Lovro Štefan

The Reliability of the Mediterranean Diet Quality Index (KIDMED) Questionnaire

The purpose of the present study was to determine the test–retest reliability of the Mediterranean Diet Quality Index (KIDMED) questionnaire in college students. Two hundred and seventy-six college students (127 men, 46%; 149 women, 54%; mean age 19.70 ± 1.32 years; mean height 1.75 ± 0.09 m; mean weight 69.28 ± 13.84 kg; mean body-mas index 22.41 ± 3.19 kg/m2) participated in the study. To investigate the reliability of the KIDMED questionnaire, the participants were asked to complete the questionnaire on two occasions two weeks apart, stratified by gender. Kappa statistics showed moderate to excellent agreement (ranging from 0.504 to 0.849) in the total sample and moderate to excellent agreement in both men (ranging from 0.467 to 0.803) and women (ranging from 0.435 to 0.927). Results in the total KIDMED score showed a moderate correlation between two occasions inthe total sample (κ = 0.597, p < 0.001) and in women (κ = 0.586, p < 0.001) and a good correlation in men (κ = 0.611, p < 0.001). Our study shows that the KIDMED questionnaire is a reliable instrument for assessing adherence to the Mediterranean diet in college students. Future studies should focus on investigating the reliability of the questionnaire in other countries and in different age groups for generating comparable data.

Self-Reported Sleep Duration and Self-Rated Health in Young Adults

STUDY OBJECTIVES This study aimed to determine the associations between the self-reported sleep duration and self-rated health in young adults. METHODS In this cross-sectional study, participants were 689 young adults (mean age 20 ± 1.35 years, 49.8% female). Sleep duration and self-rated health, as the main outcome of interest, were measured as self-reported. As potential covariates, we included sex, age, smoking status, alcohol consumption, physical activity, sedentary behavior, psychological distress, and body mass index. RESULTS Approximately 30% of participants slept 7-8 hours, 17.4% were short sleepers (categories < 6 hours and 6-7 hours), and 53.9% were long sleepers (categories 8-10 hours and > 10 hours of sleep). In an unadjusted model, compared with the reference category (7-8 hours of sleep), those who slept < 6 hours (odds ratio 0.20; 95% confidence interval 0.08 to 0.48) and between 6-7 hours (odds ratio 0.43; 95% confidence interval 0.26 to 0.69) were less likely to have good self-rated health. In an adjusted model, short (< 7 hours) and long sleep (> 10 hours) were both associated with poor self-rated health. CONCLUSIONS Our results suggest that both short (< 7 hours) and long (> 10 hours) sleepers have lower odds of having good self-rated health after adjusting for potential covariates. Health professionals should pay more attention to young adults, who have both short and long period of sleep, in order to prevent health problems and potential acute or chronic diseases.

The Associations between Sleep Duration and Sleep Quality with Body-Mass Index in a Large Sample of Young Adults

Background: The main aims of this study were to explore the associations between time spent in bed (as a proxy of sleep duration) and sleep quality with overweight/obesity status in a large sample of young adults. Methods: In this cross-sectional study, participants were 2100 university students (49.6% of women). We used Pittsburgh Sleep Quality Index (PSQI) questionnaire to assess time spent in bed and sleep quality. Body-mass index (BMI) was self-reported and dichotomized as normal (<25 kg/m2) vs. overweight/obesity (≥25 kg/m2) status. Results: In model 1, both short (<6 h/day, OR = 2.72; 95% CI 1.27 to 5.84) and long (>10 h/day, OR = 3.38; 95% CI 2.12 to 5.40) time spent in bed were associated with a greater likelihood of being overweight/obese. In model 2, poor sleep quality (>5 points, OR = 1.45; 95% CI 1.14 to 1.83) was associated with a greater likelihood of being overweight/obese. After entering time spent in bed and sleep quality simultaneously into the model 3, both short (OR = 2.64; 95% CI 1.23 to 5.66) and long (OR = 3.27; 95% CI 2.04 to 5.23) time spent in bed and poor sleep quality (OR = 1.40; 95% CI 1.10 to 1.78) were associated with overweight/obesity status. Conclusions: Our results show that both short and long time spent in bed and poor sleep quality are associated with overweight/obesity status in young adults. Special interventions and policies that use both sleep duration and sleep quality as protective factors against overweight/obesity are warranted.

The Influence of Familiarization on Physical Fitness Test Results in Primary School-Aged Children

PURPOSE The number of familiarization sessions in fitness assessments seems to be critical and inconsistent. Therefore, the primary aim of this research was to determine the number of familiarization attempts that stabilize the results in particular physical fitness tests. The secondary aim was to establish the test reliability through familiarization sessions. METHODS Thirty-nine primary school children participated in this research (age: 10.8 years, body mass: 40.6 ± 8.9 kg, and body height: 145.3 ± 7.2 cm). During six sessions, with one session every third day, participants performed the following tests to assess explosive strength (vertical jump and standing long jump), coordination (polygon backward and polygon with turn) and flexibility (toe touch). RESULTS The results of repeated analysis of variance (ANOVA) showed that there were significant increases (p < .05) in the polygon backward and polygon with turn performances from the first to third familiarization session. The standard error of measurement decreased as sessions progressed, indicating little within subject variation between the coordination test results following a familiarization period. Statistically significant differences were identified in the vertical jump test from the fourth test session compared with the first session. On the other hand, statistically significant differences for the standing long jump test were only found in the final session compared with the initial session. In the toe touch test, there were no significant increases from the first to the final familiarization session. All tests showed high a reliability coefficients, ranging from 0.979 to 0.991. CONCLUSION Polygon backward and polygon with turn performance may be a practical, reliable method to assess coordination in primary school-aged children. However, completion of at least 3 practice sessions is suggested for participants to obtain a stable score. In addition, both jump tests are feasible for assessing skill-related fitness in young children, although the scientific reliability of the two tests should be questioned and the tests should be tailored to fit the age group of the children.

Are lower levels of physical activity and self-rated fitness associated with higher levels of psychological distress in Croatian young adults? A cross-sectional study

Background Although previous evidence has shown that physical activity and physical fitness lower the level of psychological distress, little is known of simultaneous associations between of physical activity and physical fitness and with psychological distress, especially in young adults. Therefore, the main purpose of the present study was to explore both separate and simultaneous association between physical activity and physical fitness with psychological distress. Methods Participants in this cross-sectional study were 2,100 university students (1,041 men and 1,059 women) chosen from eight faculties in the city of Zagreb. Physical activity, physical fitness and psychological distress were assessed using structured questionnaires. The associations were examined using logistic regression analysis. Results After adjusting for gender, body-mass index, self-rated health, material status, binge drinking, chronic disease/s and sleep quality, “insufficient” physical activity (OR = 2.60; 95% CI [1.92–3.52]) and “lower” levels of physical fitness (tertile 2; OR = 1.94; 95% CI [1.25–3.01] and tertile 1; OR = 2.59; 95% CI [1.65–4.08]) remained associated with “high” psychological distress. When physical activity and physical fitness were entered simultaneously into the model, “insufficient” physical activity (OR = 2.35; 95% CI [1.72–3.21]) and “lower” levels of physical fitness (tertile 2; OR = 1.77; 95% CI [1.24–2.77] and tertile 1; OR = 2.00; 95% CI [1.26–3.20]) remained associated with “high” psychological distress. Conclusion Our study shows that both “insufficient” physical activity and “lower” levels of physical fitness are associated with “high” psychological distress, even after adjusting for numerous covariates. Therefore, special policies aiming to increase the levels of physical activity and fitness are warranted.

Mediterranean Diet and Its Correlates among Adolescents in Non-Mediterranean European Countries: A Population-Based Study

Little is known about the factors which might influence the adherence to a Mediterranean diet in non-Mediterranean European countries. Thus, the main purpose of this study was to determine the associations between socioeconomic, psychological, and physical factors on a Mediterranean diet. In this cross-sectional study, participants were 14–18-year-old adolescents (N = 3071) from two non-Mediterranean countries: Lithuania (N = 1863) and Serbia (N = 1208). The dependent variable was Mediterranean diet, and was assessed with the Mediterranean Diet Quality Index for children and adolescents questionnaire. Independent variables were gender, body-mass index, self-rated health, socioeconomic status, psychological distress, physical activity, and sedentary behavior. The associations between dependent and independent variables were analyzed by using logistic regression. Results showed that higher adherence to a Mediterranean diet was associated with higher self-rated health, socioeconomic status, and physical activity, yet low adherence to a Mediterranean diet was associated with being female, having higher body-mass index, psychological distress, and sedentary behavior. Our findings suggest that future studies need to explore associations between lifestyle habits—especially in target populations, such as primary and secondary school students.

The Relationship between Lifestyle Factors and Body Compositionin Young Adults

Background: Little is known of how lifestyle factors might influence on body composition parameters in young adults from Croatia. The main purpose of the present study was to investigate the relationship between the lifestyle factors and body composition in young adults. Methods: In this cross-sectional study, participants were 271 university students (59.0% of women). Body composition was measured by using bioelectric impendance analysis (BIA). Blood pressure and heart rate were measured according to standardized protocol and Mediterranean diet adherence (MD), physical activity (PA) and psychological distress (PD) were assessed with validated questionnaires. Results: Self-rated health (SRH) and PA were inversely associated with weight, body-mass index (BMI), fat-mass percentage and blood pressure in men and with weight, BMI, fat-mass percentage and heart rate in women. Higher levels of SRH and PA were positively associated with fat-free mass percentage in both men and women. Smoking was positively associatedwith BMI and fat-mass percentage in women and with heart rate in men. Alcohol consumption was positively associated with weight and BMI in women and fat-mass percentage and heart rate in men, yet inversely associated with fat-free mass percentage only in men. PD was positively associated with weight and blood pressure in men and with BMI, fat-mass percentage and blood pressure in women. Conclusions: Our study shows that higher levels of SRH, MD and PA are related with healthy body composition parameters in young adults. Special interventions and policies that enhance PA and MD and decrease substance use and misuse (SUM) and PD should be implemented within the university school systems.

How different contexts of social capital are associated with self-rated health among Lithuanian high-school students

ABSTRACT Background. Adolescents’ self-rated health is related to a number of sociodemographic and socio-economic factors, health-related behaviors, and their social environment. The impact of the latter is still not well explored. An adolescent’s social environment is represented by the social capital, i.e. social resources that they can access. The relationships between various contexts of social capital (family, neighborhood, peers, and school) and self-rated health among adolescents are still unclear. Objective. This study aims to examine the relationships between various social capital contexts and self-rated health in Lithuanian adolescents. Methods. The current cross-sectional study includes a nationally representative sample of 1863 adolescents (51.4% were girls) aged 14–18 years. The indicators of self-rated health as well as indicators of social capital in family, neighborhood, and school contexts were assessed. The results of the relationships between self-rated health and contexts of social capital were calculated controlling for the following covariates: physical activity, psychological distress, gender, body mass index, and family socioeconomic status. Results. Results indicate that there are significant relationships between good self-rated health and a higher level of family support, neighborhood trust, and vertical school trust. In the final logistic regression model, while controlling for all covariates, a higher level of family support and neighborhood trust remain significant predictors of good self-rated health. Conclusions. Family support and neighborhood trust are important correlates of self-rated health in adolescents.

Surgical Treatment of Moderate Hallux Valgus: A Comparison of Distal Chevron Metatarsal Osteotomy With and Without Lateral Soft-Tissue Release

Purpose: The purpose of the study was to determine whether lateral soft-tissue release (LSTR) has a beneficial or detrimental effect on the outcome of distal Chevron first metatarsal osteotomy (DCMO) in the treatment of moderate hallux valgus (HV). Methods: We compared the effect of different surgical treatments in 2 groups of patients: group I (23 patients, 25 feet, average age of 55 [from 43 to 77] years) was subjected to DCMO only, whereas group II (18 patients, 23 feet, average age of 59 [from 52 to 70] years]) was subjected to DCMO with LSTR. The American Orthopaedic Foot and Ankle Society’s Hallux Metatarsophalangeal-Interphalangeal scale survey was conducted postoperatively, followed by the brief survey on postoperative patient satisfaction. The patient follow-up period was from 18 to 24 months after surgical treatment, on average. Results: After surgical intervention, both groups of patients presented with an improved HV angle, but there was no significant difference between the groups. However, group II showed significant improvements in medial sesamoid bone position and patient satisfaction scores as compared with group I. Conclusion: Our midterm follow-up of surgical treatments for moderate HV deformity suggests that both procedures provide good postoperative results. However, according to our results, DCMO with LSTR provides better results than procedures without LSTR. Levels of Evidence: Therapeutic, Level III: Retrospective comparative study

A prospective randomised non-blinded comparison of conventional and Dorgan's crossed pins for paediatric supracondylar humeral fractures.

BACKGROUND Closed reduction and percutaneous pinning are the preferred treatment of displaced supracondylar humeral fractures in children. The purpose of this study is to evaluate the non-standard Dorgans method and compare its results with those of the standard percutaneous cross pinning method in treatment of unstable or irreducible Gartland type II and III supracondylar humeral fractures in children. PATIENTS AND METHODS This was a prospective evaluation of 138 consecutive patients with Gartland type II or III extension supracondylar humeral fractures referred to University Childrens Hospital during a four-year period. The patients were randomized into two groups: the first group, comprised of 71 patients, was treated with standard pin configuration and the second group, comprised of 67 patients, underwent Dorgans method. The study included 88 boys and 50 girls aged 1.5-11.4 years (mean 6.5±2). At initial presentation 8.7% (n-12) fractures were classified as Gartland type IIa, 25.4% (n-35) as Gartland type IIb and 65.9% (n-91) as Gartland type III. RESULTS Flynns criteria were used to evaluate the results. An excellent clinical outcome was reported in about 90% of patients (n-90) treated with standard pin configuration and 89.5% (n-60) of patients treated with Dorgans method. There were no statistically significant differences in outcomes between the groups in terms of their gender, age, fracture types, function and cosmetics. Neurological lesions were observed in 9.9% of patients (n=7) who were treated using the standard configuration Kirschner pins, while in those treated by Dorgans method neurological complications were not observed. However, the procedure time was longer (mean 36.54±5.65min) and radiation exposure significantly higher (mean 10.19±2.70 exposures) in the group that was treated using Dorgans method, compared to the conventional method (mean 28.66±3.76min and 7.54±1.63 exposures). CONCLUSION Two laterally inserted crossed pins provide adequate stability with good functional and cosmetic outcome for most unstable paediatric supracondylar humeral fractures with no risk of iatrogenic ulnar nerve injury.