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During the COVID-19 pandemic, sizeable groups of unvaccinated people persist even in countries with high vaccine access1. As a consequence, vaccination became a controversial subject of debate and even protest2. Here we assess whether people express discriminatory attitudes in the form of negative affectivity, stereotypes and exclusionary attitudes in family and political settings across groups defined by COVID-19 vaccination status. We quantify discriminatory attitudes between vaccinated and unvaccinated citizens in 21 countries, covering a diverse set of cultures across the world. Across three conjoined experimental studies (n = 15,233), we demonstrate that vaccinated people express discriminatory attitudes towards unvaccinated individuals at a level as high as discriminatory attitudes that are commonly aimed at immigrant and minority populations3-5. By contrast, there is an absence of evidence that unvaccinated individuals display discriminatory attitudes towards vaccinated people, except for the presence of negative affectivity in Germany and the USA. We find evidence in support of discriminatory attitudes against unvaccinated individuals in all countries except for Hungary and Romania, and find that discriminatory attitudes are more strongly expressed in cultures with stronger cooperative norms. Previous research on the psychology of cooperation has shown that individuals react negatively against perceived 'free-riders'6,7, including in the domain of vaccinations8,9. Consistent with this, we find that contributors to the public good of epidemic control (that is, vaccinated individuals) react with discriminatory attitudes towards perceived free-riders (that is, unvaccinated individuals). National leaders and vaccinated members of the public appealed to moral obligations to increase COVID-19 vaccine uptake10,11, but our findings suggest that discriminatory attitudes-including support for the removal of fundamental rights-simultaneously emerged.

Bevezetés: Az egészségügyi dolgozói ellátottság biztosítása napjainkban fontos szakmapolitikai kérdéskör. Célkitűzés: Kutatásunk célja, hogy átfogó képet adjunk az egészségügyi szakdolgozói létszámhelyzetről az OECD európai országaiban. Adatok és módszerek: Az elemzéshez az „OECD Health Statistics 2021” adatbázis gyakorló szülésznőkre, praktizáló ápolókra és gyakorló gyógytornászokra vonatkozó létszámindikátorait, illetve teljes kórházi ágyszámra vonatkozó indikátorát elemeztük a 2000–2018-as időszakra. 24 európai OECD-országot csoportosítottunk az egészségügyi rendszer és a földrajzi elhelyezkedés szerint, majd hasonlítottunk össze a 2000., 2010., 2018. évek adatai alapján paraméteres és nemparaméteres próbákkal. Eredmények: 2000 és 2018 között a vizsgált OECD-országokban 100 000 lakosra nézve 14%-kal nőtt a szülésznők, 30%-kal az ápolók és 41%-kal a gyógytornászok átlagos létszáma. 100 kórházi ágyra vetítve 72%-kal nőtt a szülésznők, 86%-kal az ápolók és 97%-kal a gyógytornászok átlagos létszáma. Szignifikáns eredményt mindhárom vizsgált évre a 100 kórházi ágyra vetített gyógytornászi létszámindikátornál kaptunk (p = 0,014; pKövetkeztetés: Az egészségügyi szakdolgozói szakmacsoportok közül a gyógytornászok létszáma nőtt a leginkább Európában. A vizsgált nyugat-európai országokban a 100 ágyra vetített egészségügyi szakdolgozói létszám szignifikánsan nagyobb a közép-európai országokhoz képest. Orv Hetil. 2022; 163(41): 1639–1648.

Positive psychology has fully examined the flourishing among healthy people but neglected to understand how “optimal human functioning” can apply to the life experiences of a vulnerable person. Considering methodological issues, this article gives a brief overview on how the conceptualization of mental health and mental disorders affects the consideration of strengths along with the presence of dysfunction with the emergence of positive psychology. First, we summarize the shortcomings of the applicability of clinical positive psychology, focusing especially on Hungarian clinical practice. Second, we discuss the problems with the conceptualization of mental health in positive psychological framework. Third, we propose a model, the Maintainable Positive Mental Health Theory based on capacities and competences. Finally, we conclude with methodological questions and present a research protocol. The key finding of our review is that the opportunity exists for psychiatrists and psychologists to embrace disability as part of human experiences and to show how people with vulnerabilities can be supported to recover.

The purpose of this study was to compare attitudes toward rape in Poland, Hungary, and Norway. Based on system justification theory, we examined whether country of origin predicts levels of rape myth acceptance, beliefs in the biological origins of gender differences, and ambivalent sexism. There is also some evidence that beliefs in the biological origins of gender differences predict rape myth among Polish students and that this relationship is mediated by hostile sexism. The current study aimed to test whether this model can be applied to other countries. Participants ( N = 266) were from Poland, Hungary, and Norway. The study was conducted online. The dependent and independent variables were measured with questionnaires. Polish participants had significantly higher levels of rape myth acceptance, beliefs in the biological origins of gender differences, and ambivalent sexism than Norwegian and Hungarian participants. Our proposed model was confirmed: belief in the biological origins of gender differences was associated with rape myth acceptance, with hostile sexism as a mediator. Benevolent sexism also turned out to be a mediator between beliefs in the biological origins of gender differences and rape myth acceptance. The mediational model of the relationship between beliefs in the biological origins of gender differences and rape myth acceptance can be applied to all three countries. This result suggests that anti-rape educational interventions should take into account the role of culture and society in the construction of gender differences.

Bevezetés: A digitalizáció egészségügyre gyakorolt hatása az elmúlt évek egyik legfontosabb kutatási területévé vált. E folyamatot a COVID–19-járvány is jelentősen katalizálta. Célkitűzés: Országosan reprezentatív, lakossági kutatásunkban (n = 1500) arra kerestünk választ, hogy a magyarországi páciensek miként használják a digitális egészség eszköztárát, milyen előnyöket, hátrányokat jelent ezeknek a technológiáknak a bevezetése és alkalmazása, és hogyan alakítja át mindez az orvos-beteg kapcsolatot. Módszer: Országos reprezentatív kérdőíves felmérést végeztünk, telefonos megkereséssel (CATI), 1500 fő megkérdezésével. A minta nem, kor, településtípus és iskolai végzettség tekintetében reprezentálja Magyarország nagykorú lakosságát. Eredmények: A válaszadók 81,3%-a használja az internetet, a használók 87,6%-a – ez a teljes minta 71,2%-át jelenti – egészséggel, betegséggel kapcsolatban is. Az internetes tájékozódás legfontosabb forrásai a weboldalak (76,3%) és a közösségi média (47,3%). Az e-receptet és az online időpontfoglalást ismerik a páciensek közül a legtöbben (92,6% és 85,2%), ugyanakkor a megkérdezettek közel fele kipróbálná a távvizitet, és szívesen venné, ha orvosa ajánlana neki hiteles weboldalakat, applikációkat és szenzorokat. Eredményeink azt mutatják, hogy a településtípus hatása a digitális egészségüggyel kapcsolatos kérdésekben nem jelentős, ugyanakkor az életkor, az iskolai végzettség és a nem hatása számottevő. Következtetés: Országos, reprezentatív lakossági felmérésünk adatai azt mutatják, hogy a digitális egészségügyi megoldások használata már jelenleg is az ellátás integráns része, ugyanakkor nagymértékű igény rajzolódik ki a további digitális lehetőségek irányában is. Orv Hetil. 2022; 163(29): 1159–1165.

Most of the early Hungarian tribes originated from the Volga-Kama and South-Ural regions, where they were composed of a mixed population based on historical, philological and archaeological data. We present here the uniparental genetic makeup of the mediaeval era of these regions that served as a melting pot for ethnic groups with different linguistic and historical backgrounds. Representing diverse cultural contexts, the new genetic data originate from ancient proto-Ob-Ugric people from Western Siberia (6th–13th century), the pre-Conquest period and subsisting Hungarians from the Volga-Ural region (6th–14th century) and their neighbours. By examining the eastern archaeology traits of Hungarian prehistory, we also study their genetic composition and origin in an interdisciplinary framework. We analyzed 110 deep-sequenced mitogenomes and 42 Y-chromosome haplotypes from 18 archaeological sites in Russia. The results support the studied groups’ genetic relationships regardless of geographical distances, suggesting large-scale mobility. We detected long-lasting genetic connections between the sites representing the Kushnarenkovo and Chiyalik cultures and the Carpathian Basin Hungarians and confirmed the Uralic transmission of several East Eurasian uniparental lineages in their gene pool. Based on phylogenetics, we demonstrate and model the connections and splits of the studied Volga-Ural and conqueror groups. Early Hungarians and their alliances conquered the Carpathian Basin around 890 AD. Re-analysis of the Hungarian conquerors’ maternal gene pool reveals numerous surviving maternal relationships in both sexes; therefore, we conclude that men and women came to the Carpathian Basin together, and although they were subsequently genetically fused into the local population, certain eastern lineages survived for centuries.

Összefoglaló. Bevezetés: Az egészségügyi ellátásban dolgozók élet- és munkakörülményei meghatározóak a betegellátás minőségét és hatékonyságát tekintve, ezért a kérdéskör vizsgálata kiemelt jelentőséggel bír. Célkitűzés: Az állami egészségügyi ellátórendszerben, a betegellátásban közvetlenül érintett dolgozók szakmai közérzetének feltárása a lelki egészség és a munkahelyi klíma jellemzőin keresztül. Módszer: Keresztmetszeti, kvantitatív kutatásunkat kényelmi mintavétel (n = 1048) alkalmazásával végeztük 2019. december és 2020. március között két Zala megyei kórházban. A mérőeszköz a szociodemográfiai és munkaköri jellemzők megismerésére irányuló kérdések mellett a lelki egészség mérésére kifejlesztett validált kérdőíveket, valamint a munkahelyi klímára vonatkozó kérdéseket tartalmazott. Eredmények: A Diener Élettel való Elégedettség Skálán a válaszadók jelentős része (77,4%) az elégedettséget kifejező valamelyik skálaértéket jelölte meg, mely az orvosok körében szignifikánsan magasabb (χ2 = 28,36; df = 10; p = 0,01). Ennek ellentmond, hogy a vizsgált egészségügyi dolgozók 61,5%-a enyhe, 24,8%-a közepes, 5,7%-a pedig súlyos depressziós tüneteket mutat a Beck Depresszió Skála alapján. A depresszió megjelenése elsősorban a diplomával nem rendelkező szakdolgozókat fenyegeti (χ2 = 17,01; df = 6; pKövetkeztetés: Eredményeink ráirányítják a figyelmet arra, hogy a munkahelyi jóllét támogatása különösen fontos azokban a munkakörökben, amelyekben a mentális terhelésnek kitett munkavállalókra nézve a kiégés és a depresszió fokozott veszélyt jelent. Orv Hetil. 2022; 163(19): 759–766. Summary. Introduction: The living and working conditions of healthcare professionals are crucial to the quality and efficiency of patient care, therefore examining this issue is of highlighted importance. Objective: To explore the well-being of employees directly involved in the public health care system, through the characteristics of mental health and the workplace climate. Method: The cross-sectional, quantitative research was performed by using convenience sampling (n = 1048) between December 2019 and March 2020 in two hospitals in Zala county, Hungary. In addition to questions on sociodemographic and job characteristics, the measure tool included validated questionnaires developed to measure mental health as well as questions on workplace climate. Results: On the Diener Life Satisfaction Scale, a significant number of respondents (77.4%) indicated a scale value expressing satisfaction that was significantly higher among physicians (χ2 = 28.36; df = 10; p = 0.01). Contrary to this, 61.5% of the sample show mild, 24.8% moderate, and 5.7% severe depressive symptoms according to the Beck Depression Scale. The appearance of depression mostly threatens professionals without a degree (χ2 = 17.01; df = 6; pConclusion: The results point out that promoting well-being at work is particularly important in jobs where burnout and depression are increased risks for workers exposed to mental strain. Orv Hetil. 2022; 163(19): 759–766.

Összefoglaló. Bevezetés és célkitűzés: Az obstruktív alvási apnoe az intermittáló hypoxia által cardiovascularis, cerebrovascularis és metabolikus betegségek kialakulását okozhatja. Kutatásunkban célunk volt a betegség főbb jellemzőinek vizsgálata, az obstruktív alvási apnoe és a kontrollcsoport általános, antropometriai, laboratóriumi paramétereinek összehasonlító elemzése által. Anyag és módszer: A prospektív vizsgálatba 100 beteget (74 férfi, 26 nő, átlagéletkor ± SD, 42,15 ± 12,7 év) vontunk be, akiket az elvégzett poliszomnográfia eredménye alapján kontroll- (36 fő) és obstruktív alvási apnoe (64 fő) csoportra osztottunk. A betegeknél részletes anamnézisfelvételt, antropometriai méréseket, laborvizsgálatot és alváskérdőív-kitöltést végeztünk. Eredmények: Az obstruktív alvási apnoe csoportban szignifikánsan nagyobb nyak- (p = 0,015), csípő- és haskörfogat (pKövetkeztetés: Az elhízás mint az obstruktív alvási apnoe legfőbb rizikófaktora és az obstruktív alvási apnoéban jellemző intermittáló hypoxia hozzájárulnak a komorbid állapotok nagyobb arányban történő megjelenéséhez, melyek mihamarabbi diagnosztikája és kezelésük megkezdése kiemelkedő fontosságú a betegek életminőségére gyakorolt hatásuk miatt. Orv Hetil. 2022; 163(15): 586–592. Summary. Introduction and objective: Obstructive sleep apnoea results in metabolic and cardiovascular disorders due to intermittent hypoxia. The main aim of the present study was to analyze the most important features of obstructive sleep apnoea, using anthropometric measurements and blood tests. Material and method: In this prospective investigation, 100 patients (74 male and 26 female patients, mean age ± SD years, 42.15 ± 12.7) were enrolled. These patients were divided into control (n = 36) and obstructive sleep apnoea (n = 64) groups regarding the results of polysomnography. The examination of the patients consisted of detailed anamnestic data, anthropometric measurements, laboratory test and the use of apnoea questionnaires. Results: In the obstructive sleep apnoea group, significantly higher neck (pConclusion: Obesity, as one of the most important risk factors for obstructive sleep apnoea and the intermittent hypoxia contribute to the development of comorbidities. The diagnosis and therapy of the comorbidities is of great importance due to their effects on the patients’ quality of life. Orv Hetil. 2022; 163(15): 586–592.

BACKGROUND In recent decades, a series of ecological studies from various countries have attempted to reveal whether there is an association between trace amounts of lithium in drinking water and suicide mortality. With some notable exceptions, results have indicated that there is an inverse association between these two variables. Since Hungary had extremely high rates of suicide with a persistent spatial pattern, we consider that our country is ideal to investigate this research question. METHODS We carried out our research on Hungarian data at the level of districts (n = 197). The dependent variable was the age- and gender-standardized mortality ratio for suicide (sSMR). Our main explanatory variable was the tap water lithium level (Li) from public drinking water supply systems using their own water source (n = 1 325). Those data, which give full national coverage, were aggregated to the level of districts. Confounding factors were religiosity, alcohol consumption and income. Various regression models were used for statistical calculations. RESULTS Findings from our most appropriate regression model - adjusted for relevant confounding variables and able to handle spatial autocorrelation and heteroscedasticity - suggest a significant (p < 0.05) and a trend-like (p < 0.1) negative association between Li and sSMR in the total population and among males, respectively. However, such an association was not found between these two variables among females. CONCLUSION In line with the majority of findings from other countries, our results indicate that the intake of lithium with drinking water may have a gender-dependent suicide-protective effect.

Wastewater-based epidemiology (WBE) is a recognised tool for tracking community transmission of COVID-19. From the second half of 2020, the emergence of new, highly infective, more pathogenic or vaccine-escape SARS-CoV-2 variants is the major public health concern. Variant analysis in sewage might assist the early detection of new mutations. Weekly raw sewage samples from 22 wastewater treatment plants (WWTPs) in Hungary (representing 40% of the population) were analysed between December 2020 and March 2021 for signature mutations N501Y and del H69/V70 of B.1.1.7 lineage by melting point genotyping and RT-digital droplet PCR (RT-ddPCR). The latter method proved to be more efficient in parallel detection of different variants and also provides quantitative information. Wastewater surveillance indicated that the B.1.1.7 variant first emerged in Budapest in early January 2021 and rapidly became dominant in the entire country. Results are in close agreement with the available clinical data (Pearson's correlation coefficient, R = 0.9153). RT-ddPCR was confirmed to be a reliable tool for tracking emerging variant ratios in wastewaters. It is a rapid and cost-effective method compared to whole-genome sequencing, but only applicable for the detection of known mutations. Efficient variant surveillance might require the combination of multiple methods.

To explore the needs and opportunities of the general population to communicate their end-of-life care wishes and to investigate what roles are assigned to healthcare providers and family members in end-of-life care discussions.A cross-sectional social survey was carried out in Hungary. Descriptive analysis and analysis of variance were performed.Nationwide survey of the Hungarian general population.The sample (Needs and opportunities of the general population to communicate end-of-life care wishes.72% of participants found it important to discuss their end-of-life care wishes with someone. Six out of ten believed that it was also the GPs' task to talk with the patients about their end-of-life care wishes. An almost equal level of engagement was expected from healthcare providers (80%) -especially physicians (72%)- and family members (75%) in end-of-life conversations. However, only 36% of participants felt that there was someone among their healthcare providers, and 56% of them had a family member or friend with whom they could speak openly about death, dying and preparing for death.Compared to their needs, the general population had fewer opportunities to speak about death, dying and preparing for death. Training programs for healthcare providers, particularly GPs, and public awareness campaigns may support the broader application of advance care planning in Hungary.Key PointsCurrent guidelines recommend that GPs initiate advance care planning discussions. However, little is known with whom the general population wish to discuss their end-of-life care preferences and with whom there is an opportunity to do so.An almost equal level of engagement was expected from healthcare providers -especially physicians- and family members in end-of-life conversations. Most of the general population thought that participation in end-of-life discussions was also the GPs' task.The majority of participants reported that there was no one among their healthcare providers and a sizable minority felt that there was no one among their family members or friends with whom they could talk openly about death, dying, and preparing for death.The highest levels of unmet needs regarding end-of-life conversations with healthcare providers were found among those who considered it important to discuss their end-of-life care wishes.

Obesity is a chronic disease, in which treatment outcomes are highly dependent on patient and family adherence to behavioural recommendations. The role of healthy eating, physical activity, medication adherence as well as adherence to pre- and post-bariatric surgery protocols are of utmost importance for long-term treatment outcomes. Even the best interventions are not likely to reach their maximum benefit without significant levels of adherence on the part of the individual and family. Traditionally, the annual meeting of the European Childhood Obesity Group (ECOG) includes an expert workshop addressing one specific topic within the field of childhood obesity. During the 30th annual meeting, hosted by the University of Pécs, Hungary, as a virtual meeting, “adherence to treatment recommendations in obesity as a chronic disease” was addressed. The discussions that developed during the workshop are summarized in the following article.

Previous studies using generic and disease specific instruments showed that both migraine and medication overuse headache are associated with lower health-related quality of life (HRQoL). The aim of our study was to assess HRQoL differences in migraineurs and in patients with MOH and to examine how headache characteristics such as years with headache, aura symptoms, triptan use, headache pain severity and headache frequency are related to HRQoL.In this cross-sectional study 334 participants were examined (248 were recruited from a tertiary headache centre and 86 via advertisements). The Comp-rehensive Headache-related Quality of life Questionnaire (CHQQ) was used to measure the participants' HRQoL. Data showed normal distribution, therefore beside Chi-squared test parametric tests (e.g. independent samples t-test) were used with a two-tailed p0.05 threshold. Linear regression models were used to determine the independent effects of sex, age, recruitment method, headache type (migraine vs. MOH) and headache characteristics (presence of aura symptoms, years with headache, headache pain severity, headache frequency and triptan use) separately for each domain and for the total score of CHQQ. Significance threshold was adopted to p0.0125 (0.05/4) to correct for multiple testing and avoid Type I error.Independent samples t-tests showed that patients with MOH had significantly lower scores on all CHQQ domains than migraineurs, except on the social subscale. Results of a series of regression analyses showed that triptan use was inversely related to all the domains of HRQoL after correction for multiple testing (p0.0125). In addition, headache pain severity was associated with lower physical (p=0.001) and total scores (p=0.002) on CHQQ subscales.Based on the results, different headache characteristics (but not the headache type, namely migraine or MOH) were associated with lower levels of HRQoL in patients with headache. Determining which factors play significant role in the deterioration of HRQoL is important to adequately manage different patient populations and to guide public health policies regarding health service utilization and health-care costs.Általános és betegségspecifikus életminőség-kérdőívet használó vizsgálatok eredményei alapján mind migrénben, mind fájdalomcsillapító-túlfogyasztáshoz társuló fejfájásban (FTTF) szenvedő betegek esetében alacsonyabb életminőség-értékeket mértek a kontrollrésztvevőkhöz hasonlítva. Vizsgálatunk célja egyrészt a migrénben és FTTF-ben szenvedő betegek életminőségének, valamint a fejfájás-karakterisztika (fejfájós évek száma, auratünetek, triptánhasználat, fejfájássúlyosság és fejfájás-gyakoriság) életminőségre gyakorolt hatásának vizsgálata volt.Keresztmetszeti vizsgálatunkban 334 beteg vett részt (248 beteg fejfájás-ambulanciánkról, valamint 86 beteg hirdetés útján). A résztvevők életminőségének értékeléséhez az Átfogó Fejfájással Kapcsolatos Élet­minő­ség kérdőívet (CHQQ) használtuk. Adataink normál­eloszlást mutattak, így χ2-próba mellett parametrikus tesz­te­ket alkalmaztunk (például független mintás t-próba), a szig­nifikanciaszintet p0,05-ban határoztuk meg. A nem, életkor, beválogatási kritériumok, fejfájástípus, va­lamint fejfájás-karakterisztika (auratünetek megléte, fej­fájós évek száma, fejfájás súlyossága, fejfájás gyakori­sága, triptánhasználat) életminőségre gyakorolt hatásának vizsgálatához lineáris regressziós modelleket használtunk mind a három CHQQ-alskála és az összpontszám tekintetében is. Az utóbbi esetében az I. típusú hiba elkerülé­sé­nek érdekében a szignifikanciaszintet p  0,0125 (0,05/4) értékben határoztuk meg.A fejfájástípust önmagában vizsgálva az FTTF-ben szenvedő betegek a szociális alskála kivételével szignifikánsan alacsonyabb CHQQ-értékeket értek el, mint a migrénes betegek. A többi változó bevonásával elvégzett regressziós elemzések alapján a triptánhasználat mutatott fordított összefüggést az összes CHQQ-alskála-értékkel (p0,0125). A vizsgált fejfájás-karakterisztikák közül a fejfájás súlyossága mutatott szignifikáns kapcsolatot az alacsonyabb fizikaialskála-értékekkel (p = 0,001), valamint az alacsonyabb CHQQ-összpontszámmal (p = 0,002).Eredményeink azt mutatják, hogy a fej­fájás-karakterisztika (és nem a fejfájás típusa önmagában) összefüggést mutat a fejfájós betegek alacsonyabb életminőségével. Az életminőség-változást előidéző faktorok meghatározása fontos a különböző betegpopulációk adekvát kezelésének, valamint az egészségügyi szolgáltatások igénybevételével és az egészségügyi költségekkel kapcsolatos népegészségügyi intézkedéseknek a megtervezése érdekében.

Background Few published data describe how joint involvement, the most prevalent extraintestinal manifestation, affects quality of life (QoL) of children with Crohn’s disease (CD). Arthritis and arthralgia rates in pediatric CD patients are reportedly 3–24% and 17–22%, respectively, but studies on pre-emptive and systematic screening of joint involvement with detailed musculoskeletal rheumatological exam are lacking. More detailed data collection on joint involvement improves our understanding of how arthropathy relates to disease activity and QoL measured by the Pediatric CD Activity Index (PCDAI) and IMPACT-III questionnaire. Our study aims were to assess joint involvement in pediatric CD and correlate it with the PCDAI and IMPACT-III. Methods In this cross-sectional, observational study, a pediatric gastroenterologist assessed consecutively-seen pediatric CD patients at a tertiary care center. Patients were screened for prevalence of current and previous arthropathy, including arthritis, enthesitis and arthralgia. A single experienced pediatric rheumatologist evaluated detailed musculoskeletal history, joint status, and modified Juvenile Arthritis Multidimensional Assessment Reports (JAMAR). PCDAI, IMPACT-III, sacroiliac MRI, and HLA-B27 genetic testing were also completed. Results A total of 82 (male:female, 1.2:1; age, 13.7 ± 3.2 years) patients were involved in this study. Mean disease duration at time of study was 21.6 ± 21 months; eight of the patients were newly-diagnosed. Of the 82 patients, 29 (35%) had evidence of arthritis; for 24 of those, this was revealed by physical exam during cross-sectional screening, and by prior documentation for the remaining five patients. Joint examination confirmed active arthritis in 8/24 (33%), active enthesitis in 1/24 (4%), and evidence of previous arthritis in 15/24 (62.5%) patients. Hip (41%) and knee (38%) joints were most commonly affected. Cumulative incidence of arthralgia was 48% (39/82), and 46% (18/39) of those patients had only arthralgia without arthritis, usually affecting the knee. Axial involvement was present in 10/82 (12%) patients. Joint involvement correlated with more severe CD disease activity, specifically higher PCDAI and lower IMPACT-III scores, and increased requirement for infliximab treatment. Sacroiliitis and HLA-B27 positivity were insignificant factors in this cohort. Conclusions When a rheumatologist performed the assessment, joint involvement in pediatric CD was more prevalent than previously reported, in this cross-sectional study. Arthritis was associated with more severe CD disease activity and lower QoL.

COVID-19 has made providing in-person care difficult. In most countries, including Hungary, telemedicine has partly served as a resolution for this issue. Our purpose was to explore the effects of COVID-19 on neurological care, the knowledge of neurology specialists on telemedicine, and the present state of telecare in Hungary, with a special focus on Parkinson's disease (PD).Between July and October 2021, a nationwide online survey was conducted among actively practicing Hungarian neurology specialists who were managing patients with PD.A total of 104 neurologists were surveyed. All levels of care were evaluated in both publicly funded and private healthcare. Both time weekly spent on outpatient specialty consultation and the number of patients with PD seen weekly significantly decreased in public healthcare, while remained almost unchanged in private care (p0.001); higher portion of patients were able to receive in-person care in private care (78.8% vs. 90.8%, p0.001). In telecare, prescribing medicines has already been performed by the most (n=103, 99%). Electronic messages were the most widely known telemedicine tools (n=98, 94.2%), while phone call has already been used by most neurologists (n=95, 91.3%). Video-based consultation has been more widely used in private than public care (30.1% vs. 15.5%, p=0.001). Teleprocedures were considered most suitable for monitoring progression and symptoms of Parkinson's disease and evaluating the need for adjustments to antiparkinsonian pharmacotherapy.COVID-19 has had a major impact on the care of patients with PD in Hungary. Telemedicine has mitigated these detrimental effects; however, further developments could make it an even more reliable component of care.A Covid-19-világjárvány jelentősen nehezíti a személyes betegellátást. A legtöbb országban, köztük Magyarországon is, a telemedicina részben meg­oldást jelent ezen problémára. A Covid-19 neurológiai betegellátásra gyakorolt hatásainak, a neurológus szak­orvosok telemedicinával kapcsolatos ismereteinek és a távellátás hazai helyzetének feltárását tűztük ki célul, elsősorban a Parkinson-kóros betegek ellátására fókuszálva.2021 júliusa és októbere között orszá­gos online felmérést végeztünk olyan aktívan praktizáló magyar neurológus szakorvosok körében, akik részt vesznek a Parkinson-kóros betegek ellátásában.Összesen 104 neurológus töltötte ki kérdő­ívünket. Az ellátás minden szintjét elemezhettük mind a közfinanszírozott, mind a magánellátásban. A járóbeteg-szakrendelésre fordított heti idő és a hetente látott Parkinson-kóros betegek száma egyaránt jelentősen csökkent a közfinanszírozott ellátásban, míg a magán­ellátásban szinte változatlan maradt (p0,001). A magánellátásban a betegek nagyobb arányban vehettek igénybe személyes ellátást (78,8% vs. 90,8%, p0,001). A legtöbb neurológus által már végzett távkonzultációs tevékenység a gyógyszerfelírás volt (n = 103, 99%). Az elektronikus üzenet volt a legtöbbek által ismert telemedicinális eszköz (n = 98, 94,2%), és a telefonhívást alkalmazta már a legtöbb neurológus (n = 95, 91,3%). A videóalapú konzultációt a magánellátásban szélesebb körben használták (30,1% vs. 15,5%, p = 0,001). A megkérdezettek a telemedicinális ellátás eszközeit a Parkinson-kór progressziójának és tüneteinek követé­sére, illetve az antiparkinson gyógyszerelésben módosítás szükségességének megítélésére tartották a legalkal­ma­sabbnak.A Covid-19 jelentős hatással volt a Par­kin­son-kóros betegek ellátására hazánkban. A telemedicina enyhítette ezen káros hatásokat, ugyanakkor további fejlesztések a betegellátás még megbízhatóbb elemévé tehetnék a telemedicinát.

Objectives The ICEpop CAPability measure for Adults (ICECAP-A) was developed to assess the capability well-being of adults for use in economic evaluations. Currently, ICECAP-A tariffs are available only for the UK population. The objectives of this study were to develop a Hungarian tariff set for the ICECAP-A instrument and to explore intercountry differences between the Hungarian and the UK value sets. Methods A survey was conducted by computer-assisted personal interviews on a sample representative of the Hungarian adult population (N = 1000) to elicit their preferences regarding ICECAP-A attributes with the use of a best-worst scaling choice task. A latent class multinomial logit model with continuous variance scale was used to estimate the weights for each of the 4 capability levels of all 5 ICECAP-A attributes, namely, attachment, stability, achievement, enjoyment, and autonomy. Results The model identified 2 preference classes with approximately equal share. The first class had a stronger relative preference for autonomy and achievement, whereas the second class had a strong preference for attachment. Multivariate analysis of the classes revealed that women, pensioners, people who are married or living in a partnership, and people with poorer health status are characteristics associated with the latter class membership (preference for attachment). Population tariffs were estimated from the model. Overall, attachment was found to be the most important attribute, followed by stability, enjoyment, achievement, and autonomy. Conclusions Hungarian tariffs are largely consistent with those found for the United Kingdom; nevertheless, autonomy seems to be less important in Hungary compared with the United Kingdom.

Background The Inventory of Statements About Self-Injury (ISAS) is a psychometrically valid tool to evaluate the motives of nonsuicidal self-injury (NSSI), but there are a few studies that test gender differences in the factor structure of the measurement. However, several differences across gender were identified in NSSI (e.g., in prevalence, methods, functions). Therefore, our study focused on further analyses of the dimensionality of the ISAS functions. Methods Among Hungarian adolescents with a history of NSSI (N = 418; 70.6% girls; mean age was 16.86, SD = 1.45), confirmatory factor analysis and exploratory structural equation modeling frameworks were used to test the factor structure of the ISAS part II. Results Results support the two-factor structure of the questionnaire. Intrapersonal and interpersonal motivation factors emerged in the whole sample, but this factor structure varied across gender. Among girls, intrapersonal motivation of NSSI was associated with higher loneliness, more inflexible emotion regulation, and a more pronounced level of internalizing and externalizing mental illness symptoms. Conclusions Our findings provide sufficiently solid arguments for the need to examine NSSI functionality separately for adolescent girls and boys because there were clear gender differences in the motives underlying NSSI. In addition, precise scanning of patterns of NSSI functions may further help us to identify the most at-risk adolescents regarding self-injury.

Objectives The aim of the study was to investigate and compare the preferences that citizens of four Visegrad countries hold concerning the communication between patient and provider. Methods The patient-practitioner orientation scale was used on a general population in our research, which consists of the Sharing and Caring subscales and assesses patient-centered or doctor-centered orientation toward communication. The statistical analysis included 4000 respondents of citizens from the Czech Republic, Slovakia, Poland and Hungary. When comparing the various demographic data and the four countries with each other univariate and multivariate logistic regressions were performed. Results Being female, middle aged, having a higher education and a poor health status were associated with significantly higher Sharing and Caring scores. Also, Hungarian citizens had a significantly higher Caring score compared to the other three countries. Conclusions Key demographic variables were identified that affect how citizens perceive the communication between patient and provider. With the exception of Caring among Hungarian citizens, no differences were observed among the Visegrad countries. Practice implications These findings have potential implications for understanding the preferences of the citizens and thus better promote a more patient-centered communication.

Background The Hungarian primary care system faces a severe shortage of family physicians. Medical students’ perceptions of family medicine need to be known and medical students need to be given appropriate and comprehensible information about this speciality. The expected future salary is an important factor in career choice. Most of the family doctors are self-employed and the practices have a corrected capitation-type financing. Although the majority of health care services are covered by social health insurance and are provided for the insured patients free of charge, informal payment is an existing phenomenon with different motivations and consequences. This study aimed to investigate medical students’ knowledge about their future earning opportunities and their attitudes towards informal payment. Methods A cross sectional survey with a self-administered questionnaire was conducted. Each of the four Hungarian medical universities were represented by their medical students who attended family medicine lectures in person from December 2019 to April 2020. The students were asked about their career plans, about their estimations of current and ideal expected salaries and about the effect of expected income for the choice of specialisation. Their attitudes towards informal payment were assessed. Results Response rate was 67.3% (N = 465/691). Almost two-thirds of the participants were women. Only 5% of the respondents (N = 23/462) plan to work as a family doctor in the future. The vast majority (91.9%) of the students had already thought about their future income. On a 10-point Likert scale (1 = ‘no influence’, 10 = ‘very big influence’) 76% answered that the expected future income exerts a considerable (≥5 Likert points) influence on their career choice in general. The mean of the ideal expected monthly income of the residents, GPs and other specialists was €1154 ± 648, €1696 ± 904 and €2174 ± 1594, respectively. The mean of the monthly income for a GP, as estimated by the studenst, was €1140 in rural and €1122 in urban settings. More than four-fifths of the students (N = 375/453) rejected the practice of informal payment. Conclusions Expected salaray is one important aspect in the career choice of medical students, students wish to have more information on this topic. The reported ideal incomes are higher than those expected. This points to a relevant gap. However, most of the students do not accept informal payment as a possibility to close this gap. The expected and the ideal income differ from the real incomes of Hungarian GPs – this indicates the need of bringing objectoive information to the students to enhance attractivity of GP as a carer choice.

Systematic registration and examination of biopsy-related data in Central and Eastern Europe are scarce, while the health condition of the population is worse compared to other more developed countries. We aim to create a database and analyze the distribution and temporal variation of the renal biopsy diagnoses in Hungary, including the effect of the recent coronavirus pandemic. The diagnoses were standardized according to the recommendation of the European Renal Association. Native biopsy samples processed between January 1, 2006, and December 31, 2020, were analyzed. During the 15 years, 2140 native kidney biopsies were performed. The number of samples increased from 24.5 to 57.9 per million person-years and the median age from 37 to 51 years (p

Background The literature suggests that farmers’ work involves a number of operational difficulties. Although alternative food networks address the majority of their problems, they can potentially generate new hardships. The aim of this study is to examine the situational and engagement-related work difficulties associated with the everyday world of Community Supported Agriculture (CSA) farmers. Methods This study used the health psychology approach, namely interpretive phenomenology, to understand the social determinants of farmers’ working lives in CSA and to explore mental health challenges within the practices of local sustainable farming. To collect data, semi-structured, in-person interviews were conducted with CSA farmers in Hungary. Results Our study shows that new modes of consumer-producer connectivity create novel situations and issues which farmers are forced to address. Three personal experiential themes emerge from the data to describe CSA farmers’ work difficulties: (1) Conflicted autonomy; (2) The pressure of boxes; (3) Social overload. The difficulties for CSA farmers seem to be rooted in the economic characteristics of alternative agriculture where farmers organize food production for the satisfaction of consumer needs. In addition, structural conditions require several different CSA farmer roles, which could even be conflicting. Conclusion This study provides participants’ perspectives on the health and wellbeing costs of sustainable farming. Newer producer-consumer connections require both time and experience and involve extra effort or skills, but farmers often lack these abilities. The results show how perceptions of work processes relate to the general framework of CSA, which necessitates a distinct strategy for farm management.

Using the same methodology as Meston and Buss (2007), three studies were conducted on a Hungarian sample (total N = 4913) which corroborate previous findings on the universal diversity of sexual motivation. Study 1 (N = 2728; 1069 women and 1659 men) identified 197 reasons for having sex based on participants’ free responses. In Study 2 (N = 1161; 820 women and 341 men), participants indicated the extent to which each of the 197 reasons had led them to have sexual intercourse. Factor analyses yielded three factors and 24 subfactors. This differed from the original YSEX? four-factor questionnaire. In Study 3 (N = 1024; 578 women and 446 men), a reliable and valid 73-item short form version of the YSEX? questionnaire was developed in a Hungarian sample (YSEX?-HSF). In addition to similarities and differences in the factor structure, we found important links between reasons for having sex and age, gender, personality, and mating strategy. For example, number of reasons for having sex tended be higher in younger compared to older participants. Men exceeded women on having sex for novelty-seeking and infidelity opportunities, whereas women exceeded men on having sex for relationship commitment and mate retention. Extraversion and neuroticism were linked with reasons for having sex, and those who pursued a short-term mating strategy reported having sex for a larger variety of reasons.

Previous studies have described the structure and function of the insular cortex in terms of spatially continuous gradients. Here we assess how spatial features of insular resting state functional organization correspond to individual pain sensitivity. From a previous multicenter study, we included 107 healthy participants, who underwent resting state functional MRI scans, T1-weighted scans and quantitative sensory testing on the left forearm. Thermal and mechanical pain thresholds were determined. Connectopic mapping, a technique using non-linear representations of functional organization was employed to describe functional connectivity gradients in both insulae. Partial coefficients of determination were calculated between trend surface model parameters summarizing spatial features of gradients, modal and modality-independent pain sensitivity. The dominant connectopy captured the previously reported posteroanterior shift in connectivity profiles. Spatial features of dominant connectopies in the right insula explained significant amounts of variance in thermal (R2 = 0.076; p 2 = 0.031; p 2 = 0.072; p

Background Efficiency and transparency of pricing and reimbursement (P&R) rules and procedures as well as their implementation in South-eastern Europe (SEE) lag substantially behind Western European practice. Nevertheless, P&R systems in SEE are rarely critically assessed, warranting a detailed and wider-encompassing exploration. Objective Our study provides a comparative assessment of P&R processes for patent-protected medicines in ten SEE countries—EU member states: Croatia, Slovenia, Hungary, Romania and Bulgaria ; and non-EU countries: Albania, Montenegro, Serbia, North Maceodina, Bosnia and Herzegovina. P&R systems are compared and evaluated through a research framework that focuses on: (1) public financing of patent-protected medicines, (2) definition of benefit packages, (3) requirements for the submission of reimbursement dossiers, (4) assessment and appraisal processes, (5) reimbursement decision making, (6) processes that occur post reimbursement, and (7) pricing. The study aims to contribute to the discussion on improving the efficiency and quality of P&R of patent-protected medicines in the region. Methods We conducted a non-systematic literature review of published literature, as well as policy briefs and reports on healthcare systems in the SEE region along with legal documents framing the P&R procedures in local languages. The information gathered from these various sources was then discussed and clarified through structured telephone interviews with relevant national experts from each SEE country, mainly current and former senior officials and/or executives of the funding and assessment/ appraisal bodies (total of 20 interviews conducted in late 2019). Results Capacity building through sharing knowledge and information on successful reforms across borders is an opportunity for SEE countries to further develop their P&R policies and increase (equitable) access to patent-protected medicines (especially expensive medicines), increasing affordability and containing costs. Simple yet robust and systematic decision-making frameworks that rely on international health technology assessment (HTA) procedures and are based on the pursuit of transparency seem to be the most cost- effective approach to strengthening P&R systems in SEE. Conclusions Further reforms aiming to develop transparent and robust national decision-making frameworks (including oversight) and build institutional HTA- related and decision-making capacity are awaited in most of SEE countries, especially the non-EU members. In non-EU SEE countries, these efforts could increase access to patent-protected medicines, which is—at the moment —very limited. The EU-member SEE countries operate more developed P&R systems but could further benefit from developing their procedures, oversight and value- for-money assessment toolbox and capacity, hence further improving the transparency and efficiency of procedures that regulate access to patent- protected medicines.

Background and Aims: Acute non-variceal upper gastrointestinal bleeding (UGIB) is associated with significant morbidity and mortality. Our aim was to evaluate the incidence, management, risk factors and outcomes of acute non-variceal UGIB in a population-based study from Hungary. Methods: The present prospective one–year study involved six major community hospitals in Western Hungary covering a population of 1,263,365 persons between January 1 and December 31, 2016. Data collection included demographics, comorbidities endoscopic management, Glasgow-Blatchford score (GBS), Rockall score (RS) transfusion requirements, length of hospital stay and mortality. Results: 688 cases of acute non-variceal UGIB were included with an incidence rate of 54.4 (95%CI: 50.5-58.6) per 100,000 per year. Endoscopy was performed within 12 hours in 71.8%. 5.3% of the patients required surgical treatment and the overall mortality was 13.5%. Weekend presentation was associated with increased transfusion requirements (p=0.047), surgery (p=0.016) and mortality (p=0.021). Presentation with hemodynamic instability or presence of comorbidities was associated with transfusion (p7points), while mortality was best predicted by the post-endoscopic RS (AUC:0.75; cut-off: RS >5points). Conclusions: Incidence rates of acute non-variceal UGIB in Western Hungary are in line with international trends. Longer pre-hospital time, comorbidities, hemodynamic instability, weekend presentation, treatment with anticoagulants or non-steroidal anti-inflammatory drugs was associated with worse outcomes.

BACKGROUND The incidence of cutaneous melanoma has risen faster than almost any other type of cancer in the last 50 years. Ultraviolet (UV) radiation and genetic susceptibility are the most important risk factors. OBJECTIVE We aimed to determine the epidemiologic indicators of melanoma in Hungary, a country with an estimated population of 9.8 million and an area of 93 030 km2. METHODS Anonymized patient records from the National Health Insurance Fund Management covering the entire population were used to determine the incidence and prevalence of melanoma in the counties of Hungary from 2013 to 2017. Altogether 20 030 melanoma cases were identified for inclusion in this study. RESULTS The prevalence of melanoma increased over the investigated period and was significantly higher among women than men. The incidence of melanoma stagnated during this period and the incidence rate was the highest among the elderly. Interestingly, the incidence was higher in males in the elderly population, while the incidence was higher in females in the younger (

Data suggests that favipiravir (FVP) could be used against SARS-CoV-2. Our aim was to investigate the role of FVP in COVID-19 treatment. A prospective sequential cohort study was performed among adults hospitalized at our center between March and August 2020 with moderate-to-severe, PCR-confirmed COVID-19. For diagnosis and severity, ECDC and WHO definitions were utilized. Patients were screened for inclusion by a priori criteria and included in the FVP cohort if standard-of-care (SOC) + FVP or the non-FVP cohort if SOC ± other antivirals without FVP were administered for > 48 h from diagnosis. Treatment allocation was done per national guidelines, based on severity and drug availability. Primary endpoint was disease progression, a composite of 14-day all-cause death, need for mechanical ventilation, or immunomodulatory therapy. The impact of FVP exposure on disease progression was analyzed by binomial logistic regression. In all, 150 patients were included, 75 in each cohort. Disease progression (17/75, 22.7% vs. 10/75, 13.3%, p = 0.13), 14-day all-cause death (9/75, 12.0% vs. 10/75, 13.3%, p = 0.8), and need for mechanical ventilation (8/75, 10.7% vs. 4/75, 5.3%, p = 0.22) were similar, while immunomodulatory therapies were required more frequently among patients receiving FVP (10/75, 13.3% vs. 1/75, 1.3%, p

Problem solving, multiple‐choice question‐based educational tools have been used for decades in molecular cell biology courses at the University of Pécs Medical School, Pécs, Hungary. A set of these tests was published in Biochemistry and Molecular Biology Education between 2002 and 2015. Such tests using an experimental approach help students to understand how living cells function. Besides being tools of education, they can be used for examination purposes as well to assess higher levels of intellectual skills (interpretation and problem solving) acquired by the students. The test presented in this paper is based on parts of an original publication in which the authors described seminal observations on the function of a viral protein in the infection process of SARS‐CoV‐2. The test is aimed at helping the students to understand the methods used in the experiments, to analyze the data and to draw conclusions from them regarding certain aspects of the mechanism of coronavirus infection.

Background The management of risk factors in patients with high cardiovascular risk and its effectiveness is of paramount importance. Over the last decade, several studies have examined the achievement of cardiovascular risk factors’ target levels in Europe. In the present Hungarian study, we assessed the cardiovascular risk level of participants aged 40–65 years and the success of achieving risk factors’ target levels in high- and very high-risk patients. We compared these results with the results of two similar European studies. Methods We conducted a cross-sectional study involving 37,778 patients aged 40–65 years from Hungary between 2019 and 2020. Cardiovascular risk levels and target values were set according to the 2016 European Guideline. Target achievement was evaluated for body mass index, waist circumference, blood pressure, total, LDL, and HDL cholesterol, triglyceride, and HbA1c (in diabetics). Results For 37,298 patients, all the data were available to determine their cardiovascular risk category. Of these, 23.1% had high and 31.4% had very high cardiovascular risk (men: 27.1 and 39.6%, women: 20.5 and 26.1%, respectively). Achievement of the LDL-C target of 1.8 mmol/l was only 8.0% among very high-risk patients, which was significantly lower than the European average (29%). Achievement of target blood pressure among high-risk patients was better than the European average (63.4% vs. 44.7%, respectively); however, achievement was slightly lower among very high-risk patients compared with the European average (49.4% vs. 58%, respectively). The proportion of patients with type 2 diabetes who achieved a HbA1c below 7% was 57.3% in the high-risk population and 53% in the very high-risk population, which was in line with the European average success rates (58.5 and 54%, respectively). Waist circumference ( Conclusions The success rate of cardiovascular risk management in Hungary is lower than the European average in several parameters. Furthermore, our data highlight the poor effectiveness of obesity management in Hungary. General practice partnerships may be important sites for positive change.

West Nile virus (WNV) is an emerging pathogen in Hungary, causing severe outbreaks in equines and humans since 2007. The aim of our study was to provide a comprehensive report on the clinical signs of West Nile neuroinvasive disease (WNND) in horses in Hungary. Clinical details of 124 confirmed equine WNND cases were collected between 2007 and 2019. Data about the seasonal and geographical presentation, demographic data, clinical signs, treatment protocols, and disease progression were evaluated. Starting from an initial case originating from the area of possible virus introduction by migratory birds, the whole country became endemic with WNV over the subsequent 12 years. The transmission season did not expand significantly during the data collection period, but vaccination protocols should be always reviewed according to the recent observations. There was not any considerable relationship between the occurrence of WNND and age, breed, or gender. Ataxia was by far the most common neurologic sign related to the disease, but weakness, behavioral changes, and muscle fasciculation appeared frequently. Apart from recumbency combined with inappetence, no other clinical sign or treatment regime correlated with survival. The survival rate showed a moderate increase throughout the years, possibly due to the increased awareness of practitioners.

Positive psychology has fully examined the flourishing among healthy people but neglected to understand how "optimal human functioning" can apply to the life experiences of a vulnerable person. Considering methodological issues, this article gives a brief overview on how the conceptualization of mental health and mental disorders affects the consideration of strengths along with the presence of dysfunction with the emergence of positive psychology. First, we summarize the shortcomings of the applicability of clinical positive psychology, focusing especially on Hungarian clinical practice. Second, we discuss the problems with the conceptualization of mental health in positive psychological framework. Third, we propose a model, the Maintainable Positive Mental Health Theory based on capacities and competences. Finally, we conclude with methodological questions and present a research protocol. The key finding of our review is that the opportunity exists for psychiatrists and psychologists to embrace disability as part of human experiences and to show how people with vulnerabilities can be supported to recover. (Neuropsychopharmacol Hung 2022; 24(3): 113-119).

Cervical cancer is one of the most common cancers among women and one of those completely preventable according to the current state of medical science. The pathogenesis of the disease is known, the human papillomavirus plays an essential role in the development in 99.9% of cases. With the available vaccines against the virus and the use of effective screening methods, the complete elimination of the disease can be achieved within a few decades, according to WHO estimates. Despite all these facts, the current state of the fight against the disease is still very controversial, which can be characterized by the epidemiological indicators of the disease. We would like to present these data in our publication, highlighting the challenges that not only developing but also developed countries face every day in relation to the prevention of cervical cancer.

A nationwide survey in Hungary found that 22 out of 58 psychiatric units performed ECT in 2014. Shortly after identifying the first COVID cases, strict control measures were introduced, and the hospital system was fundamentally transformed in the country that affected ECT provision as well. The aim of the current study was to survey the changes in ECT use in Hungary during the four waves of the COVID-19 pandemic.All the psychiatric units that indicated they had performed ECT in 2014 were sent a semi-structured question naire requesting information about changes in ECT practice and the treatment profile of the unit. If there was no reply, a follow-up telephone call was made.There were only 3 centers where ECT was performed throughout all four waves of COVID. In nine centers (47%) ECT was suspended in all four waves. The main reason why ECT was halted during COVID was the restructuring of psychiatric inpatient care: six centers were fully transformed into general COVID units, and in the remaining 13 the number of psychiatric beds was reduced in favor of general COVID care. Staff shortage constituted another barrier to the provision of ECT. The number of infected patients in a wave of COVID-19 showed a significant negative correlation with the number of active ECT centers (p=0.05). No COVID-infected patient received ECT in Hungary.During the COVID pandemic in Hungary, nearly half of the ECT services were suspended and thus a number of patients missed out on receiving an effective treatment.

The current article reports data from three Polish samples to examine the Relationship Assessment Scale (RAS) with respect to its unidimensionality, invariance across countries, gender, formal and informal relationships, degree of precision (or information) across latent levels of relationship satisfaction, and the functioning of individual items. The analyses of the data from the reference sample (n = 733) confirmed a clear 1-factor structure of the RAS-PL and good internal consistency. Configural, metric, and scalar invariance for countries (Poland, Hungary, USA), gender (women and men) and relationship types (formal and informal relationships) were achieved. Item Response Theory Analysis (IRT) suggested that the RAS-PL assesses relationship satisfaction most reliably at low to average levels. Analyses of the data from validation samples (n = 203 and n = 209) confirmed the convergent and divergent validity by weak, medium, and large correlations of the RAS-PL with measures of other theoretically related constructs. Concurrent criterion validity was demonstrated by a strong positive correlation between the RAS-PL and the intent to continue the current relationship. This investigation provides considerable psychometric information about the items and scale of the RAS-PL.

The aim of our study is to analyse the participation indicators of colorectal cancer screening between 2008-2021. Data derived from the nationwide financing database of the Hungarian National Health Insurance Fund Management. We analysed both diagnostic and screening examinations. According to our results, the screening rate was low, varying between 5.1-6.8% in the years examined. Between 2008 and 2019, the number of participating patients increased slightly. The highest number of patients can be observed in 2019 (178,568 people). In 2020 and 2021, we see a significant decrease, which is a consequence of the COVID-19 pandemic. In the number of patients of the entire examined period (2,233,963 people, 938,223 men, 1,295,740 women), the largest proportion was fecal blood detection by immunochemical method (OENO code: 22631). In 2021, at the county level, the highest number of patients can be seen in Csongrád-Csanád county (994 patients/10,000 people), and the least in Békés county (218 patients/10,000 people). The participation rate of women is higher than that of men in all counties. Participation in colorectal screening is very low. In order to prevent colorectal cancer death, it is necessary to increase the participation rate.

The objective of the present study was to compare the religiosity of the Roma in the 18th century with the present. In 1775 and 1776, Samuel Augustini ab Hortis detailed the way of life of the Roma community in the Austro-Hungarian monarchy in his work “Von dem Heutigen Zustände, Sonderbaren Sitten und Lebensart, Wie Auch von Denen Übrigen Eigenschaften und Umständen der Zigeuner in Ungarn” (On the Contemporary Situation, Distinctive Manners and Way of Life, as Well as the Other Characteristics and Circumstances of Gypsies in Greater Hungary). A detailed content analysis of the part of his work dealing with religion was performed. Subsequently, in 2018, field research was conducted in the environment in which Samuel Augustini lived and worked. It involved six key informants, each representing a different municipality. Data collection was carried out over two periods: in the summer months of 2012–2013 and the winter period of 2018–2019. After the interviews with the key informants, more than 70 participants were included in semi-structured interviews through snowball sampling, and another 40 participants were included in two focus groups. The data was evaluated and content analysis was used to process the data. The findings confirm that both in the past and the present, the Roma community adopted the dominant religion of the host country. In the studied environments, the activities of the majority, present then and now in the Catholic Church, failed, and various other missionary movements, such as the Maranatha Mission, came to the fore. Membership in new religious movements resulted in social changes in marginalized Roma communities. However, they may not have only had positive effects. Various effects of their activities may be studied in the future.

The effect of the date of birth on the incidence of cardiovascular disease was confirmed in earlier studies. We aimed to determine whether the season of birth may be associated with a higher incidence of stroke in later life by analyzing thrombolysis numbers according over a ten-year period in Hungary.We analyzed daily thrombolysis numbers between 2007 and 2016 according to the patients' date of birth based on seasons. The correlation between cumulative thrombolysis numbers between 2007 and 2016 per month and birth numbers per month based on data of the 1949 census were also examined.Our results indicate that being born in the spring and summer in the northern hemisphere may be associated with a higher frequency of ischemic stroke necessitating thrombolytic treatment. This equates to a higher risk when conception and early pregnancy occur in the summer and autumn months.This, however, cannot be defined as a causal relationship if we consider the number of live births in 1949, as both measures change similarly during the year, as indicated by the strong positive correlation between thrombolysis frequency according to date of birth between 2007 and 2016 and the number of births in the 1949 census by month.Fecha de nacimiento e incidencia del ictus isquémico agudo en Hungría.Introducción. El efecto de la fecha de nacimiento sobre la incidencia de enfermedad cardiovascular se ha confirmado en estudios anteriores. Nuestro objetivo fue determinar si la temporada de nacimiento puede estar asociada con una mayor incidencia de accidente cerebrovascular en etapas posteriores de la vida mediante el análisis de las cifras de trombólisis durante un período de 10 años en Hungría. Pacientes y métodos. Analizamos las cifras diarias de trombólisis entre 2007 y 2016 según la fecha de nacimiento de los pacientes según las estaciones. También se examinó la correlación entre las cifras de trombólisis acumuladas entre 2007 y 2016 por mes, y las cifras de nacimientos por mes según los datos del censo de 1949. Resultados. Nuestros resultados indican que nacer en primavera y verano en el hemisferio norte puede estar asociado con una mayor frecuencia de accidentes cerebrovasculares isquémicos que requieren tratamiento trombolítico. Esto equivale a un mayor riesgo cuando la concepción y el embarazo temprano ocurren en los meses de verano y otoño. Conclusión. Esto, sin embargo, no puede definirse como una relación causal si consideramos el número de nacidos vivos en 1949, ya que ambas medidas cambian de manera similar durante el año, como lo indica la fuerte correlación positiva entre la frecuencia de trombólisis según la fecha de nacimiento entre 2007 y 2016, y el número de nacimientos en el censo de 1949 por mes.

The Hungarian health technology assessment guidelines recommend the use of the EuroQol instrument family in quality-adjusted life-year calculations. However, no national value set exists for the EQ-5D-Y-3L or any other youth-specific instrument.This study aims to develop a national value set of the EQ-5D-Y-3L for Hungary based on preferences of the general adult population.This study followed the international valuation protocol for the EQ-5D-Y-3L. Two independent samples, representative of the Hungarian general adult population in terms of age and sex were recruited to complete online discrete choice experiment (DCE) tasks and composite time trade-off (cTTO) tasks by computer-assisted personal interviews. Adults valued hypothetical EQ-5D-Y-3L health states considering the health of a 10-year-old child. DCE data were modelled using a mixed logit model with random-correlated coefficients. Latent DCE utility estimates were mapped onto mean observed cTTO utilities using ordinary least squares regression.Overall, 996 and 200 respondents completed the DCE and cTTO surveys, respectively. For each domain, the value set resulted in larger utility decrements with more severe response levels. The relative importance of domains by level 3 coefficients was as follows: having pain or discomfort feeling worried, sad or unhappy mobility doing usual activities looking after myself. Overall, 12.3% of all health states had negative utilities in the value set, with the worst health state having the lowest predicted utility of - 0.485.This study developed a national value set of the EQ-5D-Y-3L for Hungary. The value set enables to evaluate the cost utility of health technologies for children and adolescents based on societal preferences in Hungary.

The aim of our study is to analyze the participation indicators of screening rounds Nr. 6-10 (2012-2021) of the organized nationwide mammography screening program. Data derived from the nationwide financing database of the Hungarian National Health Insurance Fund Management and covered the period 2012-2021. We analyzed both diagnostic and screening mammography examinations. Between 2012 and 2019 the coverage (screening and diagnostic mammography) varied between 48.1-51.5, which decreased to 31.8% in 2020-2021. Within total coverage, the organized screening rate declined from 30.3-31.2 to 20.0, while the diagnostic mammography rate decreased from 17.7-20.7% to 11.8%. We can conclude that the number of both the diagnostic and screening mammography declined. In order to reduce the mortality of breast cancer, participation rate of mammography screening program should be increased.

Background: This study aimed to create preliminary anthropometric and physiological profiles of Hungarian male soccer players belonging to different age categories (14, 15, 16, and 17–18-years) and assigned to different playing positions (forward, defender, midfielder, goalkeeper). Methods: Anthropometric and physiological profiles were created for four age groups: 14- (n = 20), 15- (n = 16), 16- (n = 22) and 17–18-year-olds (n = 23) representing the Hungarian soccer academy. Additionally, the variables were analyzed across the four player positions mentioned above. Results: The mean values of body mass, fat mass and BMI were within normal limits, although in some cases the anthropometric and body composition values were too high, particularly among the 17–18-year-olds. The mean values of HRrest were lowest among the 15-year-olds. The highest mean and maximal values of rVO2max and rVO2/AT [57.6 ± 8.12 (43.8–68.3) and 51.2 ± 7.24 (38.9–60.8) mL/kg/min, respectively] were noted in 14-year-olds. Goalkeepers performed significantly better than the remaining soccer players in terms of the most anthropometric and physiological characteristics, except for the Yo-Yo test (p < 0.001). Conclusions: The values of anthropometric parameters increased with age. As expected, the oldest group achieved the best results in the performance tests. Goalkeepers outperformed the players representing other playing positions in the tests when assessing lower limb strength, sprint performance (5- and 10-m distance), and agility tests. From a practical point of view, the presented anthropometric and physiological profiles of players representing different age groups and playing positions can be useful for soccer coaches, strength and conditioning specialists, and athletic trainers of other soccer clubs in terms of the individualization and optimalization of soccer training.

Positive psychology has fully examined the flourishing among healthy people but neglected to understand how “optimal human functioning” can apply to the life experiences of a vulnerable person. Considering methodological issues, this article gives a brief overview on how the conceptualization of mental health and mental disorders affects the consideration of strengths along with the presence of dysfunction with the emergence of positive psychology. First, we summarize the shortcomings of the applicability of clinical positive psychology, focusing especially on Hungarian clinical practice. Second, we discuss the problems with the conceptualization of mental health in positive psychological framework. Third, we propose a model, the Maintainable Positive Mental Health Theory based on capacities and competences. Finally, we conclude with methodological questions and present a research protocol. The key finding of our review is that the opportunity exists for psychiatrists and psychologists to embrace disability as part of human experiences and to show how people with vulnerabilities can be supported to recover.

Data about the coronavirus disease 2019 (COVID-19) pandemic’s collateral damage on ischemic stroke (IS) care during the second epidemic wave in Central Europe are limited. We sought to evaluate the impact of the COVID-19 outbreak on Hungarian IS care during the two epidemic waves. This retrospective observational study was based on a nationwide reimbursement database that encompasses all IS admissions and all reperfusion interventions, i.e., intravenous thrombolysis (IVT) and endovascular therapy (EVT) from 2 January 2017 to 31 December 2020 in Hungary. COVID-19 pandemic’s effect on the number of IS admissions and reperfusion interventions were analyzed using different statistics: means, medians, trends, relative rates, and linear relationships. The mean and median values of IS admissions and reperfusion interventions decreased only in some measure during the COVID-periods. However, trend analysis demonstrated a significant decline from the trends. The decline’s dynamic and amplitude have differed for each variable. In contrast to IVT, the number of IS admissions and EVTs negatively correlated with the epidemic waves’ amplitude. Besides, the decrease in the number of IS admissions was more pronounced than the decrease in the number of reperfusion interventions. Our study demonstrated a significant disruption in IS care during the COVID-19 epidemic in Hungary, in which multiple different factors might play a role. The disproportionate reduction of IS admission numbers could partially be explained by the effect of health emergency operative measures and changes in patients’ social behavior. Further studies are needed to evaluate the causes of our observations. Supplementary Information The online version contains supplementary material available at 10.1007/s11357-021-00424-z.