Predictors of performing preventive behaviors against affliction with COVID-19 based on vaccination: An application of the health belief model.

BACKGROUND: Nowadays, the COVID-19 pandemic has become one of the greatest global threats to human communities. Presently, the most important solution to deal with this pandemic is to fully comply with health protocols along with general vaccination. Given the increased vaccination rate in the community and the change in the thought of some people in the field of durable immunity and changing health behaviors, the present study determined the predictors of preventive behaviors against affliction with COVID-19 in two vaccinated and non-vaccinated groups based on the health belief model in the Iranian population aged 15-65 years. MATERIALS AND METHODS: This descriptive-analytical study was conducted cross-sectionally in 2022. A sample size of 500 Yazdi citizens was selected using the convenience non-random sampling method using the contact numbers received from the SIB system of the Iranian health deputy. They were examined online in two vaccinated and unvaccinated groups. The instrument used was Delshad Noghabi et al.'s questionnaire which was based on the health belief model. Due to the adjustment of the questionnaire according to the target group, its validity and reliability were re-checked and confirmed. Data were analyzed with SPSS22 using descriptive and analytical statistics, t-test, and linear regression. RESULTS: Based on the findings of the study, a significant difference was observed between the three variables of income level (P = 0.019), smoking (P <0.001), and employment status (P = 0.025) in two vaccinated and unvaccinated groups at the level of preventive behaviors. Besides, the constructs of perceived sensitivity (P <0.001), perceived benefits (P <0.001), action guide (P <0.001), and self-efficacy (P = 0.018) significantly predict preventive behaviors, so that the predictive value of perceived benefits (ß =3.67) was more than other variables. CONCLUSION: To prevent diseases, it is very important to increase people's awareness and information (self-efficacy) about the use of vaccination and pay attention to individual demographic characteristics in vaccination programs. Also, perceived sensitivity, perceived benefits, action guidelines, and perceived self-efficacy can be considered as important factors in determining people's willingness to be vaccinated. Therefore, education and information programs should be focused on these factors to increase people's willingness to be vaccinated.

Promises and Pitfalls of Calcineurin Inhibitors in COVID-19: A Systematic Review and Meta-analysis of Controlled Trials.

OBJECTIVE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a violent attack on the body that leads to multi-organ failure and death in COVID-19 patients. The aim of this study was to systematically review the existing literature on the potential benefits of calcineurin inhibitors (CIs) as anti-vascular endothelial growth factor (VEGF) agents in improving the clinical outcomes of COVID-19 patients. METHODS: We searched various databases, including PubMed, Scopus, ISI Web of Science, Google Scholar, Cochrane databases, and ClinicalTrials.gov from 31st December, 2019, to 3rd February, 2023, for relevant controlled trials. The quality of the evidence was assessed using the Cochrane Collaboration tool. Comprehensive Meta-Analysis Software was used for the statistical analyses using a random-effects model. RESULTS: Three trials enrolling 293 participants were reviewed in the present systematic review and meta-analysis. The results showed CIs to lead to a significant reduction in mortality rate [risk ratio (RR): 0.598, 95% CI: 0.404-0.885, P-value = 0.010] with a low between-study heterogeneity (Cochrane Q test: I2 = 0.000%, P-value = 0.371). Pooled analysis of two studies (84 patients) illustrated that CIs could not significantly increase the rate of hospital discharge (RR: 1.161, 95% CI: 0.764-1.764, P-value = 0.485) and heterogeneity was not significant (Cochrane Q test: I2 = 26.798%, P-value = 0.242). CONCLUSION: CIs are able to inhibit the virus nucleocapsid protein so that they can prevent replication and respiratory tract tissue damage caused by SARS-CoV-2. Based on the characteristics mentioned in detail, CIs can play a potential therapeutic role for COVID-19 patients.

Investigating the effect of oral synbiotic on enteral feeding tolerance in critically ill patients: A double-blinded controlled clinical trial of gut microbiota.

BACKGROUND: Probiotics are beneficial live microorganisms that can modify the gut microbiota. It is assumed that they help improve enteral feeding intolerance (EFI) and nosocomial infections in critically ill patients. The present clinical trial aimed to investigate the efficacy of synbiotics in improving EFI and oropharyngeal aspiration in patients admitted to the intensive care unit (ICU). METHODS: This randomized clinical trial was conducted on 105 critically ill patients admitted to the ICU of a tertiary referral hospital affiliated with a medical university. The patients were randomly assigned to either a synbiotic or control group and underwent 7 days of investigation. The primary end point was reduced gastric residual volume, which is suggestive of an improvement in EFI. The secondary end point included requirement for prokinetics, frequency of aspiration, duration of mechanical ventilation, length of ICU stay, and level of consciousness. RESULTS: The present clinical trial showed that synbiotic intervention has resulted in a significantly diminished requirement for prokinetics (P = 0.019), fewer oropharyngeal aspirations (P = 0.01), improved volume of bolus administration, and decreased gastric residual volume during the 7-day follow-up period. The patients who received synbiotic had an improved level of consciousness (P = 0.01). CONCLUSION: This clinical trial showed that the prescription of synbiotic from the initial days of enteral feeding has resulted in a significantly diminished requirement for prokinetics, less oropharyngeal aspiration, decreased gastric residual volume, improved volume of bolus administration, and hence, better tolerance of enteral feeding.

A characterization of cortisol level and adrenal reservation in human cardiopulmonary arrest: systematic review and meta-analysis.

BACKGROUND: Cardiopulmonary arrest (CPA) is an urgency, which is associated with high mortality. This systematic review evaluated the relationship between baseline cortisol level and the outcome of resuscitated CPA patients. METHODS: We searched the following databases: PubMed, Scopus, ISI Web of Science, and Google Scholar. Relevant observational and controlled trials were explored from inception by April 2020. The quality of the articles was assessed using the Newcastle-Ottawa Scale (NOS). RESULTS: Finally, five cohort studies (n = 201 participants in total) were eligible for including in the meta-analysis. The results of this meta-analysis showed that although the baseline serum cortisol levels were higher in survivors of cardiac arrest compared with non-survivors, the differences between groups do not reach a significance level (Hedges' g = 0.371, 95% CI, -0.727, 1.469, P value = 0.508). Between-study heterogeneity was statistically significant (Cochrane Q test: P value < 0.001, I2 = 89.323). CONCLUSIONS: The result of the present meta-analysis was suggestive of a higher baseline serum cortisol levels in survivors of CPA. Future randomized controlled studies with a large sample size will determine the exact relationship between adrenal reservation and the eventual outcome of patients with CPA. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018085468.

Design and psychometric evaluation of schools' resilience tool in Emergencies and disasters: A mixed-method.

BACKGROUND: In addition to their educational role, resilient schools have a good capacity in response to disasters. Due to the large student population, the schools can be a safe and secure environment during disasters, in addition to maintaining their performance after. Given the role and importance of the schools, the impact of culture and environment on resilience, without any indigenous and comprehensive tool for measuring the resilience in Iran, the study aimed to design and psychometrically evaluate the measurement tools. METHOD: This study was conducted using a mixed-method sequential explanatory approach. The research was conducted in two main phases of production on items based on hybrid model and the psychometric evaluation of the tool. The second phase included validity (formal, content and construction) and reliability (multiplex internal similarity, consistency and reliability). RESULT: The integration of systematic and qualitative steps resulted in entering 91 items into the pool of items. After formal and content validity, 73 items remained and 44 were omitted in exploratory factor analysis. A questionnaire with 5 factors explained 52.08% of total variance. Finally, after the confirmatory factor analysis, the questionnaire was extracted with 29 questions and 5 factors including "functional", "architectural", "equipment", "education" and "safety". Internal similarity and stability in all factors were evaluated as good. CONCLUSION: The result showed that the 29-item questionnaire of school resilience in emergencies and disasters is valid and reliable, that can be used to evaluate school resilience. On the other hand, the questionnaire on assessment of school resilience in disasters enables intervention to improve its capacity.