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.

[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.

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.

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.

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.

Examination of Preferences for COVID-19 Vaccines in Hungary Based on Their Properties-Examining the Impact of Pandemic Awareness with a Hybrid Choice Approach.

The COVID-19 pandemic has posed a huge challenge to the world in recent years. The development of vaccines that are as effective as possible and accessible to society offers a promising alternative for addressing the problems caused by this situation as soon as possible and to restore the pre-epidemic system. The present study investigated the preferences of residents in Hungary's second-largest city (Debrecen) for the COVID-19 vaccine. To achieve this aim, a discrete choice experiment was conducted with 1011 participants, and the vaccine characteristics included in the design of the experiment were determined by qualitative methods and a pilot survey: (1) country of origin; (2) efficiency; (3) side effect; and (4) duration of protection. During the data collection at three vaccination sites, respondents were asked to choose between three vaccine alternatives and one "no choice" option in eight decision situations. Discrete choice model estimations were performed using a random parameter logit (RPL) specification with the final model extended to include a latent variable measuring pandemic awareness. The results showed that the vaccine with a Chinese country of origin is the least preferred among the respondents, while the Hungarian and the European vaccines are the most preferred. Furthermore, the increase in the vaccine efficiency level increased the respondents' sense of utility for the vaccine; the short-term side effect was preferred to the long-term one; and the increase in the duration of protection provided by the vaccine increased the respondents' sense of utility for the vaccine. Based on the parameter estimated for the latent variable, it can be concluded that as the level of pandemic awareness (which is more positive among people with chronic diseases and less important among health workers) increases, the choice of a vaccine option becomes more preferred among respondents compared to the "no choice". The results of our investigation could contribute towards increasing compliance in the case of the vaccination-rejecting population, not only for COVID-19, but for any kind of vaccination procedure.

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.

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.

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.

Telemedicine in community shelters: possibilities to improve chronic care among people experiencing homelessness in Hungary.

BACKGROUND: Digital health has expanded during the COVID-19 pandemic, while the exclusion of vulnerable populations with limited access to these technologies widens the gap to receive proper care. There is very little data available on the feasibility of telemedicine solutions regarding the chronic care of homeless persons. METHODS: In our study, 75 participants experiencing homelessness were recruited from four social institutions in Budapest, Hungary. The telecare pilot service consisted of six online consultations with a physician and was available in shelters biweekly. Self-developed questionnaires were used after every online session on the originating and remote sites as well, while a follow-up study was also completed among patients after four to six months of pilot closure. Parameters as frequencies, averages, and percentage distributions were analyzed and two linear regression models were built on explaining the doctors' and patients' overall rating of visits. RESULTS: During the pilot, 92.2% (n = 415) of originally planned visits were delivered and 55 clients (73.3%) attended the full program. Both the patients' and physicians' overall satisfaction was very high (4.52 and 4.79, respectively, on a 5-point Likert scale) and the patients' overall rating remained similarly high during the follow-up. Comparing the first and sixth visits, physicians reported significant improvements in almost all aspects. The linear regression models proved that confidence in the patients' assessment and diagnosis had the most prominent effect on the physicians' overall rating, while ease of use and lack of communication gaps influenced positively the patients' rating. CONCLUSION: The results suggest that telehealth services represent a promising tool to ensure better care continuity while using shelter infrastructure and on-site assistance might reduce the digital exclusion of people experiencing homelessness.

An empirical assessment of the factors influencing acceptance of COVID-19 vaccine uptake between Kenyan and Hungarian residing populations: A cross-sectional study.

The development of effective, safe, and acceptable vaccines is a long process. COVID-19 vaccine hesitancy continues to elicit mixed reactions among different quarters despite numerous evidence of their effectiveness. This study aimed to determine the availability and acceptance rates of SARS-CoV-2 vaccines, among Kenyan and Hungarian residing populations and the underlying reasons contributing to the hesitancy of uptake. A non-probability, snowball sampling design was employed, and a survey questionnaire tool link was expeditiously disseminated. Data were carefully analyzed descriptively. Demographic variables, COVID-19 awareness, possible exposure, reasons associated with hesitancy in taking up a vaccine, choice of a vaccine, and availability of vaccines among other important variables were tested to explore their associations with vaccine acceptance rates between the two distinct countries. A total of 1960 participants were successfully enrolled in the research study, while 67 participants were excluded based on the inclusion criterion set. There was, however, no significant difference in COVID-19 public awareness between the Kenyan and Hungarian-residing participants, p = 0.300. Of the respondents, 62.4% were willing and ready to receive vaccines against COVID-19 disease. There was a significant difference (p = 0.014) between the Kenyan and Hungarian-residing respondents concerning vaccine uptake and acceptance rates. The vaccine acceptance rates in Hungary were higher than in Kenya, with mean = 0.27, SD = 0.446, S. E = 0.045 for the Hungarian population sample and mean = 0.40, SD = 0.492, S. E = 0.026, for the Kenyan sample respectively. Concerning gender and vaccine acceptance, there was a notable significant difference between males and females, p = 0.001, where the mean for males and females were 0.29 and 0.46 respectively. Acceptance rates among males were higher than among females. The functions of One-Way ANOVA and Chi-square were used to establish any significant differences and associations between means and variables respectively. Concerns regarding the safety, efficacy, and accuracy of information about the developed vaccines are significant factors that must be promptly addressed, to arrest crises revolving around COVID-19 vaccine hesitancy, especially in Kenya and among females in both populations, where acceptance rates were lower. Expansion of the screening program to incorporate antibody (serology) tests, is also highly recommended in the present circumstance. Equitable distribution of vaccines globally should be encouraged and promoted to adequately cover low- and middle-income countries. To enhance effective combat on vaccination hesitancy and apprehension in different countries, mitigation techniques unique to those countries must be adopted.

Discriminatory attitudes against unvaccinated people during the pandemic.

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

Suicide in Hungary during the first year of the COVID-19 pandemic: Subgroup investigations.

BACKGROUND: COVID-19 may unfavourably affect the mental health of individuals in various ways. Accordingly, the concern has been raised that national suicide rates will increase in the wake of the outbreak of the pandemic. METHODS: In the current study, we tested this conjecture in three age groups (<25; 25-64; ≥65) of the Hungarian total population and the male and female populations. In addition, we assessed whether the pandemic had different effects on counts of suicides committed by violent or non-violent methods. Finally, by comparing the monthly suicide rates in 2020 and the corresponding monthly rates in 2019, we also investigated the "pulling together" hypothesis that postulates that a temporary decrease in suicides may occur after large-scale catastrophic events. RESULTS: With regard to the total population only the suicide counts of individuals aged 25-64 rose significantly (p < 0.05) during the COVID months of 2020. Similar patterns, but at lower levels of significance (0.05 < p < 0.1), were found in those members of the total population aged 65 or older and among males aged between 25 and 64. Furthermore, we found that the number of violent suicides increased significantly (p < 0.05) during the COVID months. Finally, our results have not confirmed the existence of a "pulling together" phenomenon in association with the COVID-19 pandemic in Hungary. LIMITATIONS: We used non-individual level data and were therefore unable to control suicide risk factors at the level of individuals. DISCUSSION: The number of suicides rose significantly in some subgroups of the Hungarian population during the COVID months of 2020.

The impact of the COVID-19 pandemic on suicide rates in Hungary: an interrupted time-series analysis.

BACKGROUND: From 2010 to 2019, suicide mortality fell steadily and substantially in Hungary: the declining trend remained stable, and the suicide rate decreased by more than one-third which was remarkable even from an international perspective. However, despite the declining trend, regional inequalities have always characterised the distribution of suicide mortality in Hungary. Following these favourable trends, COVID-19 appeared in Hungary on the 4th of March 2020 which might lead to an increase in suicides. We aimed to investigate this hypothesis in Hungary by gender, age, educational attainment, and region, as well. METHODS: To test whether the pandemic changed the declining trend of Hungarian suicide rates, the observed number of suicides during March-December 2020 (pre-vaccination period) was compared with the expected numbers (without the appearance of COVID-19). An interrupted time-series analysis was conducted by negative binomial regression using monthly data from January 2010 to February 2020 (pre-pandemic period). RESULTS: Suicide mortality increased significantly compared to the trend during the pre-pandemic period: overall (by 16.7%), among males (18.5%), in the age group 35-49 years (32.8%), and among vocational school graduates (26.1%). Additionally, significant growths in suicide rates were detected in the two regions (Central Hungary and Central Transdanubia) with the lowest COVID mortality rates (by 27.3% and 22.2%, respectively). CONCLUSIONS: Our study revealed reversed trend in suicide mortality during the pre-vaccination period compared to the pre-pandemic period in Hungary. There were significant differences in the pattern of suicide rates by gender, age group, educational attainment, and region during the pre-vaccination period in Hungary, which might be attributed to the socio-economic effects of the COVID-19 pandemic. These findings could prove useful in preventive strategies as the identification of groups at higher risk may be important for suicide prevention; however, further investigations are needed to explore the reasons.

Discriminatory attitudes against unvaccinated people during the pandemic.

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

SARS-CoV-2 variant detection from wastewater: rapid spread of B.1.1.7 lineage in Hungary.

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

Perceived usefulness of yoga to maintain well-being and in relation to COVID-19 cases among Hungarian yoga practitioners.

BACKGROUND: The present COVID-19 epidemic has had a considerable impact on the mental health of individuals worldwide. Research projects suggests potential benefits of yoga practice for prevention, or as medical supplementation in relation to the present pandemic. This study investigated the association between yoga and health status, and how the frequency of yoga practice affected the mental well-being (MWB) of the respondents. METHODS: Hungarian yoga practitioners (N.=379) aged 20 to 75 years (93.4% female) were asked about their personal health, perceived usefulness of yoga practice for COVID-19 cases and their MWB. Data were collected between April 17 and May 17, 2021. The measurement tool used was an online questionnaire including sociodemographic data, characteristics of yoga practice, COVID-19 and health related questions, and WHO Well-being Index (WBI-5). Associations were examined through ANOVA and χ2 tests. RESULTS: There was a significant difference among the yoga practice groups by weekly frequency (once a week, 2-3 times a week, 4-5 times a week, daily) on the total mean score of well-being (WBI-5), F (3, 373) =12.97, P<0.001, ηp2=0.094. The daily practice of yoga showed the highest MWB. CONCLUSIONS: According to our findings, it can be stated that regular yoga practice is associated with higher level of MWB which can be successful in dealing with COVID-19 issues such as stress and depression.

The effect of COVID-19 pandemic on myocardial infarction care and on its prognosis - Experience at a high volume Hungarian cardiovascular center.

Introduction: The COVID-19 pandemic has impacted many aspects of acute myocardial infarction. Based on literature data, the prognosis of COVID+, STEMI patients is significantly worse than that of COVID- STEMI patients. On the other hand, physicians report fewer acute coronary syndrome (ACS) patients presenting to hospitals in countries severely affected by the pandemic. It is concerning that patients with life-threatening illness can suffer more complications or die due to their myocardial infarction. We aimed to investigate the changes in myocardial infarction care in the country's biggest PCI-center and to compare total 30-day mortality in COVID+ and COVID-patients with acute myocardial infarction treated at the Semmelweis University Heart and Vascular Center, and to investigate risk factors and complications in these two groups. Methods: Between 8 October 2020 and 30 April 2021, 43 COVID+, in 2018-2019, 397 COVID-patients with acute myocardial infarction were admitted. Total admission rates pre- and during the pandemic were compared. Results: Within 30 days, 8 of 43 patients in the COVID+ group (18.60%), and 40 of the 397 patients in the control group (10.07%) died (P = 0.01). Regarding the comorbidities, more than half of COVID+ patients had a significantly reduced ejection fraction (EF≤ 40%), and the prevalence of heart failure was significantly higher in this group (51.16% vs. 27.84%, P = 0.0329). There was no significant difference between the two patient groups in the incidence of STEMI and NSTEMI. Although there was no significant difference, VF (11.63% vs. 6.82%), resuscitation (23.26% vs. 10.08%), and ECMO implantation (2.38% vs. 1.26%) were more common in the COVID+ group. The mean age was 68.8 years in the COVID+ group and 67.6 years in the control group. The max. Troponin also did not differ significantly between the two groups (1,620 vs. 1,470 ng/L). There was a significant decline in admission rates in the first as well as in the second wave of the pandemic. Conclusions: The 30-day total mortality of COVID+ patients was significantly higher, and a more severe proceeding of acute myocardial infarction and a higher incidence of complications can be observed. As the secondary negative effect of the pandemic serious decline in admission rates can be detected.

Key issues in the effectiveness of public financial tools to support childbearing the example of Hungary during the COVID-19 crisis.

The propensity to have children, which, according to the view accepted in the literature, is a good predictor of actual childbearing, is of particular importance in countries with low fertility rates and economic prosperity. In this paper, we report the results of a representative survey of 15,700 respondents in 2021 of university students in an emerging market economy in Central Europe, mapping their intentions to have children. The PLS-SEM data analysis method was used to test our hypotheses on the relationships between social, economic, and environmental variables of childbearing. Our results confirm the dominant role of socio-cultural inclusiveness in childbearing, over socio-economic and environmental-economic factors. The novelty of our research lies in the impact analysis of family policy incentives; however, our results are consistent with those documented in the literature, namely, the primacy of socio-cultural factors in the willingness of childbearing.

Heterogeneous impact of the COVID-19 pandemic on lung, colorectal and breast cancer incidence in Hungary: results from time series and panel data models.

OBJECTIVE: During the COVID-19 pandemic, health system resources were reallocated to provide care for patients with COVID-19, limiting access for others. Patients themselves also constrained their visits to healthcare providers. In this study, we analysed the heterogeneous effects of the pandemic on the new diagnoses of lung, colorectal and breast cancer in Hungary. DESIGN: Time series and panel models of quarterly administrative data, disaggregated by gender, age group and district of residence. PARTICIPANTS: Data for the whole population of Hungary between the first quarter of 2017 and the second quarter of 2021. MAIN OUTCOME MEASURES: Number of patients newly diagnosed with lung, colorectal and breast cancer, defined as those who were hospitalised with the appropriate primary International Classification of Diseases Tenth Revision diagnosis code but had not had hospital encounters with such a code within the previous 5 years. RESULTS: The incidence of lung, colorectal and breast cancer decreased by 14.4% (95% CI 10.8% to 17.8%), 19.9% (95% CI 12.2% to 26.9%) and 15.5% (95% CI 2.5% to 27.0%), respectively, during the examined period of the pandemic, with different time patterns across cancer types. The incidence decreased more among people at least 65 years old than among the younger (p<0.05 for lung cancer and p<0.1 for colorectal cancer). At the district level, both the previously negative income gap in lung cancer incidence and the previously positive income gap in breast cancer incidence significantly narrowed during the pandemic (p<0.05). CONCLUSIONS: The decline in new cancer diagnoses, caused by a combination of supply-side and demand-side factors, suggests that some cancer cases have remained hidden. It calls for action by policy makers to engage individuals with high risk of cancer more in accessing healthcare services, to diagnose the disease early and to prepare for effective management of patient pathways from diagnosis to survival or end-of-life care.