Category: Statistics

Malays J Med Sci. 2024 Jun;31(3):149-159. doi: 10.21315/mjms2024.31.3.11. Epub 2024 Jun 27.

ABSTRACT

BACKGROUND: Existing research indicated a high prevalence of mental health issues among adolescents. Gender and parenting styles are two factors that may influence adolescents’ mental health. Nonetheless, most published studies focused on either secondary school or university students. In contrast, there is a dearth of similar research involving pre-university students. This study aimed to determine the prevalence of mental disorders among pre-university students and their association with parenting styles.

METHODS: A cross-sectional study via online questionnaire survey was conducted among students from a pre-university college on the East Coast of Malaysia. Convenience sampling was used to recruit the participants. The questionnaire consisted of three parts: i) sociodemographic data, ii) the Parental Authority Questionnaire and Depression, and iii) the Anxiety and Stress Scale (DASS-21). An online invitation to answer the questionnaire was done via the Student Representative Council (SRC). Data were analysed using descriptive statistics and Pearson’s chi-square test.

RESULTS: A total of 431 participants responded to the online survey. The prevalence of depression, anxiety and stress was 49.0% (n = 210), 68.0% (n = 293) and 37.6% (n = 162), respectively. In addition, father’s educational level (χ² = 10.332, P = 0.001) and the authoritarian parenting style (χ² = 10.099, P = 0.006) were significantly associated with mental health disorders among adolescents.

CONCLUSION: The prevalence of mental disorders among pre-university students is relatively high. Pre-university admission mental health screening is vital for early detection and intervention of mental disorders among this vulnerable group. Further research is imperative to establish a comprehensive plan of action that targets parental involvement in managing adolescent mental health disorders.

PMID:38984249 | PMC:PMC11229572 | DOI:10.21315/mjms2024.31.3.11

Malays J Med Sci. 2024 Jun;31(3):173-184. doi: 10.21315/mjms2024.31.3.13. Epub 2024 Jun 27.

ABSTRACT

OBJECTIVE: To explore regional differences (i.e. Europe, Asia and others) in the well-being of para-athletes and its potential psychosocial determinants, including the Athletic Identity Measure Scale (AIMS), the Brief Resilience Scale (BRS) and the Satisfaction with Life Scale (SWLS).

METHODS: The study was a cross-sectional survey using data from multinational badminton federations. The study participants were athletes registered in the Para Badminton Classification Master List of the Badminton World Federation (BWF). The main study outcome is the WHO Quality of Life-Disability Questionnaire (WHOQOL-DIS).

RESULTS: There were 1,385 (aged 36 years old, IQR 18 years old) registrants on the master list. Respondents totaled 170. Only 137 (65% were males) were included in the analysis after excluding those with missing data (Europe 40%, Asia 30%, others 30%). Following the results of factor analysis, the original Athletic Identity Measure Scale (AIMS) was separated into self-identity (SI) and AIMS-modified. SI, AIMS-modified, the BRS and the Satisfaction with Life Scale (SWLS) were all scored above average. The AIMS-modified scores of Europeans were significantly lower than those of other non-Asians (U = 757.000, P < 0.05). BRS was statistically higher among those with acquired disabilities (median: 3.33) compared to those with congenital disabilities (median: 3.0) (U = 1,717.000, Z = –2.711, P < 0.05) and among Europeans (median: 3.3) compared to Asians (median: 3.0) (U = 704.500, P < 0.05). The regression model explained 32% of the variability in quality of life (QOL) with five significant predictors. The SWLS (β = 0.307, P = 0.01), BRS (β = 0.269, P = 0.01), full-time employment (β = 0.191, P = 0.05) and being female (β = 0.162, P = 0.05) all had a positive effect on QOL, but not the AIMS (–0.228, P = 0.05).

CONCLUSION: The results show that the athletes’ resilience, satisfaction with life and identity vary across regions. Furthermore, satisfaction with life, employment and gender were found to be significant predictors of athletes’ QOL.

PMID:38984248 | PMC:PMC11229559 | DOI:10.21315/mjms2024.31.3.13

Malays J Med Sci. 2024 Jun;31(3):241-251. doi: 10.21315/mjms2024.31.3.19. Epub 2024 Jun 27.

ABSTRACT

BACKGROUND: In the world of sports, motivation is an essential concept that can affect the sporting performance of athletes and help them accomplish their goals. The coach is regarded as an important individual with the ability to significantly influence the athlete’s motivation. To assess the impact of the coach-athlete relationship on motivation, the objective of this study was to evaluate the psychometric properties of the Malay version of the Coach-Athlete Relationship Questionnaire (CART-Q) for coaches and athletes.

METHODS: A cross-sectional survey was conducted among the coaches and athletes in Malaysia. Data were collected using a convenience sampling approach over a 6-month period. The study was carried out in two phases using two independent samples of coaches and athletes to assess the construct validity and internal consistency of the Malay version of the CART-Q. The CART-Q consisted of 11 items measuring three constructs: i) closeness (four items), ii) commitment (three items) and iii) complementarity (four items). In phase 1, the subjects consisted of 211 coaches (21 years old-65 years old) from both sexes and from individual and team sports, ranging from levels 1 to 5. In phase 2, the subjects consisted of 362 athletes (12 years old-39 years old), also from both sexes and from individual and team sports. The statistical analyses performed included confirmatory factor analysis (CFA) to validate the translated version scale, composite reliability (CR), average variance extracted (AVE) and internal consistency (Cronbach’s alpha).

RESULTS: In phase 1, the sample of coaches, with 190 males (90.0%) and 21 females (10.0%), had a mean age of 38.6 (SD = 8.74) years old. The major sport type was archery (19.0%). The CFA revealed adequate fit indices with all 11 items retained (root mean square error of approximation [RMSEA] = 0.059, comparative fit index [CFI] = 0.964, Tucker and Lewis Index [TLI] = 0.950, standardised root mean square residual [SRMR] = 0.037). The CR values were closeness = 0.874, commitment = 0.566 and complementarity = 0.757. The AVE values were closeness = 0.357, commitment = 0.194 and complementarity = 0.275. The Cronbach’s alpha values were closeness = 0.867, commitment = 0.553 and complementarity = 0.794. In phase 2, the sample of athletes, with 175 males (48.1%) and 189 females (51.9%), had a mean age of 20.2 (SD = 3.35) years old. The major sport type was archery (11.5%). The CFA revealed satisfactory fit indices with all 11 items retained (RMSEA = 0.092, CFI = 0.948, TLI = 0.924, SRMR =.038). The CR values were closeness = 0.893, commitment = 0.786 and complementarity = 0.949. The AVE values were closeness = 0.401, commitment = 0.253 and complementarity = 0.418. The Cronbach’s alpha values were closeness = 0.900, commitment = 0.772 and complementarity = 0.900.

CONCLUSION: Overall, the study findings supported the conclusion that the Malay version of the CART-Q has adequate psychometric properties to assess the perceptions of coaches and athletes regarding their relationship.

PMID:38984247 | PMC:PMC11229560 | DOI:10.21315/mjms2024.31.3.19

Malays J Med Sci. 2024 Jun;31(3):229-240. doi: 10.21315/mjms2024.31.3.18. Epub 2024 Jun 27.

ABSTRACT

BACKGROUND: This study sought to compare the prevalence of underweight and overweight among ever-married, non-pregnant women of reproductive age in Bangladesh by urban or rural residency status.

METHODS: This study used Bangladesh Demographic and Health Survey (BDHS), 2017 data. Cross-sectional study design with two-stage stratified sampling method was employed. A sample of ever-married non-pregnant women of reproductive age was selected and multinomial logistic regression was utilised in analysis.

RESULTS: It was found that around half of rural women (45.0%, N = 4,934) and more than half of urban women (60.3%, n = 3,913) were overweight. Nearly one in seven rural women (14.0%, n = 1,537) and 1 in 12 urban women (9.0%, n = 564) were reported as underweight. Our analyses revealed that being overweight was substantially connected with age, husband’s occupation, economic status, television access, and division for both urban and rural areas. Women from poor households were significantly more likely to be underweight than women from middle- income households for both urban (P < 0.05; OR: 1.41; 95% CI: 1.03, 1.94) and rural (P < 0.05; OR: 1.23; 95% CI: 1.04, 1.46) areas. Interestingly, women without television access both in urban (P < 0.001; OR = 0.78; 95% CI: 0.67, 0.91) and rural (P < 0.001; OR = 0.75; 95% CI: 0.68, 0.84) areas had an inverse association with overweight/obesity compared to women with television access. In both areas, women in Sylhet and Mymensingh had higher likelihood of being underweight than Barisal division. Additionally, in both residential zones, women in Sylhet had lower likelihood of being overweight than Barisal division.

CONCLUSION: This study reveals that multiple characteristics are linked to both overweight and underweight among ever-married, non-pregnant women of reproductive age in Bangladesh. Addressing these variables should be a priority in public health efforts to combat the dual challenge of malnutrition in Bangladesh.

PMID:38984237 | PMC:PMC11229563 | DOI:10.21315/mjms2024.31.3.18

HCA Healthc J Med. 2024 Apr 30;5(2):75-85. doi: 10.36518/2689-0216.1594. eCollection 2024.

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, there was an increase in the number of unhoused individuals in Asheville, North Carolina resulting in more tent encampments.Understanding the physical, mental, and socially determined health characteristics associated with being unhoused can help guide stakeholders with policy development, healthcare program planning, and funding decisions to support unhoused individuals.

METHODS: In this study, we used an observational cross-section methodology. Using a convenience sample approach, we interviewed 101 participants who were receiving services from 2 emergency hotel shelters, a day center, and a resource center. Data were analyzed using descriptive statistics, and open-ended responses were collected and grouped to provide context.

RESULTS: Most participants were White (71%) and identified as male (76%). Over 60% reported having a high school education or advanced degree. Of the participants, 76% reported being unhoused for more than 6 months, and their last permanent housing was in Western North Carolina. Dental disease, chronic pain, and hypertension were common physical conditions. PTSD, depression, and anxiety were common mental health conditions. A lack of transportation was the most noted socially determined challenge. Marijuana, methamphetamine, and alcohol were the most often used substances, where methamphetamine was noted to be particularly problematic for the participants.

CONCLUSION: Understanding the physical, mental, and social issues of the complex unhoused population can assist policymakers, healthcare providers, and other stakeholders in addressing challenges and testing improvement strategies.

PMID:38984228 | PMC:PMC11229599 | DOI:10.36518/2689-0216.1594

HCA Healthc J Med. 2024 Apr 30;5(2):67-73. doi: 10.36518/2689-0216.1406. eCollection 2024.

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus, SARS-CoV-2, has accounted for more than 1 000 000 deaths in the United States alone. In May 2020, the Food and Drug Administration issued an Emergency Use Authorization to allow the investigational use of intravenous remdesivir for the treatment of suspected or confirmed COVID-19 in hospitalized children and adults. Several other agents, such as hydroxychloroquine, dexamethasone, and tocilizumab have been investigated as potential treatment options; however, dexamethasone is currently the only agent that has been proven to reduce mortality in patients who require supplemental oxygen. The purpose of this study was to determine if initiation of remdesivir treatment in patients who presented with early symptoms of COVID-19 (defined as symptom onset < 7 days) had a significant impact on in-patient all-cause mortality compared to initiation of remdesivir treatment in patients who presented with symptom onset of at least 7 days.

METHODS: This ethics-committee-approved, retrospective, multicenter, double-arm study was conducted across 10 facilities in the HCA Healthcare West Florida Division. Adult inpatients age 18 and older with confirmed COVID-19 and administered intravenous remdesivir from May 1, 2020, to July 31, 2020, were included. Exclusion criteria included patients less than 18 years of age, the concomitant use of hydroxychloroquine or tocilizumab for any indication, or an estimated glomerular filtration rate less than 30 milliliters per minute. The primary outcome of this study was in-patient all-cause mortality. Secondary outcomes included total length of stay, time to discharge, oxygen requirements, and number of ventilator days.

RESULTS: A total of 217 patients from facilities in the HCA Healthcare West Florida Division were evaluated for inclusion. The primary outcome of all-cause mortality occurred in 34.9% of patients with symptom onset of fewer than 7 days versus 31.0% of patients with symptom onset of at least 7 days (P = .57). There were no statistical differences found among the secondary outcomes.

CONCLUSION: Time since symptom onset did not result in a statistically significant difference in all-cause mortality in patients who received intravenous remdesivir for the treatment of COVID-19.

PMID:38984222 | PMC:PMC11229600 | DOI:10.36518/2689-0216.1406

Front Neuroimaging. 2024 Jun 25;3:1336887. doi: 10.3389/fnimg.2024.1336887. eCollection 2024.

ABSTRACT

INTRODUCTION: Use of functional MRI in awake non-human primate (NHPs) has recently increased. Scanning animals while awake makes data collection possible in the absence of anesthetic modulation and with an extended range of possible experimental designs. Robust awake NHP imaging however is challenging due to the strong artifacts caused by time-varying off-resonance changes introduced by the animal’s body motion. In this study, we sought to thoroughly investigate the effect of a newly proposed dynamic off-resonance correction method on brain activation estimates using extended awake NHP data.

METHODS: We correct for dynamic B0 changes in reconstruction of highly accelerated simultaneous multi-slice EPI acquisitions by estimating and correcting for dynamic field perturbations. Functional MRI data were collected in four male rhesus monkeys performing a decision-making task in the scanner, and analyses of improvements in sensitivity and reliability were performed compared to conventional image reconstruction.

RESULTS: Applying the correction resulted in reduced bias and improved temporal stability in the reconstructed time-series data. We found increased sensitivity to functional activation at the individual and group levels, as well as improved reliability of statistical parameter estimates.

CONCLUSIONS: Our results show significant improvements in image fidelity using our proposed correction strategy, as well as greatly enhanced and more reliable activation estimates in GLM analyses.

PMID:38984197 | PMC:PMC11231096 | DOI:10.3389/fnimg.2024.1336887

Crit Care Explor. 2024 Jul 8;6(7):e1124. doi: 10.1097/CCE.0000000000001124. eCollection 2024 Jul.

ABSTRACT

OBJECTIVES: Exposure to critical illness and intensive care may lead to long-term psychologic and physical impairments. To what extent ICU survivors become prolonged users of benzodiazepines after exposure to critical care is not fully explored. This study aimed to describe the extent of onset of prolonged high-potency benzodiazepine use among ICU survivors not using these drugs before admission, identify factors associated with this use, and analyze whether such usage is associated with increased mortality.

DESIGN: Retrospective cohort study.

SETTING: Sweden, including all registered ICU admissions between 2010 and 2017.

PATIENTS: ICU patients surviving for at least 3 months, not using high-potency benzodiazepine before admission, were eligible for inclusion.

INTERVENTIONS: Admission to intensive care.

MEASUREMENTS AND MAIN RESULTS: A total of 237,904 patients were screened and 137,647 were included. Of these 5338 (3.9%) became prolonged users of high-potency benzodiazepines after ICU discharge. A peak in high-potency benzodiazepine prescriptions was observed during the first 3 months, followed by sustained usage throughout the follow-up period of 18 months. Prolonged usage was associated with older age, female sex, and a history of both somatic and psychiatric comorbidities, including substance abuse. Additionally, a longer ICU stay, a high estimated mortality rate, and prior consumption of low-potency benzodiazepines were associated with prolonged use. The risk of death between 6 and 18 months post-ICU admission was significantly higher among high-potency benzodiazepine users, with an adjusted hazard ratio of 1.8 (95% CI, 1.7-2.0; p < 0.001). No differences were noted in causes of death between users and nonusers.

CONCLUSIONS: Despite the lack of evidence supporting long-term treatment, prolonged usage of high-potency benzodiazepines 18 months following ICU care was notable and associated with an increased risk of death. Considering the substantial number of ICU admissions, prevention of benzodiazepine misuse may improve long-term outcomes following critical care.

PMID:38984149 | PMC:PMC11233102 | DOI:10.1097/CCE.0000000000001124

Cas Lek Cesk. 2024;162(7-8):307-313.

ABSTRACT

The rapid increase in the proportion of women using hormonal contraception in the 1990s was positively reflected in a rapid decline in the number of abortions. Czechia was unique not only among Eastern European countries, but also worldwide. At the same time the decline in the prevalence of hormonal contraception from a peak of almost 50 % in 2007 to 30 % in 2021 meant a slowing and gradual halt in the further decline in abortions. The results of the GGP 2020-2022 survey in Czechia showed that the lower use of hormonal contraception among women was only partly offset by the increased use of other reliable methods of protection against unintended pregnancy (e.g. condom use). The largest decline in the use of hormonal contraceptives in the form of the pill occurred among the youngest women aged 18-27 years, from 76 to 37 %, which was partly reflected in the more intensive use of condoms (an increase from 21 to 35% in the 18-27 age group), but is worrying, that this age group saw the largest increase in the use of less reliable methods (withdrawal from 11 to 22 % and an increase in the use of the barren days method from 1 to 6 %) and also the largest increase in the proportion of women using neither method (from 7 to 17 %). The lowest proportion of female hormonal pill users was found among female with higher education. However an important finding is that when less reliable methods are used, there is an effort to combine at least two methods. Women have a more important role in determining how to protect themselves from unintended pregnancy.

PMID:38981717

Cas Lek Cesk. 2024;162(7-8):299-306.

ABSTRACT

The assessment of the development of fertility and abortion rates over the last three decades shows that Czechia has reached the top position in Europe with a total fertility rate of 1.83 children per woman in 2021. The postponement of fertility to women’s older age, which was behind the sharp drop in fertility to 1.1, has been gradually slowed down and halted between 2015 and 2021. In recent years, there has been an increase in fertility rates for women aged 30 and older as well as a balanced increase for women under 30. In the European context Czechia has maintained its position as a country with lower rates of reproductive ageing. The favourable demographic position of Czechia among European countries is also illustrated by the relatively low level of the abortion rate. The postponement of female fertility to older ages has not been accompanied by an increase in the abortion rate among young women, but on the contrary a decline in fertility has been accompanied by a decline in the abortion rate. Given the year-on-year increase in total fertility (from 1.71 in 2020 to 1.83 in 2021), the initial effect of the COVID-19 pandemic on fertility can be assessed positively. However, the subsequent decline to 1.62 in 2022 is already the result of a combination of adverse effects stemming from the consequences of antipandemic measures and worsening economic conditions, to which new security risks associated with the war in Ukraine have subsequently been added. This has created the conditions for a further postponement of fertility until women are older.

PMID:38981716