[Age-specific regional characteristics of COVID-19 mortality in 2021]. / A COVID­19-halandóság életkor-specifikus regionális jellemzoi 2021-ben.

INTRODUCTION: In most countries, COVID-19 mortality increases exponentially with age, but the growth rate varies considerably between countries. The different progression of mortality may reflect differences in population health, the quality of health care or coding practices. OBJECTIVE: In this study, we investigated differences in age-specific county characteristics of COVID-19 mortality in the second year of the pandemic. METHOD: Age-specific patterns of COVID-19 adult mortality were estimated according to county level and sex using a Gompertz function with multilevel models. RESULTS: The Gompertz function is suitable for describing age patterns of COVID-19 adult mortality at county level. We did not find significant differences in the age progression of mortality between counties, but there were significant spatial differences in the level of mortality. The mortality level showed a relationship with socioeconomic and health care indicators with the expected sign, but with different strengths. DISCUSSION AND CONCLUSION: The COVID-19 pandemic in 2021 resulted in a decline in life expectancy in Hungary not seen since World War II. The study highlights the importance of healthcare in addition to social vulnerability. It also points out that understanding age patterns will help to mitigate the consequences of the epidemic. Orv Hetil. 2023; 164(17): 643-650.

Impact of the three waves of COVID-19 pandemic on the HR practices of Hungarian organizations-Experience from an empirical study.

Over recent decades, the practice of human resource management in the transitional countries of Eastern Europe and in Hungary has changed significantly. Especially in local subsidiaries of foreign-owned companies and in the leading domestic large organizations, HRM has become a strategic function, while in the practice of small and medium-sized enterprises it is less common. COVID-19 hit companies, institutions and individuals unexpectedly, not only in Hungary but also in the more developed regions of the world. This crisis has also highlighted the fact that larger and better prepared organizations and public institutions have found it easier to weather this global human catastrophe. We analyze how the key tasks of HRM have changed during the successive waves, along four hypotheses. Initially, health protection, communication and home-office organization were the focus of the work of human resource professionals. In the second and third waves, securing and retaining staff became more important.

Wastewater-based modeling, reconstruction, and prediction for COVID-19 outbreaks in Hungary caused by highly immune evasive variants.

(MOTIVATION): Wastewater-based epidemiology (WBE) has emerged as a promising approach for monitoring the COVID-19 pandemic, since the measurement process is cost-effective and is exposed to fewer potential errors compared to other indicators like hospitalization data or the number of detected cases. Consequently, WBE was gradually becoming a key tool for epidemic surveillance and often the most reliable data source, as the intensity of clinical testing for COVID-19 drastically decreased by the third year of the pandemic. Recent results suggests that the model-based fusion of wastewater measurements with clinical data and other indicators is essential in future epidemic surveillance. (METHOD): In this work, we developed a wastewater-based compartmental epidemic model with a two-phase vaccination dynamics and immune evasion. We proposed a multi-step optimization-based data assimilation method for epidemic state reconstruction, parameter estimation, and prediction. The computations make use of the measured viral load in wastewater, the available clinical data (hospital occupancy, delivered vaccine doses, and deaths), the stringency index of the official social distancing rules, and other measures. The current state assessment and the estimation of the current transmission rate and immunity loss allow a plausible prediction of the future progression of the pandemic. (RESULTS): Qualitative and quantitative evaluations revealed that the contribution of wastewater data in our computational epidemiological framework makes predictions more reliable. Predictions suggest that at least half of the Hungarian population has lost immunity during the epidemic outbreak caused by the BA.1 and BA.2 subvariants of Omicron in the first half of 2022. We obtained a similar result for the outbreaks caused by the subvariant BA.5 in the second half of 2022. (APPLICABILITY): The proposed approach has been used to support COVID management in Hungary and could be customized for other countries as well.

[Suicide mortality in Hungary during the COVID-19 pandemic.] / Öngyilkossági halálozás Magyarországon a COVID­19-pandémia idején.

INTRODUCTION: While suicide rates did not change (or decreased) in the first pandemic year (i.e., 2020) in the majority of countries, in Hungary the number of completed suicides rose significantly. OBJECTIVE: In our study, we investigated whether the unfavourable trend reversal of the Hungarian suicide rate following the outbreak of COVID-19 pandemic persisted in the second pandemic year. METHOD: We used an interrupted time-series analysis with Prais-Winsten regression, controlling for time and seasonal effects as well as autoregressive effects, to estimate the effect of the pandemic on the suicide rates of the Hungarian male, female and total populations in 2020 and 2021. RESULTS: In the first pandemic year, we observed a significant increase in suicide rates in males and the total population. Although the case numbers for males and the total population in 2021 exceeded the case numbers of the pre-pandemic year, regression estimates suggest that the increase in rates did not differ significantly from the pre-pandemic years in males and it was only found to be significant at the 10% level in the total population. DISCUSSION AND CONCLUSION: Based on the examination of data from the first two pandemic years, we may conclude that by 2021 the adverse effect of the pandemic on suicidality reduced in the total population and disappeared in males. The question remains open whether this favourable development will continue. Orv Hetil. 2022; 163(48): 1895-1901.

Validation of pandemic-specific version of the Perceived Stress Scale / Az Észlelt Stressz Kérdoív járványspecifikus verziójának validálása.

Összefoglaló. Bevezetés: Egyre több adat bizonyítja, hogy a COVID-19-járvány hatással van a pszichés egészségre, beleértve a megnövekedett észlelt stresszt is. Célkituzés: Az Észlelt Stressz Kérdoív 10 tételes, járványspecifikus verziójának (PSS-PAN) megalkotása, validitásának és megbízhatóságának tesztelése. Módszer: A skála faktorstruktúráját, konvergens és divergens validitását teszteltük egy internetes vizsgálat során (n = 1164; átlagéletkor: 38,57 év; szórás: 6,27 év; 84,2% no). Eredmények: Igazoltuk a PSS-PAN egykomponensu szerkezetét. A kérdoív továbbá szignifikánsan korrelált a rövidített Beck Depresszió Kérdoív (r = 0,41; n = 1164; p<0,001), a 4 tételes Észlelt Stressz Kérdoív (r = 0,46; n = 1164; p<0,001) és az Élettel Való Elégedettség Skála pontszámaival (r = -0,29; n = 1164; p<0,001). A nok esetében a PSS-PAN átlaga szignifikánsan magasabb volt, mint a férfiaknál (t(1162) = -7,135; p<0,001), de ez a hatásnagyság nagyon csekély volt (Cohen-féle d = 0,06). A PSS-PAN átlagpontszáma szignifikánsan nem különbözött a legmagasabb iskolai végzettség kategóriái mentén (F(6;1157) = 2,035; p = 0,06; η2 = 0,01). Az alsó középosztályba tartozó résztvevok átlagpontszáma szignifikánsan magasabb volt, mint a középosztályba tartozó kitöltoké a post hoc elemzés alapján (F(4;1159) = 3,461; p = 0,01; η2 = 0,01). A skála pontszáma nem korrelált szignifikánsan az életkorral (r = -0,04; n = 1164; p = 0,13). A Cronbach-alfa 0,89 volt, vagyis a kérdoív belso megbízhatósága kiváló. Megbeszélés: A skála egykomponensu struktúrát mutatott. A többi skálával való közepesen eros és gyenge korrelációja a skála validitását igazolta, és azt, hogy a járványhoz kapcsolódó észlelt stressz külön indikátora. Pontszámát nem vagy nem erosen befolyásolta a nem, a kor, az iskolázottság vagy a szocioökonómiai státusz. Következtetés: A PSS-PAN a járványokhoz kötodo stressz mérésének megfelelo eszköze. Orv Hetil. 2021; 162(35): 1391-1396. INTRODUCTION: A growing amount of evidence indicates that the COVID-19 pandemic influences mental health, including an increased level of perceived stress. OBJECTIVE: To develop and psychometrically investigate a pandemic-specific version of the Perceived Stress Scale (PSS-PAN) that measures stress related to the pandemic. METHOD: Factor structure as well as convergent and divergent validity of the 10-item PSS-PAN were examined on the data set of an online survey (n = 1164; mean age: 38.57 years; standard deviation: 6.27 years; 84.2% women). RESULTS: A one-factor structure for the PSS-PAN was confirmed. The scale correlated significantly with scores on the Shortened Beck Depression Inventory (r = 0.41; n = 1164; p<0.001), the 4-item Perceived Stress Scale (r = 0.46; n = 1164; p<0.001), and the Satisfaction with Life Scale (r = -0.29; n = 1164; p<0.001). Women's PSS-PAN scores were significantly higher than men's (t(1162) = -7.135; p<0.001) but this difference was trivial (Cohen's d = 0.06). Further, scale scores did not differ significantly across educational attainment (F(6;1157) = 2.035; p = 0.06; η2 = 0.01). Lower middle class participants' mean scores were significantly higher than those of middle-class respondents according to the post hoc test (F(4;1159) = 3.461; p = 0.01; η2 = 0.01). PSS-PAN scores did not correlate significantly with age (r = -0.04; n = 1164; p = 0.13). Cronbach's alpha was 0.89 indicating excellent internal consistency. DISCUSSION: The PSS-PAN has a single-component structure. Moderately strong and weak correlations with other scales support its convergent and divergent validity and indicate that it is a distinct indicator of pandemic-related perceived stress. Its total score was not or not strongly associated with gender, age, education level, or socioeconomic status. CONCLUSION: The PSS-PAN is a proper instrument to measure pandemic-specific perceived stress. Orv Hetil. 2021; 162(35): 1391-1396.

[E-physicians in Hungary: Experiences and opinions related to digital health among Hungarian physicians]. / E-orvosok Magyarországon: Digitális egészséggel kapcsolatos tapasztalatok és vélemények a hazai orvosok körében.

INTRODUCTION: The digitalization of healthcare is one of the most topical issues in terms of the present and future of healthcare. The coronavirus pandemic has shed light on the potential inherent in these technologies, and at the same time brought to the surface countless tasks and problems that need to be solved. OBJECTIVE: In our national survey, our aim is to find out how medical doctors are adapting to digital healthcare solutions. METHOD: Between July 2021 and May 2022, we conducted an online questionnaire survey among doctors working in Hungary. 1774 people answered our questions, including 1576 general practitioners and 198 dentists. In this paper, the 1576 general practitioners' responses are presented. RESULTS: 78.8% of the respondent doctors recommend websites to their patients on a more or less regular basis, 52.8% have recommended apps and 46.0% have recommended social media resources. The respondent doctors perceive a high demand from patients for communication by e-mail (83.7% indicated). 86.4% of doctors are aware of telemedicine solutions and 47.5% of respondents would like to use them intensively in the next 3 years. A significant proportion of respondents would like to use apps (56.2%), sensors, portable diagnostic devices (49.0%) and artificial intelligence (28.3%) in the next 3 years. Websites, apps and social media resources are significantly more frequently recommended by general practitioners and they are the ones who are most in favour of the use of the internet for patient health and telemedicine. CONCLUSION: Our respondents manifest fundamentally positive feelings towards the digitalization of healthcare and are characterized by a cautious openness regarding the implementation and adaptation of technologies. Orv Hetil. 2023; 164(4): 132-139.

West Nile virus infections in Hungary: Epidemiological update and phylogenetic analysis of the Hungarian virus strains between 2015 and 2022.

Following the introduction of the West Nile virus (WNV) into Hungary in 2004, it has shortly become one of the most important human arbovirus infections, with a gradually increasing number of cases. The study aimed to summarize the current epidemiological situation in Hungary and sequence the WNV PCR-positive clinical specimens and virus isolates by next-generation whole genome sequencing (NGS) to obtain a detailed phylogenetic analysis of the circulating virus strains. Whole blood and urine samples from confirmed WNV-infected patients and WNV isolates were investigated by reverse transcription PCR assays. Genome sequencing was carried out by Sanger-method, followed by NGS on the Illumina MiSeq platform. Altogether 499 human infections were diagnosed between 2004 and 2022. A particularly remarkable increase in human WNV infections was observed in 2018, while the number of reported cases significantly decreased during the COVID-19 pandemic. Between 2015 and 2022, 15 WNV isolates, and 10 PCR-positive clinical specimens were investigated by NGS. Phylogenetic analysis revealed that the major European WNV lineage 2 clades, namely the Eastern European (or Russian) and the Central European (or Hungarian) clades, are presented in Hungary. Strains of the Balkan and other European clusters within the Central European clade are co-circulating in the country, following a characteristic geographical distribution. In Hungary, the presence and co-circulation of multiple lineage 2 WNV strains could be identified in the last few years. Therefore, in light of the 2018 WNV outbreak, sequence-based typing of the currently circulating strains could highly support outbreak investigations.

First booster dose uptake of COVID-19 vaccine and disease-related factors in chronic obstructive pulmonary disease-a cross-sectional survey in Hungary.

BACKGROUND: In chronic obstructive pulmonary disease (COPD), uptake of the coronavirus disease 2019 (COVID-19) booster vaccine is important, as they are more likely to develop serious complications. Our aim was to investigate the uptake rate of first booster vaccination against COVID-19 among COPD patients and to identify other related factors of vaccine uptake. METHODS: We conducted a multicenter survey of COPD patients in Hungary by region: eastern, western and central ones from 15 November 2021. Respiratory function test results, anthropometric data and vaccination status were recorded for 1,510 randomly selected patients over 35 years of age. Multiple logistic regression analysis was used to determine factors associated with uptake of COVID-19 first booster dose vaccines. RESULTS: The average age was 67 [61-72] years, for men it was: 67 [62-73] and 66 [60-72] years for women, with a sample of 47.95% men and 52.05% women. The uptake rate of the COVID-19 first booster vaccine during the study period was 62.45%. Comparing patients who received the 3rd vaccine with those who did not receive the 3rd vaccine, the difference was significant in quality of life: COPD Assessment Test (CAT): 16 [11-21] vs. 14 [10-19], P<0.001, modified Medical Research Council (mMRC) dyspnea scale: 2 [2-2] vs. 2 [1-2], P=0.01 and in the number of moderate exacerbations: 1 [0-1] vs. 0 [0-1], P=0.04. In addition, who did not take the third vaccination significantly more people were hospitalized for acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (16 vs. 0, P<0.001) and almost the same proportion (n=14) required pulmonary outpatient rehabilitation for post-COVID symptoms. The factors that were most associated with higher COVID-19 vaccine first booster dose uptake were older age [odds ratio (OR): 1.06; 95% confidence interval (CI): 1.04-1.08], male gender (OR: 0.74; 95% CI: 0.57-0.96), absence of previous COVID-19 infection (OR: 0.34; 95% CI: 0.23-0.51). CONCLUSIONS: The uptake rate of the COVID-19 booster vaccine among COPD patients in Hungary is lower than the target, and is associated with disease-related factors, and age, sex, previous COVID infection. The global COVID-19 vaccination target is 70% and 100% for elderly, vulnerable patients. Highlighting the importance of taking booster vaccine(s) should be a priority for health workers.

Outcomes of high-risk adult outpatients treated with early remdesivir therapy during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron era: experiences from the national centre of Hungary.

Emerging evidence suggests that remdesivir might improve clinical outcome of high-risk outpatients with coronavirus disease 2019 (COVID-19). Our aim was to evaluate characteristics and outcomes of nonhospitalised adults diagnosed with COVID-19 and treated with early remdesivir therapy during the omicron wave. A single-centre prospective cohort study was performed among adult patients between February and June 2022, during the circulation of phylogenetic assignment of named global outbreak (PANGO) subvariants BA.2, BA.4, and BA.5 in Hungary. Patients were enrolled based on pre-defined criteria. Clinical characteristics (demography, comorbidities, vaccination status, imaging, treatment, and disease course) and outcomes (COVID-19 related hospitalisation, oxygen supplementation, intensive care support, and all-cause death) were assessed at 28 days post-treatment. A subgroup analysis of patients with and without active haematological malignancies was also carried out. Altogether, 127 patients were enrolled: 51.2% (65/127) were female with a median age of 59 (IQR: 22, range: 21‒92) years, and 48.8% (62/127) had active haematological malignancy. At 28 days post-treatment, 7.1% (9/127) of patients required COVID-19-related hospitalisation, 2.4% (3/127) required oxygen supplementation, 1.6% (2/127) required intensive care, and 0.8% (1/127) died due to a non-COVID-19-related secondary infection at the intensive care unit, all with haematological malignancies. Early remdesivir treatment might be a feasible strategy among high-risk outpatients with COVID-19 during the omicron wave.

Vaccine attributes and vaccine uptake in Hungary: evidence from a conjoint experiment.

BACKGROUND: In an ongoing public health crisis, the question of why some people are unwilling to take vaccines with particular attributes is an especially pertinent one, since low rates of vaccination mean that it will take longer for many nations to exit the coronavirus disease 2019 (COVID-19) pandemic. METHODS: In this article, we conduct a pre-registered conjoint experiment in Hungary (N = 2512), where respondents were asked about their attitudes towards hypothetical COVID-19 vaccines whose characteristics varied across a number of attributes. RESULTS: Results indicate that vaccine attributes matter for the likelihood of uptake when it comes to the prevalence of severe side effects, efficacy and country of origin. Moreover, we find that our pre-treatment measure of institutional trust moderates the effect of our treatment, as differences in vaccine attributes are larger for those with robust levels of institutional trust compared to those with weaker levels. CONCLUSION: Our findings suggest that institutional trust matters when it comes to understanding the relationship between vaccine attributes and likelihood of uptake.

Magyarország helye Európa transzplantációs térképén.

INTRODUCTION: The incidence of organ transplantation between the Eastern and Western part of Europe is quite different. This has several reasons; the main cause may be the Great Schism (A. D. 1054) when the Byzantine Empire separated himself also religiously from Rome. Since then there has been a different historical development followable until our days. Later on, disintegration of four previous large empires into many smaller countries during the last 150 years, furthermore in the second half of the twentieth century the separation by the Iron Curtain in the middle of Europe led to different social-economic and infrastructural developments between the different parts of the continent. In the new millennium, all transplantations for the routinely performed 5 organs were available for the Hungarian patients, but the real era-changing happened in 2012/13 by joining Eurotransplant. OBJECTIVE: Our analysis is based on the transplantation numbers of the last pre-COVID pandemic year (2019). RESULTS: The abovementioned differences can be traced well by the transplantation numbers: 28 Western- and Middle-European countries have 22.2 cadaveric donors per million population versus 3.8 for 10 Eastern-European countries and another 7 do not have any. The numbers of transplanted organs are the following: 39.5 vs. 12.0 for kidney; 14.8 vs. 5.5 for liver; 5.4 vs. 0.8 for heart; 4.6 vs. 0.2 for lung. DISCUSSION: The statistics have also a rejoicing message because since the fall of the Iron Curtain, 10 Middle-European countries could reach the Western standards in organ transplantation. Their example is also good news for other Eastern European countries. CONCLUSION: Hungary was one of these countries who could benefit from the political changes and, by joining Eurotransplant, the quantity and quality of the transplanted organs was raised significantly: since then, there are by 40% more transplantations performed in our country. Orv Hetil. 2022; 163(30): 1181-1188.

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.

Internet-based health communication opportunities (blogs, podcasts, video channels) and the social media / Internetalapú egészségkommunikációs lehetoségek (blogok, podcastok, videócsatornák) és a közösségi média.

Összefoglaló. Az elmúlt években mind laikus, mind szakmai oldalról az internet vált az elso számú egészségügyi információforrássá, amit a COVID-19-pandémia tovább fokozott. Az online térben számos, különbözo jellegu platform áll rendelkezésre egészségkommunikációs célokra, melyek markánsan különböznek egymástól az átadható információ mennyiségében és minoségében, a létrehozásukhoz szükséges anyagi vagy idobeli ráfordításban, továbbá az ott létrehozott tartalom fogyasztási lehetoségeiben. Összefoglaló közleményünkben rendszerezve mutatjuk be a szöveg-, a hang-, illetve a videóalapú online egészségügyi edukációs formák elonyeit és hátrányait. Külön foglalkozunk a közösségi média (social media) egészségügyi vonatkozásaival, a benne rejlo lehetoségekkel, kiemelve a pandémia kapcsán felmerült problémákat. Az egyes platformok egészségüggyel kapcsolatos történelmének feldolgozása mellett gyakorlati oldalról mutatjuk be azok hasznosíthatóságát, elosegítve ezzel az online térbe terelt kollégák munkáját. Orv Hetil. 2022; 163(4): 132-139. Summary. In recent years, the internet has become the leading source of health-related information for both professionals and laymen, and this process has been further speeded up by the Covid-19 pandemic. There are many different platforms available for health communication purposes online, that vary greatly in the quantity and quality of transferable information; the time or financial input, which are necessary to create them; and the possibilities of the utilization of the created content. In our review, we present systematically the advantages and disadvantages of the text-, audio-, and video-based online health-related education platforms. We specify the health-related aspects of social media and its potential usability, focusing on the problems allied to the pandemic. We present the practical use of the different platforms from a healthcare perspective through the review of their respective histories, thus providing guidance to the colleagues working online. Orv Hetil. 2022; 163(4): 132-139.

E-páciensek Magyarországon: Digitális egészséggel kapcsolatos ismeretek, szokások egy országos reprezentatív felmérés tükrében.

INTRODUCTION: The impact of digitalisation on healthcare has become one of the most important research areas in recent years. The COVID-19 epidemic has been a major driver in this process. OBJECTIVE: In our nationally representative, population-based survey (n = 1500), we sought to find out how patients in Hungary use digital health tools, what the advantages and disadvantages of introducing and using these technologies are, and how this is transforming the doctor-patient relationship. METHODS: We conducted a national representative telephone questionnaire survey (CATI). The sample is representative of the adult population of Hungary in terms of gender, age, type of settlement and education. RESULTS: 81.3% of the respondents use the internet - 87.6% of whom use it in relation to health and illness, too. This is 71.2% of the total sample. Websites (76.3%) and social media (47.3%) are the main sources of information on the internet; e-prescription and online appointment booking are the most known by patients (92.6% and 85.2%, respectively), while almost half of the respondents would like to try telehealth and would welcome a recommendation from their doctor on reliable websites, apps and sensors. Our results highlighted that the effect of the type of settlement on access to digital health is not significant, but that the effect of age, education and gender is decisive. CONCLUSION: Data from our national representative population survey indicate that the use of digital health solutions is already an integral part of care and that there is a strong demand for further digital options. Orv Hetil. 2022; 163(29): 1159-1165.

Validation of the Hungarian Version of the COVID Stress Scale (CSS-H).

(1) Background: The COVID-19 pandemic is unprecedented and has affected every social class. The prevalence of moderate-to-severe stress and anxiety levels in the general population was reported to be 25%. This study aimed to describe the validation of the Hungarian version of the COVID Stress Scale. (2) Methods: The research study was a cross-section validation study with a representative sample (N = 1200) and a non-representative student sample (N = 350). The translation procedure was a four-step procedure. The interviewers conducted the data collection. (3) Results: The reliability of the Hungarian CSS was assessed using Cronbach's alpha. Convergent validity was evaluated by correlating the CSS with the PSS and WHO-WBI5. The Cronbach's alpha coefficient of the CSS-H factors was between 0.844 and 0.907 (representative sample) and between 0.878 and 0.936 (student sample), which qualified as very good. The reliability of the internal consistency was good for all six factors in both samples. The CSS-H total and all-domain scores significantly and positively correlated with the PSS total score and negatively correlated with well-being. (4) Conclusions: The Hungarian COVID Stress Scale is a valid, reliable instrument to measure COVID-19-related distress in the Hungarian population.

Burnout and occupational stress among Hungarian radiographers working in emergency and non-emergency departments during COVID-19 pandemic.

INTRODUCTION: The increased workload caused by the coronavirus pandemic may have had a significant impact on the mental health of radiographers. The aim of our study was to investigate burnout and occupational stress in radiographers working in emergency departments (ED) and non-emergency departments (NED). METHODS: Quantitative, cross-sectional, descriptive research was carried out among radiographers working in the public health sector in Hungary. Due to the cross-sectional nature of our survey, there was no overlap between the ED and NED groups. For data collection, we used simultaneously the Maslach Burnout Inventory (MBI), the Effort-Reward Imbalance questionnaire (ERI), and our self-designed questionnaire. RESULTS: We excluded incomplete questionnaires from our survey; finally, 439 responses were evaluated. Significantly higher scores for depersonalisation (DP; 8.43 (SD = 6.69) vs. 5.63 (SD = 4.21) and emotional exhaustion (EE; 25.07 (SD = 11.41) vs. 19.72 (SD = 11.72)) were observed in radiographers working in ED (p = 0.001; p = 0.001) when compared to NED. Male radiographers working in ED aged 20-29 and 30-39 years with experience of 1-9 years were more affected by DP (p ≤ 0.05). Worrying about one's own health had a negative effect on DP and EE (p ≤ 0.05). Having close friend with a COVID-19 infection had a negative effect on EE (p ≤ 0.05); not being infected with coronavirus, not being quarantined and relocating within the workplace had a positive effect on personal accomplishment (PA); radiographers who were 50 years or older with 20-29 years of experience were more affected by depersonalisation (DP); and those who worried about their health had significantly higher stress scores (p ≤ 0.05) in both ED and NED settings. CONCLUSION: Male radiographers at the beginning of their careers were more affected by burnout. Employment in EDs had a negative impact on DP and EE. IMPLICATIONS FOR PRACTICE: Our results support the implementation of interventions to counter the effects of occupational stress and burnout among radiographers working in ED.

The Role of Sports in the Subjective Psychological Well-Being of Hungarian Adult Population in Three Waves of the COVID-19 Pandemic.

(1) Background: In this study, sport and subjective psychological well-being is investigated in three waves of the COVID-19 pandemic. (2) Methods: We have conducted three different representative sample surveys (n = 3600 altogether) on the Hungarian adult population and investigated the sample's subjective psychological well-being with the WHO-5 Well-Being Index, as well as changes in their subjective well-being through the different waves of the pandemic. Sporting habits and socio-economic variables were also surveyed, and OLS regression models were created focused on the WHO-5 measures. (3) Results: The subjective psychological well-being of the Hungarian adult population decreased significantly, but in the second and third wave of pandemic restrictions, an increase in subjective psychological well-being has been measured. The relationships between the time spent on doing sports and subjective psychological well-being were significant in each pandemic waves. The highest subjective psychological well-being and its highest increase were reported by those who could increase their time spent on doing sports as well. (4) Conclusions: The relationships between the sports activities, physical health, size of settlement, changes in income and subjective psychological well-being of the Hungarian adult population were significant in all three waves of the COVID-19 pandemic.

Pomalidomide Treatment in Relapsed/Refractory Multiple Myeloma Patients-Real-World Data From Hungary.

Pomalidomide is a third generation immunomodulatory drug in the treatment of refractory and relapsed multiple myeloma patients. Our aim was to investigate the efficacy and safety of pomalidomide therapy in a real world setting. Eighty-six Hungarian patients were included, 45 of whom received pomalidomide ± an alkylating agent, while in 38 of them pomalidomide was combined with a proteasome inhibitor. 56 patients (65%) showed any response to the treatment with 18 complete or very good partial remissions and 38 partial remissions. At a median duration of follow-up of 18.6 months, the median progression-free survival (PFS) was 9.03 months, while the median overall survival (OS) was 16.53 months in the whole cohort. Patients with early stage disease (R-ISS 1 and 2) had better survival results than those with stage 3 myeloma (p = 0.002). Neither the number of prior treatment lines, nor lenalidomide refractoriness had a significant impact on PFS. PFS was found similar between the cohort of patients with impaired renal function and the cohort without kidney involvement. During the study, eight mortal infections and two fatal bleeding complications occurred, however, mild hematologic and gastrointestinal toxicities were identified as the most frequent adverse events. The results of our investigations confirm that pomalidomide is an effective treatment option for relapsed/refractory MM, besides, the safety profile is satisfactory in subjects with both normal and impaired renal function.

What is being done to respond to the rise of chronic diseases and multi-morbidity in Czechia, Hungary, Poland, and Slovakia?

Although countries in central and eastern Europe (CEE) have relatively younger populations compared to the West, their populations are often affected by higher prevalence of chronic conditions and multi-morbidity and this burden will likely increase as their populations age. Relatively little is known about how these countries cater to the needs of complex patients. This Perspective piece identifies key initiatives to improve coordination of care in Czechia, Hungary, Poland, and Slovakia, including some pioneering and far-reaching approaches. Unfortunately, some of them have failed to be implemented, but a recent strategic commitment to care coordination in some of these countries and the dedication to rebuilding stronger health systems after the COVID-19 pandemic offer an opportunity to take stock of these past and ongoing experiences and push for more progress in this area.

The Impact of Comorbidities and Obesity on the Severity and Outcome of COVID-19 in Hospitalized Patients-A Retrospective Study in a Hungarian Hospital.

Patients with comorbidities and obesity are more likely to be hospitalized with coronavirus disease 2019 (COVID-19), to have a higher incidence of severe pneumonia and to also show higher mortality rates. Between 15 March 2020 and 31 December 2021, a retrospective, single-center, observational study was conducted among patients requiring hospitalization for COVID-19 infection. Our aim was to investigate the impact of comorbidities and lifestyle risk factors on mortality, the need for intensive care unit (ICU) admission and the severity of the disease among these patients. Our results demonstrated that comorbidities and obesity increased the risk for all investigated endpoints. Age over 65 years and male sex were identified as independent risk factors, and cardiovascular diseases, cancer, endocrine and metabolic diseases, chronic kidney disease and obesity were identified as significant risk factors. Obesity was found to be the most significant risk factor, associated with considerable odds of COVID-19 mortality and the need for ICU admission in the under-65 age group (aOR: 2.95; p < 0.001 and aOR: 3.49, p < 0.001). In our study, risk factors that increased mortality and morbidity among hospitalized patients were identified. Detailed information on such factors may support therapeutic decision making, the proper targeting of vaccination campaigns and the effective overall management of the COVID-19 epidemic, hence reducing the burden on the healthcare system.