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Author(s): Mohammed A. Mamun (corresponding author) [1,2,3]; Firoj Al-Mamun [1,2,3]; Md Emran Hasan [3,4]; Nitai Roy [5]; Moneerah Mohammad ALmerab [6]; Mohammad Muhit [2]; Mst. Sabrina Moonajilin [1] 1. Introduction [...], Background: Diabetes management poses significant challenges worldwide, with individuals often facing increased risks of mental health issues, including suicidal behaviors. While traditional statistical methods have been used to assess risk factors, this study introduces machine learning techniques to predict suicidal behaviors among diabetic patients. Therefore, this study aims to investigate the prevalence and risk factors of suicidal behaviors among individuals with diabetes in Bangladesh using both traditional statistical methods and machine learning models. Methods: A cross-sectional study was carried out with 390 diabetic patients, assessing demographic characteristics, diabetes-related variables, mental health indicators, and suicidal behaviors. Statistical analyses including chi-square tests and logistic regression, and various machine learning models, were employed to examine associations and predict risk factors. Results: This study found that 13.8% of the individuals with diabetes reported lifetime suicidal behavior and 9.0% reported past-year suicidal behavior. Significant risk factors associated with higher rates of suicidal behaviors included younger age, marital status, lower monthly income, higher educational attainment, being insulin users, not having a family history of diabetes, and suffering from anxiety. Among the machine learning models tested, the CatBoost model outperformed others, obtaining low log loss values of 0.45 and 0.32 for lifetime and past-year suicidal behaviors, respectively. CatBoost demonstrated excellent accuracy rates of 83.97% and 88.46%, significantly higher than those of traditional logistic regression models. The most significant predictors identified by machine learning were treatment type, followed by occupation, anxiety, age group, and having chronic diseases. Conclusion: The findings suggest the urgent need for comprehensive interventions and support systems for individuals managing diabetes, particularly those at higher risk of suicidal behaviors. Machine learning offers improved predictive power and the ability to identify complex patterns in risk factors. Collaborative efforts between healthcare providers, mental health professionals, and public health initiatives are essential for prioritizing mental well-being in diabetes management.

The Internet Disorder Scale-Short Form (IDS9-SF) is a validated instrument assessing internet disorder which modified the internet gaming disorder criteria proposed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, the relationships between the nine items in the IDS9-SF are rarely investigated. The present study used network analysis to investigate the features of the IDS9-SF among three populations in Bangladesh, Iran, and Pakistan. Data were collected (N = 1901; 957 [50.3%] females; 666 [35.0%] Pakistani, 533 [28.1%] Bangladesh, and 702 [36.9%] Iranians) using an online survey platform (e.g., Google Forms). All the participants completed the IDS9-SF. The central-stability-coefficients of the nine IDS9-SF items were 0.71, 0.89, 0.96, 0.98, 0.98, 1.00, 0.67, 0.79, and 0.91, respectively. The node centrality was stable and interpretable in the network. The Network Comparison Test (NCT) showed that the network structure had no significant differences among Pakistani, Bangladeshi, and Iranian participants (p-values = 0.172 to 0.371). Researchers may also use the IDS9-SF to estimate underlying internet addiction for their target participants and further explore and investigate the phenomenon related to internet addiction., Author(s): Li Li [sup.1] , Mohammed A. Mamun [sup.2] [sup.14] [sup.15] [sup.16] , Firoj Al-Mamun [sup.2] [sup.14] [sup.16] , Irfan Ullah [sup.3] , Ismail Hosen [sup.2] , Syed Ahsan Zia [...]

Aim: This study aimed to evaluate the food safety knowledge, attitudes, and practices (KAP) of Bangladeshi consumers and investigate their associations with various demographic factors. Methods: This national cross‐sectional study utilized a face‐to‐face survey using a structured questionnaire to recruit 1400 adult consumers between September 2022 and November 2022. Multiple linear regression analysis was employed to determine the factors associated with the food safety KAP. Results: The current findings revealed that consumers had moderate knowledge (overall correct response rate of 65.3% with a mean score of 13.06 ± 2.88 on a scale of 0 to 20), excellent attitudes (overall correct response rate for food safety knowledge was 81.8% with a mean score of 14.72 ± 2.72 on a scale of 0 to 18), and relatively poor practices (overall correct response rate was 51.7% with a mean score of 35.17 ± 11.2 on a scale of 0 to 68). Participants who were male, had higher education, were employed, were familiar with the Bangladesh Food Safety Authority, and residing outside the Mymensingh division, demonstrated greater food safety knowledge. However, participants from Barisal, Rangpur, and Dhaka, who were less educated, had fewer children, and only occasionally cooked, had negative attitudes about food safety. Additionally, individuals from all administrative divisions except Mymensingh and Chittagong, who were employed, had fewer children, had experienced food poisoning, and had inadequate food safety practices. Conclusion: These findings suggest that the Bangladeshi government should intensify efforts to enhance consumer awareness regarding food safety. [ABSTRACT FROM AUTHOR]

Background: Excessive daytime sleepiness (EDS) among adolescents poses significant risks to academic performance, mental health, and overall well-being. This study examines the prevalence and risk factors of EDS in adolescents in Bangladesh and utilizes machine learning approaches to predict the risk of EDS. Methods: A cross-sectional study was conducted among 1496 adolescents using a structured questionnaire. Data were collected through a two-stage stratified cluster sampling method. Chi-square tests and logistic regression analyses were performed using SPSS. Machine learning models, including Categorical Boosting (CatBoost), Extreme Gradient Boosting (XGBoost), Support Vector Machine (SVM), Random Forest (RF), K-Nearest Neighbors (KNN), and Gradient Boosting Machine (GBM), were employed to identify and predict EDS risk factors using Python and Google Colab. Results: The prevalence of EDS in the cohort was 11.6%. SHAP values from the CatBoost model identified self-rated health status, gender, and depression as the most significant predictors of EDS. Among the models, GBM achieved the highest accuracy (90.15%) and precision (88.81%), while CatBoost had comparable accuracy (89.48%) and the lowest log loss (0.25). ROC-AUC analysis showed that CatBoost and GBM performed robustly in distinguishing between EDS and non-EDS cases, with AUC scores of 0.86. Both models demonstrated the superior predictive performance for EDS compared to others. Conclusions: The study emphasizes the role of health and demographic factors in predicting EDS among adolescents in Bangladesh. Machine learning techniques offer valuable insights into the relative contribution of these factors, and can guide targeted interventions. Future research should include longitudinal and interventional studies in diverse settings to improve generalizability and develop effective strategies for managing EDS among adolescents. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have examined substance use and smoking behavior among adolescents and university students. However, little is known about these behaviors among students undergoing university entrance tests, a critical transition period from adolescence to adulthood. The entrance test can significantly affect students' mental health, potentially leading to substance use. This study aims to investigate the prevalence of cigarette smoking and substance use among students taking these exams and the associated factors. Methods: A cross-sectional survey was carried out on September 4th and 11th, 2022 to collect data from 1,480 university entrance test-taking students using a convenience sampling technique. Chi-square tests and logistic regression were conducted using SPSS software. Besides, GIS mapping was used to visualize the distribution of substance use and smoking behavior across districts via ArcGIS. Results: The study found a 10% prevalence of current tobacco smoking and 4% substance use. Females (OR = 1.98; 95% CI: 1.38–2.85), urban residence (OR = 2.03; 95% CI: 1.42–2.88), repeater (OR = 1.45; 95% CI: 1.02–2.06), anxiety (OR = 1.55, 95% CI: 1.10–2.19), burnout (OR = 1.51, 95% CI: 1.00–2.12), and suicidal behavior (OR = 1.57; 95% CI: 1.03–2.40) were the significant factors for cigarette use. Whereas the urban residence (OR = 1.91; 95% CI: 1.11–3.31), anxiety (OR = 2.47, 95% CI: 1.45–4.20), and suicidal behavior (OR = 2.76; 95% CI: 1.55–4.92) significantly increased the risk of substance use. GIS analysis revealed males varied in substance use and females in tobacco smoking by district. Repeat test-takers were associated with district variations in both smoking and substance use. Conclusions: Educational institutions, public health authorities, and policymakers must implement mental health support and substance use prevention programs for students. Integrating mental health education, providing resources, and enforcing regulations can promote healthier coping strategies and reduce substance use risks among students. [ABSTRACT FROM AUTHOR]

Aim: This study aims to investigate the relationship between nurses' self‐efficacy and self‐esteem, and their job satisfaction. Design: A cross‐sectional study was conducted. Methods: Employing a random sampling method that included 234 nurses from three hospitals in Iran enrolled. This study utilized the General Self‐Efficacy Questionnaire, Coppersmith Self‐Esteem Inventory, and Minnesota Job Satisfaction Questionnaire. Descriptive analysis, independent t‐tests, Pearson correlation analyses, and linear regression were employed for data analysis. Results: The mean self‐efficacy score for nurses was 26.73 ± 5.62 (out of 40), while self‐esteem and job satisfaction scored 37.13 ± 6.87 (out of 50) and 68.27 ± 12.65 (out of 100), respectively. Significant correlations were found between self‐efficacy, self‐esteem, and job satisfaction. Moreover, self‐esteem and the age group >40 years were identified as important predictors of nurses' job satisfaction. This study highlights the influential role of self‐esteem in determining nurses' job satisfaction. [ABSTRACT FROM AUTHOR]

Background and Aims: Postpartum depression (PPD) is a globally recognized public health concern, yet research focusing on women in urban areas of Bangladesh remains unexplored. This study aimed to address this research gap by investigating the prevalence and associated factors of PPD within the first 2 years after childbirth. Methods: A cross‐sectional study was conducted, enrolling 259 women (26.66 ± 4.57 years) residing in urban areas who were attending healthcare delivery centers. Sociodemographic factors, child‐related issues, pregnancy‐related complications, and PPD using the Edinburgh Postnatal Depression Scale (EPDS) were used for data collection. Data analysis involved the application of χ2 tests and logistic regression analysis using SPSS software. Results: This study found a 60.6% prevalence of PPD using a cutoff of 10 (out of 30) on the EPDS scale. Logistic regression analysis identified several significant factors associated with PPD, including high monthly family income (odds ratio [OR] = 47.51, 95% confidence interval [CI]: 8.34–270.54, p < 0.001), income dissatisfaction (OR = 14.28, 95% CI: 4.75–42.87, p < 0.001), up to two gravidities (OR = 2.94, 95% CI = 1.25–6.90, p = 0.013), pregnancy‐related complications (OR = 2.70, 95% CI = 1.05–6.96, p = 0.039), increased antenatal care visits, and higher childbirth expenses. Conclusion: This study underscores the high prevalence of PPD among urban mothers in Bangladesh. The identified risk factors emphasize the need for targeted mental health initiatives, specifically tailored to support the vulnerable group. Implementing such initiatives can effectively address the challenges posed by PPD and enhance the well‐being of postpartum women in urban areas. [ABSTRACT FROM AUTHOR]

Prospective university students experience substantial academic stressors and psychological vulnerabilities, yet their mental health literacy (MHL) remains inadequately explored. This study investigates four dimensions of MHL - help-seeking behaviors, stigma, knowledge about mental health and understanding of mental illnesses. Besides, Geographic Information System (GIS) techniques are employed to analyze spatial disparities in MHL, which is the first in the context of MHL research. A total of 1,485 students were assessed for sociodemographic characteristics, admission-related variables, health behaviors and family histories of mental health issues. Data were analyzed using SPSS and ArcGIS software. Multivariable linear regression analyses unveiled predictors of the MHL dimensions, with gender, family income, admission test performance, smoking, alcohol and drug use, physical and mental health history, current depression or anxiety and family history of mental health and suicide incidents emerging as common predictors. GIS analysis unraveled notable regional disparities in MHL, particularly in knowledge of mental health and mental illness, with northern and some southern districts displaying higher literacy levels. In conclusion, these findings accentuate significant gender and sociodemographic inequalities in MHL among prospective university students, highlighting the imperative for targeted interventions to enhance MHL and foster mental well-being in this cohort. [ABSTRACT FROM AUTHOR]

Nomophobia (the fear of being without a mobile phone or being unable to use it) is an area of growing research interest. The 20-item Nomophobia Questionnaire (NMP-Q) is the most popular instrument to assess nomophobia. However, there is no validated scale to assess nomophobia in Bangladesh. The present study translated and validated the NMP-Q into Bangla. A cross-sectional study using convenience sampling was conducted among 585 university students. The study collected data on socio-demographics, behavioural health, academic attainment, nomophobia, smartphone addiction, and Facebook addiction. Confirmatory factor analysis was performed to validate the scale’s factor structure. The four-factor structure was supported by confirmatory factor analysis (CFA). Cronbach alphas were 0.915 for the total scale, 0.88 for Factor 1 (not being able to communicate), 0.83 for Factor 2 (losing connectedness), 0.71 for Factor 3 (not being able to access information), and 0.78 for Factor 4 (giving up convenience). Convergent validity was supported by significant associations between nomophobia and both smartphone addiction and Facebook addiction. Measurement invariance across gender was supported in multigroup CFA. The findings indicated that the NMP-Q Bangla appears to be a psychometrically valid and reliable instrument and can be used for further studies to assess nomophobia among Bangladeshi students. [ABSTRACT FROM AUTHOR]

Background and Aims: Despite evidence that COVID‐19 vaccination can strengthen mental health, there is limited evidence about this in Bangladesh. Thus, this comparative study assessed the prevalence and factors associated with mental health problems between vaccine receivers and nonreceivers. Methods: Using a snowball sampling technique, a web‐based cross‐sectional study was conducted among a total of 459 participants. The survey questionnaire included sociodemographic information, the Patient Health Questionnaire (PHQ—9), the Generalized Anxiety Disorder (GAD—7), and the Trauma Screening Questionnaire (TSQ—10). Results: The study found that mental health problems were nonsignificantly prevalent in the vaccine nonreceivers than those who received it (i.e., 24.79% vs. 20.60% for depression, 21.20% vs. 16.60% for anxiety, and 15.30% vs. 12.60% for posttraumatic stress disorder). Female gender, chronic condition, smoking status, and alcohol consumption were the risk factors for mental health problems. Conclusion: This study's findings suggest that the COVID‐19 vaccination necessarily improves mental health outcomes. However, the study had limitations in terms of its design and sampling technique, and further research is needed to establish a cause‐effect relationship between vaccination and mental health problems. [ABSTRACT FROM AUTHOR]

Background: Students are one of the most vulnerable groups to suicide. Before the COVID-19 pandemic, a Bangladeshi study was conducted assessing their suicide patterns regarding gender-based associations. But how has the pandemic changed the Bangladeshi students' suicide patterns is not studied yet, which is investigated herein. Besides, for the first time, this study provides GIS-based distribution of suicide cases across the country's administrative district. Methods: As Bangladesh has no suicide surveillance system, this study utilized media reporting suicide cases following the prior studies. A total of 127 students' suicide cases from March 2020 to March 2021 were finally analyzed after eliminating the duplicate ones, and data were synthesized following the prior studies. Arc-GIS was also used to distribute the suicide cases across the administrative district. Results: Results revealed that female (72.4%; n = 92/127) was more prone to die by suicide than males. About 42.5% of the cases were aged between 14 and 18 years (mean age 16.44 ± 3.512 years). The most common method of suicide was hanging (79.5%; n = 101), whereas relationship complexities (15.7%), being emotional (12.6%), not getting the desired one (11%), conflict with a family member (9.4%), academic failure (9.4%), mental health problem (8.7%), sexual complexities (6.3%), scolded or forbidden by parents (3.9%) were the prominent suicide causalities. In respect to gender and suicide patterns, only the suicide stressor was significantly distributed, whereas the method of suicide was significantly associated with GIS-based distribution. However, a higher number of suicide cases was documented in the capital (i.e. Dhaka) and the northern region than in its surrounding districts. Conclusions: The findings reported herein are assumed to be helpful to identify the gender-based suicide patterns and suicide-prone regions in the time of the COVID-19 pandemic to initiate suicide prevention programs of the risky students. [ABSTRACT FROM AUTHOR]

Purpose: The rising prevalence of ASD has prompted extensive research into potential environmental risk factors, with air pollution particularly emerging as a major concern. A systematic review and meta-analysis on the effect of air pollutants and time of exposure (particularly, PM2.5, PM10, NO2, and O3) and the risk of ASD was therefore performed.Following PRISMA guidelines and PROSPERO registration (Ref: CRD42023464592), a thorough literature search was conducted across multiple databases, including Scopus, PubMed/MEDLINE, Embase, PsycINFO, Web of Science, and Cochrane Library. The analysis included 27 studies encompassing 369,460 participants, 47,973 of whom were diagnosed with ASD.Preconception exposure to air pollutants showed a protective trend for PM2.5, PM10, and O3 with a 10%, 5%, and 19% reduced risk of ASD, whereas NO2 had a 28% higher likelihood of ASD. During gestation, PM2.5 exposure increased ASD risk by 15%, with 13% and 9%, 25% and 7%, and 25% and 10% increases in ASD risk with PM2.5 and NO2 for the first, second, and third trimesters, respectively. In the first year of life, 20%, 8%, 33%, and 14% increases in risk were found for PM2.5, PM10, NO2, and O3, respectively, while such risk estimates increased to 179%, 60%, 12%, and 179% for the second year of life.In this meta-analysis, the relationships between air pollutants and ASD risk revealed significant associations, particularly for PM2.5 and NO2. Exposure during preconception exhibited a protective trend, while postnatal exposure, particularly during the second year of life uncovered substantially higher ASD risk.Methods: The rising prevalence of ASD has prompted extensive research into potential environmental risk factors, with air pollution particularly emerging as a major concern. A systematic review and meta-analysis on the effect of air pollutants and time of exposure (particularly, PM2.5, PM10, NO2, and O3) and the risk of ASD was therefore performed.Following PRISMA guidelines and PROSPERO registration (Ref: CRD42023464592), a thorough literature search was conducted across multiple databases, including Scopus, PubMed/MEDLINE, Embase, PsycINFO, Web of Science, and Cochrane Library. The analysis included 27 studies encompassing 369,460 participants, 47,973 of whom were diagnosed with ASD.Preconception exposure to air pollutants showed a protective trend for PM2.5, PM10, and O3 with a 10%, 5%, and 19% reduced risk of ASD, whereas NO2 had a 28% higher likelihood of ASD. During gestation, PM2.5 exposure increased ASD risk by 15%, with 13% and 9%, 25% and 7%, and 25% and 10% increases in ASD risk with PM2.5 and NO2 for the first, second, and third trimesters, respectively. In the first year of life, 20%, 8%, 33%, and 14% increases in risk were found for PM2.5, PM10, NO2, and O3, respectively, while such risk estimates increased to 179%, 60%, 12%, and 179% for the second year of life.In this meta-analysis, the relationships between air pollutants and ASD risk revealed significant associations, particularly for PM2.5 and NO2. Exposure during preconception exhibited a protective trend, while postnatal exposure, particularly during the second year of life uncovered substantially higher ASD risk.Results: The rising prevalence of ASD has prompted extensive research into potential environmental risk factors, with air pollution particularly emerging as a major concern. A systematic review and meta-analysis on the effect of air pollutants and time of exposure (particularly, PM2.5, PM10, NO2, and O3) and the risk of ASD was therefore performed.Following PRISMA guidelines and PROSPERO registration (Ref: CRD42023464592), a thorough literature search was conducted across multiple databases, including Scopus, PubMed/MEDLINE, Embase, PsycINFO, Web of Science, and Cochrane Library. The analysis included 27 studies encompassing 369,460 participants, 47,973 of whom were diagnosed with ASD.Preconception exposure to air pollutants showed a protective trend for PM2.5, PM10, and O3 with a 10%, 5%, and 19% reduced risk of ASD, whereas NO2 had a 28% higher likelihood of ASD. During gestation, PM2.5 exposure increased ASD risk by 15%, with 13% and 9%, 25% and 7%, and 25% and 10% increases in ASD risk with PM2.5 and NO2 for the first, second, and third trimesters, respectively. In the first year of life, 20%, 8%, 33%, and 14% increases in risk were found for PM2.5, PM10, NO2, and O3, respectively, while such risk estimates increased to 179%, 60%, 12%, and 179% for the second year of life.In this meta-analysis, the relationships between air pollutants and ASD risk revealed significant associations, particularly for PM2.5 and NO2. Exposure during preconception exhibited a protective trend, while postnatal exposure, particularly during the second year of life uncovered substantially higher ASD risk.Conclusions: The rising prevalence of ASD has prompted extensive research into potential environmental risk factors, with air pollution particularly emerging as a major concern. A systematic review and meta-analysis on the effect of air pollutants and time of exposure (particularly, PM2.5, PM10, NO2, and O3) and the risk of ASD was therefore performed.Following PRISMA guidelines and PROSPERO registration (Ref: CRD42023464592), a thorough literature search was conducted across multiple databases, including Scopus, PubMed/MEDLINE, Embase, PsycINFO, Web of Science, and Cochrane Library. The analysis included 27 studies encompassing 369,460 participants, 47,973 of whom were diagnosed with ASD.Preconception exposure to air pollutants showed a protective trend for PM2.5, PM10, and O3 with a 10%, 5%, and 19% reduced risk of ASD, whereas NO2 had a 28% higher likelihood of ASD. During gestation, PM2.5 exposure increased ASD risk by 15%, with 13% and 9%, 25% and 7%, and 25% and 10% increases in ASD risk with PM2.5 and NO2 for the first, second, and third trimesters, respectively. In the first year of life, 20%, 8%, 33%, and 14% increases in risk were found for PM2.5, PM10, NO2, and O3, respectively, while such risk estimates increased to 179%, 60%, 12%, and 179% for the second year of life.In this meta-analysis, the relationships between air pollutants and ASD risk revealed significant associations, particularly for PM2.5 and NO2. Exposure during preconception exhibited a protective trend, while postnatal exposure, particularly during the second year of life uncovered substantially higher ASD risk. [ABSTRACT FROM AUTHOR]

Background: Palliative care services involve the psychological care of the caregivers of cancer patients. Psychological conditions, especially depression among caregivers, distort caregiving roles; thus, it can increase a patient's psychological suffering. Objective: To determine the prevalence of depression and associated coping strategies among caregivers of cancer patients at a rural cancer care facility. Methods: This cross‐sectional study was among 366 caregivers of cancer patients. The data was collected using a pretested questionnaire, where the symptoms of depression were assessed using the Patient Health Questionnaire‐9 at a cutoff of 10 out of 27. The coping strategies were assessed based on the Brief‐coping orientation to problems experienced Inventory. Logistic regression was used to determine the factors associated with depression. Results: The mean age of the participants was 39.01 (±11.50) years; most were females (60.38%). The prevalence of depression was 8.2%. The identified factors associated with increased likelihood of depression were coping strategies: active coping (aOR = 1.55, 95% Confidence Interval (CI) = 1.05–2.28, p = 0.026), denial (aOR = 1.62, 95% CI = 1.20–2.19, p = 0.001), and humor (aOR = 1.43, 95% CI = 1.11–1.84, p = 0.005). However, coping with positive reframing reduced the likelihood of depression (aOR = 0.70, 95% CI = 0.52–0.94, p = 0.019). There was no significant association between depression and social support. Conclusion: The lower prevalence of depression reported in this study than in the prior Ugandan studies reflects that depression severity among caregivers in rural settings is less prevalent because of the fewer care‐associated burdens they experience. Therefore, establishing palliative care near the patients can be a protective factor for caregivers' depression. In addition, the role of social support and coping strategies in depression might be helpful in mental health strategies. [ABSTRACT FROM AUTHOR]

Background: Suicide is considered as one of the major public health concerns, which can be prevented with cost-effective and timely intervention. In Bangladesh, very few studies assessed the suicidal behavior of rural community people. Thus, this Bangladesh Community Mental Health Study (BD ComMen Study) attempted to understand the current situation of suicidality in Bangladeshi rural community people considering three-time frames: lifetime, past year, and past month. Methods: A cross-sectional study was conducted in a rural community in Bangladesh between May 17 and 31, 2022, using a cluster sampling technique. Information on socio-demographics, COVID-19-related factors, depression, anxiety, insomnia, and suicidal behaviors was collected. The Chi-square test or Fisher's exact test and logistic regression were used to analyze the data. Results: During their lifetime, 33.1% of the rural community people had suicidal thoughts, whereas 5.5% made a plan for suicide and 1.8% attempted suicide. The prevalence of past-year suicidal ideation was 3.9%, whereas 1.4% had a suicide plan. In addition, 0.6% had past-month suicidal thoughts, although none of them had planned or attempted suicide. The factors associated with suicidal behaviors included males, lower age, lower educational grade, low-earning jobs, living in a government-provided house, family history of mental health and suicide, and suffering from anxiety and insomnia. Conclusions: Suicidal behaviors among the rural community people are of great concern as most of the rural people in Bangladesh do not have enough mental health literacy for treatment-seeking due to a high level of mental health-related stigma. Thus, this study would likely help to initiate further studies and stimulate suicide prevention programs, because most suicide can be prevented. [ABSTRACT FROM AUTHOR]

Background: Facebook is a popular social networking site in themodern world. It has an adverse effect such as impairing daily health and psychological health and also interpersonal relationships when the use becomes problematic. Aims: To examine problematic Facebook use (PFU) and its predictors among Bangladeshi students during the COVID-19 pandemic. Method: A cross-sectional online survey was conducted among 601 Bangladeshi students and collected data related to socio-demographic information, behavioral health, internet use behavior, depression, anxiety and problematic Facebook use [assessed using the Bergen Facebook Addiction Scale (BFAS)]. The data were analyzed using descriptive (frequencies and percentages) and inferential statistics (independent sample t-tests, one-way ANOVAs, correlations, and multivariable linear regression). Results: The results indicated that 29.1% of participants were problematic Facebook users (using cutoff =18 out of 30). Medical college students had higher mean score on PFU than other students (p < 0.001). In addition, the mean score of PFU was significantly higher among the students who were in a relationship (p = 0.001), did not engage in physical activity (p < 0.001), used the internet more than 5 h per day (p < 0.001), used social media (p < 0.001), and had depression or anxiety symptoms (p < 0.001). PFU was significantly associated with depression and anxiety among the whole sample. Predictive factors for PFU included relationship status, daily internet use time, gaming, social media use, depression, and anxiety. The model predicted almost 33.2% variance for PFU. Conclusions: Findings suggest interventions should be implemented for students with a special focus on medical students who had higher score of PFU than other types of students. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic is undoubtedly a major threat to the world. The preventive strategies designed to minimize the virus transmission by remaining at home, being isolated, and keeping social distance, which would substantially reform people's lifestyle, physical activity, eating habits, etc. Consequently, those measures might create a disturbance in weight management and overweight. Therefore, how the COVID-19 pandemic has changed the physical activities of individuals and its impacts on the Body Mass Index (BMI) is explored herein. Methods: An online-based cross-sectional study collected data from 338 Bangladeshi adults in November 2020. The questionnaire included socio-demographics, health-related variables, physical activity-related variables, and diet measurement. Inferential statistics (i.e., chi-square test, McNemar test) were used to measure the associations between BMI and studied variables with a consideration of two scenarios ('before' and 'during' the pandemic inception), where p<0.05 was considered statistically significant. Results: Results showed that the prevalence of overweight was 30.5% 'before' the COVID-19 pandemic, which increased to 34.9% 'during' the pandemic; that means 4.4% of the participants significantly gained weight after the pandemic inception. There was no significant role of socio-demographic (e.g., gender, age, current residence, occupation) or physical activity-related factors (e.g., unavailability of outdoor space, not performing regular physical exercise, exercising with a partner) in changing the BMI status after the pandemic inception. However, following a proper diet plan during the COVID-19 pandemic was observed to decrease BMI status significantly. Conclusions: The present study suggests that a minor portion of the participants reported increasing their overweight status after the pandemic inception, whereas having a proper diet plan during the pandemic can significantly decrease BMI status. Therefore, the importance of the appropriate diet plan should be considered while implementing any policies. [ABSTRACT FROM AUTHOR]

Background: Bangladeshi university students are considered to be highly suicide-prone compared to other populations and cohorts. However, no prior epidemiological studies have assessed the suicidality (i.e., past-year suicidal ideation [SI], lifetime suicide plan [SP], and lifetime suicide attempt [SA]) among Bangladeshi students, including the variables such as past-year stressful life events and family mental health history. This is arguably a major knowledge gap in the country. Therefore, the present study investigated the prevalence and associated risk factors for suicidal behaviors among Bangladeshi university students. Methods: A cross-sectional study was conducted utilizing a convenience sampling method among a total of 1844 university students between October and November 2019. Data were collected based on the information related to socio-demographics, perceived health-related questions, past-year stressful life events, family mental health history, and suicidal behaviors (i.e., SI, SP, and SA). Chi-square tests and binary logistic regressions were used to analyze the data utilizing SPSS statistical software. Results: The prevalence of past-year suicidal ideation, lifetime suicide plans, and suicide attempts were 13.4%, 6.0%, and 4.4%, respectively. Females reported significantly higher suicidal behavior than males (i.e., 20.6% vs.10.2% SI; 9% vs. 4.6% SP; and 6.4% vs.3.6% SA). Risk factors for SI were being female, year of academic study, residing in an urban area, using psychoactive substances, experiencing both past year physical and mental illness, experiencing any type of stressful past-year life events, experiencing campus ragging (i.e., senior students abusing, humiliating and/or harassing freshers or more junior students), experiencing family mental illness history, and having family suicide attempt history. SP was associated with several factors including being female, year of academic study, using psychoactive substance, experiencing both past-year physical and mental illness, and experiencing any type of stressful past-year life events. Risk factors for SA were being female, year of academic study, using psychoactive substances, experiencing past-year mental illness, experiencing any type of stressful past-year life events, and having family suicide attempt history. Conclusions: University students appear to be a vulnerable group for experiencing suicidal behaviors. The present findings warrant rigorous action and early intervention programs such as counseling and other mental health professional services by university authorities. Longitudinal studies are highly recommended involving countrywide representative samples. [ABSTRACT FROM AUTHOR]

Purpose: The present study is the first investigating unexplored psychological issues of university entrance test‐taking students in Bangladesh. Design and Methods: This cross‐sectional study investigates suicidal behaviors and their socio‐demographic, admission test‐related, and psychopathological risk factors among a total of 911‐Bangladeshi university entrance test‐takers. Findings: About 17.7% of the participants report suicidal thoughts, whereas it is 8.0% and 2.5% for suicide plans and suicide attempts, respectively. Significantly higher suicidal thought is observed in the repeat test‐taking students compared to the first‐time test‐takers (20.7% vs. 14.6%, χ2 = 5.669, p = 0.017), though the suicide plan and suicide attempt are not associated with student status. The suicidal thought risk factors include female gender, urban residence, satisfaction with the mock test, mental disorders etc. Practical Implications: The present findings warrant implementing initiatives for this suicide‐prone cohort, especially for the test‐failing students. [ABSTRACT FROM AUTHOR]

Getting admission into a university is highly competitive globally and can be regarded as a mental stressor for some individuals. In Bangladesh, most of the universities allow students to repeat the test, whereas repeat test-taking students are supposed to suffer from psychological issues like burnout because of academic non-achievement in their first attempt. But there is no prior study assessing burnout to the population, which was investigated herein. A cross-sectional study was carried out among a total of 911 Bangladeshi university entrance test-taking students (i.e., 49.5% first-time test-takers). The survey measures included socio-demographics, admission-related issues, and mental health problems (depression, anxiety, and burnout). Of the mental health problems, depression, anxiety, and burnout were assessed by the Patient Health Questionnaire (PHQ-9), Generalized anxiety disorder (GAD-7), and Maslach Burnout Inventory—Student Survey (MBI–SS), respectively. In light of two-dimensional and three-dimensional cutoff schemes of the MBI—SS, about 43.7% and 17.3% of the test-taking students, respectively, were classified to be burnout in the total sample. Additionally, 48.1%, 71.4%, and 49.1% of the students in the total sample reported higher emotional exhaustion, higher cynicism, and lower academic efficacy, respectively. In respect to the student status, two-dimensional burnout (48.0% vs. 39.2%; χ2 = 7.164, p = 0.007), and emotional exhaustion (52.2% vs. 43.9%, χ2 = 6.789, p = 0.034) were significantly higher among the repeat test-taking students. Satisfaction with previous mock tests, depression, and anxiety were the associated factors of burnout in all three samples. Based on the present study, it can be concluded that the university entrance test appearing students are highly prevalent to burnout, and the rate increases with academic non-achievement. As the first study assessing burnout to the population, the findings are anticipated to be helpful for policymaking and further studies both inside and outside Bangladesh. [ABSTRACT FROM AUTHOR]

Purpose: Although depression has adverse effects on all aspects of university students' quality of life, fewer studies have been conducted in Bangladesh; which was investigated herein. Design and Methods: A cross‐sectional study was carried out among 1844 students enrolled at the University of Dhaka, Bangladesh. Hierarchical regression analyses were performed to investigate the explanatory power of the variables predicting depression in this population. Findings: Depression prevalence was 28.7%; and female gender, first‐year student status, substance use, past‐year physical and psychological illness, stressful life events, family psychiatric history, and personal suicidal behaviors were the main risk factors. The final model considering all the studied variables explained 23.5% of the variance in depression. Practical Implications: Effective psychological help services, awareness and intervention programs, and so on, should be implemented to reduce students' psychological burdens. [ABSTRACT FROM AUTHOR]

Assessing individuals' knowledge and preventive behaviors towards the Coronavirus Disease of 2019 (COVID-19) is essential for the related public health surveillance strategies. Although some of the studies were conducted in Bangladesh, none of these studies considered the geographical distribution of knowledge and preventive behaviors towards COVID-19. Therefore, the present nationwide cross-sectional study with 10,067 samples for the first-time aims to assess the knowledge gap by presenting the geographical distribution of the COVID-19 knowledge and preventive behaviors across all administrative districts of Bangladesh. The measures included socio-demographics and questions about knowledge and preventive behaviors related to COVID-19. One-way ANOVA, independent t-test, and multiple linear regression were used to analyze the data. In addition, GIS-based mapping identified district-wise distribution of the outcomes. Results indicated that the overall mean score of knowledge related to COVID-19 was 14.363 ± 3.073, whereas 16.95 ± 2.89 was for preventive behaviors. Participants' being male, being divorced or widowed, consuming alcohol, smoking cigarettes, living in villages, and having no formal education reported lower performing preventive COVID-19 behaviors. Those participants with higher knowledge scores reported higher preventive COVID-19 behaviors (β = 0.053, p<0.001). However, the model predicted only 13.2% of the variation in preventive COVID-19 behaviors while the overall model being significant. The findings suggest that the Bangladeshi government should initiate appropriate far-reaching program of health education focusing on knowledge and preventive behaviors towards COVID-19 at a community level. After all, the strategies to combat COVID-19 will require individuals' involvement to control and prevent the disease outbreak, for which education is essential. [ABSTRACT FROM AUTHOR]