BackgroundThe Pittsburgh Sleep Quality Index (PSQI) dimensionality is much debated, with the greatest number of reported factor structures. Therefore, this review appraised the methodologies of studies investigating the factor structure of the PSQI.Material and methodsMEDLINE, PsycInfo, AJOL, BASE, Cochrane Library, Directory of Open Access Journals (Lund University), CINAHL, and Embase were searched systematically to include articles published till 23rd March, 2018. The articles with the objective of factor analysis of the PSQI (20 articles) or with a major section on the same subject (25 articles) were included. There was no limitation about participant characteristics. Descriptive analysis of articles for measures of the suitability of the data for factor analysis, details of the exploratory factor analysis (EFA) and details of the confirmatory factor analysis (CFA) was performed.ResultsThe analysis used by the majority did not employ the simplest scheme for interpreting the observed data: the parsimony principle. Other shortcomings included under- or non-reporting of sample adequacy measures (11 out of 45 articles), non-use of EFA (20 out of 45 articles), use of EFA without relevant details, non-use of CFA (11 out of 45 articles), and use of CFA without relevant details. Overall, 31 out of 45 articles did not use either EFA or CFA.ConclusionWe conclude that the various PSQI factor structures for standard sleep assessment in research and clinical settings may need further validation.Trial registrationNot applicable because this was a review of existing literature.

Background: There is a gradual increase in the prevalence of stress during professional courses. Previous studies reported a high incidence of stress among university students. The psychometric properties of the perceived stress scale-10 (PSS-10) have been established in different populations. The current study aimed to assess psychometric properties of the PSS-10 in Saudi university students. Methods: Healthy university students (n= 192) participated in this cross-sectional study. All the participants were explained about the aim and procedures of the study. Participants were requested to complete the English version of the PSS, the generalized anxiety disorder-7 (GAD-7), the sleep hygiene index (SHI), and demographic details. Results: The range of the PSS-10 total score was 0-35; 1% reported minimum score of 0, but none reported maximum score of 40. Therefore, there was no issue of ceiling or floor effect in the PSS-10 total score. Positive and significant correlations of the PSS total and the PSS Factor-1 (distress perception) with the GAD-7 total score, SHI item-8 and SHI item-13 score support its convergent validity. Negative or no correlation of the PSS Factor-2 score (coping perception) with the GAD-7 total score, SHI item-8 and SHI item-13 scores demonstrate its divergent validity. The internal homogeneity test indicated moderate to strong positive correlations (r=0.-60-0.82) between the PSS Factors and the items loading on them. The internal consistency test showed a good agreement for the PSS Factor-1 and the PSS Factor-2 scores (Cronbach's alpha 0.78 and 0.71, respectively), suggesting an acceptable level of consistency. Factor analysis favored a 2-Factor model of the PSS in the Saudi students. Conclusion: The current study supported the use of the PSS-10 to assess the perceived stress among Saudi university students.

Background:Previous studies in diverse ethnic groups have reported that progressive resistance training is effective for glycemic control. However, it is unknown whether this form of exercise therapy leads to clinically meaningful changes in metabolic, cardiovascular and anthropometric parameters in Asian Indians.Aim:The study was designed to investigate the efficacy of progressive resistance training on glycemic, musculoskeletal, anthropometric and cardiovascular variables in untrained middle-aged type 2 diabetic patients living in North India.Materials and Methods:Forty-eight untrained patients, 35 men and 13 women (mean ± SD age, 44.7 ± 4.2 years), with a diagnosis of type 2 diabetes were randomly divided into 2 groups: A group receiving progressive resistance training and a control group who provided participative involvement. The primary outcomes were glycemic control and muscle strength. Additionally, anthropometric and cardiovascular risk parameters were evaluated at baseline and after intervention or control program at 8 weeks.Results:Mixed ANOVA revealed a significant group-by-time interaction for the main outcomes of the study. Change in glycosylated hemoglobin was mean ± SD, 0.6 ± 0.5 in progressive resistance training group compared to no change in control group (P < .001). Progressive resistance training group showed a greater improvement in upper and lower body muscle strength (P < .001), waist circumference (P = .008), and high density lipoprotein cholesterol (P = .004). However, no significant group-by-time interaction was detected on body weight, total cholesterol, triglycerides, low density lipoprotein cholesterol, and systolic and diastolic blood pressure.Conclusions:A short-term progressive resistance training program leads to clinically meaningful improvements in glycemic control and muscle strength in untrained middle-aged type 2 diabetic patients of Asian Indian ethnicity.

Background: Modern antiretroviral therapy has extended the life expectancies of people living with HIV; however, the prevention and treatment of their associated neurocognitive decline have remained a challenge. Consequently, it is desirable to investigate the prevalence and predictors of neurocognitive impairment to help in targeted screening and disease prevention. Materials and Methods: Two hundred and forty-four people living with HIV were interviewed in a study using a cross-sectional design and the International HIV Dementia Scale (IHDS). Additionally, the sociodemographic, clinical, and psychosocial characteristics of the patients were recorded. Chi-square and binary logistic regression analysis were used to determine the level of significance among the independent risk factors and probable neurocognitive impairment. Results: The point prevalence of neurocognitive impairment was found to be 39.3%. Participants' characteristics of being older than 40 years (AOR= 2.81 (95% CI; 1.11-7.15)), having a history of recreational drug use (AOR= 13.67 (95% CI; 6.42-29.13)), and being non-compliant with prescribed medications (AOR= 2.99 (95% CI; 1.01-8.87)) were independent risk factors for neurocognitive impairment. Conclusion: The identification of predictors, in the Ethiopian people living with HIV, may help in the targeted screening of vulnerable groups during cART follow-up visits. This may greatly help in strategizing and implementation of the prevention program, more so, because (i) HIV-associated neurocognitive impairment is an asymptomatic condition for considerable durations, and (ii) clinical trials on neurocognitive impairment therapies have been unsuccessful.

▼ Objectives : Core Stability Training (CST) is widely used as a sport training and therapeutic exercise. The current study was aimed to determine the eff ectiveness of the CST in enhancing dynamic balance (DB) in soccer players. Methods: A convenience sample of 40 professional soccer players with mean age of 18 ± 2 years were divided into 2 groups, experimental and control group (n = 20) in each group. The experimental group participants were given CST. Both the experimental and control groups were allowed to follow their normal playing and training schedule. The total study duration was for 4 weeks. Core Stability (CS) and DB outcomes were measured between pre and post intervention at 3 phases using Double Straight Limb Lowering Test (DSLLT) and Star Excursion Balance Test (SEBT). Results: Overall results revealed signifi cant differences of DB and CS within the experimental group as compared to the control group (p < 0.05). The post hoc analysis observed that signifi cant improvement in the DB after the completion of phase-II, however experimental group showed signifi cant improvement in CS even between phaseI and phase-II, however maximum improvement observed after the completion of phase-III (p < 0.05). Conclusions: CST can be added for enhancing the DB and CS in players in addition to their training sessions. The current study observed that minimum duration of 2 weeks CST requires improving the DB whereas and CS can show improvement even after one week of CST in soccer players.