BACKGROUND: Psychological distress among medical students is commonly observed during medical education and is generally related to poor academic self-perception. We evaluated the role of peer social support at medical schools in the association between psychological distress and academic self-perception. METHODS: An online survey was conducted in a medical degree program for 138 international students educated in English in the Czech Republic. The Medical Student Well-Being Index was used to define the students' psychological distress. Perceived peer social support was investigated with the Multidimensional Scale of Perceived Social Support. Poor academic self-perception was defined as the lowest 30% of a subscale score of the Dundee Ready Education Environment Measure. Analyses evaluated the presence of additive interactions between psychological distress and peer social support on poor academic self-perception, adjusted for possible confounders. RESULTS: Both psychological distress and low peer social support were negatively associated with poor academic self-perception, adjusted for local language proficiency and social support from family. Students with psychological distress and low peer social support had an odds ratio of 11.0 (95% confidence interval (CI): 2.1-56.6) for poor academic self-perception as compared with those without distress who had high peer social support. The presence of an additive interaction was confirmed in that the joint association was four times as large as what would have been expected to be on summing the individual risks of psychological distress and low peer social support (synergy index = 4.5, 95% CI: 1.3-14.9). CONCLUSIONS: Psychological distress and low peer social support may synergistically increase the probability of poor academic self-perception among international medical students. Promoting peer social relationships at medical school may interrupt the vicious cycle of psychological distress and poor academic performance.

• MeSH
• dospělí MeSH
• hodnocení rizik MeSH
• internacionalita MeSH
• interval spolehlivosti MeSH
• klinické kompetence * MeSH
• lidé MeSH
• mladý dospělý MeSH
• mnohojazyčnost MeSH
• odds ratio MeSH
• průřezové studie MeSH
• psychický stres diagnóza   epidemiologie   MeSH
• sebepojetí * MeSH
• školy lékařské MeSH
• sociální opora * MeSH
• studenti lékařství psychologie   MeSH
• studium lékařství pregraduální metody   MeSH
• vyrovnaná skupina * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

OBJECTIVES: This study investigated the differences between non-excessive, moderately excessive, and highly excessive internet use among adolescents. These differences were explored in terms of personal characteristics, psychological difficulties, environmental factors, and manner of internet use. METHODS: A representative sample was investigated, consisting of 18,709 adolescents aged 11-16 and their parents, from 25 European countries. Excessive internet use was measured using a five item scale covering following factors: salience, conflict, tolerance, withdrawal symptoms, and relapse and reinstatement. The main data analysis utilised multinomial and binary logistic regression models. RESULTS: The vast majority of respondents reported no signs of excessive internet use. Moderately excessive users (4.4%) reported higher emotional and behavioural difficulties, but also more sophisticated digital skills and a broader range of online activities. The highly excessive users (1.4%) differed from the non-excessive and moderately excessive users in their preference for online games and in having more difficulties with self-control. CONCLUSIONS: Adolescents who struggle with attention and self-control and who are inclined toward online gaming may be especially vulnerable to the otherwise uncommon phenomenon of excessive internet use.

• MeSH
• časové faktory MeSH
• chování mladistvých psychologie   MeSH
• dítě MeSH
• duševní zdraví * MeSH
• hodnocení rizik MeSH
• internet statistika a číselné údaje   MeSH
• interval spolehlivosti MeSH
• lidé MeSH
• logistické modely MeSH
• mladiství MeSH
• multivariační analýza MeSH
• návykové chování * MeSH
• odds ratio MeSH
• pozornost fyziologie   MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• sebepojetí MeSH
• videohry statistika a číselné údaje   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Geografické názvy
• Evropa MeSH

BACKGROUND: Longitudinal investigation of the association between mobile health (mHealth) app use and attitudes toward one's body during adolescence is scarce. mHealth apps might shape adolescents' body image perceptions by influencing their attitudes toward their bodies. Adolescents might also use mHealth apps based on how they feel and think about their bodies. OBJECTIVE: This prospective study examined the longitudinal within-person associations between mHealth app use, body dissatisfaction, and physical self-worth during adolescence. METHODS: The data were gathered from a nationally representative sample of Czech adolescents aged between 11 and 16 years (N=2500; n=1250, 50% girls; mean age 13.43, SD 1.69 years) in 3 waves with 6-month intervals. Participants completed online questionnaires assessing their mHealth app use, physical self-worth, and body dissatisfaction at each wave. The mHealth app use was determined by the frequency of using sports, weight management, and nutritional intake apps. Physical self-worth was assessed using the physical self-worth subscale of the Physical Self Inventory-Short Form. Body dissatisfaction was measured with the items from the body dissatisfaction subscale of the Eating Disorder Inventory-3. The random intercept cross-lagged panel model examined longitudinal within-person associations between the variables. A multigroup design was used to compare genders. Due to the missing values, the final analyses used data from 2232 adolescents (n=1089, 48.8% girls; mean age 13.43, SD 1.69 years). RESULTS: The results revealed a positive within-person effect of mHealth app use on the physical self-worth of girls: increased mHealth app use predicted higher physical self-worth 6 months later (β=.199, P=.04). However, this effect was not consistent from the 6th to the 12th month: a within-person increase in using apps in the 6th month did not predict changes in girls' physical self-worth in the 12th month (β=.161, P=.07). Regardless of gender, the within-person changes in the frequency of using apps did not influence adolescents' body dissatisfaction. In addition, neither body dissatisfaction nor physical self-worth predicted app use frequency at the within-person level. CONCLUSIONS: This study highlighted that within-person changes in using mHealth apps were differentially associated with adolescents' body-related attitudes. While increased use of mHealth apps did not influence body dissatisfaction across genders, it significantly predicted higher physical self-worth in adolescent girls 6 months later. A similar association was not observed among boys after 6 months. These findings indicate that using mHealth apps is unlikely to have a detrimental impact on adolescents' body dissatisfaction and physical self-worth; instead, they may have a positive influence, particularly in boosting the physical self-worth of adolescent girls.

• Klíčová slova
• RI-CLPM, adolescent, body dissatisfaction, longitudinal study, mHealth app, physical self-worth, random intercept cross-lagged panel model,
• MeSH
• chování mladistvých * psychologie   MeSH
• dítě MeSH
• lidé MeSH
• longitudinální studie MeSH
• mladiství MeSH
• mobilní aplikace * statistika a číselné údaje   MeSH
• nespokojenost s tělem * psychologie   MeSH
• představa o vlastním těle * psychologie   MeSH
• prospektivní studie MeSH
• průzkumy a dotazníky MeSH
• sebepojetí * MeSH
• telemedicína statistika a číselné údaje   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

PURPOSE OF THE STUDY: The study aim is to present changes in the self-rating of health and functional status in performing activities of daily living, reported by the elderly persons with ischaemic heart disease (IHD), at the time interval of 12 years. Gender-related differences as well as socio-medical characteristics have been involved in the analysis changes. DESIGN AND METHODS: The study was carried out in 607 elderly respondents who participated in two surveys at the time interval of 12 years. The analysis of the functional ability in performing daily activities in both surveys was based on the ADL and IADL scales, self-rated health was based on the scale ranging from very poor to excellent health. RESULTS: It has been observed in the baseline survey that the respondents with IHD reported lower mobility, functional activity and scored their health lower than other respondents. Though females with IHD scored higher their functional ability than males with the same disease, decrease of their functional ability at the time interval between both surveys was three-fold higher compared to males with the same disease. The results of the second study demonstrated age-related level of self-coping with the activities of daily living (ADL scale) in females with IHD, while none of the factors from the baseline survey had influence on their functional independence (irrespective of IHD). Functional status in the second study of males with IHD has been influenced by age and presented in baseline study willingness to life, while in males who have not reported IHD, any factor coming from the 1st survey have not determined the level of independence in activities of ADL in survey II. Functional ability in males with IHD was affected in the IInd study, besides age, by the attitude denying weariness of life demonstrated in the baseline survey. None of the factors from the baseline survey determined self-coping with daily activities by the males without IHD as it was observed in the IInd study.

• MeSH
• činnosti denního života * MeSH
• ischemická choroba srdeční epidemiologie   patofyziologie   MeSH
• lidé MeSH
• neparametrická statistika MeSH
• průzkumy a dotazníky MeSH
• regresní analýza MeSH
• rozdělení chí kvadrát MeSH
• sebeodhalení MeSH
• senioři MeSH
• sexuální faktory MeSH
• zdravotní stav * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Polsko epidemiologie   MeSH

The study of reliability was part of a project funded by the Grant Agency of the Czech Ministry of Health. The repeatability of answers, 180 questionnaires being sent again after a six week interval, was assessed by two methods: by the percentages of agreement and using the Kappa index. We evaluated 61 questions, which were divided into five sections (general questions, questions on employment, lifestyle, health, and personality). The agreement rate varied from 46% to 100% and the value of the Kappa index from -0.01 to 1. The agreement performed by the Kappa index was divided into 4 groups (< or = 0.4--poor; 0.41-0.6--average; 0.61-0.80--good; 0.81-1 almost perfect). The agreement across our questionnaire was poor in 6.6% of the questions, average--in 31.1%, good--in 45.9% and almost perfect--in 16.4% of the questions. Next we divided the questions by their content into two groups--the factual questions (group 1) and questions where answers contain an evaluative or motivational element (group 2). Significant differences (p < 0.001) were found between groups 1 and 2 in the agreement (86.8%; 72.1%) and the Kappa index (0.73; 0.48). In questions where agreement of answers is evaluated as average or even weak we used three types of solution: a) substitution by the analogous questions with a higher agreement, b) aggregation of the answers if possible, or c) the questions were not used for the analyses. These important results will be considered in further analyses of the data and in the interpretation of the study results. The detailed information about the whole project and the results has already been published or presented are available on the following web site: www.zuova.cz/projekty/ses.php.

• MeSH
• lidé MeSH
• postoj ke zdraví MeSH
• průzkumy a dotazníky normy   MeSH
• sebeodhalení MeSH
• společenská třída * MeSH
• stupeň vzdělání MeSH
• zdravé chování * MeSH
• zdravotnické přehledy * MeSH
• životní styl * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• validační studie MeSH
• Geografické názvy
• Česká republika MeSH

PURPOSE: Comorbidity has a negative impact on quality of life (QoL). This study aimed to investigate whether the impact of comorbidity on QoL is lower in older home care clients with positive attitudes toward aging. METHODS: Totally, 361 older adults aged 50-91 years who were clients of 14 home care agencies in two regions in the Czech Republic gave an in-person interview to research nurses and completed the WHOQOL-BREF, the WHOQOL-OLD, and the Attitudes to Aging Questionnaire. The Charlson comorbidity index was calculated using ICD-10 codes. To address possible interaction between comorbidity and attitudes toward aging for QoL, the presence of additive interaction between comorbidity and attitudes toward aging on QoL was examined by synergy index. All analyses were adjusted by age, gender, education, and living arrangement. RESULTS: A higher comorbidity index was significantly associated with lower scores of both QoL measures; one index increase was associated with 3.7 [95 % confidence interval (CI) 1.5: 5.9] decreases in generic QoL and 3.6 (95 % CI 1.3: 5.9) decreases in older-specific QoL. In stratified analyses by attitudes toward aging, comorbidity showed no association with QoL among those with positive attitudes, while it was significantly associated with low QoL in those without positive attitudes. The presence of additive interactions between comorbidity and less than positive attitudes on falling in low QoL was clearly suggested. CONCLUSIONS: The negative impact of comorbidity on QoL might be mitigated by promoting a positive self-perception of aging in older people.

• MeSH
• charakteristiky bydlení * MeSH
• kvalita života psychologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• optimismus * MeSH
• postoj * MeSH
• průzkumy a dotazníky MeSH
• sebepojetí MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• služby domácí péče * MeSH
• stárnutí psychologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH