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A tanulmány célja, hogy az oxitocinnal kapcsolatos összefoglaló tanulmányok alapján áttekintést adjon arról, mit tudunk ma az oxitocin termelődésérôl és mű­kö­dé­séről, szerepéről az emberi szervezetben. A jelenlegi összkép az oxitocin rendkívül szerteágazó hatáskörével kapcsolatban az, hogy az oxitocin koordináló funkciót tölt be az emberi fejlődésben, katalizátorként működik a társas interakciókban.

Media and information literacy is a key competency in the 21st century knowledge societies. It is much more than just knowing to use the digital technology. The media and information literate person knows how to learn, how knowledge is organized, and how to find, select, evaluate, organize and use information. The Institute of Library and Information Science at the University of Pécs made an online survey in 2014 about information competencies of university students all over Hungary. The aim of the survey was to get information about students’ information searching strategies, favourite resources, information seeking, selection and evaluation methods, and to base a new information literacy strategy. The results of this survey, compared with other surveys, show that during their studies students get a lot of assignments for which they need to find relevant information and literature, and analyzing them articulate a personal view about the problem. The biggest challenge for the new generation is the evaluation and selection of information. They don’t know how to make considered decisions, and very often they don’t even feel why this is important. That’s why it is crucial to develop special, professional information literacy competencies of students more efficiently. There is a special emphasis to be placed on the role of libraries, since they are the institutions that play a major role in the acquisition and development of information literacy. At the same time, this situation poses a serious challenge for libraries that they need to prepare for. There are international programs and projects that can help libraries in this endeavour.

A tanulmány célja, hogy az oxitocinnal kapcsolatos összefoglaló közlemények alapján áttekintést adjon arról, mit tudunk ma az oxitocin szerepéről a szülés és szoptatás során. Rámutat az élettani (perifériás) hatások és a centrális, pszichoaffektív hatások összefüggéseire. Emellett összegzi azokat az ismert következményeket, amelyek a különféle beavatkozások révén módosítják a természetes (endogén) oxitocin hatáskörét szüléskor, illetve szoptatáskor. Javaslatokat fogalmaz meg arra nézve, hogy hogyan lehet támogatni az endogénoxitocin-rendszert, minél kevesebb beavatkozással élve. Orv Hetil. 2022; 163(41): 1629–1638.

This study explored the influence of suggestions on differences in electrodermal laterality of the skin conductance orienting response (SCR). Thirty-two participants were randomly assigned to eitheripermitting/ioriexcluding/isuggestions. During the dream task in the permitting condition the suggestion was: "You are aware of your surroundings and any distractions that might disturb your dream," while in the excluding condition the wording was: "No outside stimulus will disturb your sleep." Participants were presented with 12 standards and 2 deviant computer-generated tones during active-alert hypnosis and musical control conditions in a mixed within-between design. High hypnotizables produced higher SCRs after permissive compared to excluding suggestions during hypnosis, while low hypnotizables did the same in the control condition. Study limitations include some loss of data due to equipment failure and relative homogeneity of sample, therefore results cannot be considered definitive.

A kutatás célja, hogy bemutassa a tudományos teljesítmények értékelésére használható tudománymetriai, bibliometriai mérések jelentőségét a bölcsészet- és társadalomtudományok publikációs stratégiáinak megismerésében. Az elméleti alapok után a 2000-2015 közötti időszak hazai neveléstudományi publikációinak vizsgálatán keresztül mutatja be a publikációs stratégiák tudományspecifikus jellegzetességeit. A neveléstudomány mintaként alkalmas arra, hogy körvonalazódjanak a bölcsészet- és társadalomtudományok sajátosságai. A vizsgálat második része a nemzetközi adatbázisokban is regisztrált magyar publikációkat vizsgálja hasonló módszerekkel. Hipotézisünk szerint a publikációk statisztikailag mérhető jellemzőiből kibonthatók a tudományterületre jellemző publikációs stratégiák, és ezek változásaiból nyomon követhetők a tudományterületre jellemző publikációs trendek. Az eredményekből jól látszik, hogy bár a bölcsészet- és társadalomtudományi témájú publikációk, ezen belül is a neveléstudomány kutatási eredményei jelentős számban vannak jelen a magyar szakirodalomban, számuk mégis folyamatosan csökken. Ezzel párhuzamosan növekszik a nemzetközi fórumokon megjelenő publikációk száma, de kisebb mértékben. A hazai és nemzetközi megjelenésű publikációknál egyaránt uralkodó publikációs forma a tanulmány, ez is főként gyorsan megjelentethető folyóiratcikk formában. Az átlag terjedelem az évek során növekvő tendenciát mutat. Tematikailag dominálnak az empirikus kutatások. A szerzők nagyobb része a szakterületi folyóiratokban törekszik publikálni, viszonylag kicsi a szakirodalom szóródása. A nemzetközi publikációk idézettsége jóval magasabb, mint a magyaroké, és erőteljesen növekszik.

Research on the efficacy of hypnosis applications continues to grow, but there remain major gaps between the science and clinical practice. One challenge has been a lack of consensus on which applications of hypnosis are efficacious based on research evidence. In 2018, 6 major hypnosis organizations collaborated to form the Task Force for Establishing Efficacy Standards for Clinical Hypnosis. This paper describes a Guideline for the Assessment of Efficacy of Clinical Hypnosis Applications developed by the Task Force, which makes 10 specific recommendations. The guideline is intended to be a tool for those who want to assess the quality of existing evidence on the efficacy of clinical hypnosis for any particular indication. The paper also discusses methodological issues in the interpretation and implementation of these guidelines. Future papers will report on the other products of the Hypnosis Efficacy Task Force, such as best practice recommendations for outcomes research in hypnosis and an international survey of researchers and clinicians on current practice and attitudes about hypnosis.

A státusz az orvosi dokumentációnak az a része, amely a beteg felvételekor elvégzett fizikális vizsgálat eredményeit rögzíti. A leírás tükrözi a vizsgálat egyes lépéseinek megszabott rendjét (megtekintés, tapintás, kopogtatás, hallgatózás), ezért állandósult sorrendiség és konvencionalizált minták, ismétlődő kifejezések jellemzik. Ebben a tekintetben a kórboncolási jegyzőkönyv műfajával mutat rokonságot. Vizsgálatunk során a Semmelweis Egyetem klinikáin gyűjtött 82 anonimizált zárójelentés státuszrészeit emeltük ki, így összesen 27211 szövegszó terjedelmű státuszleírás terminológiai és szövegtipológiai elemzését végeztük el. A státuszokat tartalmazó zárójelentések 10 különböző szakorvosi területen keletkeztek. Tanulmányunkban az erre a műfajra jellemző anatómiai nevek, állapotok, kórképek terminológiai jellemzőit mutatjuk be (magyar vagy latin névhasználat, betűszók, rövidítések), a különböző észleletek leírásának jellegzetességeit negatív és kóros lelet esetén (egyes szervekre jellemző színek, tapintásérzetek, hanghatások), továbbá a státuszokban előforduló kifejezések terminologizáltsági fokát vizsgáljuk. Szoftveres elemzéssel gyakorisági, konkordancia- és statisztikai vizsgálatot végeztünk, amelynek eredményeképpen kiemeljük e műfaj jellegzetes mintázatait, szaknyelvi frazémáit.

A pénz kialakulásától kezdve mindennapi életünk része, értékmérőként, forgalmi és fizetőeszközként, kincsképzőként egyaránt. Szerepét az évszázadok folyamán különböző áruk, nemesfémek, bankjegyek töltötték be, amíg eljutottunk a bankszámlapénz bevezetéséig. A pénzegységek elnevezése hiteles képet mutat az egyes korok gazdasági folyamatairól és kapcsolatrendszeréről. Bár a pénzegységek neveit általában nem sorolják a gazdasági szaknyelv terminusai közé – mivel az adott közösség mindennapi nyelvhasználatának a részét képezik –, az áru- és pénzforgalom szaknyelvének terminologizált szókincsének tekinthetjük őket. Tanulmányunkban az orosz pénzegységnevek nominációjáról nyújtunk áttekintést az orosz történelem és gazdaság folyamatainak keretébe illesztve. Etimológiai, szótörténeti, gazdaság- és művelődéstörténeti elemzés alapján mutatjuk be a pénzegységek nevének eredet és a megnevezés motivációja szerinti csoportjait (pl. áru, anyag, előállítás módja, rész-egész viszonyok, szín, szám, ábrázolás, földrajzi név, vándorszók stb.), és felvázoljuk az orosz pénztörténet korszakait a nemzeti valuta megjelenéséig.

There is an abundance of outcomes research for clinical hypnosis showing promising results, however, hypnosis is still underutilized in clinical care. For a behavioral intervention to enter mainstream clinical care, efficacy needs to be demonstrated with exceptionally high quality of evidence. Furthermore, the reporting of these studies also needs to be complete and sufficiently clear to show quality of evidence, and to enable replication and clinical use. The Task Force for Establishing Efficacy Standards for Clinical Hypnosis conducted a review of best practice guidelines in outcomes research, including a review of the CONSORT statement, TIDieR checklist, and the Cochrane Handbook for Systematic Reviews of Interventions. The present article provides best practice guidelines specific to conducting clinical hypnosis research. The guidelines comprise recommendations for planning, conducting, and reporting research in this field. The recommendations are presented in two tiers. Tier I recommendations include essential best practices, such as a call for the use of detailed research and intervention manuals, plans for and reporting of participant-education about hypnosis, the use of hypnotizability scales with good psychometric properties, and clear reporting of the hypnotizability measurement. They also instruct for sharing of intervention scripts and manuals, and the clear reporting of the induction procedure, the labeling of the intervention for participants, and the definition of hypnosis used. Tier II includes preferred recommendations, calling for measurement of adherence to home practice, measurement of hypnotizability by someone other than the interventionist, the use of hypnotizability scales with both subjective and behavioral measures of responsiveness, and the involvement pf participants from the full hypnotizability spectrum. They also recommend the assessment of response expectancy, therapeutic relationship, and other variables related to proposed mechanisms of action, and the reporting of participants prior hypnosis experiences, and the relationship of expectancies and treatment outcomes.This list of recommendations will be useful for researchers, reviewers, and journal editors alike when conducting, reporting, or evaluating studies involving clinical applications of hypnosis.

Glial engulfment of dead neurons and neurites after trauma, during development and in neurodegenerative diseases plays a crucial role in nervous system maintenance. Axon debris generated after traumatic injury is cleared by phagocytic glia via Draper receptor signalling in Drosophila. However, mechanisms governing the efficiency of axon debris phagocytosis and degradation have remained largely unexplored. Here we show that glial LC3-associated phagocytosis (LAP), an engulfment pathway assisted by certain components of the macroautophagy machinery, promotes clearance of degenerating axons in the Drosophila wing nerve. A LAP-specific subset of autophagy-related (Atg) genes is required in glia for efficient debris elimination, which includes members of the Atg8a (LC3) conjugation system and the Vps34 lipid kinase complex subunits UVRAG and Rubicon but not Atg14 or the Atg1 kinase complex. Atg8a and Rubicon are recruited to Rab7-positive phagosomes and Atg8a lipid conjugation is essential for debris-containing phagosome maturation. Finally, Rubicon overexpression in glia accelerates axon debris elimination. Our results reveal the critical role of LAP in glia in the clearance of neuronal debris in vivo, with important implications for the recovery of the injured nervous system.

This retrospective study was a nonrandomized comparison of exercisers' (runners and participants of a spinning class) states of consciousness with subjects of active-alert hypnosis (AAH) and students in a class (control). Three hundred and seventy-five participants completed the Phenomenology of Consciousness Inventory (PCI). Runners, spinners, and participants of AAH scored higher on the

A felsőoktatási intézményekben tanuló diákok, fiatal felnőttek fizikai fittsége romló tendenciát mutat. E folyamat okainak megvizsgálásához releváns adatokra van szükség. Ennek érdekében a 2017-18-as tanévtől kezdve, egy longitudinális felmérés-sorozat keretében az egyetemi testnevelés órák és sportfoglalkozások hatását vizsgáltuk meg. Első ütemben hatvan inaktív hallgató, férfiak és nők egyaránt (a Debreceni Egyetem tanulói) fittségi állapotát mértük fel a mozgásprogram elkezdése előtt, majd utána. A vizsgálatban résztvevők heti egy alkalommal 90 perces sportfoglalkozásokon (pilates, spinning, wellness-általános kondicionálás, alakformálás) vettek részt. A szemeszter elején és végén a résztvevők a Hungarofit tesztrendszerből ismert három motoros próbát (ingafutás (Beep teszt), karhajlítás-nyújtás, felülés) hajtottak végre. Eredményeink azt mutatták, hogy a négy sporttevékenység az aerob teljesítőképességre, a felső végtag és a hasizom-törzs erő-állóképességére is eltérő módon hatott. Bár a nemzetközi ajánlások heti 150 perc fizikai aktivitást javasolnak, heti egyszeri másfél órás közepes intenzítású mozgással is fejleszthető. a motoros képességek szintje.

Background Assessing prenatal health-related quality of life (HRQoL) by parity using a comprehensive consistent instrument with the transient nature of pregnancy is still under investigation. Objective To assess HRQoL and specify its predictors among expectant women in Hungary through Patient Reported Outcomes Measurement Information System (PROMIS-43). Method s: 477 healthy pregnant women were asked to fill the Hungarian version of PROMIS-43 and further instruments in late pregnancy.The PROMIS-43 investigates seven parameters, including anxiety, ability to participate in social roles and activities, depression, fatigue, sleep disturbance, physical function, and pain interference. Results While physical function and fatigue subscales obtained the highest proportion in the mild and moderate range, respectively, other subscales were felled into the normal range in all participants. A comparison of parity showed that the mean T-score of subscale "Anxiety" was significantly higher in nulliparous than that of in multiparous women (p = 0.02). The assessments indicated that the predictors, including parity, anxiety, and depression were the most common predictors for the poor HRQoL domains in both the nulliparous and multiparous women. In nulliparous, social support was a significant predictor for better HRQoL in depression, fatigue, and pain intensity domains. In multiparous, the strongest predictors included social support for lower depression, wanted pregnancy for lower pain intensity, and previous emergency cesarean section for higher pain intensity subscale. Conclusion The results of PROMIS-43 support the fact that the screening and continuous assessment of physical function and psychological status at early and over pregnancy is still on demand to optimize the outcomes of maternity care.

Purpose There is still no generally accepted quality model of consulting services. This is particularly the case for management consulting projects, where scope is often indefinite. The purpose of this paper is to identify the clients’ underlying utility preferences and their perceived quality dimensions. Design/methodology/approach The research is a qualitative data collection from 22 expert interviews performed in the financial service sector. Interviewees from the client-side were decision-makers from different hierarchical levels with considerable experience in working with consultants, while the consultant sample was obtained by selecting professionals with relevant project experience. The model development was based on the grounded theory. Findings Based on a content analysis of a 600-page transcript of interviews, it was found that customers construct their judgments on consulting service quality through five main attributes: consultants, client adaption, consulting process, deliverables and communication. Because of the strong overlaps of the attributes, four better separable quality dimensions – as a conceptual model – were identified: expertise, relations, involvement and performance. Practical implications Among managerial implications for consulting firms, support of buying organization in setting clear project objectives, flexibility in partnership and readiness for overperformance can be underlined. Originality/value There is little empirical research that focuses on the conceptualization of management consulting service quality from a client perspective. The value of the paper is the exploration of perceived service quality dimensions of management consulting projects and a consulting context-specific list of quality attributes.

In light of the coronavirus disease 2019 pandemic, we explore the role of stress, fear, and the impact of positive and negative emotions on health and disease. We then introduce strategies to help mitigate stress within the health care team, and provide a rationale for their efficacy. Additionally, we identify strategies to optimize patient care and explain their heightened importance in today’s environment.

There has been increasing clinical interest in active-alert hypnosis (AAH). However, relatively few studies have been devoted to studying its properties systematically. The present study compared the subjective experiences of subjects (31) and hypnotists (5) during AAH, using Pekala's Phenomenology of Consciousness Inventory (PCI), the Dyadic Interactional Harmony (DIH) scale and the Archaic Involvement Measure (AIM). Results demonstrated similarities between the experiences of subjects and hypnotists. The only significant difference between the subjects' and the hypnotists' experiences was shown by the PCI, which highlighted the differences stemming from the different roles of hypnotist and subject during the AAH. The study suggests it may be important to examine subjective descriptors in the exploration of personal experiences in studies of AAH.

A vezetesi tanacsadas egy feltetelezett kompetenciaval biro szakertő csoport altal tett megoldasi javaslat. Az uzleti problema jellege alapjan nem mindig definialhato egyertelműen, hogy a tranzakcioban milyen foku egyuttműkodes varhato el a felek kozott. A tanacsadasi szolgaltatas jelentős mertekben befolyasolhatja a vevő uzleti sikeret, ezert magas kapcsolati komplexitasu szolgaltatasrol van szo, ahol kiemelt szerepe van a kolcsonossegnek es a bizalomnak. Az ugyfel-tanacsado kapcsolat es a tanacsadok altal kialakitott szerepkorok es tanacsadoi stilus nagyban befolyasoljak az ugyfelek ertekiteletet a szolgaltatas minősegeről, ezert kiemelkedően fontos mindket fel szamara, hogy megertsek a tanacsadok szerepet es feladatait. A tanulmany bemutatja a legfontosabb szerepklasszifikacios modelleket, feltarva a kutatasi terulet főbb iranyait. Huszonket feltaro szakertői melyinterjus kutatas eredmenyere tamaszkodva kiserletet tesz a kulonboző tanacsadoi szerepek bemutatasara, valamint ravilagit a szervezeti hierarchia kulonboző szintjein levők preferencia-attributumaira.

Hypnosis has proven to be an effective treatment in disorders that affect the autonomic nervous system (ANS). However, the studies investigating the nature of its effect on the ANS have reported contradictory results. Measurement of electrodermal activity (EDA) is an objective way to assess the activity of the sympathetic branch of the ANS. We aim to elucidate the effects of hypnosis on EDA. Here, we report the results of two studies, both investigating the psychophysiological effects of hypnosis.In the first experiment, subjects engaged in an HGSHS:A group hypnosis session to measure their hypnotizability. EDA was measured bilaterally from their wrists. We found a significant reduction in EDA levels and the number of nonspecific responses during the hypnotic induction phase. This effect was observed in all three hypnotizability groups—high, medium, and low hypnotizables. A three-way interaction confirmed that EDA patterns on the left and right sides were characteristically different in these three groups. Left-side dominance was typical in high hypnotizables, whereas low hypnotizables were characteristically right-sided. EDA levels of the two sides remained synchronous in medium hypnotizables. During the suggestion phase, we found significant differences in EDA levels depending on the test suggestions, modulated by hypnotizability. A suggestion, harder to respond to, elicited higher arousal in high hypnotizables as compared to low hypnotizables. In the second experiment, we performed five consecutive hypnosis sessions to confirm the reproducibility of the most prominent effect found in Study 1—a gradual decrease in the level of skin conductance during hypnotic induction. We also confirmed that this effect is independent of the hypnotizability level. We conclude that arousal is bilaterally reduced during hypnosis induction, which is persistent across different levels of hypnotizability. At the same time, lateral differences define unique EDA patterns in the induction phase, characterizing high, medium, and low hypnotizables.

Tracking and monitoring stress within the financial system is a key component of macroprudential policy. This paper introduces a new measure of contemporaneous stress: the Factor-based Index of Systemic Stress (FISS). The aim of the index is to capture the common components of data describing the financial system. This new index is calculated with a dynamic Bayesian factor model methodology, which compresses the available high frequency and high dimensional dataset into stochastic trends. Aggregating the extracted four factors into a single index is possible in a multitude of ways, but averaging yields satisfactory results. The contribution of this paper is the usage of the dynamic Bayesian framework to measure financial stress, as well as producing the measure in a timely manner without the need for deep option markets. Applied to Hungarian data the FISS is a key element of the macroprudential toolkit.

Az első anatómiai nómenklatúra, a bázeli „Nomina anatomica” (1895) megjelenésével az anatómiai nevek megalkotásának folyamata nem zárult le, a nemzetközi anatómiai nevezéktan azóta is folyamatos revízió alatt áll. A nevezéktan újragondolását és javítását az új anatómiai struktúrák megnevezése, az archaikus szemléletű nevek megújítása (pl. ramus descendens anterior helyett ramus interventricularis anterior), a már használatban levő nevek hibáinak javítása, a szemlélet egységesítése mellett a más orvosi területekkel, különösen a klinikai ágak nyelvhasználatával való harmonizáció teszi szükségessé. A korábbi kiadásokat következetesség szempontjából felülmúló „Terminologia anatomica” (1998) a különböző orvosi szakterületek terminológiájának egységesítését tűzte ki célul. Az egységes, több terület átfogó anatómiai nómenklatúra létrehozása csak terminológusok, nyelvészek, anatómusok és a klinikai ágak művelőinek szoros együttműködésével valósítható meg.

Objective: To assess the prevalence of intuitive decision-making (IDM) among health care practitioners (HCPs) and explore its person- and job-specific factors. Design and Outcome Measures: We used on-line survey data from a cross-sectional sample of Hungarian physicians and nurses (N = 460) to assess their reliance on IDM. In a second survey we asked physicians (N = 104) to rate medical specialties on dimensions of ‘emergency’ (necessity of making instantaneous decisions in unforeseeable situations) and ‘complexity’ (necessity of considering multiple perceptual and diagnostic aspects of patients’ health condition along with diverse treatment options). Results: Altogether 40% of participants reported ever relying on IDM. Using logistic regression analysis, we found the estimated probability of IDM was 0.24 greater for physicians than for nurses, 0.10 greater for females than for males, and 0.11 greater for advanced level HCPs than for novices. Reaching expert level further increased (by 0.31) the probability of IDM for physicians, but not for nurses. Concerning physicians, practicing in a medical specialty of ‘high likelihood of emergency’ or ‘high complexity’ increased the probability of IDM by 0.25 and 0.23; the same effects for nurses were 0.20 and 0.07. We found some (inconclusive) evidence for education positively influencing HCPs’ propensity for IDM. Additionally, we performed content analysis of participants’ free-text answers to explore the psychological background of IDM instances. HCPs educated in the subject of IDM were found more disposed to perform or request further medical investigation, less prone to deviate from medical protocols, apter to reflect on their mental processes, and more inclined to rely on a large scope of information for their decisions. Conclusions: The associations between job- and person-specific factors and HCPs’ propensity for IDM may have implications for their training and allocation in the health care system. Education has great potential for enhancing the quality of IDM in clinical practice.

The aim of this study is to provide an overview about the role of oxytocin in childbirth and breastfeeding, based on the review of studies on oxytocin. It highlights the relationship between physiological (peripheral) effects and central, psycho-affective effects. It also summarizes the known consequences of various interventions that modify the natural (endogenous) oxytocin action during childbirth and breastfeeding. Suggestions are made on how to support the endogenous oxytocin system by as few interventions as possible.A tanulmány célja, hogy az oxitocinnal kapcsolatos összefoglaló közlemények alapján áttekintést adjon arról, mit tudunk ma az oxitocin szerepéről a szülés és szoptatás során. Rámutat az élettani (perifériás) hatások és a centrális, pszichoaffektív hatások összefüggéseire. Emellett összegzi azokat az ismert következményeket, amelyek a különféle beavatkozások révén módosítják a természetes (endogén) oxitocin hatáskörét szüléskor, illetve szoptatáskor. Javaslatokat fogalmaz meg arra nézve, hogy hogyan lehet támogatni az endogénoxitocin-rendszert, minél kevesebb beavatkozással élve. Orv Hetil. 2022; 163(41): 1629–1638.

Background Over a third of critical illness survivors suffer from mental health problems following hospitalization. Memories of delusional experiences are a major risk factor. In this project, ICU doulas delivered a unique positive suggestion intervention targeting the vulnerable time period during critical illness when these memories are formed. Methods Adult critically ill patients were recruited for this single-arm, prospective pilot study. These ICU patients received a positive suggestion intervention daily during their ICU stay in parallel with their medical treatment. The intervention was designed to be delivered over a minimum of two sessions. Feasibility was defined as intervention delivery on ≥ 70% of ICU days after patient enrollment. As a secondary analysis, psychometric questionnaires were compared to those of a historic control cohort of patients receiving standard care in the ICU using adjusted linear regression models. Results Of the 97 patients who received the intervention and were alive at the end of their ICU course, 54 were excluded from analyses mostly for having received only one session because of a short ICU length of stay of N = 299), patients receiving the intervention had higher severity of illness and longer length of stay. When adjusted for baseline differences, patients both with and without mechanical ventilation who received the intervention scored lower on the Hospital Anxiety and Depression Scale (HADS)—Depression subscale. The intervention was also associated with reduced HADS-Anxiety subscale among ventilated patients. Conclusions Positive therapeutic suggestion delivered by ICU doulas is feasible in the ICU setting. A randomized trial is warranted to better delineate the role that positive suggestion and ICU doulas may play in ongoing interprofessional efforts to humanize critical care medicine. The study was registered on clinicaltrials.gov (NCT03736954) on 03/14/2018 prior to the first patient enrollment https://clinicaltrials.gov/ct2/show/NCT03736954?cond=ICU+Doulas+Providing+Psychological+Support&draw=2&rank=1.

In this special issue of the International Journal of Clinical and Experimental Hypnosis (IJCEH), mostly young colleagues share their experiences with hypnosis or suggestion techniques in various f...

BackgroundThe evidence on long-lasting effects of certain specific aspects of birth circumstances on the maternal mental health later during pregnancy in offspring is scares.AimThis study aimed to investigate the association between birth circumstances and prenatal maternal mental health in offspring.MethodIn this retrospective survey, 380 pregnant women completed the Hungarian translation of Wijma Delivery Expectancy/Experience Questionnaire A, Beck Depression Inventory-Short Form, Beck Anxiety Inventory to measure prenatal fear of childbirth (FOC), depression, and anxiety, respectively. Information on peri and postnatal events were obtained from participants’ biological mothers through Mother’s Birth Circumstances Questionnaire. This included questions regarding mode of birth, administered medical interventions during labor, early life care, and breastfeeding during infancy. Multiple Linear regression was performed for statistical analysis.ResultsAfter adjusting for potencial confounders, administration of Oxytocin (OT) induction during labor was significantly associated with higher levels of prenatal FOC (B = 7.64; 95% CI, 0.55, 14.73), depression (B = 1.60; 95% CI, 0.47, 2.73), and anxiety (B = 3.80; 95% CI, 0.55, 6.99). Moreover, having been breastfed for more than 12 months was significantly associated with lower level of prenatal FOC in offspring (B= -10.45; 95% CI,-18.79,-2.11).ConclusionPoor prenatal mental health might be rooted in administered OT induction as a common medical practice during labor while long duration of breast feeding can have a positive effect on improving prenatal maternal mental health in offspring. Further studies of prospective design are on demand to explore the biological trajectories of these findings in humans.

Összefoglaló. Bevezetés: A magyarországi vesetranszplantáció 2013 óta az Eurotransplant (ET) keretein belül zajlik. A debreceni vesetranszplantációs centrumhoz évente kb. 200 kadáverdonorvese-felajánlás érkezik, melyek 37%-a kerül a megismert adatok alapján elfogadásra. Nem minden elfogadott vese kerül beültetésre, aminek számos oka lehet. Célkitűzés: A debreceni szakmai gyakorlat elemzése és bemutatása reprezentatív mintán. Módszer: A debreceni centrumhoz 2016. november és 2020. március között 624 vesefelajánlás érkezett. A felajánlott vesék 37%-a (n = 229) került előzetesen elfogadásra, később az elfogadott vesék 63%-a (n = 144) került beültetésre. Centrumunkban az ún. 'standard criteria', azaz tökéletes minőségű donorvesék szignifikánsan magasabb arányban kerültek elfogadásra, majd beültetésre, mint az 'extended criteria', azaz kompromisszummal vállalhatók. Az elfogadott és nem elfogadott veséket vizsgálva a KDPI (kidney donor profile index) és a KDRI (kidney donor risk index) értéke szignifikánsan magasabb volt az elutasított donorok esetében (p0,001). Eredmények: Elemeztük, hogy a felajánlott, de a centrum által nem beültetett donorveséket más ET-centrumban elfogadták-e. Látható, hogy a felajánlott 624 donorvese közül 144 Debrecenben, 313 pedig más ET-centrumban került beültetésre, viszont 167 vese beültetése egyik ET-centrumban sem történt meg (discarded organ). A 36-85 KDPI-értékkel rendelkező csoportból került beültetésre a legtöbb donorvese (180 vese) más ET-centrumban. A Debrecenben beültetett kadáverdonor-vesék KDPI- és KDRI-értéke szignifikánsan alacsonyabb volt a nekünk felajánlott, majd máshol beültetett vesékhez képest. Következtetés: Összességében elmondható, hogy a debreceni centrumban a magas rizikócsoportba tartozó donorszervek elutasításra kerültek, miközben más centrumban a nagy részüket beültették. Ez alapján a 36-85 KDPI-értékű csoport a transzplantációs esetszám bővítésének lehetséges forrása a recipiens ismeretében. Orv Hetil. 2021; 162(26): 1022-1028.Kidney transplantation in Hungary is carried out via Eurotransplant (ET). Our centre in Debrecen receives around 200 kidney offers a year, of which 37% are accepted. Not all accepted kidneys are transplanted, which can be a result of a number of causes. Obejctive: A debreceni szakmai gyakorlat elemzése és bemutatása reprezentatív mintán.Between November 2016 and March 2020, the centre of Debrecen received 624 kidney offers. 37% (n = 229) of the offered kidneys got preliminarily accepted, of which 63% (n = 144) were transplanted later. In our centre, standard criteria donor kidneys were accepted and transplanted in significantly higher rate, than extended criteria donor kidneys. Looking at accepted and rejected kidneys, KDPI and KDRI values were significantly higher in the case of the refused ones (p0.001).Part of our assessment is to analyze whether kidneys offered to and refused by us got accepted in other transplant centres. In the examined period, of the 624 kidneys offered to our centre 144 were transplanted in Debrecen, 313 were transplanted in other ET centres, while 167 were not transplanted at all (discarded organ). The majority of transplanted kidneys in other ET centres had KDPI values between 36 and 85 (180 kidneys.) KDPI and KDRI values of kidneys transplanted in our centre were significantly lower than those that were offered to us, but got transplanted elsewhere.To summarize, we can say that high-risk donor organs are refused in the transplant centre of Debrecen, while the majority of them are being transplanted in other centres. Based on this, kidneys of KDPI value between 36 and 85 are a possible source of expanding the number of transplantations, with regards to the recipient. Orv Hetil. 2021; 162(26): 1022-1028.

Research on the efficacy of hypnosis applications continues to grow, but there remain major gaps between the science and clinical practice. One challenge has been a lack of consensus on what applications of hypnosis are efficacious based on research evidence. In 2018, six major hypnosis organizations collaborated to form a Task Force for Establishing Efficacy Standards for Clinical Hypnosis. This paper describes a Guideline for the Assessment of Efficacy of Clinical Hypnosis Applications developed by the Task Force which makes ten specific recommendations. The guideline is intended to be a tool for those who want to assess the quality of existing evidence on the efficacy of clinical hypnosis for any particular indication. The paper also discusses methodological issues in the interpretation and implementation of these guidelines. Future papers will report on the other products of the Hypnosis Efficacy Task Force, such as best practice recommendations for outcomes research in hypnosis, and an international survey of researchers and clinicians on current practice and attitudes about hypnosis.

Background:The evidence on long-lasting effects of certain specific aspects of birth circumstances on the maternal mental health later during pregnancy in offspring is scares. Aim: This study aimed to investigate the association between birth circumstances and prenatal maternal mental health in offspring. Method: In this retrospective survey, 380 pregnant women completed the Hungarian translation of Wijma Delivery Expectancy/Experience Questionnaire A, Beck Depression Inventory-Short Form, Beck Anxiety Inventory to measure prenatal fear of childbirth (FOC), depression, and anxiety, respectively. Information on peri and postnatal events were obtained from participants’ biological mothers through Mother’s Birth Circumstances Questionnaire. This included questions regarding mode of birth, administered medical interventions during labor, early life care, and breastfeeding during infancy. Multiple Linear regression was performed for statistical analysis.Results: After adjusting for potencial confounders, administration of Oxytocin (OT) induction during labor was significantly associated with higher levels of prenatal FOC (β= 0.14; 95% CI, 0.59, 14.70), depression (β= 0.18; 95% CI, 0.47, 2.73), and anxiety (β= 0.15; 95% CI, 0.50, 6.95). Moreover, being breast fed for more than 12 months was significantly associated with lower level of prenatal FOC in offspring (β= -0.12; 95% CI, -18.42, -1.36). Conclusion: Poor prenatal mental health might be rooted in administered OT induction as a common medical practice during labor while long duration of breast feeding can have a positive effect on improving prenatal maternal mental health in offspring. Further studies of prospective design are on demand to explore the biological trajectories of these findings in humans.

Background: The purpose of our study was to analyze body composition and spiroergometric data of young (14-15 years) elite level ball sport players. We suggested that three-ball sports (handball, soccer, and basketball) share common performance indicators, as each ball sport is primarily characterized by rapid intermittent movements. Methods: We selected one-hundred and ten, handball (n=30), basketball (n=40) and soccer (n=40) players male and female from local clubs in Hungary. To measure their performance to develop high-quality training programs adequately age was differing from 14 to 15, they represented the elite level of their sports. They participated in performance analysis, the protocol included a body composition analysis and spiroergometric tests. We measured body composition and physiological parameters utilizing an In Body 720 device, and a standard Bruce treadmill protocol. Although we were aware of the limitations of the Bruce protocol in elite athletes, we choose this protocol as a safer alternative for younger inexperienced athletes. Results and conclusions: We concluded that in young male soccer and basketball players mean peak /load (W), peak/VE (l), peak/Vtex (l), peak/VO2 (ml/min), peak/VCO2 (ml/min), and peak/ O2 pulse (ml) data is a reliable indicator of the sport-specific performance. We may also suggest, that in our population of male basketball and handball players peak/Vtex (l) is the only variable, which is significantly different. Between groups of male handball and soccer players, peak/VO2/kg (ml/min) may be a valid performance indicator too. Among female basketball and handball players we found a significant difference in three performance variables: peak/Vtex (l), peak/VO2 (ml/min) and peak/ O2 pulse (ml). Although we must be careful when interpreting results, prior experiences with exercise testing, biological maturation differences must be considered. Trial registration: All examinations involving human subjects were approved by the Hungarian Ethical Committee ETT TUKEB:15117-4/2018/EÜIG.

This study aims to assess the effectiveness of psychosocial techniques to decrease postoperative pain and improve perioperative clinical care in orthopedic surgery. A systematic review and meta-analysis was performed to evaluate the effects of psychosocial methods among adults undergoing orthopedic surgeries. The systematic review included both randomized and nonrandomized trials, but only randomized controlled clinical trials (RCTs) were included in the meta-analysis. Key outcomes were postoperative pain, analgesic requirement, perioperative anxiety, quality of life, and recovery. After searching the databases from January 1980 to September 2016, a total of 62 RCTs were included with a pooled sample size of 4,908. Psychosocial interventions significantly reduced postoperative pain (Hedges’ g = 0.31 [95% confidence interval = 0.14, 0.48]), and preoperative and postoperative anxiety (g = 0.26 [0.11, 0.42] and g = 0.4 [0.21, 0.59], respectively). Furthermore, psychosocial interventions improved recovery (g = 0.38 [0.22, 0.54]). However, no significant effects were found for postoperative analgesic use (g = 0.16 [−0.01, 0.32]) and quality of life (g = 0.14 [−0.05, 0.33]). Patient education and relaxation techniques produced the most consistent positive effects, showing benefits on pain, anxiety, and recovery. Cognitive or behavioral techniques improved recovery. Furthermore, larger effects were found for studies that included acute surgeries compared to elective surgeries. The results indicate that psychosocial interventions, especially patient education and relaxation training, may reduce perioperative side effects and improve recovery in patients undergoing orthopedic procedures, but the quality of evidence is generally low. More well-powered, high-quality studies are needed to increase confidence. Perspective In this meta-analysis of RCTs in orthopedic surgeries, significant benefits in postoperative pain, perioperative anxiety, and recovery were found, suggesting that psychosocial interventions, especially patient education and relaxation techniques, are useful in improving clinical care.

It is increasingly clear that oxytocin and cortisol play an intricate role in the regulation of behavior and emotions impacting health, relationships, and well-being. Their long-term, cross-generational effect makes them an important focus of the present study. This exploratory research examined changes in oxytocin and cortisol levels and their correlations with different phenomenological measures in both hypnotist and subject during active-alert hypnosis. The level of oxytocin increased whereas the level of cortisol decreased in the hypnotist. When comparing the oxytocin changes of subjects with their hypnotizability, those with low hypnotizability scores experienced an increase in oxytocin, and those with medium and high hypnotizability scores showed no change or decrease. This could explain why clients' hypnotizability is not considered an important factor during hypnotherapy.

Shifts in hemispheric dominance were previously proposed to play a role in hypnosis. Participants (N = 32) were exposed to an active–alert hypnosis induction and a music-control condition while electrodermal activity was registered bilaterally, providing information on alterations in hemispheric dominance. The results suggest that highly hypnotizable participants show a shift to right-sided and low hypnotizable participants demonstrated a shift to left-sided electrodermal dominance in response to the induction, whereas no change in laterality is present in the control condition. Additionally, the authors found that self-reported hypnosis experiences were also associated with a shift in laterality. These results underline the importance of the shift to right hemispheric activity in hypnosis and underscore the importance of hemispheric changes in shaping subjective experience. (Less)

Management of reed beds primarily includes controlling water levels and removing vegetation by mowing, burning, or grazing. Although recent studies have demonstrated increased diversity and abundance of wetland specialists after reed bed management, documenting demographic benefits to individual species would add additional support to the advantages of appropriate management. Here, we explore the effects of reed management on the philopatry of Great Reed Warblers (Acrocephalus arundinaceus) over 7 yr. Reed beds were managed in the winter by occasional burning at mining ponds and large canals, infrequent burning in marshes, and frequent mowing of small canals. Based on resightings and recaptures of 1,243 adult and 1,428 nestlings individually marked at 57 sites in 6 different reed habitats, we built Cormack-Jolly-Seber models to estimate the apparent annual survival and encounter probabilities of birds banded as nestlings or as adults. Apparent survival varied in time for both age groups and both ...

Suggestions can be used without formal hypnosis, especially with critically ill patients, due to their spontaneous trance state. In this paper we outline data on the effectiveness of therapeutic suggestions. We interpret the possible mechanism of therapeutic suggestions in the context of stress cognition. Basic principles of formulating suggestions are discussed and some recommended versions of non-pharmacological pain control are provided. Case vignettes are given of how suggestions are used with critically ill ICU patients.

Hypnotizability is related to the Val158Met polymorphism of the COMT gene. The authors' aim was to find associations between candidate genes and subjective dimensions of hypnosis; 136 subjects participated in hypnosis and noninvasive DNA sampling. The phenomenological dimensions were tapped by the Archaic Involvement Measure (AIM), the Phenomenology of Consciousness Inventory (PCI), and the Dyadic Interactional Harmony Questionnaire (DIH). The main results were that the "Need of dependence" subscale of AIM was associated with the COMT genotypes. The GG subgroup showed higher scores, whereas AA had below average scores on the majority of the subjective measures. An association between the 5-HTTLPR polymorphism and the intimacy scores on the DIH was also evident. The effects are discussed in the social-psychobiological model of hypnosis.

Buday György grafikus, fametsző, díszlettervező, a Szegedi Fiatalok Művészeti Kollégiumának vezetője és Bauer Lilla pályakezdő mozdulatművész 1933 augusztusában találkoztak először Szegeden. 1937-ig tartó szerelmük Buday fametszőművészetében új, intenzív korszakot nyitott. Bauer Lilla – kisebb megszakításokkal – 1934-től haláláig Angliában élt, így személye és művészete itthon kevéssé ismert. Az életrajzi vázlat – Buday hozzá írott levelei és a korabeli sajtó segítségével – pályafutásának rövid hazai szakaszát mutatja be.

Morphine and its derivatives play inevitably important role in the μ-opioid receptor (MOR) targeted antinociception. A structure-activity relationship study is presented for novel and known orvinol and thevinol derivatives with varying 3-O, 6-O, 17-N and 20-alkyl substitutions starting from agonists, antagonists and partial agonists. In vitro competition binding experiments with [3H]DAMGO showed low subnanomolar affinity to MOR. Generally, 6-O-demethylation increased the affinity toward MOR and decreased the efficacy changing the pharmacological profile in some cases. In vivo tests in osteoarthritis inflammation model showed significant antiallodynic effects of thevinol derivatives while orvinol derivatives did not. The pharmacological character was modelled by computational docking to both active and inactive state models of MOR. Docking energy difference for the two states separates agonists and antagonists well while partial agonists overlapped with them. An interaction pattern of the ligands, involving the interacting receptor atoms, showed more efficient separation of the pharmacological profiles. In rats, thevinol derivatives showed antiallodynic effect in vivo. The orvinol derivatives, except for 6-O-desmethyl-dihydroetorfin (2c), did not show antiallodynic effect.

Twin studies provide evidence for the heritability of social attitudes, e.g. competitiveness, however, there are no psychogenetic association results linking competitive attitudes to genetic polymorphisms. Candidate gene studies report association with competitiveness-related phenotypes, risk taking for example was linked with the 7-repeat allele of the dopamine D4 receptor gene. This polymorphism has been studied extensively with novelty seeking and certain psychiatric disorders, as it plays a crucial role in molecular genetic mechanisms driving behavioral responses to the environment, especially modulating behavior through the reward circuitry. In the present study, we examined association of the DRD4 48-bp VNTR and competitiveness using self-report data from 399 non-related Caucasians. We found an interesting gene-sex interaction: 7-carrier males were more hypercompetitive as compared to non-carriers, while 7-carrier females were less hypercompetitive as compared to non-carriers. This finding remained significant after Bonferroni correction for multiple testing. Interestingly, among females we observed a significant positive correlation between hypercompetitiveness and mood characteristic variables, however, no such relationship could be detected in males. In 7-carrier females the association of hypercompetitiveness and anxiety or depression was more robust as compared to non-carrier females. These results highlight the importance of cultural influences in interpreting gene-sex interaction effects. Our results underlies interaction between genes and the environment; suggesting that the 7-repeat allele plays an important role in adaptivity, enabling sex-specific behavior to social expectations.

This study aimed to assess fear of childbirth (FOB) among Hungarian pregnant women and determine predictors based on WDEQ-A subscales. This cross-sectional study was conducted among 423 healthy pregnant women during their third trimester. A socio-demographic and obstetrics characteristics, the Hungarian version of WDEQ-A, Beck Depression Inventory-Short Form and Beck Anxiety Inventory were used. The analysis was performed using multivariate linear regression. Among four WDEQ-A subscales, Fear (19%) and Lack of positive emotion (13%) obtained the largest and smallest percentages of cases with severe FOB. The nulliparous obtained significantly higher mean score in subscales Isolation and Lack of positive emotion compared to the multiparous. Anxiety was the most common predictor for all subscales in both groups. In the nulliparous group, significant predictors included economic hardship for Moment of birth, being a housewife for Fear, and wanted pregnancy for Lack of positive emotion. In the multiparous women, the strongest significant predictors were being married, previous elective caesarean section and being a housewife for subscales Isolation, Moment of birth, and Fear, respectively. Assessing FOB using WDEQ-A among Hungarian women revealed different mean scores and predisposing factors for each subscale. The topic should be further explored relative to its constituent factors.

Hip and knee replacement surgery is very demanding for patients. Medication consumption is further increased by perioperative anxiety. Besides pain killer and anxiolytic medications, patients' recovery can be enhanced by applying therapeutic suggestions, which are easily applicable during the patient-physician communication.In our prospective, randomized, controlled study we examined the effects of positive suggestions on patients undergoing hip or knee arthroplasty in spinal anaesthesia. Members of the suggestion group received the therapeutic suggestions during a pre-surgery physician visit, and by listening to an audio recording during surgery.Compared to the control group (n = 50), in the suggestion group (n = 45) the need of medication (pain killer and adjuvant pain medication) during the surgery was lower (p = 0.037), the mean change from baseline in the well-being of the patients was better on the 2nd [1.31 (0.57; 2.04); p0.001] and 4th [0.97 (0.23; 1.7); p = 0.011] postoperative day and less transfusion had to be administered (OR: 2.37; p = 0.004). However, there was no difference between the two groups in the postoperative need of medications, in the length of hospitalisation and in the frequency of complications. Conslusion: Our results indicate that the administration of therapeutic suggestions in the perioperative period may be beneficial for orthopaedic surgery patients. Orv Hetil. 2018; 159(48): 2011-2020.Absztrakt: Bevezetés és célkitűzés: A csípő- és térdprotézisműtétek jelentős megterheléssel járnak a betegek számára. A műtétek körüli gyógyszeres fájdalomcsillapítás és szorongásoldás mellett a betegek gyógyulása az orvos–beteg kommunikáció során könnyen alkalmazható terápiás szuggesztiókkal is segíthető. Módszer: Prospektív, randomizált, kontrollált tanulmányunkban csípő- és térdprotézisműtéten spinalis anesztéziában átesett betegeken vizsgáltuk a pozitív szuggesztiók hatását. A szuggesztiós csoport tagjai műtét előtti beszélgetés során, valamint műtét alatt hangfelvételről kapták a szuggesztiókat. Eredmények: A kontrollcsoporthoz (n = 50) képest a szuggesztiós csoportban (n = 45) alacsonyabb volt a műtét alatti fájdalomcsillapítók és adjuváns szerek iránti összesített igény (p = 0,037), jobb volt a betegek közérzetének átlagos változása a műtét utáni 2. [1,31 (0,57; 2,04); p0,001], illetve 4. [0,97 (0,23; 1,7); p = 0,011] napon, és kevesebb transzfúzió adására (OR: 2,37; p = 0,004) volt szükség. Ugyanakkor nem mutatkozott különbség a műtét utáni gyógyszerek iránti igényben, a hospitalizáció időtartamában és a szövődmények gyakoriságában. Következtetés: Eredményeink igazolják, hogy a terápiás szuggesztiók alkalmazása a műtét körüli időszakban kedvezően befolyásolja a gyógyulási folyamatot. Orv Hetil. 2018; 159(48): 2011–2020.

Background:. Surviving critical illness often creates a lasting psychological impact, including depression, anxiety, and post-traumatic stress. Memories of frightening and delusional experiences are the largest potentially modifiable risk factor, but currently, there is no proven intervention to improve these inciting factors. Psychological support based on positive suggestion is a psychotherapeutic approach that can be provided even to patients in altered cognitive states and is therefore a viable psychotherapy intervention throughout the ICU stay. Traditional ICU care team members have limited time and training to provide such psychological support to patients. Doulas are trained supportive companions who have been effectively used to provide patient advocacy and emotional support in other clinical settings and may address this need. Our aim was to train and implement a psychological support based on positive suggestion program for the critically ill using doulas, and measure acceptance of this intervention through stakeholder feedback. Methods:. Doula training included three objectives: an introduction to ICU practice structure and policies; education about fundamental aspects of critical care conditions and procedures; and didactic and hands-on learning experiences in effective use of psychological support based on positive suggestion in the critically ill. Doulas were evaluated at the end of their training and during subsequent clinical activities using competency-based assessments as well as through survey-based questions and interviews with key stakeholders. Results:. The ICU doulas performed psychological support based on positive suggestion on 43 critically ill patients in the ICU setting. Stakeholder feedback from nurses, patients, and patient families was positive. The majority (28/32) of surveyed bedside ICU nurses reported that the doulas’ involvement was helpful for both patients and nurses alike. All interviewed family members offered positive comments about the ICU doula presence and of the 40 patients who recalled the intervention 37 found it comforting. Conclusions:. Our program successfully trained two doulas to work effectively in the ICU setting performing patient-centered psychological support based on positive suggestion interventions. Their training improved their skill sets and was reported as beneficial by patients, families, and critical care nursing. This training program offers a proof of concept that could be applied in other medical centers, bringing doulas more commonly into the ICU practice to help humanize the experience for patients, families, and medical teams.

We describe a case of infectious spondylodiscitis of the lumbar spine complicated by epidural and bilateral psoas abscesses which started with subtle symptoms and a non-specific clinical picture. Diagnosis is based on clinical, laboratory and radiological features. It can be difficult and often delayed due to the rarity of the disease and the high frequency of low back pain in the general population. Our aim is to raise awareness for the possibility of specific low back pain which requires quick and indispensable action from the physician.

This study examined whether positive suggestions applied without a hypnotic induction in the perioperative period reduces the need for red blood cell transfusions in patients who underwent total hip or knee arthroplasties with spinal anesthesia. No hypnotic assessment was performed. Ninety-five patients were randomly assigned to the suggestion group (n = 45) and to the control group (n = 50). Patients in the suggestion group received verbal suggestions before and audiotaped suggestions during the surgery for reducing blood loss, anxiety, postoperative pain, and fast recovery. Our study showed that using positive suggestions in the perioperative period significantly decreases the necessity for transfusion.

A szerző áttekintést nyújt arról, hogyan használják a hajképleteket a kriminalisztikai hajmorfológiában.

Aims Pain and anxiety are commonly reported among those undergoing orthopaedic surgery. Improvement in anxiety and pain control might be achieved by supplementing standard care with psychological interventions. However, the effectiveness of adjunctive psychosocial interventions in anxiety and pain control have not been addressed sufficiently by previous systematic reviews in orthopaedic surgeries. The present study aimed to assess the effectiveness of adjunctive psychosocial techniques to improve perioperative clinical care in orthopaedic surgery, to identify the most effective intervention types and to evaluate potential moderators. Methods We will perform a systematic review and meta-analysis to address the study aims. PubMed, PsycINFO, CINAHL and ProQuest Dissertations & Theses will be searched between 1980 and 2015. Prospective controlled clinical trials completed in adults, contrasting standard care and standard care supplemented with psychosocial methods, will be eligible for inclusion. Effectiveness will be assessed through the outcomes of postoperative pain intensity, analgesic requirement, perioperative anxiety, quality of life and postoperative recovery. The results of a random-effect meta-analysis will be reported. To aid implementation of best practice, moderating effects of the type and timing of psychosocial intervention, type of surgical intervention and type of anaesthesia will be evaluated through meta-regression. Sensitivity analyses and subgroup contrasts will follow as necessary. Discussion Recommendations will be made to improve medical care in orthopaedic procedures. The quality of evidence will be rated using GRADE criteria. Copyright © 2016 John Wiley & Sons, Ltd.

In this study we explored the linkage between wing size of Great Reed Warbler males (Acrocephalus arundinaceus) and their habitat selection and relate these linkages to differences in reed habitat quality. We measured the wing sizes of males nesting in 6 different reed habitats. To explain reed habitat selection, we modeled male wing size as a function of 7 predictor variables describing reedbeds: proportion of managed reed; densities of mixed, old, and fresh reed; reed stem diameter; water depth; and fluctuation of water level. Mean wing size was greatest for males at large canals, intermediate at mining ponds and smaller canals, and lowest at marshes and very small canals. The proportion of managed reed and fluctuation of water level were negatively related to wing size, and water depth was positively related to wing size, which suggests that males with larger wings preferred reed habitats with little management in deep water with little fluctuation in water level. We concluded that the availab...