A Predictive Model of Spiritual Well-Being Based on Belief in a Just World Mediated by the Positive and Negative Affects in University Students

Background: Spiritual well-being is crucial in human health and reduces anxiety and depression. Therefore, identifying its underlying variables can improve individuals’ health. Objectives: This study aimed to predict a model of spiritual well-being based on belief in a just world mediated by positive and negative effects in university students of Tehran. Methods: This was a descriptive correlation study performed through path analysis. The statistical population consisted of students studying at different universities of Tehran during 2020 - 2021. The research sample comprised 301 university students (199 female and 102 male). The participants completed the Spiritual Well-Being Scale, Belief in a Just World Scale, and Positive and Negative Affect Schedule (PANAS). The model was evaluated using path analysis in AMOS 24.0. Results: The results showed that the path coefficient between positive affect and spiritual well-being was positive and significant, and the path coefficient between negative affect and spiritual well-being was negative and significant (P < 0.001). The total path coefficient between the belief in a just world (BJW) and spiritual well-being was positive and significant, and the path coefficient between the belief in an unjust world (BUW) and spiritual well-being was negative and significant (P < 0.001). Furthermore, there was a significant positive indirect path coefficient between BJW and spiritual well-being (P < 0.001). Accordingly, the positive and negative affects played positive mediating roles between BJW and spiritual well-being. Conclusions: Based on the findings of the present study, it can be concluded that BJW, positive effects, and strengthening them can enhance the level of spiritual well-being and reduce the students’ negative effect, anxiety, and depression levels.

The Antibiotic Resistance Pattern and Prevalence of blaTEM, blaSHV, blaCTX-M, blaPSE-1, sipB/C, and cmlA/tetR Genes in Salmonella typhimurium Isolated from Children with Diarrhea in Tabriz, Iran

Background: Salmonella gastroenteritis is a global health concern. Recently, increased resistance to Salmonella typhimurium has been reported in several countries. Objectives: The present study aimed to evaluate the prevalence of blaTEM, blaSHV, blaCTX-M, blaPSE-1, sipB/C, and cmlA/tetR genes in S. typhimurium isolates and determine their antibiotic resistance. Methods: This cross-sectional descriptive study was conducted on 110 fecal samples, which were collected from the patients referred to the hospitals and medical centers in Tabriz, Iran during eight months. After phenotypic identification, the antibiogram test and double-disc synergy test were performed on the isolates. Following that, the prevalence of resistance genes was evaluated using multiplex PCR and specific primers. Results: Out of 110 fecal samples, 26 samples (23.63%) were positive for S. typhimurium. The highest resistance of the isolates was against ceftazidime, cefotaxime, amikacin, and tetracycline (100%), and the lowest resistance was against imipenem (3.85%) and nalidixic acid (7.69%). In total, 15 S. typhimurium isolates (57.69%) were positive for the extended-spectrum beta-lactamases. In addition, the most common resistance genes in the isolates were cmlA/tetR (38.46%), blaTEM (34.61%), and blaCTX-M (26.92%). Four isolates (15.38%) carried sipB, three isolates (11.53%) contained blaSHV, and two isolates (7.69%) carried blaPSE-1. Conclusions: The obtained results indicated the high prevalence of antibiotic-resistant S. typhimurium. Therefore, the identification of resistance genes is an important strategy for identifying and counteracting antibiotic resistance.

The Correlation of Self-esteem and Depression in the Students of Kermanshah University of Medical Sciences, Iran

Background: Depression is a common mental disorder, and one of the symptoms is low self-esteem. The study of depression and its correlation with self-esteem in students is paramount. Objectives: The present study aimed to determine the correlation between self-esteem and depression in the students of Kermanshah University of Medical Sciences (KUMS), Iran. Methods: This descriptive-analytical, cross-sectional study was performed on 308 students of KUMS in 2018. Data were collected using the questionnaire of self-esteem and Beck depression inventory. The participants were selected via stratified sampling. Data analysis was performed using Chi-square and Mann-Whitney U test. Results: A significant correlation was observed between self-esteem and depression in the students (P < 0.01). Furthermore, significant associations were denoted between self-esteem, marital status, and interest in the field of study. However, no significant correlations were observed between self-esteem, depression, gender, grade point average, major, education level, and the place of residence. Conclusions: Due to the correlation between high self-esteem and the lower prevalence of depression in students, it is suggested that students' self-esteem be improved by conducting the necessary interventions, such as lifestyle modification, nutrition, and physical activity.

Equity in Out-of-Pocket Payments for Healthcare Service Delivery in Urban and Rural Households: Evidence from Iran

Background: Out-of-pocket payments for medical services may undermine access to medical services and equity in healthcare financing. Objectives: The present study aimed to determine the distribution of the burden of out-of-pocket payments for healthcare services among the households in Qazvin province, Iran. Methods: This descriptive-analytical study was conducted on the urban and rural households in Qazvin province, Iran during 2019 - 2020. Data were obtained from the Statistics Center of Iran (2019 - 2020). The optimal sample size was calculated to be 992 households, and the households were selected via three-stage random cluster sampling. Data were collected using a valid questionnaire and via face-to-face interviews with the household owners. The fair financial contribution index (FFCI), concentration index, and Kakwani index were estimated in the Stata software. Results: The estimated parameters indicated that during the study period (March 21, 2019-March 20, 2020), the FFCI value of the rural and urban households was 0.782 and 0.854, respectively. The out-of-pocket payment concentration index based on income rank was estimated at 0.188 in rural households (P < 0.05) and 0.031 in the urban households. In addition, the Kakwani index of the urban and rural households was calculated to be -0.165 and -0.84, respectively. Conclusions: According to the results, out-of-pocket payments were unequally distributed among the households in Qazvin province in 2019 - 2020. These payments were mostly concentrated on the 5th - 7th deciles of urban households. On the other hand, the out-of-pocket payments during the study period were regressive. To promote financial equity, Qazvin health policymakers must run payment exemptions for low-income groups and also expand the medical insurance coverage and universal coverage of healthcare services.

Effects of Schema Therapy for Children and Adolescents on the Externalizing Behaviors of the Adolescents Referred to the Counseling Centers in Ahvaz, Iran

Background: Internalizing and externalizing behaviors often emerge during adolescence. Early interventions could prevent severe or chronic mental health issues such as depression, suicidal tendencies, crime, and social harm, thereby potentially mitigating their adverse consequences. Objectives: The present study aimed to investigate the effects of schema therapy for children and adolescents (ST-CA) on the externalizing behaviors of the adolescents referred to the counseling centers in Ahvaz, Iran. Methods: This quasi-experimental study was conducted with a pretest-posttest design and a control group. The sample population included adolescents aged 12 - 14 years with behavioral, educational, and mood problems who were referred to the counseling centers in Ahvaz, Iran in 2020. In total, 30 adolescents were selected via convenience sampling and randomly divided into two groups of experimental and control (15 per each). The experimental group received 14 sessions of ST-CA (120-minute weekly sessions). Data were collected using the child behavior checklist. Data analysis was performed in SPSS version 26.0. Results: In the experimental group, the mean scores of externalizing behaviors at the pretest and posttest were 70.52 ± 6.11 and 58.27 ± 4.80, respectively. The mean score of aggression in the experimental and control groups at the posttest was 57.60 ± 3.83 and 64.20 ± 7.41, respectively. The mean score of rule-breaking in the experimental and control groups at the posttest was 55.53 ± 6.10 and 61.07 ± 7.63, respectively. ST-CA could significantly alleviate the externalizing behaviors of the subjects, such as aggression and rule-breaking (P < 0.001). Conclusions: According to the results, ST-CA could effectively decrease externalizing behaviors. Therefore, this approach should be incorporated into the interventions designed for these cases. Our findings could lay the groundwork for further investigation in this regard.

The Mediating Role of Mathematics Self-Concept in the Association of Self-esteem and Classroom Environment Perceptions with Math Anxiety in Students

Background: Math anxiety (MA) emerges as a state of discomfort and anxiety when a student is faced with a math problem. Objectives: The present study aimed to investigate the association between self-esteem and classroom environment perceptions with math anxiety through the mediating role of mathematics self-concept (MSC) in female high school students. Methods: This descriptive-correlational study was conducted on all the female high school students in Ahvaz, Iran in the academic year 2020 - 2021. In total, 237 students were selected as the sample population via single-stage cluster sampling. Data were collected using the Math Anxiety questionnaire (MAQ), Self-Esteem questionnaire (SEQ), Dundee Ready Educational Environment measure (DREEM), and Mathematical Self-Concept questionnaire (MSCQ). The proposed research model was evaluated using structural equation modeling. Results: With the exception of self-esteem and classroom environment perceptions (CEPs), all the direct paths were significantly correlated with MA (P = 0.001). Moreover, the indirect paths of self-esteem were significantly correlated with MA considering the mediating role of MSC (β = -0.240; P = 0.002). Furthermore, a significant association was observed between CEP and MA, mediated by MSC (β = -0.129; P = 0.001). Conclusions: According to the results, the proposed model had a good fit and could be an important step in identifying the influential factors in the MA of students.

Face Mask Consumption and Medical Waste Generation During the COVID-19 Pandemic in Iran: Challenges and Problems

Background: The outbreak of COVID-19 has caused a devastating pandemic scenario in the world. The mortality rate has increased and new socio-economic challenges are emerging. Millions of gloves, gowns, face masks, and face shields are used daily to prevent airborne transmission and facilitate the treatment of COVID-19. Mismanagement of these wastes can lead to increased concerns due to their contamination potential. A comprehensive plan to improve the management of medical wastes in every country requires awareness of the current status of solid waste. As a result, the study aimed to calculate and estimate the consumption rate of face masks and medical waste generation rate during the COVID-19 pandemic in Iran. Also, the performance of different departments of medical waste management and future challenges are discussed. Methods: The daily consumption of face masks and medical waste generation were calculated based on the population data, the percentage of the urban population, face mask acceptance rate, the number of face masks needed per person per day, total COVID-19 confirmed cases, and medical waste generation rate (kg/bed/day). Results: The consumption of face masks in Iran is estimated at 46576000 pieces per day. Also, the three provinces of Tehran (9,560,000 pieces), Khorasan Razavi (3,825,600 pieces), and Isfahan (3,523,200 pieces) have the highest consumption rate of masks, respectively. Increasing the number of confirmed COVID-19 cases has increased the medical waste generation rate. Until April 3, 2021, more than 1,920,394 cases of COVID-19 have been confirmed in Iran, and calculations show that the medical waste generation rate in Iran is about 7,585.56 tons per day. Conclusions: COVID-19 is a highly infectious and problematic disease. The continuous increase in the number of confirmed COVID-19 cases has increased face mask consumption rate and medical waste generation rate, and as a result, new challenges have emerged in the field of solid waste management. These emerging challenges in managing solid waste during the COVID-19 pandemic necessitate the development of appropriate waste management policies and strategies.

Effect of Virtual Nutrition Training Based on the Health Belief Model on the Awareness of Patients with Type II Diabetes

Background: Various teaching methods could be used to reduce complications in diabetic patients. Objectives: The present study aimed to assess the effect of nutrition training based on the health belief model (HBM) and electronic methods on the awareness of patients with type II diabetes in Kermanshah, Iran in 2012. Methods: This quasi-experimental study was conducted at a diabetes clinic in Kermanshah City. In total, 60 patients were selected via convenience sampling and divided into three groups of 20, including SMS, blog, and collaborative blog. Data were collected before, immediately after, and three months after the educational intervention using a standard questionnaire. Data analysis was performed in SPSS version 16 using the Kruskal-Wallis test, Friedman’s test, and analysis of variance (ANOVA) at the significance level of 0.05. Results: The mean score of awareness was considered significant (P < 0.01). In addition, significant differences were observed in the perceived sensitivity and barriers, cue to action, and self-efficacy in the blog group (P < 0.05) before and three months after the intervention. In the collaborative blog group, a significant difference was denoted in the perceived severity and cue to action before and three months after the intervention (P < 0.05). Cue to action also differed significantly in the SMS group, and the self-efficacy score significantly changed only in the blog group after the intervention (P = 0.006). Conclusions: According to the results, using blogs, group/collaborative blogs, and SMS could effectively increase the awareness of the diabetic patients. Therefore, virtual training could enhance the structures of the HBM, with the exception of the perceived sensitivity domain.

Psychometric Properties of the Persian Version of the Observable Social Cognition Rating Scale (OSCARS)

Background: Social interactions require social cognition. Social cognition and its shortcomings could be assessed by questionnaires and interviews. Objectives: The present study aimed to examine the psychometric properties of the Persian versions of the Observable Social Cognition Rating scale (OSCARS) in students. Methods: This correlational study was conducted on 250 male and female students at the high schools of Dezfoul, Iran during 2019 - 2020. The participants were selected via multistage random sampling. The reliability, congruent validity, and concurrent validity of the Persian version of the OSCARS were evaluated using the teacher’s form of the OSCARS and the cognitive abilities questionnaire. The validity of the OSCARS was measured by confirmatory factor analysis, and its congruent validity and reliability were measured using the Cronbach’s alpha and split-half method. Results: The Cronbach’s alpha value of the entire scale, teacher’s form, and cognitive abilities questionnaire was 0.65, 0.60, and 0.85, respectively. The split-half coefficient for the entire scale was estimated at 0.60, and the correlation between the OSCARS and the teacher’s form was 0.35. Moreover, the correlation between the OSCARS and cognitive abilities questionnaire with the social cognition subscale was 0.15 and 0.13, respectively. The results of confirmatory factor analysis indicated the excellent fitness of the OSCARS structure (RMSEA = 0.02). Conclusions: According to the results, the Persian version of the OSCARS has good reliability and validity.