

Results: The findings showed that after adjusting the pre-test scores, ACT in the post-test has a significant effect on the Lack of regulation of emotional and physiological arousals, and despair and wishful thinking with values (F=90.143, F=178.324 respectively, P<0.001). Also, after adjusting the pre-test scores, ACT in the post-test showed a significant effect on the difficulty in identifying feelings (P<0.001, F=91.278), difficulty in describing feelings (P<0.001, F=189.328), and externally-oriented thinking (P<0.001, F=165.544).

Conclusion: Based on the results, ACT training had a positive influence on emotional stability and alexithymia of high school students; the implementation of this protocol in schools and counseling centers is recommended.

Mediating role of gender on the impact of human resource strategies on knowledge-based employees: a study on human strategies affecting organizational health

Sedigheh Hasani Ahmadiyeh , Alireza Manzari Tavakoli, Sanjar Salajegheh , Navid Fatehi Rad

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-12
https://doi.org/10.22037/sdh.v8i1.38102

Background: Rapid growth of the organization depends on capable and efficient human resources that provide the conditions for producing more diverse, better, and more products in global markets by using any technology.

Methods: The present study was applied-developmental in terms of purpose and descriptive-correlational method. All 86750 employees of public organizations in Kerman province in 2019 were considered the study's statistical population. Using Cochran's formula, the sample size was estimated at 384 people. The selection was done by the stratified sampling method. Data collection included a 98-item questionnaire of knowledge-based staff with a 0.87 validity and a 0.74 reliability and a 50-item questionnaire of human resources strategies with a 0.85 validity and a 0.87 reliability. Data analysis was performed using Amos and SPSS software.

Results: The results revealed a significant difference effect of secondary, a free agent, committed strategies on knowledge-based employees in public organizations in Kerman province considering the mediating role of gender. However, the effect of paternalistic strategy on knowledge-based employees in Kerman public organizations considering the mediating role of gender was not significant.

Conclusion: Managers and policymakers could apply the findings of this study in determining the position and level of employees as designers and key actors of the organization and in the appointment, recruitment, retention and evaluation system.

Background: Mothers with autistic children encounter with many challenges due to their child's developmental problems. This study aims to compare the effect trainings of cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) on cognitive flexibility of the mothers with autistic children.

Methods: The present research is a quasi-experimental study as pretest and posttest with a control group, which was performed on mothers with autistic children in three autism rehabilitation centers of Mashhad in 2020-2021. 45 people designated by purposive sampling method and randomly settled in three groups of 15 people (2 groups as experimental and 1 group as control). The experimental groups underwent interventions of CBT and ACT in 8 sessions of ninety minutes; whereas, control group didn’t undergo any training. All three groups completed the cognitive flexibility inventory (CFI) in the pretest and posttest. Statistical analyses were performed using SPSS 23 software and method of covariance analysis (ANCOVA).

Results: The results indicated that both training methods of CBT and ACT significantly increased the cognitive flexibility of the mothers with autistic children (P <0.05). Based on the results of Tukey's test, CBT training was more effective on cognitive flexibility of the mothers with autistic children compared to ACT training.

Conclusion: With regards to the more effectiveness of the CBT, this therapeutic intervention approach can be used to improve emotion regulation strategies and increase the cognitive flexibility the mothers with autistic children.

Disusing the mobility aids devices in the elderlies: how much and why?

Zohre Rahaei, maryam tavakoli, Alireza Beigomi, Sara Jambarsang

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-9
https://doi.org/10.22037/sdh.v8i1.36453

Background: Given that society is rapidly aging, identifying the problems of the elderly can help society and individuals, so in this study investigates the abundance of elderlies in need of mobility aids devices and the factors related to their disuse.

Methods: This cross-sectional study was performed on 209 elderlies who selected by random sampling in Taft city. Data gathering tools were MMSE and TUG tests, and a researcher-made questionnaire. The data were analysed Mann-whitney & chi-square test.

Result: Among the elderlies, 75.12% of them required to use mobility aids devices that 49% of these people did not use these devices due to the feeling of shyness, needless, ignorance of the device's necessity, and negative attitude of other people.

Conclusion: Despite the need of most elderly for motor assisted devices, almost half of them do not use these devices because of educational and attitudinal reasons.

Optimal location of medical emergencies in the road network: a combined model approach of agent-based simulation and a metaheuristic algorithm

Bijan Elmi , Naghi Shoja, Abbas Toloie Ashlaghi , Soleiman Iranzadeh

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-13
https://doi.org/10.22037/sdh.v8i1.38612

Background: The ability of ambulance centers to respond to emergency calls is an important factor in the recovery of patients' health. This study aimed to provide a model for the establishment of emergency relief in the road network in 2020 in East Azerbaijan province.

Methods: This applied-descriptive and experimental research with an explanatory modelling approach used the comments of 70 experts to run a model, which was based on the use of a metaheuristic (genetic) algorithm ,Simulation for the number of ambulances and the composition of the monitoring list simultaneously , objective and subjective data combined ,the  agent and environmental variables, were determined and modelled through a meta-hybrid approach during the agent-based simulation and the metaheuristic algorithm.

Results: To travel the initial structure for 40 dangerous points and five stations, the initial time was equal to 7860 Minutes, which reached a number between 2700 and 4000 Minutes after genetic optimization, production of a new list, and the mutation of ambulances from one station to another.

Conclusion: This type of optimization can be used to accelerate activities and reduce costs. Due to the dissimilar traffic of the areas, the ambulance does not arrive at dangerous points at equal times. The travel time of all dangerous points can be reduced by changing the location of points, moving forward or backwards depending on the conditions, customizing the features of ambulances and dangerous points, and combining the list of areas to find the best location for emergencies according to the interaction between agents, environmental constraints, and different behavioral features.

A conceptual model of performance management using balanced scored card models and European foundation for quality management

Seyed Ali Alavi Nasab , Saeed Sayadi, Masoud Pourkiani , Sanjar Salajegheh

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-11
https://doi.org/10.22037/sdh.v8i1.37799

Background: This study is aimed to present a conceptual model of performance management using Balanced Scored Card models and European Foundation for Quality Management

Methods: The method of present study was descriptive-survey. Its statistical population included all 1800 employees of Gol Gohar Mining and Industrial Company (n=904). The research sample size was estimated at 270 people based on Cochran's formula. They were selected by random sampling method. Data were collected through review of literature, research background and researcher-made Balanced Scored Card (BSC) and European Foundation for Quality Management (EFQM) questionnaires. To determine the strategic goals of Gol Gohar Mining and Industrial Company, BSC and EFQM models were used for quality function deployment (QFD). Quantitative goals of each measure, program, actions and cause and effect relationships were identified to determine the strategy map of Gol Gohar Industrial and Mining Company. confirmatory factor analysis, Cronbach's alpha and QFD matrix were used to analyze the data. SPSS-21 software, MINITAB-17, and LISREL- 8.8 software was used.

Results: Stakeholder goals, internal process, learning, financial resources and issues related to leadership, policy, growth and learning of human capital, partnerships and resources, internal processes, customers, human resources, Society and practice are important in the development model.

Conclusion: These finding can be used to present a conceptual model of performance management using BSC and EFQM models in Gol Gohar Mining and Industrial Company given the importance of mentioned company in the Iran’s capital market and meeting the needs of society.

The relationship between psychological empowerment and job burnout: a model with a mediating role of self-efficacy in nurses

Sedigheh Yazdanparast , Hamdollah Manzari Tavakoli, Saeed Sayadi , Zahra Shokooh, Sanjar Salajegheh

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-10
https://doi.org/10.22037/sdh.v8i1.38755

Background: The present study aimed to investigate the relationship between psychological empowerment and job burnout with a mediating role of self-efficacy in nurses of private hospitals in Shiraz.

Methods: The present study was applied in terms of aim. The statistical population included nurses of private hospitals in Shiraz. According to the statistics of the Deputy of Shiraz University, their number was 750 people. Using Cochran's formula, the sample size was determined at 256 people. To collect data, Maslach job burnout questionnaire, Spreitzer psychological empowerment questionnaire and Sherer & Adams self-efficacy questionnaire and structural equation method were used to analyze the data.

Results: The absolute value of the path coefficient to explain the relationship between psychological empowerment and job burnout was -0.545 and t-statistic is higher than 1.96. There was a negative relationship between psychological empowerment and job burnout. Also, psychological empowerment with a mediating role of self-efficacy has a negative path coefficient was -0.704 and t-statistic is higher than 1.96. Self-efficacy increased the effect of psychological empowerment on job burnout.

Conclusion: Since perfectionist people and those extremely involved at work suffer from job burnout emotionally and self-efficacy relationship in line with psychological empowerment and inverse relationship with job burnout, it is necessary to take special measures for psychological empowerment to prevent job burnout by managers to increase the efficiency of nurses.

A human resource auditing model with the approach of functional and macro level strategies in hospitals

Somayeh Poursoltani Zarandi , Malikeh Beheshtifar, Amin Nikpour

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-11
https://doi.org/10.22037/sdh.v8i1.37798

Background: The aim of this study was presenting a human resource auditing model strategies in hospitals affiliated to social security organization.

Methods: This study was conducted using a qualitative method. The statistical population of the study included audit and human resources elites in hospitals affiliated with social security in Kerman, ten of them were selected using purposeful (non-probabilistic) sampling method. During the study and survey of experts, 106 indicators for the implementation of functional and macro level strategies were identified and were placed in the form of 15 concepts. The content validity index of the questionnaire was confirmed with a value of larger than 0.79. The developed questionnaire was submitted to 10 human resources experts. Kappa coefficient index has been used to determine the reliability, Fuzzy Delphi technique and cognitive mapping method are used to analyze the data of this study. The data in the final cross-matrix questionnaire were used as input data for the Ucinet and NetDraw system to design the pattern.

Results: 106 Indicators were determined under 15 categories including mental, psychological, physical and scientific skills, interaction, allocation, organization, supervision, thinking, professional, cognitive, individual, interpersonal, strategic and managerial. It was individual skills. Management skills were identified as a focal node called the ego with nodes directly connected to the alter.

Conclusion: The results of the present study can be used by managers to the rules, goals and macro policies of related organizations.

Background: Parental stress and coping style in the face of life stresses have a long-term effect on the behavior, performance and personality of the child. The aim of this article is to investigate the role of parental stress of mothers in predicting academic and social adjustment of students with learning disabilities.

Methods: The present applied research is a descriptive-correlational study. Statistical population of the study included all mothers of children with learning disabilities, received services from government learning disability centers in Mashhad in the winter of 2019 (330 people).  Based on the Morgan's table, 181 people were selected using a convenience sampling method. The Aydin (1983) Parental Stress Scale and the Sinha and Singh Student Adjustment Scale (1993) were used to collect data. Cronbach's alpha coefficients for all variables and components of the study were greater than 0.7, so the reliability of the research questionnaires is acceptable. Data were analyzed by regression coefficient test using SPSS-22 software.

Results: 0.09 of the changes in the level of academic adjustment and 0.06 of the changes in the level of social adjustment of students with learning disabilities were affected by the variable of parental stress of mothers.

Conclusion: To improve and enhance the academic and social adjustments of students with learning disabilities, it is necessary to pay attention to mental health, stress status and the styles used by parents, especially mothers, in coping with stressful situations.

Human resource development model in the area of social welfare: a model with a future research approach

Jamileh Karimi , Saeed Sayadi, Masoud Pourkiani , Sanjar Salajegheh , Alireza Arabpour

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-14
https://doi.org/10.22037/sdh.v8i1.38842

Background: Many managers believe that past behavioral models fail to solve problems of systemic mechanisms. The aim of this study was to present the Human resource development model in the area of social welfare with a future research approach.

Methods: This study was an applied research in terms of aim, descriptive in terms of nature and exploratory in terms of approach. The statistical population of the study included 275 experts and managers of the General Directorate of Cooperatives, Labor and Social Welfare (GDCLS) of Sistan and Baluchestan Province. The sample size according to Cochran's formula was calculated at 160 people with a quantitative stratified sampling method. Data were collected using a researcher-made questionnaire consisting of 96 questions scored on a 5-point Likert scale. Confirmatory factor analysis in AMOS-18 software was used to analyze the data.

Results: Factor loadings of the human resource development measurement model (path coefficients) consisted of communication skills (0.82), job knowledge and competences (0.81), decision skills (0.80), socio-cultural variable and technological factor (0.80), behavioral factors (0.77), organizational knowledge (0.70), intellectual factors (0.66) and creativity factor (0.69) had an impact on human resource development according to the future research approach. Based on the paired t-test, there was a significant difference between the current and desired statuses of human resource development components with the futures research approach (p-value< 0.001).

Conclusion: Organizations should direct organizational capitals towards support human resource development. To be successful in the future, public organizations need to study issues related to the future.

The effect of social network marketing on online purchase intention: a model in the health market

Toktam Salari , Omar Yousefi , D. Anand

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-9
https://doi.org/10.22037/sdh.v8i1.38742

Background: This study aimed to investigate the role of social network marketing on the intention of online shopping in the health market.

Methods: This study was a descriptive survey. The data collection tool was a researcher-made questionnaire and its validity was confirmed by university professors and its reliability was confirmed by Cronbach's alpha test. Students of Islamic Azad University, Kermanshah Branch were statistical population and sample selected with random sampling.  Considering that students are active and knowledgeable groups in the field of social networks, therefore, the effect of social network marketing on brand awareness and perceived security on the willingness to buy online in this group of social was investigated. SPSS software, One-Sample T-Test, and the Friedman test were used to rank the variables. AMOS was used to rate the importance of each component.

Results: The men’s groups were up 57% of the population, and the age group of 18 to 22 years was the largest. The correlation coefficient of brand awareness, Perceived security component, advertising component, promotion component, Information sharing, and creating friendship groups were 0.76, 0.74, 0.59, 0.55, 0.49, and 0.47, respectively. Data analysis showed that the significance differences of advertising, advertising, creating friendship groups, information sharing, brand awareness, and perceived security were 0.12, 0.16, 0.39, 0.24, 0.25 and 0.17, respectively. A significant difference was between the total observed variables and the latent variable in the proposed model all correlation coefficients have a significant difference.

Conclusion: It is necessary to use new digital marketing strategies in health marketing to maximize the efficiency of marketing costs and create a higher rate of return.

Determinants of medical tourism considering a geographical model: a case study of Iran

Ali Faridi Masouleh, Keramatollah Ziari , Mohammadreza Rezvani, Javad Etaat, Mohammad Amin Khorasani, Zabih-allah Torabi

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-17
https://doi.org/10.22037/sdh.v8i1.37852

Background: Medical Tourism has received significant attention worldwide as the most remarkable phenomenon in the tourism industry. Medical Tourism was considered a medical tourist’s behavior concerning the push/pull factors and three fundamental flows to assess the BTD model (Birthplace-Transportation-Destination). The present study aimed to unearth determinable factors of medical tourism based on a geographical model named BTD in Iran.

Methods: Firstly, with 301 respondents and 11 expert judges, after literature review, item building, and some assessments, the primary checklist leads to 49 items. Two next steps, some processes were common, including sample-to-item ratio (10.12, 10.24), the Cronbach's alpha (over 0.81, 0.85-0.96), Bartlett's Test (both were significant), and KMO (0.896, 0.915). Finally, EFA in the first study and PCA in the second study were assessed and reported. In the third study, to check multicollinearity, the VIF (1.809-2.917), AVE (0.50-0.55), and CR (0.59-0.68) were calculated. Then, AVE was compared with SIC. Ultimately, SEM was conducted that the 3-factor model, especially without the Mahalanobis distance, indicates better results. The study is developed in five cities called Khorasan, Tabriz, Tehran, Fars, and Isfahan.

Results: Regardless of cost, other significant factors were recognized, including birthplace-related factors, transportation-related factors, and destination-related factors.

Conclusion: As can be seen, the construction and the push/pull factors surveyed to assess the BTD model covering all main flows were well defined. Meaningful statistical relationships support the internal and external validity of the multidimensional construct. Therefore, present results are functional for interested sectors, and researchers must not disregard the market.

The effect of targeted subsidies on healthcare costs in rural areas

Azita Zand, Masomeh Arfaee ; Serveh Ahmadi

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-14
https://doi.org/10.22037/sdh.v8i1.39007

Background: This study aimed to investigate the effect of targeted subsidies on health costs in the Khur and Biabank districts.

Methods: This was descriptive-analytical research. The statistical population included 1326 heads of households in Khor and Biabank cities. Using the Krejcie and Morgan table, the statistical sample size was 300 people, who were selected by a random sampling method. The tool was a questionnaire. Experts confirmed its validity and its reliability were confirmed using a preliminary test and Cronbach's alpha coefficient. Structural equation modeling was used in Lisrel and SPSS software.

Results: Targeted subsidies with a factor load of 0.99 on the price of household appliances, with a factor load of 0.97 on the cost structure of education and cultural services, with a factor load of 0.96 on the cost structure of tourism, has a factor loading of 0.90 on the structure of transportation costs ,has a factor loading of 0.89 on the structure of housing and fuel costs, has a factor loading of 0.89 on the cost of agricultural products, has a factor load of 0.70 on the cost structure of food and tobacco, has a factor load of 0.69 on the cost structure of health and treatment.

Conclusion: Due to the importance of the targeted subsidies effect on costs, the attention of policymakers in macro-planning is necessary.

Studying Early Maladaptive Schemas and Personality Factors in Betraying and Injured Spouses

Vajiheh Shariati , Elham Taheri, Ghazaleh Garivani

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-10
https://doi.org/10.22037/sdh.v8i1.37259

Backgrond :The family foundation is established by marriage. What is of utmost importance, is marital satisfaction which is one of the crucial concepts for the evaluation of happiness and stability in marriage.

Methods:The present research study is an applied descriptive-correlational and causal-comparative research ,aimed at studying the early maladaptive schemes and personality factors in the betraying spouses and those injured by betrayal.The statistical population of the present study included all betraying and injured couples and also ordinary married people of Mashhad city in 2020. They participated online in the study due to the coronavirus outbreak. To collect data, the Young Early Maladaptive Schemas Questionnaire (Short Form) and Millon Clinical Multiaxial Inventory (MCMI) were used and collected using Pearson correlation coefficient, discriminant diagnostic analysis, and multivariate analysis of variance (MANOVA) were analyzed in SPSS 22 software.

Result: There was a positive meaningful relationship between early maladaptive schemas with all personality factors among betraying partners and  meaningful relationship between the maladaptive schemas with all personality factors except the self-destructive, schizotypal, and borderline disorder.Early maladaptive schemas and personality factors were able to predict marital infidelity in the injured group and betraying one; there was a meaningful difference between the three betraying, injured, and normal groups in terms of early maladaptive schemas and personality factors. two betraying and injured groups had higher maladaptive schemas and personality factors compared to the normal group.

Conclusion:Marital infidelity can have severe emotional consequences for the injured couple.

Investigation of Genetic-molecular Sources of Multidrug Resistance of Salmonella Isolated from Eggs

Mohammad Saram , Arash Chaichi Nosrati, Leila Modiri , Khossrow Issazadeh

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-11
https://doi.org/10.22037/sdh.v8i1.39325

Background: Bacteria can be transmitted to consumers around the world due to the movement of animals, and food products. One of the most important sources of Salmonella transmission to humans is through eggs.

Methods: 500 egg samples from 37 Iranian brands were extracted from Salmonella yolk and shell source and after confirmation by differential phenotypic methods and resistance test for tetracycline, cellophanamide and nitrofurantoin-furazolidone antibiotics were performed. DNA of strains was extracted and using PCR with specific primers, the presence of tetA, tetB, tetC, tetD, tetG, tetE, tetE, tetH, sul (I), sul (II), sul (III), nfsA, nfsB were examined according to control DNA (ATCC14028).

Results: Among the genes of teta, tetb.tetc, tetd, tete, tetf, tetg and teth, the presence of tetc was seen in 81% of the samples and not in 19% of them. Other tetracycline resistance genes were not found in the samples. Tracing of genes related to sulfonamide resistance by PCR showed that among the Sul1, Sul2, and Sul3 genes, sulfonamide resistance of Sul2 was observed in 95.5% of the samples and was not seen in 4.5% of the samples. Nitrofurantoin resistance genes in the samples showed that 9.1% of the samples contained nfsa gene and 4.5% contained nfsb gene. Other samples did not have any nitrofurantoin resistance gene.

Conclusion: Improper use of antibiotics has caused multidrug resistance to Salmonella, so the study of genes and resistance mechanisms in Salmonella strains isolated from produced eggs in Iran is vital.

The effects of green tax on Iran's economy

Masoumeh Soltaninejad , Sayyed Abdolmajid Jalaee, Mohsen Zayandehroodi

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-14
https://doi.org/10.22037/sdh.v8i1.39228

Background: This research was conducted with the aim of investigating the effects of green tax on Iran's economy.

Methods: This was analytical research using the Nordhaus economic model. The data relating to torques and statistical tests were used to compare actual and model data to determine how well the designed Nordhaus model corresponds to the data on Iran's economy, t and f statistical tests were designed to determine the degree of conformity of the Nordhaus model, and the first and second-order coefficients were used for the variables. Data analysis of the gross domestic product, investment, government spending and oil revenue was used with GAMS software.

 Results: The values of the simulated and real characteristics did not differ significantly at the 95% confidence level(P-value=0.05), which shows the high compliance of the Nordhaus model with the real data of these variables. According to the Nordhaus model, green tax affects economic welfare. It reduces economic growth in the short term and increases it in the long term. By reducing production, the level of leisure increases and leads to compensate for the reduction in consumption due to reduced production and increased economic welfare.

Conclusion: One percentage of increase in the rate of tax on return of capital leads to a reduction in consumption and a reduction in capital. Increasing the rate of tax on return of capital leads to increased tax revenues and helps governments to compensate for pollution costs and improve the quality of the environment.

Criteria for feasibility of establishing an organizational roadmap for organizational entrepreneurship

Shahla Yaghoubi , Saeed Sayadi, Sanjar Salajegheh

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-12
https://doi.org/10.22037/sdh.v8i1.39546

Background: The present study aimed to investigate and explain the criteria for the feasibility of deploying an organizational roadmap in line with organizational entrepreneurship.

Methods: In the qualitative section, using the Delphi technique, experts’ opinion about the designed questionnaire to identify the indices and status was obtained and then using the exploratory method, the model was designed. In the quantitative section, a descriptive-survey method and a researcher-made tool were used to measure its external effectiveness. The statistical population of the first group consisted of selected experts and academics that 21 respondents answered the questionnaire. The statistical population of the second group consisted of managers of municipalities and their deputies in 15 different districts of Isfahan municipality who were a total of 240 people. Based on the sampling method, 144 individuals were surveyed. Questionnaires were distributed in the same number of the statistical population and 203 questionnaires were collected at the end. After editing, coding, and entering the data, descriptive and inferential statistics methods and LISREL8.5, SPSS21, and Excel2013 were used to analyze the data.

Results: Indicators of organizational entrepreneurship introduced as agility, flexibility, innovation, opportunism, and low cost were approved by experts. Indicators of roadmap design including technical, economic, legal, operational, and temporal ones were approved by experts.

Conclusion: Mayors' use of entrepreneurship and creative ideas, in addition to urban development, prevents excess costs and time and waste of government facilities and achieves urban development goals in line with the organizational roadmap.

The socioeconomic and political determinants of life expectancy in selected countries of the world

Fatemeh Yari, Lotfali Agheli, Hossein Sadeghi, Sajjad Faraji Dizaji

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-9
https://doi.org/10.22037/sdh.v8i1.37839

Background: Longevity as an important measure of health is evaluated based on life expectancy at birth. Since the mid-twentieth century, increasing life expectancy has been considered as an evident indication of demographic change, and most countries have experienced a significant increase in life expectancy. The aim of this study is to identify the economic, social and political determinants of life expectancy and to estimate their related effects.

Methods: With the use of panel data obtained from World Bank and GLS approach, we investigate the effects of the factors on life expectancy at birth in selected countries of the world during 2000-2016.

Result: The econometric results show that GDP per capita, literacy rate, health expenditure per capita and democracy impact the life expectancy positively. Reversely, GDP per capita squared (in logarithm) influence life expectancy negatively. GDP per capita has the strongest impact on life expectancy. The results indicate at per to 20000 capita income equal US$, 1% increase in GDP per capita causes 0.205%, 0.207% and 0.209% increase in life expectancy for total population, males and females, respectively.

Conclusion: Positive effect of economic variables of GDP per capita and health expenditure per capita on life expectancy conducts to adopt policies and interventions to improve economic status on a global scale, especially in poor and low income countries. Also, the provision of education opportunities, especially in the low-income countries, and the transition from autocratic political systems to democratic societies may result in longevity and increase the supply of labor in the long-run.

Background: The present study aimed to evaluate the urban metabolism in line with sustainable development of Qarchak city, Iran.

Methods: The present study was applied in terms of type and descriptive-analytical in terms of method. The statistical population of the study included Qarchak city as one of the cities of Tehran province with a population of 231075 people based on 2016 census. It is located in the northwest of Varamin city. Information was collected through library studies, documents and databases were checked. After identifying the criteria, they were converted into quantitative indices and the indices were weighted and prioritized within the framework of AHP weight model. Data analysis was done with the Metabolic Outcomes Assessment (MIA) method.

Results: The final score of the study area was 29.61, while the optimal status is 60.64. Therefore, the current status of the area compared to the optimal status, gained about 45% of the scores. It indicates that the metabolic status of the study area is poor. Also, according to experts, water criterion with a weight of 0.388 has the highest rank and air criterion with a weight of 0.075 has the lowest rank and importance. Also, the incompatibility coefficient is 0.09, which is acceptable.

Conclusion: Based on the results of the present study, understanding the deep relationship between the city and the environment to solve urban and environmental problems, optimization of systems and multiple natural and human processes is essential that should be considered by public people and urban planners.

Background: Patient communication skills are considered as one of the quality standards of nursing care. Educational methods play a major role in increasing nursing students' communication skills. Thus, the present study was conducted to evaluate and compare the effects of lecture-based and role-playing educational methods on patient communication skills in nursing students.

Methods: The present study was a quasi-experimental study. The statistical population of the study consisted of 42 third-year nursing students of Jahrom Nursing and Paramedical School in 2020. They were selected by using a census method and were randomly assigned to role-playing and lecture-based educational groups. Communication skills educations were held in three two-hour sessions for three weeks in both groups. Data were collected using a communication skills checklist before and one month after the intervention and analyzed using independent t-test, paired t-test and chi-square and in SPSS-21 software.

Results: The mean scores of patient communication skills in the role-playing and lecture-based educational groups were not statistically significant before the intervention (P > 0.05). However, after the intervention, the mean scores of patient communication skills in the students of the role-playing education group (67.38 ± 8.71) were higher compared to students of the lecture-based education group (47.00 ± 12.82) and this difference was statistically significant (p <0.05).

Conclusion: Both educational methods have an effect on increasing patient communication skills in nursing students, but role-playing education was more effective than lecture-based education.

Background: Emotional dysregulation, metacognitive beliefs, intolerance of uncertainty, and anxiety can play a very important role in a person's personal and social life. This study aimed to determine the discriminational role of emotion dysregulation, metacognitive beliefs, intolerance of uncertainty, and anxiety in discriminant two groups of students with and without cell phone addiction.

Methods: The present study was descriptive and correlational. The statistical population consists of all male students in high school in Tehran in the year academic 2019-2020. According to the convenience sampling method, 400 students (74 students with cell phone addiction and 326 students without cell phone addiction) were selected by model Kline. They were asked to mobile phone addiction questionnaire (MPAQ) of Savari, difficulties in emotion regulation scale (DERS) of Gratz and Roemer, meta-cognitions (MCQ) of Cartwright-Hatton and Wells, intolerance of uncertainty scale (IUS-27) of Freeston and et al., and Beck anxiety inventory (BAI). Data were analyzed by using SPSS-24 software and the discriminant analysis method.

Results: The results showed that emotion dysregulation, metacognitive beliefs, intolerance of uncertainty, and anxiety can help to cell phone addiction, and function discriminant analysis assigned 93.3 percent of the students with and without cell phone addiction. Some factors, including emotion dysregulation, metacognitive beliefs, intolerance of uncertainty, and anxiety were found to affect cell phone addiction.

Conclusion: To cell phone addiction, attention should be paid to emotional disorders, metacognitive beliefs, intolerance of uncertainty, and students' anxiety, and the necessary training should be given in this regard.

Relationship between perceived social support and academic well-being based on the mediating role of developmental assets in first-year high school students

Hadis Saeedi , Alireza Manzari Tavakoli, Mitra Kamyabi , Zahra Zeinaddiny Meymand , Mahshid Tajrobehkar

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-8
https://doi.org/10.22037/sdh.v8i1.39963

Background: The present study aimed to investigate the relationship between perceived social support and academic well-being considering the mediating role of developmental assets in students.

Methods: The present study was applied in terms of aim, descriptive-correlational in term of nature. It was conducted using path analysis approach. The statistical population of the study included the students of the first-year high school in Kerman city in the academic year of 2021-2022. A sample of 300 people (girls and boys) was selected using multi-stage cluster sampling method. The tools of the study were the developmental assets questionnaire, Tuominen-Soini et al., academic well-being questionnaire, and the perceived social support scale. Path analysis was used in Amos Software to analyze the data.

Results: The influence of social support on the transformation of academic capital is 0.37 and it is significant at 0.001 level. When people receive support from their families, friends, and other groups that include comfort, respect, love, and interest, it affects their psychological well-being, so all these benefits are actually capital transformations that lead to their well-being. Therefore, the research hypothesis about the relationship between perceived social support and academic well-being through the mediating role of developmental assets in first-year high school students is confirmed.

Conclusion: With social support including consolation, affection and care from family, friends and other groups, it is possible to develop and strengthen the developmental assets and finally the academic well-being of students.

Designing and validating a digital leadership model in the education system: A case study with a mixed approach

Mostafa Mollazehi , Sanjar Salajegheh, Amaneh Firooz Abadi , Zahra Shokooh

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-13
https://doi.org/10.22037/sdh.v8i1.38908

Background: This research aimed to design and validates a digital leadership model in the education system.

Methods: This research was a case study with a mixed qualitative-quantitative approach. The statistical population in the qualitative section was 23 experts in education organization, and in the quantitative section, it was 400 education organization employees in Sistan and Baluchestan province.  After semi-structured interviews and qualitative content analysis in MAXQDA software, interview coding was done and primary and secondary categories of the research were identified. The causal relationships between categories were identified by structural-interpretive modeling method and MICMAC software and the model was validated by using the partial least squares technique and SMART PLS software.

Results: A total of 39 secondary categories were categorized into 7 primary concepts including leadership, technological infrastructure, governance structure, strategy development, policy-making, human resource management and digital culture. It was found that governance structure and digital technology infrastructure, as the underlying variables of digital leadership model, directly affects "digital strategy formulation" and digital strategy affects "human resource management" and "digital policymaking". "Digital culture" can also be institutionalized in the organization through digital policymaking and human resource management, and finally "digital leadership" can be achieved.

Conclusion: The present study results can be used by relevant managers in today's dynamic environments that pursue the establishment of digital leadership model in the Iran’s education system, especially in Sistan and Baluchestan province.

Human resource strategic management at the universities: an indigenous model with an emphasis on the role of organizational structure

Ali Reza Rouhani Ghehsareh , Alireza Manzari Tavakoli, Sanjar Salajegheh , Samaneh Mehdizadeh

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-10
https://doi.org/10.22037/sdh.v8i1.39482

Background: This study aimed to study the effect of organizational structure and its dimensions including complexity, centralization and formalization on the strategic human resource management (SHRM).

Methods: The study was applied-developmental and descriptive-correlational method. Interviews with experts and library studies were used to determine the dimensions of SHRM .The data were collected randomly using a researcher-made questionnaire whose validity and reliability were confirmed from a sample of 140 official staff of the university, with validity (KMO = 0.729) and reliability (Cronbach's alpha = 0.892) confirmed by the experts was used to conduct the study that had 57 items for SHRM in the Universities and 27 items for organizational structure and randomly distributed among 140 university staff and 95 questionnaires were collected. SPSS24 and AMOS23 software were used for data analysis.

Results: Complexity, centralization and formalization dimensions, respectively, affect the organizational structure by 0.69, 0.69 and 0.82. The effect coefficients of human resource environment, human resource insight, goals, strategy and human resource systems were, respectively, 0.18, 0.34, 0.76, 0.56 and 0.79. The effect coefficients of the organizational structure and its dimensions (complexity, centralization and formalization) on SHRM in the Universities were, respectively, 0.506, 0.118, 0.142 and 0.360.

Conclusion: A lot of attention has to be paid to the level of human resource activity to maintain the Universities in this critical competitive position and upgrade it from administrative duties to aligning with the level of business strategy and as an important decision maker.

Relationship between moral values and administrative health: an organizational assessment

Masoumeh Durrani , Mohammad Jalal Kamali, Yaser Salari , Zahra Shokooh , Hamidreza Molaei

Social Determinants of Health, Vol. 8 (2022), 1 January 2022, Page 1-10
https://doi.org/10.22037/sdh.v8i1.39570

Background:  A human society with any culture needs to observe administrative health. In the health of organizations, addressing ethical values is a requirement. The purpose of this article was to investigate the effect of ethical values of the employees of Kerman Urban Water and Sewerage Company on organizational factors related to administrative health.

Methods: This was with applied purpose and descriptive nature of the correlation type and structure of qualitative and quantitative study. The statistical population included all employees of Kerman Urban Water and Sewerage Company (1050). The sample size calculation was based on Cochran's formula 290 which was selected by stratified random sampling method. To collect data, study literature and research background and questionnaire were prepared. The administrative health questionnaire included 4 dimensions and 10 questions. The Ethical Values Questionnaire includes 7 dimensions and 16 questions. Data analysis was performed by structural equation modelling with PLS software.

Results: At a significance level of less than 0.05, the variables of occupational health (P=0.341), transparency (P=0.332), internal control and supervision (P=0.337) and education (P=0.374) affected moral values. The model coefficient of determination value is 0.116, so it can be stated that about 12% of the changes in the dependent variable of occupational health are explained by ethical-religious values.

Conclusion: Ethics in organizations can lead to the promotion of health and administrative efficiency and the effectiveness of creating job satisfaction among employees. Occupational health affects moral values and improves occupational health.

Community Case Report


Background: The art of music and architecture are one of the most visible manifestations of culture and ethnicity in every historical period, and music has historically played a valuable role in softening human perception and spirits; thus, can play a decisive role in health life for a long time.

Methods: Non-pharmacological therapies, have the potential to supplement medical treatment alternatives to aid recovery and well-being in health care. Music therapy is a relatively new discipline of musicology that has lately been able to assist individuals in the treatment of ailments that are inextricably linked to architecture. Is it possible for music and architecture, which have an unbreakable link with the past, to retain this bond and build a relationship of abuse and violation with the science of psychology and counselling?

Results: This essay was written in a combined-analytical (comparative, descriptive, and analytical) style, using data collected via documentary, library, and field research approaches. The findings of this study reveal that music and architecture may have a similar effect on the human psyche, and the science of music therapy has been able to capitalize on these similarities in medicine.

Conclusion: The current article first introduces the commonalities of music and architecture and expresses the importance of these two arts' commonalities, after which it will be addressed how these commonalities in an ancient ritual called Chamri, which is held in Ilam province.

Letter to Editor