Growing couch potatoes? The impact of COVID-19 in the light of personal values in Hungary.

The spread of the COVID-19 pandemic has unprecedentedly affected consumer behaviour. This paper reflects on changes in food consumption, buying, and training (working out) habits using a representative sample of 1000 Hungarian consumers and identifies consumer segments with unique needs based on personal sources of motivation. The widely known Schwartz Portrait Value Questionnaire was used to characterize individual value profiles. Employing k-medians clustering, three clusters were identified. "Business-as-usual People" managed to maintain their daily routines. The frequency of buying local food decreased the least among them. The sedentary lifestyle of the next cluster, "Inactive savers", appears to have been accompanied by a lower level of food intake. Accordingly, this group was possibly less subject to the negative impacts of obesity, but more in need of psychological support to avoid devastating mental health outcomes. The third cluster initially appeared to encompass "Couch Potatoes" based on their COVID-induced lifestyles. However, the analysis of the value portraits of the latter showed that they were not couch potatoes at all, but rather active and proactive "Stay-at-home Businesspeople" who may benefit from guidance regarding how to manage the increase in housekeeping and childcare, and how to become more physically active in the home environment. The results are valuable from both a scientific and practical perspectives.

Impact of the epidemiological instructions due to the COVID-19 pandemic on general surgical care at the Bajcsy-Zsilinszky Hospital in Budapest / A COVID-19-járvány miatt bevezetett járványügyi intézkedések hatása a hasi sebészeti ellátásra a Bajcsy-Zsilinszky Kórházban.

Összefoglaló. Bevezetés: 2020 elso negyedévében a koronavírus gyors terjedése, az általa okozott betegségek súlyos következményei miatt világszerte, így hazánkban is megváltozott az egészségügyi ellátás. Közleményünkben bemutatjuk, hogyan befolyásolták egy fovárosi kórház hasi sebészeti osztályának betegellátását, az ellátott esetek számát és összetételét a járvány elso, 2020-as tavaszi hulláma idején bevezetett járványügyi korlátozó intézkedések. Célkituzés: Célunk az volt, hogy adatokkal összehasonlítsuk 2021., 2020. és 2019. április sebészeti fekvobeteg-ellátásának jellemzoit osztályunkon. Módszer: A 2019. április 1. és 30., 2020. április 1. és 30. és 2021. április 1. és 30. közötti idoszakokban a fovárosi Bajcsy-Zsilinszky Kórház Sebészeti, Érsebészeti és Mellkassebészeti Osztályán az általános sebészeti fekvobeteg-ellátás keretében végzett hasi sebészeti mutéti beavatkozások adatait hasonlítottuk össze. Az adatokat MS Excel és SPSS (25. verzió) programokkal vizsgáltuk, és statisztikai elemzéseket végeztünk. Eredmények: A bevonási kritériumoknak 197 eset felelt meg 2019 áprilisában, 77 eset 2020 áprilisában és 95 eset 2021 áprilisában. Az osztályos ápolási ido 2019-ben átlagosan 4,51 nap, míg 2020-ban 6,31 nap és 2021-ben 6,29 nap volt. 2019-ben napi átlagban 2,54 akut és 6,2 tervezett mutét, 2020-ban napi 2 akut és 1 tervezett mutét, míg 2021-ben napi 2,8 akut és 0,9 tervezett mutét történt. Az 1 fore jutó kíséro betegségek száma a tervezett mutétek esetében 2019-ben 1,69 volt, míg 2020-ban 2,97, 2021-ben pedig 2,74. Az akut mutétre került betegek kíséro betegségeinek eloszlása szignifikánsan eltért, 1 betegre 2019-ben átlagosan 2,5, 2020-ban 3,75, míg 2021-ben 3,25 kíséro betegség jutott. Az akut sebészeti ellátáson átesett betegek halálozása 2019-ben 11,8%, 2020-ban 13,33%, 2021-ben 15,66% volt. Következtetés: A COVID-19-járvány miatt bevezetett járványügyi intézkedések velejárója volt, hogy hasi sebészeti osztályunkon lényegesen kevesebb elektív mutétet végeztünk. A sürgosséggel ellátott páciensek kíséro betegségeinek száma szignifikánsan emelkedett, valószínuleg ezzel magyarázható a halálesetek számának párhuzamos emelkedése. Orv Hetil. 2021; 162(44): 1761-1768. INTRODUCTION: Due to the rapid spread of the coronavirus and the serious consequences of the diseases, the organization of healthcare worldwide changed in the first quarter of 2020. We show effects of restriction due to protection against the first (April 2020) wave of coronavirus in our surgery care. OBJECTIVE: The aim of this study was to compare characteristics of general surgical inpatient care in April 2020 and April 2021 with April 2019 by the hospital database. METHOD: We compared general surgical data of April 2021, 2020, and 2019 from the medical informatic system at the General, Vascular and Thoracal Surgery Department of the Bajcsy-Zsilinszky Hospital in Budapest. The data were analyzed with MS Excel and SPSS (version 25) programs. RESULTS: Study inclusion criteria met with 197 cases from April 2019, 77 cases from April 2020, and 95 cases from April 2021. Length of stay at surgical department was average 4.51 days in 2019, 6.31 days in 2020, and 6.29 days in 2021. In 2019, average 2.54 urgent and 6.2 planned operations were done, in 2020 these numbers were average 2 and 1 per day and in 2021, 2.8 urgent and 0.9 planned surgical procedures were performed. The number of co-morbidities per capita in elective cases was 1.69 in 2019, 2.97 in 2020, and 2.74 in 2021. Distribution of coded co-morbidities in the case of patients with urgent surgery was significantly different between the groups, in 2019 it was 2.5, in 2020 3.75, and in 2021 3.25 per capita. Postoperative mortality at the same care of patients after urgent surgery was 11.8% in 2019, 13.33% in 2020, and 15.66% in 2021. CONCLUSION: Due to the government instructions because of COVID-19 pandemic, less elective general surgery procedures were performed in our department. Co-morbidities of patients with urgent surgery significantly increased, probably this is responsible for the increase of postoperative mortality. Orv Hetil. 2021; 162(44): 1761-1768.

Potential considerations in decision making on laparoscopic colorectal resections in Hungary based on administrative data.

BACKGROUND: Laparoscopic colorectal surgeries offer numerous advantages over their open counterparts. To compare these measurable short-time outcomes of open and laparoscopic resections in Hungary, data of colorectal surgeries were collected and analysed. The study focused on identifying patients' characteristics that can influence the decision on laparoscopic colorectal resections and on comparing efficiency of Hungarian colorectal operations with international data. METHODS: Using patients' data of laparoscopic and open colorectal surgery performed in 2015 and 2016 from the National Health Insurance Fund of Hungary, a countrywide retrospective comparative analysis was done. Logistic regression was used to explore main influencing factors for laparoscopic colorectal surgery. RESULTS: A total of 17,876 colorectal surgical cases, including 14,876 open and 3,000 laparoscopic resections were selected and analysed. Laparoscopy was used only in 16.78% of all cases. Comparison of age groups showed that odds ratio (OR) of laparoscopic colorectal resections was significantly lower in over 40 years than in younger patients (18-39 years). In university institutes patients had higher odds (OR: 2.23 p<0.0001) for laparoscopic colorectal resections. Presence of comorbidity codes and preoperative treatment in internal medicine department decreased odds for laparoscopic colorectal operations. CONCLUSIONS: Patients' age, comorbidities and hospital type influenced the likelihood of decision on laparoscopic colorectal resection. Selection of patients contributed to improved laparoscopic outcomes.

Farm diversification as a potential success factor for small-scale farmers constrained by COVID-related lockdown. Contributions from a survey conducted in four European countries during the first wave of COVID-19.

This paper explores to what extent product and marketing channel diversification contributed to the economic success of small-scale agricultural producers involved in short food supply chains after the outbreak of the COVID-19 pandemic. A survey was conducted between April and July 2020 in four countries of the European Union-Estonia, Hungary, Portugal and Romania,-resulting in a relatively large sample of farmers (N = 421). The analysis was built on a semi-nonparametric approach. Approximately 19 percent of small-scale producers were able to increase sales during the first wave of the pandemic, although country-level variation was significant. Fruits and vegetables were by far the most popular products. The importance of specific channels varied across countries, but farm gate sales were among the most important marketing channels both before and during the first wave. The importance of channels that were based on digital resources and home delivery increased. Our evidence indicates that diversification was a strategy that paid off, both in terms of marketing channels and different product categories. However, the impact appears to be nonlinear; the initial advantage generated by diversification rapidly tapered off, either temporarily (in the case of products), or permanently (in the case of marketing channels). Later research may clarify whether these findings are generalizable in other socio-economic contexts, as well as in a non-COVID situation.

The impact of COVID-19 on alternative and local food systems and the potential for the sustainability transition: Insights from 13 countries.

The COVID-19 pandemic has been a major stress test for the agri-food system. While most research has analysed the impact of the pandemic on mainstream food systems, this article examines how alternative and local food systems (ALFS) in 13 countries responded in the first months of the crisis. Using primary and secondary data and combining the Multi-Level Perspective with social innovation approaches, we highlight the innovations and adaptations that emerged in ALFS, and how these changes have created or supported the sustainability transition in production and consumption systems. In particular, we show how the combination of social and technological innovation, greater citizen involvement, and the increased interest of policy-makers and retailers have enabled ALFS to extend their scope and engage new actors in more sustainable practices. Finally, we make recommendations concerning how to support ALFS' upscaling to embrace the opportunities arising from the crisis and strengthen the sustainability transition.

[Analysis of patients with colorectal cancer treated with surgery in 2015 and 2016, using a statistical model]. / A 2015-ben és 2016-ban vastag- és végbélmutéten átesett daganatos betegek adatainak vizsgálata matematikai-statisztikai modellel.

INTRODUCTION: The purpose of this study was to analyze the data of the open and laparoscopic colorectal cancer surgeries countrywide in an administrative database of the National Health Insurance Fund of Hungary in 2015-2016. AIM: Hungarian surgical data of colorectal cancer from 2015-2016 were analyzed based on the following objectives: diagnosis of care, complications and co-morbidities; age; sex and medical institutions. METHOD: We used crosstabs and partial least squares path modeling to analyze the relations between data groups. Results of three LVPLS models (group of open, laparoscopic interventions and the whole population of the survey) were compared. RESULTS: From the 4941 analyzed operative cases, 4562 were open and 379 laparoscopic. Based on the three LVPLS models, we found nexus between complication groups and co-morbidity groups and progressivity of medical institutions in laparoscopic operations. As far as complications, in the laparoscopic model bleeding and anaemia, in cases of total population and open operations septic complications played dominant role. CONCLUSIONS: Laparoscopic resections in patients with multiple co-morbidities are carried out in medical institutions with high professional progressivity most frequently. In cases of laparoscopic colorectal operations, the higher the progressivity of an institution, the lower the complication rate was. Differences in the results in the models may be due to patient selection, and further research should be carried out in this regard. Anaemia and bleeding are dominant complication factors in the laparoscopic model, which are influenced by patient selection besides the differenced in surgical technique. Orv Hetil. 2019; 160(11): 426-434.

[Laparoscopic subtotal gastrectomy -- our experience]. / Laparoscopos technikával végzett subtotalis gyomorresectióinkról.

Laparoscopic surgery gained significant popularity in the last two decades. In our department, laparoscopic gall bladder, hernia and large bowel surgeries are the most frequent ones. Recently we started to do laparoscopic surgery for early gastric cancer, too. Initially, wedge resections, distal gastrectomy and laparoscopically asssisted periventricular lymphadenectomies were carried out. Later on, laparoscopic subtotal gastrectomy was also done. Therefore, we can provide three different ways of surgical treatment for gastric malignancies by now: wedge resection, intramucosal resection as well as subtotal gastrectomy. Four laparoscopic gastrectomies were carried out with D1 or D2 lypmhadenectomy - in case it was needed - in our department by the end of 2010. All patients' gastric cancer was less than 3 cm in size, and it was verified by preoperative histology (adenocarcinoma, T1b/N0/M0 or T2/N0/M0). The cancers were localized in the antrum or distally in the peripyloric region, and were ulcerated frequently. Subtotal gastrectomy with retrocolic gastroentero anastomosis was carried out in every case.Patient's age was not considered in patient selection. Surgical time was between two and four hours. We discuss our experience with laparoscopic gastric surgery and recommend its incorporation into practice.