[Adolescents' sleep quality in the context of Internet use]. / Serdülok alvásminosége az internethasználattal összefüggésben.

Background and purpose: Background and purpose - The present study is a continuation of our previous research, our aim is to assess the sleep quality of adolescents in light of Internet use. Methods: We conducted a cross-sectional, quantitative, descriptive questionnaire survey among students aged 12-18 in primary and secondary education (n = 308). A self-edited questionnaire, a scale of sleep hygiene rules, and the Athens Insomnia Scale were used. Results: On the Athens Insomnia Scale, they scored an average of 5.39 (3.93) points, with 17% of adolescents considered insomniac. Students watch an average of 1.27 (1.04) hours of film a day, and 47% of them use the Internet for more than two hours a day. Excessive internet use (p < 0.001) and use of smart devices before falling asleep (p = 0.002) have a negative effect on sleep quality. Stress increases in parallel with Internet use (p = 0.001). Those who sleep better perform better in school (p = 0.034). Conclusion: Excessive use of smart devices is associated with higher stress levels and poorer sleep quality. Our goal is to draw the attention of parents and adolescents to the reduction of Internet use and the possible consequen-ces of deteriorating sleep quality.

Fecal calprotectin levels in pediatric cow's milk protein allergy.

Introduction: The most prevalent food allergy in younger children is cow's milk protein allergy (CMPA), a hypersensitivity reaction to cow's milk protein and its most common clinical manifestation is allergic colitis. The goal of our recent study was to assess somatic symptoms of CMPA and to prospectively observe the effects of a dairy elimination diet using objective parameters and questionnaires. Methods: The County Hospital in Szekszárd, Hungary, investigated children aged 1 to 18 who had clinical signs that might indicate CMPA. Stool samples were taken and analyzed using a fecal calprotectin (FC) rapid test (Quantum Blue fCAL, Bühlmann Laboratories, Switzerland) at the time of the diagnosis and following 3 months of an elimination diet. At the baseline visit as well as the first and second follow-up, questionnaires were filled out. Patients were divided into two subgroups according to dietary guidelines based on the results of the questionnaires. Results: A total of 47 patients participated in the study [42.55% female, mean age: 7.36 (SD 4.22) years]. There was no significant difference in FC levels between baseline and after 3-month elimination diet [73.98 (71.12) µg/g and 68.11 (74.4) µg/g, respectively, p = 0.331]. After three months, there was a significant decrease in FC levels among patients who adhered to the strict diet [84.06 (79.48) µg/g and 41.11 (34.24) µg/g, respectively, p = 0.001]. Conclusion: The findings of our study suggest that FC can be an objective marker in confirming the diagnosis of CMPA. Significant improvement in clinical symptoms and in FC levels can only be expected after a strictly followed elimination diet.

Regional Variation of Gap Junctional Connections in the Mammalian Inner Retina.

The retinas of many species show regional specialisations that are evident in the differences in the processing of visual input from different parts of the visual field. Regional specialisation is thought to reflect an adaptation to the natural visual environment, optical constraints, and lifestyle of the species. Yet, little is known about regional differences in synaptic circuitry. Here, we were interested in the topographical distribution of connexin-36 (Cx36), the major constituent of electrical synapses in the retina. We compared the retinas of mice, rats, and cats to include species with different patterns of regional specialisations in the analysis. First, we used the density of Prox1-immunoreactive amacrine cells as a marker of any regional specialisation, with higher cell density signifying more central regions. Double-labelling experiments showed that Prox1 is expressed in AII amacrine cells in all three species. Interestingly, large Cx36 plaques were attached to about 8-10% of Prox1-positive amacrine cell somata, suggesting the strong electrical coupling of pairs or small clusters of cell bodies. When analysing the regional changes in the volumetric density of Cx36-immunoreactive plaques, we found a tight correlation with the density of Prox1-expressing amacrine cells in the ON, but not in the OFF sublamina in all three species. The results suggest that the relative contribution of electrical synapses to the ON- and OFF-pathways of the retina changes with retinal location, which may contribute to functional ON/OFF asymmetries across the visual field.

Health behavior, sleep quality and subjective health status among Hungarian nurses working varying shifts.

BACKGROUND: Distinctly, shift work is burdensome for nurses and may lead to health problems. OBJECTIVE: The purpose of the study was to examine the nursing shift system genres and to analyze the potentially debilitating effects upon sleep quality and the subjective state of physical and mental health when considering varying shift schedules. METHODS: The first cross-sectional study (n = 639) was performed at the Clinical Center at the University of Pécs, and throughout various hospitals in the South-Danubian Region. The Hungarian version of the Bergen Shift Work Sleep Questionnaire, the Berlin Questionnaire and the 13-item Sense of Coherence Scale were implemented. In the longitudinal survey (n = 52), the quality of sleep was determined by the ActiGraph GT1M type of activity meter supplemented with a sleep diary. RESULTS: Interestingly, most respondents weight gained among the irregular schedule group (p = 0.004). The nurses working a flexible schedule reportedly slept better (p = 0.003), had a higher sense of coherence (p = 0.013) and exhibited better subjective health status (p = 0.017) than when compared with nurses working irregular shifts. The frequency of psychosomatic complaints aligned with the length of rest periods proved influential (p = 0.013). CONCLUSION: Admittedly, the irregularity of work schedules is stressful for nurses. Due to the health status of nurses, it is a worthy consideration to establish the least exhausting work schedules.

[Sleep habits among preschool- and schoolchildren]. / Alvási szokások és alvásminoség óvodás- és iskoláskorú gyermekek körében.

BACKGROUND AND PURPOSE: Objective - Our aim is to evaluate sleep habits, sleep quality and influencing factors among preschool- and schoolchildren. METHODS: Two questionnaires were recorded. Questionnaire 1 dealt with sleeping habits, breastfeeding and health behavior of preschool children and infant, and it contained the abbreviated version of the Children's Sleep Habits Questionnaire. Questionnaire 2 dealt with health behavior and the application of sleep hygiene rules, as well as it contained the Athens Insomnia Scale. Subjects - We assessed a total of 1063 questionnaires: 516 kindergarten children participated in our online survey across the country; 547 primary and secondary school students participated in the 2nd questionnaire survey in Szolnok. RESULTS: Parents' observation shows that the average nighttime sleeping time of kindergarten children is 10 hours 20 minutes on weekdays and 10 hours 36 minutes on weekends. The most popular sleeping habits in kindergarten age: teal reading (65.1%) and co-sleeping (42.8%). Parents of infants used breastfeeding (50.4%) and rocking (43.2%) most frequently before sleep. Co-sleeping has a positive influence on the length of lactation. Among the preschool sleeping habits we have proved a number of positive effects of teal reading, while watching television have negative effects. The sleep quality of school-age children according to the Athens Insomnia Scale is 6.11 points (SD: 4.11), 19% of the children are insomniac. Their sleep time is 7 hours 31 minutes on weekdays and 9 hours 30 minutes on weekends. The usage of good health behavior and sleep hygiene rules positively influence sleep quality and sleep duration. CONCLUSION: With our results, we would like to draw the attention of children and parents to the importance of sleeping and using sleep hygiene rules.

[Diagnostic challenges in pediatric cow's milk protein allergy]. / A gyermekkori tehéntejfehérje-allergia diagnosztikai kihívásai.

Introduction and aim: The aim of our research is to evaluate and compare commonly performed diagnostic tests, and to examine the psychological disorders induced by this food allergy. Children with symptoms suggesting cow's milk protein allergy were included in this study (n = 47). Blood and saliva samples were collected from the participants. Parents were asked to fill in a questionnaire constructed by the research team (containing the DSM-5 symptoms checklist about attention deficit hyperactivity disorder). Method: One of the most widely used diagnostic tool is the skin allergy test, which was performed in 47 subjects (n = 47, mean age: 7.36 years); only 2 children showed positive test result for cow's milk. Lymphocyte transformation test was observed to be positive in 8 children (17%), 4 subjects demonstrated questionable results. In our sub-study about psychological symptoms (n = 43, mean age: 7.88 years), the score was according to the attention deficit hyperactivity disorder symptom checklist before the diet (6.88, SD: 4.43) and showed significant decrease after 3 months of the elimination diet (4.48, SD: 3.69, p = 0.001). Scores of children with sleep disorder (10.62, SD: 4.23) also represented a significant reduction after 3 months of the diet (6.69, SD: 4.59, p = 0.009). Salivary cortisol levels did not show significant changes before and after elimination diet. Results: According to our data, skin allergy testing and lymphocyte transformation test are not reliable diagnostic tools for establishing the diagnosis. Conclusion: We conclude that a significant improvement in clinical symptoms can only be achieved with a strict elimination diet. Orv Hetil. 2019; 160(33): 1311-1318.

Different work schedules of nurses in Hungary and their effects on health.

BACKGROUND AND PURPOSE: The shift work is burdensome for nurses and may lead to health problems. Aims - The purpose of the study was to examine the nursing shift system types and to analyse the effects on nutritional status, subjective state of physical and mental health in case of different shift schedules. METHODS: In the first phase of the research 326 nurses working in changing shifts filled out the Bergen Shift Work Questionnaire after adaptation into Hungarian. 518 nurses participated in our second study in hospitals of the South-Danubian Region, in clinics of University of Pécs and at trainings organized by the Faculty of Health Sciences of the University of Pécs. RESULTS: Based on the psychometric characteristics of Bergen Shift Work Questionnaire technically it is suitable for the examination of sleeping disorders associated with shift work. Sleeping quality is worse in those working in irregular work shifts compared to those working in regular and flexible work schedules (p<0.001). The irregular work schedule is worse than the regular work schedule according to 76.6% of the nurses. According to 63.8% of the respondents the following regular work schedule is the best: after one 12-hour day shift one 12-hour night shift, followed by two days of rest. The average Body Mass Index (BMI) is 26.16 kg/m2. Since the nurses work in shift work 47.7% of them reported weight gain. Among the psychosomatic symptoms the most frequent is back pain (78.4%) related elevated BMI (p=0.013). The nurses' sense of coherence on average is 61.76 points. In case of full-time employees the sense of coherence is better than those who work in shifts (t=2.933, p=0.004). The nurses working irregular shift work asses their health worst (mean rank: 166.61; p=0.019), and their sense of coherence is lower (p=0.04). CONCLUSION: The irregularity of work schedules is stressful for nurses. Due to the health of nurses it would be useful to establish the least exhausting work schedules.

[Insomnia and habits to help to fall asleep among adults]. / Insomnia és elalvást segíto szokások felmérése felnottek körében.

INTRODUCTION: The quality of sleep can be influenced by several factors, insomnia in turn has an effect on the state of health. AIM: The aim of our survey is to measure the effects of insomnia, furthermore, the sleep affecting agents and habits to help to fall asleep among adults. METHOD: We collected the online nationwide and the written datas from the South-Transdanubia region, 455 adults filled the questionnaire which contains the Athens Insomnia Scale. RESULTS: 13.4% of participants has insomnia, it is influenced by the quality of diet (p<0.001), comsumption of coffee (p = 0.045) and the physical activity (p = 0.011), what is more in correlation with the prevalency of chronic deseases (p = 0.001) and psychosomatic symptoms (p<0.001). The most frequent causes of sleep disorders are: work-related stress (35.6%), personal-life stress (35.4%) and pain (24.2%). In case of dormition problems most of the participants watch television (52.1%) and read (33%); 7.5% and 11.4% of the responders use sleeping pills and tisane. CONCLUSIONS: We attract attention to the prevalency and effects of insomnia, and the habits to help to fall asleep. Orv. Hetil., 2016, 157(49), 1955-1959.

[Work schedules in the Hungarian health care system and the sleep quality of nurses]. / Munkarendek a hazai egészségügyi rendszerben, és az ápolók alvásminosége.

INTRODUCTION: One way of ensuring the continuity of health care is the shift work, which is burdensome and it can lead to sleep disturbances. AIM: The aim of the study was to measure the typical Hungarian nursing shift systems in hospitals, to analyse the causes of irregular work schedules, and to compare the sleep quality of nurses in different work schedules. METHOD: 236 head nurses filled out the national online survey, and 217 nurses in clinics of the University of Pécs filled the Hungarian version of Bergen Shift Work Sleep Questionnaire. RESULTS: The head nurses provided data of 8697 nurses's schedules. 51.89% of nurses work in flexible shift system. 1944 employees work in regular shift system, most of them in the following order: 12-hour day shift and 12-hour night shift, followed by a one- or two-day rest. Where there is no system of shifts, the most frequent causes are the needs of nurses and the nurse shortage. Nurses who are working in irregular shift system had worse sleep quality than nurses who are working in flexible and regular shift system (p = 0.044). CONCLUSIONS: It would be helpful if the least burdensome shift system could be established.

[Sleep quality of nurses working in shifts - Hungarian adaptation of the Bergen Shift Work Sleep Questionnaire]. / Váltott muszakban dolgozó ápolók alvásminoségének vizsgálata a magyar nyelvre adaptált Bergen Shift Work Sleep Questionnaire alkalmazásával.

INTRODUCTION: Sleep disorders among shift workers are common problems due to the disturbed circadian rhythm. The Bergen Shift Work Sleep Questionnaire assesses discrete sleep problems related to work shifts (day, evening and night shifts) and rest days. AIM: The aim of the study was to develop the Hungarian version of this questionnaire and to compare the sleep quality of nurses in different work schedules. METHOD: 326 nurses working in shifts filled in the questionnaire. The authors made convergent and discriminant validation of the questionnaire with the Athens Insomnia Scale and the Perceived Stress Questionnaire. RESULTS: The questionnaire based on psychometric characteristics was suitable to assess sleep disorders associated with shift work in a Hungarian sample. The frequency of discrete symptoms significantly (p<0.001) differed with the shifts. Nurses experienced the worst sleep quality and daytime fatigue after the night shift. Nurses working in irregular shift system had worse sleep quality than nurses working in regular and flexible shift system (p<0.001). CONCLUSIONS: The sleep disorder of nurses working in shifts should be assessed with the Hungarian version of the Bergen Shift Work Sleep Questionnaire on a nationally representative sample, and the least burdensome shift system could be established.