Vol. 9 (2023)

Systematic Review

Background: One of the most basic tools and strategies for developing new ideas and entrepreneurship is establishing the entrepreneurial culture in the organization. The present study explained and analyzed the dimensions and components of organizational entrepreneurship based on organizational learning.

Methods: The approach of this study was qualitative and was carried out with the seven-step hybrid method. Systematically analyzed the results of previous studies. According to the depth of the study in this approach, the range of scientific articles and documents is less than 70 cases. To achieve the basic framework of the research based on the seven-step method of Sandelowski.

Results: The concept of organizational entrepreneurship based on organizational learning was identified and classified into 6 components, 16 dimensions, and 159 indicators. The components included causal, contextual, intervening factors, axial phenomenon, strategies, and implications of organizational entrepreneurship based on organizational learning. The causal conditions included indicators of organizational performance, competitive advantage, organizational change, strategic leadership, and individual factors of organizational learning. Contextual factors included organizational environment and organizational infrastructure.

Conclusion: Entrepreneurship is a tool to create jobs and generate wealth. Entrepreneurial activities in the organization can be considered innovative actions guided through an organized system of human relations and a combination of resources to achieve a specific goal. If organizational entrepreneurship is implemented with an organizational learning approach, it can play a very effective role in improving the organization's performance and achieving goals.

Community Case Report

Background: inequalities in travel time, travel cost, and travel risk (ITTRC) can consistently affect access to primary care and social services for disadvantaged and marginalized patients. At the same time, the most disadvantaged patients may face the highest travel time, travel cost, and travel risk due to pre-existing disability, poverty, or other intersectional marginalization.

Case Report: to study ITTRC as a confounder which reinforces social and health inequalities, key-informants in the World Health Organization Healthy Cities program, Age-Friendly Cities program, and global EcoCities research initiatives (n=5) were engaged to validate a city planning model towards minimizing ITTRC. A case review of Vancouver, Canada, shows developments which help minimize ITTRC have increased over the last decade, but are not financially-accessible for disadvantaged and marginalized patients.

Conclusion: ITTRC can be reduced through city planning, but underlying classism and capitalism must be acknowledged and addressed towards equitable physical access to life opportunities.

Case Report

Background: One of the main goals of health organizations is to prepare all members to solve their needs and problems so that all people can integrate with each other and with the whole society. The purpose of this study was to defend the idea of how these two writers give priority to collective values and not to the personal interests of the characters, which can be a threat to the concept of well-being and health, through the analysis of Anton Chekhov's "Misfortune" and Langston Hughes' "Thank You Ma'am".

Methods: This research is a quantitative study of language patterns in both stories with a parallel examination of different realizations and representations of preparation, individualism and well-being, which has examined the linguistic elements of the strategies presented by Anton with a detailed statistical analysis. Chekhov and Langston Hughes direct all action and dialogue between relatively distant cultural identities in order to foster some collective value, and thus individual well-being and promoting health.

Results: The average length of expression in morphemes (MLUm) and the average length of expression in words (MLUw) were almost completely correlated. This finding shows that MLUw can be used as effectively as the mothers as a measure of the child's gross language development, which can be a decisive and important policy in health sector communication.

Conclusion: The classification of the introduced words/phrases was useful in comparing other literary texts and also to examine the different styles that the authors may use in the speech of their writings.

Original Articles

Background: The emergence of global markets and competitors and new competitive strategies based on quality, speed and cooperation agreements have forced managers to adopt new management strategies. The present study aimed to provide a model of human resource outsourcing and its impact on the executive performance of companies affiliated to the Ministry of Health.

Methods: The research steps were: to determine the components of human resources outsourcing in the Ministry of Health, to determine the causes of the dynamics of the human resources outsourcing model in the Ministry of Health, and to determine the causal relationships of the components of human resources outsourcing in the Ministry of Health, respectively. First, a level, flow map and model simulation were developed. Then, the model test was performed based on the model validation tests, and finally, policies were designed and evaluated.

Results: As strategic factors increase, management factors improve. Social factors lead to the growth of strategic factors. The growth of service-related factors improves technology and quality, and leads to the growth of more economic factors, which ultimately improves the outsourcing of human resources.

Conclusion: Outsourcing, which is nowadays considered as a method of assigning a part of the work to the outside of the organization on a contract basis, like any other method that can be useful, might have many disadvantages if it does not have defined conditions and standards.

Mediating role of organizational partnership and hospital staff management in improving hospital performance and staff satisfaction

Seyedeh Nafiseh Mohammadi Yousefnejad , Zahra Shokoh, Shiva Madahian , Ameneh Firozabadi , Hamidreza Molaei

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-9

Background: The circumstances of employment are determined by a variety of elements in today's world. The present study investigated the mediating role of organizational partnership and hospital staff management in improving hospital performance and staff satisfaction.

Methods: This study was applied, descriptive-correlation. The statistical population included all employees of hospitals in Bushehr province. Using stratified random sampling, 384 participants were chosen as the sample size based on Morgan's table. Organizational development was assessed using the 36-question questionnaire developed by Avolio, Gardner, and Valium, while organizational participation was assessed using the Hosseininoveh questionnaire. 30 elite individuals' opinions were sought after in order to verify and examine the face and content validity of the surveys. Over 0.70 indicates acceptable reliability, according to Cronbach's alpha coefficient. Data analysis tools included SPSS 23 and the Sobel test.

Results: According to the findings, there is a link between organizational development in public organizations and internalized ethical perspective, idealized influence, and intellectual stimulation through organizational collaboration.

Conclusion: Labor productivity is one of the most significant factors in economic policymaking. According to the studies and the trust of experts, one can expect productivity in other production factors when the factors affecting organizational development are first known. 

Compilation and validation of the puppet show-based social skills training package and its effectiveness on the behavioral problems of the preschoolers

Abbas Sadeghzadeh , Fariborz Dortaj, Hassan Asadzadeh , Ali Delavar , Esma'il Sadipour

Social Determinants of Health, Vol. 9 (2023), 1 January 2023,

Background: The aim of this study was to compile and validate the social skills training (SST) package based on puppet shows and determine its effectiveness on the behavioral problems of preschoolers.

Methods: 40 preschool children were selected using available sampling method to evaluate the effectiveness of the compiled package on behavioral problems of preschool children (puppet shows, all components of preschool social skills) using a semi-experimental method with a pretest-posttest design. Then the intervention and the control group were selected. The opinions of the experts were collected by the Delphi method. The research population at this stage was all the specialists in the field of SST of children whom 10 were selected using purposive sampling method. The validity was confirmed using content validity index (CVI). Data of the behavioral problems subscale were collected using the Social Skills Rating System (SSRS), and analyzed using one-way analysis of covariance.

Results: The findings showed that the effect of the SST package based on puppet show in the intervention group was statistically significant (F=47.28, P<0.05), so that it was effective in reducing behavioral problems of preschoolers. To validate the package, content validity index (CVI) was used, which was obtained as 0.87.

Conclusion: In order to prevent and treat behavioral disorders in children, harmless treatment methods can be replaced physical punishment and verbal aggression. Correct and continuous training of social skills, along with correct and friendly communication with attractive and entertaining methods such as showing puppets to children, can be a solution to improve behavioral problems at this age.

Occupational stress among IT professionals in Chennai, Tamilnadu

Jasmine Maruthupandian, Buvnesh Kumar M, Suganthi S, Rajeshkannan S, Divya Ilanchoorian, Gowthamkarthic R, Manoj P

Social Determinants of Health, Vol. 9 (2023), 1 January 2023,

Background: Stress in the workplace can have impact on physical and mental health. It can also be result in absenteeism, reduced productivity and monetary problems among the working population. The objective of this study is to assess the stress levels among the Software Professionals working in a private firm, Chennai

Methods:  A cross-sectional study was conducted over six months in a private software firm in Chennai. A sample size of 364 participants was determined based on previous research, with data collected through interviews using a pre-tested questionnaire. This questionnaire covered demographic information, perceived stress scale, and various lifestyle factors, including exercise and hobbies. Data were analyzed using statistical tests, including Chi-square, and significance was set at p < 0.05.

Results: The study included predominantly young male participants (mean age 27 ± 3.5), with 81.9% experiencing moderate stress levels. High stress was more prevalent among males and those under 28 years old. Software professionals with over three years of experience and those working on computers for more than six hours a day were more likely to report moderate to high stress levels. However, individuals who engaged in exercise and hobbies exhibited lower stress levels.

Conclusion: Coping strategies and periodic health education should be recommended to reduce the development of stress and its consequences.

Investigation of Association Between Internet Addiction and Quality of Life Dimensions Among University Students

Sahar Mohammadnabizadeh, Mohammad Vahedian-Shahroodi, Vahid Ghavami

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-7

Background: Despite the fact that the technology of internet has provided noteworthy chances in economic, communicative, and scientific aspects for societies, its excessive and unsuitable usage particularly during the pandemic of COVID-19, is a serious and significant warning to the well-being and health of the people, particularly the young. The objective of this study was to investigate the association between internet addiction and quality of life dimensions among university students. Methods: This cross-sectional study was conducted on 400 students of Alzahra University of Mashhad, Iran. The data collection tools were demographic questionnaire, Internet Addiction questionnaire and quality of life questionnaire. Statistical analysis was done using SPSS. Results: Most of the participants were of a moderate level of internet addiction (62.5%), 21% of the participants were of the normal level, and 16.5% were of a severe level. There were significant negative correlations between between internet addiction and all dimensions of life quality. Furthermore, based on the analyses of linear regression, psychological symptom was the stronger predictor of internet addiction. Conclusion: If someone suffers from clinical problems such as depression and anxiety she/he is at higher internet addiction risk since some might utilize the internet in order to distract yourself from fears and concerns. These findings are indicative of the importance of preventive actions in the form of educational intervention programs for students concerning to the appropriate Internet usage.

Analyzing the opinions and emotions of Internet customers using deep ensemble learning based on rbm

Sara Hajighorbani , Changiz Valmohammadi, Kiamars Fathi Hafshejani

Social Determinants of Health, Vol. 9 (2023), 1 January 2023,

Background: The emotions and opinions of Internet users are critical, as they directly influence the provision of proper services. The aim of this study was analyzing the opinions and emotions of internet customers using deep ensemble learning based on rbm.

Methods: Method of this study was based on the deep ensemble learning technique which uses a deep ensemble neural network based on Gaussian restricted Boltzmann machine and cost-sensitive tree the opinions and emotions of Internet customers were analyzed in terms of semantics and linguistics in virtual shops. To analyze behavior or emotions, existing algorithms were divided into groups of semantic approach, language approach and machine learning. The semantic, linguistic and group learning aspects (machine learning) were considered together. The opinions, feelings, and behaviors of Internet customers were analyzed. The proposed method was implemented in MATLAB software. To evaluate this method, conventional criteria that were /applied in data mining applications have been used including accuracy, recall, and F score.

Results: Based on the experiments performed and by evaluating this method against individual and ensemble methods plus the approaches presented in data mining so far, it was revealed that the proposed model outperforms other methods regarding data mining assessment criteria.

Conclusion: Based on social engineering, the suggested model is provided to forecast consumer behavior. In addition to analyzing customers' behavior which examined their emotions and feelings based on their opinions. The results of this study can be used by planners in the field of competitive internet markets.

Background: Creativity is a person's ability to create ideas and insights in science and other fields, learning critical thinking includes the development of thought processes beyond self-centered attitudes and perceptions and immediate sensory experience. This study aim was to investigate the simple and multiple relationships between critical thinking and learning style and creativity in Ahvaz high school students.

Methods: All high school students in District 2 of Ahvaz (2000 people), who were studying in the academic year of 2018-2019 were included in the study. 280 of whom were selected as a sample by multi-stage random sampling. Data collection tools was included Abedi, Creativity Test, the California Critical Thinking Test and the Kolb, Learning Styles Questionnaire. To analyze data, Pearson correlation coefficient and multiple regression analysis were used.

Results: There was a significant relationship between critical thinking, reflective observation and active experimentation and creativity. However, there was no significant relationship between concrete experience and abstract conceptualization and creativity in the subjects. Also, based on the results of regression analysis, among the predictor variables, critical thinking and reflective observation, respectively, were the best predictors for students' creativity.

Conclusion: It seems that the educational and lesson planning of students should be reviewed and teachers should revise their teaching methods and use active teaching methods to encourage them to critical learning styles in students and promote creativity.

Development of structural equation model for human resource management in health sectors

Sara Tavakoli , Sanjar Salajegheh, Saeed Sayadi , Masoud Pourkiani , Hojat Babaei

Social Determinants of Health, Vol. 9 (2023), 1 January 2023,

Background: To achieve sustainable productivity, creativity and innovation, proper quality of organizational performance, and effective management of human resources is essential. The aim of this study was to determine the structural equation model of human resources management in healthcare centers.

Methods: This study was a descriptive-correlational. Library search method was used to review the literature. The statistical population of the study included staff of health centers and experts in different departments of Hormozgan health centers (n=420). According to the Cochran's formula, the sample size was 200 people who were selected by random sampling. To collect data by reviewing the research literature and surveys of experts. A researcher-made questionnaire was prepared that includes 50 items in the form of 6 categories, including contextual, interventional, core concept, the strategies and the consequences. To analyze the data, structural equation modeling was used in PLS software.

Results: Causal factors have had an effect on strategies with a rate of 0.705 in the main category (employment and retention of hospital employees) and the main category (recruitment and retention of hospital employees) with a rate of 0.379 with a confidence level of 95%. Intervening factors with a rate of 0.129, background factors on strategies with a rate of 0.457, and finally strategies with a rate of 0.849 had an effect on the results.

Conclusion: Strategic human resource management has been presented as the only way to the success of health centers in the new era.

Interpretive structural modeling of physician-patient communication avoidance

Rohollah Mirjalili , Hossein Kazemi, Malikeh Beheshtifar

Social Determinants of Health, Vol. 9 (2023), 1 January 2023,

Background: Communication between physician and patient and medical personnel is the cornerstone of good medical care and communication skills play an important role in patient satisfaction and their treatment. The purpose of this research was to model the interpretive structure of avoiding communication between physicians in the public hospitals of Yazd city.

Methods: This research was conducted qualitatively and with a structural interpretative method in two hospitals of Shahid Sadougi University of Medical Sciences, Yazd. The study samples included 12 general practitioners and specialists working in the hospital, who were selected as a sample in a purposeful way until the theoretical saturation limit was reached. Data were collected using semi-structured interviews.

Results: Interpretive structural modeling showed that religious and belief factors were the cornerstones of the model. Hospital environment factors, challenges related to the medical profession, challenges related to colleagues, challenges related to the patient, information disorder, lack of skills, and social harms are on the second level, which affect the first level factors. First-level family factors and psychological factors by themselves do not affect other factors.

Conclusion: The ability to communicate correctly was one of the most important characteristics of health workers, and communicating correctly has positive effects on patients. Disruption in communication leads to misdiagnosis, reducing patient participation in treatment, and physician-patient communication is effective in providing primary health services and the efficiency of medical services.

Background: Obsessive-compulsive disorder (OCD) is a prevalent condition of psychological dysfunction in students and causes anxiety in them. The present study aimed to investigate the mediating role of referential thinking in the relationship between perfectionism and OCD among gifted students.

Methods: The statistical population of this descriptive correlation study included all gifted high school students in Tehran in 2020. Multistage random cluster sampling was employed to select 110 students (55 males and 55 females), and structural equation modeling was used for data analysis. The research instruments included the Perseverative Thinking Questionnaire (PTQ), Frost Multidimensional Perfectionism Scale (FMPS), and Maudsley Obsessive-Compulsive Inventory (MOCI).

Results: Referential thinking mediated the relationship between perfectionism and OCD in an indirect, negatively significant manner (P<0.001). Perfectionism and referential thinking were directly and significantly correlated; however, referential thinking had a significant negative relationship with OCD (P<0.001). According to the results, perfectionism predicted 11% of the variance in referential thinking, while perfectionism and referential thinking together predicted 17% of the variance in OCD. Moreover, the findings did not reveal a significant direct relationship between perfectionism and OCD.

Conclusion: Perfectionism and referential thinking contribute to the alleviation of OCD in gifted high school students. Intellectually gifted students can adopt creative coping techniques, which can mitigate the adverse effects of OCD, as they have high levels of creativity, self-awareness, and sensitivity.

Performance prediction based on employees' job engagement mediated by ethical leadership

Fahimeh Forootani , Alireza Manzari Tavakoli, Navid Fatehi Rad , Sanjar Salajegheh, Mahdi Mohammad Bagheri

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-10

Background: Education has a great impact on the social, economic and cultural progress of society. This study's goal was to develop a thorough model for performance prediction that was based on employee job engagement and was mediated by moral leadership.

Methods: This study was applied and a descriptive-correlational. The statistical population was included 341 people from employees and managers of the education department in Kerman province. They were chosen at random by a stratified sample. Information was gathered using questionnaires created by the researcher, including a work performance questionnaire with 28 questions, a job engagement questionnaire with 34 questions, and a questionnaire on ethical leadership with 46 questions. Assessing the validity of the components by the Delphi method by surveying 30 experts and the results of fit of the components obtained with AMOS software were determined. The Cronbach's alpha coefficient of the variables was more than 0.7, suggesting that the items were internally coordinated and that the reliability was confirmed.

Results: With the increase of behavioral involvement such as commitment to time, intensity and seriousness of work, cognitive involvement such as concentration, work attraction and emotional involvement such as enthusiasm and mental flexibility, along with the rise in ethical leadership, the degree of ethical leadership in education grew, the level of performance, the employment of employees increased.

Conclusion: The importance of mediating role of ethical leadership in education department employees in predicting performance based on job engagement can be used by managers in the area of learning and education in the country.

Modeling the dark personality traits according to childhood trauma: the mediating role of guilt sense and anxiety

Zainab Jahangir Kalestan, Afshin Salahian, Bita Nasrollahi

Social Determinants of Health, Vol. 9 (2023), 1 January 2023,

Background: The dark aspects of personality, including the three traits of narcissism, antisocialism, and Machiavellianism were in the spotlight in the last decade. This study was aimed to modeling the prediction of dark personality traits according to childhood trauma with the mediating role of guilt sense and anxiety

Methods: This research was a correlational study and based on the structural equation modeling method. In the study, all students of the University in the academic year 2020-2021.were included, and 382 people were selected as convenience sampling. Here, the dark personality traits questionnaire, anxiety scale, guilt sense scale and childhood trauma questionnaire were used. Data analysis was performed using AMOS 18 software, correlation coefficient, factor analysis, and fit indices.

Results: The results indicated that the path of childhood trauma to dark personality traits is not significant. After examining the fit indices, guilt sense did not soundly play a mediating role in the correlation between childhood traumas and dark personality traits (P=0.39), while childhood traumas through anxiety had a significant indirect relationship with dark personality traits (P<0.05).

Conclusion: To reduce the effects of dark personality traits, attention should be paid to childhood traumas. Childhood traumas can increase dark personality traits in a person through the mediation of anxiety.


Effective factors in dealing with industrial crises caused by widespread virus outbreaks

MahdiReza Adamian, Abbas Toloie Eshlaghy, Reza Radfar, Alireza Pour Ebrahimi

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-16

Background: The global spread of the COVID-19 virus has not only posed a severe threat to public health but has also triggered a profound economic crisis affecting numerous industries. Addressing and mitigating the economic repercussions of the pandemic is imperative to prevent further damage. While prior research has explored the negative impacts of the COVID-19 pandemic on various industries, there has been a notable gap in understanding the specific factors that influence how industrial crises stemming from viral outbreaks are managed.

Methods: This article undertakes a comprehensive investigation into these influential factors. Through in-depth interviews with industry experts, we identified a set of 30 pivotal variables in this context, forming the basis of an initial model. Subsequently, a questionnaire was administered to a cohort of one hundred managers and industry experts to assess these variables. Employing exploratory factor analysis, we categorized the 30 variables into six distinct categories: producer-related factors, supplier-related factors, distributor-related factors, retailer-related factors, consumer-related factors, and government-related factors.

Results: Our findings revealed several strategic considerations for effectively addressing industrial crises in the face of viral outbreaks. These include the importance of building trust with customers in emerging markets, streamlining the adoption of digital technologies by customers, enhancing the customer relationship management process, prioritizing awareness, concern, and environmental consciousness, and providing support to consumers during times of viral spread.

Conclusion: To effectively navigate industrial crises triggered by the widespread dissemination of viruses like COVID-19, businesses and governments should prioritize strategies that align with the identified factors. By focusing on these key areas, industries can bolster their resilience and minimize the adverse effects of such crises, ultimately contributing to economic stability and recovery in the face of global health emergencies.

The mediating effect of emotional intelligence on the performance of Imam Khomeini Hospital Staff in Tehran

Mohammadreza Shahbazimoghaddam , Alireza Manzari Tavakoli, Sanjar Salajegheh , Hamidreza Molaei , Navid Fatehi Rad

Social Determinants of Health, Vol. 9 (2023), 1 January 2023,

Background: The quality of services is significant factors in evaluating the performance of organizations. The purpose of this research was to examine how emotional intelligence mediated the performance of Tehran's Imam Khomeini Medical personnel.

Methods: A questionnaire was employed in this practical cross-sectional investigation. Its constituent parts were ascertained by a review of relevant literature in the form of the first suggested model and verification by professionals in the fields of management and healthcare. The Ale-Omran Hospital service quality indicators, Salovey & Mayer's emotional intelligence emotions, and questionnaires evaluating customer expectations and perceptions were among the study's instruments. In this regard, 360 questionnaires were sent online using random stratified sampling. Exploratory and confirmatory factor analysis and validity were analyzed.

Results: At 0.6, the coefficient of determination, or R2, suggests that the predictor variables account for 60% of the variation in the dependent variable. When it comes to increasing quality-oriented services, "setting strategic goals" has a greater impact than other predictor factors, according to the F2 value of the effect size of the predictor variables. The association between quality-oriented services and quality-oriented structure is therefore verified, with emotional intelligence acting as a mediating factor.

Conclusion: Hospital organizational structures must take into consideration the elements that are effective in providing high-quality medical services from the perspective of their patients, given the mediating role that emotional intelligence plays in the relationship between quality-oriented services and quality-oriented structures.

Effect of the rehabilitation program on the fatigue of patients with coronary artery diseases

Saeedeh Piri, Zahra Safavi Bayat , Seyedeh Nafiseh Mohammadi Yousefnejad , Sima Zohari Anboohi, Mohamad Amin Pourhoseingholi , Shokoufeh Shafiee , Shokoufeh Shafiee

Social Determinants of Health, Vol. 9 (2023), 1 January 2023,

Background: This study aimed to evaluate the changes in fatigue of patients with coronary artery diseases after the rehabilitation intervention based on demographic and clinical variables.

Methods: This study was a single-arm clinical trial with a pre and post-intervention design. The statistical population of the study included patients with coronary artery diseases who underwent coronary artery bypass surgery or percutaneous coronary interventions, 4-6 weeks after discharge, referred to Khorramabad Cardiac Rehabilitation Center. They were selected by a purposeful sampling method. The data were collected through demographic and clinical information questionnaires and Piper Fatigue Measurement Questionnaire. Education on risk factors at home (weeks 4 and 8) was presented in the area of rehabilitation, the data were analyzed with descriptive and analytical statistics in SPSS software.

Results: Most of the patients were male (54.4%), married (87%), and in the age group of 47-58 years (50%). Their mean age was 54.63 ± 8.87 years, and the mean duration of heart disease in the subjects (by months) was 33.24 ± 50.84. Comparing the mean changes in fatigue after the intervention based on some influencing demographic variables of the patients, including age, gender, type of treatment, and the duration of the disease showed no significant difference (p>0.05).

Conclusion: The implementation of a home cardiac rehabilitation program by nurses, as a low-cost, accessible, and feasible intervention, can be considered an effective step in reducing the fatigue of patients with coronary artery disease and should be considered by managers.

The impact of social approval and respect model criteria on social relations

Zahra Rezaei, Ahmad Sadeghi, Hamed Bakhshi

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-15

Background: Social relations are a complex process and originate from the interaction of a person with the environment. People have an inherent need to establish social relations to have the approval and respect of the others. The current study was conducted to design a model of approval and respect in the social relations of the people of Quchan.

Methods: The research philosophy was in the realm of pragmatism and the research method was mixed. Also, the research strategy in the qualitative part was foundational data theorizing, and in the quantitative part, the survey. To analyze the data of this research, in the qualitative part, MAXQDA software was used, and in the quantitative part, SPSS software (version 22) and PLS software were used.

Results: The results obtained from the analysis of qualitative data show that the model of approval and respect in the social relations of the people of Quchan includes 19 open codes, of which 5 codes are related to the category of causal factors, 2 codes are related to the central category, 2 codes related to the strategy category, 4 codes related to the consequences category, 3 codes related to the context category, and 3 codes related to the intervention category. Also, in the quantitative part, the results of the data showed that the mentioned model has the required validity.

Conclusion: It can be concluded that social relations imply desirable learned behaviors that enable people to have effective relationships with others and avoid unreasonable social reactions.

Background: Child food insecurity (CFI) in Florida is 25% higher than the national average, however, no studies currently exist which investigate the association between CFI and population health or social determinants of health in the State. The goal of this study was to identify those variables in order to inform future policy addressing CFI in the state of Florida.

Methods: Data on CFI, child health, and social determinants of health were collected from the Florida Department of Health website for the years 2014-2018. Variables were selected based on previous studies on CFI conducted primarily in the United States. A correlation analysis was conducted to determine associations between the selected variables and CFI in Florida.

Results: CFI had a moderate positive association with emergency department visits among children aged 0-5 in the years 2017 and 2018. All other child health outcomes examined in this study did not have significant associations with CFI. Teenage mothers represented the strongest positive association with CFI whereas breastfeeding represented the strongest negative association. 

Conclusion: In Florida, CFI surprisingly had few correlations with population health outcomes that have known national associations. This indicates that the factors contributing to and resulting from CFI are different in Florida relative to those found nationally. Several social determinants of health were identified that could help identify individuals and communities at increased odds of having CFI.

Background: Frontline healthcare workers, a vital workforce in developing countries is often out of mainstream vision and their challenges and coping behaviors under stressful conditions remain unclear to stakeholders. This study was undertaken with the objective to explore the challenges faced by community surveillance workers and their coping strategies during COVID-19 pandemic.

Methods: A qualitative descriptive study with constructivism paradigm was undertaken for a period of one year by conducting eight focus group discussions and eight in-depth interviews among the health workers undertaking COVID-19 surveillance selected purposively from eight wards within three Boroughs of a Municipal Corporation using interview guide. Thematic analysis was used to compare and contrast the codes to generate themes inductively under two constructs.

Results: The first construct, factors influencing work related stress was categorized into four themes related to- work environment, community’s response towards pandemic surveillance, organizational support and personal factors. Main predisposing factors of work place stress were risk of self-infection, concern for family safety, inadequate training, shortage of manpower and protective equipment etc. While a strong commitment towards work, assistance from local community influencers, administrative appreciation and supportive supervision were protective factors against stress. Second construct on coping strategies was categorized into managing stress by problem-focused strategies like adapting with experience, gathering information and sharing experiences, adopting self-care practices; while emotion-based coping strategies included denial, venting out, or turning to religion etc.

Conclusion: Community surveillance workers faced considerable and variable stress during pandemics due to various underlying work stressors, managed innovatively, using self-coping strategies.

Determinants of real stock return of pharmaceutical products and materials companies

Hojjatollah Marzban , Reza Sotudeh, Habib Piri

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-12

Background: The present study aimed to investigate the factors that determine the actual efficiency of pharmaceutical companies.

Methods: This study was an applied and descriptive-correlation research. Using the financial information of 28 pharmaceutical materials and products companies of Tehran Stock Exchange during 2013-2016, modeling of multiple variables on the real returns of pharmaceutical companies was performed. Data entered to excel and were calculated and the relationship between independent and dependent variables was analyzed by performing multiple regression tests in Eviews software.

Results: There is a significance association between company size and real stock returns, but there was no relationship between assets and real stock returns and between equity returns and real stock returns. Between financial leverage and real stock returns, between price-to-earnings ratio and real stock returns; a significance association was observed between the ratio of book value to the market and the real stock return, and between the margin profit and the real stock return.

Conclusion: Considering the importance of the factors determining the real return of pharmaceutical products and materials companies, it is expected that the financial characteristics of pharmaceutical companies and Stock returns on the Tehran Stock Exchange should be used by planners as a guide for investors in Tehran Stock Exchange.

Prevalence, treatment-seeking behavior, and cost of Headaches: a descriptive study from Iran

Rozhin Amin, Sepehr Shafiee, Mohammad-Reza Sohrabi

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-7

Background: This study was conducted with the intention of evaluating the prevalence of headache disorders in Tehran, assessing medical seeking behavior and costs endured by individuals affected, and compare them between men and women.

Method: A cross-sectional study was conducted including individuals aged 18 and older from general population of Tehran through stratified random sampling method. Information on demographic characteristics, headache features, medical help seeking behaviors, medications used, and economic cost endured were collected through a self-administered structured questionnaire. The characteristics of the study population were presented using descriptive analysis. Chi-squared test and Independent T test were performed to compare the variables between sexes.

Result: Data on 523 adult participants were analyzed. Main findings showed a prevalence of 96% for all headaches in adults, including 47.9 % (n = 241) women and 52.1% (n = 262) men. Mostly described their headache as a squeezing sensation (32.8 %) felt bilaterally (78%) with medium intensity (59%). About a third (31%) reported reduced productivity due to headache. The prevalence of self-treatment was 75% in study population and about two third reported using medications for acute treatment of headache. Mean± SD out of pocket payment of US$139 ± 114.6, and average monthly expenditure of US$4.1 ± 13.4 for headache management purposes were documented. No significant differences were found between the sexes in terms of headache features, treatment-seeking behaviors, and headache management expenditures.

Conclusion: Findings point to the importance of prioritizing headache disorders in future decision-making and resource allocation strategies.

The effective factors on empowerment of faculty members to launch start-ups

Zahra Hesari , Ramezan Jahanian, Mohammadali Hosseini

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-11

Background: This study aimed to investigate the factors affecting the empowerment of faculty members to launch start-ups in the branches of the Islamic Azad University of Tehran.

Methods: This research was descriptive-analytical. Its statistical population included 27,000 faculty members working in the Islamic Azad University, Tehran branch. The sampling method was cluster random sampling. The sample size was 50 people in the qualitative part and 384 people in the quantitative part. The research tools were researcher-made questionnaires, with a Likert scale and semi-structured interviews. For statistical analysis, confirmatory factor analysis tests, t-tests, and multivariate regression were used by SPSS software version 23.

Results: The results showed that there is a significant difference in the components affecting empowerment, including marketing and commercialization of knowledge (β=0.354), attracting elites and from business (β=0.306), and knowledge sharing (β=0.265). financial risk analysis (β=0.143), formation of business support association (β=0.111), value design and use of new technologies (β=0.075), financial and legal support of the government (β=0.066), creating environmental changes (β=0.056), increasing value-creating activities (β=0.044), providing infrastructure (β=0.037), and discussing startups (β=0.024) in the order of priority. The partial regression showed the impact of discussion about startups and environmental changes on the empowerment of faculty members.

Conclusion: It is essential to consider human resources, knowledge commercialization, elite recruitment, knowledge sharing, financial risk analysis, financial and business support, use of new technologies, environmental change, value creation activities, providing infrastructure, about start-ups based on the transformational attitude of management.

Background: Many factors are effective in business development and experts have emphasized marketing and consider it one of the most important factors determining business survival. This study aimed to present a model of how small and medium companies enter regional markets with an entrepreneurial marketing approach.

Methods: This study was a mixed research type. In the qualitative part of this study, market entry strategies were investigated and identified using the method of literature review and existing texts. To design the questionnaire, the opinions of 15 business management experts were used by the snowball method to obtain suitable samples for the study, and then the model was approved by the experts using the meta-heuristic method.

Results: 100 people were present for the implementation of this study, 6.7% of the participants in the study had less than 10 years of work experience and 40% between 16 and 20 years, and 20% had more than 20 years of service. The proposed conceptual model of the research, which is obtained from the met heuristic process, shows that the initial conceptual model of the research consists of 4 categories of dimensions (entrepreneur orientation, market orientation, customer orientation, and innovation orientation) and 48 concepts and 182 codes (indicators).

ConclusionGiven the importance of socioeconomic factors on health outcomes, businesses should consider the market distribution network, knowledge infrastructure, business capability, product innovation, the risk of participation, competitors, market development, and strategies.

Investigating the challenges and barriers of promoting national philanthropy in the charity area: a mixed study

Masoudeh Parvaresh , Hamid Taboli, Mohammad Ziaaddini

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-10

Background: Nowadays, charitable activities are considered as one of the most important strategies to reduce poverty and respond to social deprivation. Although many charitable organizations and institutions have been established to organize charitable affairs, the functioning of these centers and organizations is still associated with many barriers. Thus, this study was designed and implemented with the aim of investigating the challenges and barriers of promoting national philanthropy in the area of charity, considering the role of various governmental and social institutions.

Methods: This mixed study was conducted using two quantitative and qualitative phases. The quantitative phase included a descriptive-cross-sectional study that was conducted on 300 employees of the Imam Khomeini Relief Committee Organization in Kerman province, and the qualitative phase was conducted using the institutional mapping method. The participants in this section included experts in the philanthropy sector at the level of Kerman province.

Results: The results of this study revealed that the mean score of the participants in the organizational performance scale was estimated at 118.74±14.74. In the qualitative section, the results showed that policy-making takes place in the public sector regardless of the quality of its implementation, and regarding the non-governmental organizations and charitable organizations, the results indicate their non-participation in decision-making and policy-making.

Conclusion: The present research indicated that there are various barriers in the area of national philanthropy, and it is recommended that institutions and organizations operating in the relevant areas pay attention to the identified factors.

Indicators of social and emotional health competence of education department administrators: a case study in Bandar Abbas

Shahpari Zakeri Dehvostanezhad, Mahmoud Sabahizadeh, Kolsum Nami , Nadergholi Ghourchian

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-12

Background: This study was conducted with the aim of identifying indicators of social and emotional health competence of managers of education departments, as a case study of Bandar Abbas city.

Methods: This study was applied research conducted by descriptive-correlational method. In the first section, using content analysis method (interview with experts), 20 experts attend in the field of educational sciences and educational management. In the second, to design a structural-interpretive model, 15 experts were used to answer the questionnaire. Data collection was performed by a researcher-made questionnaire. The reliability of the questionnaire was confirmed by Cronbach's alpha coefficient, composite reliability coefficient and factor loads. The validity of the questionnaire was confirmed by content and construct validity. Analysis of descriptive indices and correlation matrix between them were performed with SPSS and model fit was examined with Smart PLS software.

Results: Factors affecting social and emotional competencies have high influence. Professional competencies, especially basic and teaching-related competencies have a significant effect on teachers' educational performance. Themes include 8 main variables about quality of work life, protectionism, realism, trust building, social commitment, job competence, individual and social competence. Weak, medium and strong value of the structural part of the model is determined by criterion of R2 were 0.19, 0.33 and 0.33.

Conclusion: Emotional and social functioning and concurrent conditions among education and referral managers for the implementation of evidence-based interventions may be useful for the overall performance. The results of study are useful for improving the emotional and social skills of education managers.

The factors affecting job motivation of university employees and its relationship with health factors at workplace

Mehran Nazari , Saeed Sayadi, Masoud Pourkiani , Mohammad Jalal Kamali

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-11

Background: Job motivation of workforce is one of the most important issues that organizations face to perform their tasks and duties well and with confidence and maintain their effectiveness.

Methods: The present study was applied research conducted by using a combination of library studies and Delphi technique. The sample size of the present study was 332 employees of Islamic Azad University of Khuzestan. They were selected using Cochran's formula. Two researcher-made questionnaires including job motivation questionnaire with 54 questions and health factors questionnaire with 30 questions were used to collect the data. The collected data were analyzed by SPSS-22, Lisrel, and Amos-22 Software.

Results: The variable of factors related to job motivation consisted of 15 components. The variable of job motivation in general found that according to the scoring scale of Abbas Bazargan, this variable is at more than satisfactory level. The variable of health factors was at more than satisfactory level. There was significant association between job motivation with health factors (P<0.001). Relationship between job motivation and health factors showed that direct and significant relationship between job motivation with health factors. The value of path coefficient of impact of health factors on job motivation showed that the relationship between job motivation and health factors is significant.

Conclusion: Job motivation is a multidimensional phenomenon that cannot be measured directly by one variable. One of the important tasks of organizations is finding the ways to create and strengthen motivation. Managers should consider motivating employees as one of the most important tasks.

Association between Metabolic syndrome and Subjective social status in coronary artery disease patients, a cross sectional study

Tolou Hasandokht, Hossein-Ali Nikbakht, Arsalan Salari, Soheil Soltanipour, Behrang Motamed, jalal Kheirkhah

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-9

Aims: The  purpose  of  this  study  was  to  examine  the  association  of  metabolic  syndrome (MetS)  with  subjective  social  status (SSS)  and   depression  symptoms  among  coronary artery disease patients (CAD).

Materials and methods: in  a  cross  sectional  study  during   2019- 2020,  patients  with  CAD    older  than  30  through  simple  sampling  method  were  selected. SSS  and  depression  were  assessed  using  MacArthur  scale  and  Persian  version  of  the 13  items  beck  depression  scale,  respectively.  The components  of  Metabolic  syndrome,  ,  and  demographic  factors  were  collected  based  on  patients  medical  records.

result: data  related  to  500  CAD  patients  aged  61.81  ±  12.25  years  were  assessed. prevalence of  MetS  was  57 % . Almost  75%  of  study  subjects  were  in  low  category  of  SSS.  Univariate  logistic  regression  analysis  showed  the  odds  of  MetS   in  patients  with  higher  SSS  was  21%  less  than  patients  with  lower  SSS  (OR=0.79, 95% CI=0.53-1.19, P=0.274). The  odds  of  MetS  was  higher  in  women [OR=1.67(1.16-2.42)] , married  subjects[OR=1.55(0.74-3.26)] , in  rural  area [OR=1.30(0.88-1.91)] ,  those  without  job [OR=0.83(0.58-1.19)]  and  literacy[OR= 0.83(0.58-1.19)] . There  was  no  significant  association  between  depression  and  the  odds  of  metabolic  syndrome (OR=0.98,  95%  CI= 0.63-1.52, P= 0.950). In  multivariate  logistic  regression  analysis  ,  the  inverse  association  between  SSS  and  MetS  was  still  remained  (OR= 0.74, 95% CI=0.49-1.12, P=0.163).

Conclusions: MetS  was  more  prevalent  in  lower  even  considering  demographic  factors  and  depression  symptoms. More  researches  need  to  assess  the  effect  of  perceived  social  standing  on  cardiometabolic   risk  factors.

Neural network analysis of the functions of social participation in improving the environment

Masoumeh Arfaee, Azita Zand , Serveh Ahmadi , Sahar Dehyouri

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-9

Background: The aim of this research was to investigate the effect of the participation functions in green space projects of Tehran Municipality on the development of the areas covered by these projects.

Methods: The present study was an analytical cross-sectional design that 34 employees of municipal green spaces in Tehran were selected by random sampling method. Artificial neural network is a practical method for learning various functions. The questionnaire used in this study was developed by an extensive reviewing of the existing literature on the research topic by the researcher and using the opinions of the advisors and supervisor. Data collection was done using a questionnaire and analysis was done with SPSSWin16 and MATLAB.

Results: There is a significant relationship between urban social functions, urban economic functions, urban environmental functions, urban institutional functions, rural social functions, participation. Urban environmental functions of participation in green space projects, urban institutional functions of participation in green space projects, and rural social functions of participation in green space projects in total account for 55% of the variable changes in the development of the covered areas. The use of artificial neural networks showed that the municipality's green space has been effective in urban and rural population changes.

Conclusion: there is a significant relationship between the social, economic, environmental, institutional, and rural social functions of participation and the development of the covered areas, urban planning managers can use neural network to investigate the role of municipal green spaces in urban and rural population changes so that effective action can be taken.

Institutional barriers to the development and construction of urban hospitals

Hossein Ayoubi Najaf Abadi , Navid Fatehi Rad, Sanjar Salajegheh , Mohammad Jalal Kamali

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-9

Background: Increasing urban population and the need for accountability and citizen orientation have led decision makers to use the desired methods in the area of urban management. This article identified the barriers to development and construction of hospitals in metropolitan of Isfahan.

Methods: This study was descriptive-correlational in terms of method. 376 people were studied. They were selected using stratified random sampling method. To data collection, a researcher-made questionnaire was used. It included 41 questions in two dimensions of urban and regional barriers and planning and management. The construct validity of the research variable structure was confirmed by exploratory factor analysis. Cronbach's alpha coefficient was also estimated to be higher than 0.7. Data analysis was performed using confirmatory factor analysis in AMOS-23. 

Results: The indicators shown that the model for measuring institutional obstacles to achieve good urban governance is suitable. The results showed that planning and management and urban and regional variables as institutional barriers have a significant impact on the construction of the hospital and it shows that these structures have a direct impact on these barriers. Therefore, it can be said that the influence of planning and management variables was more than other dimensions.

Conclusion: Based on the observations can be shown that the policy makers should identify the obstacles facing the collaborative models and then provide a suitable platform for their organizations. In order to reduce planning and management obstacles, should be managed within the framework of plans and stakeholders should be involved in the decision-making process.

A model to predict communications in dynamic social networks

Ahmad Ghadamkheir , Seyed Alireza Derakhshan, Ashraf Shahmansoury

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-13

Background: social networks are dynamic due to continuous increases in their members, communications, and links, while these links may be lost. This study was conducted with the aim of investigating the link and communication between social network users using the centrality criterion and decision tree.

Methods: After checking the nodes in the network for each pair of unrelated nodes, some common nodes in the proximity list of these two groups were extracted as common neighbors. Analysis was performed based on common neighbors, association prediction process, and weighted common neighbors. Prediction accuracy improved. Centrality criteria were used to determine the weight of each group. New Big Data techniques were used to calculate centrality measures and store them as features of common neighbors. Personal characteristics of users were added to build complete data for training a data mining model. After modeling, the decision tree model was used to predict communication.

Results: There was an increase in sensitivity, which indicated model power in identifying positive categories (i.e., communications) when users' characteristics were used. It means that the model could identify potential latent communications. It can be stated that users are more willing to make a relationship with users similar to them through common neighbors. Personal characteristics of users and centrality were effective in method efficiency, while removal of these properties in the learning process of the decision tree model caused a reduction in efficiency criteria.

Conclusion: Prediction of latent communications through social networks was promising. Better results can be obtained from further studies.

Comparison of adolescent mental health in monogamy and polygamy families

Aziz ollah Khosravi Shastan, Ali Reza Rajaei, Saeed Teymouri

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-11

Background: Family shapes children's mental health and is a safe environment to ensure their mental health. This study aimed at comparing the mental health of adolescents in monogamy and polygamy families based on maternal psychological, economic, and social variables.

Methods: This is a causal-comparative study, which was carried out on all adolescents aged 14-18 years old in the monogamy and polygamy families of Saravan city in the academic year of 2020-2021 with their mothers. Two hundred forty people were selected by convenience sampling method. Goldberg and Hillier General Health Questionnaire, Ghodrat-Nama Socioeconomic Status Questionnaire, and Drogaits Symptom Check list-90-Revised (SCL-90-R) were used. SPSS-26 was used to analyze the data. The results were analyzed using independent t-test, and multivariate analysis of variance.

Results: The results showed that there was a significant difference between the mental health of adolescents in monogamy and polygamy families (P=0.034). Adolescents in monogamy and polygamy families were significantly different in only one component of mental health which is hostility (P<0.05), but in terms of other components there were no significant differences (P>0.05). Adolescents in polygamy families had lower mental health than children of monogamy families with moderate mental symptoms (P=0.003). Moreover, the high socio-economic status of mothers brought about a significant difference in adolescents' mental health (P=0.020).

Conclusion: According to the results, the mental health and socio-economic status of mothers affect the mental health of adolescents, so comprehensive programs to promote mental health and attention to the socio-economic status of mothers can increase it in adolescents.

Background: Several studies have investigated the role of physical activity (PA) in self-efficacy (S-EF) and self-esteem (S-ES) of people, especially visually-impaired individuals. Therefore, the goal of this research was to compare the S-EF and S-ES in athlete and non-athlete blind and visually impaired individuals.

Methods: In this study, the population comprised all blind and visually impaired people in Arak, among whom 92 participants with the mean age of 32.42 ± 11.46 were selected as the sample of the study by purposive sampling method. Based on a demographic questionnaire, they were divided into two groups of athletes and non-athletes. The research instruments included a self-esteem index (SEI) and a general self-efficacy scale (GSES) which were completed by an interview. The results were analyzed using one-sample and independent samples t-tests. SPSS version 26 was used to analyze the data at a significance level of P = 0.05.

Results: The results indicated that overall in athletes, the average S-EF and S-ES were higher than those in non-athletes. The results also showed that the S-ES of athletes was significantly higher than the theoretical average (P = 0.001) and there was a significant difference between the overall S-ES of the visually impaired and blind athletes and non-athletes (P = 0.001).

Conclusion: In general, the results showed that exercise and PA, especially group PA, may play an effective role in increasing S-EF and S-ES of the blind and visually impaired people.

The role of tax exemption and financing and investment decisions on the performance of medical equipment companies

Abdolhamid Jahangirvand , Mohammad Reza Shurvarzi, Zahra Noori Tupkanloo

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-9

Background: This study aim was to investigate the relationship between the importance of tax exemption, financing and investment decisions on the performance of medical equipment companies in the capital market of Tehran.

Methods: The research environment included Tehran capital market and the research population included 29 companies. Using random sampling method, 101 managers or financial and administrative deputies, financial managers, accounting heads and accounting experts were selected and questionnaires were distributed among them. Using SPSS22 software (demographic and reliability description) and Smart PLS2 software, confirmatory factor analysis (review of measurement model) and exploratory factor analysis (review of structural model), the fit and overall quality of the model was examined and research questions were analyzed.

Results: Based on the results, tax exemption has a significant relationship with financing decisions of medical equipment companies in Tehran capital market. Tax exemption has a significant relationship with the investment decisions of medical equipment companies in the capital market of Tehran. Financing decisions have a significant relationship with the performance of medical equipment companies in Tehran's capital market. Also, investment decisions are significantly related to the performance of medical equipment companies in the Tehran capital market.

Conclusion: It can be shown that the necessary support, such as tax exemption, will increase the performance of medical equipment companies in the Tehran capital market by influencing investment and financing decisions, considering the capacity of this sector and potential markets.

Background: Today, education and training are associated with deep, broad, and meaningful concepts which approached to serve humanity. This study aimed to compare the effectiveness of psychodrama with training parenting behavior management skills on social adjustment, anger, and aggression in preschool children.

Methods: The research method was experimental with a pre-test and post-test design and a control group. The statistical population included all preschool students of Tehran-Iran (District 9) during 2020. The samples were selected through cluster sampling (n=45) and randomly assigned to experimental and control groups (n=15 each). Participants were measured through Dokhanchi social adjustment questionnaires and Anger and Aggression-Novako scale. Parental behavior management skills training programs are administered in six sessions 90 minutes for parents and psychodrama included ten 45-minute sessions for children. The control group did not receive any intervention during the study. The results were analyzed using an analysis of covariance. SPSS version 24 was used to analyze the data.

Results: The results showed that the social adjustment of children in the psychodrama and the parental behavior management groups increased comparing the control group (P=0.001). Psychodrama reduced all three components of aggressive behavior, thinking, and feeling (P =0.001). The components of anger and aggression in parental behavior management have reduced significantly comparing the control group (P=0.001). Also, parental behavior management program effectiveness was significantly higher than psychodrama (P<0.05).

Conclusion: The study results showed that the effect of parental management skills on reducing anger-aggression and increasing social adjustment was higher than psychodrama.

Background: Responsive teaching values students' cultural references in all aspects of learning. This study aimed to investigate the status of different dimensions of responsive and justice-oriented education in the area of health from the perspective of experts at Hormozgan University of Medical Sciences and to provide solutions to improve the quality of health services.

Methods: This is an applied, descriptive survey with a mixed approach to develop educational programs. Using stratified random sampling 335 faculty members of the Educational and Medical Center of Payambar-e Azam were selected. A literature review and survey of experts for Qualitative data review were done. A researcher-made questionnaire consisting of 5 main dimensions and 170 items was prepared. For Qualitative data review, the data obtained from semi-structured interviews with experts. The content validity of the questionnaire was confirmed and Cronbach's alpha of the questionnaire was greater than 0.70, indicating the confirmation of reliability.

Results: The status of responsive and justice-oriented education in the area of medical science education is desirable in most components, but the components of educational equipment and financial resources, acceptance of new ideas, sense of responsibility in the educator, selection of capable people to provide education, planning educational programs, and the ability of education officials to make decisions in difficult times were not in desirable status.

Conclusion: It is necessary to develop educational programs so that students can acquire the necessary knowledge and skills for their future profession and the ways to be paved for their mastery and clinical skills.

The mediating role of cognitive emotion regulation strategies in the relationship between early maladaptive schemas with psychological distress

Reza Ghorbani Hassan Abadi , Mehdi Ghasemi Motlagh, Mahmoud Jajarmi

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-11

Background: Psychological distress among prisoners has a higher percentage than among the general population. This study investigated cognitive emotion control techniques' mediating function in the interaction among maladaptive early schemas with psychological distress.

Methods: The male inmates of Chenaran Prison in Razavi Khorasan Province were the participants of this correlational and descriptive study in 2021. Out of which 350 people were selected as samples using the method of convenience sampling. Data were collected by the questionnaires of Young Schema Short Form, Psychological distress, and Cognitive Emotion Regulation. Software such as Amos 24, SPSS 25 and structural equation modeling were used to analyze the data.

Results: Path coefficient findings indicated that early maladaptive schemas have a positive and significant direct impact on cognitive emotion regulation strategies (g= 0.58, P = 0.01) and psychological distress (g= 0.37, P= 0.01). Also, the direct effect of cognitive emotion regulation strategies on psychological distress was positive and significant (b= 0.65, P= 0.001). Examining the standardized coefficients of indirect effects showed that by cognitive emotion control techniques, maladaptive early schemas used to have a beneficial and substantial impact on psychological distress (IF= 0.37, P = 0.001).

Conclusion: According to the findings, early maladaptive schemas can predict the level of psychological distress by influencing emotion regulation strategies. This research reveals the requirement to pay closer attention to the inmates' mental health through comprehensive planning to empower them and timely interventions.

Comparison the effectiveness of Emotion-Focused Couple and Acceptance and Commitment Therapies on Marital Forgiveness in Incompatible Couples

Hossein Zaeimi, Ali Reza Rajaei, Mohammad Reza Saffaran Tousi, Hamid Nejat

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-9

Background: Using effective interventions to reduce incompatibility among couples can play a role in preventing divorce in the family. The present study aimed to compare the effectiveness of emotion-focused couple therapy (EFCT) and acceptance and commitment therapy (ACT) on forgiveness in incompatible couples.

Methods: The present research is a quasi-experimental study that was done on couples referred to a family therapy clinic in Torbat-e-Jam City. Here, 24 incompatible couples were selected through purposive methods and randomly replaced in three groups. The first and second groups (8 couples in each group) received emotion-focused couples and acceptance and commitment therapies, respectively, and the third group as control (8 couples) did not receive any intervention during the study period. All three groups were evaluated before and after the intervention with a standard questionnaire of Bagarozi forgiveness (2001). Data were analyzed through SPSS software version 20 and covariance analysis.

Results: The findings revealed that both therapies of EFCT and ACT had a meaningful effect on forgiveness (P < 0.001, F = 41.73, and P = 0.031, F = 5.13; respectively); while the results indicated that the two groups under intervention have no significant difference in terms of effectiveness on the variable of forgiveness (P=0.63, F=0.23).

Conclusion: According to the results and effectiveness of the two therapy groups, it is recommended to use a combination of approaches according to the therapeutic goals.

Coping strategies among patients in a tertiary hospital: associations with quality of life and mental wellbeing

Chizoba Achor, Chidi Okafor, Emmanuel Essien, Ibene Ekpor, Iniobong Williams, Bassey Edet, Owoidoho Udofia

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-8

Background: Coping is essential for adjusting to life's stresses to optimize wellbeing. This study examined associations between coping, quality of life, and psychological wellbeing among adult patients seen in the primary care clinic of the University of Calabar Teaching Hospital.

Methods: Using a cross-sectional design, we elicited information from 230 subjects that were selected using systematic sampling. Four instruments were administered: the Hospital Anxiety and Depression Scale (HADS), the Coping Strategies Inventory – short form (CSI-SF), the World Health Organization Quality of Life-Bref (WHOQOL-Bref) and the Mini International Neuropsychiatric Interview (MINI). Pearson correlation and logistic regression were done using IBM SPSS version 23.0.

Results: Most subjects were less than 30 years old (54.3%) and female (53.0%). Problem-focused engagement positively correlated with all QOL domains and associated negatively with depression (p<0.05). Emotion-focused engagement positively correlated with the psychological and environmental domains (p<0.05). Emotion-focused disengagement negatively correlated with the physical, psychological, and social domains and positively correlated with anxiety and depression (p<0.05). Problem-focused disengagement positively correlated with the psychological domain and negatively correlated with depression (p<0.05). In logistic regression, emotion-focused disengagement was the only predictor of psychiatric diagnosis (OR: 1.05, 95%, CI: 1.01-1.09).

Conclusion: Coping strategies are linked to life quality and mental wellness. More research is advocated to explore the observed interrelationship further.

Tetracycline and sulfonamide residues in commercial egg yolks in the north of Iran

Reza Abolghasemi , Arash Chaichi Nosrati, Leila Modiri , Mirsasan Mirpour

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-17

Background: Excessive and anachronous antibiotics using in the food industry and the production of livestock products has resulted in multidrug resistance (MDR) in bacteria against various antibiotics. This study aim was to investigate tetracycline and sulfonamide residues in commercial egg yolks.

Methods: Escherichia coli was extracted from 500 egg yolk samples of 37 Iranian brands and tested by phenotypic isolation method and resistance tests for tetracycline, sulfonamide, and nitrofurantoin antibiotics. DNA was extracted from 12 identified multidrug-resistant strains to investigate the molecular mechanism of MDR by PCR with specific primers for tetA, tetB, tetC, tetD, tetG, tetE, tetH, sul I, sul II, sul III, nfsA, and nfsB genes compared to control DNA (ATCC25922). Strains were using the cluster analysis by average Euclidean distance with Jaccard coefficient in SPSS-22.

Results: Examination of 12 antibiotic-resistant E. coli by PCR indicated that there were a limited number of resistance genes in the strains. From the group of resistant genes, St2 and St12 strains contained the highest gene number (three genes) and tetracycline-resistant genes were absent in aTcc, St8, St4, and ST3 strains. A maximum of one gene from the sulfonamide-resistant group and one gene for nitrofurantoin-resistance were detected among the studied strains. The highest susceptibility belonged to atcc, St3, and ST8 strains, which were grouped compared to other strains (P-value ≤ 0.05).

Conclusion: Manufacturers and managers of the food industry should particularly consider the risk of increased bacterial resistance to antibiotics and implement programs for resistance monitoring to protect human and animal health.

The outcomes of behavioral abnormalities of human resources of the Ministry of Health and Medical Education

Aaliyeh Mirzaei , Malikeh Beheshtifar, Mohammad Ziaaddini

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-11

Background: The last criterion for behavioral abnormality occurs outside social and cultural norms. The present study aimed to design a model of behavioral abnormalities of human resources of the Ministry of Health and Medical Education.

Methods: The outcomes were identified through library studies, and the fuzzy Delphi technique was used with the opinion of experts until we reached a theoretical consensus. First, 13 factors were confirmed using the opinion of 50 experts. Then, a questionnaire was designed based on the results of the first stage of the study, and the experts were asked to specify the importance of each identified stage using verbal variables. Then, the verbal variables were converted into fuzzy triangular numbers, and the triangular fuzzy mean was de-fuzzified using the Minkowski formula by Excel and SPSS-21 software.

Results: The members of the expert group reached a consensus on all components (dissatisfaction, drug abuse, alcohol consumption, reduction of motivation, moral corruption, malice and revenge, suicide, absenteeism, early and excessive leaves, theft and destruction of property, procrastination, arguments and physical violence, sexual harassment, violation of laws and character assassination and humiliation of colleagues). The de-fuzzified mean difference of experts' opinions in the two stages was less than 0.1, indicating the intensity of experts' agreement with each of the components of the conceptual model of the study.

Conclusion: Behavioral abnormality is one of the problems of today's organizations, and the development of behavioral models in organizations is one way to guide employees' behavior and prevent the occurrence of abnormal behaviors.

The role of intergenerational family in family functions and cultural values in Aligudarz, Iran in 2022

Mohsen Esmaeili , Omid Ali Ahmadi, Ali Roshanaei , Mohammad Hossein Asadi Davoodabad

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-9

Background: Based on diversified intergenerational living in urban Iran, this study was conducted to determine the role of intergenerational family in family functions and cultural values in Aligudarz.

Methods: This study was analytical cross-sectional based on questionnaire. The population were included over 18 years of age in Aligudarz, 376 people were selected as a sample using Cochran sampling by simple random sampling method. Library and survey methods were used to collect data. One-way analysis of variance and Pearson correlation tests were used to test the hypotheses.

Results: Elderly people have better family functions than others (P=0.011) and adhere more to cultural values. Elderly people have more management in family crises with f value of 3.140 (p=0.019). The correlation coefficient between family cohesion and family functions is 0.152 with a direct correlation (P=0.003). As the level of family cohesion increases, family functions also increase. There is a direct correlation between kinship relations and family functions (P=0.777, -0.015). There is no relationship between the level of kinship and family functioning.

Conclusion: It is possible to improve the current status given the level of adherence to cultural values, crisis management, and family cohesion, Kinship relationships among different generations, and the relationship between the variables of adherence to cultural values, crisis management and cohesion, and family functions.

Role of social responsibility on the employer's branding model in an organization

Kousar Shakeri , Karim Hamdi, Hossein Vazifehdust

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-13

Background: The main aim of this study was evaluating the role of social responsibility in the employer's branding model in the government organization of the Statistics Center of Iran.

Methods: This study was applied research and a mixed method. The research tools included semi-structured interviews and researcher-made questionnaires. The statistical population in the qualitative stage included 10 experts and managers of the Statistics Center of Iran, and in the quantitative stage, it included 340 managers and staff of the Statistics Center who were selected using Cochran's formula. The data were analyzed in the qualitative section by grounded theory method using Max QUDIA software MAXQDA2020, and in the quantitative section, they were analyzed by descriptive and inferential methods using SPSS 16 and Smart PLS software.

Results: In this study 340 people were analyzed. Fit tests showed that social responsibility plays an important role in the employer branding model of the Iran Statistics Center. All components with a factor load above 0.6 indicate that the model is "very desirable". Social responsibility is one of the essentials of employer branding and it is one of the important dimensions of the operational activities of organizations. The factor load of the components of "identity and credibility" was less than 0.3, these components were removed from the analysis.

Conclusion: Considering the importance of social responsibility as one of the requirements of employer branding and one of the important dimensions of operational activities of organizations, managers and decision-makers should pay attention to it.

The trend of relevance of value of accounting information: a study on pharmaceutical companies listed in the Tehran Stock Exchange

Norallah Khodadadi , Mehrdad Ghanbari, Babak Jamshidinavid , Javad Masudi

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-12

Background: Financial statements are one of the main ways for companies to communicate in order to provide financial and non-financial information to their stakeholders. The purpose of this research was to investigate the relevance of accounting information value. It was for pharmaceutical companies active in Tehran Stock Exchange.

Methods: This descriptive-correlational study was conducted on 26 pharmaceutical companies admitted to the stock exchange during the period of 2000 to 2019. The method of collecting information was based on two library models and the information included in the financial statements of the companies. To estimate the value relevance of accounting information in this study, the non-parametric method of classification and regression tree (CART) was used, which automatically includes non-linear relationships and interactions between variables, and simple linear regression was used to test the trend of value relevance.

Results: The results showed that the trend of relevance of the composite value of accounting information increased during the research period for pharmaceutical companies, but it was not statistically significant. The results of the relevance of the value of single variables show a decrease in the relevance of the value of known intangible assets, which includes goodwill and software, and an increase in the relevance of the value of alternative performance measures for pharmaceutical companies.

Conclusion: The relevance of the accounting information value of pharmaceutical companies allows investors to easily adjust their investment strategies in the Bahadra Stock Exchange and make informed decisions to achieve their goals and allocate resources to more profitable investments.

Background: Along with the increase in the use of social networks, the relationship between couples has undergone fundamental changes compared to the past. So that the bedroom or living room in a house is no longer considered a private place. This research aimed to study the relationship between addiction to social networks and marital satisfaction in Iran.

Methods: The current study was cross sectional. The study population included 185124 married women in Kerman, Iran. Using an available sampling method, 401 participants were selected. The study instruments included: The Enrich marital satisfaction scale and addiction to mobile-based social networks questionnaire. The collected information was analyzed by descriptive and inferential statistics.

Results: The results showed that 41.1% of the respondents entered the virtual space and connected to social networks while spending time with the family. Among the respondents, 62.8% use smartphones to connect to social networks in cyberspace. Findings showed that there is a significant and negative relationship between using social networks and marital satisfaction (r = -0/51, p<0/05). Components such as time management, personal performance and self-control, and social relationships had a significant effect on marital satisfaction (p<0/05). Also, demographic variables (duration of marriage and age difference between couples) were effective on marital satisfaction.  

Conclusion: The findings showed that there was a significant and negative relationship between the use of social networks and marital satisfaction. Components such as time management, personal performance and self-control, and social relations had a significant effect on marital satisfaction.

The relationship between entrepreneurship components and communication skills of managers: a structural equation modeling

Saeeid Hossein Abadi , Rostam Pourrashidi, Hamid Reza Mollaei , Mahdi Mohammad Bagheri

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-10

Background: The purpose of this study was to look into how managerial integrity and the elements of academic entrepreneurship relate to one another.

Methods: This research was descriptive-correlational in nature. 1832 people made up the statistical population of the survey, including management, staff, and faculty from Islamic Azad Universities in District 6. 315 individuals that were chosen using stratified random sampling made up the estimated sample size. Data collection method was an academic entrepreneurship questionnaire that included 23 questions and a managers’ good character questionnaire that included 26 questions. By using exploratory factor analysis, the dimensions of academic entrepreneurship were discovered, and the internal validity of the questionnaires was confirmed by Cronbach's alpha (higher than 0.7).

Results: The elements of academic entrepreneurship (organizational competencies, continuous contact, university aims and policies, entrepreneurial marketing, and culture) and the positive and substantial path coefficient (p = 0.001) were found to be significantly correlated.

Conclusion: The change in educational quality and the investigation of the effective parameters for encouraging entrepreneurship in academic settings were the key factors in increasing the willingness for entrepreneurship. If the willingness for entrepreneurship was associated with a good character, it can have positive results and effectiveness that can be used by managers.

Satisfaction of patients presenting to health insurance offices: using data mining method

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

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-10

Background: The quality of healthcare services can be determined by patient satisfaction as it affects the performance, sustainability, and durability of health services. The aim of this study was to analyze the satisfaction of patients presenting to health insurance offices by using the data mining method.

Method: A cross-sectional study was conducted on those who referred to the offices of the Health Insurance Organization (e.g., Kerman, Sistan and Baluchestan, Hormozgan and Yazd provinces) who were selected by non-random cluster sampling. A researcher-made questionnaire consisting of 79 items was used for data collection. Face and content validity of 0.86% was obtained using the views of five academic experts. Cronbach's alpha coefficient of the questionnaire was 0.966. Data were analyzed by SPSS-18 software.

Results: The studied variables regarding quality service indicators included speeding up the administration of affairs, non-discrimination between clients, empathy with clients, keeping clients' secrets, politeness and kindness, paying attention to the needs and wishes of clients. Access to information, raising awareness, payment of compensation, attention to the rights of the disabled, rule of law and clarification of matters and criticisms were in a favorable condition, and service quality is the only unfavorable indicator in health insurance offices.

Conclusion: Governments are required to respect people's rights regardless of skin color, race, religion, gender, and in the present study, the satisfaction of clients with the performance of insurance service offices was evident.

Letter to Editor

Review Article

A comparison of artificial intelligence algorithms in diagnosing and predicting gastric cancer: a review study

Hamed Mazreati, Reza Radfar, Mohammad-Reza Sohrabi, Babak Sabet Divshali, Mohammad Ali Afshar Kazemi

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-10

Today, artificial intelligence is considered a powerful tool that can help physicians identify and diagnose and predict diseases. Gastric cancer has been the fourth most common malignancy and the second leading cause of cancer mortality in the world. Thus, timely diagnosis of this type of cancer could effectively control it. This paper compares AI (artificial intelligence) algorithms in diagnosing and predicting gastric cancer based on types of AI algorithms, sample size, accuracy, sensitivity, and specificity.  This narrative-review paper aims to explore AI algorithms in diagnosing and predicting gastric cancer. To achieve this goal, we reviewed English articles published between 2011 and 2021 in PubMed and Science direct databases. According to the reviews conducted on the published papers, the endoscopic method has been the most used method to collect and incorporate samples into designed models. Also, the SVM (support vector machine), convolutional neural network (CNN), and deep-type CNN have been used the most; therefore, we propose the usage of these algorithms in medical subjects, especially in gastric cancer.

Spinal fusion surgery for high-risk patients: a review of hospitals information

Mohsen Rasoulivalajoozi, Ghada Touir

Social Determinants of Health, Vol. 9 (2023), 1 January 2023, Page 1-12

Background: Spinal fusion surgery (SFS) is commonly performed as an elective procedure in the United States that employs minimally invasive techniques; however, it possesses potential risks and side effects and is still considered an experimental treatment. As such, patients can often be hesitant when proposed SFS. In that regard, this study aimed to analyze and critique available SFS instructive materials, to account for the procedure’s potential risks for patients.  

Methods: We have reviewed information concerning surgical procedures and policies (pre-operative to postoperative) on 20 hospitals and medical center websites. All possible keywords regarding SFS were systematically arranged and considered in various ways. The collected data was assessed and compared to identify common themes.

Results: Our results indicate that, although some informational sources reaffirm each other’s materials, few provided key SFS details, such as potential candidates, outcomes, risks, and aftercare. Moreover, information was neither delivered systematically nor consistently, leading patients to feel anxious, fearful, or confused when making decisions involving SFS.

Conclusion: This paper recommends a comprehensive and interactive information system (IS) with a patient-oriented approach, which will facilitate patient decision-making and help people discern between factual data and false information supplied through social media or word of mouth. This information system could then be used for other elective procedures.