Sandra Šipetić Grujičić

Introduction Studies consistently link excessive smartphone use to poor sleep quality, depression, anxiety, and stress. This study specifically aimed to investigate these associations among medical students in Belgrade and Nis (Central Serbia). Materials and methods The cross-sectional study included a sample of 761 students, who were selected from both the Faculties of Medicine at the University of Belgrade and the University of Nis. Questionnaires, including the International Physical Activity Questionnaire – Short Form (IPAQ-SF), Smartphone Addiction Scale – Short Version (SAS-SV), the Pittsburgh Sleep Quality Index (PSQI), and the Depression, Anxiety, and Stress Scale – 21 items (DASS-21), were completed by the participants. Statistical analysis techniques, such as the Chi-square test, student’s t -test, and logistic regression, were employed to examine the relationship between smartphone addiction, physical activity, sleep quality, depression, anxiety, and stress. Results The findings indicated a prevalence of smartphone addiction among medical students at 21.7%, with rates of 22.9% among males and 21.1% among females. Females exhibited significantly higher scores on the SAS-SV scale compared to males ( p = 0.032). Univariate logistic regression analysis revealed significant associations between smartphone addiction and spending over 4 h daily on smartphones (OR = 2.39; p < 0.001), poor sleep quality (OR = 1.65; p = 0,005), as well as elevated levels of stress (OR = 1.75; p = 0.003), anxiety (OR = 2.04; p < 0.001), and depression (OR = 2.29; p < 0.001). Multivariate regression analysis identified spending more than 4 h daily on smartphones (OR = 2.39; p < 0.001) and increased levels of depression (OR = 2.51; p < 0.001) as independent significant factors associated with smartphone addiction. Conclusion This study sheds light on the prevalence of smartphone addiction among medical students, with spending excessive time on smartphones and higher levels of depression standing out as significant factors. Future research should delve into the underlying mechanisms and causal relationships between smartphone addiction and these psychosocial factors. Understanding these connections will aid in developing effective interventions and strategies to tackle this growing public health concern.

OBJECTIVE: To investigate if there is a reduced risk of type 1 diabetes in children breastfed or exclusively breastfed by performing a pooled analysis with adjustment for recognized confounders. RESEARCH DESIGN AND METHODS: Relevant studies were identified from literature searches using MEDLINE, Web of Science, and EMBASE. Authors of relevant studies were asked to provide individual participant data or conduct prespecified analyses. Meta-analysis techniques were used to combine odds ratios (ORs) and investigate heterogeneity between studies. RESULTS: Data were available from 43 studies including 9,874 patients with type 1 diabetes. Overall, there was a reduction in the risk of diabetes after exclusive breast-feeding for >2 weeks (20 studies; OR = 0.75, 95% CI 0.64-0.88), the association after exclusive breast-feeding for >3 months was weaker (30 studies; OR = 0.87, 95% CI 0.75-1.00), and no association was observed after (nonexclusive) breast-feeding for >2 weeks (28 studies; OR = 0.93, 95% CI 0.81-1.07) or >3 months (29 studies; OR = 0.88, 95% CI 0.78-1.00). These associations were all subject to marked heterogeneity (I(2) = 58, 76, 54, and 68%, respectively). In studies with lower risk of bias, the reduced risk after exclusive breast-feeding for >2 weeks remained (12 studies; OR = 0.86, 95% CI 0.75-0.99), and heterogeneity was reduced (I(2) = 0%). Adjustments for potential confounders altered these estimates very little. CONCLUSIONS: The pooled analysis suggests weak protective associations between exclusive breast-feeding and type 1 diabetes risk. However, these findings are difficult to interpret because of the marked variation in effect and possible biases (particularly recall bias) inherent in the included studies.

Aim . To examine the prevalence of low back pain, to identify self-perceived triggers of low back pain, and to investigate the impact of perceived pain on the daily activities and mood among medical students. Methods . This cross-sectional study enrolled 459 fourth year students at the Faculty of Medicine in Belgrade during December 2014. The anonymous questionnaire was used for data collection. In data analysis, the chi-square test and t -test were used. Results . The lifetime prevalence of low back pain was 75.8%, 12-month prevalence 59.5%, and point prevalence 17.2%. Chronic low back pain was experienced by 12.4% of the students. Both the lifetime (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.001</mml:mn></mml:mrow></mml:math>) and the 12-month (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.001</mml:mn></mml:mrow></mml:math>) low back pain prevalence rates were significantly higher among female medical students. Mental stress during an exam period (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.001</mml:mn></mml:mrow></mml:math>), sitting at the university (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.002</mml:mn></mml:mrow></mml:math>), fatigue (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.043</mml:mn></mml:mrow></mml:math>), improper body posture (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M6"><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.005</mml:mn></mml:mrow></mml:math>), and lack of exercise (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M7"><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.001</mml:mn></mml:mrow></mml:math>) as self-perceived triggers of low back pain were significantly more often reported by female students, compared to males. Regarding daily functioning, the experience of low back pain mostly affects students sleeping (14.6%) and walking (12.0%). Conclusions . The prevalence of LBP is high among Belgrade medical students and significantly affects their everyday functioning.

OBJECTIVE: The aim if the study was to investigate whether children born to older mothers have an increased risk of type 1 diabetes by performing a pooled analysis of previous studies using individual patient data to adjust for recognized confounders. RESEARCH DESIGN AND METHODS: Relevant studies published before June 2009 were identified from MEDLINE, Web of Science, and EMBASE. Authors of studies were contacted and asked to provide individual patient data or conduct prespecified analyses. Risk estimates of type 1 diabetes by maternal age were calculated for each study, before and after adjustment for potential confounders. Meta-analysis techniques were used to derive combined odds ratios and to investigate heterogeneity among studies. RESULTS: Data were available for 5 cohort and 25 case-control studies, including 14,724 cases of type 1 diabetes. Overall, there was, on average, a 5% (95% CI 2-9) increase in childhood type 1 diabetes odds per 5-year increase in maternal age (P = 0.006), but there was heterogeneity among studies (heterogeneity I(2) = 70%). In studies with a low risk of bias, there was a more marked increase in diabetes odds of 10% per 5-year increase in maternal age. Adjustments for potential confounders little altered these estimates. CONCLUSIONS: There was evidence of a weak but significant linear increase in the risk of childhood type 1 diabetes across the range of maternal ages, but the magnitude of association varied between studies. A very small percentage of the increase in the incidence of childhood type 1 diabetes in recent years could be explained by increases in maternal age.

Background and Objectives: Studies on the effects of studying on a medical student’s quality of life are sparse. The World Health Organization Quality of Life (WHOQOL-BREF) questionnaire is a widely used scale that enables the assessment and international comparisons of the quality of life. The aim of this study was to evaluate psychometric properties of the WHOQOL-BREF questionnaire among Serbian medical students. Material and Methods: We conducted a cross-sectional study that involved 760 medical students at a state medical faculty at the University of Kragujevac, Serbia. The reliability of the WHOQOL-BREF was evaluated using Cronbach’s alpha coefficient and test–retest analysis, and the validity was examined using principal component analysis, with Promax rotation method. Results: Cronbach’s alpha coefficient for the whole WHOQOL-BREF scale was 0.896. Internal reliability for all domains was above 0.70, except for the domain “Social Relationships” (0.533). The test–retest reliability for all domains was significant at p &lt; 0.01 level, showing good stability of the scale. Principal component analysis with Promax rotation method indicated four main components that explained 49.5% of variance. Conclusion: The Serbian version of the WHOQOL-BREF scale showed satisfactory psychometric properties that facilitate estimation of the quality of life of medical students.