PROTOCOLS FOR RESTARTING TOURISM IN COVID-19 CONDITIONS AND DEVELOPING PANDEMIC IMMUNITY.

The purpose of the study is to provide a better understanding of the protocols for restarting tourism considered as an international prior action plan, and to present an academic output supporting the development of pandemic immunity. In this direction, the global guidelines of United Nations World Tourism Organization dated 28 May 2020 and new-normal protocols of World Travel and Tourism Council dated 29 May 2020 were translated into Turkish and subjected to content analysis. The entire analysis process, from coding to Sankey diagram creation, conducted via ATLAS.ti - v.22.1.4.0, a computer-aided qualitative data analysis software. Among the results;the role in restarting tourism and the aspects of developing pandemic immunity of implementing hygiene-oriented innovative practices even if they will require changes in the organizational chart, prioritizing coordination, communication and cooperation not only in the steps taken by the government and businesses but also by the other interested parties, making the dynamism within the internal processes brought about by the turbulent conditions efficient and standardized via the adoption of protocols establishing a specific business manner and procedure are stand out. (English) [ FROM AUTHOR] Çalışmanın amacı;uluslararası nitelikteki turizmi yeniden başlatma protokollerinin detaylı bir şekilde incelenerek somutlaştırılmasıdır. Böylece benzer krizlerin şok etkisini kısaltan, eyleme geçme sürecini daha etkili ve hızlı kılan bir pandemi bağışıklığının geliştirilmesine katkı sağlanması hedeflenmektedir. Bu doğrultuda, Türkçeye çevrilmiş olan Birleşmiş Milletler Dünya Turizm Örgütü'nün 28 Mayıs 2020 tarihli küresel yönergesi ile Dünya Seyahat ve Turizm Konseyi'nin 29 Mayıs 2020 tarihli yeni-normal protokolleri içerik analizine tabi tutulmuştur. Kodlama işleminden Sankey diyagramı oluşturmaya kadar tüm analiz süreci, bilgisayar destekli bir nitel veri analiz yazılımı olan ATLAS.ti - v.22.1.4.0 vasıtasıyla gerçekleştirilmiştir. Sonuçlar arasından;örgüt şemasında değişimleri gerektirecek olsa dahi hijyen odaklı inovatif uygulamaların hayata geçirilmesinin, yalnızca hükümetin ve işletmelerin değil;diğer ilgili tarafların atacağı adımlarda da koordinasyonun, iletişimin ve iş birliğinin öncelikli olarak değerlendirilmesinin, çalkantılı koşulların işletme içi süreçlerde meydana getirdiği olumsuzlukların protokollerin benimsenmesi aracılığıyla standardize edilmesinin ve verimli kılınmasının, turizmin yeniden başlatılmasındaki rolü ve pandemi bağışıklığını geliştirici yönleri ön plana çıkmaktadır. (Turkish) [ FROM AUTHOR] Copyright of Pamukkale University Journal of Social Sciences Institute / Pamukkale Üniversitesi Sosyal Bilimler Enstitüsü Dergisi is the property of Pamukkale University, Social Sciences Institute and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Tápcsatornai endoszkópos eljárásokkal összefüggo infekciós kockázat a SARS-CoV-2-járvány idején.

INTRODUCTION: COVID-19 significantly affects endoscopic labs' workflow. Endoscopic examinations are considered high-risk for virus transmission. OBJECTIVES: To determine impact of COVID-19 pandemic on Hungarian endoscopic labs' workflow and on infection risk of endoscopic staff. METHOD: A nation-wide, cross-sectional online questionnaire was sent to heads of endoscopic labs in Hungary. The average number (with 95% confidence intervals) of upper and lower gastrointestinal endoscopies performed in 2020 was compared to that in 2019. The number of SARS-CoV-2-infected endoscopic staff members and the source of infection was also investigated. RESULTS: Completion rate was 30% (33/111). Neither the number of upper (1.593 [743-1.514] vs. 1.129 [1.020-2.166], p = 0.053), nor that of lower gastrointestinal endoscopies (1.181 [823-1.538] vs. 871 [591-1.150], p = 0.072) decreased in 2020, but both upper and lower gastrointestinal endoscopies' number decreased by 80% during peak phases. Separate examination room was available in 12% of institutes. Appropriate quality personal protective equipment (PPE) was available during the first and second peak phase in 70% and 82%, respectively. Infection risk stratification by questionnaire and PCR testing was routinely performed in 85% and 42%, respectively. Employee number decreased by 33% and 26% for physicians, and by 19% and 21% for assistants during peak phases, mainly due to age restrictions and COVID care assignments. 32% of assistants and 41% of physicians were infected (associated with inappropriate PPE use in 16% and 18%, respectively). CONCLUSION: Peak phases' restrictions increase endoscopic workload afterwards. Despite PPE availability, 15% of employees' COVID infection resulted from inappropriate PPE use in pre-vaccination era. Orv Hetil. 2022; 163(46): 1814-1822.

A hatályos büntetőeljárási törvény egyes változásainak vizsgálata a szervezett bűnözés elleni fellépés tükrében

Cél: Bűn nem maradhat büntetlenül – tartja a mondás. A szervezett bűnözői csoportok tevékenységeinek állandó változása miatt kiemelt rendőrségi feladattá vált azok bomlasztása, illetve felszámolása. A szervezett bűnözés elleni fellépést segítik elő többek között a hazai jogszabályok is, ezek között a büntetőeljárásról szóló 2017. évi XC. törvény olyan fejezetei, ami a titkos információgyűjtést 2018. július 1-jétől, a törvény kihirdetésétől alapjaiban megváltoztatta. Ezért annak a gyakorlati, jogalkalmazói megjelenése, új lehetséges szervezeti modellje, továbbá az Európai Unió más tagállamaiban kialakított megoldásainak összehasonlítása nélkülözhetetlen. A szerző tanulmányával kifejezetten a Be. törvény jogalkalmazói gyakorlatát kívánja vizsgálni a bűnügyi felderítés területén, különösen a jogászi hivatásrendek, az ügyészség és a nyomozó hatóság szemszögéből, mivel a büntetőeljárás mindennapi alkalmazása során merülhet fel számos olyan jelenség, ami a lehetséges problémákra rávilágíthat. Kutatási kérdésként került megfogalmazásra, hogy hazánkban a szervezett bűnözés elleni fellépést mennyire segítették elő a hatályos büntetőeljárási törvény egyes változásai? Módszertan: Az alkalmazott kutatási módszerekkel a cél, hogy az elmélet és a gyakorlat összhangja bemutatásra kerüljön. A tanulmány tartalmaz többekközött leíró elemzést, fogalmi, jogintézményi és szervezeti vonatkozásban, illetve joggyakorlat-elemzést és jogszabályelemzést. A kutatás alapját képezi egy esettanulmány, amelyben jelenleg is nyomozás folyik emberkereskedelem bűntett elkövetése miatt, illetve az Európai Unión belüli tagállamok mint részes felek közös nyomozó csoport felállításáról állapodtak meg. Az esettanulmány által lesz lehetőség arra is, hogy a nemzetközi bűnügyi együttműködés kapcsán megjelenő esetleges akadályok megfigyelésre kerüljenek, ehhez kapcsolódik még a koronavírus-járvány idején felmerülő egyéb akadályozó tényezők feltárása. Az esettanulmány elemzését megelőzően spontán interjúk készítésére is sor került rendőri és igazságügyi oldalról is. A rendőri oldalt tekintve felderítőkkel, igazságügyi oldalról pedig ügyészekkel készültek az interjúk. A kutatás során a szerző kitekintést tesz az Európai Unió más tagállamai által kialakított eljárásokra is. Megállapítások: A hazai büntetőeljáráson belül a leplezett eszközök megjelenése, átalakítása – a tanulmány kapcsán készült kutatás szerint – eltérően mutatkozik a rendőri és az ügyészi oldalon. A közös nyomozó csoport hatékonysága a gyakorlatban több szempontból is jól nyomon követhető. A nemzetközi érintettségű ügyekben az eljárásjogi akadályok kiküszöbölésére, illetve a nemzetközi bűnügyi és igazságügyi együttműködés kapcsán is számos előnyt jelent, ha a tagállamok közös nyomozó csoport felállításában állapodnak meg. Érték: A tanulmányban megállapítottak alkalmasak lehetnek a gyakorlatban dolgozó nyomozó hatóságok tagjai számára, akik nemzetközi vonatkozású ügyekben érintettek, illetve az ügyészség számára is egyfajta keresztmetszetet nyújt a jelenlegi helyzetről, további cél, hogy a leírtak megfontolásra kerüljenek. Mindemellett a tanulmány kitekintést is nyújt a nemzetközi bűnügyi együttműködés megvalósulására a koronavírus-járvány idején.Alternate : Aim: Crime cannot go unpunished – so the saying goes. The ever-changing activities of organised crime groups have made disrupting and dismantling them a priority for the police. Among other things, the fight against organised crime is facilitated by domestic legislation, including the chapters of Act XC of 2017 on the Code of Criminal Procedure, which fundamentally changed the collection of secret information from 1 July 2018, when the Act was promulgated. Therefore, its practical and law enforcement manifestation, its new possible organisational model, as well as the comparison with the solutions developed in other EuropeanUnion Member States are indispensable. The author with her study specifically intended to examine the practice of the application of the Criminal Procedure Act in the field of criminal investigation, in particular from the perspective of the legal professions, the prosecution and the investigating authority, since the everyday application of criminal procedure may give rise to a number of phenomena that may highlight potential problems. A research question was formulated: to what extent has the fight against organised crime in Hungary been facilitated by certain changes in the existing Criminal Procedure Act? Methodology: The aim of the research methods used is to demonstrate the consistency of theory and practice. The study includes, inter alia, descriptive analysis in conceptual, institutional and organisational aspects, as well as case law analysis and legislative analysis. The research is based on a case study of an ongoing investigation into the crime of trafficking in human beings and the fact that Member States within the European Union have agreed to set up a joint investigation team as parties to the case. The case study will also provide an opportunity to monitor possible obstacles to international criminal cooperation, including the identification of other obstacles that may have arisen during the coronavirus epidemic. Prior to the analysis of the case study, spontaneous interviews were also conducted with police and judicial authorities. Interviews were conducted with investigators on the police side and prosecutors on the judicial side. In the course of the research, the author also looks at the procedures developed in other EU Member States. Findings: The emergence and transformation of disguised instruments in domestic criminal proceedings – according to the research carried out for the study – differs between the police and the prosecution. In practice, the effectiveness of the joint investigation team can be traced in several ways. In cases with an international dimension, there are a number of advantages to be gained from Member States agreeing to set up a joint investigation team, both in terms of removing procedural obstacles and in terms of international criminal and judicial cooperation. Value: The findings of the study may be useful for practitioners in the investigative authorities involved in cases with an international dimension, as well as for the prosecution service, to provide a cross-section of the current situation, with the additional aim of giving the issues described here some consideration. In addition, the study also provides an insight into the implementation of international criminal cooperation in the period of the coronavirus epidemic.

SAFETY CHALLENGES AND CRISIS COMMUNICATION IN HUNGARIAN BUSINESS HOTELS DURING COVID-19

The aim of the study is to examine the means used by 4-star domestic business hotels to motivate tourists to visit during the coronavirus epidemic, to carry out an investigation of these hotels' attempts to preserve their image and to ascertain their main safety messages before, during and after the crises. In the framework of the empirical research, in-depth interviews were conducted with the staff responsible for crisis communication in the examined hotels;as a supplementary investigation, the authors also reviewed their Facebook pages and websites as crisis communication interfaces. The coronavirus epidemic did not negatively affect the image of hotels, and its preservation was achieved through communication and participation in movements. After the pandemic, safety became the main topic;the most important messages are that the guest is safe in the hotel, the regulations are followed, hygiene is taken care of, and the guest can count on them. (English) [ FROM AUTHOR] A tanulmány célja annak vizsgálata, hogy a hazai négycsillagos üzleti szállodák a koronavírus-járvány első két hulláma alatt milyen eszközökkel motiválták a turistákat látogatásra, mit tettek ebben az időszakban az imázs megőrzése érdekében, illetve mi a fő üzenetük a biztonság vonatkozásában a krízis előtt, közben és után. Az empirikus kutatás keretében a szerzők mélyinterjúkat készítettek a vizsgált szállodák kríziskommunikációért felelős munkatársaival, kiegészítő kutatásként egy kvantitatív és kvalitatív tartalomelemzés során a Facebook-oldalakat és weboldalakat mint kríziskommunikációs felületeket nézték át. A vizsgált szállodák különböző eszközökkel ösztönözték az üzleti utazókat foglalásra. A koronavírus-járvány nem érintette negatívan a szállodák imázsát, ennek megőrzését folyamatos kommunikációval és mozgalmakban való részvétellel kívánták elérni. A vizsgált szállodák kommunikációjában jelentős változások történtek. A pandémia megjelenését követően a biztonság lett a fő témakör, a legfontosabb üzenet, hogy a vendég biztonságban van a szállodában, betartják a szabályokat, odafigyelnek a tisztaságra és higiéniára, illetve a szálloda nyitva van és a vendég számíthat rájuk. (Hungarian) [ FROM AUTHOR] Copyright of Vezetéstudomány / Budapest Management Review is the property of Corvinus University of Budapest and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

SAFETY CHALLENGES AND CRISIS COMMUNICATION IN HUNGARIAN BUSINESS HOTELS DURING COVID-19.

The aim of the study is to examine the means used by 4-star domestic business hotels to motivate tourists to visit during the coronavirus epidemic, to carry out an investigation of these hotels' attempts to preserve their image and to ascertain their main safety messages before, during and after the crises. In the framework of the empirical research, in-depth interviews were conducted with the staff responsible for crisis communication in the examined hotels;as a supplementary investigation, the authors also reviewed their Facebook pages and websites as crisis communication interfaces. The coronavirus epidemic did not negatively affect the image of hotels, and its preservation was achieved through communication and participation in movements. After the pandemic, safety became the main topic;the most important messages are that the guest is safe in the hotel, the regulations are followed, hygiene is taken care of, and the guest can count on them. (English) [ FROM AUTHOR] A tanulmány célja annak vizsgálata, hogy a hazai négycsillagos üzleti szállodák a koronavírus-járvány első két hulláma alatt milyen eszközökkel motiválták a turistákat látogatásra, mit tettek ebben az időszakban az imázs megőrzése érdekében, illetve mi a fő üzenetük a biztonság vonatkozásában a krízis előtt, közben és után. Az empirikus kutatás keretében a szerzők mélyinterjúkat készítettek a vizsgált szállodák kríziskommunikációért felelős munkatársaival, kiegészítő kutatásként egy kvantitatív és kvalitatív tartalomelemzés során a Facebook-oldalakat és weboldalakat mint kríziskommunikációs felületeket nézték át. A vizsgált szállodák különböző eszközökkel ösztönözték az üzleti utazókat foglalásra. A koronavírus-járvány nem érintette negatívan a szállodák imázsát, ennek megőrzését folyamatos kommunikációval és mozgalmakban való részvétellel kívánták elérni. A vizsgált szállodák kommunikációjában jelentős változások történtek. A pandémia megjelenését követően a biztonság lett a fő témakör, a legfontosabb üzenet, hogy a vendég biztonságban van a szállodában, betartják a szabályokat, odafigyelnek a tisztaságra és higiéniára, illetve a szálloda nyitva van és a vendég számíthat rájuk. (Hungarian) [ FROM AUTHOR] Copyright of Vezetéstudomány / Budapest Management Review is the property of Corvinus University of Budapest and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Sleep Disorders and Associated Factors in Children Who Admitted to the Child and Adolescent Psychiatry Outpatient Clinics During the Pandemic.

Objective: This study determined whether children have sleep disorders during the Coronavirus disease-2019 (COVID-19) pandemic restriction process, and if they do, to determine in which areas they have problems with sleep, as well as to examine the relationship of sleep disorder with chronotype and coronavirus anxiety. Materials and Methods: In April-November 2020, 98 patients attending Kocaeli University Child Psychiatry clinics and attending primary school 1-4th grade were recruited. "Sociodemographic Form", "Child Sleep Habits Questionnaire", and "Children's Chronotype Questionnaire" were applied to the parents. The short form of the "Coronavirus Anxiety Scale" and the information form about the pandemic process were applied to the children. Results: According to the sleep habits questionnaire, 70.4% of the group had clinically significant sleep problems. The most common sleep disorders observed in our study;are bedtime resistance, delayed falling asleep, and nighttime awakenings. A significant relationship was found between physical illness in the family (p=0.019), smoking (p=0.032), sleep pattern change during the pandemic (p=0.002), sleep change of the mother (p=0.006) and/or father (p=0.035), change in appetite (p=0.010), and sleep disorder. According to the chronotype scale, 66 children were morning and children's anxiety toward coronavirus was low. Conclusion: Our study shows that sleep disturbance in children is marked during the pandemic period, but this is due to changes in sleep patterns and parents' sleep rather than problems related to anxiety or chronotype associated with the pandemic. It will be useful to question these factors and make arrangements in this direction when evaluating the sleep-related problems of patients who apply to outpatient clinics. (English) [ FROM AUTHOR] Amaç: Bu çalışmada, Koronavirüs hastalığı-2019 (COVID-19) pandemisi kısıtlama sürecinde çocukların uyku bozukluğu yaşayıp yaşamadığının, eğer yaşıyorlarsa uyku ile ilgili hangi alanlarda sorun yaşadıklarının saptanması, ayrıca uyku bozukluğunun kronotip ve Koronavirüs anksiyetesi ile ilişkisinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Nisan-Kasım 2020 tarihleri arasında Kocaeli Üniversitesi Çocuk ve Ergen Psikiyatri polikliniklerine başvuran;ilkokul 1-4. sınıfa giden 98 hasta çalışmaya dahil edilmiştir. Ebeveynlere "Sosyodemografik Bilgi Formu", "Çocuk Uyku Alışkanlıkları Anketi", "Çocukluk Dönemi Kronotip Anketi";çocuklara ise "Koronavirus Anksiyete Ölçeği Kısa Formu" ve pandemi süreci ile ilgili beş maddeden oluşan bilgi formu uygulanmıştır. Bulgular: Uyku alışkanlıkları anketi toplam puanına bakıldığında, grubun %70,4'ünün klinik olarak anlamlı düzeyde uyku sorunu yaşadığı saptanmıştır. Çalışmamızda gözlenen en yaygın uyku bozuklukları;yatma zamanı direnci, uykuya dalmanın gecikmesi ve gece uyanmalarıdır. Ailede fiziksel hastalık (p=0,019), sigara kullanımı (p=0,032), pandemide uyku düzen değişikliği (p=0,002), annenin uyku değişimi (p=0,006), babanın uyku değişimi (p=0,035), ve iştah değişimi (p=0,010) ile uyku bozukluğu arasında anlamlı ilişki saptanmıştır. Kronotip ölçeğine göre 66 çocuğun sabahçı, 31 çocuğun ara form, bir çocuğun ise akşamcı olduğu gözlenmiştir. Çocukların Koronavirüse yönelik anksiyetesinin düşük olduğu saptanmıştır. Sonuç: Çalışmamız, çocuklarda pandemi döneminde uyku bozukluğunun belirgin düzeyde olduğunu ancak bu durumun pandemi ile ilişkili anksiyete ya da kronotip ile ilgili sorunlardan çok, uyku düzenlerindeki değişiklik ve ebeveynlerin uykusundaki değişimlerden kaynaklandığını göstermektedir. Polikliniklere başvuran hastaların uyku ile ilgili sorunları değerlendirilirken bu faktörlerin sorgulanması ve bu yönde düzenlemeler yapılması yararlı olacaktır. (Turkish) [ FROM AUTHOR] Copyright of Journal of Turkish Sleep Medicine is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Sleep Disorders and Associated Factors in Children Who Admitted to the Child and Adolescent Psychiatry Outpatient Clinics During the Pandemic

Objective: This study determined whether children have sleep disorders during the Coronavirus disease-2019 (COVID-19) pandemic restriction process, and if they do, to determine in which areas they have problems with sleep, as well as to examine the relationship of sleep disorder with chronotype and coronavirus anxiety. Materials and Methods: In April-November 2020, 98 patients attending Kocaeli University Child Psychiatry clinics and attending primary school 1-4th grade were recruited. "Sociodemographic Form", "Child Sleep Habits Questionnaire", and "Children's Chronotype Questionnaire" were applied to the parents. The short form of the "Coronavirus Anxiety Scale" and the information form about the pandemic process were applied to the children. Results: According to the sleep habits questionnaire, 70.4% of the group had clinically significant sleep problems. The most common sleep disorders observed in our study;are bedtime resistance, delayed falling asleep, and nighttime awakenings. A significant relationship was found between physical illness in the family (p=0.019), smoking (p=0.032), sleep pattern change during the pandemic (p=0.002), sleep change of the mother (p=0.006) and/or father (p=0.035), change in appetite (p=0.010), and sleep disorder. According to the chronotype scale, 66 children were morning and children's anxiety toward coronavirus was low. Conclusion: Our study shows that sleep disturbance in children is marked during the pandemic period, but this is due to changes in sleep patterns and parents' sleep rather than problems related to anxiety or chronotype associated with the pandemic. It will be useful to question these factors and make arrangements in this direction when evaluating the sleep-related problems of patients who apply to outpatient clinics. (English) [ FROM AUTHOR] Amaç: Bu çalışmada, Koronavirüs hastalığı-2019 (COVID-19) pandemisi kısıtlama sürecinde çocukların uyku bozukluğu yaşayıp yaşamadığının, eğer yaşıyorlarsa uyku ile ilgili hangi alanlarda sorun yaşadıklarının saptanması, ayrıca uyku bozukluğunun kronotip ve Koronavirüs anksiyetesi ile ilişkisinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Nisan-Kasım 2020 tarihleri arasında Kocaeli Üniversitesi Çocuk ve Ergen Psikiyatri polikliniklerine başvuran;ilkokul 1-4. sınıfa giden 98 hasta çalışmaya dahil edilmiştir. Ebeveynlere "Sosyodemografik Bilgi Formu", "Çocuk Uyku Alışkanlıkları Anketi", "Çocukluk Dönemi Kronotip Anketi";çocuklara ise "Koronavirus Anksiyete Ölçeği Kısa Formu" ve pandemi süreci ile ilgili beş maddeden oluşan bilgi formu uygulanmıştır. Bulgular: Uyku alışkanlıkları anketi toplam puanına bakıldığında, grubun %70,4'ünün klinik olarak anlamlı düzeyde uyku sorunu yaşadığı saptanmıştır. Çalışmamızda gözlenen en yaygın uyku bozuklukları;yatma zamanı direnci, uykuya dalmanın gecikmesi ve gece uyanmalarıdır. Ailede fiziksel hastalık (p=0,019), sigara kullanımı (p=0,032), pandemide uyku düzen değişikliği (p=0,002), annenin uyku değişimi (p=0,006), babanın uyku değişimi (p=0,035), ve iştah değişimi (p=0,010) ile uyku bozukluğu arasında anlamlı ilişki saptanmıştır. Kronotip ölçeğine göre 66 çocuğun sabahçı, 31 çocuğun ara form, bir çocuğun ise akşamcı olduğu gözlenmiştir. Çocukların Koronavirüse yönelik anksiyetesinin düşük olduğu saptanmıştır. Sonuç: Çalışmamız, çocuklarda pandemi döneminde uyku bozukluğunun belirgin düzeyde olduğunu ancak bu durumun pandemi ile ilişkili anksiyete ya da kronotip ile ilgili sorunlardan çok, uyku düzenlerindeki değişiklik ve ebeveynlerin uykusundaki değişimlerden kaynaklandığını göstermektedir. Polikliniklere başvuran hastaların uyku ile ilgili sorunları değerlendirilirken bu faktörlerin sorgulanması ve bu yönde düzenlemeler yapılması yararlı olacaktır. (Turkish) [ FROM AUTHOR] Copyright of Journal of Turkish Sleep Medicine is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The gastrointestinal effects of COVID­19 infection during childhood and among the children affected with inflammatory bowel disease / A COVID-19-fertozés gastrointestinalis hatásai gyermekkorban és a gyulladásos bélbeteg gyermekekben.

Összefoglaló. A SARS-CoV-2-infekció változatos kórlefolyású, a gyermekpopulációban növekvo incidenciát mutató fertozés. Ebben a korcsoportban a felnottekkel szemben sokkal gyakrabban tapasztalhatók gasztroenterológiai tünetek a betegség során, 18-32%-ban jelentkezik legalább egy szimptóma. Ezek nem specifikusak, gyakran megegyezhetnek a virális enteritisek, a gyulladásos bélbetegségek vagy a vakbélgyulladás tüneteivel. A gyermekkori SARS-CoV-2-infekciónak egy viszonylag ritkán megjeleno, de súlyos, akár életveszélyes szövodménye a gyermekkori sokszervi gyulladásos szindróma (multisystem inflammatory syndrome in children, MIS-C). Ilyenkor a gastrointestinalis tünetek gyakorisága 60-100%-ra no, sok esetben akut has benyomását keltve. A jelenlegi kutatások eredményei alapján a gyulladásos bélbeteg gyerekek az alapbetegségük miatt nincsenek nagyobb veszélynek kitéve az átlagpopulációhoz képest a COVID-19-fertozés szempontjából. A terápiájukban alkalmazott gyógyszereik közül a nagy dózisú szteroidkezelés okoz nagyobb kockázatot a megfertozodésre, illetve ebben az esetben a súlyosabb kórlefolyásra. Az éppen remisszióban lévo gyulladásos bélbetegek fenntartó terápiájának módosítások nélküli folytatása javasolt, kiemelt figyelmet fordítva a biológiai terápiák idoben történo, megszakítás nélküli alkalmazására. Törekedni kell a személyes vizitek számának csökkentésére a pandémia idején, ezek telemedicinával történo helyettesítése javasolt. A halasztható endoszkópos vizsgálatok noninvazív vizsgálómódszerekkel történo átmeneti kiváltása részesítendo elonyben a betegség aktivitásának, a terápia hatékonyságának megítélésére. A gyulladásos bélbetegségben szenvedo gyermekek COVID-19 elleni védooltása javasolt, jelenleg minden elérheto oltóanyag alkalmazható náluk (az élo ágenst tartalmazó vakcinák ellenjavalltak). Immunmoduláns, szteroid- vagy anti-tumornekrózisfaktor (TNF)-alfa-terápia esetén az oltás lehetséges csökkent hatékonyságával kell számolni. Orv Hetil. 2022; 163(6): 214-221. Summary. The SARS-CoV-2 infection is showing high variety in the disease course, with a constantly increasing incidence among the pediatric population. In this age group, at least one gastrointestinal symptom appears in 18-32% of the cases, showing a significant difference compared to the adult population. The gastrointestinal signs of COVID-19 are not specific, can mimic the symptoms of viral enteritis, inflammatory bowel diseases or acute appendicitis. The multisystem inflammatory syndrome in children (MIS-C) is a rather rare, but serious complication of the pediatric COVID-19 disease: in these cases, the incidence of the gastrointestinal symptoms is increased up to 60-100%, often observed as acute abdomen. Based on recent researches, patients with inflammatory bowel diseases (IBD) are shown to have the same risk in developing COVID-19 infection compared to the normal population: in their medications, the high dose steroid treatment is proved to increase the risk of infection or to make the disease course more serious. The treatment of patients with IBD should be continued without any changes (when the disease is in remission). The use of biologics should be done with special care, with more attention keeping the schedule and the continuity. It is advised to minimise the number of personal visits during the pandemic, they should be substituted with telemedicine. The postponable endoscopic examinations should be temporarily redeemed by non-invasive methods for screening the disease activity and the efficacy of the treatment. The vaccination against COVID-19 is advised in the population with IBD. All vaccines currently available are usable in this patient group (the use of vaccines containing live agents are contraindicated). In the case of patients treated with immunmodulators, steroids or anti-tumor necrosis factor (TNF) alpha, a possible lower efficacy can be expected after the vaccination. Orv Hetil. 2022; 163(6): 214-221.

COVID-19 in patients with primary immunodeficiency. / COVID-19 primer immunhiányos betegekben.

Összefoglaló. Az új típusú koronavírus (SARS-CoV-2) okozta pandémia súlyos terhet és nagy kihívást jelent a fertozésekkel szemben általában is fogékony, szerteágazó immunológiai és genetikai hátteru, primer immundeficiens (PID-) betegek számára. Az eddigi megfigyelések arra utalnak, hogy a SARS-CoV-2-fertozés és a súlyos COVID-19 mortalitása nem elsosorban az immunológiai alapbetegséggel, hanem sokkal inkább egyéb, a PID talaján megelozoen kialakult (például bronchiectasia, asthma, autoimmun betegség stb.) vagy attól független krónikus társbetegséggel (például diabetes, krónikus szív- és érrendszeri vagy vesebetegség) és szervi károsodással függ össze. A betegek egy kis csoportjában az I. típusú interferon-immunitás zavarát okozhatják génmutációk vagy autoantitestek termelése. A közleményben az eddig közölt adatok alapján beszámolunk a SARS-CoV-2-fertozés és a COVID-19 lefolyásáról és mortalitásáról PID-betegekben. Orv Hetil. 2022; 163(5): 166-170. Summary. The pandemic caused by the novel coronavirus (SARS-CoV-2) has resulted in tremendous challenges to the management of patients with primary immunodeficiencies (PIDs) representing a wide range of immunological and genetic entities. Preliminary data suggest that patients with PID would be at increased risk of severe disease and mortality from this newly emerged coronavirus. However, morbidity and mortality by SARS-CoV-2 may depend only partly on specific defect of immunity. Most of disease morbidity and mortality has been published to be related to previous damage of organs and tissues that had developed on the bases of PID before contracting SARS-CoV-2 or other, PID-independent disorders. In a small fraction of patients, impaired type I interferon immunity was found to predispose PID patients to severe coronavirus disease. In this review, we provide an update on published data about SARS-CoV-2 infections and COVID-19 in various PIDs. Orv Hetil. 2022; 163(5): 166-170.

A fizikai aktivitás és a szubjektív egészségi állapot értékelése magyar középiskolások körében a COVID-19-pandémia okán elrendelt távoktatási idoszakban.

Összefoglaló. Bevezetés: A SARS-CoV-2-világjárvány idején a középiskolai oktatás távoktatás formájában zajlott világszerte, így Magyarországon is. A csökkent fizikai aktivitás és az inaktív viselkedésmódok növekedése az elhízás, a cukorbetegség és a szív- és érrendszeri betegségek fokozott kockázatához vezet. Célkituzés: Vizsgálatunk a fizikai aktivitás (aerob testmozgás, izomerosítés, csapatsportok) és az egészségi állapot szubjektív megítélésének változásaira irányult serdüloknél és fiatal felnotteknél a világjárvány alatt. Módszer: Középiskolás diákokat kérdeztünk meg 37 magyarországi város 66 állami iskolájában (n = 2508). A fizikai aktivitásra és az egészségi állapot szubjektív megítélésére vonatkozó kérdoíves tételeket a WHO Health Behaviour of School-aged Children Survey és a Centers for Disease Control and Prevention Youth Risk Behavior Survey felmérésébol vettük át. 2 × 2 × 4 faktoriális ANCOVA-t használtunk a nem és/vagy az életkor, illetve a régiók hatásának tesztelése céljából a fizikai aktivitás és az egészségi állapot szubjektív megítélésének változásaira, a távoktatási idoszak elott és alatt. Eredmények: A középiskolás diákok többsége kevesebb fizikai aktivitást jelzett, a fizikai aktivitás gyakoriságának csökkenése volt jellemzo a távoktatás idoszakában. Átlagosan heti 2-3 nappal kevesebbszer végeztek fizikai aktivitást régiótól függetlenül. Közel egynegyedük az egészségi állapotát rosszabbnak minosítette a távoktatás alatt, mint elotte. Az egészségi állapot szubjektív csökkenésérol nagyobb arányban számoltak be azok, akik a fizikai aktivitásukban is csökkenést jeleztek. Következtetés: A távoktatás idoszakában tapasztalható csökkenés a fizikai aktivitás gyakoriságában együtt jár az egészségi állapot szubjektív megítélésének csökkenésével, különösen a lányok, a vidéken élok és a serdülo korú személyek körében. Orv Hetil. 2022; 163(17): 655-662. INTRODUCTION: High school education took place in the form of distance learning during SARS-CoV-2 pandemic worldwide, including Hungary. Decreased physical activity and an increase in inactive behaviours may lead to an increased risk of obesity, diabetes, and cardiovascular disease. OBJECTIVE: Our study focused on changes in physical activity (aerobic exercise, muscle strengthening, team sports) and subjective perceptions of health status in adolescents and young adults during the pandemic. METHOD: High school students in 66 public schools in 37 cities in Hungary (n = 2508) were surveyed. Questionnaire items on physical activity and subjective perceptions of health were adapted from the WHO Health Behaviour of School-aged Children Survey and the Centers for Disease Control and Prevention Youth Risk Behavior Survey. 2 × 2 × 4 factorial ANCOVA was used to test the effect of gender and/or age and region on changes in subjective perceptions of physical activity and health before and during distance education. RESULTS: The majority of the high school students reported a decrease in physical activity frequency during the distance learning period, with an average of 2-3 fewer days of physical activity per week regardless of region. Nearly a quarter of them rated their health as worse during distance learning than before. A higher proportion of those who reported a subjective decline in health also reported a decline in physical activity. CONCLUSION: A decline in physical activity during the period of distance learning is associated with a decline in subjective perceptions of health, especially among rural adolescent girls. Orv Hetil. 2022; 163(17): 655-662.

Krónikus légzőszervi betegek élményvilágának vizsgálata a COVID–19-világjárvány idején interpretatív fenomenológiai analízissel

Background: During a coronavirus pandemic, respiratory patients may be more vulnerable to mental health problems in addition to their physical vulnerability. Due to the specific nature of their illness, they are more likely to have pre-existing experience of crisis situations, serious existential issues and coping with them. Despite a growing body of literature based on quantitative research, there is still a lack of insight into the subjective experiences of those affected. Aim: Our aims were to explore and deepen our understanding of the experiences of chronic respiratory patients at risk of pandemic COVID-19. Our research questions were: 1. How do the interviewees relate to their underlying respiratory condition? 2. What does it mean to experience vulnerability? 3. How do the initial experiences of the underlying disease affect the experience of vulnerability to pandemic disease? Methods: We used interpretative phenomenological analysis. The study involved 8 participants: 7 women and one man, aged 29–60, with one of the following diagnoses: asthma, chronic obstructive pulmonary disease, cystic fibrosis. Results: Three main themes emerged from the analysis of the semi-structured interviews: 1. respiratory illness as a defining experience in everyday life, 2. the impact of the COVID-19 pandemic on the self and identity organisation, and 3. adaptation to experiencing vulnerability. Breathlessness is the most frightening feature of progressive lung disease, and can be linked to fear and anxiety in different ways. The potentially contagious nature of COVID-19 draws a sharp line between the endangered Self and the dangerous Other, and represents a critical life situation for the satisfaction of social needs and desires. In coping with them, we observe essentially self-defense mechanisms and emotion-focused strategies. Conclusions: The current pandemic is having a widespread and powerful impact on the lives of affected patients. Because of the nature of the coronavirus, which primarily affects the airways, those affected consider themselves to be at risk. Experiencing vulnerability fundamentally determines their lives: their decisions, their connection to the world, organization of identity, coping and their belief in the security of the world. Identifying their experiences and difficulties is of particular importance for the development of strategies to mitigate the psychosocial impact of the epidemic. (English) [ FROM AUTHOR] Elméleti háttér: A koronavírus világjárvány idején a krónikus légzőszervi betegek fizikai sérülékenységük mellett a mentális problémákra is fokozottan érzékenyek lehetnek. Betegségük sajátosságaiból kifolyólag nagyobb valószínűséggel rendelkeznek már meglévő tapasztalattal krízishelyzetek, súlyos egzisztenciális kérdések és az ezekkel való megküzdés területén. Ezeknek a korábbi tapasztalatoknak szerepe lehet a COVID–19-járvánnyal kapcsolatos veszélyeztetettség megélése szempontjából. Az egyre nagyobb számú kvantitatív kutatáson alapuló szakirodalom ellenére az érintettek szubjektív tapasztalatainak megismerése továbbra is hiányzik. Cél: Kutatásunk célja a krónikus légzőszervi betegek COVID–19-világjárvány általi veszélyeztetettségélményének, tapasztalatainak feltárása és mélyebb megértése volt kvalitatív, idiográfiás módszerrel. Az alábbi kutatási kérdésekre kívántunk választ kapni: 1. Hogyan viszonyulnak az interjúalanyok a légzőszervi alap- betegségükhöz? 2. Mit jelent a számukra a veszélyeztetettség megélése? 3. Hogyan hatnak az alapbetegséggel kapcsolatos eredeti tapasztalatok a világjárvánnyal járó sérülékenység megélésére? Módszerek: Vizsgálatunkhoz az interpretatív fenomenológiai analízis módszerét használtuk. A kutatásban 8 fő vett részt: 7 nő és 1 férfi, 29–60 évesek, a következő diagnózisok valamelyikével: asztma, krónikus obstruktív tüdőbetegség, cisztás fibrózis. Eredmények: A félig strukturált interjúk elemzése során három főtéma bontakozott ki: 1. légzőszervi betegség mint a mindennapokat meghatározó tapasztalat, 2. a koronavírus világjárvány hatása az énre és az identitásszerveződésre, illetve 3. a veszélyeztetettség megéléséhez való alkalmazkodás. A levegőtlenség a progresszív tüdőbetegségek legnehezebben tolerálható, leginkább félelmetes velejárója, amely élmény különböző módokon kapcsolódhat a félelemmel és a szorongással. A COVID–19 potenciális fertőző volta éles határvonalat húz a veszélyeztetett Én és a veszélyes Másik;vagyis az én és a világ közé, továbbá kritikus élethelyzetet jelent a társas szükségletek és vágyak kielégíthetősége szempontjából. Adaptációjukban alapvetően énvédő mechanizmusok, illetve érzelem- fókuszú stratégiák bontakoztak ki. Következtetések: A jelenlegi világjárvány jelentős hatást gyakorol az érintett betegek életére. A koronavírus elsősorban légutakat érintő természete miatt az érintettek veszélyeztetettként tekintenek önmagukra, a veszélyeztetettség megélése pedig alapvetően meghatározza életüket;döntéseiket, a világhoz való kapcsolódásukat, identitásszerveződésüket, megküzdésüket, s megkérdőjelezi a világ biztonságosságába vetett hitüket. A krónikus légzőszervi betegek tapasztalatainak feltárása kiemelt jelentőséggel bír a járvány pszichoszociális hatásait mérséklő stratégiák kidolgozásában. (Hungarian) [ FROM AUTHOR] Copyright of Mentalhigiene es Pszichoszomatika / Journal of Mental Health & Psychosomatics is the property of Akademiai Kiado and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Evaluation of the impact of COVID-19 pandemia on pediatric urological operations and the number of outpatient clinic patients in a province with, the highest birth rate Turkey

Investigation of the effect of Covid-19 pandemic on pediatric urology operations in Şanliurfa province, where the birth rate is the highest in Turkey : Objective: The aim of this study is to investigate the effect of the COVID-19 pandemic on pediatric urology operations. Materials and Methods: Hospital records of pediatric patients who applied to Harran University Medical Faculty Pediatric Urology Clinic during the pandemic period (19 March-22 December 2020) and pre-pandemic period (19 March-22 December 2019) and were operated with precautions were retrospectively analyzed. The number of outpatient clinic patients during and before the pandemic period, the number of operations and indications, and the types of surgery were compared. The names and numbers of surgical procedures are listed according to the European Association of Urology (EAU) priority classification. Results: During the COVID-19 pandemic period, the number of pediatric patients admitted to the outpatient clinic was 2361, while it was 5214 in the same period before the pandemic. It was observed that the number of patients who applied to the outpatient clinic decreased by 54.8% during the pandemic period. While the total number of pediatric operations was 316 during the pandemic period, it was 741 before the pandemic period. When the pandemic period was compared with the pre-pandemic period, a 58.4% reduction was observed in pediatric urology operations. The number of emergency operations was 69 during the pandemic period and 85 in the pre-pandemic period. During the pandemic period, the reduction in emergency operations was 18.8%. No complications were observed due to COVID-19 in any of the operated patients. Conclusion: During the COVID-19 epidemic, it was observed that the number of pediatric urology outpatient clinic admissions and surgeries in our hospital decreased. In cases where urgent interventions were required, adequate precautions were taken, and surgical operations could be applied without any contamination and mortality. Keywords: Coronavirus, coronavirus disease 2019, pandemic hospital, pediatric urological surgery.Alternate :et Amaç: Bu çalışmada COVID-19 pandemisinin pediatrik üroloji ameliyatlarına etkisini araştırmayı amaçladık. Materyal ve metod: Tıp Fakültesi Pediatrik Üroloji Kliniği’ne pandemi döneminde (19 Mart-22 Aralık 2020) ve pandemi öncesi dönemde (19 Mart-22 Aralık 2019) polikliniğe başvuran ve önlemler eşliğinde ameliyat edilen pediatrik hastaların hastane kayıtları retrospektif incelendi. Pandemi dönemi ve öncesi poliklinik hasta sayıları, ameliyat sayıları ve endikasyonları, ameliyat türleri karşılaştırıldı. Cerrahi prosedürlerin isimleri ve sayılar Avrupa Üroloji Derneği (EAU) öncelik sınıflandırmasına göre listelendi. Bulgular: COVID-19 pandemisi döneminde polikliniğe pediatrik hasta başvuru sayısı 2361 iken pandemi öncesi aynı dönemde 5214 idi. Pandemi döneminde polikliniğe başvuran hasta sayısının % 54,8 azaldığı görüldü. Pandemi döneminde toplam pediatrik ameliyat sayısı 316, pandemi dönemi öncesi 741 idi. Pandemi dönemi, pandemi öncesi ile karşılaştırıldığında pediatrik üroloji ameliyatlarında %58,4 azalma olduğu görüldü. Pandemi döneminde acil ameliyat sayısı 69, pandemi öncesi dönemde 85 idi. Pandemi döneminde acil ameliyatlardaki azalma %18,8 idi. Opere edilen hiçbir hastada COVID-19 nedeniyle komplikasyon izlenmedi. Sonuç: COVID-19 salgını sırasında hastanemizdeki pediatrik üroloji poliklinik başvurusu ve ameliyat sayısının azalmış olduğu görüldü. Acil müdahalelerin gerekli olduğu olgularda yeterli önlemler alınarak, herhangi bir kontaminasyon ve mortalite olmaksızın cerrahi operasyonlarının uygulanabilirliği görüldü.

COVÍD-19 tanısı alan hastalarda yatarak tedavi görmeyi öngörmede 3 prediktör: yaş, laktat dehidrogenaz ve nötrofil/lenfosit oranı

et Amaç: Aralik 2019’da Çin’in Hubei eyaleti Wuhan’da nedeni bilinmeyen pnömoni salgını yaşandı ve bu hastalık Dünya Sağlık Örgütü (WHO) tarafından koronavirüs hastalığı (COVÍD-19) olarak adlandırıldı. COVÍD-19 hızlıca dünyaya yayıldı. Bu hastalık hastalarda farklı şiddette seyretmektedir. Bu nedenle hastalar yatarak tedavi veya ayaktan tedavi gibi farklı alternatifler ile tedavi edilmektedir. Bu çalışmada bizim amacımız biyokimyasal parametreler ile hastaların ayakta tedavi veya yatarak tedavi almasındaki ilişkiyi araştırmaktır. Gereç ve yöntem: Çok merkezli retrospektif kohort çalışmamızda hastalar iki gruba ayrıldı;yatan hastalar ve ayaktan tedavi alan hastalar. Yatarak tedavi alan 60 hasta olmak üzere 102 hasta çalışmaya alındı. Koronavirüs;WHO’nun kılavuzuna göre gerçek zamanlı polimeraz zincir reaksiyonu (PZR) yöntemiyle SARS-CoV-2 RNA saptanmasıyla belirlenmiştir. Kan parametrelerinde nötrofil/lenfosit oranı (NLR) hesaplanmıştır. Bulgular: Yatan hasta grubunda daha ileri yaş (32,0 (26,0-39,3);54,0 (38,3-59,3), p<0,001), kan değerlerinde daha yüksek laktat dehidrogenaz (LDH) (195,0 (156,5-225,3);248,5 (200,3-334,5), p<0,001) ve daha yüksek NLR (1,56 (1,08-2,62);2,60 (1,65-4,90), p<0,001) görüldü. Sonraki adımda lojistik regresyon analizinde;ileri yaş (OR:1,072 95 % CI:1,031-1,115, p=0,001), yüksek LDH (OR:1,021 95 %CI:1,009-1,034, p=0,001) yüksek NLR (OR:1,402 95 % CI:1,049-1,874, p=0,023) yatarak tedavi almayı bağımsız olarak predikte etti. Sonuç: COVÍD-19 hastalarında ileri yaş, yüksek LDH ve yüksek NLR değerleri hastanede yatarak tedavi almayı öngördürmüştür. COVID- 19 continues to spread rapidly all over the world. Patients may experience the disease at different severity. Therefore, they can be treated by choosing alternative approaches including outpatient treatment or hospitalization. Our aim in the present study is to investigate the relationship between some biochemical parameters on admission and treatment location preference (inpatient or outpatient) Materials and methods: At our multi-center retrospective cohort study, we divided the study into 2 groups as inpatients and outpatients. A total of 102 patients, 60 of whom received inpatient treatment, were enrolled. Coronavirus was determined by detecting SARS-CoV-2 RNA with a real-time PCR method in accordance with the WHO guide. Blood parameters were recorded and NLR was calculated. Results: Inpatient group was older (32.0 (26.0-39.3) vs 54.0 (38.3-59.3), p<0.001) and had significantly higher level of LDH (195.0 (156.5-225.3) vs 248.5 (200.3-334.5), p<0.001) and NLR (1.56 (1.08-2.62) vs 2.60 (1.65-4.90), p<0.001) in blood samples. In forward stepwise logistic regression analysis;advanced age (OR:1.072 95 % CI:1.031-1.115, p=0.001), high LDH (OR:1.021 95 %CI:1.009-1.034, p=0.001) and NLR (OR:1.402 95 % CI:1.049-1.874, p=0.023) were shown as independent predictors of hospitalization Conclusion: Advanced age, high LDH, and NLR level predicted hospitalization in patients with COVID-19. Keywords: Coronavirus, laktate dehydrogenase, neutrophil/ lymphocyte ratio (NLR)

Pneumothorax and Pneumomediastinum in Patients admitted to Intensive Care Unit with COVID-19 Pneumonia: A Single-Center Retrospective Analysis.

Objectives: This study aimed to examine the frequency, and clinical features of pneumothorax and pneumomediastinum cases in patients admitted to the intensive care unit due to coronavirus disease-19 (COVID- 19) pneumonia. Methods: We retrospectively screened the COVID-19 cases hospitalized in our intensive care unit between March 11, 2020, and January 11, 2022. Patients diagnosed as pneumothorax or pneumomediastinum were determined. The frequency and clinical features of pneumothorax and pneumomediastinum were investigated. Results: Seven hundred and twenty patients hospitalized in our intensive care unit between March 11, 2020, and January 11, 2022 were screened. Twenty-four (3.3%) patients had pneumothorax or pneumomediastinum. Pneumothorax occurred 17 patients (70%), and pneumomediastinum in 14 patients (58%). The number of patients who developed pneumomediastinum and pneumothorax together was 7 (29%). COVID-19-associated pneumothorax tended to be unilateral (n=16) and right-sided (n=11). In 18 (75%) patients, pneumothorax or pneumomediastinum developed during invasive mechanical ventilation, 5 (20.8%) patients during non-invasive mechanical ventilation. One patient developed pneumothorax when mechanical ventilation was not applied. The mortality rate at 60 days was 75% (n=18) in patients who were admitted to the intensive care unit with COVID- 19 and developed pneumomediastinum or pneumothorax. Conclusion: Pneumothorax and pneumomediastinum are complications of COVID-19 pneumonia with high mortality rates. (English) [ FROM AUTHOR] Amaç: Bu çalışmada, koronavirüs hastalığı-19 (COVID-19) pnömonisi nedeniyle üçüncü basamak yoğun bakım ünitesine başvuran hastalarda gelişen pnömotoraks ve pnömomediastinum sıklığının ve klinik özelliklerinin incelenmesi amaçlandı. Yöntem: Yoğun bakım ünitesinde, 11 Mart 2020 ile 11 Ocak 2022 tarihleri arasında yatan COVID-19 hastaları geriye dönük olarak incelendi, pnömotoraks ve pnömomediastinum tanıları alan hastalar belirlendi. Pnömotoraks ve pnömomediastinum sıklığı ile klinik özellikleri araştırıldı. Bulgular: Yoğun bakım ünitesinde 11 Mart 2020 ile 11 Ocak 2022 tarihleri arasında yatan 720 hasta tarandı. Yirmi dört hastanın pnömotoraks veya pnömomediastinum olduğu izlendi (%3,3). On yedi (%70) hastada pnömotoraks, 14 (%58) hastada ise pnömomediastinum izlendi. Pnömomediastinum ve pnömotoraksın birlikte geliştiği hasta sayısı 7 (%29) idi. COVID-19 ile ilişkili pnömotoraks tek taraflı (n=16) ve sağ taraflı olma (n=11) eğiliminde idi. Hastaların 18’i (%75) pnömotoraks veya pnömomediastinum gelişimi sırasında invaziv mekanik ventilasyon, 5’ine (%20,8) noninvaziv mekanik ventilasyon uygulanmaktaydı. Bir hastada mekanik ventilasyon uygulanmıyorken pnömotoraks gelişti. COVID-19 hastalığı ile yoğun bakıma yatan, pnömotoraks veya pnömomediastinum gelişen hastalarda 60. günde ölüm oranı %75 (n=18) idi. Sonuç: Pnömotoraks ve pnömomediastinum COVID-19’a bağlı pnömoni hastalarında gelişebilen mortalitesi yüksek komplikasyonlardır. (Turkish) [ FROM AUTHOR] Copyright of Journal of the Society of Thoracic Carido-Vascular Anaesthesia & Intensive Care is the property of Gogus Kalp Damar Anestezi ve Yogun Bakim Dernegi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Knowledge and Attitude Levels of Nurses Towards COVID-19 in the Second Peak Period of the Novel Coronavirus Epidemic in Turkey

Objective: The aim of this study is to analyze the knowledge levels and attitudes of nurses towards COVID-19 during the second peak period of the COVID-19 epidemic in Turkey, as well as to test the structural relationship between knowledge levels and attitudes with structural equation modeling. Materials and Methods: The hospital-based cross-sectional study design was employed in the study. The population of the research consisted of nurses working in three different private hospitals operating in Istanbul, which have international quality and accreditation certificates. The data were collected by the researchers themselves by using face-to-face and online survey techniques. The total number of questionnaires that were evaluated and used in the analysis of the data is 390. SPSS 26 and AMOS 24 package programs were used in the analysis of the data. The quantitative research method was used. Descriptive statistics, independent sample t-test, ANOVA test and structural equation modeling were applied to the data. Results: Structural equation analysis revealed the direct effect positively of the nurses' COVID-19 knowledge level on attitude toward COVID-19 have an acceptable index of fit Furthermore, the relationship between the level of knowledge toward COVID-19 and female gender was found to be significant. Conclusion: In general, the level of knowledge of the nurses participating in the study about COVID-19 was found to be high and it was observed that they had a more optimistic attitude towards preventing COVID-19 and keeping the process under control. An increase in knowledge about COVID-19 has led to an increase in the behavior of a more optimistic attitude towards prevention and control of COVID-19.Alternate :bilgi düzeylerini ve tutumlarını analiz etmek ve bunun yanı sıra bilgi düzleri ile tutumları arasındaki yapısal ilişkiyi yapısal eşitlik modellemesi ile test etmektir. Gereç ve Yöntem: Araştırmada hastane tabanlı kesitsel çalışma deseni kullanılmıştır. Araştırmanın evrenini Ístanbul ilinde faaliyet gösteren uluslararası kalite ve akreditasyon belgesine sahip üç farklı özel hastanede çalışan hemşireler oluşturmuştur. Veriler yüzyüze ve online anket teknikleri birlikte kullanılarak bizzat araştırmacılar tarafından toplanmıştır. Değerlendirmeye alınan ve verilerin analizinde kullanılan toplam anket sayısı 390 dır. Verilerin analizinde SPSS 26 ve AMOS 24 paket programları kullanılmıştır. Nicel araştırma yöntemi kullanılmıştır. Verilere, tanımlayıcı istatistikler, bağımsız örneklem t testi, ANOVA testi ve yapısal eşitlik modellemesi uygulanmıştır. Bulgular: Yapısal denklem analizi, hemşirelerin COVID-19 bilgi düzeylerinin COVID-19'a yönelik tutumları üzerindeki olumlu etkisinin kabul edilebilir bir uyum indeksine sahip olduğunu ortaya koymuştur. Ayrıca COVID-19'a yönelik bilgi düzeyi ile kadın cinsiyeti arasındaki ilişki anlamlı bulunmuştur. Sonuç: Genel olarak, araştırmaya katılan hemşirelerin COVID-19'a yönelik bilgi düzeyleri yüksek bulunmuştur ve COVID-19'u önlemeye ve sürecin kontrol altında tutulmasına yönelik daha iyimser bir tutum sergiledikleri görülmüştür. COVID-19'a yönelik bilgi düzeyindeki bir artış, COVID-19'un önlenmesi ve kontrol altına alınmasına yönelik daha iyimser bir tutum davranışında artışa neden olmuştur.

SARS‐CoV‐2’nin Erkek Üreme Sistemi Üzerindeki Etkileri

Yeni Koronavirüs (SARS-CoV-2) ilk olarak Çin’in Vuhan şehrinde ortaya çıkmış ve Yeni Koronavirüs Hastalığı’na (Covid-19) neden olmuştur. Covid-19 dünya çapında hızla yayılmakta ve vaka sayısı tüm ülkelerde artmaktadır. 22 Kasım verilerine göre dünya genelinde vaka sayısının 57.8 milyonu geçtiği ve 1.3 milyon kişinin hayatını kaybettiği bildirilmiştir. SARS‐CoV‐2’nin, hücrelere girmek için bir reseptör olarak anjiyotensin-dönüştürücü enzim 2’yi (ACE2) kullandığı bilinmektedir. ACE2 ekspresyon dağılımının organa özgü olduğu, testis ve böbrek dokuları başta olmak üzere kardiyovasküler ve gastrointestinal sistemde de bulunduğu belirtilmiştir. ACE2 reseptörlerinin ekspresyonu hem erkek hem de dişi üreme organlarında yer almaktadır. SARS‐CoV‐2’nin enfeksiyon oranları yaş gruplarına göre farklılık göstermektedir. Erkekler kadınlardan daha yüksek hastalık prevalansına sahiptir. Normal testis dokularında ACE2 antikorunun kullanıldığı immünohistokimyasal (ÍHK) analizlerde, seminifer tübül ve Leydig hücrelerinde yüksek boyanmaya neden olduğu görülmüştür. SARS‐CoV‐2’den etkilenen hücrelerin spermatogenezi engelleyeceği ve erkek infertilitesine neden olabileceği belirtilmiştir. SARS-CoV-2’nin üreme sistemini etkileme düzeyini belirlemek oldukça güçtür. Bu hastalığın tedavisinde kullanılacak kesin bir ilaç veya aşı olmadığı için, çalışmaların uzun bir süre devam edeceği ve daha çok şey öğreneceğimiz düşünülmektedirAlternate :The New Coronavirus (SARS-CoV-2) first appeared in Wuhan, China and caused the New Coronavirus Disease (Covid-19). Covid-19 is spreading rapidly around the world and the number of cases is increasing in all countries. According to the data of 22 November, it has been reported that the number of cases exceeded 57.8 million and 1.3 million people died worldwide. SARS‐CoV‐2 is known to use angiotensin-converting enzyme 2 (ACE2) as a receptor to enter cells. It has been reported that the distribution of ACE2 expression is organ-specific, and it is found in the cardiovascular and gastrointestinal systems, especially in testes and kidney tissues. Expression of ACE2 receptors is located in both male and female reproductive organs. The infection rates of SARS‐CoV‐2 vary according to age groups. Men have a higher prevalence of the disease than women. In immunohistochemical (IHC) analyzes using ACE2 antibody in normal testicular tissues, it was observed that it caused high staining in seminiferous tubule and Leydig cells. It has been stated that cells affected by SARS‐CoV‐ 2 will inhibit spermatogenesis and cause male infertility. It is very difficult to determine the effect level of SARS-CoV-2 on the reproductive system. Since there is no definitive drug or vaccine to be used in the treatment of this disease, it is thought that the studies will continue for a long time and we will learn more.

HAVA KÍRLÍLÍĞÍ VE COVID-19

Yeni Koronavirüs Hastalığı-2019 hızla dünyaya yayılmış ve büyük bir halk sağlığı sorunu olarak, sosyal ve ekonomik zararlara neden olmuştur. Risk faktörleri;sosyodemografi, tıbbi durum ve çevresel maruziyetler şeklinde gruplandığında;çevresel risk faktörlerinden biri de hava kirliliğidir;nüfusun COVID-19 patogenezine olan duyarlılığının artmasında önemli rol oynayabileceği düşünülmektedir. Sokağa çıkma yasağı gibi insan hareketliliğini kısıtlayan önlemlerin;yemek, eğlence, endüstri, madencilik, ulaşım ve ticaret faaliyetlerinin azalması dikkate alındığında hava kirleticilerinin emisyonu üzerinde azaltıcı etki gösterebileceği öngörülebilir. Hava kalitesi değerlendirilirken kullanılan ana kirletici parametrelerin artışlarının bulaş, hastalığın seyri ve sonuçları üzerinde, viral iletimde kolaylaştırıcı olduğu, solunum ve kardiyovasküler hastalık riskini arttırdığı çalışmalarda gösterilmiştir. COVID-19 için R0 katsayısı hesaplanırken kullanılan faktörlerin incelenmesinde hava kirliliğinin;temas oranı, bulaş yolu, enfekte dönem üzerinde etkileri olduğu görülmektedir. Yüksek partikül madde konsantrasyonuna uzun süreli maruziyet ile kardiyovasküler hastalık riskleri de artmış olan bazı insanlar yüksek kan basıncı nedeniyle tedavi almaktadır. Angiotensin Converting Enzyme (ACE2), bazı korona virüsler için hücrelere giriş noktası görevini üstlenir. Yüksek kan basıncını tedavi etmek için kullanılan ACE inhibitörleri ve anjiyotensin reseptör blokerlerinin (ARB'lerin) ikisinin de ACE2 miktarını arttırdığı ve bu nedenle koronavirüs enfeksiyonlarının şiddetini arttırabileceği gösterilmiştir. Profesyonel topluluklar standart ACE inhibitörü ve ARB tedavisine devam edilmesini önermektedir. Kısıtlamaların uygulanması ile genel olarak faaliyet kaynaklı kirleticilerin miktarının azalması ve bu süreçte insanların hava kirleticilerine maruz kalmalarının da azalmasından dolayı etkili halk sağlığı müdahaleleri yapılmıştır. Sağlık profesyonellerince;hava kirliliğini önlemeye yönelik kanıt temelli çalışmalar yapılmalı ve paylaşılmalıdır.Alternate : COVID-19 has spread rapidly around the world and has caused socio-economic damage as a major public health problem. Risk factors;when grouped as sociodemographic, medical condition, and environmental exposures;one of the environmental risk factors is air pollution;It is thought that it may play an important role in increasing the sensitivity of the population to the pathogenesis of COVID-19. Measures that restrict human mobility, such as a curfew;considering the decrease in food, entertainment, industry, mining, transportation, and trade activities, it can be predicted that air pollutants may have a reducing effect on their emissions. Studies have shown that increases in the main pollutant parameters used when assessing air quality are a facilitator of transmission, the course, and results of the disease, viral transmission, and an increase in the risk of respiratory and cardiovascular diseases. In the examination of the factors used in calculating the R0 coefficient for COVID-19, air pollution;is seen that it has effects on contact rate, transmission route, and the infected period. Some people who also have an increased risk of cardiovascular disease with long-term exposure to a high concentration of particulate matter receive treatment for high blood pressure. The angiotensin-converting enzyme acts as an entry point into cells for some coronaviruses. ACE inhibitors and ARB used to treat high blood pressure have both been shown to increase the amount of ACE2 and therefore may increase the severity of coronavirus infections. Professional societies recommend continuing standard-ACEinhibitor and ARB therapy. Effective public health interventions have been made because the implementation of restrictions generally reduces the amount of activity-related pollutants, and in the process also reduc s people's exposure to air pollutants. By health professionals;evidence-based studies should be conducted and shared to prevent air pollution.

W-kilábalás a koronavírusjárvány két hullámában

Tanulmányunk célja a makrogazdasági adatok, valamint lakossági és vállalati felmérés segítségével annak vizsgálata, hogy a koronavírus-válság lefolyása hogyan zajlott egyes területeken. Eredményeink szerint a vírus a különböző ágazatokat eltérő mértékben érintette míg egyes ágazatokat gyors kilábalás, addig másokat elhúzódó válság jellemzett. A koronavírus őszi, második hulláma szintén visszaesést eredményezett a gazdasági adatokban, azonban ennek mértéke elmaradt a tavaszi első hullámban tapasztalttól. Összességében a válság lefolyása W-alakúnak tekinthető, bár egyes szempontok, illetve ágazatok ettől eltérő képet mutatnak. A vírushelyzet enyhülésével azonban a gazdaságpolitika fontos feladata lesz annak elérése, hogy a W utolsó szára meredek legyen, azaz a magyar gazdaság vissza tudjon térni a korábbi növekedési pályájához. Ehhez elengedhetetlen a korlátozások feloldása - hogy a lakossági fogyasztás ismét a növekedés motorjává válhasson -, illetve a vállalatok beruházási hajlandóságának a növelése.Alternate :Our study aims to examine what course the coronavirus crisis took in certain areas, using macroeconomic data and a household and business survey. Our results suggest that the virus has affected different sectors to varying degrees: while some sectors have experienced rapid recovery, others have been characterised by a protracted crisis. The second wave of the coronavirus in the autumn also resulted in a decline in economic data, but to a lesser extent than the first wave in the spring. Overall, the course of the crisis can be considered W-shaped, although some aspects and sectors show a different picture. However, as the viral situation improves, it will be an important task of economic policy to ensure that the last stem of the W is steep, i.e. that the Hungarian economy can return to its previous growth trajectory. To this end, it is essential to lift restrictions, so that household consumption can once again become the engine of growth, and to increase the willingness of companies to invest.

What influences the support for anti-epidemic measures?

Public reactions to the COVID pandemic range from extreme fear to the negligence of risk messages;one possible explanation for this is the scepticism about risk factors or preventive strategies. The relationship between support for prevention measures and epidemic-related scepticism or other potential explanatory variables (trust, worldview, experience with the disease) was examined in a sample of undergraduate and graduate students. In the study, the direct impact of the sceptical statements on policy support is tested. The authors focus on the antecedents of policy support and their relationship with scepticism using a structural equation model. Their path analysis confirms that scepticism is a strong predictor of support for preventive measures and also plays a mediating role between policy support and its antecedents. The order of questionnaire items is influential, i.e., those who first saw the sceptical arguments reported slightly lower support for prevention policies. Prosocial values, the credibility of scientists and, surprisingly, a lack of trust in others can help increase support for policies. Contrary to the authors' assumption, trust in others shows a negative correlation with support for policies, suggesting that when people do not trust others, they require stricter regulations to increase their own safety. (English) [ FROM AUTHOR] A közvélemény Covid19-pandémiára adott reakciói a szélsőséges félelemtől a járvány okozta kockázatok teljes elutasításáig terjednek, amelyek egyik lehetséges magyarázata a kockázati tényezőkkel vagy a megelőző intézkedésekkel szembeni szkepticizmus. A szerzők alap-és mesterszakos hallgatói mintán vizsgálták különböző prevenciós rendelkezések támogatottságának kapcsolatát a járvánnyal összefüggő kételyekkel és egyéb lehetséges magyarázó változókkal (bizalommal, világnézettel, betegséggel összefüggő tapasztalatokkal). Kovarianciaalapú strukturális egyenletek modelljére épülő útelemzésük megerősíti, hogy a Covid-szkepticizmus erős előrejelzője a megelőző intézkedések támogatottságának, valamint fontos közvetítő szerepe tölt be e rendelkezések elfogadása és annak magyarázó változói között. A válaszadóknak feltett kérdések sorrendjének hatása is szignifikáns, vagyis azok, akik kérdőívének elején a prevenciós intézkedésekkel szembeni szkeptikus érvek szerepeltek, valamivel kevésbé támogatják a járványügyi rendelkezéseket másokhoz képest. A társadalmi szolidaritás, a tudósokba vetett bizalom és - meglepő módon - a mások iránti bizalom hiánya pedig növelheti a Covid-elleni lépések elfogadottságát. Az utóbbi összefüggés arra utal, hogy amikor az emberek nem bíznak másokban, saját védelmük növelése érdekében szigorúbb szabályozást igényelnek. (Hungarian) [ FROM AUTHOR] Copyright of Hungarian Statistical Review / Statisztikai Szemle is the property of Hungarian Central Statistical Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Digitalizáció a munkában: táguló horizontok joghézagokkal

The focus of the study is on the emergence and spread of digitization in employment. In this context, the study presents the forms of work that use digitization. On the other hand, it describes the labour market effects of digitalization. The study looks in detail at how COVID-19 has changed the role of teleworking and the home office in employment. This is followed by the presentation of the Hungarian labour law regulation, which deals exclusively with telework. The study makes two proposals to address the codification gap. On the one hand, in connection with application-based work, the introduction of the status of a person with a similar legal status to an employee, which was regulated in the draft of the Labour Code. On the other hand, to impose employer obligations (retraining, job offers) in connection with the spread of automation and robotics in order to prevent dismissal.Alternate : A tanulmány fókuszában a digitalizációnak a foglalkoztatásban történő megjelenése és elterjedése áll. Ennek keretében a tanulmány egyrészt bemutatja a digitalizációt felhasználó munkavégzési formákat, másrészt ismerteti a digitalizáció munkaerőpiaci hatásait. A tanulmány részletesen vizsgálja, hogy a COVID-19 miként változtatta meg a távmunka és a home office szerepét a foglalkoztatásban. Ezt követi a magyar munkajogi szabályozás bemutatása, ami kizárólag a távmunkával foglalkozik. A kodifikációs hiányosság megszüntetésére a tanulmány két javaslatot is tesz. Egyrészt az applikációs alapú munkavégzéssel kapcsolatban az Mt. tervezetében már szabályozott, a munkavállalóhoz hasonló jogállású személy státuszának bevezetésére. Másrészt az automatizálás és a robotika terjedésével kapcsolatban munkáltatói kötelezettségek előírására (átképzés, munkakör felajánlás) a felmondás megelőzése érdekében.