latest.sql

 SELECT Count(*) AS cnt
FROM   user_study
       LEFT JOIN user_question
              ON user_question.user_study_id = :user_study_id
                 AND user_question.question_group_id = '673'
                 AND user_question.id = (SELECT MAX(id) FROM user_question WHERE question_group_id = 673 AND user_study_id = :user_study_id)
       LEFT JOIN user_question_response
              ON user_question_response.user_question_id = user_question.id
                 AND user_question_response.question_id = '6118'
WHERE  user_study.id = :user_study_id
       AND ( user_question_response.question_answer_id = '37432' )