Social determinants of adherence to COVID-19 preventive guidelines: a comprehensive review

Adherence to coronavirus disease 2019 (COVID-19) preventive guidelines (ACPG) is an important strategy to control the COVID-19 pandemic effectively. The present study aimed to identify and summarize the social determinants of ACPG among the general population. A comprehensive review was performed from December 2019 to February 2021 through searching electronic databases. Two independent reviewers assessed and selected relevant studies. Next, the characteristics and main findings of the included studies were summarized. Finally, the World Health Organization’s conceptual framework of social determinants of health was used to synthesize the identified social determinants of ACPG. Forty-one of 453 retrieved articles met the inclusion criteria. The study results showed different patterns of ACPG among various communities. Furthermore, 84 social determinants were identified and categorized into structural and intermediary determinants. ACPG is a set of complex behaviors associated with different individual sociodemographic and behavioral characteristics; living and working conditions; COVID-19 knowledge, attitudes, and risk perceptions; exposure to sources and information level; leisure activities; social support; trust; social norms; psychosocial well-being; socio-economic position; and the socio-economic and political context. Interventions to promote ACPG among the general population should consider the identified social determinants of ACPG.

Inequalities in access to hospitals: a case study in the Islamic Republic of Iran 1997–2012

Background: Nowadays, the significance of applying Geographic information system (GIS) to survey accessibility to hospitals and understanding disparities in this regard has increased.

Aims: The main aim of this descriptive–analytical research was to study the spatial accessibility of the population of Kermanshah for 3 years 1997 (n=693157), 2007 (n=794863), and 2012 (n=851 405) to hospitals based on age and gender groups through GIS.

Methods: The study was conducted based on network analysis models, mean centre, and standard distance in the environment of Arc/GIS. A standard radius of 1500 metres was set for the medical centres, and a 25-minute walking span was set for the distance of each person from home to the nearest hospital.

Results: The results of the network analysis demonstrated that the hospitals were inaccessible to the populations according to our criteria, and their geographical access to hospitals measured 68.80%, 64.23% and 66.20% in 1997, 2007, and 2012, respectively. Women aged 65 years and above were more at risk in this regard.

Conclusions: Over the total period under study, the results revealed that hospitals were concentrated in the central and southern areas of Kermanshah

Mediator role of experiential avoidance in relationship of perceived stress and alexithymia with mental health

This cross-sectional study investigated the mediatory role of experiential avoidance in the relationship between perceived stress and alexithymia with mental health. We enrolled 440 students [age 18-30 years] at Kermanshah University of Medical Sciences through stratified random sampling method. The study tools were demographic checklist, GHQ-28, Toronto Alexithymia Scale-20 and Perceived Stress Scale. Data were analysed by SPSS-18 and AMOS-18 using Pearson correlation, hierarchical regression analysis and structural equation modelling [SEM]. There was a significant positive correlation between perceived stress and experiential avoidance, and alexithymia and mental health problems [P < 0.001]. SEM showed that the relationship between perceived stress and mental health problems by experiential avoidance was 0.19 [[beta = 0.19; standard error [SE] = 0.09; P = 0.001], and the relationship between alexithymia and mental health problems through experiential avoidance was 0.09 [beta = 0.09; SE = 0.43; P = 0.01]. The mediatory role of experiential avoidance was confirmed in such a way that the effects of alexithymia and perceived stress decreased

relationship between rural women's health-related quality of life and domestic violence

Nowadays, by development of societies, health related quality of life has become a very important issue. Traditionally for health assessment, some indexes such as; morbidity, mortality, and life expectancy, have been taken into consideration but these factors are not able to assess life satisfaction. The present study was aimed to investigate the relationship between rural women's health-related quality of life [HRQOL] and domestic violence. This cross-sectional study was carried out in the rural districts of Kermanshah, Iran, 2012. Using multistage cluster sampling, 394 women were selected. They completed WHOQOL-BREF and Conflict Tactics Scale [CTS] questionnaires. Data analyzed by SPSS 16, using Pearson correlation and regression tests. The mean scores of total QOL were 55.8 +/- 12.9. There was significant inverse correlation between domestic violence dimensions and all health-related quality of life domains [P < 0.01]. Domestic violence can affect rural women's health-related quality of life negatively. Regarding the hidden nature of domestic violence and its presence in all communities, taking into consideration policies to reduce violence through legal education and raising women awareness can positively affect women's quality of life

Perceived Stress, Alexithymia, and Psychological Health as Predictors of Sedative Abuse / 가정의학회지

BACKGROUND: The harmful effects of sedative medications and substances in conjunction with limited research regarding predictive psychological constructs of drug abuse necessitate further investigation of associated factors. Therefore, the present study aimed to elucidate the roles of perceived stress, alexithymia, and psychological health as predictors of sedative abuse in medical students. METHODS: In this cross-sectional study, 548 students at Kermanshah University of Medical Sciences, Iran, were selected using stratified random sampling. The data were obtained using the Perceived Stress Scale, an alexithymia scale (Farsi version of the Toronto Alexithymia Scale-20), and a General Health Questionnaire to assess psychological health. Data were analyzed using discriminant analyses. RESULTS: The results demonstrated that the user and non-user of sedative substances groups had significantly different predictive variables (except for social function disorder) (P>0.05). Physical complaints, alexithymia, and perceived stress, which had standard coefficients of 0.80, 0.60, and -0.27, respectively, predicted sedative drug use. CONCLUSION: The results of the present study indicate that perceived stress, alexithymia, physical complaints, anxiety, and depression are associated with sedative drug abuse.