Factor structure and cut-off scores of the Hospital Anxiety and Depression scale (HADS) in a Croatian sample of adult patients suffering from advanced cancer.

BACKGROUND: Patients with cancer should be systematically screened for psychological problems at key points in their pathway. Usage of self-report scales for measuring anxiety and depression (such as Hospital Anxiety and Depression scale (HADS)) is a very practical methodfor detecting anxiety and depression. The aim of this research was to determine latent structure, reliability and cut-off scores of HADSin a Croatian sample of adult patients suffering from advanced metastatic cancer. SUBJECTS AND METHODS: According to inclusion and exclusion criteria, participant were recruited at University Hospital Centre Zagreb (N=46; January 2015) and Clinical Hospital Centre 'Sisters of Mercy' (N=29; April 2015). All participants underwent short structured psychodiagnostic interview, cognitive evaluation (usingMontreal Cognitive Assessment (MoCA) test) and were given HADS. RESULTS: When using PCA separately for the items of each original scale of HADS, only four items for the component Depression satisfactorily saturate principal component and when using PCA for all the items, only seven items from the original scale satisfactorily saturate unique principal component. Maximum Likelihood extraction method showed that only four items from the original scale satisfactorily saturated the theoretical scales. CONCLUSIONS: The results show that the best solution to use HADS, in defined Croatian population, is as one-dimensional screening instrument (Cronbach's alpha coefficient of internal consistency=0.774) with cut-off score 11/12.

Exercise Participation Motives and Engaging In Sports Activity among University of Ljubljana Students.

AIM: The main aim of this study was to examine differences in sport participation motives, the frequency of engaging in sports activities according to gender, region and field of study, but also the association between the incidence of engaging in sports activity and the motivation for sports activity of students at the University of Ljubljana. MATERIAL AND METHODS: Five thousand two hundred seventy-one students completed The Exercise Motivations Inventory (EMI-2), with additional questions about 12 socio-demographic parameters. RESULTS: The results reveal that most of the students are engaged in unorganized sports activities. Male students engage in sports activity more often than female students do. For male students, dominant participation motives are enjoyment, challenge, social recognition, affiliation, competition and strength but also endurance, for female students these are: stress and weight management, revitalisation, ill-health avoidance, positive health, appearance and nimbleness. Gender differences in participation motives are partly reflected also in differences according to the field of study. The correlations between the frequency of engaging in sports activity and the participation motives are mainly statistically significant. We did not find any significant differences in participation motives by region. CONCLUSION: In spite of these discouraging findings, increasing physical activity among students continues to be a national priority.

Construction of the Questionnaire on Foreign Language Learning Strategies in Specific Croatian Context.

Learning strategies are special thoughts or behaviours that individuals use to understand, learn or retain new information, according to the point of view of O'Malley & Chamot. The other view, promoted by Oxford, believes learning strategies are specific actions taken by the learner to make learning easier, faster, more enjoyable, and more transferrable to new situations of language learning and use. The use of appropriate strategies ensures greater success in language learning. The aim of the research was to establish metric characteristics of the Questionnaire on learning strategies created by the author, in line with the template of the original SILL questionnaire (Strategy Inventory for Language Learning). The research was conducted at the Rochester Institute of Technology Croatia on a sample of 201 participants who learned German, Spanish, French and Italian as a foreign language. The results have shown that one-component latent dimensions which describe the space of foreign language learning strategies according to Oxford's classification, have metric characteristics which are low, but still satisfactory (reliability and validity). All dimensions of learning strategies appeared not to be adequately defined. Therefore, we excluded compensation strategies and merged social and affective strategies into social-affective strategies into the unique dimension. Overall, this version of Oxford's original questionnaire, based on Oxford's theoretical construct, applied on Croatian students, clearly shows that current version of the questionnaire has poor metric characteristics. One of the explanations of the results obtained could be positioned in multicultural context and intercultural dialogue. Namely, particular social, political and economic context in Croatia could shape even foreign language learning strategies.

Metrically adjusted questionnaires can provide more information for scientists- an example from the tourism.

The article deals with the issue of research methodology, illustrating the use of known research methods for new purposes. Questionnaires that originally do not have metric characteristics can be called ¼handy questionnaires«. In this article, the author is trying to consider the possibilities of their improved scientific usability, which can be primarily ensured by improving their metric characteristics, consequently using multivariate instead of univariate statistical methods. In order to establish the base for the application of multivariate statistical procedures, the main idea is to develop strategies to design measurement instruments from parts of the handy questionnaires. This can be accomplished in two ways: before deciding upon the methods for data collection (redesigning the handy questionnaires) and before the collection of the data (a priori) or after the data has been collected, without modifying the questionnaire (a posteriori). The basic principles of applying these two strategies of the metrical adaptation of handy questionnaires are described.

The profiling of university of Ljubljana students according to their motives for exercise participation.

INTRODUCTION: The main research objective is the analysis of the grouping of the students of the University of Ljubljana, with respect to the intensity of different types of exercise participation motives, their gender, discipline and year of study, level of physical activity, status of physical education class, organization of physical activities during study, and place of residence. METHODS: Data were collected using personal data sheets during enrolling students at the University of Ljubljana. Students completed The Exercise Motivations Inventory (EMI-2), with additional data about sociodemographic parameters. RESULTS: The results reveal that the students could be grouped in three distinctive clusters, which can be very clearly explained in terms of the prevalence of exercise participation motives in general. The students grouped in the first cluster have the lowest average values (means) in all exercise participation motives. The students grouped in the second cluster have the profile with moderate means in all exercise participation motives, while the students grouped in the third cluster have the profile with the highest means in all exercise participation motives. CONCLUSIONS: The results indicate overall higher motivation for physical activity in men. All the sub-samples are different in their relevant features used in clustering (e.g., male students are dominant in life sciences, etc.), which provide a guide both for the explanation of the results obtained and for practical implications.

Family Financial Situation, Parental Marital Status and Self-Harm amongst Adolescents in Croatia.

The aim of this study was to determine the level of self-harm behaviors among adolescents in the general population (students of secondary schools in Zagreb, Croatia), as well as to determine if the level of self-harm behaviors differed according to financial circumstances of the family and marital status of the parents. The study was conducted in 701 adolescents (male and female, age range 14 to 19 years). A specially designed questionnaire that included family and demographic data was used to determine the family financial circumstances. The Scale of Auto-Destructiveness measuring instrument was used to assess the level self-harm. Study results revealed that 87.3% of adolescents indicated average levels of self-harm, whereas above-average and high above-average self-harm was indicated in 12.7% of the adolescents. Results also showed that single-parent families significantly differentiated the level of self-harm among adolescents of both genders, whereas financial deprivation (perception of financial stress) partially differentiated these levels. Practical implications of this study emphasize the importance of social support to parents of adolescents grown up in single-parent and/or financially challenged families.

Psychosocial Determinants of Satisfaction with Hospital Care in Adult Patients Suffering from Advanced Cancer.

In this observational study, direct and indirect (moderator and mediator) relationships between sociodemographic (age, gender, life partner, education level, income and length of treatment) and psychological (Hospital Anxiety and Depression Scale, HADS) variables and satisfaction with hospital care (EORTC INPATSAT32) in adult (advanced cancer) patients were investigated. Study sample consisted of 75 hospitalized advanced cancer patients recruited at the Zagreb University Hospital Centre and Sestre milosrdnice University Hospital Centre in 2015. Statistically significant negative correlations were found between HADS and elementary school education level, as well as with all satisfaction variables (satisfaction with physicians, nurses and organization). Moderate to high and statistically significant positive correlations were found between elementary school level and all satisfaction variables. Gender and level of education appeared as significant moderator variables in the relationship between HADS and satisfaction with nurse care. There were no significant mediator effects of sociodemographic variables on the correlation between HADS and satisfaction with care. Male participants who were more disturbed emotionally were more satisfied with nurses. Participants with elementary and high school levels of education and lower scores on HADS were more satisfied with nurses, while participants with university level of education had higher HADS scores and lower level of satisfaction with nurses.

Relationship between the Names of People and Enterprises with Plant Origin with Phytotoponyms in Five Croatian Regions.

In this study, the first and last names of people (FN and LN), enterprises (EN) (with plants'species roots in their names) and phytotoponyms (PT) in five Croatian regions are analyzed, in their relationships. The goals of the study were: to determine the correlations between FN, LN, EN and PT; to determine the latent structure of these variables; to forecast number of PT (criterion) on the base of predictors (FN, LN, EN); to determine grouping of the places (within certain regions) as cases by two plants' categorizations; to determine grouping of the plants as cases by regions. We have analyzed 15 places, grouped in five regions, with 39 different plant species. The results revealed that the only principal component highly positively correlated with the variables last name and office name, while the projections for the variables first name (moderate high) and phytotoponyms (low size) were negative. Prediction of the criteria phytotoponyms is satisfactorily good, using three predictors: last name, first name and the office name. First cluster analysis revealed that phytotoponyms are mostly related with trees and deciduous plants, while names are related with trees, deciduous and herbaceous plants. Second cluster analysis obtained clear distinction between regions in dominant PTs, based on certain plants' names. The results indicate clear association between phytotoponyms and names of people.

Measuring Physical Activity in Pregnancy Using Questionnaires: A Meta-Analysis

Physical activity (PA) during normal pregnancy has various positive effects on pregnant women's health. Determination of the relationship between PA and health outcomes requires accurate measurement of PA in pregnant women. The purpose of this review is to provide a summary of valid and reliable PA questionnaires for pregnant women. During 2013, Pubmed, OvidSP and Web of Science databases were searched for trials on measurement properties of PA questionnaires for pregnant population. Six studies and four questionnaires met the inclusion criteria: Pregnancy Physical Activity Questionnaire, Modified Kaiser Physical Activity Survey, Short Pregnancy Leisure Time Physical Activity Questionnaire and Third Pregnancy Infection and Nutrition Study Physical Activity Questionnaire. Assessment of validity and reliability was performed using correlations of the scores in these questionnaires with objective measures and subjective measures (self-report) of PA, as well as test-retest reliability coefficients. Sample sizes included in analysis varied from 45 to 177 subjects. The best validity and reliability characteristics (together with effect sizes) were identified for the Modified Kaiser Physical Activity Survey and Pregnancy Physical Activity Questionnaire (French, Vietnamese, standard). In conclusion, assessment of PA during pregnancy remains a challenging and complex task. Questionnaires are a simple and effective, yet limited tool for assessing PA.

Diversity of Y-chromosomal and mtDNA Markers Included in Mediscope Chip within Two Albanian Subpopulations from Croatia and Kosovo: Preliminary Data.

The aim of this preliminary study is to analyze genetic specificity of Kosovo Albanians comparing with neighboring populations using new genetic tool - MEDISCOPE gene chip, to investigate the feasibility of this approach. We collected 37 DNA samples (9 Croats, 17 Albanians from Croatia and 11 Albanians from Kosovo) from unrelated males born in Croatia and Kosovo. Additionally, samples were expanded with female individuals and mtDNA analysis included a total of 61 samples (15 Croats, 23 Albanians from Croatia and 23 Albanians from Kosovo). This pilot study suggests that the usage of the MEDISCOPE chip could be recognized as an efficient tool within recognition of the population genetic specificity even within extremely small sample size.

Chronic unreduced shoulder dislocations: Experience in a developing country trauma centre.

Chronic shoulder dislocations are extremely rare. The goal of this retrospective study was to describe the epidemiology of chronic shoulder dislocation in our environment and to evaluate the outcome of treatment. Bio-demographic data and injury details were retrieved from case files. Definitive method of reduction and stabilisation and duration of follow-up care were also noted. Nine cases of subcoracoid anterior chronic shoulder dislocation were seen during the 6-year period of the study. Seven (78%) of these patients were male and two (22%) were female. The mean age was 42 (±17.5) years. The common mechanisms of injury were road traffic crash in four patients (44%), domestic falls in four patients (44%) and dislocation while getting out of bed in one patient (12%). None of the patients had neurovascular deficit at presentation. Five patients were managed operatively and four were managed non-operatively. Mean follow-up was 8 months (range 6-12 months). Clinical evaluation by Rowe shoulder score revealed that operated cases had significantly higher mean rank scores than non-operated cases using the Mann-Whitney U test. Two operated cases were graded fair and three poor. All cases managed non-operatively had poor outcome grades. Meticulous attempt at soft tissue repair and early supervised physiotherapy can contribute to a favourable outcome.

Pattern of emergency room mortality among road traffic crash victims.

Road traffic injuries are a major cause of death in the emergency room. The goal of this study was to highlight the demographic pattern of road traffic-related deaths in the accident and emergency room of a regional trauma centre. This was a 5-year retrospective study in which road traffic-related cases of emergency room mortality between June 2009 and June 2014 were reviewed. A total of 33 road traffic crash-related deaths occurred during this period with a male-to-female ratio of 2.3:1. Most of these patients were pedestrians with severe injuries involving two or more Abbreviated Injury Scale (AIS) coded regions. The mean time between injury and presentation in the first trauma facility was 112.1 (±55.4)min, and between presentation in the emergency room and death was 410 (±645)min. Mangled lower extremity, bilateral long bone lower limb fractures, pelvic injuries, blunt injuries to the chest and abdomen, and cranial fossae fractures were the common injury pattern. Median ISS and NISS in these patients were 22 (interquartile range [IQR]=11) and 25 (IQR=17), respectively. Severe injuries, delayed presentation, multiple referrals and delayed resuscitative measures contribute to road traffic crash-related mortality.

Complications in leg lengthening using an Ilizarov external fixator and intramedullary alignment in children: comparative study during a fourteen-year period.

BACKGROUND: The purpose of this retrospective study was to evaluate the complications associated with leg lengthening in children treated with the Ilizarov external fixator (IEF) and compare them between two groups of patients: one group was treated using an IEF alone and the other group was treated using an IEF in association with intramedullary alignment (IA). PATIENTS AND METHODS: The study was performed at the University Children's Hospital in Belgrade, Serbia during a fourteen-year period (from 2000 to 2014). Complications occurred in 73 paediatric patients who underwent the leg lengthening procedure. Complications were classified according to the Caton classification and compared between two groups. Group I comprised 39 patients who underwent the limb lengthening procedure using IEF alone. Group II consisted of 34 patients who were treated with the combination of IEF and IA using two Kirschner wires (K-wires) or Titanium Elastic Nails (TEN). The duration of hospital treatment was also compared between the two groups and the impact of the type of IA on the occurrence of complications was assessed. RESULTS: There was a high rate of complications in patients treated using an IEF compared with those treated using the combination of IEF and IA, but there was no statistically significant difference between the two groups. There was a statistically significant difference in the duration of initial hospitalisation between the two groups, particularly when comparing TEN usage in IA. A comparison of the group of patients treated using an IEF in association with K-wires and patients treated using IEF and TEN showed there was no statistically significant difference in complication rate and duration of initial hospitalisation. CONCLUSION: IA has multiple advantages as a method of treatment of leg length inequality. The major effect of applying IA in association with a circular IEF is significantly reduced complication rate and duration of initial hospitalisation, particularly when using TEN as a method of IA. This method of treatment also decreases hospital costs.

Athletic Engagement and Athletic Identity in Top Croatian Sprint Runners.

The aim of the research was to determine construct validity and reliability for two questionnaires (Athlete Engagement Questionnaire-AEQ and Athletic Identity Measurement Scale-AIMS), applied on elite Croatian athletes-sprinters, as well as the correlations among the dimensions in these measuring instruments. Then, we have determined the differences in the dimensions of sport engagement and sport identity, according to gender, education level and winning medals on international competitions. A total of 71 elite athletes-sprinters (former and still active) are examined, from which 27 (38%) females and 44 (62%) males. The results of factor analyses revealed the existence of dimensions very similar as in the original instruments, which showed moderate to-high reliabilities. A small number of statistically significant correlations have been found between the dimensions of sport engagement and sport identity, mainly in male sprinter runners. Small number of statistically significant differences in the dimensions of sport engagement and sport identity have been found according to the gender, education level and winning medals on the international competitions. The most reasonable explanation of these differences could be given in terms of very similar characteristics of elite athletes on the same level of sport excellence.

Performance Indicators of the Top Basketball Players: Relations with Several Variables.

The aim of this study was to determine the differences in performance indicators for top senior male basketball players, with respect to several independent variables: position in the team, total situation-related efficiency, age, playing experience and the time spent on the court within the game and during championship season. The final sample of participants was selected from all teams in A-1 Croatian men's basketball league. Significant differences have been found according to the players': position in the team, total situation-related efficiency, and in interactions of the position in the team / total situation-related efficiency and minutes spent on the court in a game / playing experience. The differences in the situation-related efficiency between players have not been found according to the players' age and the number of games played. Further research can be directed towards deeper analysis of the influence of more complex differentiated variables playing experience and time spent on the court in a game on situation-related efficiency in basketball.

Gender Differences in Validity Scales of Personality Measuring Instruments in Psychiatric Patients.

The main goal of the study was to determine gender differences in validity scales of personality measuring instruments, among the psychiatric patients. Additional goals are to find the differences among male and female psychiatric patients, in relation to their age group, education level and type of psychiatric diagnosis. A total of 331 male and 331 female participants (psychiatric patients) are examined, classified by the categories of diagnosis, as following: Schizophrenia, schizotypal and delusional disorders (F20-F29), Mood (affective) disorders (F30-F39); Neurotic, stress-related and somatoform disorders neurotic, (F40-F48) and Disorders of adult personality and behavior (F60-F69). Four control scales are applied: Lie Scale (MMPIL or L scale), Scale of bizarre and confusing thinking (MMPIF or F scale) K scale of Defensiveness (MMPIK), together with Bias-scale in Plutchik's Emotion Profile Index (EPI). Three-factorial MANOVA was used in the analysis of the main effects, while non-parametric tests in the analysis of differences for each independent variable. Results reflect characteristic statistically significant gender differences in validity scales of personality measuring instruments, in most of the independent variables (the main effects are found for the level of education and age group). These results were interpreted within the theoretical framework of simulation and dissimulation.

Development and validation of a self-administered food frequency questionnaire to assess habitual dietary intake and quality of diet in healthy adults in the Republic of Croatia. .

Food frequency questionnaires (FFQ) are designed to assess habitual diet by asking about the frequency with which food items or specific food groups are consumed over a reference period. In this study, we have developed a FFQ to assess habitual dietary intake of healthy adults to estimate the quality of their nutrition and conducted a study to validate the developed FFQ against a three-day 24-hour recall. Second aim of the study is to establish the correlation between the FFQ to assess habitual dietary intake and a three-day 24-hour recall, in relation with participants' age and education level. FFQ used in our study was adapted from the Harvard Semiquantitative Food Frequency Questionnaire, consisted of 101 food items, divided into 9 groups. The 24-hour recalls were collected during one week (the same week when the FFQ was completed) and on each different day of the week (two weekdays and one weekend day). Both the FFQ and three day 24-hour recall were distributed to 100 healthy, employed subjects, 32 males (aged 39.73 +/- 14.02) and 36 females (aged 34.20 +/- 10.63). The results indicated that the developed FFQ is valid instrument to assess the habitual intake of energy and most of the nutrients in healthy adults in the Republic of Croatia, while men tended to have higher correlation coefficients than women and therefore a higher correlation of the FFQ with the three 24-hour recalls. Statistically significant correlations are not found between energy and nutrient intake based on the education level of the participants.

Quality of life in Croatian metastatic melanoma patients.

The aim of this study was to examine the quality of life (QoL) in 40 Croatian metastatic melanoma patients who had completed at least first-line treatment and to see if there was a correlation between QoL parameters and serum lactate dehydrogenase (LDH). LDH levels were measured and all patients clinically examined between April and September 2013. Two QoL questionnaires were used for patient self-evaluation: the European Organization for Research and Treatment of Cancer Quality of life Questionnaire (EORTC QLQ-C30) and the Dartmouth Primary Care Cooperative Research Network and the World Organization of National Colleges, Academies, and Academic Associations of General Practitioners/Family Physicians (COOP/WONCA) charts. The average EORTC QLQ-C30 score for global health status (GHS) was 41.204. The average scores for functional scales were high, with the exception of emotional functioning (65.02). Blood LDH levels positively correlated with the Eastern Cooperative Oncology Group (ECOG) status (r = 0.415; p < 0.01) and pain (r = 0.345; p < 0.05), but not with any functional or COOP/WONCA scores. Global health status (GHS) positively correlated with patient age at the time of evaluation (r = 0.386; p < 0.05) and age at the time when metastatic disease had been diagnosed (r = 0.366; p < 0.05). Quality of life for the studied group of metastatic melanoma patients in Croatia can be considered generally good, with the exception of emotional functioning and symptoms of fatigue, dispnoea, insomnia, and financial difficulties.

Participation Motivation and Student's Physical Activity among Sport Students in Three Countries.

The main aim of this study was to examine the differences in motivation to participate in sport activities among sports students from three different countries. On a sample of 390 sports students from Slovenia, Croatia and Germany we studied what motivates an interest in being sports active. The sample was stratified across the choice to attend table tennis lessons at all three institutions and all students have completed the Participation Motivation Questionnaire (PMQ). The results revealed that the latent structure of the types of sports students' motives consisted of six factors (sport action with friend, popularity, fitness & health, social status, sports events, relaxation through sports). We also found significant sex differences in motivation to participate in sport activities for all sports students from the three different countries. We did not find relevant age-based differences among the students, and this is the only initial hypothesis that we can reject. Key pointsThe potential implications of the result can be in better understanding the relationship between different motivational orientations - in particular, extrinsic motivation - and sport motivation among school-aged individuals.In the context of Self Determination Theory, students can be encouraged in developing more autonomous orientations for sport activity, rather than controlled and impersonal, especially in certain countries.Significant factors of differences have been found in motivation to participate in sport activities among sports students from three different countries and also some significant sex differences have been found in motivation to participate in sport activities for all sports students.

A comparison of two conative characteristics of top basketball and recreational table tennis players.

The purpose of this study is to adapt imported instruments for measuring multidimensional perfectionism in sport situations and perceived group cohesion, in terms of construct validity and reliability, as well as from the aspect of interpretability, addressed on Croatian samples of athletes. Group Environment Questionnaire (GEQ) and Sport Multidimensional Perfectionism Scale (MSSP) are applied. The sample of 223 male Croatian athletes comprises of N1 = 107 top basketball players from nine teams in A-1 Croatian Basketball League and N2 = 116 recreational table tennis players who play in Table Tennis Organization of Clubs and Actives in Zagreb. Principal Components Analyses at both instruments showed two-component structures: combined social-task cohesion and friendship were latent dimensions of perceived group cohesion, while the internalized standards and externalized standards revealed two aspects of multidimensional perfectionism in sport situations. In perceived group cohesion, basketball players achieved higher average results than table tennis players in the friendship, while the table tennis players showed higher combined social and task orientation than basketball players. In multidimensional sport perfectionism, basketball players have higher average result than table tennis players in the dimension of internalized perfectionism, but in externalized perfectionism there is no statistical significant difference. Younger players showed higher average results than older players in the dimension of friendship, while older players showed higher combined social and task orientation than younger players. Younger players have higher average scores in internalized perfectionism. The main importance of the research is adjustment of multidimensional perfectionism in sport situations and perceived group cohesion to Croatian athletes, providing additional possibility of cross-cultural adjustment of both concepts, psychometrically and theoretically.