Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Statistical Methods for Health Care Research

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Preventing Chronic Diseases: A Vital Investment

This article suggests that while mental health problems affect 10—20% of children and adolescents worldwide, the mental health needs of children and adolescents are neglected, especially in low-income and middle-income countries. The authors review the evidence and the gaps in the published work in terms of prevalence, risk and protective factors, and interventions to prevent and treat childhood and adolescent mental health problems.

Child and adolescent mental health worldwide: evidence for action

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Health Behavior And Health Education Theory Research And Practice

Considering the epidemic of corona disease in the world and the importance of paying attention to pregnant women as one of the most important vulnerable groups, it is felt necessary to conduct studies and properly teach them preventive behaviors. Therefore, the present study was conducted with the aim of investigating the factors influencing the prevention of covid-19, based on the Protection Motivation Theory (PMT), among pregnant women. This cross-sectional study was conducted during 2020 with the participation of 231 pregnant women who referred to the comprehensive health service centers of Langrod city, who were selected by simple random sampling. The tool of data collection was a questionnaire consisting of two sections of demographic information and PMT constructs. According to the results, 10.32% reported a history of Covid-19 infection. Carrying out protective behaviors, such as using a mask (94.4 percent), washing hands frequently with soap and water (88.8 percent), maintaining a distance of at least one and a half meters from other people (84.5 percent) in a favorable position and avoiding. The participation in the periods (71.4 percent) was relatively favorable. The result of linear regression analysis showed that perceived self-efficacy (β=0.450) and perceived response effectiveness (β=0.305) were predictors of protective motivation or intention to perform protective behaviors against Covid-19. Also, 66.7% of women were on the path of perceived risk. The PMT can be used as a framework in designing educational programs in order to perform preventive behaviors against infectious diseases such as Covid-19.

Factors Affecting Prevention Behaviors Against Covid-19 Infection Among Iranian Pregnant Women: Application of Protection Motivation Theory

The protection motivation theory is a common framework illustrating the use of protective behaviours. The aim of this study was to develop and evaluate the psychometric properties of the protection motivation theory questionnaire for fall prevention in older people in Iran. This study used a psychometric design. A literature review was initially performed and developed a 35-item questionnaire consisting of eight sub-constructs of the protection motivation theory. A panel of experts and a group of older people aged 60 years or above were invited to assess the content and face validity of the questionnaire. Thereafter, construct validity was evaluated by using confirmatory factor analysis. The reliability of the questionnaire was examined using test–retest reliability and internal consistency. Data analysis was performed using the partial least squares path modelling version three software. A total of 300 people living in retirement centres completed the questionnaire. In the expert panel review, all tasks received a content validity index above 0.90 and a content validity ratio above 0.80, representing good content validity. In total, 32 items remained in the final version of the questionnaire. Confirmatory factor analysis confirmed an acceptable eight-factor model fit of the protection motivation theory sub-constructs with factor loadings from 0.59 to 0.93. The discriminant validity was verified using the Fornell–Larcker criterion. The Cronbach's alpha ranged from 0.68 to 0.90 and the test–retest reliability ranged from 0.78 to 0.90, displaying an acceptable result. The results of this study suggest that the protection motivation theory questionnaire had good validation and can be used to measure the psychological predictors of fall behaviour in older people. Further studies are needed to evaluate the validity in various settings.

Development and validation of the Iranian version of the protection motivation theory questionnaire for fall prevention in older people

Background: The present study was conducted to assess the determinants of the intention to receive the COVID-19 vaccination among the Iranian population. Methods: In this cross-sectional study, 1,056 individuals of the general population living in Hamadan County were studied from April to June 2021. Using a proportional stratified sampling method, subjects were selected from those covered by 34 comprehensive health service centers and health bases. Then, the subjects were selected by simple random sampling. Data were collected by sending a questionnaire link to eligible individuals, who completed it online. The questionnaire determined demographic data and constructs of the Theory of Planned Behavior. Results: 1,056 subjects answered the study; women accounted for 57.9% of the respondents. According to the findings, the majority of respondents (79.5%) reported that they would strongly agree and agree to get vaccinated against COVID-19. Older age, male gender, occupation, underlying chronic disease, death of relatives and friends due to COVID-19, and history of influenza vaccinations were significantly related to the intention to get vaccinated against COVID-19 (P>0.05). Also, the intention was associated with increased scores in the attitude toward the behavior, subjective norm, and perceived behavioral control. Conclusion: Despite doubt about the details of the intention to receive COVID-19 vaccination, most subjects reported intending to be vaccinated against COVID-19, but the real rate of vaccination may be lower. Vaccination intention reflects overall vaccination attitudes, subjective norms, and perceived behavioral control.

Saeed Bashirian

Papers

Factors Affecting Prevention Behaviors Against Covid-19 Infection Among Iranian Pregnant Women: Application of Protection Motivation Theory

Development and validation of the Iranian version of the protection motivation theory questionnaire for fall prevention in older people

Predictors of COVID-19 vaccination intention among Iranian population: applying the theory of planned behavior

The Effects of Educational Intervention Based on the Health Belief Model on Improving Foot Self-Care Behaviors in Older Adults