Cross-sectional Study Research Articles

Reduced contrast sensitivity function and outer retina thickness in convalescent Vogt-Koyanagi-Harada disease

Abstract Background To evaluate contrast sensitivity function (CSF) in convalescent Vogt-Koyanagi-Harada (VKH) disease and investigate the relationship between CSF and chorioretinal thickness in VKH patients with and without sunset glow fundus (SGF). Methods This is a cross-sectional study. Seventy-six eyes of VKH patients and 56 eyes of normal controls were evaluated. Patients were divided into SGF and non-SGF groups. The best-corrected visual acuity (BCVA) of all the participants was ≤0.0 logMAR. Their CSF and macular chorioretinal thickness were measured with quantitative CSF (qCSF) and Optical Coherence Tomography (OCT) and compared using repeated measures analysis of variance at the group level. Relationships between CSF and macular chorioretinal thickness were evaluated using generalized estimating equations. Results The CSF was significantly impaired in the SGF group compared to that in the control group (p = 0.001), especially at medium and high spatial frequencies. No significant CSF difference was found between the non-SGF group and control group, nor between the SGF and non-SGF groups. Compared to the controls, outer retinal thickness (ORT) in both VKH subgroups was significantly reduced (P < 0.001 or 0.005, respectively), although their outer nuclear layer thickness (ONLT) and choroidal thickness (CT) were not significantly different (both P = 1.000, P = 0.829 or 0.112, respectively). We found no significant correlation between CSF metrics and outer retinal thickness. Conclusions Despite good recovery of visual acuity, reduced CSF and outer retina thickness were found in convalescent VKH patients. CSF may be an important and sensitive metric to evaluate functional vision in VKH disease.

The quality of psychosocial health and psychosocial illness among women with and without shelter homes: a cross-sectional study

BackgroundExisting research on the psychosocial wellbeing of sheltered women is primarily from Western contexts, with limited studies from collectivistic cultures like Pakistan. This study aims to compare the psychosocial health and illness of sheltered women in Pakistan with those of women living with their families.MethodsA total of 184 sheltered women and 207 women from the general population from four Pakistani cities participated in this study. Data were collected using two validated instruments: the Psychosocial Health Evaluator and the Sukoon Psychosocial Illness Scale. The study employed independent sample t-tests, simple linear regression and Pearson correlation.ResultsThe study revealed significant differences between women residing in shelters and those in the general population. Sheltered women exhibited lower levels of psychosocial health and higher levels of psychosocial illness. Emotional, sexual, spiritual, and social health were notably lower among sheltered women. Sheltered women also reported elevated levels of psychosocial problems, including emotional, social, and professional difficulties. Additionally, the length of stay in shelters was negatively correlated with psychosocial health and positively correlated with psychosocial illness, while education showed a positive correlation with psychosocial health.ConclusionThe current research highlights the psychosocial vulnerability of women residing in shelter homes. Government, non-governmental organizations, and mental health professionals are advised to work together to uplift the psychosocial health of women residing in Pakistani shelter homes. Appointments of psychological counselors in shelter homes are highly recommended in this regard.

Assessing cognitive impairment in chronic pain: a cross-sectional study with healthy controls

Purpose The aim of this study is to clarify inconsistencies in the literature regarding the neuropsychological impact of chronic pain and determine how pain catastrophizing and pain intensity may explain cognitive impairment. Methods This cross-sectional study involved 30 participants with chronic primary musculoskeletal pain and 30 healthy controls without pain. The instruments used were the Pain Catastrophizing Scale, the Visual Analogue Scale, the Beck Anxiety Inventory, the Beck Depression Inventory–II, the Wisconsin Card Sorting Test, the Stroop Test, and the Working Memory Index of the Wechsler Adult Intelligence Scale. Results Chronic pain patients showed slight cognitive impairments in selective attention, sustained attention, working memory, problem solving, planning, abstract reasoning, inhibition, and resistance to interference. The data also indicate that higher levels of pain catastrophizing and pain intensity were independently associated with greater cognitive impairment in patients with pain, specifically in attention and executive functioning. Additionally, the interaction between these pain-related variables predicted further cognitive impairment. Conclusions This research has contributed to establishing the neuropsychological profile of patients with chronic primary musculoskeletal pain and reinforces evidence of the impact of chronic pain on cognition. These findings may help guide the design of programs aimed at improving cognitive performance.

The impact of internet medical service on rural gender inequality in health opportunity: a cross-sectional study

BackgroundThe increasing popularity of Internet medical service may have alleviated the gender inequality in health opportunity faced by rural women. However, research to ascertain the association between Internet medical service and gender inequality in health opportunity is scarce. This study explored the impact of Internet medical service on gender inequality in health opportunity among rural women and the underlying mechanisms involved.MethodsA multistage stratified cross-sectional survey was conducted across six counties in three provinces in China, yielding 3,108 responses for a 97.13% response rate. The questionnaire was used to collect information on Internet healthcare use, health status, health behaviors, social activities and personal exercise, chronic disease status, and demographic and socio-economic characteristics of the participants. Based on Roemer's theory of equality of opportunity (EOP), we established a decomposition strategy for the fairness gap between genders, which we used for the measurement of the gender inequality in health opportunity Fixed effects models, propensity score matching (PSM), and least absolute shrinkage and selection operator (LASSO) regression were utilized to explore the impact of Internet medical service on rural gender inequality in health opportunity.ResultsOn average, rural women experienced a gender health fairness gap of 1.63. Internet medical service significantly mitigated this inequality (β = -0.0602, P = 0.0002), and this finding remained significant across propensity score matching (PSM) and LASSO regression analyses. Mechanistic analysis revealed that human capital positively moderates this effect (β = -0.0510, P < 0.01), while income (β = 0.0370, P < 0.001) and marital status (β = 0.2039, P < 0.001) have negative moderating effects.ConclusionsBy focusing on gender inequality in the digital era, this study highlights the mitigating role of Internet medical service on gender inequality in health opportunity in rural areas. This study proposes and validates the mechanisms through which Internet medical service alleviates gender inequality in health opportunity, suggesting that human capital amplifies this effect, while high personal income and marital status attenuate this effect. These findings contribute to understanding how the digital age can narrow gender health opportunity equality, providing support for future interventions aimed at promoting health equity and gender equality.

Objective and subjective evaluation of the use of protective clothing on the thermal strain and mental workload of nurses during the Covid-19 pandemic.

Nurses are among high-risk occupational groups during the outbreak of epidemics. Therefore, these people are required to use personal protective equipment (PPE). Previous studies have shown that the use of personal protective equipment can affect people's thermal strain and mental workload. The present study was conducted with the aim of objectively and subjectively evaluating the use of protective clothing on the thermal strain and mental workload of nurses during the covid-19 pandemic. This cross-sectional study was divided into two groups with a sample size of 300 people who were selected by systematic random method. In the first group, 120 people were objectively evaluated (use of protective clothing). In the second group, 180 people only completed the questionnaire of mental workload, feeling of heat and sweating and other information related to the type of clothing and the duration of its use, etc. Measurements were done in August and September of 2021 and in the morning shift of hospitals. Data were analyzed using SPSS version 21 software and chi-square, independent T-test and linear regression tests. The average age and average working hours per month of the participants in the study were 33.51±7.88 years, 187.91±35.37 hours, respectively. The results showed that the predicted average vote (PMV) index and the predicted percentage of dissatisfied (PPD), moisture felt on the skin surface, the feeling of desirability and pleasantness of the temperature, the weight of sweat and the humidity inside the clothes between the two groups of people using insulated clothes There is a significant difference between medicine and dressing (P < 0.05). There was a significant relationship between mental workload and type of clothing, average working hours per month. The use of medical isolation clothes causes a high heat load on nurses and can increase their mental workload. On the other hand, people using normal gowns suffer from a high mental workload due to the fear of disease due to the uncertainty of high-level protection. In addition, medical isolation clothes increase the humidity of the skin due to their impermeability, which causes skin complications.

Pathways from Childhood Emotional Neglect to Traditional Victimization among Secondary Vocational School Students: The Roles of Family Functioning, Psychopathy, and Socioeconomic Status

Considering the high prevalence and detrimental developmental outcomes of traditional victimization, it is imperative to explore the influencing factors and mechanisms of traditional victimization to formulate targeted prevention interventions. Previous studies have shown a significant and positive association between childhood emotional neglect and traditional victimization. To our knowledge, there is a limited understanding of the mechanism of this association. To fill this gap, this study examined the relationship between childhood emotional neglect and traditional victimization, as well as the roles of family functioning, psychopathy, and socioeconomic status (SES) among secondary vocational school students. A cross-sectional study was carried out among 605 secondary vocational school students from grades 10 to 11 ( Mage = 16.19, SD = 0.79). Participants provided data on demographic variables, childhood emotional neglect, traditional victimization, family functioning, psychopathy, and SES by answering anonymous questionnaires. The findings showed that childhood emotional neglect was not directly related to traditional victimization, but it was indirectly related to traditional victimization through the mediation of family functioning, the mediation of psychopathy, as well as the chain mediation of family functioning and psychopathy among secondary vocational school students. Additionally, SES could not moderate the relationships between childhood emotional neglect and family functioning, psychopathy, as well as traditional victimization among secondary vocational school students. These findings suggest that interventions for decreasing traditional victimization among secondary vocational school students should not only focus on reducing childhood emotional neglect but also target family functioning and psychopathy. Besides, these findings also imply SES cannot remediate the negative effects of childhood emotional neglect on secondary vocational school students.

The mediating effect of social intelligence in the association between social anxiety and mental health among Chinese nursing students

Social anxiety is highly prevalent among nursing students and is associated with poor mental health. However, the underlying mechanism in such an association remains unclear. This study aimed to examine the potential mediating role of social intelligence in the association between social anxiety and mental health using the Stress-Coping Model (SCM) as the theoretical framework. A cross-sectional study was conducted among 748 nursing students recruited from a Chinese University from December 2022 to March 2023. Students completed an online questionnaire to assess their social anxiety, social intelligence, and mental health. The PROCESS SPSS Macro (model 4) was used to test the mediation effect of social intelligence on the association between social anxiety and mental health. The results showed that nursing students had moderate levels of social anxiety, social intelligence, and mental health, which varied according to their profile characteristics. Social anxiety was negatively associated with mental health, and the association was partially mediated by social intelligence. Our study offers fresh insights into the impact of social anxiety on mental health and sheds light on the intricate mediating role of social intelligence. These findings offer valuable insights for research and clinical endeavors aimed at formulating psychosocial interventions to enhance the mental health of nursing students.

FAMILY PLANNING AND MENTAL HEALTH IN PRIMARY CARE: NURSES' PERSPECTIVES

Family planning is among the actions in Primary Care that are relevant and impactful in terms of women's quality of life indicators, but the particularities of women with mental disorders are still invisible to health professionals. The study aims to evaluate family planning performed by Primary Care nurses aimed at women with mental disorders. This is a qualitative and cross-sectional study using Alceste Software for content analysis. The results showed that Primary Care nurses who perform family planning have difficulties in managing the program in their routines. When women with mental disorders are highlighted, these difficulties are accentuated, and in many cases, they are not even identified during the care, which remains fragmented in terms of the demand presented, without considering the woman's comprehensiveness. The nurses also pointed out that they feel a lack of matrix support and collaboration from CAPS in implementing the program. We conclude that family planning should have a prominent place in ongoing training and integrate nurses working in Mental Health, to achieve comprehensive care for women, demystifying myths about pathologies and providing quality of life for this population.

Association between mental health and male fertility: depression, rather than anxiety, is linked to decreased semen quality

BackgroundInfertility is increasingly recognized as a global health issue affecting couples of reproductive age, with male factors contributing to approximately 50% of infertility cases. However, the association between depression and anxiety-two of the most prevalent mental health conditions-and impaired male fertility remains a subject of ongoing debate.MethodsIn this cross-sectional study, male participants seeking fertility counseling at an IVF clinic were recruited. Symptoms of depression and anxiety were assessed using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7), respectively. Generalized linear regression models (GLMs) were employed to investigate the relationships between mental health status and semen parameters.ResultsStatus of depression was negatively associated with semen quality parameters, whereas no statistically significant association was recognized between anxiety and semen quality except that sperm concentration was decreased by 25.60 (95% CI, 1.226 to 49.965, P=0.040) ×106/ml in moderate to severe anxiety group referring to normal group. Furthermore, when stratified by sleep duration, moderate to severe depression group showed a great decrease in progressive motility (PR), total motility, concentration and total sperm count (TSC) as referred to normal group in participants with sleep duration less than 7 hours.ConclusionThe present study revealed that depression rather than anxiety was a negative factor that affected semen quality, especially in individuals with shorter sleep duration.

Association of dietary inflammatory index with sarcopenia in patients with Metabolic dysfunction-associated fatty liver disease: a cross-sectional study

BackgroundSarcopenia is a common complication of fatty liver, and sarcopenia increases the risk of advanced liver fibrosis in patients with Metabolic dysfunction-associated fatty liver disease (MAFLD). Chronic inflammation is the crucial link between sarcopenia and fatty liver. An anti-inflammatory diet is expected to be an essential measure to prevent sarcopenia in patients with fatty liver, and the dietary inflammatory index (DII) is a crucial tool for assessing the inflammatory potential of diets. However, the relationship between DII and sarcopenia in patients with fatty liver is unclear.ObjectiveThis study investigated the correlation between the dietary inflammatory index (DII) and sarcopenia in patients with Metabolic dysfunction-associated fatty liver disease (MAFLD).MethodsData for this study were obtained from the National Health and Nutrition Examination Survey (NHANES) 2017–2018, with 917 patients with MAFLD participating in the study. Participants were divided into three groups based on DII tertiles: group T1 (n = 305), group T2 (n = 306), and group T3 (n = 306), and binary logistic regression was used to assess the relationship between DII and sarcopenia with stratified analyses based on the weights recommended by the NHANES and multivariate linear regression was used to evaluate the association of DII with total appendicular lean mass.ResultsAfter adjusting for all confounders, DII was significantly and positively associated with the risk of sarcopenia in women [OR: 1.61, 95% CI: (1.226, 2.06), p &amp;lt; 0.001]. The risk of sarcopenia was higher in the T3 group compared to the T1 group [OR: 4.04, 95% CI: (1.66, 9.84), p = 0.002]. DII was negatively associated with appendicular lean mass adjusted for body mass index in both men and women.ConclusionDII was significantly associated with the risk of sarcopenia in female patients with MAFLD, with higher DII scores related to a higher risk of sarcopenia. Higher DII scores related to a higher risk of sarcopenia in men with significant fibrosis.

State Divorce Laws, Reproductive Care Policies, and Pregnancy-Associated Homicide Rates, 2018-2021

ImportanceBarriers to divorce and reproductive health care can threaten the health and safety of pregnant and recently pregnant females.ObjectiveTo examine state laws about divorce, reproductive health care (access to contraception, family planning services, and abortion), and pregnancy-associated homicide rates in US states over a 4-year period (2018-2021).Design, Setting, and ParticipantsIn this cross-sectional study, bivariate tests and regressions were used to analyze crude rates of pregnancy-associated homicide from the National Violent Death Reporting System in 181 state-years for calendar years 2018 to 2021, with analyses conducted on September 8, 2024.ExposuresAccess to divorce while pregnant and reproductive health care over a 4-year period in the US.Main Outcomes and MeasuresPrimary outcomes (pregnancy-associated homicide by intimate partners vs non–intimate partners and rates among younger Black, Hispanic, and White females) were assessed using the National Violent Death Reporting System. Negative binomial regression was used to test 2 hypotheses: access to divorce while pregnant and reproductive health care are associated with pregnancy-associated homicide rates.ResultsIndividual level data, including exact sample size, were not available in this study of state-level homicide rates. Negative binomial regression analysis showed that, where finalizing divorce during pregnancy is prohibited, intimate partner homicide rates (incidence rate ratio [IRR], 2.11; 95% CI, 1.09-4.08; P = .03) and rates among younger (age 10-24 years) White females (IRR, 2.39; 95% CI, 1.12-5.09; P = .02) were significantly higher. In state-years with greater access to reproductive health care, rates were significantly lower for non–intimate partner homicide (IRR, 0.92; 95% CI, 0.87-0.98; P = .01) and for younger Black females (IRR, 0.91; 95% CI, 0.87-0.96; P &amp;amp;lt; .001) and younger Hispanic females (IRR, 0.87; 95% CI, 0.79-0.96; P = .007).Conclusions and RelevanceIn this cross-sectional study of pregnancy-associated homicide rates, barriers to divorce were associated with higher homicide rates and access to reproductive health care was associated with lower homicide rates. This study highlights the association between state legislation and pregnancy-associated homicide in the US, which is important information for policymakers.

Sleep quality and the need for recovery among nurses working irregular shifts: A cross-sectional study.

Shift work affects the mental and physical health of nurses, yet the effect of working irregular shifts on sleep and its association with the need for recovery is under-explored. The purpose of this study was to investigate the sleep quality of nurses working irregular shifts, including night shifts, and to determine whether sleep quality is associated with the need for recovery. This cross-sectional study included 405 nurses working irregular shifts. Data were collected using an online questionnaire that included sociodemographic characteristics, the Sleep-Wake Experience List, sleep problems, sleep duration, and the Need for Recovery scale. Data analyses included descriptive statistics, chi-square tests, t-tests, logistic and multiple linear regressions. Nurses who worked irregular shifts had poor sleep quality. Those who also worked night shifts, had significantly poorer sleep quality and experienced more difficulties in daily functioning than those who did not work night shifts. Sleep quality was significantly associated with the need for recovery and this remained so after controlling for confounding variables (β= .554, p = .001). The findings indicate that in nurses who work irregular shifts, the sleep quality is low. In this group, the sleep quality in nurses who work night shifts is lower than in nurses who do not work night shifts. Furthermore, better sleep quality was associated with lower need for recovery. These findings suggest that improving sleep quality in nurses working irregular shifts may lower their need for recovery, which may improve health, and reduce burnout and sickness absence.

Socio-Demographic Determinants of Junk Food Consumption among University Students: A Cross-Sectional Study in Central Department of Education, TU

College life is a critical period during which students are particularly vulnerable to developing unhealthy dietary behaviors. This study assessed the socio-demographic determinants of junk food consumption (JFC) among higher education students. A quantitative cross-sectional study was conducted using a self-administered survey questionnaire among 272 university students studying at the Central Department of Education, TU. The findings revealed that although only six percent of students preferred to consume junk food, a surprisingly high proportion (83.5%) reported consuming it. Peer pressure was mentioned by nearly half of them (47.8%) as the main cause of JFC. Bivariate analysis showed a significant relationship between JFC and selected socio-demographic variables, including sex (p&lt;0.05), subject specialization (p&lt;0.001), and caste/ethnicity (p&lt;0.05). The results indicate a high prevalence of JFC among university students, with socio-demographic factors such as sex, subject specialization, and caste/ethnicity being significantly associated with JFC. To lower the frequency of JFC among university students, the study emphasizes the urgent need for university-based health promotion and education initiatives.

Awareness of Peptic Ulcer Disease among the General Population in Al-Ahsa

Abstract Introduction: Peptic ulcer disease (PUD) is a condition characterized by discontinuity in the gastrointestinal (GI) tract’s inner lining, often caused by factors such as Helicobacter pylori infection and NSAID consumption. PUD can lead to various symptoms, but up to 70% of patients may not experience any symptoms. Diagnosing PUD can be challenging due to the unreliability of individual symptoms and signs. PUD can have serious complications if left untreated. Despite its significance, there is a lack of studies measuring the awareness of PUD among the population in Al-Ahsa, Saudi Arabia. Therefore, this study aimed to assess the level of awareness of PUD among the general population in Al-Ahsa. Methodology: A cross-sectional study was conducted in Al-Ahsa, Saudi Arabia, from September to December 2023. The study included 399 adult residents of Saudi Arabia who agreed to participate. A convenient nonprobability sampling technique was used to collect data. An online self-administered questionnaire, distributed through social media platforms, was used to gather information on participants’ awareness of PUD. The questionnaire included sociodemographic characteristics and questions related to PUD awareness. Data were analyzed using SPSS, and qualitative data were presented as numbers and percentages. The Chi-square test was used to examine qualitative data between the two groups. Results: Of the 399 participants, 71.4% demonstrated a good level of knowledge regarding PUD, whereas 28.6% had a low level of knowledge. The sample consisted of nearly equal numbers of males and females, with participants aged 18–55+ years. The majority of participants had attained a bachelor’s degree and were employed. The findings suggest a relatively high level of education among the study population. Conclusion: The study highlights the need for increased public awareness of PUD in Al-Ahsa, Saudi Arabia. While some participants showed good knowledge of PUD, a significant number had low awareness. Educational initiatives are essential to improve understanding and knowledge of PUD among the community. By enhancing awareness, early detection and appropriate management of PUD can be promoted, resulting in improved health outcomes for individuals in Al-Ahsa.

Antibiotic adoption effects on nutrition and quality of life in lung cancer patients undergoing radiotherapy and chemotherapy: A meta-analysis

BACKGROUND: Lung cancer (LC) is one of the leading causes of death worldwide. Treatment methodologies such as chemotherapy and radiotherapy have improved patient survival rates. Nevertheless, these treatments can also lead to adverse reactions and impact patients’ nutritional status and quality of life (QOL). Antibiotics are commonly used for treating infections, but there is still controversy regarding their potential adverse effects on LC patients. OBJECTIVE: This work aimed to investigate the impact of antibiotic adoption on the nutritional status and QOL of LC patients undergoing radiotherapy or chemotherapy, providing valuable insights for the clinical management of LC. METHODS: A meta-analysis approach was employed to comprehensively evaluate the relationship by synthesizing relevant literature. Published studies were identified through searches in databases such as PubMed, EMBASE, Cochrane Library, Web of Science, and CNKI. The inclusion criteria encompassed randomized controlled trials, cohort studies, and cross-sectional studies. Assessment indicators included patient weight, BMI, hemoglobin levels, and QOL. Meta-analysis was conducted using software such as the Cochrane Collaboration and RevMan5.3. Heterogeneity was evaluated using the Higgins I2 index, where values between 25% and 50% indicate moderate heterogeneity, and values greater than 50% indicate substantial heterogeneity. RESULTS: 12 eligible studies involving 1,917 patients were finally included. LC patients who received antibiotics during radiotherapy or chemotherapy were found to have a higher risk of malnutrition. The antibiotic group exhibited a more significant decrease in body mass index (BMI) (P&lt; 0.05) and lower serum albumin levels (P&lt; 0.05) versus the control (C) group. Additionally, the overall QOL scores in the antibiotic group were dramatically lower than those in the C group, showing a significant difference with P&lt; 0.05. Sensitivity analysis indicated that the overall conclusions of this work were robust and unbiased. CONCLUSION: Antibiotics in LC patients undergoing radiotherapy or chemotherapy may increase the risk of malnutrition and decrease their QOL. Hence, physicians should carefully consider antibiotics and take necessary preventive measures and supportive treatments to improve LC patients’ nutritional status and QOL.

The association between the knowledge, perception, and practice of dietary supplement among Chinese adults

IntroductionRapid growth has been found in the market of dietary supplements (DSs) in China. However, studies about the knowledge level, intentions, and behavior related to DS remained limited in the Chinese population. This study aimed to explore the knowledge level, perception, and practice toward DS among Chinese adults.MethodsThis is a cross-sectional design among 1,714 participants aged between 18 and 65 years. A total of 54.1% of participants reported purchasing supplements in the past 6 months. Knowledge levels were assessed with a score from 1 to 10 based on correct answers to 10 binary questions about supplements.ResultsOnly 29.1% of participants answered seven or more questions correctly, while 7.9% answered three or fewer questions correctly. Participants with high and middle knowledge levels were more likely to seek medical advice when experiencing discomfort symptoms and were less likely to choose DS, with corresponding odd ratios (ORs) of 1.58 (95% CI: 1.16, 2.13) and 0.69 (95% CI: 0.52, 0.91) in high knowledge group and ORs of 1.36 (95% CI: 1.03, 1.80) and 0.96 (95% CI: 0.72, 1.30) in middle knowledge group (Pfor trend = 0.003 and 0.028, respectively). No significant differences were found in the motivation of DS use between knowledge levels. Although higher knowledge levels were associated with less spending on DS (OR high = 0.69; 95% CI: 0.49, 0.99; OR middle = 0.88; 95% CI: 0.64, 1.20; Pfor trend = 0.038), it did not guarantee better and more accurate awareness toward DS use.DiscussionIn conclusion, there is a growing demand for supplements among Chinese adults, but a significant gap between knowledge and behavior exists, affecting decision-making behaviors regarding DS.

Relación de la victimización de bullying y cyberbullying en las dificultades de regulación en adolescentes del Ecuador

The present study aims to identify the relationship between bullying victimization (BV) and cyberbullying victimization (CBV) in emotional regulation difficulties (ERD) in a sample of adolescents in Ecuador. This work is based on a quantitative, descriptive, correlational, gender-comparative, cross-sectional design. The sample consisted of 384 adolescents, with 44% being females and the remaining 56% males, aged between 14 and 19 years (M= 15.7; SD= 4.4). The students came from 9 schools in two cities in Ecuador. BV and BCV levels were found to be low, while ERD levels were moderate. There were only gender differences in BV, with a higher presence in males than females. Finally, there was a positive relationship between BV (moderate), BCV (slight) and DRE. BV and BCV are also positively and moderately related. BV and BVB are elements that interact in a relevant way with DRE in adolescents in Ecuador, indicating a particular connection.

The role of illness perception in the physical activity domain of health-promoting lifestyle among patients with non-communicable diseases: A systematic review

Background The global mortality caused by non-communicable diseases is on the rise. Health-promoting lifestyles are among the most effective approaches, yet the physical activity domain consistently scores the lowest. Physical activity is linked to individual behaviour and influenced by numerous factors. Illness has been identified as a key factor in behavioural change. Therefore, the primary purpose of this review was to investigate the role of illness perception in the physical activity domain among patients with non-communicable disease. Method This systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. A literature search was conducted across three scientific databases (Scopus, PubMed, and Web of Science), targeting original articles published in English between 2014 and 2024. The quality of the eligible articles was assessed using the Joanna Briggs Institute Critical Appraisal tools. The findings were synthesised through content analysis. Results A total of 17 studies were included, identifying both the direct and indirect effects of illness perception variables as a whole or in their respective dimensions. The illness perception variable has demonstrated a significant positive and negative relationships with the physical activity domain. Limitation The majority of the included studies had a cross-sectional design. Therefore, the evidence quality was relatively low and exhibited a high risk of bias. Furthermore, there was language bias as only English-language publications were selected. Conclusion The findings of this review will serve as a guide for healthcare providers in enhancing physical activity adherence among patients with non-communicable diseases through an illness perception approach. This approach can be integrated into clinic consultations and intervention programmes. Future studies are warranted to evaluate the effectiveness of the illness perception approach in promoting physical activity adherence.

How are pre-service physical education teachers’ perceptions of educator-created (dis)empowering climates associated with their motivational processes and teaching intention?

Building upon the bright and dark pathways outlined in Self-Determination Theory and Duda and Appleton's (2016) hierarchical conceptualisation of motivational climate, the purpose of this research was to examine how perceived educator-created (dis-)empowering climates can be combined and related to need-based experiences, quality of motivation, and teaching intention in initial physical education (PE) teacher education. A convenience sample of 369 pre-service PE teachers (197 men and 171 women, Mage = 27.28, SDage = 6.71) participated in this cross-sectional research. The results from the structural equation modelling found a positive relationship from a perceived empowering climate to teaching intention via need satisfaction and autonomous (indirect effect: β = .053, 95 %CI = .015–.091, p-value = .022), as well as a negative association from a perceived disempowering climate to teaching intention via need frustration and amotivation (indirect effect: β = -.046, 95 %CI = -.091 to − .002, p-value = .047).The results from the latent profile analysis identified four profiles with varying levels of (dis-)empowering climates. The high empowering–low disempowering profile was the most adaptive in motivational outcomes and teaching intention whereas the moderate empowering–very high disempowering and low empowering–high disempowering profiles were the most maladaptive, with the former having more controlled motivation and the latter being more amotivated. The moderate empowering–moderate disempowering profile was less adaptive than the high empowering-low disempowering profile, and less maladaptive than the moderate empowering–very high disempowering and low empowering–high disempowering profiles. This study highlights that the teacher educator combines (dis-)empowering climates to varying degrees with different contributions to specific motivational outcomes and teaching intention among pre-service PE teachers.

The DOSE index in chronic obstructive pulmonary disease: evaluating healthcare costs

Background and objectivesThe DOSE index, which incorporates Dyspnea, Obstruction, Smoking, and Exacerbations, is a widely used tool for assessing the severity and prognosis of Chronic Obstructive Pulmonary Disease (COPD). In addition to risk assessment, it has potential clinical utility in predicting healthcare costs, which are primarily driven by exacerbations. While several indices, such as the BODE (Body-mass index, Obstruction, Dyspnea, Exercise) and ADO (Age, Dyspnea, Obstruction) indices, exist for risk prediction, there is a lack of dedicated tools for forecasting healthcare costs. This study explores the potential of the DOSE index compared to other indices, including BODE, ADO, and the Charlson Comorbidity Index (CCI), for this purpose.Materials and methodsThis cross-sectional retrospective study analyzed data from 396 COPD cases. We examined associations between the DOSE index, BODE index, ADO index, CCI, and healthcare costs, including hospitalizations and emergency room treatments. Healthcare costs were categorized as direct medical expenses.ResultsSignificant associations were observed between the DOSE index and various healthcare parameters. DOSE quartiles showed strong correlations with outpatient visits (p = 0.013) and outpatient medical expenses (p = 0.011). In addition, hospitalization frequency, duration, and associated costs were significantly correlated with higher DOSE quartiles (p < 0.001). A significant difference was found when comparing DOSE quartiles between patients with high (CCI ≥ 3) and low (CCI < 3) comorbidity scores (p = 0.018). The DOSE index outperformed other indices, likely due to its inclusion of exacerbations, a key driver of healthcare costs.ConclusionThe DOSE index demonstrates potential in predicting healthcare costs, particularly due to its inclusion of exacerbation frequency. This study highlights the importance of considering exacerbations alongside traditional risk factors for more accurate cost forecasting in COPD management. Our findings suggest that the DOSE index may be a valuable tool in both clinical and economic assessments of COPD patients, though further research is warranted to validate these findings in larger datasets.